In recent years, global health stakeholders have begun to recognize the profound potential that drug shops have to advance public health goals, such as those related to malaria diagnosis and treatment, child health, and family planning. These outlets, for reasons of convenience and cost, are the first choice of care for millions of people - and until recently, they have largely been ignored. “Drug shops and pharmacies are important sources of health care, particularly in rural areas or urban slums with few public clinics.
There was an awkward silence and then soft giggling as the girls looked at each other. I had just finished talking about strategies for persuading sexual partners to use a condom. Laughter during these skills-building and girls empowerment sessions with 30+ secondary school students in Morogoro, Tanzania was not uncommon, particularly given the sometimes sensitive topics of discussion, but this time, the joke was lost on me.
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.
What it takes for health systems to provide lifelong antiretrovirals
Soon after her husband’s death in 1991, Bahati Shellinah tested positive for HIV, but antiretroviral drugs (ARVs) were not yet available. In 2004 she fell ill, but, luckily, this time ARVs were available. Bahati visited the Joint Clinical Research Centre (JCRC) outside of Kampala, Uganda, and she began taking ARVs for the first time
This year’s World Population Day coincides with the Family Planning Summit—a global moment where intentions and commitments to the right to health for all are revitalized. An essential component of HIV prevention and treatment, family planning must be prioritized in global and national agendas. Here are four reasons why: Family planning is essential to maintaining progress on HIV goals: Meeting the needs of young people, particularly in developing countries, is critical to maintaining progress and momentum in controlling the HIV and AIDS epidemic.
Before the civil war in the late 1990s, the Democratic Republic of Congo (DRC) had a large network of clinics and health facilities. But decades of conflict weakened a fragile health system and robbed this resource-rich country of its potential to become one of sub-Saharan Africa’s wealthiest nations. By 2010, 70 to 80 percent of Congolese people had little or no access to healthcare, and the country suffered from a lack of basic security, communication systems, power, clean water, and transportation.
On this World AIDS Day, we reflect on our global successes in scaling up HIV prevention and treatment efforts and averting new infections.
The “treat all” recommendation issued by the World Health Organization in 2015 was a critical milestone in the HIV response. Also known as “test and treat,” the recommendation expands antiretroviral therapy (ART) eligibility to include all people living with HIV, regardless of CD4 count, and recommends universal lifelong treatment.
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.
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 #HealthSystems.
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.
By Sherif Mowafy
Chantal, an HIV-positive woman, waits for her monthly supply of antiretroviral medication at the Hôpital Immaculée Conception in Haiti.Photo credit: Jean Jacques Augustin, SCMSAs the warm Haitian sun comes up, Chantal leaves her four children behind to get her HIV treatment, traveling for three hours in the back of a crowded jeep.
She bumps over unpaved roads to her monthly visit for antiretrovirals, one that she has been doing routinely for several years to keep her disease at bay.
Many years ago I began my public health career in Ciudad Nezahualcoyotl, then a squatter settlement of 1.8 million people, bordering Mexico City in the State of Mexico. Lack of land and unaffordable rents forced poor migrants, streaming in from the country side in search of employment and a better life in the city, to settle in the surrounding peri-urban areas. This large municipality, with few paved streets, was difficult to navigate in the rainy season. During the dry season, the wind would kick up dust storms that made it hard to see a block ahead.
"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.
A woman. A newborn. A child. In many countries, their basic health and rights are tenuous. These women, newborns, and children are the health system.
A woman is ostracized: abandoned by her husband, her family, and her community. She suffered a fistula after giving birth to her son. After 20-plus years, an operation repairs her fistula; now, she is teaching again, and a part of the community.
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.
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.
The teenage years. Changes seem to happen overnight. Puberty. Your first crush. Fighting with a parent. Discovering your identity, your purpose, and your role in the community. A confusing and challenging, yet rewarding, coming of age... an emerging adult.
My home region of Tigray in northern Ethiopia has made great strides in ending preventable maternal mortality. Best estimates suggest that the maternal mortality ratio in our region dropped from approximately 653 maternal deaths per 100,000 live births in 1990, to 267 in 2014. However, while most pregnant women in Tigray attend at least one antenatal care visit, only 41 percent attend the recommended four visits, and less than 63 percent deliver with a skilled birth attendant.
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.
Management Sciences for Health (MSH) is pleased to announce the availability of the 2014 edition of the International Drug Price Indicator Guide. The Guide provides a spectrum of prices from 25 sources, including pharmaceutical suppliers, international development organizations, and government agencies.
Use the Guide to determine the probable cost of pharmaceutical products for programs, compare current prices paid to prices available on the international market, assess the potential financial impact of changes to a medicines list, and to support rational medicine use education.
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.
We spoke with MSH’s Chryste D. Best, BS, product quality assurance manager, The Partnership for Supply Chain Management (PFSCM), about her selection as one of the top 300 women leaders in global health by the Global Health Programme of the Graduate Institute of International and Development Studies in Geneva. Best provides innovative quality assurance oversight for the global procurement of medicines and commodities by MSH and partners.
The Partnership for Supply Chain Management (PFSCM), an organization formed through a partnership between Management Sciences for Health (MSH) and John Snow Research & Training Institute, Inc., (JSI R&T), uses an innovative consortium model that draws on the capabilities and experience of 13 internationally-renowned organizations. PFSCM harnesses this expertise to strengthen, develop and manage secure, reliable, cost-effective and sustainable supply chains to meet the needs of health care and other public services.
This week, African Strategies for Health (ASH)—a USAID-funded, MSH-led project that identifies public health best practices in sub-Saharan Africa and advocates for their adoption—has been attending the International Conference on Urban Health from May 24 through 27 in Dhaka, Bangladesh. At the conference, ASH has been sharing A Corridor of Contrasts, a report compiling photographs and stories of the people living along the West African Abidjan to Lagos transport corridor, which crosses Côte d'Ivoire, Ghana, Togo, Benin and Nigeria.
“I started feeling this coughing… so I went to the health center and got tested. It was positive for TB,” says Grace*, a young Ugandan woman. She started on medicines, but after two months, she stopped adhering to treatment. They told me to continue with the drugs for five more months, but I stopped.
Members of the global health community commemorated International Women’s Day (IWD) on March 8 by celebrating recent advances in women and girls’ health and indeed there was much to celebrate: maternal deaths have declined 45% worldwide, The Global Fund to Fight AIDS, Tuberculosis and Malaria has distributed over 450 million bed nets, and over 1 million babies have been born HIV-free thanks to the President’s Emergency Plan for AIDS Relief (PEPFAR); but there is still work to do. What happens once the day is over? How do we turn that attention into action?
I am a woman. I am a Nigerian. I am a mother. I am a leader. And, I am a daughter. As the Nigerian country representative, I guide Management Sciences for Health (MSH)’s efforts to ensure the people of my country have access to quality health services. Indeed, I am many things. Before all else:
I am a woman of Nigeria.
The Girl Child in Nigeria
From the beginning, our girl children are at a disadvantage.
When Mearege gets really sick, her husband leaves town. Bedridden and in the care of her parents, Mearege gets tested and learns she--and her daugther--are HIV-positive. Through the support of mother mentors, trained by the Ethiopia Network for HIV/AIDS Treatment, Care and Support Program (ENHAT-CS), Mearege finds solace, guidance, and healing -- and decides to have another child.
