Blog Posts by Jonathan Quick

{Photo credit: MSH staff, South Africa}Photo credit: MSH staff, South Africa

This post, first published on The Huffington Post, is part 5 in the MSH series on improving the health of the poorest and most vulnerable women, children, and communities by prioritizing prevention and preparing health systems for epidemics. Join the conversation online with hashtag .

Struck with a prolonged and worsening illness, Faith, a 37-year-old Nairobi woman raising her two children, sought help from local clinics. She came away each time with no diagnosis and occasionally an absurdly useless packet of antihistamines. Finally, a friend urged her to get an HIV test. When it came back positive, Faith wanted to kill herself, and got hold of a poison.

All epidemics arise from weak health systems, like the one that failed to serve Faith. Where people are poor and health systems are under-resourced, diseases like AIDS, Yellow Fever, Ebola, TB, Zika, Malaria, steadily march the afflicted to an early grave, decimating families, communities and economies along the way.

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

This post appears in its entirety on HuffPost Impact.

Pandemics are back on the agenda for the 2016 G7 Summit, which convenes this week in Ise-Shima, Japan. The Group of Seven is expected to further its commitments to global health security.

Look what has happened in less than one year since the G7 last met (June 2015), just after the Ebola crisis peaked at over 26,300 cases, 10,900 deaths.

 {Photo credit: Associated Press/Aurelie Marrier d’Unienvil}Women celebrate as their country is declared Ebola free in the city of Freetown, Sierra Leone, Saturday, Nov. 7, 2015.Photo credit: Associated Press/Aurelie Marrier d’Unienvil

When 18-year-old Ianka Barbosa was 7 months pregnant, an ultrasound showed the baby had an abnormally small head, a dreaded sign of microcephaly due to Zika infection.  Upon hearing the news, Ianka’s husband fled. In her poor neighborhood of Campina Grande, Brazil, Ianka soon became a young mother alone.

As Ianka’s baby Sophia grows, she may never walk, or talk. She could develop seizures before she reaches six months.  By the end of the year there may be a staggering 3,000 Sophias in Brazil – mostly in the poorest places.

Epidemics erase the gains women have achieved.

The world has suffered a series of “Zikas”—virtually unknown diseases that seemed to come from nowhere and explode with devastating consequences for families and entire countries – before Zika, Ebola, SARS, AIDS, and others.

Epidemics don’t just leave behind a death toll.  They can demolish the gains women have made in maternal, newborn, child, adolescent, and reproductive health—gains that have been propelled by women’s rights and empowerment. 

 {Photo credit: Fred Hartman/MSH}Billboard, Liberia.Photo credit: Fred Hartman/MSH

[Universal Health Coverage Day.]Universal Health Coverage Day.Management Sciences for Health (MSH) bloggers are discussing universal health coverage (UHC) and why we support health for all this week, leading up to Dec. 12, UHC Day. MSH is a founding member of the UHC Day coalition. Today, MSH authors Chelsey Canavan, Jonathan Jay, and Dr. Jonathan D. Quick discuss if, and how, UHC could help prevent major outbreaks, like the current Ebola virus outbreak in West Africa.

This post originally appeared on Devex.

Dec. 12, marks Universal Health Coverage Day, the second anniversary of a United Nations resolution endorsing UHC as a global priority. The last two years have seen a growing consensus that pursuing UHC will save lives and alleviate poverty, especially in developing countries.

Meanwhile, the devastating Ebola crisis continues to claim lives and stifle opportunity in West Africa. Observers were quick to note that UHC could have helped arrest the spread of Ebola, yet countries like Nigeria, Uganda and the Democratic Republic of the Congo — all quite early on their paths toward UHC — have successfully contained Ebola outbreaks.

So is UHC really the answer?

Ebola shows us that more resources must go toward public health infrastructure. That’s an important lesson for UHC reforms, which could easily overlook those investments in favor of individual health services. UHC strategies can’t rest on individual service delivery to mitigate major health threats. When we imagine UHC, we should see institutions and organizations actively promoting the public’s health—long before the need for emergency response.

{Photo credit: Todd Shapera.}Photo credit: Todd Shapera.

In a health clinic outside Nairobi, Kenya, Janet* waits to see a doctor. Janet is a 32-year-old widow and mother of four from Kibera, a neighborhood of Nairobi. Her 11-year-old daughter, Jane*, isn’t feeling well. Both mother and daughter are HIV-positive.

