Global Health News Last Week

POLITICS AND POLICY

  • South Africa’s government has set out its plans to introduce a universal health care scheme with a pilot program in 10 areas by 2012 and nationally over the next 14 years.
  • The U.N. must make reducing salt intake a global health priority, sayUK scientists. Writing in the British Medical Journal they say a 15% cut in consumption could save 8.5 million lives around the world over the next decade.
  • IRIN reports on the story of Daniel Ng’etich, a Kenyan man who was arrested and jailed for not continuing his TB treatment.
  • Dr. Jill Biden is leading a high level American delegation toKenya, which includes Raj Shah, to look into the American response to the famine crisis in the Horn of Africa.
  • A report on the state of maternal health in South Africa by Human Rights Watch has uncovered some alarming trends.

PROGRAMS

  • WHO has launched a new website to help those combating malnutrition. eLENA, a new e-library, gathers together evidence-informed guidelines for an expanding list of nutrition interventions. It is a single point of reference for the latest nutrition guidelines, recommendations and related information.

RESEARCH

  • A TB vaccine designed for those with HIV enters phase IIb trials this week in Senegal. The vaccine works by boosting response of T cells already stimulated by the traditional BCG vaccine.
  • Female smokers are more at risk for heart disease than male smokers, finds a systematic review and meta-analysis published in the Lancet.  This is a concern, as smoking rates are increasing in young women worldwide.
  • Scientists are in the second phase of research into using microwaves to kill malaria parasites in mice.
  • A USC researcher has developed a lentiviral vector that can track down HIV infected cells which can potentially act as a marker for targeted elimination of infected cells.
  • People living with HIV who receive the proper ARV treatment have no greater risk of death compared to people without HIV, finds Danish researchers.
  • Around 30 genetic risk factors for developing multiple sclerosis have been discovered by a UK-led team.
  • A new study, showing that a simple blood test can accurately determine the sex of a fetus 95 percent of the time, is great news for parents at high risk of having a baby with rare genetic diseases. But it is bad news to those concerned that the tests could be used to abort a fetus based on gender.
  • British researchers have discovered that the introduction of spermless male mosquitoes can lead to fewer malaria carrying females.
  • A device which can test blood for HIV/AIDS in a matter of minutes has been developed by University of Columbia scientists.

DISEASES AND DISASTERS

  • As if it did not have enough problems already, Somalia is now facing cholera epidemic, World Health Organization officials said.
  • In an August 4 article, Trustlaw’s Lisa Anderson exposes the “silent health emergency” faced by child brides around the globe.  Not yet physically mature, they face grave danger in childbirth, due to narrow pelvises. Girls younger than 15 years of age have a five times greater risk of dying during delivery than women over 20; most of these deaths occur in developing countries that lack adequate and accessible pre- and postnatal care.
  • Amid contradictory government statistics, a volunteer group in Japan has recorded 500,000 radiation points across the country.
  • A Mexican teenager is the first officially known person to die from vampire bat induced human rabies infection. The 19-year-old victim was a migrant farm worker in theUnited States.
  • An estimated 500,000 people in West Africaare infected with lassa fever every year, the World Health Organization (WHO) said on Wednesday, amid calls for more money to be spent on preventing its spread.
  • Over at Global Pulse, Human Rights Watch researcher Katherine Todrys guest blogs on the HIV epidemic in Uganda’s penitentiaries.Uganda, she explains, has often been presented as a success story in the global fight against HIV/AIDS, and has received over $1 billion from the US for AIDS programs. Many HIV-positive Ugandans have been excluded from these efforts, though, including gay men, drug users, sex workers, and prisoners.
  • Sleep apnea, a fairly common and treatable disorder that causes people to stop breathing momentarily while they sleep, may lead to cognitive impairment and even dementia.
  • Although cases of sexual violence have been under-counted during some wars, during others, such as the ongoing unrest in Libya, they have been vastly over-counted.
  • All patients getting cancer treatment should be told to do two and a half hours of physical exercise every week, says a report by Macmillan Cancer Support.

