Noting the progress made since the beginning of the HIV/AIDS epidemic and the upcoming recognition of World AIDS Day on December 1, Ronald Valdiserri, deputy assistant secretary for health, infectious diseases at the Department of Health and Human Services, writes in a Public Health Reports opinion piece (.pdf), “[W]e would do well to keep in mind the following caution. No matter the elegance of the controlled trial, the statistical significance of the results, or the superiority of the science, we must confront this inevitable reality: We will never be able to take full advantage of our progress in HIV clinical and prevention science until we develop and sustain the human, organizational, and structural capacities necessary to implement these new scientific breakthroughs.” He continues, “If we fail to attend to the ‘on-the-ground’ details of implementation, we risk dissipating the promise of new drugs, novel therapies, and enhanced interventions that could, in fact, lead us to an AIDS-free generation.”
Health Workforce & Capacity
AllAfrica correspondent Cindy Shiner recently interviewed Vanessa Kerry, CEO of the Global Health Service Corps, at the annual meeting of the American Society of Tropical Medicine and Hygiene taking place in Atlanta this week. Next year, volunteer doctors and nurses will travel through the Service Corps to Tanzania, Malawi, and Uganda to work in partnership with the Peace Corps, according to AllAfrica. In the interview, Kerry said the program grew out of a desire on the part of physicians and other health care workers to help in resource-poor countries, as well as calls from those countries for more U.S. assistance in building health system capacity. Kerry discusses the focus of the program, how it works as a private partner with public programs, and how the first countries were chosen (11/13).
The Wall Street Journal examines how “Greece has seen decades of advances in public health rolled back, as a flood of illegal immigrants, a dysfunctional government and budget cuts ravage a once proud health-care system.” Noting “[o]ver the past two years, more than 50 endemic cases of [malaria] and more than 100 imported cases have been identified in Greece,” the newspaper writes, “The return of malaria, a scourge in developing countries, to Greece is a disturbing indicator of the nation’s decline since it crashed in 2009 under the weight of a debt binge.” The Wall Street Journal examines the history of malaria’s return to the country and how the government is responding. “In addition to malaria, public health officials say they are worried about rises in everything from infectious respiratory-tract diseases and skin conditions to tuberculosis and HIV,” the newspaper notes (Granitsas, 11/14).
Since its arrival in Haiti two years ago, “cholera has sickened more than 600,000 people and killed more than 7,500,” and “[t]his year the epidemic is on track to be among the world’s worst again, with nearly 77,000 cases and 550 deaths, according to the Haitian Ministry of Health,” Ralph Ternier and Cate Oswald of Zanmi Lasante/Partners in Health in Haiti write in the Huffington Post’s “Impact” blog. “Despite the decrease in cases from 2011, every new case represents an unnecessary and preventable infection and an even further potential of completely preventable and unnecessary death in hardest-to-reach areas,” they state. Though a “multi-pronged approach” to treating and preventing cholera has significantly decreased the number of cases, “[t]he sad reality is that … we know that cholera is not going away, [yet] emergency funding for cholera is,” they write.
Noting World Bank President Jim Yong Kim at the World Knowledge Forum last month “spoke of the need to ‘lay the foundations for a new field that will collect and distribute Practical Knowledge that countries can use to get delivery right in their unique contexts,'” Wolfgang Munar, a senior program officer in the Family Health Division at the Bill & Melinda Gates Foundation, and Larry Prusak, an adviser on knowledge networks for the Foundation, examine in the organization’s “Impatient Optimists” blog why “[p]ractical knowledge is a topic worth exploring and better understanding for business, governments and philanthropies.” According to the authors, “the global health community faces the challenge to better understand, foster, and share practical, implementation knowledge that can, in turn, improve people’s lives” (11/7).
