Antimicrobial resistance (AMR) occurs when a microorganism becomes resistant to a drug that was originally effective for treating the infections it caused. It is one of the world’s most pressing global health threats and could erode progress made thus far in the treatment of HIV/AIDS, TB, malaria, and many other infectious diseases.
Management Sciences for Health’s (MSH) role in combatting AMR was recently featured in the peer-reviewed journal, Global Public Health.
Tuberculosis remains the world’s leading infectious disease killer. Ending TB will require a comprehensive approach and targeted action, rapid innovation and proven interventions, bold leadership, and intensive community engagement.
On this World TB Day, the global health community is calling for “Leaders for a TB-Free World” to work together, make history, and end TB once and for all.
The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program helped make sure that some of the world’s most vulnerable people have timely access to safe, affordable medicines and to quality services to improve their health. Funded by USAID, the program worked for six years in 46 countries to comprehensively strengthen pharmaceutical systems by addressing five interrelated functions, with a focus on medical products—governance, human resources, information, financing, and service delivery.
This story was originally published by SIAPS.
Over its six years working in dozens of countries, SIAPS has carried out a vision for health system strengthening that USAID developed and has supported for more than two decades. In partnership with countries and organizations, the agency has led pharmaceutical systems strengthening interventions that have helped countries deliver affordable, quality-assured medicines and related products and services.
This story was originally published on the SIAPS Program homepage.
To be fully effective, health system strengthening projects should have sustainable impact and lay the groundwork for future progress. Here’s how SIAPS’ work supported health system reform in Ukraine.
The Philippines has one of the highest TB burdens in the world—and 2.6% of its more than 286,000 new cases in 2015 were of multi-drug-resistant TB (MDR-TB). This threatens the progress the country has made in addressing the deadly disease over the past few decades and its goal to make the country TB-free by 2030. Further, MDR-TB cases will likely rise steadily in the Philippines and the world over the next two decades.
(Cross-posted on the Global Health Council website).
Between 2000 and 2015, great strides have been made in fighting malaria. Globally, malaria case incidences declined by 41% and mortality rates by 62%. However, approximately 212 million people were infected and 429,000 people died in 2015, with the majority being children under the age of 5 in sub-Saharan Africa. Malaria also places a great financial burden on individuals and health systems. In sub-Saharan Africa alone, the annual cost of case management related to malaria is estimated at USD 300 million.
How health workers use technology to combat illness
Treatments for diseases like tuberculosis (TB) and HIV are lengthy and complex. Medications need to be taken regularly and for extended periods. Interruptions come at a high cost for patients, their families, and the health systems that treat them.
Some 13.5 million people desperately require humanitarian assistance in Syria, which includes access to essential medicines and other pharmaceutical products. Managing a sound supply chain is challenging in the best of circumstances—and in a crisis like this, there are many potential pitfalls and little room for error.
We have made great strides in ridding the world of malaria, but there’s still work to be done—and the time is right to finish the job. New technology is helping communities around the world prevent, diagnose, and treat malaria in new and innovative ways. In Mozambique, the Malaria Consortium has developed a phone app that helps community health workers diagnose and treat malaria. In Zanzibar, Tanzania, local health facilities can use text messages to report malaria cases.
This article was originally published on LillyPad, a blog run by the global health care company Eli Lilly, on February 16.
Antimicrobial resistance (AMR) is a global health crisis. In his AMR review, renowned economist Jim O’Neill estimates a loss of US$100 trillion in global productivity by the year 2050 if swift, comprehensive action to fight AMR is not taken. The publication acknowledges multi-drug resistant tuberculosis (MDR-TB) as a “cornerstone of the global AMR challenge.”
This post was originally published on the SIAPS website on January 30, 2017. The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program is funded by USAID and implemented by MSH. This project works to assure the availability of quality pharmaceutical products and effective pharmaceutical services.
This post originally appeared on the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program blog as, "UHC Day 2016: Strong pharmaceutical management boosts access to essential medicines".
by Devex's Noa Gutterman and Management Sciences for Health
This summer, Devex partnered with Management Sciences for Health (MSH) to host Access to Medicines (#Access2Meds), a conversation that has analyzed and amplified the discussion on global access to medicines.
Over the last three weeks, #Access2Meds has examined major questions including:
bringing medicines to the world
from communities to global policy -- innovations to access medicines underway
engaging the private sector for better health care delivery
Saving lives and improving health continues long after diagnosing disease or delivering medicines.
(Watch Faith tell her story)
Faith had been ill for months. She was 31 and had two daughters. She didn’t know what was wrong. A friend urged her to get an HIV test; it came back positive.