Fellowship: Jacaranda Health Maternal Health Fellowship (Nairobi)

Jacaranda Health: Maternal Health Fellowship

Background
Jacaranda Health is a start up social enterprise that aims to set a new a new standard for maternity care in East Africa. We are combining business and clinical innovations to create a self-sustaining and scalable chain of clinics that provide reproductive health services to poor urban women. Our model is a combination of two tightly-integrated services (a) Jacaranda Maternities near the slums where women can go for respectful obstetric care, safe delivery, and postnatal care; and (b) mobile vans that create a direct link with our patients, generate demand and healthy outcomes through antenatal care and birth preparedness. Jacaranda has received awards for its model, and we are also planning to work as an “innovation laboratory” for new approaches in improving maternal health, from outreach and marketing, to low-cost mobile technologies

We are piloting the model in Nairobi with a Jacaranda Maternity and mobile unit. We have just launched our first mobile clinic and are providing services to women in peri-urban Nairobi. We are working quickly to prepare to launch a fixed clinic for deliveries and basic emergency obstetric care.

Job Summary
Jacaranda Health is looking for a medical student or MPH with experience and interest in maternal health to help us develop evidence-based protocols for our new maternity clinic. This is an opportunity for an ambitious student or recent graduate to spend three to six months working with some of the most exciting innovations in maternal health. We have a great team in Nairobi, and good advisors internationally, and would like to have some help from someone who has a combination of a clinical and public health research background

Responsibilities
The Maternal Health Fellow would work with our international clinical advisors, our front-line clinical staff, and our operations manager to help develop a set of clinical protocols that are truly world-class and evidence based. This will require research, compiling protocols from our library of protocols and academic research in maternal health, and vetting them with our clinical staff in the field. We want to take the best practices from maternal health globally and translate it into a set of protocols that provide clear checklists and decision support for our frontline nursing staff. There will also be an opportunity to get involved in other clinical activities, such as systematizing our clinic processes, working with our partners at Harvard School of Public Health on our impact evaluation, and some of the new technologies that Jacaranda is piloting.

Timing
This is a full-time three to six month position, preferably based in Nairobi. Start date as soon as possible: August or September through November. The position is a volunteer fellowship, but Jacaranda can offer a stipend for expenses and housing.

Qualifications

  • MPH or medical resident, with experience working in maternal health, ideally from both a clinical and a research perspective
  • Highly resourceful, independent, and self-starting
  • Demonstrated professional experience and an interest in maternal health
  • Flexible and easy-going enough to work in a fluid, cross-cultural startup environment in Nairobi
  • Ability to communicate findings compellingly to colleagues and advisors
  • Desired: experience working in East Africa

Benefits

  • Opportunity to work with our advisors and partners from obstetricians at Harvard and internationally, to experienced nurses and midwives in Kenya
  • Exposure to all facets of building innovative maternal health organization. You will have a chance to see first hand the clinical, operations, marketing, technology, and business elements that go into building a successful social enterprise
  • Learn about maternity experience and clinical challenges faced by low-income mothers in peri-urban areas
  • Significant responsibility and independence

Additional Comments
Interested candidates may apply by email with an up to date CV and cover letter to jobs@jacarandahealth.org. Please put “Maternal Health Fellowship” in the subject line.

Notes on IH Section Conference Call: Current Developments in MCNH (June 27, 2011)

The IH Section held its third topic-focused conference call on Current Developments in MCNH on Monday, June 27, 2011 from 1:00 to 2:00 EST. We had several members of the IH section offer their commentary and expertise on current issues concerning maternal and child health.

