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Recent Releases In Global Health

Lancet Perspective Offers Ethical Case For Pursuing Polio Eradication

A Lancet perspective piece examines the ethical case for pursuing polio eradication, ahead of an anticipated announcement by the World Health Assembly next month to endorse an aggressive strategy to stop polio transmission. “In a world of limited and finite resources there have to be trade-offs. Pursuing the eradication of one disease will inevitably raise questions. Why eradicate polio and not focus resources towards something else? Are moral duties absolute in a world of fixed resources? Are there easier rescues?” the authors ask. “These are legitimate questions. It need not be the case, however, that disease prevention, detection, and treatment should be selected at the expense of eradication of specific diseases, or vice versa.”

The piece concludes, “Failure to complete polio eradication now could undermine plans to target other infectious diseases in the future. We are on the last kilometre of a marathon; surely it is worth crossing the finish line?” (Emerson/Singer, 4/17).

Lancet Examines Global Burden Of Acute Lower Respiratory Infection In Children Under 5

“Acute lower respiratory infection (ALRI) is the leading cause of global child mortality,” according to a Lancet study that quantifies the global burden of the infections on children under five in 2005. Based on systematic review data, the authors found there were an estimated 33.8 million new episodes of Respiratory syncytial virus (RSV)-associated ALRI in children who were under five in 2005. Additionally, the study adds, “66,000 – 199,000 children younger than 5 years died from RSV-associated ALRI in 2005, with 99% of these deaths occurring in developing countries” (Campbell et al., 4/16).

“Respiratory-tract infections remain the foremost cause of death in young children and are a major obstacle to achievement of Millennium Development Goal 4 – to reduce under-5 mortality by two-thirds by 2015,” an accompanying Lancet comment notes. “The current burden of RSV in young children indicates the potential of an effective vaccine. However, information from developing countries – where most of the world’s children live – is scarce, making estimation of childhood disease and mortality a challenge. … The current increase and preponderance of the burden of RSV in nations with limited resources, suggested by these findings, should help to focus strategies for control of RSV” (Breese Hall, 4/16).

Blog: Senate Committee Calls On Ugandan Government To Reject Anti-Homosexuality Bill

“The Senate Foreign Relations Committee [on Wednesday] approved a resolution opposing Uganda’s Anti-Homosexuality Bill,” saying that “‘such laws undermine our commitment to combating HIV/AIDS globally’ by stigmatizing and criminalizing at-risk populations,” according to the “Science Speaks” blog.

The resolution “calls on Uganda’s Parliament to reject the bill and similarly urges other countries ‘to reject and repeal similar criminalization laws.’ It was introduced by Sens. Russ Feingold, D-Wisc., Tom Coburn, R-Okla., Ben Cardin, D-Md., and Susan Collins, R-Maine” (Shesgreen, 4/14).

Kaiser Policy Brief Highlights Issues, Questions Regarding GHI

A Kaiser Family Foundation policy brief highlights several key issues and questions surrounding President Barack Obama’s Global Health Initiative. The brief was released during a GHI forum this week, hosted by the Foundation, during which senior Obama administration officials shared details regarding the implementation of the GHI. A webcast of the forum is available here (4/14).

WHO Launches Commission On Women’s Health In Africa

The WHO on Wednesday launched a Commission on Women’s Health for Africa, according to a WHO press release. “The 17 member multidisciplinary Women’s Health Commission, set up by WHO Regional Director for Africa, Dr. Luis Sambo, will provide more evidence on the key factors influencing the current state of women’s health in Africa and make recommendations on what needs to be done across all sectors to achieve rapid and sustainable improvements,” the release notes, adding, Liberian President Johnson-Sirleaf will serve as the Commission’s Honorary President (4/14).

Blog: Decrease In Maternal Mortality Does Not Mean ‘Mission Accomplished’

“While the decrease in the maternal mortality ratio reported [this week] by the Lancet is a victory, it is anything but a ‘mission accomplished,’” a Huffington Post blog writes. For instance, the same report found, “HIV is responsible for more than 60,000 maternal deaths each year,” the blog notes.

“Further progress in reducing the global maternal mortality ratio cannot be achieved without an aggressive shift towards comprehensive health programs that integrate HIV interventions and maternal health care,” the post continues before outlining other key factors for the U.S. to consider for its global health policy. “Reducing the maternal mortality ratio means honestly confronting the reality of illness. The decrease in the maternal mortality rate does not justify a decrease in attention, urgency, or funding. Rather, it requires a strategy that meets the needs of those it affects. HIV and maternal mortality have demonstrated that they are linked. U.S. policy needs to respond accordingly,” the blog concludes (Sippel, 4/14).