“A yellow fever outbreak in Sudan’s Darfur region has killed 67 people so far,” and “the number of cases has more than doubled since the start of the epidemic last month,” the WHO said in a statement on Wednesday, the U.N. News Centre reports. The report “stated that the outbreak has now affected 17 localities in central, south, west and north Darfur, with 194 cases reported — a significant increase from the 84 initial cases reported at the start of the outbreak,” according to the news service (11/7). “WHO announced in the report a plan of action to counter the spread of the disease, including a vaccination campaign and training of medical cadres,” the Sudan Tribune writes. The Ministry of Health “said it needs four million vaccine units to counter the outbreak,” according to the newspaper (11/7). “The report’s recommendations also include strengthening disease surveillance in eastern Darfur, continuing laboratory testing of patients from newly affected localities, and finalizing a vaccination plan that identifies resources available as well as partners to implement it,” the U.N. News Centre writes (11/7).
Emergency Obstetric Care Reduced Maternal Mortality Rates Up To 74% In Two African Projects, MSF Reports
According to a new briefing paper (.pdf) from Medecins Sans Frontieres (MSF), access to emergency obstetric care, including ambulance service, could help save the lives of up to three quarters of women who might otherwise die in childbirth, AlertNet reports (Batha, 11/19). In two projects, one in Kabezi, Burundi, and the other in Bo, Sierra Leone, MSF showed “that the introduction of an ambulance referral system together with the provision of emergency obstetric services can significantly reduce the risk of women dying from pregnancy related complications,” according to an MSF press release. The services, which cost between $2 and $4 per person annually, are offered 24 hours a day, seven days a week, and are free of charge, the press release notes (11/19). The projects “cut maternal mortality rates by an estimated 74 percent in Kabezi and 61 percent in Bo,” Reuters writes, adding, “The charity hopes its model could serve as an example for donors, governments and other aid agencies considering investing in emergency obstetric care in countries with high maternal mortality rates” (11/19).
“An Indian government program to reduce the number of home births by giving expectant mothers cash grants has increased the number of hospital deliveries, but gaps in healthcare services are still causing avoidable maternal deaths, an alliance of health organizations has said,” BMJ reports, noting, “The health ministry’s Janani Suraksha Yojana (Mothers Protection Program) provides a cash incentive of 1400 rupees (Â£16; â‚¬20; $25) mainly to poor and underprivileged pregnant women to give birth in hospital.” According to the journal, “[t]he ministry said that the program had helped increase the proportion of hospital deliveries in India from less than 49 percent when it was launched in 2005 to more than 72 percent.” However, BMJ adds, “[t]he National Alliance for Maternal Health and Human Rights, a non-governmental coalition, has said that India’s health ministry has stirred demand and increased the number of hospital deliveries without paying enough attention to factors that determine maternal safety.”
As part of its “Blueprint” series discussing the creation of a U.S. global AIDS blueprint called for by Secretary of State Hillary Clinton in July, the Center for Global Health Policy’s “Science Speaks” blog features an opinion piece by Salmaan Keshavjee of Harvard Medical School and Partners In Health. With an estimated 1,000 people with HIV dying of tuberculosis (TB) every day, “[i]t is clear that our current approaches to addressing the global tuberculosis pandemic are inadequate,” he writes. Keshavjee says, “First, bold targets for reducing tuberculosis incidence and zero TB-HIV deaths must be prioritized in the blueprint. … Second, known strategies for stopping the spread of tuberculosis have to be actively implemented. … Lastly, any effective strategy has to ensure that HIV advocates at the community level are educated about the threat of tuberculosis,” and he describes each of his points in detail. He concludes, “The United States has shown visionary leadership in the area of HIV treatment and changed the lives of countless people for the better. It is time to take on tuberculosis with the same moral and pragmatic vigor” (Barton, 10/31).
Sarah Arnquist, who runs Global Health Hub, writes in Harvard University’s Global Health Delivery Project blog about a Monday session at the American Public Health Association’s annual conference that discussed “[u]sing online communities to promote health and engage communities — of either professionals or patients.” As a member of the panel, Arnquist discussed GHDonline, “a platform of expert-led communities where health care implementers collaborate to improve the delivery of health care” and provide discussion through “virtual expert panels” to members of the GHDonline community, she says. “Each discussion is summarized into a ‘discussion brief’ that provides busy people a quick overview of key points and links to useful background research,” she writes and details some recent topics (10/31).