Speakers
Laura Altobelli (Future Generations)
Elvira Beracochea (Midego)
Carol Dabbs (U.S. Department of State)
Miriam Labbock (Carolina Global Breastfeeding Insititute)
Mary Anne Mercer (University of Washington)

Laura Altobelli: Brief presentation of the APHA policy resolution proposal submitted by the IH section entitled, “Call to Action to Reduce Global Maternal, Neonatal, and Child Morbidity and Mortality.”
Laura discussed the new APHA policy proposal on MCH. There was nothing previously on the APHA policy regarding global action on this issue per se – one previously existing resolution focuses on reducing maternal and child mortality in the US, and one focuses on breastfeeding and has both domestic and global aspects. This, then, is the first policy proposal on global MNCH. Justification for the policy proposal is lack of progress on the MDGs and lack of policy commitment to protect vulnerable populations. APHA will be joining important other organizations that are putting out strategies, including the Partnership for MNCH (WHO), and the UN, and attended global meetings in 2010 in observation of the Year of Maternal Health (some of these mentioned below). There is also an effort to increase attention to this in the Global Fund and GHI. Six other sections/forums are co-sponsoring the resolution.

Elvira Beracochea: Update on the Millennium Development Goals 4 and 5.
A factsheet has been sent out (available upon request – please contact jmkeralis [at] gmail [dot] com). These MDGs and their targets have served us well to measure our progress so far. There have been improvements, though progress has been uneven. MDGs 4 and 5 focus on reducing mortality but not necessarily on improving health, development and well-being, and we need to address this as well. We know where women and children die and how. We also have the knowledge to prevent these deaths. We need to coordinate work at global scale and have a concerted strategy to ensure the rights of all women and children are met. We need to take global health goals to a new level of effectiveness using efficient strategies and a human-rights-based approach. A rights-based approach does not focus on only survival, but also on development. We need new targets and indicators that measure not only deaths but also number of children whose right are fulfilled; the children that are breastfed, fully immunized, drink clean water, are protected from malaria, and that that attend school. We need targets and indicators that measure not only the number of women that died or delivered with assistance of a skilled attendant, but that also measure the number of pregnancy complications effectively treated. We need new MDGs and targets.

Miriam Labbok: An update on reproductive health continuum (birth, breastfeeding and birth spacing promotion, protection, support) as an essential MNCH intervention approach.
It is vital that we pay attention to the reproductive health continuum within the life-cycle approach: birth, breastfeeding and birth spacing. Programming must include not only promotion, but also skill- and capacity-building so that support can be provided. In addition, policy change is needed to: support treating women with dignity, provide NFP knowledge (at least for the times that family planning supplies run out), and create the capacity to support health-supportive birth, breastfeeding and spacing practices. All such programming and policy creation should be carried out with recognition of the rights of both women and children to the best possible health support and with attention to appropriate technologies, as one size does not necessarily fit all. In addition, programs that address cultural change and intimate family and social decisions demand the building of trust that comes with reliability and long-term relationships. Programming should be designed for the long term, with a strong base and phased in activities, and with excellence and sustainability as the focus.

Mary Anne Mercer: Partnership for Maternal, Neonatal and Child Health – what it does and how one can get involved.
The Partnership for Maternal, Neonatal and Child Health is a WHO-based coalition of organizations that support increased funding commitments to MDGs 4 and 5. Any organization that supports MCH can be a member simply by filling out an application from the PMNCH web site at http://www.who.int/pmnch/. Be sure your organization is a member (it’s free!) by checking the member list. Also check out the ‘Knowledge Portal’ that aims to maintain updated programmatic information on current approaches to improving MCH. I am on the Board of Directors of the Partnership as an NGO representative, and we will be electing a new member of the Board this year that will represent an Africa-based NGO or the Africa office of an international NGO — please let me know if you have any suggestions for good candidates for that position.

