“Global health programs now teeter on the edge of disaster,” Foreign Affairs writes in this feature article, adding, “The world economic crisis and the politics of debt reduction are threatening everything from malaria control and AIDS treatment to well-baby programs and health care worker training efforts.” The article provides a historical overview of global health programming and funding. “Like it or not, the burden of reducing suffering and increasing the health of the world’s poor now falls largely on the backs of the two Washingtons,” Foreign Affairs writes, referring to politicians in Washington and the Washington state-based Bill & Melinda Gates Foundation. The article concludes, “It would be a catastrophe were the ‘age of generosity’ to end so soon after it began, leaving millions without life-sparing medicines and tools they have come to rely upon” (Garrett, 5/6).
Programs, Funding & Financing
The Kansas City Star examines HIV education and care in Egypt, where “the Ministry of Health says there are 2,700 cases, but the true number is estimated conservatively at more than four times that — and growing.” The newspaper writes that while “HIV education has become an international cause throughout Africa, where the rate of infection devastated many sub-Saharan nations but is being brought under control by concerted efforts on prevention and treatment,” similar efforts “are largely nonexistent in North Africa and the Middle East, and AIDS activists now worry that the rise of a conservative Islamic government in Egypt, where former longtime Muslim Brotherhood member Mohammed Morsi became the country’s first democratically elected president over the summer, will make matters worse.”
“The U.N. is leading the AIDS education effort here, and there have been efforts by individuals to bring attention to the issue,” the Star notes, adding, “According to one survey, 57 percent of doctors here think that HIV can be transmitted through a mosquito bite, according to a footnote in a U.N. report,” and “[m]any patients, unaware of the symptoms or risks, learn only by chance that they’ve been infected, when a blood test required for a visa or a medical procedure comes back positive.” The newspaper writes, “Ehab Abdel Rahman, the director of the HIV program at the Ministry of Health, balks at the suggestion that Egypt isn’t doing enough. … The blame, he said, lies with patients who try to diagnose and medicate themselves.” But “Omnia Kamal, a Morsi adviser on women’s issues and a member of the committee that’s charged with drawing up the country’s new constitution, offers a different view. In a nation plagued with economic programs and a litany of social issues, AIDS is not a priority, she said” (Youssef/Ismail, 10/22).
U.S. Secretary of State Hillary Clinton in a statement on Monday “announced an extra $58 million in aid for Horn of Africa countries,” Agence France-Presse/Times Live reports (10/23). “Clinton said the humanitarian situation in the region is fragile, with more than nine million people in need of assistance because of conflict, flooding, drought, and economic problems,” VOA News writes, noting, “The U.S. State Department says the United States has given $1.3 billion in emergency assistance since 2011 to affected people in Somalia, Kenya, Ethiopia, and Djibouti” (10/22). “The U.S. ‘is also fighting chronic food insecurity by helping vulnerable communities diversify and adapt their livelihoods, improve smallholder agricultural and other efforts so they can become more resilient,’ [Clinton] said,” according to AFP (10/23).
Noting that the Global Health Initiative (GHI) leadership and the three core entities of GHI — USAID, the Centers for Disease Control and Prevention (CDC) and PEPFAR — announced the closure of the GHI office and an end to the initiative’s current phase on July 3, Serra Sippel, president of the Center for Health and Gender Equity, writes in the Huffington Post’s “Politics” blog that “the three agencies will be responsible for ensuring that the GHI principles are implemented in the field to achieve global health goals.” She continues, “A focus on the GHI principles — especially principles of health sector integration, equal rights for women and girls, country ownership, and health systems strengthening — is indeed necessary to ensure U.S. global health programs are effective. The principles are the most important piece of GHI, and what has given global health advocates optimism since it was launched in 2009.”
“Last month, U.N. Secretary-General Ban Ki-moon convened a group of global leaders, including [Bill & Melinda Gates Foundation Co-Chair] Bill Gates and heads of state of polio-affected countries, to renew the commitment to eliminate polio,” William Keenan, executive director of the International Pediatric Association, and Robert Block, president of the American Academy of Pediatrics, note in the Huffington Post’s “Global Motherhood” blog. “This show of solidarity reminds us that the fight is not finished,” they write, and continue, “Armed with effective vaccines, pediatricians, partner organizations and front-line workers around the globe have eliminated 99 percent of all new polio cases.” They state, “We can’t afford to lose sight of this remaining one percent of polio cases.”
In the Huffington Post’s “Politics” blog, Serra Sippel, president of the Center for Health and Gender Equity, notes that Secretary of State Hillary Rodham Clinton said at the XIX International AIDS Conference in July that all women should be able to decide “when and whether to have children” and that PEPFAR, in a guidance [.pdf] released last week, said, “Voluntary family planning should be part of comprehensive quality care for persons living with HIV,” and referred to family planning as a human right. “Then, in bold type, they punctuated it with, ‘PEPFAR funds may not be used to purchase family planning commodities,'” she writes. “They take it a step further with a caveat that before anyone decides they’d like their program to have anything to do with family planning, they had best consult relevant U.S. legal counsel first,” she adds. “To be fair, they do say that PEPFAR programs can just refer women to a different program that offers family planning,” but those programs are not always available, Sippel writes, adding, “So the suggestion is flawed from the start.”
PlusNews examines challenges and concerns over an announcement by the Zimbabwean government that it plans to train nurses to prescribe and administer antiretroviral drugs (ARVs) to people living with HIV in the country. “Previously, nurses were allowed only to administer the drugs after a doctor had prescribed them,” the news service writes, adding, “Now, changes made in the job descriptions of nurses by the Nurses’ Council of Zimbabwe will see them prescribing the medication.” Owen Mugurungi, director of the HIV/AIDS and TB unit in the Ministry of Health and Child Welfare, said, “I need to point out that it’s not enough that a professional council allow nurses to administer drugs; this should be followed up with measures to capacitate nurses to do this work correctly,” according to PlusNews. The news agency looks at how the possibility of work overload for nurses, a government hiring freeze on nurses, and ARV availability could affect the country’s plan to reach 85 percent of the population in need of HIV treatment by the end of this year (10/16).
“A new survey of European Union [E.U.] residents reveals that even an economic crisis doesn’t dampen Europeans’ support for aid,” Amie Newman, a communications officer and editor for the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, writes in the blog, noting, “Eighty-five percent of Europeans say that Europe should continue helping developing countries — primarily those, however, that are affected by a natural crisis or a conflict.” She adds, “On the other hand, the majority of respondents want to see emerging economies including Brazil, India, and China cut off from aid” (10/16).
Though “conflict and insecurity problems in Afghanistan, Pakistan, and Nigeria have presented challenges to polio immunization, … these are surmountable obstacles,” Siddharth Chatterjee, chief diplomat and head of strategic partnerships and international relations at the International Federation of the Red Cross and Red Crescent Societies, writes in the International Peace Institute’s Global Observatory. “Millions of children have received polio vaccines in countries ravaged by conflict and poverty, thanks to determined action by national governments and the work of courageous health workers from UNICEF, WHO, Red Cross-Red Crescent National Societies, and [non-governmental organizations],” he notes. In addition to providing political will and humanitarian solidarity, “[w]e must ensure the effort is fully funded; not just year-by-year, but for the long term,” he writes, concluding, “We have the opportunity to ensure success, and we must not fail to deliver a legacy of a polio-free world” (10/16).
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.