Fragile States

Fragile States (including Afghanistan, Democratic Republic of Congo, Haiti, Liberia and South Sudan)

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

In 2012, the United Nations unanimously passed a resolution endorsing the concept of universal health coverage (UHC), urging governments everywhere to “provide all people with access to affordable, quality health care services”. Management Sciences for Health (MSH) and the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program are among global champions for UHC and joined global leaders celebrating UHC’s notable inclusion in the Sustainable Development Goals (SDGs) last Fall. Now, we continue to help countries face the obstacles of making UHC a reality.

Access to medicines has not always been at the forefront of the global discourse on UHC, which instead has tended to focus on financing. UHC programs must include adequate health financing and coverage of essential medicines if they are to deliver meaningful health outcomes. Policymakers attempting to establish and maintain UHC programs therefore need to have a sound understanding of the pharmaceutical sector and those pharmaceutical system components that must be considered to ensure ready access to the pharmaceuticals needed to support any UHC program.

 {Photo credit: Brigid Boettler/MSH}Expert panelists discuss MDR-TB (from left): Joshua Michaud, Kaiser Family Foundation; Alexander Golubkov, USAID; Muluken Melese, MSH, Ethiopia; and Kenneth Mutesasira, MSH, Uganda.Photo credit: Brigid Boettler/MSH

“When we started our project in 2011, there was no system in place to identify multidrug-resistant tuberculosis (MDR-TB),” explained Muluken Melese, project director for the Help Ethiopia Address the Low Tuberculosis Performance (HEAL TB) project. However, since then, the five-year USAID-funded project, implemented by Management Sciences for Health (MSH), has expanded access to TB services to over half the population of Ethiopia and led a 15-fold increase in the number of MDR-TB patients on treatment.

 {Photo credit: Matt Martin/MSH}About 20 of the nearly 30 MSH staff attending the 4th annual ICFP gather for the opening ceremony.Photo credit: Matt Martin/MSH

Three weeks ago, nearly 3,500 family planning researchers, program managers, and policymakers came together in Nusa Dua, Indonesia to discuss the latest research findings and best practices on family planning at the 4th International Conference on Family Planning (ICFP). It was the largest gathering of family planning enthusiasts to date.

Nearly 30 MSH staff from 8 countries attended ICFP, showcasing our health systems expertise and experiences in family planning.

 {Photo: MSH/Ashleigh Cooper}Panelists (from left) Jemal Mohammed, Director, Leadership Management and Governance Project, MSH; Tarek Rabah, Area Vice President, Middle East and Africa, Astra-Zeneca; and H.E. Dr. Kestebirhan Admasu, Minister of Health, Federal Democratic Republic of Ethiopia; and moderator Jeffrey Sturchio, CEO, Rabin Martin; at the Future of Health in Africa session.Photo: MSH/Ashleigh Cooper

Management Sciences for Health (MSH) joined more than 1,000 attendees, including global and local businesses and governments, at the Corporate Council on Africa (CCA)’s 10th Biennial US-Africa Business Summit, hosted in partnership with the African Union and the Federal Democratic Republic of Ethiopia, in Addis Ababa, this week. Established in 1993 to promote business and investment between the US and nations of Africa, CCA serves as a neutral, trusted intermediary connecting its members with essential government and business leaders. MSH joined the CCA as a member for the first time this year. Representatives from MSH Ethiopia and the US attended the summit.

Healthcare is growing and changing rapidly in Africa, and the demand for quality healthcare is creating opportunities for business investment and engagement. The Summit's Health track focused on the transition from the Millennium Development Goals to the Sustainable Development Goals; how public/private partnerships between businesses, NGOs, and governments can address the challenges and opportunities; and the importance of building resilient health systems and healthy workforces.  

{Photo: Gwenn Dubourthournieu}Photo: Gwenn Dubourthournieu

For the fourth year in a row, Management Sciences for Health (MSH) invited staff to submit stories about how health systems save lives and improve the health of the poorest and most vulnerable worldwide. MSH staff from 34 projects submitted over 50 stories from 2015. These 12 stories, selected by MSH staff judges, demonstrate how good storytelling and effective partnerships can save more lives.

In this special edition of our Global Health Impact Newsletter (subscribe), meet health workers, community leaders, pharmacy managers, beneficiaries working together toward healthier communities. Stories and authors appear alphabetically by country:

An Accredited Medicines Stores (AMS) seller receives an infrared thermometer to use in Ebola and other outbreak surveillance.

by Arthur Loryoun

Editor's note: This post originally appeared on the Bill & Melinda Gates Foundation's blog, Impatient Optimists. Funded by the Gates Foundation and led by Management Sciences for Health (MSH), the Sustainable Drug Sellers Initiative (SDSI) project worked to ensure the sustainability of public-private drug seller initiatives in Tanzania and Uganda, and to roll-out the initiative in Liberia.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

This blog post is a web-formatted version of the Global Health Impact newsletter: Stronger Health Systems Stop TB and Save Lives (December 2015). (View or share the email version here.) We welcome your feedback and questions in the comments or email us. On social media, use hashtag and tag .  Subscribe

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

This week, at the 46th Union World Conference on Lung Health (hashtag ), the US Agency for International Development (USAID)-funded and Management Sciences for Health (MSH)-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is launching a new tool to improve how the safety and effectiveness of medicines is monitored in low- and middle-income countries.

All medicines undergo rigorous clinical testing prior to being made publicly available. Continuing to monitor the safety and effectiveness of medicines in real world settings, also referred to as pharmacovigilance, is critically important to ensure that medicines can be used over a prolonged period of time, in conjunction with other medicines, among new patient populations, and in patients with multiple illnesses. 

Low- and middle-income countries, however, often lack the resources, capacity, and systems required to effectively implement pharmacovigilance activities. They often rely heavily on passive reporting methods which can underestimate potential medicines use issues.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Despite improvements in child survival in recent decades, children in low- and middle-income countries still suffer from illnesses virtually nonexistent in the industrial world.

Pneumonia is the deadliest of these, responsible for the death of 900,000 children under five worldwide in 2013—more than any other infectious disease.

And more children are killed by pneumonia in Democratic Republic of Congo (DRC) than in any other country except for India and Nigeria. Every year, approximately 148,000 children under five die of pneumonia, accounting for 15 percent of child deaths in the country.

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