Uganda “has overcome a violent past, but hope is daily threatened by a force more deadly than any warlord or civil unrest”: the mosquito, Ugandan Health Minister Christine Ondoa writes in a GlobalPost opinion piece. According to the WHO, “Uganda has the highest incidence of malaria in the world,” and the disease is endemic in more than 95 percent of the country, she notes. Malaria “deeply affect[s]” Uganda’s economy, Ondoa says, noting Ugandans spend 25 percent of their incomes to treat and prevent the disease; children miss “countless school days,” and the disease renders some developmentally impaired after becoming infected. “As a result of these tremendous losses, African economists estimate that, if unchecked, malaria’s toll on Uganda’s annual GDP will rise over the next five years to as much as $3.2 billion,” she states.
A report (.pdf) released last week by the Kaiser Family Foundation outlines the U.S. Department of Defense’s (DoD) global health work, “present[ing] the first comprehensive analysis of DoD’s activities and budget in this area” and “aim[ing] to contribute to discussions about DoD’s role in global health, understandably regarded as controversial by many observers,” a Lancet editorial states. “The report notes that DoD’s work in global health is varied,” “[n]o overarching policy or strategic document guides the department’s global health-related efforts and there is no single budget for such activities,” the Lancet writes. The report estimates that DoD’s budget for global health work in FY 2012 was more than half a billion dollars, more “than the global health budgets for either the Centers for Disease Control and Prevention or the National Institutes of Health during the same period”; however, “the effectiveness of this investment is unclear,” according to the editorial.
“Between 1970 and 2010, most emerging countries achieved impressive gains in contraceptive coverage,” but, “[b]y contrast, many sub-Saharan African (SSA) countries … have started their contraceptive revolution very late and progress to date has been minimal,” John May, a visiting fellow at the Center for Global Development (CGD), and Jean-Pierre Guengant, researcher emeritus at the Research Institute for Development (IRD) in Marseille, France, write in CGD’s “Global Health Policy” blog. “The widespread belief in SSA that ‘development was the best contraceptive’ has been the major reason why countries did not launch organized family planning programs,” they write, adding, “By and large, the lack of progress in contraceptive coverage has precluded significant decreases in fertility in the region” (10/11).
“The global maternal mortality has dropped dramatically during the last decade,” but “too many women continue to die from pregnancy-related causes,” Sharon Camp, president and CEO of the Guttmacher Institute, writes in the BMJ Group Blogs. “In part, this is because unsafe abortion — one of the leading preventable causes of maternal death — is a public health crisis that is going largely ignored,” she continues, adding, “It is time for a public health approach to prevent unsafe abortion and the harm it causes individuals, families and society as a whole” (10/11).
“Worldwide, evidence-based interventions are being implemented in an effort to drive down child mortality and there are some signs that they are working,” a Lancet editorial states. “However, few countries are on course to meet the targets set by Millennium Development Goal 4,” the editorial notes. “Most maternal and child health programs do not reach the world’s poorest families; it is believed that efforts to do so cannot be successful, cost effective, and equitable,” it continues, adding, “Yet if interventions could reach these families, overall nutrition and health would improve and the lives of millions of children could be saved.”
“Pregnancy and childbirth is still the leading cause of death for teenage girls in the poorest corners of the world, and despite all the progress in reducing maternal mortality by 47 percent, we have yet to save these young, vulnerable lives,” Sarah Brown, founding chair of the Global Business Coalition for Education, writes in the Huffington Post’s “Global Motherhood” blog. “One of the biggest issues to resolve is child marriage; this is rightly front and center of the first International Day of the Girl Child on October 11, 2012,” she continues, adding, “That is why the White Ribbon Alliance for Safe Motherhood has joined the campaign against child marriage and is calling on its supporters to take the lead with one of their recommended actions.”
“As the importance of [America's] foreign assistance has grown, so has the number of mechanisms to dispense it,” Sen. Dick Lugar (R-Ind.) and David Beckmann, president of Bread for the World and co-chair of the Modernizing Foreign Assistance Network, write in the Huffington Post’s “Politics” blog. The authors note that “more than 24 different agencies play some role in our development and assistance efforts,” including USAID, PEPFAR, and the Department of Defense. They continue, “Policymakers have for some time recognized that we need to bring better strategic guidance and coordination to this system,” adding, “In particular, we need a better way to monitor and evaluate these programs to make sure they are working well and fulfilling their policy goals.”
Some countries in Africa “still rely on dichlorodiphenyltrichloroethane (DDT) for [malaria] vector control,” therefore “[i]t is … problematic that the U.N. Environment Programme (UNEP), without the consent of member states, and violating its own treaties, exerts relentless pressure to ban DDT globally,” Richard Tren, director of Africa Fighting Malaria, and Richard Nchabi Kamwi, Nambia’s minister of health and social services, write in a BMJ opinion piece. Nineteen countries reserve the right to use DDT under the 2000 Stockholm Convention, which “made an exception for DDT in disease vector control,” and the WHO endorses DDT, “arguing that a premature shift to less effective or more costly alternatives will have a negative impact on disease burden,” the authors state.
“Our global food security challenges are daunting: food price spikes and increasing food prices look set to continue unabated, around one billion are suffering from chronic hunger, and we must feed a growing population in the face of a wide range of adverse factors, including climate change,” but “I believe there is reason for optimism,” Sir Gordon Conway, professor of international development and agricultural impact at Imperial College London, writes in the Huffington Post U.K. “Impact” blog. “Yes we can feed the world, but only if we accept that agricultural development is the best route to achieving sustainable economic growth in developing countries, and achieve an agriculture that is highly productive, stable, resilient and equitable,” he continues, adding, “I believe there are four interconnected routes to achieving a food secure world: innovation, markets, people and political leadership.”
In a BMJ Group Blogs post, Caroline Robinson, global health advocacy manager for Results U.K., discusses the prevalence and treatment of tuberculosis (TB) and drug-resistant TB in Europe and provides the example of Romania. She writes, “[E]vidence brought to light in a new report [.pdf] released recently outlining the effect funding shortages will have on HIV and TB, including drug-resistant TB, in the European region suggests that Romania does not have the institutional capacity to ensure its citizens have the basic right to health. The country relies on grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which look set to end in 2013.” She continues, “[Global Fund] Board members should ensure that middle-income countries with epidemics among key populations can access critical Global Fund contributions and the E.U. and its member states must continue to provide the resources the fund requires to meet demand. Unless such support is given, countries like Romania will continue to fall further down the league tables in terms of treatment for this curable disease” (10/10).