PLoS Medicine Study Proposes New Method For Tracking Child Mortality

“A vital registration system that captures all births and deaths is the optimal way to monitor trends in child mortality; however, very few developing countries have complete vital registration systems,” write the authors of this PLoS Medicine study that proposes new methods for estimating under-five mortality using summary birth history data. “If we are to make rapid progress with the unfinished agenda of reducing child deaths, policy and practice must be better informed by more comprehensive, relevant, and timely information. Systematic application of the methods proposed here will establish that evidence base, and thereby increase accountability among countries and the global health community to accelerate efforts to reduce the global toll of child deaths,” the authors conclude (Murray, Rajaratnam et al., 4/13).

“A priority for the improvement of the measurement of mortality in developing countries should be to increase the empirical underpinnings in countries without high-quality death registration data systems,” writes a related PLoS Medicine perspective. “Such improvements should include promotion of prospective measurement through civil registration systems as a mid- to long-term investment; regular demographic and health surveys with full or, if that is not possible summary, birth histories and sibling survival histories; and decennial censuses with the appropriate mortality questions” (Mathers and Boerma, 4/13).

More Data Needed To Determine Effectiveness Of Indoor Residual Spraying For Malaria Prevention, Cochrane Review Finds

Although it is widely accepted that indoor residual spraying (IRS) – the spraying of the walls of homes with insecticides – works in the prevention of malaria, “the number of high-quality trials are too few to quantify the size of effect in different transmission settings,” conclude the authors of this Cochrane review (4/14). “Given the World Health Organization’s 2007 decision to move towards world-wide malaria eradication, policy makers now also require good evidence on the combination of both IRS and ITNs [insecticide-treated nets],” according to a Wiley-Blackwell press release. “Currently we have no evidence to show whether or not a combination would be justified both from the cost and the impact side and this needs to be urgently generated,” study co-author Christian Lengeler said in the release (4/13).

American Enterprise Institute Journal Examines WFP Transparency, Accountability

An article, appearing in The American journal, examines potential corruption in the World Food Program (WFP), and notes that “[a] significant part of its budget comes from U.S. contributors, and USAID coordinates some of its work through the WFP.”

“Certainly an agency as large and diffuse as WFP – it has offices in 80 countries and provides food relief to 100 million people a year – is bound to have some problems. But questions remain as to how WFP executives monitor their vast network and how transparent and responsive they are when questions arise. … Why hasn’t the WFP, which portrays itself as a model of transparency, opened its books so the international community can exercise appropriate accountability and oversight? And what actions are other international agencies requiring of humanitarian aid agencies to ensure transparency?” (Bruckner/Entine, 4/11).

Blog: Recommendations For How Global Fund, PEPFAR, World Bank Should Use Funds

A “Global Health Policy” blog post outlines the recommendations from a recent Center for Global Development report on funding strategies for the Global Fund to Fight AIDS, Tuberculosis and Malaria, PEPFAR and the World Bank. Before noting the recommendations, the blog writes: “As funding becomes more constrained, donors and recipient countries will need to do more and better with the same amount of money – for HIV treatment, prevention and care, health systems strengthening, family planning, maternal and child health and nutrition. This pressure pushes donors to ensure that funding goes only to the most effective programs” (Oomman, 4/8).

Washington Quarterly Examines Strategies For Global Hunger Reductions

A Washington Quarterly article discusses strategies to reduce hunger worldwide. “Make no mistake: the battle against global hunger vulnerability is winnable. The risk paradigm that has long placed the burden of managing food uncertainty on the hungry poor can be transformed to build lasting resilience. Combined with strong national policy frameworks and essential farm trade and subsidy reforms through a successful Doha round of global trade negotiations, these initiatives can drive investments in food and agriculture” (Sheeran, April 2010).

Advocacy Group’s Recommendation For Enhancing Global Food Security

A Partnership to Cut Hunger and Poverty In Africa policy brief makes recommendations for six actions the U.S. government could take to deal with food security challenges. The recommendations are based on February forum, which is summarized here (April 2010).

State Department Journal Examines How Agriculture Can Expand Global Food Security

A recent issue of the State Department’s eJournal USA titled, “21st –Century Agriculture,” examines agricultural approaches to feeding the growing world population. The publications features articles from Obama administrations officials, scientists and winners of the World Food Prize. “The marriage of technical prowess and agricultural skill promises advances on many fronts: a greater abundance of food, much of it more healthful, and available in a global marketplace that affords more of us access to this bounty,” according to the introduction from the editors (March 2010).