In a study published on Wednesday in the Lancet, researchers from the Centers for Disease Control and Prevention found that “[a]mong 1,278 patients who were resistant to two or more first-line tuberculosis drugs in Estonia, Latvia, Peru, Philippines, Russia, South Africa, South Korea and Thailand, 43.7 percent showed resistance to at least one second-line drug,” which “suggest[s] the deadly disease may become ‘virtually untreatable,'” according to the study, Bloomberg Businessweek reports (Kitamura/Narayan, 8/29). “In about a fifth of cases, they found resistance to at least one second-line injectable [versus oral] drug,” according to Reuters, which states “[t]his ranged from two percent in the Philippines to 47 percent in Latvia.” Overall, 6.7 percent of patients had extensively drug-resistant TB (XDR-TB), meaning patients are resistant to the first-line drugs isoniazid and rifampicin as well as drugs in the fluoroquinolone antibiotic class and a second-line injectable antibiotic, Reuters adds, noting “[r]ates in South Korea, at 15.2 percent, and Russia at 11.3 percent, were more than twice the WHO’s global estimate of 5.4 percent at that time” (Kelland, 8/30).
Quality of Care
Though many pregnant women are aware that treatment could save their lives and the lives of their infants if they test HIV-positive during prenatal care, a new study and literature review have found that a “[f]ear of being stigmatized as an AIDS patient is still a major barrier to good medical care for pregnant young women in many countries,” the New York Times reports. The study, published last week in PLoS Medicine, was “based on a survey of 1,777 women in rural Nyanza Province in Kenya,” according to the newspaper, which adds, “Only 44 percent of mothers in the province delivered in clinics, and the study found that a major obstacle was that they feared HIV tests.” The study’s author, Janet Turan, a professor of public health at the University of Alabama at Birmingham, in July also published “a review of multiple studies in many countries” that documented multiple accounts of “stigmatizing behavior,” the newspaper notes (McNeil, 8/27).
“Counterfeit medications are a serious and sometimes deadly problem in developing countries,” but “two teams of U.S.-based scientists have developed quick tests can identify counterfeit drugs before they can cause harm,” VOA News reports. Toni Barstis, a chemist at Saint Mary’s College in Indiana, and a team of researchers “presented the new testing methods this week at the annual meeting of the American Chemical Society in Philadelphia,” the news service writes, noting, “Scientists hope their efforts can help prevent the thousands of deaths caused by fake medicines every year.”
Study Finds 'Inconclusive' Evidence To Support Use Of WHO-Backed Drug To Prevent Hemorrhage During Labor
According to a study published Monday in the Journal of the Royal Society of Medicine, “[t]he World Health Organization [WHO] should review its approval of a drug used to prevent life-threatening bleeding in women in childbirth because there is not enough evidence that it is effective,” Reuters reports. The study finds that “the evidence to support the use of misoprostol is ‘at best inconclusive,’ yet it is increasingly used in poorer countries to prevent postpartum hemorrhage (PPH),” the news service writes, noting “researchers analyzed 172 previous studies on the use of misoprostol during labor and found that only six had enough information to say whether or not the drug was effective in preventing PPH in rural and community settings in poor countries” (Kelland, 8/20).
“Ethiopia is preparing for a flood of medical doctors within ‘three to four years,’ an influx meant to save a public health system that has been losing doctors and specialists to internal and external migration,” IRIN reports. “‘We are now implementing strategies that intend to increase the current below-World Health Organization [WHO] standard number of medical doctors and retaining them in public hospitals,’ Tedros Adhanom, Ethiopia’s minister of health, told IRIN,” the news service writes. “‘We have now reached an enrollment rate of more than 3,100,’ [Adhanom] said,” adding, “The rate of enrollment in the country’s medical schools has increased tenfold from 2005, when it was below 300,” according to the news service.
Building on its seven-year-old National Rural Health Mission (NRHM), India’s government plans to launch the National Urban Health Mission (NUHM), which “will focus on improving health care delivery and public health systems,” the Lancet reports. Prime Minister Manmohan Singh recently “expressed hope that the two programs together will in the future lead to a unified National Health Mission,” according to the journal. “Unplanned urbanization brings forth a whole set of new health problems. [The] urban poor are three times more likely to die before attaining the age of five years, 20 times more likely not to have any antenatal care, three times less likely to get primary immunization, and two and a half to three times more likely to be stunted and wasted than urban richest,” Chandrakant Pandav, head of the Centre for Community Medicine at the All India Institute of Medical Sciences, New Delhi, said, citing the third National Family Health Survey, the Lancet notes (Bhaumik, 8/11).
Inter Press Service reports on the successful efforts of Tanzania’s Kigoma Region “to train assistant medical officers to conduct life-saving c-sections at its rural health centers,” allowing pregnant women with complications to deliver at more local facilities instead of having to travel to regional or district hospitals. Tanzania’s maternal mortality rate is high, at 578 deaths for every 100,000 live births, IPS notes. “[A]t one point the Kigoma Region had the highest rate in the country, at 933 per 100,000 live births in the early 1980s,” but “maternal mortality in this region [now] is considered to be lower than in the rest of the country,” according to the news service.
The U.S. Government Accountability Office (GAO) recently released two reports on issues related to global health. In “Ensuring Drug Quality in Global Health Programs,” the agency writes, “Concerns have been raised about the potential for substandard drugs to enter the supply chains of global health programs,” and notes that it concluded, “U.S.-funded global health programs have put regulatory and policy requirements in place to help prevent procurement of substandard drugs” (8/1). In another report looking at the WHO, titled “Reform Agenda Developed, but U.S. Actions to Monitor Progress Could be Enhanced,” GAO found, “The United States has provided input into WHO’s reform agenda, particularly in the areas of transparency and accountability, but the Department of State’s (State) tool for assessing progress in the area of management reform could be enhanced” (7/23).
BBC News reports on a $15 million college in northern Nigeria’s Jigawa state that is working to train nurses and midwives. The first class of the three-year program is expected to graduate in September, and “[t]he hope is these new nurses and midwives will stay in Jigawa’s villages once their training is complete, rather than drifting to towns and cities where the work is usually better paid,” BBC notes, adding, “The college represents a start in addressing what has been a gaping lack of resources.” Four years ago, there were 14 midwives trying to serve “the state’s population of 4.5 million people” and “cover more than 600 small health centers,” BBC continues. However, a British-funded project called Paths 2, which aims “to reduce the state’s high level of preventable deaths among pregnant women,” has helped facilitate the creation of training programs for local health care workers, the news service notes (Dreaper, 8/2).
On the first stop of a 10-day tour of Africa, Secretary of State Hillary Clinton stopped at the Phillipe Maguilen Senghor Health Center in Dakar, Senegal, where Awa Marie Coll-Seck, the country’s minister of health, “explained to Secretary Clinton how these operational centers dramatically improve maternal and child health,” according to a post in USAID’s “IMPACTblog.” Coll-Seck “also noted that USAID-supported distribution of insecticide impregnated mosquito nets across the country had drastically reduced the incidence of malaria,” according to the blog, which adds that Clinton “was pleased to hear that the United States is playing a key role in helping meet one of its biggest challenges: decentralizing services so they are available at the village level throughout the country.” In an address several hours later, “Clinton invoked the Senghor center … saying she was highly impressed by the integrated nature of the facility” and that “[i]t was a successful model she hoped could be duplicated throughout Senegal and the entire West African region” (Taylor, 8/1).