Faith started on antiretroviral treatment.
But, in 2013, one of her antiretroviral medicines started to work against her, causing misshapen fat deposits to develop on her body.
Strong health systems are necessary to help prevent and mitigate epidemics, including the oft-overlooked epidemic of antimicrobial resistance. This is the third post in a new series on improving the health of the poorest and most vulnerable women, girls, families, and communities by prioritizing prevention and preparing health systems for epidemics (see also: Part 1 and Part 2). Join the conversation online with hashtag #HealthSystems.
The Epidemic We Can See Coming: A Call to Act on Antimicrobial Resistance
Many child deaths in developing countries are preventable: Children die from treatable conditions, such as pneumonia, diarrhea, and malaria, because families in rural, hard-to-reach, or conflict-ridden areas can’t access or afford the treatments. The Sustainable Development Goals (SDGs), launched in September 2015, set ambitious targets of ending preventable child deaths by 2030 and reducing mortality among children under age five to at least 25 per 1,000 live births.
Cross-posted with permission from Devex.com.
The World Health Organization’s first global report on diabetes released this month highlights the disease’s “alarming surge” with rates that have quadrupled in fewer than three decades. The report reminds us that essential diabetes medicines and health technologies, including lifesaving insulin, are available in only one in three of the world’s poorest countries.
"Medicines are a key component of treatments to save lives"
~ Kwesi Eghan, trained Ghanian pharmacist and MSH portfolio manager for the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program in South Sudan and Afghanistan A child in Tanzania has a fever for three days. A pregnant woman in Namibia is taking antiretroviral therapy (ART) to treat HIV and prevent transmission of HIV to her baby. A man in Swaziland suffers from drug-resistant TB and struggles to adhere to treatment.
Medicines are a critical component of quality health care. In fact, most of the leading causes of death and disability in low- and middle-income countries could be prevented or treated with the appropriate use of affordable, effective medicines.Yet, about two billion people—one third of the world’s population—lack consistent access to essential medicines. Fake and substandard medicines exacerbate the problem. When these people fall ill and seek treatment, too often they end up with small quantities, high prices, poor quality, and the wrong drug.
In 2012, the United Nations unanimously passed a resolution endorsing the concept of universal health coverage (UHC), urging governments everywhere to “provide all people with access to affordable, quality health care services”. Management Sciences for Health (MSH) and the US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program are among global champions for UHC and joined global leaders celebrating UHC’s notable inclusion in the Sustainable Development Goals (SDGs) last Fall.
Niranjan KonduriMotivated frontline health workers play a key role achieving global strategies to fight tuberculosis (TB), writes MSH Principal Technical Advisor Niranjan Konduri, of USAID's Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, for The Lancet Global Health Blog. Using the story of Irina Chaban, a Ukrainian TB doctor, as an example, Konduri highlights the challenges health workers in low- and middle-income countries must overcome while working to eradicate TB.
The universal health coverage (UHC) movement has reached a turning point. With an unprecedented coalition of global partners rallying behind the UHC movement, the inclusion of UHC as a key aim of the newly launched sustainable development goals, and growing recognition of health as a human right, the real work of achieving UHC has begun – many countries are now grappling with the challenge of making UHC a reality.
This blog post is a web-formatted version of the Global Health Impact newsletter: Stronger Health Systems Stop TB and Save Lives (December 2015). (View or share the email version here.) We welcome your feedback and questions in the comments or email us. On social media, use hashtag #GlobalHealthImpact and tag @MSHHealthImpact. Subscribe
This week, at the 46th Union World Conference on Lung Health (hashtag #WCLH2015), the US Agency for International Development (USAID)-funded and Management Sciences for Health (MSH)-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is launching a new tool to improve how the safety and effectiveness of medicines is monitored in low- and middle-income countries.
Picture a scenario where infections become totally untreatable because none of the available antimicrobial agents work. This is not imaginary, but is likely to happen very soon if we don’t act urgently, intensely, and consistently to tackle the rising tide of antimicrobial resistance (AMR).
Management Sciences for Health (MSH) presented seven abstracts at the 8th International Aids Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2015) in Vancouver, Canada, July 19-22, 2015.
In May 2015, the World Health Assembly discussed and endorsed a global action plan on antimicrobial resistance. The action plan sets five strategic objectives to promote better understanding of the threat of antimicrobial resistance, and to ensure the proper use and conservation of existing antimicrobials.
