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 News Last Week

May 18 was HIV Vaccine Awareness Day.

POLITICS AND POLICY

  • Hundreds of Kenyan AIDS activists held a protest on 18 May in the capital, Nairobi to demand that the government meet its commitment to increase annual health and HIV funding.
  • In response to the mutual expulsion of diplomats, the UK’s DFID announced that it has frozen new aid to Malawi.
  • DDT has made a controversial re-appearance in Uganda.

PROGRAMS

RESEARCH

  • The World Health Organization has just launched a new web-based information resource tool that should be of interest to many in global health and development community, the Global Health Observatory.
  • According to the World Health Organization, the worldwide prevalence of obesity has more than doubled between 1980 and 2008.
  • New research has found that a variant in one gene can lead to a 30 percent lower risk of developing cerebral malaria.
  • A new study from Bangladesh concludes that most of the world’s pregnant women don’t need vitamin A supplements.
  • American scientists have tested a treatment regimen for tuberculosis which will reduce the amount of time it takes to complete the full treatment as compared to current plans.
  • A new report from the Guttmacher Institute finds that that 7 in 10 women in Sub Saharan Africa, south central Asia and south east Asia who want to avoid pregnancy, but are not using modern methods give reasons for non-use which suggest available methods do not fulfill their needs.
  • Average life expectancy across much of the world — except Iraq and South Africa — is steadily climbing and infant deaths dropped across the world during the first decade of the 21st century, according to figures released by the World Health Organization.
  • The Clinton Health Access Initiative and Gates Foundation have teamed up to support research into developing a cheaper version of the drug Tenofovir.

DISEASES AND DISASTERS

  • China has reduced its AIDS mortality by two-thirds since it began distributing free antiretroviral drugs in 2002; however, the improvements were seen largely in patients who acquired HIV through blood transfusion, rather than through sex or drug use. On a darker note, Chinese authorities ordered an AIDS activists’ web site shut down after it had published an open letter from a retired senior official concerning news restrictions placed on a 20th-century public health scandal.
  • Dr. Orin Levine looks at a disturbing global trend: Infectious killers that had been beaten back by aggressive immunization efforts are making a comeback in places long thought to be safe havens.

WORLD HEALTH ASSEMBLY

The IH Blog was featured in the “Buzzing in the Blogs” section of the Healthy Dose this week! Thanks to Tom Murphy for reading and tweeting us!

Attention Students: Internship Opportunities with PATH

PATH is pleased to announce the launch of the 3rd year of its highly successful summer Graduate Internship Program!

As an international nonprofit organization invested in creating sustainable, culturally relevant solutions to enable communities worldwide to break longstanding cycles of poor health, PATH is well-positioned to offer a variety of high-caliber internships to graduate students seeking to gain experience in the field of global health. As a highly acclaimed educational institution, we would like to invite the University of Washington to advertise this opportunity with your Graduate students and encourage them to apply.

Most internships last from June through August, and there is a monthly stipend of $1250 provided to cover housing and potential travel costs. Current open positions include analyzing PATH’s market research practices alongside the Safe Water commercialization team and developing a qualitative research plan regarding clinical breast cancer exams to implement in Peru with the Reproductive Health team.

For more information all internships and details on the application process, see PATH’s website. For further questions, please contact internship [at] path [dot] org.

Global Health News Last Week (plus interest in a new working group!)

Attention IH Section Members: Dr. Kaja Abbas, MPH student at the University of Rochester, is gauging interest in forming a working group focused on using system science to improve global health, similar to the intitiaves being promoted by NIH. Her interests are in conducting system science research on global health policy by modeling population and disease dynamics and economic evaluation of public health interventions and systems, with a focus on HIV and TB. Dr. Malcolm Bryant, our section chair, has encouraged the expansion of our section’s activities in areas of technical expertise, and Dr. Abbas is enthusiastic about a working group within the section that promotes system science methodologies for global health solutions. She welcomes your thoughts and suggestions at kaja [dot] abbas [at] gmail [dot] com.

Global Health Delivery online’s HIV prevention community is hosting a “virtual expert panel” March 7-11 to continue the dialogue around PrEP as a novel approach to prevention. Panelists from Uganda, South Africa and the United States will lead the online discussion, highlighting various barriers and opportunities to implementing PrEP in clinical settings; how to encourage long-term adherence; and what additional research questions need to be answered. Panelists include (1) Douglas Krakower, MD, a fellow in Infectious Diseases at Beth Israel Deaconess Medical Center/Harvard Medical School, (2)Andrew Mujugira, MBChB, MSc, the East Africa regional medical director for the Partners PrEP study, and (3) Vivek Naranbhai, PhD, who was involved in CAPRISA microbicide gel study. All GHDonline members can participate in this online discussion. You can sign up here if you are not currently a member.

POLICY

  • Paramount Chief Mpezeni of the Ngoni people in the Eastern Province of Zambia has urged his subjects to get circumcised in order to reduce the chances of spreading HIV/AIDS and other communicable diseases in his land.
  • Britain is threatening to pull out of the Food and Agriculture Organization due to “patchy” performance.
  • Due to uncertainty in past estimates, the Indian government has formed a 16-member expert group to determine the annual death rate caused by malaria in the country each year.
  • The breakdown of the air conditioning in the plenary hall of the Philippines’ House of Representatives stalled the heated debate of a controversial reproductive health bill. The bill is vehemently opposed by the Catholic Church and pro-life groups and has caused a stir in the largely Catholic country.
  • A massive demonstration rally was held in New Delhi to protest a free trade agreement between India and Europe, which many fear may threaten the production of low-cost generic drugs, particularly HIV medicines.

RESEARCH

PROGRAMS

DISEASES