The Supply Chain Management System (SCMS), established in 2005 under the US President’s Emergency Plan for AIDS Relief (PEPFAR) administered by the US Agency for International Development (USAID), supplies lifesaving medicines to HIV & AIDS programs around the world and is led by the Partnership for Supply Chain Management (PFSCM), a nonprofit organization established by Management Sciences for Health (MSH) and John Snow, Inc. SCMS first established a presence in Haiti in 2007. MSH manages SCMS operations in Haiti.
The first Lesotho National Conference on Vulnerable Children, December 8-11, 2014, was organized by the Government of Lesotho, with support from US Agency for International Development (USAID)/The US President's Emergency Plan for AIDS Relief (PEPFAR) through Management Sciences for Health’s Building Local Capacity for Delivery of HIV Services in Southern Africa Project, and in collaboration with UNICEF, UNAIDS, and other development partners.
This post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) as "The role of the private sector in responding to OVC issues". As we travelled to the Mountain Kingdom of Lesotho, I had mixed emotions about the National Conference on Vulnerable Children I was going to attend. Issues of orphans and vulnerable children are very close to my heart, as I have first-hand experience of growing up with a cousin who is an orphan due to HIV and AIDS.
This post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) as "Meeting the needs of vulnerable children: where are we and where do we need to go?".
The first Lesotho National Conference on Vulnerable Children (LCVC), December 8-11, 2014, reflected upon the state of the response to vulnerable children and facilitated a systematic approach of generating and articulating evidence for future direction for an efficient, effective, and well-coordinated response within the region.
For more than a decade, health teams in over 40 countries have improved their performance using MSH’s Leadership Development Program (LDP) and the latest version, Leadership Development Program Plus (LDP+), which improves public health impact and scale-up. During the same period, there has been a tremendous expansion of information and communication technologies (ICTs) in health and mHealth interventions, particularly using mobile devices.
“MSH is like my mother,’’ said Yimenu, a young medical professional from East Gojam, a place about 600 kilometers from Ethiopia’s capital, Addis Ababa. “I have been suffering for five years and it was because of MSH that I started living all over again.”
Yimenu is the voice of thousands: the symbol of partnership that contributed significantly to the country’s increasingly strengthened health sector to save lives.
“I ask no more than an opportunity to help others,” said Yimenu looking at the crowd with complete joy.
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).
Join Management Sciences for Health (MSH) at the 45th Union World Conference on Lung Health (WCLH2014) in Barcelona, Spain, October 28 - November 1, 2014, as we launch our Quan TB 2.0 tool, highlight our latest Challenge TB win, and promote our work on HIV/TB integration. MSH staff are presenting 19 posters and 5 oral presentations and speaking at 5 symposiums and 1 workshop. We also will have a booth (#43) in the technical exhibition area.
Join us as world leaders gather for the Clinton Global Initiative (CGI) Annual Meeting and the 69th United Nations General Assembly (UNGA) in New York, NY (US).
MSH President & CEO Dr. Jonathan D. Quick will address CGI participants this week to share our vision for scaling-up access to medicines to 70 million people in rural and underserved areas in Africa. Throughout CGI and UNGA, MSH also will highlight our work and vision for universal health coverage and improving women's health in the post-2015 development.
From a somber beginning to a closing ceremony calling for “Stepping Up the Pace on HIV & AIDS,” health, and human rights (PDF), the 20th International AIDS Conference (AIDS 2014) provided insight, inspiration, and imperative for the critical work ahead. Here are our top eight takeaways from AIDS 2014.
MSH welcomes the news that Uganda's anti-homesexuality law has been annulled by the country's Constitutional Court. President Yoweri Museveni signed the law into effect in February.
According to BBC News Africa (August 1, 2014): [The Ugandan Constitutional Court] ruled that the bill was passed by [Members of Parliament] in December without the requisite quorum and was therefore illegal.
Homosexual acts were already illegal, but the new law allowed for life imprisonment for 'aggravated homosexuality' and banned the 'promotion of homosexuality'.
This post originally appeared on the MSH@AIDS2014 conference blog and on Crowd360.org on July 23, 2014. On August 1, 2014, Uganda's Constitutional Court annulled the anti-homesexuality law. Since HIV was first identified in sub-Saharan Africa, Uganda has distinguished itself as a leader in developing and implementing an effective HIV response. In recent years, however, HIV incidence has been increasing in the country, and a series of restrictive, punitive measures have replaced the common sense, public-health approach that had set this beautiful country apart.
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.)
Guess who's coming to the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, July 20-25?
President Bill Clinton, 42nd President of the US and founder of the Clinton Foundation; activist Sir Bob Geldof; Michel Sidibé, Executive Director of UNAIDS; and Ambassador Deborah Birx, US Global AIDS Coordinator of US President's Emergency Plan for AIDS Relief (PEPFAR), are among confirmed high-level speakers.
The Building Local Capacity for Delivery of HIV Services in Southern Africa (BLC) Project, funded by the US Agency for International Development (USAID) and led by Management Sciences for Health (MSH), provided a grant to The Luke Commission (TLC) to deliver safe medical male circumcision to men and boys in Swaziland. The BLC Project also provides organizational capacity building support to TLC. A version of this post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) blog.
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.
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?
Four Ethiopian HIV-positive mothers received 2014 REAL Awards for their outstanding contributions to the fight against HIV, particularly prevention of mother-to-child transmission of HIV (PMTCT), at a ceremony in Addis Ababa, Ethiopia, on April 10, 2014. Created by Save the Children and the Frontline Health Workers Coalition, the REAL Awards are designed to develop greater respect and appreciation for health workers and the lifesaving care they provide globally, as well as in the United States.
Meet Tsegay, Haile, Alemayehu, and Derebrew
MSH staff and projects participated in International Women's Day celebrations in dozens of countries around the world. We share some of our stories with photos and excerpts from South Africa, Uganda, and Afghanistan.
Natalie Campbell and Elizabeth McLean of MSH and colleagues co-authored a new journal article, "Taking knowledge for health the extra mile: participatory evaluation of a mobile phone intervention for community health workers in Malawi," in the latest issue of Global Health: Science and Practice.
This post originally appeared on the K4Health blog.
For over four decades, MSH has promoted equal access to healthcare for women and girls in more than 135 countries, as we work toward our vision of "a world where everyone has the opportunity for a healthy life." Health for all is a human right, and we believe strengthening health systems within a gender framework can help achieve this vision.
Knowledge is power, so the saying goes.
No one understands that more than Teberih Tsegay, Almaz Haile, Jember Alemayehu, and Yeshi Derebew, of Korem Town, Ethiopia, who have used their knowledge to save the lives of babies in their community. "Some years back there was no one to teach us, so we gave birth to HIV-positive children. But now we can teach others so no child will be born with the virus," said Jember.
This post originally appeared on the LMGforHealth Blog.
In discussions around the importance of country ownership of health-related activities and initiatives, both Management Sciences for Health (MSH) and the Leadership, Management, and Governance (LMG) Project are committed to making sure that the role of civil society is taken into consideration and promoted, in line with USAID Forward’s drive to engage and strengthen local capacity.
