“The nearly two-year conflict in Syria has taken tens of thousands of lives, destroyed entire neighborhoods and sent hundreds of thousands of people fleeing. But more quietly, it has also eaten away at the country’s health care system,” IRIN reports. Many pharmaceutical factories, “which used to produce more than 90 percent of the country’s drug needs,” have shut down or cut production, the news service writes, adding, “Those medicines that are available have also risen in price, and amid skyrocketing unemployment and rising food prices, many Syrians — especially those displaced from their homes by the violence — are struggling to afford their usual medication.”
Health Workforce & Capacity
The Lancet examines Indonesia’s efforts to reduce maternal mortality, one of the Millennium Development Goals President Susilo Bambang Yudhoyono has identified as a national priority. Indonesia’s risk of maternal death is one in 150, compared with one in 4,000 in developed nations, and the government has set a goal of reducing mortality to 102 for every 100,000 live births by 2015, one-quarter of the rate in 1990, according to the journal. Gita Maya Koemara Sakti, recently appointed as director of maternal health, explained the Ministry of Health “has adopted a four-step plan that starts with bolstered family planning campaigns,” the Lancet writes. Other efforts include providing free maternal health care through the national social assistance system, improving the national midwifery program, and providing more funding to rural health clinics, the journal notes. The Lancet includes quotes from other government officials and non-governmental organization representatives regarding these efforts and the challenges faced (Webster, 12/8).
GlobalPost’s “Global Pulse” blog features an interview with freelance reporter and artist-in-residence at the University of Washington in Seattle Joanne Silberner, a former NPR correspondent, about her recent series for PRI’s “The World,” titled “Cancer’s New Battleground — The Developing World.” Produced in collaboration with the Pulitzer Center on Crisis Reporting, the series examines cancer prevention, control, and research efforts in Uganda, Haiti, India, and the U.S., according to the blog. Silberner said she was “astounded” to learn “there are more deaths from cancer (in the developing world) than if you added up the deaths from HIV, [tuberculosis], and malaria,” the blog notes. She also said she was “surprised” to learn about the stigma against cancer in the developing world, which “keeps people from coming in [to clinics]” and “keeps local governments from supporting treatment efforts.” Silberner also said coverage of global health issues is important to raise awareness and knowledge in the U.S. (Judem, 12/6).
Chris Endean of the GAVI Alliance writes ahead of the GAVI Partners Forum in a CNN opinion piece about efforts to vaccinate members of the Maasai tribes in Tanzania’s Arusha National Park. Noting Maasai tribes are “constantly on the move searching for water and fresh pasture for their cattle,” he describes “severe logistical challenges” health workers face when trying to reach their patients and notes, “The need to get to hard-to-reach people like the Maasai and the rest of the estimated eight percent of Tanzania’s population that do not receive basic life-saving vaccines has taken on a new urgency with the country’s recent launch of a five-year development plan” called the “One Plan.” Endean notes the forum is taking place in the country’s capital, Dar es Salaam, and that during the event, “the health ministry will launch two new vaccines into the national immunization program — pneumococcal and rotavirus — tackling the primary causes of pneumonia and diarrhea — two of the leading killers of under-fives in Tanzania” (12/5).
A study led by World Bank economist Jishnu Das and published in Health Affairs on Monday examines the quality of primary care delivered by private and public health care providers in rural and urban India, a World Bank press release notes. The study found many providers do not have medical degrees; the quality of medical training is low; and less than half of providers provide correct diagnoses, according to the press release, which says the results show an “urgent need” to carefully measure the quality of care. “The study could help policymakers make evidence-based decisions,” the press release notes, adding, “In November, the government announced a five-year plan to triple health spending and improve the quality of health services” (12/3).
PRI’s “The World” this week features a series examining the challenges of addressing cancer in the developing world. The series, produced in collaboration with the Pulitzer Center on Crisis Reporting, includes radio stories, multimedia features, an interactive map, and infographics, according to the main page. The radio stories examine cancer prevention, control, and research efforts in Uganda, Haiti, India, and the U.S. (12/3). In an interview with the series’ principal reporter, Joanne Silberner, Lancet editor Richard Horton said, “Cancer is certainly being under-recognized and neglected in low- and middle-income countries. … I think cancer is slowly becoming more recognized but there is a long way to go before it gets the attention it so urgently needs (12/3). On December 5, PRI will host a Facebook chat from 10am-4pm EST that will feature Silberner and cancer researchers and advocates (12/4).
In a post on the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Christopher Elias, president of global development at the foundation, discusses progress on “the Decade of Vaccines, a vision and commitment to reach all people with the vaccines they need.” He says “the Global Vaccine Action Plan, a roadmap for saving more than 20 million lives by 2020,” as well as the GAVI Alliance, UNICEF, WHO, health experts, dedicated vaccinators and many others,” are helping “vaccines [reach] more children, in more places, than ever before.” According to Elias, the Gates Foundation is “co-hosting a vaccine summit in Abu Dhabi in April” during World Immunization Week. He notes, “We’re holding the summit in Abu Dhabi to recognize that Middle Eastern and Islamic countries are emerging as leaders in efforts to immunize children against polio and other diseases” (12/2).
The New York Times’ “India Ink” blog examines how “a growing number of ‘affordable health care’ entrepreneurs are focused on developing new solutions for the rural and remote parts of the country.” According to the blog, “Across India, access to health care remains a pressing problem, exacerbated by the country’s large population and shortage of doctors. Nowhere is this challenge more acute than in rural India, which is experiencing a severe shortage of qualified health care practitioners.” But one pilot program in Tamil Nadu is training and certifying traditional medical doctors “to serve as ‘independent care providers’ in a rural setting,” the blog states, noting the program was developed in conjunction with the University of Pennsylvania School of Nursing (Lavakare, 11/29).
The Guardian on Sunday published the winning article and a number of shortlisted articles from its International Development Journalism Competition. The winning article, Medicine versus myth in Sierra Leone, examines how a “lack of medical staff results in many preventable deaths” in the country. Shortlisted articles examine maternal mortality in Uganda, domestic abuse in Timor-Leste, and health worker shortages in Malawi, among other issues (11/25).
The “grand experiment” of the Affordable Medicines Facility-malaria (AMFm) — a pilot program that aims to get artemisinin-based combination therapies (ACTs) into rural areas of several African nations — “seems likely to end, its successes underrated and potential improvements not yet explored,” a Nature editorial says. In October, “an independent evaluation found that it had performed remarkably well on the main benchmarks of success, increasing the number of outlets stocking ACTs and lowering prices,” but last week “the Global Fund to Fight AIDS, Tuberculosis and Malaria decided to end the AMFm as a stand-alone program, by integrating it into the fund’s core system for awarding malaria-control grants to countries,” the editorial notes, adding, “This integration probably spells the end for AMFm, because there will be no new money for the program after the end of next year.”