Blog Posts by Gloria Sangiwa

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

Today, April 7, we celebrate World Health Day, started by the World Health Organization (WHO) to mark its founding in 1948.

Amid Ebola, Zika, maternal and child mortality, and other global health challenges, WHO chose diabetes, for the first time, as its World Health Day theme (“Stay super. Beat diabetes”).  To urge global action on the rising diabetes burden, WHO released a new global report yesterday, April 6, highlighting key global diabetes findings, country profiles, and recommendations to reach the Sustainable Development Goal (SDG) target 3.4, which calls on countries to reduce premature death from noncommunicable diseases (NCDs), including diabetes, by 30 percent by 2030. 

 {Management Sciences for Health and Novo Nordisk}Save Lives of Women & Newborns through Gestational Diabetes Screening: A Call to Action (Postcard: front)Management Sciences for Health and Novo Nordisk

Detecting and treating diabetes in pregnancy offers a simple, low-cost opportunity to improve maternal and child health and reduce maternal deaths. Yet, it has received scant attention as a public health priority, especially in low- and middle-income countries.

To put gestational diabetes on the global development agenda and call for action, Management Sciences for Health (MSH) and Novo Nordisk sponsored a technical advocacy event on the sidelines of the 68th World Health Assembly (WHA) in Geneva that closely examined gestational diabetes mellitus (GDM) and featured case studies and lessons learned from Ethiopia and Colombia.

[Catharine Howard Taylor, MSH Vice President, Center for Health Services, gives an overview of gestational diabetes and the need for routine screening to open the conversation.] {Photo credit: Barbara Ayotte/MSH}Catharine Howard Taylor, MSH Vice President, Center for Health Services, gives an overview of gestational diabetes and the need for routine screening to open the conversation.Photo credit: Barbara Ayotte/MSH

{Photo: Mark Tuschman, Kenya}Photo: Mark Tuschman, Kenya

Not Beyond Us. This is the theme of World Cancer Day 2015. But how will we achieve it? Cancer can seem insurmountable. The global cancer burden is great. In 2012, 8.2 million people died from cancer-related causes—most of them in Africa, Asia, and Central and South America, which experiences more cases and more deaths than anywhere else: 60 percent of the 14 million new cancer cases annually and 70 percent of all cancer-related deaths occur in the developing world. The same countries bearing the brunt of the cancer burden have the fewest resources to tackle it.

Still we know and remind one another today, the 4th of February: We can and must stop vaccine-preventable cancers and reduce preventable cancer deaths. We must reduce the cancer inequities.

Cancer, you are not beyond us.  

Among women, cervical cancer is one of the deadliest -- and most easily preventable -- cancers.  Women in the developing world account for 85 percent of the 270,000 deaths every year.  Yet we know that effective prevention, treatment and care are possible.

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

In the beginning of my medical career during the early 1990’s, I witnessed the devastating effects of HIV & AIDS.  Nearly 60 percent of the hospital beds I attended were filled with AIDS patients, many of them my close friends and colleagues. At the time, little was known about the AIDS epidemic; no effective treatments were available; and as a physician, I watched helplessly as day after day those closest to me suffered until their death.  

Today, almost three decades later, thanks to increased prevention and access to care and treatment for HIV, most of these hospital beds have emptied of HIV & AIDS patients.  Now, these same beds are filled by those suffering from preventable chronic diseases, including vaccine-preventable cancers.

Today, February 4, we commemorate World Cancer Day, joining the global community to raise awareness about the global cancer epidemic, and renew our commitment to address cancer in low-and middle-income countries (LMICs).

 {Photo credit: Warren Zelman}Democratic Republic of CongoPhoto credit: Warren Zelman

November 14 is World Diabetes Day. This year’s theme, “Protect our future,” emphasizes the importance of engaging and inspiring local communities to promote awareness and education on the effects of diabetes and its preventable risk factors. 

