Blog Posts by Jonathan Quick

When the Taliban were chased from power in Afghanistan in December 2001, the health system was in shambles---devastated by years of war and neglect. Access to primary care was below 10% and immunization rates had fallen below 20% throughout the country. Less than half the hospitals had both electricity and running water.  Medicines and medical supplies were scarce and the quality was often unreliable. There were essentially no female health workers active in most of the Afghanistan---a country in which cultural sensitivities mean female providers are essential for women’s health. Nine out of 10 women were on their own for labor and delivery, with no trained birth attendant. Not surprisingly, maternal, child, and infant mortality were among the highest in the world.

Dr. Ronald O'Connor, Founder of MSH, and Marcia Herrera, Director of Talent Management at MSH, co-authored this blog post.

Dr. David Sencer died on Monday, May 2, 2011 in Atlanta, Georgia at age 86. He died at Emory University Hospital, due to complications of heart disease.

Dr. Sencer, one of the major twentieth century public health thought leaders, was also one of the rarest: a warm-hearted, modest man of great accomplishments and lifelong dedication to Management Sciences for Health's mission of closing the gap between what is known and what is done to solve important public health problems around the world.

From 1986 until his retirement in 1993, Dr. Sencer was a valued MSH colleague and advisor; he served in the roles of Chief Operating Officer and Senior Fellow. Dr. Sencer led by empowering others; he believed that more could and would be done when leaders put the action, and often the visibility, in the hands of those most directly on the front lines of practical public health action.

Indeed, Dr. Sencer was doing it long before MSH was conceived, in a career that spanned many personal and professional challenges: Dr. Sencer overcame tuberculosis as a young physician and went on to lead many important health initiatives and institutions.

It’s common sense that a mother who is on treatment for AIDS, pregnant, has a sick child, and is accompanying a sister debilitated by Tuberculosis should not have to visit four separate service delivery points to receive care. Integrated health services not only make the world a healthier place, but also decrease the burden on health systems.

Integration is a comprehensive approach to service delivery. It is the transition from a vertical or horizontal approach to a diagonal, synergistic approach at all levels of a health system. Smart integration means coordinating disease specific programs (such as HIV and AIDS) with other health programs that have operated independently in the past (for example, family planning) to deliver services at the same time or, more importantly, with the same funding. Integration helps organizations maximize the impact of their health investments while allowing people, information, and funding to flow more easily among collaborating groups and stakeholders. Equally important, integration enables providers to treat the health needs of individuals and families more efficiently---regardless of the initial reason a person seeks care.

In March 2011, the CSIS Global Health Policy Center asked bloggers around the world: What should the key priority of the upcoming UN High Level Meeting on Non-Communicable Diseases be and why? We had a number of great submissions.  Dr. Jonathan D. Quick was one of our four finalists.  Read his entry below and look out in the days and weeks ahead for other finalist's blogs and another blog contest on NCDs. 

This was originally posted on smartglobalhealth.org.

The most common NCDs are diabetes, heart disease, cancers, and chronic lung diseases. According to the World Health Organization, about 36 million people die each year due to NCDs, and a quarter of NCD deaths are of people aged under 60; 9 in 10 of these people are from developing countries. Breast cancer kills over 270,000 women in the developing world each year.

Political and social momentum has been building, as the United Nations High Level Meeting on NCDs approaches, for a change from emergency, disease specific responses to an integrated systems-strengthening response.

Strong leadership, governance, and management are the cornerstones of successful global, national, and local efforts to save lives and achieve the  maximum impact from health investments. Yet effective leadership, management, and governance skills and practices too often are the vital missing elements in public, civil society and even private health organizations. Fortunately, these skills can be developed. They are best developed working in teams, in one’s own setting, over time, while facing real challenges.

With our partners, MSH works to build capacity at all levels within public and private organizations to improve leadership and management practices. Improved capacity ensures sound governance policies, creates a work climate that supports staff motivation, increases flexibility, and realigns staff to focus on common, achievable objectives.

