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).
The January issue of the WHO Bulletin features an editorial on non-communicable diseases and post-conflict countries; a public health round-up; an article on Arab health professionals; a research paper on caesarean section rates in China; and a series of round table articles on the Global Fund and the interaction of public and private interests (January 2011).
Noting that the “fifth Millennium Development Goal target for 90 percent of births in low- and middle-income countries to have a skilled birth attendant (SBA) by 2015 will not be met,” researchers from University College London estimate “that there will be between 130 and 180 million non-SBA births in South Asia and sub-Saharan Africa from 2011 to 2015 (90 percent of these in rural areas)” in this BioMed Central Pregnancy & Childbirth article. They conclude, “Efforts to improve access to skilled attendance should be accompanied by interventions to improve the safety of non-attended deliveries” (1/17).
Community health workers (CHWs) “are seen to be a key part of a functioning primary health system,” especially in African nations, Jeffrey Sachs, director of the Earth Institute at Columbia University, writes in a post on Huffington Post’s “Impact” blog. “This system should include a clinic within short walking distance, with supplies, a skilled birth attendant and other staff, electricity, and safe water; an ambulance for emergency transport; an emergency ‘911’ number; a policy of free care at the point of service (so as not to turn away the indigent); and trained and remunerated CHWs, taught also to treat diseases and save lives in the community,” he says.
In this post in the Huffington Post’s “Impact” blog, Jeffrey Sachs, director of the Earth Institute at Columbia University, examines the role of community health workers (CHWs), “increasingly on the frontlines of disease control in rural Africa,” in providing Africa’s rural population with access to life-saving health care. He writes, “When [my colleagues and I at the Earth Institute] began the work in the Millennium Villages in 2006, Africa’s community health workers were generally unpaid, untrained, unsupervised volunteers with no diagnostic or therapeutic capabilities. … Now the CHWs are seen to be a key part of a functioning primary health system.”