In this post in the IntraHealth “Global Health Blog,” Kate Tulenko, senior director of health systems innovation at IntraHealth, provides an excerpt of her recently published book, “Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad,” in which she argues that the practice of “relying on foreign-born health workers to fill health care gaps, particularly in providing primary care … has dire economic and social consequences, threatening the quality of medical care in both source countries and the U.S.” (8/30). The blog also links to a recent interview by IntraHealth in which Tulenko discusses the issues raised in her book (8/29).
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“The top United Nations relief official said [.pdf] today that humanitarian efforts to alleviate the devastating food crisis affecting Mali have begun to yield results, but warned that much still remains to be done and the situation could worsen without continued donor support,” the U.N. News Centre reports (8/30). Under-Secretary-General for Humanitarian Affairs Valerie Amos “on Thursday called for more resources in Mali to save children from severe malnutrition,” Agence France-Presse reports. The widespread food crisis in the Sahel region is compounded in Mali by a militant insurgency in the north of the country, according to the news agency. “The food crisis, which follows a drought in 2011, has affected 4.6 million people in Mali alone,” and “[a]lmost 150,000 children across Mali have been treated for acute malnutrition … this year,” the news agency writes (8/30).
In this post in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Gary Darmstadt, head of the Family Health Division at the foundation; Wolfgang Munar, senior program officer in the Family Health Division; and Amie Newman, a communications officer and editor of the blog, highlight a recently published paper, “A model for scale up of family health innovations in low-income settings: a mixed methods study,” that proposes a framework to scale up successful maternal and newborn health interventions in order to “reach more communities and improve the health of many more people.” They write, “That framework, called AIDED (Assess/Innovate/Develop/Engage/Devolve), will help us get to the next level in terms of spreading the proven health care solutions to communities that desperately need them” (8/30).
“Abortions are just as safe when performed by trained nurse practitioners, midwives and physician assistants as when doctors do them, a new review of the evidence suggests,” Reuters reports. “Researchers analyzed five studies that compared first-trimester abortion complications and side effects based on who performed the procedures in close to 9,000 women — and typically found no differences,” the news service writes. The review is published in BJOG: An International Journal of Obstetrics and Gynaecology, according to the news service.
U.S. Ambassador to Nigeria Terence McCulley spoke on Monday in Abuja at the inauguration of a Defense Reference Laboratory, Leadership reports, noting he said the laboratory, “which is the first of its kind in the sub-region,” was supported by U.S. funding. According to the newspaper, McCulley said the Reference Laboratory Program is part of U.S. assistance to Nigeria through a partnership between the U.S. Department of Defense (DOD) and Nigeria’s Ministry of Defense (NMOD) through the Walter Reed Program (WRP-N) and the Emergency Plan Implementation Committee (EPIC), which began in 2005 (8/30).
Brazil is expanding its national HIV/AIDS treatment program to include about 35,000 additional people, the Associated Press/Seattle Times reports. “Ronaldo Hallal of the [health] ministry’s Sexually Transmitted Disease Department said people with 500 or fewer CD4 cells per cubic millimeter will receive antiretroviral HIV treatment,” increasing the cutoff from 350 or less CD4 cells per cubic millimeter prior to the expansion, the news service writes. The Ministry of Health noted on its website that the expansion will require spending an additional 120 million reals, or $60,000, annually, according to the news service, which adds, “Hallal said Brazil already spends 1.2 billion reals ($600 million) each year in its free anti-AIDS program that is currently treating 223,000 people.” The AP notes Health Minister Alexandre Padilla said in a statement, “Brazil will be the only large country in the world to offer this kind of treatment that will reduce the risk of opportunistic infections like tuberculosis” (8/29).
“Many innovative solutions are being proposed to help tackle the spread of counterfeit drugs in developing countries,” GlobalVoices reports. The blog includes highlights from several news articles and blog posts on the topic, including a number of solutions used to identify such drugs. The blog also includes a link to a TEDxBoston talk by Ashifi Gogo, an entrepreneur from Ghana, in which he “explains how his solution works by combining cell phones, community, and the cooperation of governments and pharmaceutical companies” (Rakotomalala, 8/30).
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).
The Center for Global Health Policy’s “Science Speaks” blog examines a recent study that found only slightly more than 44 percent of women in the Nyanza province of Kenya deliver their infants in a health care facility, with many women citing fear of stigma and discrimination as a reason for not attending clinics for prenatal care. Janet Turan of the University of Alabama led the study, published in the August edition of PLoS Medicine, as well as a literature review showing the impact of stigma and discrimination on efforts to prevent mother-to-child HIV transmission, according to the blog. The researchers “conclude that efforts to address HIV-related stigma in and out of health settings are needed, if efforts targeting maternal mortality and parent to child HIV transmission are to succeed,” the blog writes (Barton, 8/29).
Noting that a “thin place” is “a place or situation that Celtic Mystics believed to be a coming together of heaven and earth,” Gary Darmstadt, head of the Bill & Melinda Gates Foundation’s Family Health Division, and Wendy Prosser, a research analyst with the Family Health Division, write in the foundation’s “Impatient Optimists” blog, “The London Summit on Family Planning was a ‘thin place’ for the global health community and for millions of women around the world who want to plan their families. It was transformational for so many reasons.” They continue, “The Summit brought family planning back into the mainstream of global health conversations, a place it hasn’t been in decades. And it put the focus of that conversation on women and what they want — voluntary access to contraceptives and the ability to plan their families and their futures” (8/29).