Just a few months ago, the province of KwaZulu Natal, South Africa, captured the world’s attention for unfortunate reasons: xenophobic attacks on foreign African nationals. This week, from June 9 to 12 in Durban, the same province is hosting the 7th South African AIDS conference, a gathering expected to bring together thousands of activists from within the country, the Southern African region and, indeed, the rest of the continent and the world, to “reflect, refocus, and renew” efforts in response to HIV and AIDS.
MSH's May 2015 newsletter highlights the global health impact of pharmaceutical management: Ensuring access to affordable, quality medicines saves lives (subscribe).
by Jonathan D. Quick, MD, MPH
Health care is largely dependent upon essential medicines for preventing infection, reducing pain, and treating illness. The development of effective medicines, however, is only the beginning.
Quality care means getting the right medicine, in the right dose, at an affordable price, for all the people who need it.
Antimicrobial resistance is a major threat to the long-term security of public health and has the potential to negatively impact our society. It is a serious and growing global health security risk, which needs to be prioritised at local and international levels.
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.
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. It was an exciting year for maternal health.
In December 2013, Africa’s newest country, South Sudan, imploded with violence between government forces and a rebel opposition led by a former vice president. The violence continues today despite regional efforts at reconciliation by the Intergovernmental Authority on Development (IGAD) and other state actors. The war, however, has not stopped South Sudan’s frontline health workers in their efforts to build a public health system, including access to medicines, from the ground up.
The US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health (MSH), in collaboration with the Stop TB Partnership Global Drug Facility, will host a technical conference titled, “Building the Post-2015 Agenda: Novel Approaches to Improving Access to TB Medicines and Pharmaceutical Services” from March 2-6, 2015 at the Conrad Bangkok Hotel in Bangkok, Thailand.
Post updated December 19, 2014.
This post originally appeared on the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program Blog. Funded by the US Agency for International Development (USAID) and implemented by Management Sciences for Health (MSH), SIAPS works to assure the availability of quality pharmaceutical products and effective pharmaceutical services to achieve desired health outcomes.
My name is Tiglu. I was born and raised in Bahir Dar. When I first learned that I am living with the [HIV] virus, my mind went blank. I was depressed. After that, I started taking antiretroviral treatment. Then they found TB in me... Meet Tiglu, a living example of how partnering for stronger health systems saves lives. In Ethiopia, about 790,000 people are living with HIV. Tiglu, a patient at the Bahir Dar Health Center in the Amhara Region of north-western Ethiopia, discovered he is HIV positive three years ago, and started on antiretroviral treatment (ART).
This post originally appeared on the Frontline Health Workers Coalition blog.
Ayelew Adinew was working as a pharmacist in a large public hospital in Addis Ababa, Ethiopia. He looked around and saw that the 100-year old pharmaceutical system was broken.
November is Prematurity Awareness Month in the US, and the 17th is World Prematurity Day. But I never need any reminders about the importance of access to medicines and services for premature babies. Every November, I celebrate the birthday of my own little preemie. On November 30, 1997, I went into labor just after reaching 32 weeks. I was terrified. I had had a healthy second pregnancy up to that point and my doctor did not believe me at first when I told her I was in labor.
This post originally appeared on SIAPSProgram.org. Accounting for more than one million under-five deaths each year, pneumonia is the leading killer of children under the age of five worldwide, claiming more lives than AIDS, malaria, and tuberculosis combined. This year’s World Pneumonia Day (WPD) theme is “universal access to pneumonia prevention and care”. In commemoration of WPD, child health advocates are calling for pneumonia control through proven interventions that protect against, prevent, and treat pneumonia.
Guaranteeing that patients have uninterrupted access to anti-tuberculosis (TB) treatment begins with national TB programs (NTP) making complex calculations about how many cases to expect in the future. Vigilant stock management, accurate number of cases started on each type of treatment along with forecasting the expected number of patients that will be enrolled on treatment, are vital to ensure that medicines are available to all patients who need them.
MSH spoke with Fabio Castaño, MD, MPH, global technical lead of family planning and reproductive health about MSH’s approach to family planning and what will define the future of family planning and global health. Below is part one of the conversation.
What is MSH’s approach to family planning and reproductive health?
Dr. Fabio Castaño.Fabio:
Expanding access to essential maternal health medicines saves mothers’ lives. Access to life-saving maternal medicines requires an effective supply chain that delivers the right medicines to the right people at the right times. In many countries, weak pharmaceutical management systems are unable to meet the challenges of providing access to these essential medicines.
This post originally appeared on the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program blog.