Every day people are dying in the developing world because they cannot access affordable, quality medicines. Modern pharmaceuticals have revolutionized health care, but weak health systems prevent many people from accessing basic life-saving medicines. The health of men, women, and children can be dramatically improved throughout the world by enhancing access to and improving the use of essential medicines and other health care technologies.

Gaps in the management and availability of essential medicines and health commodities have been a constant weakness for developing countries. These gaps hamper the ability to access and distribute the pharmaceutical and medical supplies needed to treat infectious diseases. We have seen particular success in addressing pharmaceutical management challenges when interventions include: increasing access to products and services, improving the use of those products and services, promoting rational pharmaceutical use, developing public-private partnerships, providing thorough assessments and trainings, and improving procurement processes.

Millions of people around the world die each year from preventable diseases because they cannot access affordable health care. Developing countries often struggle with insufficient resources and they face numerous challenges trying to strengthen weak health systems. A strong health system working well at all levels, from the household to the community to health facilities to national authorities, can provide effective services to improve the health of the people they serve.

Health financing is the critical foundation for strengthening health systems and ultimately for achieving health impact. Health financing is the starting point – money is the fuel to start and keep a strong health system running. Health financing includes generating funds, distributing those funds, ensuring effective and efficiency use of funds, and protecting the poor from the financial hardship of accessing health services. Without financial resources and proper management of these resources, health workers, health facilities, and medicines would not exist. In difficult economic times, generating those resources seems an insurmountable task. Yet some countries are showing how it can be done.

MSH CEO, Jonathan Quick, MD, MPH moderates panel on AIDS, Human Rights, and Vulnerable Populations (Ben Greenberg/MSH)

Human rights are no longer considered peripheral to the AIDS response. Human rights are an essential tool of public health. 80% of countries explicitly acknowledge or address human rights in their national AIDS strategies. However, 80 countries still have punitive laws against people with HIV which pose significant challenges to the AIDS response

In the past decade, there have been some major developments in the HIV epidemic. New cases have decreased, 5 million people are now on treatment, and people are discussing the importance of human rights in relation to the disease. However, 33 million people are infected and only one-third of those in need of treatment are receiving it.

Health Workers in Southern Sudan

A few weeks ago, I had the opportunity to visit Southern Sudan. For over five decades, Southern Sudan endured civil war, unrest, and several waves of forced displacement and refugees. The infrastructure of nearly every sector was mostly destroyed throughout the region. It is a classic fragile state situation.

Since the Comprehensive Peace Agreement was signed five years ago, the Government of Southern Sudan, donors, international organizations, nongovernmental organizations, private organizations, and, most importantly, health workers are coming together to rebuild a shattered health system.

Now the global community focuses attention on Southern Sudan as they prepare for a Referendum vote to decide if they will officially break away from Northern Sudan to become an independent state. The vote is scheduled to begin January 9, 2011.

Over 33 million people are currently living with HIV & AIDS throughout the world. Despite great strides in slowing the epidemic, there remains a stunning gap in prevention, care, and treatment efforts. This is especially true for most-at-risk-populations, which include commercial sex workers (CSWs) and their clients, injecting drug users (IDUs), men who have sex with men (MSM), and prisoners. People in these risk groups are so stigmatized and discriminated against in many countries that it becomes extremely difficult – sometimes impossible – to provide them with much-needed HIV prevention, care and treatment services. Even more, MARP behaviors often are illegal, which then compromises needed action and support from government authorities.

Denial of such basic human rights as access to prevention, care, and treatment for the most-at-risk-populations is unacceptable. It leaves those most in need underserved and severely marginalized. As World AIDS Day 2010 approaches with this year’s message of “Universal access and human rights,” I am reflecting on the specialized HIV interventions that MSH helps provide to most-at-risk populations.

Pages

Printer Friendly Version