Carol Dabbs: Trends in US government funding levels for global MNCH.
Funding has increased and is overseen by the State Department. Global Health targets are to be achieved with funding from FY 09-14, generally for implementation in FY 10-15. The Global Health Initiative includes principles supporting country-led plans and to coordination with other partnerships and donors, as well as between USG agencies and health programs. Eight countries have been selected as “plus” countries (places to conduct learning laboratories): Ethiopia, Kenya, Mali, Malawi, Rwanda, Bangladesh, Nepal, and Guatemala. Almost all of the Global Health Initiative funding is from USAID and State (there is also some DHHS funding, but that was not included in this discussion). There are two stages in the fiscal year: requesting funds from Congress and appropriation of funds by Congress. Unfortunately, delays have been a reality this year. However, we should look at trends and context of the rest of foreign assistance and of overall health fundig. The budget now includes nutrition as a separate item, and it’s included in the MNCH numbers here. There has been a trend of increased funding; funding for MNCH has increased about by 22% over two years (FY 2008 to FY 2010), but the full year continuing resolution for FY 2011 allocation to MNCH is still pending. We do not know what the appropriations for FY 2012 and FY 2013 will be.

Discussion: Is this in addition to Dept of State HIV funds? Yes, there are additional funds in USAID for HIV/AIDS, as well as funds for MCH and the rest of the health programs.

Global Health TV Video: Nutrition, obesity and exercise in maternal and child health

At the 38th Annual International Conference on Global Health, four distinguished panelists — Mirta Roses Periago, Hon. Richard Visser, James Whitehead and Marc Van Ameringen — discuss the dual burden of undernutrition and obesity in developing countries.

IH Section Conference Call: Current Developments in MCNH

Please join us for our next bi-monthly conference call!  The IH Section is hosting its topic-focused conference call for the month of June.  The call will be held on Monday, June 27 from 1:00 to 2:00 p.m. EST.  This call will be hosted by section members Miriam Labbock and Laura Altobelli, who will be discussing current developments in maternal, neonatal, and child health (MCNH).  The call will include:

  • Brief presentation of the APHA policy resolution proposal submitted by the IHS entitled, “Call to Action to Reduce Global Maternal, Neonatal, and Child Morbidity and Mortality”
  • Update on the Millenium Development Goals 4 and 5
  • An update on breastfeeding and child spacing as essential MNCH interventions
  • Update on the Global Alliance to Prevent Prematurity and Stillbirth
  • Partnership for Maternal, Neonatal and Child Health – what it does and how one can get involved
  • Trends in US government funding levels for global MNCH

Background information to review before the call includes:

  • APHA policy resolution proposal submitted by the IHS entitled, “Call to Action to Reduce Global Maternal, Neonatal, and Child Morbidity and Mortality*
  • Factsheet on the Millenium Development Goals 4 and 5*
  • Innovations June 2011 (newsletter on maternal health)*
  • Partnership for Maternal, Neonatal and Child Health
  • Global Alliance to Prevent Prematurity and Stillbirth:
    1. The Lancet special series on Stillbirth came out in late April and all articles and comments are available for free from the series webpage. People may need to register on The Lancet website, but that is also free.*
    2. The Global Alliance to Prevent Prematurity and Stillbirth plans to launch additional advocacy around preterm and stillbirth and the GAPPS conference in July 2012 will highlight research and discovery needs around both PT and SB.*

*If you would like copies of these documents or have questions about these two issues, please contact Andrew E. Barrer, Ph.D., at aebarrer@gmail.com or (202) 674-9294.

 TOPIC: Current Developments in Maternal, Neonatal, and Child Health (MCNH)
DATE AND TIME: Monday, June 27, from 1:00 p.m. to 2:00 p.m. EST
PHONE NUMBER: (712) 432-1001 (please note that this is not a toll-free number)
PASSCODE: 477461343#

You are welcome to submit comments and questions for the speakers; however, we ask that you submit them in advance so that the panel can present them to the speaker. This will allow us to keep things organized. Please e-mail questions for the speakers to jmkeralis [at] gmail [dot] com  by Friday, June 24 at 8 p.m. EST (June 3, 2011).