Does antimicrobial resistance mean the end of modern medicine as we know it? Not quite yet. However, in a report recently released on global surveillance of antimicrobial resistance (AMR), the World Health Organization (WHO) warned that "a post-antibiotic era–in which common infections and minor injuries can kill–is a very real possibility for the 21st century."
Although the global community has had significant success in reducing maternal and child deaths in the past two decades, they continue to die of preventable causes at an alarming rate. This is especially pronounced for the most vulnerable and hard-to-reach populations. Universal access to maternal, newborn, and child health (MNCH) commodities and services remains a major challenge, even among countries that are on track to achieve the Millennium Development Goals for reducing maternal and child mortality.
On the eve of the 20th International AIDS Conference (AIDS 2014), Rachel Hassinger, editor of MSH’s Global Health Impact Blog, spoke with Dr. Scott Kellerman, global technical lead on HIV & AIDS, to discuss his latest research on prevention of mother-to-child transmission (PMTCT) of HIV and pediatric HIV & AIDS. Kellerman and colleagues will be attending AIDS 2014, July 20-25, in Melbourne, Australia. (Read more about the conference.)
This post originally appeared on the SIAPS blog. Many countries in Central and South America have made significant progress toward eliminating malaria. Between 2000 and 2012, 13 countries in the Americas saw malaria incidence rates drop by more than 75 percent. Argentina, Belize, Costa Rica, Ecuador, El Salvador, Mexico, and Paraguay have all reached the pre-elimination phase, a designation given by the World Health Organization (WHO) when countries meet certain critical steps in eliminating the disease and preventing its reintroduction.
The most recent edition of the MSH Global Health Impact Newsletter (May 2014, Issue 5) highlights MSH and global efforts moving toward universal health coverage (UHC) in the post-2015 development framework. This issue includes: MSH President & CEO Dr. Jonathan D.
The availability of new and essential medicines and other health technologies to treat life-threatening illnesses have helped millions of people lead long and productive lives. However, global availability does not necessarily mean access by the end-consumer to these lifesaving health products in low-and middle-income countries. Effective supply chains are needed to deliver these health products in hard-to-reach, resource-constrained settings that often times are inhospitable to collaborative, high-performing supply chain systems.
So how do we get safe, quality, essential medicines and commodities to the people who need them, at the right time and in the right quantities?
In commemoration of World Malaria Day, SIAPS joins the global health community in recognizing the remarkable strides that have been made in the fight against malaria. More than ever, people in malaria-endemic countries, especially those who are particularly vulnerable like mothers and children, are receiving effective prevention, diagnosis, and treatment services and have better access to life-saving antimalarial medicines and health supplies. In 2012, over 200 million rapid diagnostic tests and over 330 million courses of antimalarial treatment were provided globally.
Pablos-Méndez Applauds and Encourages MSH Representatives and Partners at DC Country Health Impact Fair
Representatives from 13 MSH countries—Afghanistan, Angola, Cote d’Ivoire, DRC, Ethiopia, Ghana, Haiti, Kenya, Nigeria, Rwanda, South Africa, Tanzania, and Uganda—shared stories and materials about the lives saved and health impact of MSH’s work, in partnership with US Agency for International Development (USAID) and others, at the MSH Country Health Impact Fair at the Ronald Reagan Building in Washington, DC, last week. Country ownership and health impact were common themes at the fair. Ariel Pablos-Méndez (MD, MPH), assistant administrator for global health at the US Agency for International Development (USAID), addressed participants and attendees.
It can be easy to take healthcare workers for granted. For the majority of us living in the United States, you know that a trained doctor and nurse will see you when you need assistance; a lab technician will do your blood work; and a certified pharmacist will dispense your prescriptions. But imagine going into labor and not knowing if a midwife or doctor will be present? Or, if you need a medication and there is no pharmacy to provide it?
Successfully combating the tuberculosis (TB) epidemic requires that national TB programs (NTPs) prevent new infections and ensure that current patients are cured. Although the treatment for drug-sensitive TB is very effective, curing the disease requires that patients adhere to a strict daily regimen of multiple pills for six to nine months. Adding to the challenge is the fact that treatment for drug-resistant TB is longer, more toxic, and less effective.
The highest rate of multi-drug resistant (M) and extensively drug-resistant (XDR) cases of tuberculosis (TB) is found in the World Health Organization (WHO) European Region. The Consolidated Action Plan to Prevent and Combat M/XDR-TB in the WHO European Region specifies that, by the end of 2013, all member states assure provision of an interrupted supply of quality first- and second-line medicines for treatment of all TB and M/XDR-TB patients.