Every year, billions of US dollars’ worth of medicines are purchased by or through international procurement agencies, NGOS–such as UNICEF, UNITAID, The Global Fund, Médecins Sans Frontières (MSF)–and governments for use in developing countries. The World Health Organization’s (WHO's) PreQualification of Medicines Programme (PQP) helps ensure that these medicines meet acceptable standards of quality, safety and efficacy.
SCMS and MSH at the forefront of efforts to remove supply chain barriers to the scale up of HIV/AIDS treatment programs For many of us in the developed world, it is easy to overlook the critical role that well-functioning supply chains play in effective healthcare. When supply chains are operating as they should, we take for granted that the medicines we need will be in stock and available.
Yesterday, January 9, President Obama nominated Dr. Deborah Birx as the next United States Global AIDS Coordinator -- a move MSH celebrates with others in the global AIDS and global health communities.
Dr. Birx, a renowned national and international expert in the field of HIV & AIDS, would lead the US strategy for addressing HIV globally and implementation of the US President's Emergency Plan for AIDS Relief (PEPFAR).
To commemorate World AIDS Day, Management Sciences for Health (MSH) recently teamed up with Save the Children and ONE in conjunction with the Office of Representative Barbara Lee (D-CA) to co-host an event on Capitol Hill entitled Getting to an AIDS-Free Generation: Overcoming Remaining Challenges.
Advancing a health systems strengthening approach to HIV & AIDS requires advocacy and education, especially of decision makers. In honor of World AIDS Day 2013 (December 1, observed in some places December 2) we invite you to commemorate the day wherever you are, and help our global family achieve an AIDS-free generation.
I remember attending the Durban international AIDS conference in 2000, my first. That was the one where everything was going to turn around and we were going get a handle on the epidemic. Nelson Mandela spoke at that one, in a hall that was the size of three football fields. And the crowd was joyous, raucous, the noise was deafening and it was one of the most memorable days of my life.
This post originally appeared on USAID’s IMPACT blog. USAID is observing World AIDS Day this year by celebrating ten years of HIV and AIDS work under PEPFAR.
More than 85,000 infants in Nigeria are at risk of HIV transmission from their mothers every year. While the number of HIV-positive pregnant women who receive antiretroviral treatment (ART) is increasing, robust efforts to improve coverage are needed if national targets (PDF) for prevention of mother-to-child transmission of HIV (PMTCT) are to be met in 2015.
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.
The Kenya National AIDS and STI Control program (NASCOP) under the Ministry of Health (MOH) disseminated preliminary results of the Kenya AIDS Indicator Survey (KAIS) 2012 on September 10, 2013. The dissemination conference was attended by all major stakeholders in the HIV and AIDS response in Kenya, including Management Sciences for Health (MSH).
MSH Global Technical Lead on HIV & AIDS, Scott Kellerman, MD, MPH, has a new article published today in the PLOS Medicine magazine. Scott Kellerman and colleagues argue that the scope of the current HIV elimination agenda must be broadened in order to ensure access to care and treatment for all children living with HIV.
Strengthening health systems at all levels is the core of MSH’s response to the HIV epidemic. We build organizational capacity to implement innovative HIV, prevention, care, and treatment interventions in over 35 countries---from Côte d'Ivoire to Ethiopia to Vietnam.
Today, as we celebrate International Youth Day and the theme of “Youth Migration: Moving Development Forward,” we are reminded of difficult situations millions of young people experience every day—and of the power young people have to create change in their lives when they connect with their peers.
The World Health Organization (WHO) made waves at the International AIDS Society conference in Kuala Lumpur when it issued revised guidelines for HIV treatment. The new guidelines—WHO’s first major update since 2010—recommend an earlier start to treatment, from a CD4 threshold of 350 cells/mm3 to 500 cells/mm3.
In 2005, "Chima" abandoned "Sinachi" and their four children to marry another woman. Heartbroken and unemployed, Sinachi returned to her home village and became a farmer. Although she worked hard, Sinachi’s children often went hungry and did not attend school for three years because she was unable to pay the fees.
Management Sciences for Health (MSH) joined African civil society organizations (CSOs) at a side event on July 2 of the Abuja +12 meeting of African heads of governments. The groups agreed that universal health coverage should be included in the post-2015 development agenda.
Cross-posted with permission from the LMGforHealth.org blog.
I had the pleasure and privilege of moderating a stimulating discussion, hosted by the USAID-funded AIDSTAR-Two project entitled, "Organizational Capacity Development: How Do We Measure Impact?".
This post originally appeared on the Southern Africa HIV and AIDS Regional Exchange (SHARE) blog."All the people we need to make a difference in HIV globally are sitting in this room," said Paul Waibale, deputy director of the Building Local Capacity Project (BLC) for the Delivery of HIV Services in Southern Africa, during the opening of the Southern African Development Community (SADC) HIV prevention workshop, "New evidence, new thinking."With funding from USAID, the week-long workshop on enhancing national and regional approaches to HIV prevention kicked off April 8, 2013, with 32 of Swazila
This week’s Lancet returns the spotlight to Option B+, an innovative strategy for preventing mother-to-child transmission of HIV which was first developed in Malawi with technical assistance from MSH. Four letters respond to the concern that international organizations have too quickly endorsed the Option B+ approach of providing lifelong triple antiretroviral therapy (ART), irrespective of CD4 count, to pregnant women with HIV in high-burden countries.
For most of my life, women in Uganda---as in most countries---were treated as inferior to men. Girls were less likely to be educated than their brothers, and had little control over the direction of their lives. Many girls grew up being told how to act, eat, and talk; many women were regarded as little more than domestic caregivers. However, in 1986 the ruling government radically changed the dynamics of Ugandan women in global development and their participation in decision-making at all levels of government.
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.
Shelly has always been very athletic. She competed in both her high school track events and in community races in her hometown of Essequibo, Guyana. In 2010, she was ecstatic after winning a cash prize for placing first in an annual regional championship. However, her life took a turn one year later.Shelly became pregnant and, during an antenatal care appointment, tested positive for HIV. The news devastated her, as she believed that an HIV diagnosis meant her athletic career was over.
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.Saving women's lives: Meeting the unmet need for family planning.
In recent years, Haiti has endured some of the greatest misfortunes in its history, including hurricanes, floods, the devastating 2010 earthquake, and the cholera epidemic that followed. These natural disasters and public health crises have added to the harm already caused by the country’s widespread poverty, social and political unrest, and under-resourced health system.
I got a call from the resident doctor to come to exam room 6. As soon as I entered the room, I prepared myself. The little girl, 7- or maybe 8-years-old, didn't look well; she was “floppy,” combative, and not entirely aware of where she was or what we were doing to her. She was HIV-positive, and my colleague needed to get an IV line in her arm to test the latest in experimental treatments for kids with HIV– and needed the four of us interns to help hold her still.It was 1993 during my residency in pediatrics in Cleveland, Ohio.
http://www.youtube.com/watch?feature=player_embedded&v=joX9cq692WcMichel Sidibé, Executive Director of UNAIDS, discusses the new UNAIDS World AIDS Day report: Results at a press conference today in Geneva.Learn more about the UNAIDS World AIDS Day Report.Discuss in the comments below or on Twitter with #Results and @UNAIDS.
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.
