“It is in poor countries and communities, where health needs are greatest and physicians are scarce, that nurses take an even greater role in health care delivery, often serving as the sole providers in rural villages or urban slums,” Sheila Davis, director of global nursing at Partners In Health, writes in a Huffington Post “Impact Blog” opinion piece, noting this is International Nurses Week. “But although nurses deliver 90 percent of all health care services worldwide, they remain largely invisible at decision-making tables in national capitals and international agencies. Their absence constitutes a global health crisis,” Davis continues.
Health Workforce & Capacity
“The CIA’s vaccination gambit put at risk something very precious — the integrity of public health programs in Pakistan and around the globe” and has “also added to the dangers facing nongovernmental organizations (NGOs) in a world that’s increasingly hostile to U.S. aid organizations,” opinion writer David Ignatius writes in a Washington Post opinion piece. Noting that attention in the U.S. has focused on a 33-year prison sentence given to Shakil Afridi, a doctor convicted of treason for helping the CIA track down Osama bin Laden through a vaccination program, Ignatius says, “Afridi and his handlers should reckon with the moral consequences of what they did. Here’s the painful truth: Some people may die because they don’t get vaccinations, suspecting that immunization is part of a CIA plot.”
VOA News features a five-part series on South Africa’s rural public health sector, which the news service writes is “plagued by a high burden of infectious diseases, severe doctor and nurse shortages, lack of medicines and essential medical equipment and incompetent management,” resulting in high patient death rates. “Eighty percent of South Africa’s population of about 50 million people depends on public health care,” the news service notes. In the first part of the series, VOA writes that “international health care monitoring groups … consistently rate South Africa’s public health sector among the worst in the world,” “despite the fact that the government gives more than 100 billion rand ($13.3 billion) every year to state health — one of the biggest expenditures on such services in the developing world.”
In a two-part series in his Slate blog “The Reckoning,” author Michael Moran examines the “silo” effect of Western aid to improve health in Africa, writing in the first part, “Charities know that raising money for exotic disease eradication in the West is a good deal easier than, say, funding upgrades to substandard cardiac facilities. Yet the later is the real win in the long run.” He references an article published recently in Foreign Affairs by Thomas Bollyky, which Moran summarizes by saying, “Bollyky argues coordinated action to confront communicable crises like HIV/AIDS, malaria or tuberculosis must be part of the world’s approach to global health. But by ignoring far greater, non-communicable problems, he says, we doom Africans to low life expectancies and fail to create the impetus for reform and behavioral changes that could be transformational” (5/28).
In a report (.pdf) released on Tuesday, the non-governmental organization Medecins Sans Frontieres (MSF), also known as Doctors Without Borders, said a new $10 billion global vaccination plan “fails to address the 20 percent of babies — some 19 million infants — who never receive basic, life-saving shots,” and that, “[r]ather than pushing for novel vaccines, the plan should focus more concretely on strategies to get existing vaccines to children,” Nature’s “News Blog” reports (Maxmen, 5/15). The “‘Global Vaccine Action Plan’ has been designed to implement the ‘Decade of Vaccines’ project and will be considered by health ministers gathering next week in Geneva for the 65th World Health Assembly,” according to an MSF press release, which adds, “MSF welcomed the increased emphasis on vaccines stimulated by the ‘Decade of Vaccines’ but expressed concern that some key challenges are being glossed over” (5/15).
“An outbreak of Ebola hemorrhagic fever has claimed possibly as many as 31 lives in the northeast of the Democratic Republic of Congo since May, Health Minister Felix Kabange Numbi said Thursday,” Agence France-Presse reports. “Numbi said an international committee for technical and scientific coordination in the fight against Ebola had carried out retrospective research to find previous cases, which raised the death toll,” according to the news agency (9/13). “We can expect an increase in the number of cases as more people are tracked. These are not necessarily new cases,” WHO spokesperson Tarik Jasarevic said, adding, “I want to stress that this is a serious outbreak, and there is a risk of the Ebola virus spreading, but we would not say that it’s out of control,” NPR’s health blog “Shots” reports (Doucleff, 9/13). “The latest WHO figures show there are now 65 probable or suspected cases of Ebola in Congo, with 108 people under surveillance,” Reuters notes (9/13). “Last month an outbreak of a more deadly Ebola strain in neighboring Uganda killed 16 people, but health workers say the two outbreaks do not appear to be related,” according to BBC News (9/13).
