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).
Health Workforce & Capacity
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.”
IRIN examines how the WHO’s recent declaration that the MenAfriVac meningitis A vaccine can be transported or stored for up to four days without refrigeration will affect immunization campaigns in Africa’s meningitis belt, which runs from Senegal to Ethiopia. “As a result, very remote populations will access the vaccine more easily, the logistics of vaccine campaigns will be simpler, and vaccine campaign costs will drop both for partners and for national governments, said Michel Zaffran, coordinator of WHO’s Expanded Programme on Immunization (EPI), and Marie-Pierre Preziosi, director of the Meningitis Vaccine Project, a partnership between international NGO PATH and WHO,” IRIN writes. Zaffran said, “I am quite confident that within the next year or two, we’ll have one or two more [vaccines] re-licensed in this way,” according to the news service. “Analysis on the heat stability of hepatitis B and HPV (human papillomavirus) vaccines is under way; next on the list are yellow fever, rotavirus and pneumococcal disease,” IRIN notes (11/20).
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).
Ariel Pablos-Mendez, USAID assistant administrator for global health, writes in the agency’s IMPACTblog about his recent trip to Burma and the challenges the country faces as it transitions to an open society. “Hope springs anew for a transformative era of peace, prosperity and development for a country that’s just emerging from isolation from the international community,” he says, adding, “[W]hile maternal and child health, HIV/AIDS, [tuberculosis (TB)] and malaria are obvious targets for investment, there was a strong emphasis on the importance of strengthening health systems and stemming the growing problem of chronic diseases and injuries.” Pablos-Mendez continues, “New commitments in health” from the country’s leadership, the U.S., and other partners “hold promise for the Burmese people” (11/14).