Blog Posts by Jonathan Quick

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

Originally posted on Devex.

“If you want to go fast, go alone,” says an African proverb. “If you want to go far, go together.”

It’s been thirteen years since the international community adopted the Millennium Development Goals, an ambitious, self-imposed “report card” for global development that helped focus attention and resources on issues like HIV and AIDS. Since then, the global HIV response has gone fast. In 2002, just 300,000 people with HIV were receiving antiretroviral therapy in developing countries; today, UNAIDS reports, treatment reaches nearly 10 million.

{Photo credit: MSH}Photo credit: MSH

This post originally appeared on Devex.com.

The Afghan health system was in shambles after the Taliban government was chased from power in December 2001. Immunization rates had fallen below 20 percent and nine out of ten women were on their own for labor and delivery. Suhaila Seddiqi, newly appointed as public health minister, could have begun her tenure with highly visible and politically popular moves like building hospitals in the major cities. She didn’t. Instead, she led the development of a basic package of essential primary care services and coordinated its delivery to Afghans throughout the country, including remote rural areas. It worked. By 2010, twice as many Afghans had access to family planning, maternal deaths were down by two thirds, and reductions in child mortality had saved 150,000 lives.

{Photo credit: Dominic Chavez}Photo credit: Dominic Chavez

(This post has also appeared on the Bill & Melinda Gates Foundation blog, Impatient Optimists and on the blog of the Frontline Health Workers Coalition.)

Our MSH colleague Lucy Sakala was an HIV counselor in Malawi. She worked with clients who were receiving HIV tests. When clients were diagnosed HIV positive, many were eligible for treatment and could begin antiretroviral therapy. HIV care had become available in Malawi because of transformative efforts to reduce ARV prices and increase their availability, such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, TB and Malaria.

Dr. Jonathan Quick, President and CEO of MSH, tours with Dr. Christian Nzitimira, director of Kibagabaga Hospital in Rwanda. {Photo credit: Jon Jay/MSH.}Photo credit: Jon Jay/MSH.

In a postoperative ward of Kibagabaga Hospital, the district hospital serving Rwanda’s capital city of Kigali, Eric Bizimana sits up in bed. Bizimana, 25, had sought care after severe pain in his right leg forced him to stop work as a barber. He was diagnosed with a bone infection called osteomyelitis. Antibiotics alone couldn’t clear the infection. Without an operation to remove the diseased bone, Eric faced the possibility of losing his leg.

Eric was one of the 40 patients who enter Kibagabaga for surgery every day. In Rwanda’s tiered healthcare delivery system, patients are referred from local health centers up to the district hospital when their conditions require more complex care. Most babies are delivered at health centers, for example, but a woman suffering complications or who was expected to need a C-section would be referred to the district level.

Mary Ngari, Permanent Secretary of Kenya’s Ministry of Medical Services, addresses conference attendees on the first day. {Photo credit: MSH.}Photo credit: MSH.

In my 35 years working in international health, I've attended hundreds of conferences. Conferences are opportunities to exchange ideas and form connections. They’re often fascinating. But once in a while a conference itself can be a pivotal moment. A great example was last year’s International AIDS Conference, the first held in the United States after President Obama finally lifted the longstanding travel ban against foreigners living with HIV.

And recently, people around MSH, and throughout the Kenya health community, have been talking about Kenya’s First National Conference on Health Leadership, Management and Governance. The conference, held in early February, demonstrated the long-term vision of the Kenyans who are running the health system. These leaders understand the value of training health systems managers to improve the quality of service delivery.

Dr. Quick discusses Myanmar’s health system with Dr. Pe Thet Khin, the minister of health. {Photo credit: Myanmar Ministry of Health.}Photo credit: Myanmar Ministry of Health.

In Myanmar, 50 years of military dictatorship left behind a seriously underdeveloped health system, serving barely one in twenty of the country’s 60 million people. You might expect that the first minister of health under civilian rule would be despondent. But on my recent trip I found the opposite: Dr. Pe Thet Khin and his team are aligned around an ambitious vision for building a strong health system for the country.

MSH: Saving lives and improving health in 2013.{Image credit: MSH.}Image credit: MSH.

We have seen some remarkable gains in global health in 2012. Yet millions of women, children, and men still die from preventable causes. As we pause and reflect on 2012 and look ahead to the new year, I invite you to read and share some of our favorite blog posts from the year.

Richard Horton moderates a panel on post-2015 development goals. {Photo credit: HSR-Symposium.org}Photo credit: HSR-Symposium.org

Last month, I joined over 1,800 participants from more than 100 countries in Beijing at the Second Global Symposium on Health Systems Research. We've made some concrete steps forward since we last met in Montreux, Switzerland, two years ago, among them the launch of a new research society Health Systems Global. Central topics of this year's discussions included: “Inclusion and Innovation towards Universal Health Coverage” (UHC), the symposium theme, and monitoring and evaluation.

Democratic Republic of the Congo {Photo credit: MSH.}Photo credit: MSH.

Last night, while in the Democratic Republic of the Congo (DRC) visiting our programs, I attended a US election-eve gathering of mostly Congolese people in Kinshasa. The DRC is one of those “distant nations” President Obama was referring to in his early morning acceptance speech today, where people are, “risking their lives just for… the chance to cast their ballots like we did today.”

Fragile, conflict-ridden nations, such as the DRC, struggle with leadership and governance. Its people have been victims of horrific violence, stunning gender inequality, and some of the worst health conditions in the world. They deserve better.

The United States reelected President Barack Obama to lead not only our country, but also to lead on addressing global health and other global development challenges such as those faced by the DRC.

Management Sciences for Health (MSH), a global non-profit organization dedicated to saving lives and improving health for the poorest and most vulnerable in the world, has long been a partner with the US government, foundations, and other donors, working in more than 140 countries to build stronger and more sustainable health care systems.

A Rwandese woman shows her child's community-based health insurance card. {Photo credit: C. T. Ngoc/MSH.}Photo credit: C. T. Ngoc/MSH.

Eugénie, a widow in Rwanda, farms to provide for her children. In January 2012, she had surgery to remove a tumor, a procedure that would have devastated her family economically if she did not have insurance. Rwanda’s health insurance program is the most successful of its kind in sub-Saharan Africa: it supports the health of more than 90 percent of the population, including the most vulnerable, like Eugénie.

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