HIV & AIDS

MSH President & CEO Jonathan D. Quick says: "Let this be a loud call to action for greater investment in strong local health systems and global networks..." in today's The New York Times.

"Let this be a loud call to action for greater investment in strong local health systems and global networks to prevent, detect and respond to public health threats. We know how to prevent the next local outbreak from becoming the world’s next major epidemic," says MSH President & CEO Jonathan D. Quick in a Letter to the Editor, published today in The New York Times.

Dr. Quick responds to “Yes, We Were Warned About Ebola,” an April 7 opinion editorial by Bernice Dahn, Vera Mussah, and Cameron Nutt, saying:

Dr. Dahn, the chief medical officer of Liberia’s Ministry of Health, and her colleagues express dismay that missed information from 1982 contributed to the gravely flawed conventional wisdom that Ebola was absent in West Africa. An even greater error of conventional wisdom was the longstanding misjudgment by experts that Ebola was a “dead-end event,” killing its human host too quickly to spread out of control.

On behalf of our 2,200-plus worldwide staff, we wish you, your family, and communities, a happy World Health Day!

This World Health Day, we celebrate the heroes among us: health workers. We envision a world where everyone has the opportunity for a healthy life. Says a nursing officer from Kenya:

My vision is to have the best maternal services in this community.

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For more than 40 years, MSH has expanded access to quality maternal, neonatal, and child health services by strengthening all levels of the health system.

We support health workers at all levels -- ministries of health, community volunteers, midwives, medicine shop owners, nursing officers, and more -- so that every woman and newborn, even in the most remote areas, has the opportunity for a healthy life.

Envision a world where everyone has the opportunity for a healthy life!

 {Photo credit: Bright Phiri/MSH}Delegates learn about pharmaceutical management from Systems for Improving Access to Pharmaceuticals and Services (SIAPS) Program staff while visiting Mokopane Hospital in Limpopo Province, South Africa.Photo credit: Bright Phiri/MSH

Management Sciences for Health (MSH) sponsored a Congressional Staff Study Tour to South Africa and Zambia in February 2015 to examine the local impact of US funded health capacity strengthening in Southern Africa. During the trip, site visits and meetings highlighted the impact of local health capacity building efforts in pharmaceutical management of essential medicines and HIV & AIDS drugs and technical and managerial development opportunities for community workers.  

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

Nearly three years ago, I blogged about a systems approach to improving access for a Maternal Health Task Force (MHTF) series on maternal health commodities:

Increasing access to essential medicines and supplies for maternal health requires a systems approach that includes: improving governance of pharmaceutical systems, strengthening supply chain management, increasing the availability of information for decision-making, developing appropriate financing strategies and promoting rational use of medicines and supplies.

 {Photo credit: Emily Phillips/MSH Afghanistan}A postnatal woman with her newborn and mother-in-law.Photo credit: Emily Phillips/MSH Afghanistan

Last month I represented Management Sciences for Health (MSH) at Oxfam India’s South Asia Consultation on Maternal Health in Kathmandu, Nepal. The purpose of the meeting was to discuss significant maternal health programming experiences in Afghanistan, Bangladesh, India, Nepal, Pakistan, and Sri Lanka, and to suggest strategic directions for Oxfam India’s future maternal health programming. More than 30 representatives from governments, national and international universities, and nongovernmental organizations attended.

Three elements of improving maternal health outcomes stood out in my mind from discussions at the meeting:

{Photo credit: MSH staff/Afghanistan}Photo credit: MSH staff/Afghanistan

“I started feeling this coughing… so I went to the health center and got tested. It was positive for TB,” says Grace*, a young Ugandan woman. She started on medicines, but after two months, she stopped adhering to treatment.

They told me to continue with the drugs for five more months, but I stopped.

I thought I was ok.

She started coughing again, went to the hospital, and was diagnosed with multidrug-resistant TB (MDR-TB). MDR-TB cannot be treated with two of the most powerful first-line treatment anti-TB drugs. Her treatment regimen? Six months of injections and two years of drugs.

{Photo credit: Andrew Esiebo/MSH Nigeria}Photo credit: Andrew Esiebo/MSH Nigeria

I am a woman. I am a Nigerian. I am a mother. I am a leader. And, I am a daughter. As the Nigerian country representative, I guide Management Sciences for Health (MSH)’s efforts to ensure the people of my country have access to quality health services. Indeed, I am many things. Before all else:

I am a woman of Nigeria.

The Girl Child in Nigeria

From the beginning, our girl children are at a disadvantage.

Our culture (like many are) is strongly patriarchal. The boy child is given higher status than the girl child. If a family has to choose, the boy child is the first to go to school. The girl child is the first to be dropped from school.

No matter how young she is, the girl child feels that it is her responsibility to care for her siblings. She is expected to take on added responsibilities and earn money to keep the other children. This pressure frequently leads to early sexual activity, transactional sex, and sex with older men-- increasing her risk of getting HIV and other sexually-transmitted infections.

Then Boko Haram came to the North East Zone of Nigeria. They take our girls away. They abuse them. They rape them. They marry them off to older men.

{Photo: Dominic Chavez}Photo: Dominic Chavez

The key element of any health system is the people who run it. Nowhere is this more true than in countries in the midst of, or recovering from, conflict. Indirect or direct threats faced by health workers exacerbate a population’s challenges in seeking and receiving health care.

In conflict settings, health workers may be forced to flee to safe havens as refugees, internally displaced people, or leave the country as migrants—if they have the means to do so. Some of the most capable are absorbed into international agencies. Those who remain frequently have insufficient resources to perform their jobs and must carry on as best as they can under daunting circumstances.

This situation has worsened in recent years with a growing number of direct attacks on health workers in fragile states, such as those against polio vaccinators in Pakistan and Nigeria. These blatant violations of the Geneva Conventions inhibit an already difficult environment for the delivery of health services and the recovery or development of the health system.

When Mearege gets really sick, her husband leaves town. Bedridden and in the care of her parents, Mearege gets tested and learns she--and her daugther--are HIV-positive. Through the support of mother mentors, trained by the Ethiopia Network for HIV/AIDS Treatment, Care and Support Program (ENHAT-CS), Mearege finds solace, guidance, and healing -- and decides to have another child.

Mearege is one of many HIV-positive women in Ethiopia whose lives have been transformed, with the support of ENHAT-CS. Says Mearege:

I was able to have a healthy child because I followed up with the mentor mothers and applied their teaching...

Presented by ENHAT-CS in partnership with the National Network of Positive Women Ethiopians, this video is made possible by the generous support of the US President's Emergency Plan for AIDS Relief (PEPFAR) through the US Agency for International Development (USAID).

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