Global Health News Last Week

SECTION NEWS
The Advocacy/Policy Committee would like to invite you to participate in our first Advocacy Day, led in partnership with the Global Health Council. The day, scheduled for Thursday, November 3rd, 2011, immediately following the annual meeting in Washington, D.C., will be an opportunity for us to voice support for a continued focus on international health to our elected officials. With the intense Congressional pressure to cut the budget, our voices can make a real difference. As a participant during this exciting day, you will be provided with training materials on effective advocacy techniques to ensure your message is clearly heard. Even if you do not have advocacy experience, you need not hesitate to sign up because you will be teamed with others. Please consider joining your fellow International Health Section members on Thursday, November 3rd, 2011 on Capitol Hill to advocate for a healthy globe.  Interested parties should register here.  Please note that registration will close on October 14th.  Any questions should be directed to Peter Freeman, Advocacy/Policy Committee Chair, at pffreeman@gmail.com or 773.318.4842.


POLITICS AND POLICY

  • GOP Presidential hopeful Michelle Bachmann has been slammed by scientists, doctors and others for claiming that the HPV (human papilloma virus) vaccine can cause mental retardation. An ethicist has now put up money behind his challenge to her claim.
  • A commitment by G20 nations to strengthen agricultural research in developing countries will help reduce food insecurity as long as it focuses on small farmers and their needs, officials and experts said at a G20-backed conference this week.

PROGRAMS

  • The Gates Foundation has presented the Harvard School of Public Health with a $12 million grant to support its maternal health task force.
  • USAID is teaming up with former President George Bush to reduce cervical cancer deaths by 25% in five years for target developing countries.
  • The magic number may be $6 billion to make a real dent in ending the spread of AIDS.
  • A collaboration between UK and US funding agencies has announced more than £3.5M new funding for research aimed at controlling the transmission of diseases amongst humans, animals and the environment.

RESEARCH AND INNOVATION

  • The number of African countries with national policies on traditional medicine increased almost fivefold between 2001 and 2010, according to a report on a decade of traditional medicine on the continent.
  • The recently published results from two malaria vaccine trials appear to show that scientists are getting closer to developing a vaccine against the mosquito-borne illness.
  • Effective nursing is the backbone of a high quality health care delivery system. GHDonline’s nursing community will discuss how ongoing mentoring and training programs can enhance nursing in an expert panel discussion September 19-23.
  • The number of young women with breast cancer has more than doubled worldwide since 1980, say researchers at Seattle’s Institute for Health Metrics and Evaluation.
  • After 2 years of analyzing the results of the largest AIDS vaccine clinical trial ever held, the so-called Thai prime-boost trial, and the only one so far to show some protection against HIV, researchers say they have discovered insights that could lead to an effective vaccine.
  • IUDs can prevent cervical cancer, finds a study published in the Lancet.
  • Reducing the incidence of malaria could also drastically reduce the number of deaths from bacterial infections among children in Africa, a study has found.

DISEASES AND DISASTERS

  • Authorities worry that tropical mosquitoes found in San Gabriel Valley could spread disease if they gained a foothold in Southern California.
  • A human rights investigator for the United Nations says up to a quarter of the world’s trash from hospitals, clinics, labs, blood banks and mortuaries is hazardous and much more needs to be done to regulate it.
  • A report from UNICEF and the WHO shows the decrease in the rate of deaths for children under the age of five.
  • The WHO warns that thousands may die if multi-drug resistant and forms of tuberculosis continue to spread throughoutEurope.
  • One of the scientific advisers to the new blockbuster movie “Contagion” says the “risks are very real — and are increasing drastically… Our vulnerability to such diseases has been heightened by the growth in international travel and the globalization of food production.”

FOCUS – NON-COMMUNICABLE DISEASES

  • Cancer, cardiovascular disease, respiratory illness and diabetes account for 63 percent of all global deaths, yet up to half could be prevented, according to a new report, Noncommunicable Diseases Country Profiles 2011, released Wednesday by the  World Health Organization.
  • The WHO released a 207 page “global score card” on the prevention of chronic illness, one week ahead of the NCD summit at the UN.
  • Eli Lilly and Company has committed $30 million to the Global Health Initiative. The Lilly NCD Partnership will work to identify comprehensive, sustainable approaches to patient care. Initially it will concentrate on diabetes.

Thanks to Tom Murphy and Mark Leon Goldberg, Tom Paulson, Isobel Hoskins, and Public Health Newswire.

Global Health News, Week of August 28-September 3

Global Fund round 11 is now open for proposals.

GREAT LEARNING OPPORTUNITY

A seven-part webinar series, called the “Outstanding Presentations Workshop,” began this Wednesday and is available for free to all who register. Each one-hour seminar will be streamed live over the next few weeks on Wednesday and will be recorded for later viewing.  Take advantage of this wonderful opportunity to improve your presentations and spare your audiences death by PowerPoint. More information is available here, and the schedule can be accessed here.

