Global Health News Last Week

The IH Newsletter is up! The Winter 2011 edition features several articles written by section members on various topics, a social media corner, fellowships and internships, and member publications. Check it out, and please consider contributing to the Spring edition!

On Tuesday, USAID administrator Dr. Rajiv Shah gave the 2011 David E. Barmes Global Health Lecture at NIH. His speech, titled “Addressing Grand Challenges:The Role of Science in Global Health Development,” can be viewed here. The transcript can also be downloaded, or you can read it on USAID’s website here. Also, you can check out commentary by Amanda Glassman, Sarah Arnquist, and K4Health.

Cholera, as usual, remains in the news: experts say the outbreak in Haiti has plateaued, while the one in Papua New Guinea rages on, and it is just getting started in Ghana. Meanwhile, health officials in Bangladesh prepare to launch the world’s largest cholera vaccine trial near Dhaka, the capital.

Scientists from Edinburgh University claim that the malarial parasite is particularly deadly because it competes with other strains of the infection by focusing on producing quickly-replicating cells, thus “duking it out” in the bloodstream. On a more positive note, Kenyan scientists believe that a spider that is attracted to the smell of human sweat may aid in the fight against the disease.

UN experts maintain that the laws in many Asian countries obstruct access to HIV/AIDS care and services. Nineteen countries in the region outlaw same-sex relations, and 29 criminalize prostitution. The remarks were made just before the Global Commission of HIV and the Law took place in Bangkok, where experts from around the world gathered to discuss HIV-related legal and human rights issues. Also, China has declared its intention to bring the spread of AIDS under control by 2020.

According to the WHO, Moldova has emerged as the world leader in per-capita alcohol consumption.

Experts have been sounding the alarm about rising food prices, and many analysts have linked the crisis to the recent riots in north Africa and the Middle East.

Obama and the Republicans continue to battle over the budget, as the president requests a modest increase in global health funds while Congressional Republicans try to slash spending.

More cell phones than toilets: Mobile technology emerges as the new lifeline for the world’s poor

A report on inadequate sanitation, released by the UN University, made waves earlier this year when it reported that while 45% of India’s population owned cell phone, only 31% of them had access to improved sanitation in 2008.1  Headlines proclaiming “India has more cell phones than toilets” found their way into several of my e-mail news digests.  “It is a tragic irony to think that in India, a country now wealthy enough that roughly half of the people own phones, about half cannot afford the basic necessity and dignity of a toilet,” said Zafar Adeel, Director of United Nations University’s Institute for Water, Environment and Health (IWEH), and chair of UN-Water.  With the focus on the Millennium Development Goals growing more acute as the deadline approaches, people were understandably astonished.  

It is shocking to think that so many of the world’s poor cannot access appropriate sanitation.  However, the widespread use of cell phones should not be juxtaposed against the conditions of poverty, but should rather be seen as a way to empower the poor to improve their conditions.  The cell phone market has seen explosive growth in the last decade: 90% of the world’s population will soon be within the coverage of wireless networks,2 and there are already an estimated five billion cell phones used globally.3  Villages without running water or electricity often have at least one mobile phone, and people can switch out their own SIM cards for access.  They are being adopted faster than basic services such as routine medical care and schools.2  When a basic toilet costs 15 times more than a basic cell phone ($3001 compared to $203), it becomes easier to understand the discrepancy between access to sanitation vs. mobile technology.  If mobile penetration is so widespread, then, should it not be viewed as a tool and an opportunity for innovation?  

A man holds a cell phone in front of a woman with four children.
Photo taken from mHealth Alliance Executive Director David Aylward's blog entry in the Global Health Magazine.

Some governments and organizations have already caught on.  In Rwanda, for example, the government provides free cell phones to rural health workers to register expectant mothers, get answers to their questions from a health expert, and send monthly status reports to doctors.2  Other programs send reminders to HIV-positive pregnant women to take ARVs and work to reduce stock-outs of drugs in rural clinics.  Pharmaceutical companies are also working with application developers to fight drug counterfeiting: customers will be able to submit a numeric code on drug packaging via SMS and get a reply that states whether the drug is “NO” or “OK,” along with the drug’s name, expiration date, and other information.4  And I have already featured Tostan’s Jokko Initiative, which applies their literacy lessons to cell phone usage and includes a lesson on the health-related utility of SMS.  Other applications include facilitating electronic banking and providing information on crop disease and weather to farmers.2  

Progress on the MDGs should not be overlooked, and the importance of access to sanitation is should certainly not be downplayed at all.  With an expected return between $3-34 for every dollar spent on sanitation, it is absolutely worthwhile to stress the importance improving people’s access to this need.  Now, if only we could develop an app to improve sanitation – that would be perfect.