Cross-posted from the K4Health blog. No matter which health system building block you are trying to improve, you need specific data, information, and knowledge to inform your decision-making process—this is where good knowledge management comes in handy.“The Intersection of Knowledge Management and Health Systems Strengthening: Implications from the Malawi Knowledge for Health Demonstration Project” provides an interesting case study of the connection between improved knowledge management and health systems strengthening.Even though the K4Health Malawi project was f
In January 2011, Amelia and her partner, Luke --- both HIV positive --- began accessing HIV care and support services at the Agape Network through its community home and palliative care program.Agape Network is one of the NGOs that receives technical support from the PEPFAR-funded, USAID-implemented, Guyana HIV/AIDS Reduction and Prevention Project (GHARP II), led by MSH.When the Agape staff first met Luke and Amelia, they were living with their two daughters at Luke’s family’s home.
The Ugandan government launched a new prevention of mother-to-child HIV transmission (PMTCT) strategy on September 12.
Uganda will transition from an approach based on the World Health Organization's (WHO) Option A --- which is contingent on an HIV-positive pregnant woman’s CD4 count --- to WHO's newest PMTCT strategy, Option B+.
“J’mappelle Mompati. Comment t’appelles tu?”Overcoming my confusion at being greeted by a French-speaking man in Botswana, I smile, take his proffered hand and reply in my rusty, stilted French, “J’mappelle Naume...”Mompati is Mahalapye Hospital’s dynamic public relations officer. Now that he has my full attention, Mompati wastes no time in telling me about his work linking the hospital and the surrounding community through events and the media.
Each year over 10 million men, women, and children in developing countries die as a result of our collective failure to deliver available safe, affordable, and proven prevention and treatment. A recent analysis of innovations in products and practices for global health, from the Hepatitis B vaccine to use of skilled birth attendants, revealed virtually none of these life-saving interventions reaches much more than half their target population—even after as many as 28 years of availability.
It's been nearly two weeks since former President William J. Clinton closed the last session of the XIX International AIDS Conference (AIDS 2012) and delegates returned home.
This year's conference featured commitment and calls for an AIDS-free generation, a growing interest in Option B+, and new research towards a cure. Here are some reflections from what we learned at AIDS 2012, where we truly started "turning the tide together".
Clinton calls for a blueprint toward an AIDS-free generation
The XIX International AIDS Conference featured five full days of plenaries with high-level speakers and community activists. The plenaries exemplified the diversity of topics covered throughout, and the global experience of people attending the July 22-27 conference. The plenary round-ups below are a great way to re-enter the experience of AIDS 2012, whether you attended the conference or just want to learn more.Read more at storify.com.
(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.
(Cross-posted on MSH at AIDS 2012 conference blog) Science was at the forefront of the opening event of the XIX International AIDS Conference on day two, but the “dream team” and a rock star also made an appearance, in a rousing plenary session attended by more than a thousand members of the global public health community in Washington, DC.In an opening presentation entitled, “Ending the HIV/AIDS Pandemic: From Scientific Advance to Public Health Implementation,” Dr Anthony Fauci of the National Institute of Allergy and Infectious Diseases (NIAID) captured mo
I am in Luanda, Angola right now, and what an interesting place. It is the most expensive city in the world: a can of coke costs $5, a car and driver for the day costs between $250-$300, and a basic hotel room with a view of people living in shacks below and cranes building more skyscrapers above is $380 (and it is difficult to find it for less).Luanda feels like Africa mixed with Latin American and European energy and music. The traffic is bumper to bumper. It is not possible to have more than two meetings in a day because it takes that long to get from one area to another in the city.
The prospect that we may see the end of AIDS in our lifetime has never been greater. Over the last decade, the global HIV & AIDS community has achieved stunning successes, including a steady decrease in new HIV cases, a massive scale-up of antiretroviral therapy (ART), and proof that treatment is prevention. As we begin the XIX International AIDS Conference, we are also excited by new scientific advances in prevention and treatment, such as Option B+ for prevention of maternal-to-child transmission (PMTCT).
Seasoned HIV & AIDS experts gathered at the Center for Strategic and International Studies (CSIS) on Saturday evening, July 21, to weigh in on the President’s Emergency Plan for AIDS Relief (PEPFAR) on the eve of the XIX International AIDS Conference, dubbed "AIDS 2012".The conference is taking place in the USA for the first time in 20 years thanks to President Obama’s lifting of the travel ban on HIV-positive visitors.“What has been PEPFAR’s strategic significance?”An illustrious panel including Ambassador Eric Goosby (United States Global AIDS Coordinator),
SESSION DETAILSWhile building on the momentum of the UN Summit in September 2011, this satellite recognizes that PLHIV both treated and untreated, suffer from co-morbidities due to chronic NCDS. This satellite will examine the role of chronic NCDs and their link with HIV. More specifically, we will review lessons learned from the AIDS Decade of the 2000s and determine what lessons can be leveraged and applied beyond 2015 in the context of an emerging global burden of chronic NCDs.
Cross-posted on MSH at AIDS 2012 conference blog.
This new video from Uganda, Mildred's Story: Treating HIV & Chronic NCDs, premiered today at a satellite session of the 19th International AIDS Conference: Beyond MDG 6: HIV and Chronic NCDs: Integrating Health Systems Toward Universal Health Coverage.
Watch video and share.
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USAID and partners are hosting a Twitter chat in preparation for the 19th International AIDS Conference. The #AIDSChat began at 10 am EDT and continues throughout the day.Management Sciences for Health (MSH) will be co-hosting from 2:00 - 2:30 pm on the topic of prevention of mother-to-child transmission (PMTCT) of HIV with Scott Kellerman, MD, MPH, tweeting from @MSHHealthImpact.Ask questions, comment and follow on Twitter with #AIDSChat.
Over 40 Management Sciences for Health (MSH) staff from around the world will join the twenty thousand health workers, activists, researchers, donors, and policy makers at the XIX International AIDS Conference, "Turning the Tide Together". Visit us at the following events, poster and oral presentations, Booth #162, or online.Catch live blog updates, July 22-27, and follow us on Twitter with #AIDS2012, #PMTCT, and #OptionBplus.
The World Health Statistics 2012 report released this year reveals a mixed bag of amazing progress and underachievement.The report --- the World Health Organization's (WHO) annual compilation of health-related data for its 194 Member States --- includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets.Countries have achieved amazing success in some areas and little or no progress in others.
Karla came from a troubled home where there was domestic violence, drug use, and general turbulence. She was repeatedly sexually abused by a relative in her home.In 2008, Karla participated in the In School Youth (ISY) HIV prevention program at her secondary school in Region 4, Guyana.Agape Network Incorporated, a USAID-funded, faith-based organization, leads the ISY program.
“I knew I wanted to be a nurse since I was 10. A woman used to come home to my village in her nurse uniform on the weekends and she was so smart and nice. It was my goal,” said Anna.Anna finished nursing school and her formal training in 1998 and started working in 1999. In 2000, she began working at Kaginima Hospital in eastern Uganda, where she still works today.Kaginima Hospital is an expanding facility and uniquely has a lot of space for patients and services.
Rabi gives a public awareness lecture on HIV. (Photo credit: MSH, Nigeria)Forty-year old Rabi Suleiman lives in Koko Besse area in Kebbi state, Nigeria. She is married without children. Rabi, who now lives with her third husband, recalls that her ordeal with illness and social ostracism began in 2009. Rabi’s three marriages were the result of her inability to conceive, and a continuous search for a partner with whom she could successfully bear children.