Janet and Jane are lucky to live walking distance to the Langata Health Center, where they receive high-quality health care for free. Jane has been on antiretroviral medication for more than two years. Janet hasn’t paid a shilling. Around the world, millions of people living with HIV struggle to pay for care, or receive none at all. But Janet and Jane are among the 600,000 Kenyans whose HIV care is free through programs from the Government of Kenya, US President's Emergency Plan for AIDS Relief (PEPFAR) program, and The Global Fund to Fight AIDS, TB and Malaria.

Janet wishes everyone could receive the same care that she does at Langata. But even for her, the system just barely works. She explains:

The doctor is only one, and we are many.

Patients at Langata face long waits to see a doctor or pick up their medications. Patients like Janet spend hours away from work and may have to arrange for child care.

{Photo credit: Rui Pires.}Photo credit: Rui Pires.

Cross-posted with permission from WBUR's CommonHealth Blog.

A study released last week found that insurance is saving lives in Massachusetts. Expanded coverage will mean 3,000 fewer deaths over the next 10 years. We have state-of-the-art health facilities and are among the healthiest of Americans. Despite the fiasco of our failed enrollment website, the state maintains near-universal health coverage, and inspired the Affordable Care Act.

Our example is heartening not just for America, but for the many low- and middle-income countries around the world working toward universal health coverage. These countries aren’t just taking a page from our book, though — they have valuable lessons for us, too.

Here are four things Massachusetts could learn about health from developing countries:

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

“A world where everyone has the opportunity for a healthy life.” This is MSH’s vision, guiding our efforts every day to save lives and improve health among the poorest and most vulnerable populations. In 2014, universal health coverage (UHC) will play a pivotal role in helping us attain this vision.  MSH has vigorously supported UHC because we’re committed to the human right to health, deeply embedded in UHC, and because it’s the only approach that transforms health systems to mobilize all available resources towards the affordable, quality health services that people need.

{Photo credit: Rui Pires. Uganda.}Photo credit: Rui Pires. Uganda.

The world needs more girls like "Alana".

Alana is one of the "lucky" ones. Just five years ago in Uganda, a child had more than a 1 in 10 chance of dying before she reached her fifth birthday. Today the odds have improved slightly, but Uganda remains among the top countries with some of the highest rates of death for children under-five. As the father of three daughters myself, I simply can’t accept that a child’s chance of surviving depends upon where in the world she happens to have been born.

When I see a photo like this, of a bright-eyed girl from a village in Uganda accessing the health care she needs and getting well, I’m reminded why Management Sciences for Health (MSH) works every day to further our vision of a world where everyone has the opportunity for a healthy life.

We’ve come a long way: we’ve reduced child mortality by nearly 70 percent in just 50 years. But a child born in a low-income country is still 18 times more likely to die before the age of five than a child born in a wealthy country.

The tragedy is that we already know how to prevent most child deaths through low-cost, high-impact interventions.

Screenshot of Heartfile website

When in 1995 entrepreneur Jeff Bezos launched Amazon.com from his garage in Seattle (USA), fewer than 1 in 200 people worldwide had internet access and online shopping was just a year old. Today, Bezos’ innovative website has made Amazon.com the world’s largest online retailer, with $60 billion in annual sales – $170 million a day. Online shoppers see Amazon.com as their primary interface—this is the technology innovation. Amazon.com and its accompanying vast information technology capabilities can predict what we want. It catalogues our searches and purchases, and gives us suggestions of what we want.

A brilliant example of the power of technology innovation – right? Only half right. What we don’t see is actually more profound: it’s the power of partnering technology innovation and systems innovation. If you thought Amazon’s secret sauce was simply the technology innovation, think again. In fact, it’s the systems innovation that makes Amazon work. 

[Systems model: Amazon.com] {Graphic by MSH}Systems model: Amazon.comGraphic by MSH

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

This post originally appeared as part of a series produced by The Huffington Post and the NGO alliance InterAction around the United Nations General Assembly's 68th session and its general debate on the Millennium Development Goals (MDGs).  

Thirty years ago, I was a young physician practicing family medicine in rural Talihina, Oklahoma. We saw unusual cases, including snakebites and a man who survived a gunshot through the heart. But what I loved most was delivering babies – bringing new lives into the world and great joy to parents. Sadly, my most vivid memory from those years is of a baby girl who didn’t make it. Her parents, first-time pregnant, didn’t recognize the warning signs. When they reached the hospital, our team was too slow.  Too late.

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