Suffering from chronic fatigue, weight loss, and repeated infections, twelve-year-old Hadija had made frequent visits to the national referral and teaching hospital in the capital city of her Sub-Saharan African country. At first, doctors presumed she had HIV, testing both her and her parents. Then physicians looked for cancer. After several follow-up visits and investigations, the physicians tested for and confirmed that Hadija had type 1 diabetes. 

Despite finally arriving at an accurate diagnosis, the hospital struggled to track down and provide the next key ingredient Hadija needed: human insulin as treatment for her disease. Eventually, Hadija was fortunate that her doctors were able to get her the needed treatment in time and that a health care provider and patient support group, along with community volunteers, were able to help her adhere to treatment. Other children have not fared as well.

Think diabetes is a problem of the rich and developed countries? Think again. 

Makasi after two months of tuberculosis treatment. {Photo credit: A. Massimba/MSH.}Photo credit: A. Massimba/MSH.

With less than 1000 days until the Millennium Development Goals expire, the process for setting post-2015 goals continues to ramp up.  We take this opportunity to reflect on the current state of community health systems in low- and middle-income countries and consider how the post-2015 agenda could reshape them—perhaps dramatically.

Community health systems today

Integration moves ahead

Poor and rural communities in low- and middle-income countries are leaving behind the “one clinic, one service” approach. So-called vertical programs, which organized resources according to single health conditions, created a patchwork of health services at the community level. You could get HIV care from one provider, but would have to go down the hall, down the street, or often much farther to get maternal health care or malaria care.

Ambassador Betty E. King, Permanent Representative of the United States to the United Nations and Other International Organizations in Geneva {Photo credit: US Mission, Geneva.}Photo credit: US Mission, Geneva.

The World Health Organization (WHO) established a global monitoring framework for non-communicable diseases (NCDs) at a Geneva meeting on November 9, 2012 --- a little over a year after the UN General Assembly adopted a political declaration on NCDs.

The chronic disease burden on low- and middle-income countries is vast: 28 million people in developing countries die annually from chronic diseases; yet, 8 million of these deaths are preventable.

An Accredited Drug Dispensing Outlets (ADDOs) dispenser in Tanzania, an example of a successful, scale-able public-private sector collaboration. {Photo credit: MSH.}Photo credit: MSH.

Chronic diseases --- notably cancers, cardiovascular diseases, chronic lung diseases, and diabetes --- now account for nearly 35 million deaths annually. The human and economic burden of chronic diseases are staggering, especially in developing countries. Left unchecked, by 2030 the epidemic will kill twice as many people in low- and middle-income countries as it does today.

One year ago, the world came together to address this emerging global epidemic. Country representatives, policy makers, and civil society convened in New York for the United Nations (UN) High-Level Meeting on Non-Communicable Diseases (NCDs), and the UN General Assembly adopted a declaration, promising to strengthen and accelerate the response.

(Cross-posted on MSH at AIDS 2012 conference blog)

On Sunday, July 22, 2012, Management Sciences for Health (MSH) hosted a satellite session, Beyond MDG 6: HIV and Chronic NCDs: Integrating Health Systems Towards Universal Health Coverage at the XIX International AIDS Conference (AIDS 2012). The session panelists were (left to right): Dr Ayoub Magimba, Till Baernighausen, Dr Jemima Kamano, John Donnelly (moderator), Sir George Alleyne, Dr Doyin Oluwole, and Dr Jonathan D. Quick

Three women gather outside a Tanzanian health center. {Photo credit: M. Paydos/MSH.}Photo credit: M. Paydos/MSH.

The 65th World Health Assembly is convening this week in Geneva, beginning May 21. For six days, the Assembly will focus the world’s attention on chronic non-communicable diseases (NCDs), universal health coverage, mental disorders, nutrition and adolescent pregnancy, among other health issues.

This is the second time in less than a year that chronic NCDs --- such as cancer, cardiovascular disease, diabetes and lung diseases --- are in the international spotlight. Last fall, the High Level Summit on Non-Communicable Diseases convened in New York, when, for only the second time in the history of the United Nations, a high level summit focused on a global health concern.

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