Securing funds from donors and partners can be challenging for Nigerian non-governmental organizations (NGOs), given the nation’s large pool of competing organizations. In order to earn funds, NGOs must have strong proposal writing skills, the ability to defend their proposals, and efficient operational capacity.The Global Health Awareness Research Foundation (GHARF) is a community-based organization operating in Enugu state in southeastern Nigeria.
Ramatu Fullah is a 27-year-old woman in the Pujehun district of Sierra Leone. She comes from a poor family and, for years, had to earn her living as a sex worker to take care of her two children. Recently, Ramatu learned skills that enabled her to change her trade through an awareness-raising campaign supported by the USAID West Africa Regional Health Office's Action for West Africa Region II (AWARE II) project, managed by Management Sciences for Health (MSH). Today, Ramatu sells acheke, a local delicacy, on the streets of Sierra Leone.
Over 100 conference delegates came together at the United Nations Conference on Sustainable Development last week in Rio de Janeiro, Brazil, to strategize smart solutions to global development and poverty reduction while promoting environmental concerns such as clean energy, sustainability, and equitable use of resources. Popularly known as “Rio+20” --- for occurring twenty years after the 1992 Earth Summit --- the three days of high-level meetings attended by heads of state and government and high level representatives resulted in “The Future We Want,” a 53
Good governance in health care matters at all levels of the health system—from communities to health facilities to governments. When a community HIV & AIDS association in Zanzibar grew from 40 members to more than 1,000, it needed better governance. When women in Senegal raised concerns about lack of privacy and poor security at a district hospital, it needed better governance.
The prevention of mother-to-child transmission (PMTCT) of HIV is taking center stage this week during USAID’s 5th Birthday campaign -- and rightly so. Preventing mother to child transmission of HIV is one of the most critical, effective tools to helping kids reach their fifth birthdays.Ambassador Eric Goosby and UNAIDS Executive Director Michel Sidibé have called for the elimination of pediatric HIV by 2015.
When Arifa arrived in August 2010 at Family Awareness Consciousness Togetherness (FACT), a USAID-funded non-governmental organization (NGO) that receives technical support from the MSH-led GHARP II Project, it was immediately evident that she had major communication challenges. At age 17, Arifa found it difficult to have even brief conversations with anyone.The Berbice Technical Institute had sent Arifa to FACT as a work-study student for a two-month term.
Improving Child Health in Communities and at Home, the April/May 2012 edition of MSH's Global Health Impact newsletter (subscribe), features personal stories about child survival and child health in developing countries."Prevention, treatment and care close to the home are keys to saving children's lives," says Dr. Jonathan D.
Stigmatized, isolated, and conditioned to undertake hard labor, 14 year-old Chinaecherem Nwodo shows that one can overcome the most dire circumstances. Chinaecherem was despised and accused of witchcraft in her community, the Onu-Orie-Obuno-Akpugo village in Nkano West Local Government, Enugu State, Nigeria. Her abusive treatment by community members reflected the challenges facing some children in rural areas of Nigeria.The community blamed her for her mother’s death and father’s insanity.
Early in the morning of January 31, 2012, caregivers, support group members, village leaders, and the local council secretary gathered to say goodbye to 9 girls and 11 boys, orphaned youth ranging in age from 15 to 17. From 10 different villages in the Mohale’s Hoek district of Lesotho, these teens were headed for new horizons.The adults wished the youth well, encouraged them to try their very best, and waved them off as they boarded the bus.
Nearly 50 countries, including Afghanistan, Democratic Republic of the Congo, Haiti, Liberia and South Sudan, are considered a fragile or conflict-affected state -- a state that is in conflict, recovering from conflict or crisis, or a state that has collapsed or has a strong and repressive government.
On this World Health Day, we invite you to meet Okata, a 3-year-old orphan living with HIV, and his grandmother, his caretaker.World Health Day, celebrated April 7th, marks the founding of the World Health Organization. This year's theme, "Good health adds life to years," encourages the global community to rethink what it means to be "old".Watch the video, Building a Stronger Health System in Uganda, and share Okata's story with your network of family and friends.
It was 11 o’clock one February morning when the Santé pour le Développement et la Stabilité d’Haiti (SDSH) project technical team arrived on site at St. Joseph Health Center.The center’s activities were well underway. Dozens of people sat on benches or stood in line, waiting for their turn. One person comes to care for her child who has had a high fever. Another comes for contraception. Another just gave birth to a healthy infant.St.
Kalu, a young man from Kenya, dreamed of becoming a star footballer (soccer player). Little did he know when he traveled to South Africa to pursue his dream that he carried in him a hidden passenger: the HIV virus.
Yvonise is a good-natured 40-year-old woman with an easy smile. She is mother to four children: two boys and two girls. Her youngest, a little girl, is six years old.
Today, Yvonise sits patiently at the pharmacy of Hôpital Immaculée Conception de Port-de-Paix (HIC Port-de-Paix) in Haiti, waiting for Miss Sevrine, her caregiver, to provide her with a month’s supply of life-saving medicine.
Namibia, with just 2.2 million people, has one of the highest AIDS prevalence rates in the world, at roughly 13.1 percent. The country’s small population is spread over a large geographic area, making the delivery of AIDS services a challenge especially in remote villages.
Inside Story: The Science of HIV/AIDS, a new feature-length docudrama in which USAID plays a supporting role, premiered to a packed theater in Johannesburg, South Africa, on World AIDS Day, December 1, 2011.Inside Story is a unique mixture of science and fiction and includes cast members and characters from Nigeria, Kenya and South Africa.Kalu, a rising Kenyan soccer player, migrates to South Africa to establish his career. A romantic encounter leads to the unwelcome realization that he is HIV positive.
Shortly after delivering her baby boy at home, Alice Gune grew nervous for his health. Her baby had a high fever and was obviously uncomfortable and unhappy.
She took him to see Rose Kujang, the Maternal and Child Health Worker, during a community outreach program orchestrated by Kuda Primary Health Care Center (PHCC). Rose examined Alice’s baby and, recognizing the danger signs he presented, immediately referred her to Kuda PHCC for further diagnosing and treatment.
The 16th International Conference on AIDS and Sexually Transmitted Infections (ICASA) opened today, December 5, 2011, at the newly refurbished Millennium Hall in Addis Ababa, Ethiopia, with a colorful and lively music and dance production by the Ethiopian National Theatre and Traditional Music Group and the Addis Ababa Youth & Children’s Theatre.UNAIDS Executive Director Michel Sidibé gave an impassioned welcome speech remembering the last 30 years of AIDS and the 24 million African lives lost to the epidemic.
This year is not only MSH’s 40th anniversary; it is also 30 years since the first reported cases of HIV. Thirty years ago HIV was considered a new, always-fatal disease. ...Today 6.6 million people—nearly half of those in need—will take life-saving antiretrovirals.
Zakia, a nurse in Afghanistan, has become a leader in her health center. After participating in an MSH leadership development program, Zakia led a team of nurses in increasing awareness about family planning, resulting in a doubling of the use of contraceptive pills and an eight-fold increase in the number of condoms distributed in two years. “Everyone here no longer thinks of problems as obstacles in our way, but challenges we must face,” Zakia says.
I am fortunate. I know this from years of experience of reporting about people who have poor or no access to quality health care, from rural areas of West Virginia to Afghanistan to Zambia. But today I feel this deeply, in large part because of an email that I just received.