“The World Health Organization (WHO) on Tuesday said Nigeria was not on track in the effort to eradicate wild polio virus before the end of December this year,” Leadership/AllAfrica.com reports. Speaking at the 24th Expert Review Committee (ERC) Meeting on Polio Eradication in Abuja, Bruce Aylward, WHO assistant director-general for polio, emergencies and country collaboration, said Nigeria had the tools and capacity to turn back the increasing number of polio cases that pose a “real and growing danger to international public health,” the news service notes. Aylward “recommended eight major steps for polio eradication for the country, including the implementation of the new house-based micro planning and monitoring method,” refresher training for all personnel to emphasize the emergency status declared by the WHO, and the identification and immunization of missed children and those in insecure areas, among others, according to the news service. ERC Chair Tomori Oyewale “called on Nigerians to change their attitude to polio eradication to ensure the success of the fight against the virus,” the news service writes (9/11).
Ugandan Parliamentarians Threaten To Hold Up National Budget Unless More Funding Committed To Health Care
In Uganda, where “there are fewer than two health workers for every 1,000 people — a level the World Health Organization defines as a severe shortage” — the nation’s parliamentary “social services committee, which has initial oversight of the country’s health budget, pushed a resolution through parliament last week threatening to hold up approval of the entire budget unless funding to recruit and retain new health workers is increased,” VOA News reports. “Committee members, with support from the Women’s Parliamentary Association, called for a specific increase of at least $103 million to the sector,” the news service notes. “In addition to the funding increase, the parliamentarians are calling for an end to a wage freeze for current employees and a ban on recruiting new health workers,” as well as “demanding a supplementary pool of money to improve health care in communities that are particularly short staffed,” according to the news service.
“International relief officials reported an increasingly grim aid crisis stemming from the Syria conflict on Tuesday, with two million people there not getting desperately needed help, and a sudden acceleration of refugees overwhelming the ability of neighboring countries to absorb them,” the New York Times reports. “In the province of Homs, so many doctors have fled that only three surgeons remained to serve a population of two million, the officials said,” according to the newspaper. “The World Health Organization said that a United Nations mission to Homs last week had found that more than half a million people needed aid, including health care, food and water,” it writes, adding, “The mission found that the biggest hospital in Homs had been destroyed, and that only six of the 12 public hospitals and eight of the 32 private hospitals were still functional.” The newspaper notes, “At the United Nations, the head of UNICEF and the European Union’s top relief official said that only about one-third of the three million people in Syria who needed help were getting any, and that combatants on both sides would be held responsible for respecting international law protecting civilians during war” (Cumming-Bruce/MacFarquhar, 9/11).
“As many as 200 million children across the world fail to reach their full potential because their early brain development is held back by poverty, disease and malnutrition, global health experts said on Thursday,” Reuters reports (Kelland, 9/13). The Canadian government-funded Grand Challenges Canada on Thursday “announced $11.8 million CAD [$12 million] in funding over two years for 11 bold ideas from innovators in the developing world, to address health conditions causing diminished cognitive potential and stunting,” according to a Grand Challenges Canada press release (9/13). The projects, which will be implemented in developing countries such as Thailand, Pakistan, Bangladesh, and Colombia, “include plans to encourage so-called ‘kangaroo mother care,’ where low-weight newborns are held skin to skin rather than put into incubators, and ways of combating maternal depression to boost interaction between mothers and babies,” Reuters notes (9/13).