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Lancet Articles Address Variety Of Global Health Issues

Health Community Should Welcome Human Rights Community’s Help With Reducing Maternal Deaths

Efforts by the human rights community to reach the 2015 U.N. Millennium Development Goal of reducing maternal deaths by three-quarters “should be welcomed by the health community,” according to a Lancet editorial. “The health community must be willing to learn about human rights, realise the common ground, and work with human-rights professionals in a respectful, constructive, and practical partnership to prevent the unacceptably high number of maternal deaths that occur each year,” writes the Lancet (Lancet, 6/27).

Cash Transfers Can Improve Child Health

“Accumulating evidence from large-scale programmes is starting to show positive effects of cash transfer programmes on many levels,” and a new Save the Children report “highlights the importance of regular cash transfers, such as child benefits or pensions, as one crucial intervention to get Millennium Development Goal 4 – reduction of mortality in children younger than 5 years by two-thirds – back on track,” a Lancet editorial writes. The report makes “a very strong case to include child and maternal cash transfers, especially for young children, into the package of interventions to reduce neonatal and child mortality,” according to the journal (Lancet [2], 6/27).

More Evidence Needed To Support AMFm

In a Lancet Infectious Diseases reflection and reaction piece, Roger Bate of the American Enterprise Institute and Kimberly Hess of Africa Fighting Malaria examine the Affordable Medicines Facility for malaria (AMFm), which aims “to increase access to artemisinin-based combination therapies (ACTs) for the treatment of malaria” through subsidies. Although AMFm proponents cite “data from four pilot ACT subsidies as evidence that a worldwide ACT subsidy would be successful, “a report compiled by the Clinton Foundation and others… offers no conclusive evidence that the AMFm will achieve its goals and would therefore caution against such enthusiasm,” they write. “There are always costs of both action and inaction; however, before a costly scheme is funded, better evidence of its effectiveness should be established,” according to Bate and Hess (Bate/Hess, Lancet Infectious Diseases, 7/09).

Economic Crisis Presents Opportunity For Health System Strengthening

The current economic crisis, while “placing additional strains on a world that is already overburdened by its inability to meet the basic needs of billions of its inhabitants,” also presents the opportunity for health system strengthening, writes Julio Frenk, dean of the Harvard School of Public Health, in a comment appearing in the Lancet. Frenk writes, “There are several concrete actions to protect health during times of crisis, which the G8 could support as part of its efforts to strengthen health systems,” such as enhanced information systems and a commitment to the protection of health workers and workforce programs despite tightening budgets. “A crisis is not the time to stagnate into the status quo, but to be bold and imaginative in introducing innovations for universal social protection,” Frenk writes (Frenk, Lancet, 6/27).

HIV-Positive Children And Pneumococcal Vaccination

While efforts are underway in Rwanda to vaccinate all infants against pneumococcal disease by the end of 2009, an editorial appearing in Lancet Infectious Disease says “equally at risk older children with HIV are unfortunately not yet on the agenda.” Streptococcus pneumoniae “claims the lives of up to 1 million children every year,” with the deaths “disproportionately represented in the developing world, particularly in children infected with HIV of whom there are about 2 million in sub-Saharan Africa alone.” The authors conclude, “Global vaccination of children against pneumococcal disease is important, but will take time; we argue that vaccinating children that are HIV-positive is more feasible and worth implementing now” (Meehan et al., Lancet Infectious Diseases, 7/09).