Azmara Ashenafi, a 35-year-old woman from the Amhara region of Ethiopia, was diagnosed with tuberculosis (TB) and placed on treatment. She was fortunate. Many people with TB are missed by health systems altogether. But Azmara’a treatment wasn’t helping. Despite taking medicine for months, her symptoms persisted and became more severe.
In many places, her story would have a sad ending—TB is one of the top three leading causes of death for women 15 to 44 in low- and middle-income countries.
"At the Duka" tells the story of a Systems for Improved Access to Pharmaceuticals and Services Program (SIAPS) project to increase early detection of tuberculosis in Tanzania.
SIAPS partnered with the Tanzanian National Tuberculosis and Leprosy Program to train drug dispensers on the symptoms of TB, so that they could refer clients with these symptoms to TB diagnostic and treatment centers for follow up.
MSH's Principal Technical Advisor for Reproductive, Maternal, Newborn and Child Health (RMNCH) Beth Yeager has been named Chair of the Maternal Health Caucus of the Reproductive Health Supplies Coalition.
This special January 2014 edition of the Global Health Impact Newsletter (subscribe) features 12 stories from 2013 highlighting how MSH is saving lives by strengthening health systems at all levels--from the household to the community to the health facility to national authorities. The stories were selected through an internal storytelling contest (available in print soon).
We are also pleased to share a post from President and CEO Jonathan D. Quick outlining our vision for 2014.
A Note from Dr. Jonathan D. Quick
Vision 2014: UHC and the Opportunity for a Healthy Life
Last month, I had the honor of welcoming United States Agency for International Development (USAID) Administrator Rajiv Shah to Democratic Republic of the Congo (DRC) during a visit that took place December 15-18, 2013.
Today, November 12, is World Pneumonia Day. Pneumonia is the leading cause of death among children under five, killing more children annually than AIDS, malaria, and tuberculosis combined. About 1.1 million children under five died of pneumonia last year, 99 percent in developing countries.
A version of this post originally appeared on the SIAPS program blog.
"Health care is not about what doctors and nurses do in hospitals," said Dr. Sania Nishtar. "There are a range of different stakeholders that need to play their parts."
The Supply Chain Management Subgroup of the Community Case Management (CCM) Taskforce is organizing a webinar series, beginning May 15, 2013.Hosted by the CORE Group, the May 15 webinar will "provide an overview of the common pitfalls and bottlenecks of the CCM supply chain and potential solutions to these challenges."Jane Briggs, principal technical advisor for USAID's Systems for Improved Access to Pharmaceuticals and Services (SIAPS) at MSH, and Sarah Andersson, a country technical advisor for the Bill & Melinda Gates Foundation's Supply Chain for Community Case Management (SC4CCM) at J
Mildred Fernando lives and works in the Philippines for the USAID-funded, MSH-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Mildred spoke at several World TB Day events in Washington, DC, including at a senate briefing and an event honoring TB survivors and advocates (watch video). The interview below first appeared on the SIAPS blog.It all began in November 2001 for Mildred Fernando when she was diagnosed with tuberculosis (TB), a preventable and curable disease which caused the death of 1.4 million people in 2011.
The state of tuberculosis (TB) is in a tug-of-war as current challenges threaten to undo past successes. One of the primary hurdles currently facing TB prevention and cure is the emergence of strains that are resistant to at least two of the most effective medicines (rifampicin and isoniazid).So-called drug-resistant (DR)-TB arises when patients are unable to complete a full-course of appropriate, high quality anti-TB medicines.
Cross-posted from the SIAPS website.
“Respectful maternal care was said to be more than just a means to an end, and can be framed as several issues: human rights, quality of care, equity and public health,” Jocalyn Clark, senior editor of PLoS Medicine, noted about the final day of the 2013 Global Maternal Health Conference (GMHC).
Formally launched in 2012 in Cameroon, the USAID-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health, has been working on strengthening the overall pharmaceutical management system, specifically to ensure the people of Cameroon have access to safe and affordable medicines at the central and peripheral levels.
In a new podcast, US Deputy Chief of Mission in Cameroon Lisa Peterson discussed SIAPS’ important work in the country and how it will impact the local population.
Crossposted on Maternal Health Taskforce's mhtfblog as part of the Maternal Health Commodities Blog Series.Despite a decade of significant progress reducing maternal mortality rates, very few countries are on target to meet Millennium Development Goal #5a of reducing the maternal mortality ratio by three-quarters by 2015.What is most alarming is that a large proportion of maternal deaths could have been avoided if women had access to adequate health services, where the necessary quality medicines and supplies were available and skilled health providers were present.