Joanie, a woman from Linden, Guyana who is mentally ill, was diagnosed HIV positive in 2005. Her mental illness prevented her from accessing health services and support. Her HIV remained untreated. She rejected the attempts of relatives and friends to assist her, and spent most of the day on the bank of the nearby Demerara River, refusing to wear clothes.
In Kasungu District, Malawi, trained Community-Based Distribution Agents (CBDAs) gather for their final and perhaps most challenging training: couples counseling.With HIV, couples often do not freely discuss issues and concerns.
Picture trees, water, mountains, mud, birds and fish. This is Lake Chirwa -- the second largest of the five lakes in Malawi and the main habitat of small fish called Matemba. The lake offers a trading opportunity for fishermen from many walks of life.Lying in the southern region of Malawi, Lake Chirwa is a wetland for people of three districts: Phalombe, Zomba and Machinga. All these people have frequent contact with Mozambique as they lie near the bordering frontiers.
Lucia Afiki and Esther Goodson are living positively with HIV. They are counselors for family planning and HIV & AIDS at Salima District Hospital in Malawi, where they openly tell their clients that they are HIV-positive. “When we are open with them about our status,” says Afiki, “people say, ‘Come closer, we want to learn from you.’” Goodson adds: “They say, ‘What should I do to look as good as you?’” The counselors tell them to visit a doctor and join a support group. This is an approach that saves lives.
HIV-positive women in Nigeria are the primary caregivers for their own families and other people living with HIV. This disproportionately high burden of care has detrimental effects not only on their health but also on their economic well-being.The MSH-led, USAID-funded, Prevention Organization Systems AIDS Care and Treatment (ProACT) project in Nigeria has helped establish HIV support groups whose participants are 80 percent women.
Mary Umoh, colleague and friend -- and one of the winners of an internal MSH abstract contest for staff -- traveled from Nigeria to Rome to present her poster at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2011).
Mary* was married at the young age of 13 in her hometown, Crabwood Creek, Region 6, Guyana. At age 15, after she gave birth to her first child, her husband deserted them. Mary was left to provide for herself and her child. She tried a few odd jobs, but they did not work out. In 1989, at age 15, she turned to commercial sex work. At this time, Mary had never heard of condoms and had never used one. Her earnings were adequate, as much as $300 some weeks.
From Alima Twaibu’s village in Nhkotakota district, it is 10 km to the nearest Health Center or 16 km to the District Hospital. With more than 80% of the population living in rural areas, the majority of Malawians experience similar challenges to accessing care. People have to walk long distances to receive services when they are sick. And when time away from work or paying for transport competes with other basic expenses, the decision to seek preventive services like family planning and HIV testing and counseling (HTC) is even more difficult.
Malawi leads the developing world as the first to propose an approach to prevention of mother to child transmission (PMTCT) of HIV that addresses the health of the mother. Recently my MSH colleague Erik Schouten and his colleagues in Malawi wrote a commentary in the Lancet about Malawi’s innovative, public health approach to PMTCT.
Grace Bonongwe is a grandparent. She comes from Zovuta Village T/A Nsamala in Balaka, about 10 kilometers from the nearest health facility. Of the nine children she has given birth to, only one lives to this day. The rest have died over the years from different diseases.Grace is no stranger to disease and affliction considering she has gone through the pain of losing eight of her children. So when her husband fell ill, she dismissed it as a normal occurrence that would eventually lead to his demise.
Monday at the International AIDS Society conference in Rome, an expanded session featured information on the HPTN 052 study, the Partners PrEP Study, and the Centers for Disease Control’s TDF2 study presented in a joint session titled Treatment Is Prevention: The Proof Is Here, on Monday.
In 2006, Jamila, a 24 year old Guyanese waitress, took the opportunity to work in a store overseas with the hope of building a better life for her children. But her dreams were dashed when she arrived in the new country and realized the only job available was as a commercial sex worker.
Thirty years ago, we learned of a disease that began with a few cases and quickly transformed into an epidemic the world had not seen before. We were not exactly sure what it was, how it was spread, or how to care for people who had it. HIV & AIDS has had a dramatic impact on the world – and especially on people in low and middle income countries.
On Tuesday, June 14 at the 38th annual Global Health Council Conference, MSH hosted a lively discussion about non-communicable diseases and harnessing health systems. The speakers included: Felicia Knaul, PhD, Director, Harvard Global Equity Initiative and Founder of Tómatelo a Pecho; Herb Riband, MedTronic, Vice President, External Affairs; Debbie Birx, MD, Centers for Disease Control, Director, Division of Global HIV/AIDS, Center for Global Health; and Claudine Humure, cancer survivor, Rwanda. Jonathan D.
Over the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff.LILONGWE, Malawi – The problem with writing about improvements in Malawi’s health system is focus.
Over the next couple of months, as MSH celebrates it's 40th anniversary, reporter John Donnelly and photographer Dominic Chavez will be traveling to several countries to report on MSH’s work in the field. The stories will go into a book due out in the fall on MSH’s 40 years in global health. This blog entry is a post from the road, to give a flavor of their experiences with MSH staff. SALIMA, Malawi – For three years, Lucy Sakala has helped counsel people seeking HIV tests at the Salima District Hospital.
Yesterday the results of HIV Prevention Trials Network (HPTN) 052, a clinical trial funded by the National Institutes for Health, offered definitive proof of what we have long suspected---that treating HIV infected persons substantially reduces the risk of transmitting HIV to uninfected persons.This is FANTASTIC news and offers very convincing evidence that, at least for heterosexual discordant couples (the study was not able to enroll significant numbers of gay men), if the infected person is on ART, the uninfected partner is protected.
In the village of Owa Ofie, Nigeria, Cynthia Isioma, a young girl who has survived enormous odds reclaimed her dream of secondary education.
Cynthia lost both parents at the age of two and was left in the care of her grandmother who died three years later. Cynthia’s situation grew more challenging when she was then moved to her blind grandfather’s home at the age of five.
This blog post originally appeared on the US Agency for International Development's IMPACT blog. As a procurement specialist with PEPFAR’s SCMS (the Supply Chain Management System) project, I am one of a growing number of women working in supply chain management in Ethiopia. I manage procurements of HIV/AIDS commodities---including the complex procurement of specialized medical equipment used to treat HIV/AIDS---as well as the vehicles that distribute those commodities.Well planned, strategic procurement is a smart investment.
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.
This is a guest post from Olive Mtema, Policy Advisor, from the Community Based Family Planning and HIV & AIDS Services project in Malawi. Olive is an employee of the Futures Group. On March 12, 2011, Muslim Leaders gathered in Lilongwe, Malawi for a conference on Reaffirming Muslims' Positions on Family Planning and HIV & AIDS Issues.
Malawi has some of the worst health statistics in the world, ranking 166 out of 177 countries. This is the result of HIV & AIDS, food insecurity, weak governance, and many human resources challenges. Health care vacancies range anywhere from 30-80%, and Malawi only has 252 doctors in the entire country. The health system is regularly plagued with stock outs of key medicines and supplies, as a result of poor procurement and distribution practices.