POLITICS AND POLICY

  • In Uganda, the landmark legal case of Jennifer Anguko, a mother who died while she was in labor for 12 hours in a government hospital, will begin in early September.
  • Critics of the World Health Organization say it needs to redefine and reposition itself within the increasingly complex and convoluted field of global health. These experts suggest that the world will not suffer if the WHO cuts certain programs while narrowing its focus.
  • In the United States, the American College of Obstetricians and Gynecologists are promoting the use of IUDs as the “most effective form of reversible contraception available and safe for most women.”
  • The Global Fund may cut its contributions to China by half.
  • USAID Admin Dr. Raj Shah announced that $23 million in new aid will be directed towards the Horn of Africa crisis.
  • Anonymity is no longer a right of people seeking HIV/AIDS tests in China, and the change has lead to a significant drop in the number of tests being performed.
  • The Asian Development Bank has called for Asia-Pacific countries to collaborate on combating HIV/AIDS at the International Congress on AIDS in Asia and the Pacific.
  • Tension between the United States and Pakistan will not prevent USAID from continuing to support health, energy and education systems says the USAID Pakistan Chief.
  • The epidemics of diabetes, heart disease and cancers that have stricken the populaces of wealthy countries are spreading to the developing world, yet the United Nations lacks an agreement, let alone an overall goal, on how to limit the preventable illnesses and deaths arising from these so-called non-communicable diseases. The British Medical Journal reports many developed countries, including the U.S. and Canada, are resisting specific targets for reduction in fats, sugars and salt in processed foods.

PROGRAMS

  • Overall, more newborn children are surviving, but slower progress in cutting death rates among babies in the first weeks of life is putting the global goal of reducing child deaths by two-thirds in jeopardy.
  • One expert says as the question of aid effectiveness has moved to the centre of development debates. If donors want to make their aid more effective, then they need to engage strategically with the private sector.
  • In the Washington Post, Michael Gerson makes the “pro-life” case for increased support for contraception and family planning worldwide.
  • UNICEF and international NGOs are working to raise awareness and encourage West African communities to invest in the construction of more pit latrines. Pit latrines, say advocates, can drastically reduce the spread of diarrhea, cholera and worms.

RESEARCH

  • A study published in Lancet finds that the workers who took part in the efforts to rescue people from the World Trade Center on 9/11 are at a high risk of suffering physical and mental illness.
  • A study by the Elizabeth Glaser Paediatric AIDS Foundation in Uganda and Zambia found high rates of syphilis and HIV co-infection among pregnant women, but showed that “integrating rapid syphilis screening and HIV testing for pregnant women was feasible, cost-effective, and helped to prevent transmission of syphilis and HIV from mother-to-child.”
  • A genetically engineered virus may be the key to combating cancer, says a group of scientists.
  • Believed to only help children under four, researchers have determined that the rotavirus vaccine also reduces deaths in children between the age of five and fourteen.
  • Researchers who have tracked Haitian cell phone SIM cards relative to the cholera outbreak are optimistic that their findings will lead to future use of the same technology for other outbreaks.
  • Scientists may have found a critical weakness in Plasmodium falciparum, the parasite that causes malaria. Researchers say the discovery provides a promising target for new malaria therapies.
  • Engineers at Michigan State University are developing a low-cost mobile phone application that can detect certain types of cancer.
  • Danish scientists say mosquito populations are dropping in many parts of Africa, even in parts where there are no human efforts such as insecticide spraying or bed net distributions underway.
  • A study published in the British Medical Journal reports a 24% reduction in deaths in children who received vitamin A.
  • A new approach to malaria vaccines grows the parasite inside mosquitoes and extracts vaccine components from the salivary gland.

DISEASES AND DISASTERS

  • A study published in Nature says that the last three waves of cholera can all be traced back to the Bay of Bengal.
  • Despite a massive humanitarian effort after the 2010 earthquake, females in Haiti remain neglected, rights activists say, lacking access to care as they give birth to babies in squalid conditions, often as a result of sex in trade for food or other necessities.
  • UN FAO warns that the bird flu is on the rise in Bangladesh, China, Egypt, India, Indonesia and Vietnam.
  • Reports from the Libyan capital Tripoli say a humanitarian crisis appears to be emerging following the ouster of long-time ruler Muammar Qaddafi. There is a shortage of medicine, fuel, food, water, and power supplies, and growing piles of uncollected garbage.
  • Polio has been reported in China and Kenya.

Thanks to Tom Murphy and Mark Leon Goldberg, Tom Paulson, Isobel Hoskins, and UN Wire.

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.

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.

Are Millennium Development Goals (MDGs) Unfair to Africa?

eckhard-kleinau.jpg“At the midway point between their adoption in 2000 and the 2015 target date for achieving the Millennium Development Goals, sub-Saharan Africa is not on track to achieve any of the Goals”. http://www.un.org/millenniumgoals/docs/MDGafrica07.pdf

Yes, according to William Easterly, author of “The White Man’s Burden”, at a February 6 event, Africa was set up to fail by the way MDG targets were set and indicators defined (http://www.brookings.edu/events/2008/0206_africa.aspx). With wit and by taking occasional cheap shots at those who developed the MDG goals and targets, Easterly held the attention of a large audience. Using data and trends, he made a compelling case why MDGs did not give sub-Saharan Africa credit for its considerable progress, thus contributing to the stereotype of “Africa’s failure”. In his response, Danny Leipziger of the World Bank took issue with many of Easterly’s claims pointing out, for example, that Tanzania was treated no different from Nepal for most MDG goals. Here is the question: Do you believe that MDGs are fair or unfair to Africa? Continue reading “Are Millennium Development Goals (MDGs) Unfair to Africa?”