VOA News examines the South African government’s decision in September 2011 to stop providing a free six-month supply of infant formula to mothers with HIV and have “its health facilities … encourage the women to exclusively breastfeed for at least the first six months of their babies’ lives.” Though some criticized Health Minister Aaron Motsoaledi for implementing the policy, “doctors at a hospital in an isolated part of South Africa’s Eastern Cape province praised the minister’s action as brave and visionary and said it would ultimately result in many lives being saved,” the news agency writes. The article profiles the experience of doctors at Zithulele Hospital in Oliver Tambo District, which has followed the exclusive breastfeeding policy since 2006 and where one of every four mothers is infected with HIV; outlines why exclusive breastfeeding is preferable to mixed feeding; and discusses the challenges to implementing the policy nationwide (Taylor, 6/19).
New UNICEF Publications Show Universal Health Coverage Achievable Through Social Protection Measures
“Two newly released UNICEF publications demonstrate that while reaching universal health coverage (UHC) is possible in most countries, this requires a comprehensive social protection system of which health insurance is a crucial component,” according to this post on the UHC Forward blog. A recent UNICEF study “finds that even in middle and low-income countries that have adopted a formal policy of universal health coverage … many socio-economic barriers to access persist,” the blog reports, adding, “It is for this reason that the study has been framed in the broader approach recommended by UNICEF’s first global Social Protection Strategic Framework, which stresses the importance of developing and strengthening integrated social protection systems” (O’Connell, 6/4).
Policy Review Article Examines Need For 'Structural And Philosophical' Shift In Global Health Framework
In this article in “Policy Review,” a publication of Stanford University’s Hoover Institution, Mark Dybul, co-director of the Global Health Law Program and the inaugural global health fellow at the George W. Bush Institute; Peter Piot, director of the London School of Hygiene and Tropical Medicine; and Julio Frenk, dean of the Harvard School of Public Health, discuss the need for “a structural and philosophical shift” in the global health field, writing, “As we approach the post-[Millennium Development Goal] era, now is the time for a new framework to establish an accelerated trajectory to achieve a healthy world.” The authors recount the history of global health work in recent years and outline several “conceptual foundations of a new era in global health and development.” They conclude, “That is an audacious vision, but the recent history of global health and a long history of great human achievements teach us that what seems impossible can be done” (6/1).
Al Jazeera examines Afghanistan’s health care system since the fall of the Taliban, writing, “Standards of health care in Afghanistan have improved significantly since the fall of the Taliban, but security continues to play a large role in determining access to and quality of care provided.” According to the video report, Afghanistan’s constitution mandates that health services be provided free of charge, which “leaves many small clinics reliant on foreign aid.” The news service notes, “There’s a big difference in the type of care you can get [in] rural areas and in urban areas,” adding, “Many procedures still require patients to travel to city hospitals, putting them at risk from violence and grueling journeys on poorly maintained roads” (Smith, 6/3).
Targeted Financial Assistance Offers Middle Ground Between Arguments For And Against Higher Development Spending
In this post on the Guardian’s “Poverty Matters Blog,” Bjorn Lomborg, author and director of the Copenhagen Consensus Center, examines the issue of foreign aid in this time of austerity, writing, “Targeted financial assistance offers a middle path between the arguments for and against higher development spending.” He adds, “A different way of focusing this spending would be to examine where we could do the most good â€¦ Instead of focusing on the issues that have the most vocal proponents or the most heart-wrenching pictures, looking at costs and benefits puts the focus on solutions that will do the most good for the least money.”
In this post in the IntraHealth “Global Health Blog,” Kate Tulenko, senior director of health systems innovation at IntraHealth, provides an excerpt of her recently published book, “Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad,” in which she argues that the practice of “relying on foreign-born health workers to fill health care gaps, particularly in providing primary care … has dire economic and social consequences, threatening the quality of medical care in both source countries and the U.S.” (8/30). The blog also links to a recent interview by IntraHealth in which Tulenko discusses the issues raised in her book (8/29).
“Government assurances that the scaling back of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program in South Africa (SA) will be carefully managed to protect patients are welcome, but … [t]he reality is that the Department of Health is struggling to cope with severe medical staff shortages, financial resources that never seem to stretch far enough, inadequate infrastructure and maintenance programs, and administrative bottlenecks,” a Business Day editorial states. Though the reworking of PEPFAR funding will take place over five years “and does not entail the complete loss” of funding, “the shortfall will have to come from somewhere,” the editorial says, adding, “It will be tragic if, just as we are starting to see light at the end of the long, dark tunnel of the HIV/AIDS epidemic in SA, the gains of the past few years were to be reversed due to the loss of critical foreign funding and the government’s lack of capacity to plug the gap.”
The Center for Strategic & International Studies (CSIS) on Tuesday released a report titled “Road to Recovery: Rebuilding Liberia’s Health System,” the center’s “Smart Global Health” blog reports. “The process of rebuilding Liberia’s health system, shattered by 14 years of devastating conflict, is entering a crucial and potentially destabilizing phase,” the blog writes, adding, “This report focuses on specific things the United States can do to sustain the momentum on public health in Liberia” (Downie, 8/28).
Brazil is expanding its national HIV/AIDS treatment program to include about 35,000 additional people, the Associated Press/Seattle Times reports. “Ronaldo Hallal of the [health] ministry’s Sexually Transmitted Disease Department said people with 500 or fewer CD4 cells per cubic millimeter will receive antiretroviral HIV treatment,” increasing the cutoff from 350 or less CD4 cells per cubic millimeter prior to the expansion, the news service writes. The Ministry of Health noted on its website that the expansion will require spending an additional 120 million reals, or $60,000, annually, according to the news service, which adds, “Hallal said Brazil already spends 1.2 billion reals ($600 million) each year in its free anti-AIDS program that is currently treating 223,000 people.” The AP notes Health Minister Alexandre Padilla said in a statement, “Brazil will be the only large country in the world to offer this kind of treatment that will reduce the risk of opportunistic infections like tuberculosis” (8/29).
Building on its seven-year-old National Rural Health Mission (NRHM), India’s government plans to launch the National Urban Health Mission (NUHM), which “will focus on improving health care delivery and public health systems,” the Lancet reports. Prime Minister Manmohan Singh recently “expressed hope that the two programs together will in the future lead to a unified National Health Mission,” according to the journal. “Unplanned urbanization brings forth a whole set of new health problems. [The] urban poor are three times more likely to die before attaining the age of five years, 20 times more likely not to have any antenatal care, three times less likely to get primary immunization, and two and a half to three times more likely to be stunted and wasted than urban richest,” Chandrakant Pandav, head of the Centre for Community Medicine at the All India Institute of Medical Sciences, New Delhi, said, citing the third National Family Health Survey, the Lancet notes (Bhaumik, 8/11).