This post originally appeared on K4Health's blog. I am the mother of a teenager, living in a text-obsessed world of communicating by “LOL, OMG, and 2GTBT.” I even have to admit that I’ve succumbed to the ease of texting “IM outside” when I arrive at school to pick him up---or more frequently “Where R U?” Hmmm. What’s up with that? So it brought joy to my heart when I visited the Knowledge for Health (K4H) Learning Center in Salima, Malawi and experienced texting in a whole new way---in a purposeful way---better yet, in a life saving way.
(This blog post was originally posted on Global Health Council's Global Health Magazine blog.)How do we set a gold standard for monitoring and evaluating capacity building?Last week I attended the inaugural HIV Capacity Building Partners Summit in Nairobi from March 16-18, 2011.
News from the HIV Capacity Building Partners Summit in Nairobi, KenyaOn the second day of the first ever Regional HIV Capacity Building Partners Summit in Nairobi, Kenya, one of the key issues that continued to dominate the conversations in various sessions was sustainability.Many speakers noted that despite a mild increase in organizational capacity building efforts by donors, governments, and nongovernmental organizations in the Eastern and Southern Africa region, the documentation and dissemination of these efforts and their effects on HIV & AIDS programs and other health programs and s
News from the HIV Capacity Building Partners Summit in Nairobi, KenyaSub Saharan Africa still remains the unenviable epicenter of the global HIV and AIDS epidemic. Over the years, the region has witnessed intensified emergency efforts to expand access to HIV treatment, prevention, care and support.
Aberu Hailu is a 31 year old, mother of four living in Hidmo, Ethiopia a rural community 8 kilometers south east of Adigodum town in Tigray. Two years ago, she visited the Adigodum Health Center to be tested for HIV, a disease she had learned about through community health education. She discovered she was HIV-positive and informed her husband that he should be tested, but he refused.Two months later, Aberu became pregnant and found herself in despair.
One hundred years ago on March 8, a handful of countries celebrated the first International Women’s Day. Today it is celebrated around the world as an opportunity to look back on women’s accomplishments and look forward to the realization of their full economic, political, and social rights.
Last week, the House of Representatives cut the international affairs budget by 20% of the FY 2010 levels. While these are tough times, these cuts are disappointing given investments made in international affairs account for only 1 percent of the overall US Government budget.
This article was orignially posted on FHI's Interagency Youth Working Group (IYWG) blog. Several months ago, I was asked to help manage a newly redesigned site that focuses on children and HIV & AIDS. I knew that over the last decade there had been an enormous increase in both the amount of and access to global health information. Thus, the challenge was to shift from simply producing more material to organizing, exchanging, and effectively using this growing knowledge base.
Part six of the blog series: Spotlight on Global Health Initiative Plus Countries Amid grave health statistics, the Global Health Initiative (GHI) brings hope of a healthier future in Mali.Mali is one of the ten poorest countries in the world, ranking 173 out of 175 countries on the 2007 Human Development index of the United Nations Development Program (UNDP).
The Global Health Initiative (GHI) and its approach of integrating health programs with HIV & AIDS, malaria, tuberculosis, maternal, newborn, and child health, nutrition, and family planning and reproductive health is in line with the current approaches and health priorities of the Government of Malawi.Malawi, with a population of slightly over 13 million people, has 83% of its people living in the rural hard to reach, underserved areas. The biggest health challenge facing the country is access to basic health services by the rural population.
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 responseIn 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.
Prior to January 12, 2010, Management Sciences for Health’s Leadership, Management and Sustainability Program was working with Haiti’s Ministry of Public Health and Population to build capacity in several areas: family planning and reproductive health; commodity management and security; coordinating HIV & AIDS awareness and community mobilization activities; and leadership development.
This blog post originally appeared on K4Health's blog. The most important item in Amon Chimphepo’s medical kit is a small cell phone. This single piece of technology has proved to be a lifeline for people living in one of the most remote regions of Malawi. Its power to reach and initiate help immediately from the closest hospital is saving lives and improving health outcomes. In fact, I met a woman, alive today, because Mr.
At the First Global Symposium on Health Systems Research in Montreux, Switzerland in November, Dr. Yogesh Rajkotia, of USAID Rwanda, moderated a panel discussion noting that Performance-Based Financing (PBF) is an effective health systems strengthening strategy. The presentations were made on behalf of the Rwandan Ministry of Health with the guidance of Dr. Agnes Binagwaho, Permanent Secretary.
Three months ago, Annie Likhutu, a mother of six, came to Migowi Health Center in Phalombe, Malawi to receive voluntary HIV counseling and testing (VCT); now, she is back at the health center and ready to be tested for a second time.“It is very important to know your status, it is no good waiting until you get sick,” she said.Annie initially learned of the importance of testing through a radio advertisement from Word Alive Ministries International (WAMI), which is aired regularly and encourages listeners to go to health centers for VCT.Although Annie takes pride in knowing her stat
Today, MSH teams around the world observed World AIDS Day by participating in national commemorations and offering HIV testing, counseling, and prevention messages.In Guyana, the GHARP II team announced the winners of a contest among journalists and media houses for the best projects to reduce stigma and discrimination.In Honduras, AIDSTAR-Two supported its partner NGOs in a variety of special events, including puppet shows, health fairs, and HIV rapid test promotion.In Ethiopia, HCSP is having an exhibition booth at the national celebration displaying Information Education Communication
On this World AIDS Day, we reflect yet again on progress made toward global commitments to fight the HIV epidemic. According to UNAIDS, new infections have decreased this past year from 2.7 million to 2.6 million, but, 30 years into the epidemic, only 5.2 million people out of the estimated 15 million who need drugs have access to treatment.
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.
The results from the first Pre-exposure Prophylaxis (PrEP) clinical trial, the iPrEx Study, were just made public and published in today’s issue of the New England Journal of Medicine. In short, the trial showed an overall 44% efficacy in preventing HIV infection in gay, bisexual and transgender subjects who took the daily fixed dose combination antiretroviral pill Truvada (tenofovir [TDF] and emtracitabine [FTC]), compared with participants receiving a placebo.
Last year, the mHealth Alliance and the National Institute of Health (NIH) sponsored their first mobile health (mHealth) “Summit,” at the Ronald Reagan building in Washington, DC. The location was telling: it is the home of the US Agency for International Development (USAID). This year’s mHealth Summit has nearly doubled in size, moved its location to the Convention Center, and is being keynoted by Bill Gates and Ted Turner. It is safe to say that mHealth is certainly a topic de jour.
Blog post also appeared on Global Health Magazine. As the country with the second highest maternal mortality rate in the world, outranked only by India, Nigeria loses one in every 18 women during child-birth.
A team of experts from WHO, UNICEF, UNFPA, and World Bank recently published a report on maternal mortality entitled “Trends in Maternal Mortality: 1990 to 2008" (PDF).The document reports some fantastic news about a public health indicator that has until recently refused to budge. That indicator is the maternal mortality ratio, the number of maternal deaths per 100,000 live births. The improvement between 1990 and 2008 is significant and promising.The part of the report that received much less coverage relates to HIV and its strong, adverse effect on maternal mortality.
Blog post originally appeared on Global Health Magazine. Six years ago the Malawi health system was on the verge of collapse due to severe shortages of health workers. Every year the College of Medicine would train 20 doctors and every year, half of them would leave the country. Nurses were overwhelmed by the demand for services.Ratios of doctor and nurses to population were the lowest of all countries in Southern Africa. HIV & AIDS was on the rise and without more health staff, the roll-out of antiretroviral therapy (ART) would remain just a dream.
