In this post in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, editor Amie Newman, a communications officer at the foundation, highlights the work of “two HIV home-visit health workers who work with the CDC Kenya (Centers for Disease Control) to visit with a family in a remote area in the Nyanza province.” According to the blog, the “center is responsible for most of what goes on when it comes to researching HIV/AIDS in this country: what prevention and treatment methods work, monitoring the number of new HIV/AIDS cases, the number of births, deaths, implementing those treatment and prevention methods (including voluntary medical male circumcision, distribution of condoms, medicine for treatment), and maternal and newborn health issues which are directly connected to HIV (like prevention of mother-to-child transmission)” (6/25).
Health Workforce & Capacity
“Since Myanmar gained independence from the British in 1948, it has been wracked by armed conflicts and fragile ceasefires with civilians and ethnic rebels,” and “[t]he health of Myanmar’s women has been one of the biggest casualties,” GlobalPost reports. Though recent news coverage has focused on political reform in the nation, “little attention has been paid to a more immediate need: affordable, decent health care,” the news service states. The “military junta that ruled the country for a half century spent very little on health care,” little international aid has come into the country, and “the government restricts where and how aid organizations can operate, blocking the delivery of medical services,” the news service writes, adding, “The result has been a health care system that in conflict areas, does not exist, and in large cities, is too expensive for ordinary people, according to experts inside Myanmar and on the Thai border.”
GlobalPost Examines Investment In Community Care Workers In South Africa As PEPFAR Moves Toward Local Implementation Of Programming
“Nearly a decade after it came into being, the President’s Emergency Plan for AIDS Relief (PEPFAR) … is moving increasingly to support local leadership and implementation capacity” in South Africa, GlobalPost’s “Global Pulse” blog reports. “And given the South African health system’s weaknesses in the face of the magnitude of AIDS and TB, that means an investment in … lay listeners with just a few weeks of training,” who can discuss treatment and other issues with patients, the blog writes. The blog profiles Goodness Henama, “one of 22 community care workers in Wallacedene township, in the Cape Town suburb of Kraainfontein.”
In a feature story, Al Jazeera examines Cuba’s national health care system, which “works — or is supposed to work — by emphasizing primary and preventative health care.” However, after subsidies from the former Soviet Union “ended and Cuba’s economy went into a tailspin, nothing was the same again,” according to the news agency, which notes the system experiences drug shortages, patients have long wait times, and some hospitals are dirty or malfunctioning. “In all fairness, in the past five years, the government has made great efforts to improve hospitals and health centers, but again, lack of resources is making the process painfully slow,” Al Jazeera writes, adding, “The system is free, but it is neither fast nor efficient for two important reasons. One is obviously the lack of financial resources, and the other — which is related to the first — is the ‘export’ of doctors, nurses and dentists in exchange for hard currency.” The feature concludes, “But for all its shortcomings, Cubans do have better access to health care than the majority of those living in many ‘developing nations,’ where public health is shockingly inadequate” (Newman, 6/18).
South African TB Conference Hears Demands From Advocacy Organizations To Improve, Decentralize Treatment
The 2012 South African TB Conference opened Tuesday night in Durban, with the Treatment Action Campaign, Section27, and Oxfam delivering “a memorandum containing five demands to conference organizers shortly before the opening,” health-e News Service reports. The organizations “called for patients with drug-resistant TB who were failing to respond to treatment to be given ‘access to the best available medicines,'” even if they are not yet approved by the Medicines Control Council; “the diagnosis of all people living with TB”; and “the decentralization of care for people with drug-resistant TB, enabling them to be treated at home instead of hospitalized for long periods,” the news service writes (Cullinan, 6/13).
GlobalPost reports on Cuba’s medical outreach to Africa, writing, “A generation ago, Fidel Castro sent Cuban soldiers to intervene in African civil conflicts and fight the Cold War against U.S. proxies. Now, Cuba’s doctors are fanning out across the continent as the island expands its role in administering medical services to some of the world’s most ailing countries.” The news service continues, “Some 5,500 Cubans are already working in 35 of Africa’s 54 countries, Cuban Foreign Ministry official Marcos Rodriguez told reporters this week at a press conference in Havana,” noting, “Of those, 3,000 are health professionals, and 2,000 are doctors, he said.”
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).
“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.”
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).
PRI’s “The World” profiles Gabon’s Albert Schweitzer Hospital, which “is struggling to achieve the goals of its founder while adapting to a new century and a different Africa.” The story recaps the hospital’s history and its board’s recent efforts to address what one board member described as locals’ “dependency” on historically European directors. However, Lachlan Forrow, a doctor at Harvard Medical School and Boston’s Beth Israel Deaconess Medical Center and the only American on the hospital’s board, recently became president of the board, and he has worked to establish “a new relationship between locals and outsiders — blacks and whites,” PRI reports. Forrow “found an experienced Gabonese hospital administrator — Antoine Nziengui –” who is now the Schweitzer Hospital director, an African “for the first time since the hospital was founded 99 years ago,” the news service writes, adding that the hospital “still faces huge obstacles: a million-dollar budget deficit, antiquated facilities, a rising burden of HIV and tuberculosis” (Baron, 5/17).