Part one of the blog series: Spotlight on Global Health Initiative Plus CountriesGender Mainstreaming in EthiopiaWith the announcement of the “GHI Plus” countries, we have a major opportunity to move the gender agenda beyond the rhetoric. The new guidelines clearly show that this issue is not only important, but also one of the major pillars for global health. The mandate has been given and the challenge now is to build on this legitimacy that has been hard earned and continue to seek opportunities, design interventions, and diligently document best practices.
In mid-June the United States Government continued to show its commitment to global health by announcing the first Global Health Initiative (GHI) Plus countries: Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal, and Rwanda. The GHI is a six-year, $63 billion initiative to help partner countries improve measurable health outcomes by strengthening health systems and building upon proven results.
Originally appeared in Global Health Magazine. Over the last several decades, millions of dollars have been invested in capacity building interventions, and the chorus of capacity building enthusiasts continues to grow. Yet, both in description and practice, capacity building remains somewhat fuzzy.
This article originally appeared on The Huffington Post. As world leaders gather next week at the U.N. to review progress on the Millennium Development Goals (MDGs) to eradicate poverty, hunger, and disease by 2015, a new integrated approach to funding and delivering health services in developing countries is critical if the UN's global health targets -- especially for women and children -- are to be met. Currently, the health goals are competing with each other for money, people, and other scarce resources.
This article was originally posted on K4Health’s Blog.Twelve months ago the K4Health project began its needs assessment to better understand how the flow of knowledge, information, and communications could be improved with regards to Family Planning and Reproductive Health, and HIV & AIDS, in support of the K4Health project.Seven months ago – in December 2009 – the project returned to disseminate the results of the assessment; to meet with key stakeholders at the national, district and community levels; and to present some ideas for improving the flow of information up an
Pick up any American newspaper these days, and all of the stories coming out of Haiti are negative: earthquake relief work is going slow, displaced people are still living in tented camps, men and women are still struggling to find work. And while these facts can’t be disputed, there are many other stories that are being left untold. Working in Haiti earlier this month, I encountered six women who are on the front lines of the battle against Haiti’s HIV & AIDS epidemic, who shared their stories with me.In the bustling, dense Delmas section of Port au Prince, these w
Originally posted on Global Health TV's website. Watch Video Coverage of Dispelling Myths About HaitiThe Global Health Council and its partners held a press conference at the International AIDS Conference in Vienna, to bring the attention of the media back to Haiti six months after it was devastated by earthquake.Experts such as Dr. Paul Farmer, Dr. Jonathan Quick from Management Sciences for Health, Jeff Sturchio from the Global Health Council, and Dr.
The AIDS 2010 conference theme “Rights Now, Right Here” was delivered loudly, clearly, and passionately throughout the week in Vienna as delegates discussed the practical and urgent implications for truly gaining universal access to HIV treatment, prevention, and care. Over 10 million HIV positive people are without access to treatment, without universal access, the MDGs will not be achieved by 2015.Human rights violations are a barrier to learning about the epidemic or receiving critical prevention information. Some HIV positive people are subject to unethical surveillance.
By Muku MugwagwaLast week , the keynote speaker at the opening plenary of the 2010 International AIDS Conference in Vienna, Austria, was former President Bill Clinton. He took charge of the stage to address how to move forward in the global fight against AIDS. HIV & AIDS has become a chronic disease – we must transition our efforts from an emergency response to one we can sustain.Clinton began his speech on an optimistic note, stating that the fight against AIDS has managed to raise more funding than any other epidemic in the world.
At the International AIDS Conference in Vienna, Austria, my colleagues and I gathered to discuss the principles of smart integration and its challenges, successes, and recommendations for implementation. Smart integration means coordinating HIV & AIDS programs with other health programs that have operated independently in the past; providing comprehensive services at all levels of the health system – from households to health facilities and across the continuum of prevention, treatment, and care; and building stronger partnerships between public and private sectors.There are thr
On July 19, here in Vienna at the XVIIIth International AIDS Conference, positive results were announced from the CAPRISA 004 Phase IIb microbicide trial of 1% tenofovir gel, which was tested in 889 South African women.
The South African Minister of Health, Dr. Aaron Motsoaledi, provided a clear picture of a new era of HIV & AIDS care, treatment, and prevention in South Africa at the International AIDS Conference on Tuesday morning.All of South Africa is united behind one goal of fighting HIV & AIDS, he said. Dr. Motsoaledi stands behind a firm commitment to human rights, “access to care, treatment, and prevention is a human right.”He is working with the Government of South Africa to ensure universal access in their country.
As we have heard, Haiti is the poorest country in Western Hemisphere and has some of the worst health statistics. Many things did not work well before the earthquake and the recovery effort has not progressed as many had hoped.There is a perception among some, though, that nothing was working before the January 12th earthquake and that nothing has happened since.Certainly in the health sector, and specifically in AIDS, this perception is simply wrong.
Originally appeared in GLOBAL HEALTH magazine.Men who have sex with men (MSM) bear a disproportionate share of the HIV/AIDS burden in Eastern Europe and Central Asia, but data on and services for this population are woefully inadequate. With a better understanding of this marginalized community's needs, donors and implementers can help support effective policies and programs for MSM infected and affected by HIV.In Eastern Europe and Central Asia, as in many parts of the world, the HIV epidemic among MSM is underreported and under”acknowledged.
On June 17, 2010, I was honored to attend and speak at a ceremony where Management Sciences for Health officially handed over 35 tons of life saving essential drugs to the Republic of Congo (DRC) in Kinshasa. The ceremony was chaired by Dr. Victor Makwenge Kaput, the DRC’s Minister of Health. These drugs represent the first half of an initial order of pharmaceuticals and medical supplies worth more than $ 1.5 million, and were made available through funding from USAID/DRC.
Next month in Vienna, Austria, thousands of activists, community workers, donors, health leaders, and government officials will gather for the VVIII International AIDS Conference. This year’s theme is Rights here, right now: a mandate on the importance of health as a human right for all. While it is easy to talk about health as a human right, it is much more difficult to deliver to diverse communities in some of the poorest countries around the world. Last year when President Obama announced his Global Health Initiative (GHI), he spoke about meeting the health needs of t
Just over five months ago, Haiti suffered a devastating earthquake that displaced more than 700,000 people. Addressing the health needs of such a large population in a post-disaster situation is a complex challenge, one Management Sciences for Health (MSH) is supporting through its many programs including our Leadership, Management and Sustainability Program (LMS).
UNAIDS’s new campaign aims to eliminate mother to child transmission (MTCT) of HIV by the 2012 World Cup in Brazil. It is fantastic to see that UNAIDS is using the enthusiasm and media coverage of World Cup to draw attention to one of Africa’s most pressing health issues, perinatal transmission of HIV.
My colleague Jude Nwokikie, program manager of the Strengthening Pharmaceutical Systems (SPS) project in South Africa and Namibia declared, “The world is no longer in the mood to tolerate MTCT.”
Global Health TV visits Ethiopia’s capital, Addis Ababa, to see how MSH’s systems approach at the community level results in better lives for people living with HIV & AIDS. Management Sciences for Health, an international nonprofit organization, uses proven approaches developed over four decades to help leaders, health managers, and communities in over 60 countries build stronger health systems for greater health impact.Watch the video.