July 2013

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

Reforming a health system in pursuit of universal health coverage (UHC) has the potential to transform health and save lives, but it carries enormous challenges for the leaders committed to this vision. From revenue collection to enforcement of quality standards, every aspect of the system must come together to make UHC successful and sustainable.

With over 100 countries working their way toward UHC--and UHC a prime consideration in post-2015 sustainable development conversations--MSH is devoting this issue of the Global Health Impact newsletter (subscribe) to one of the essential elements of successful UHC: access to medicines.

A NOTE FROM DR. JONATHAN QUICK

Post-2015: Sustainable Health Development Requires UHC: Dr. Quick on Devex

{Photo credit: MSH/Carmen Urdaneta}Photo credit: MSH/Carmen Urdaneta

Management Sciences for Health (MSH) has been awarded the contract for “Technical Assistance in Service Delivery and Management Capacity Building for the Salud Mesoamérica 2015 Initiative Countries,” a $9.3 million, 18-month award by the Inter-American Development Bank. The goal of the Salud Mesoamérica 2015 Initiative (“salud” is Spanish for health) is to reduce health equity gaps in eight countries in the Mesoamérica region.

Under the Salud Mesoamérica 2015 Initiative, MSH will provide ongoing technical assistance in seven of the eight countries to improve the quality of, access to, and use of health services at the primary and secondary levels of care for the poorest 20% of the population. The countries are: Chiapas-Mexico, El Salvador, Guatemala, Honduras, Costa Rica, Nicaragua and Panama. MSH’s technical assistance will focus on expanding essential obstetric and neonatal care, newborn and child health, family planning services, assuring quality in those services, monitoring and use of health information system data for decision-making, and results-based financing models.

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

Management Sciences for Health (MSH) welcomes the report of the United Nations High Level Panel (HLP) of Eminent Persons on the Post-2015 Development Agenda. The HLP’s advisory report, released May 30, is part of an ongoing process of defining the global targets that will replace the Millennium Development Goals. MSH believes the report demonstrates the panel’s ongoing commitment to health as an essential component of sustainable development and improving lives around the world.

The panel named five specific health targets focusing on infant and child health, immunization, maternal mortality, sexual and reproductive health and rights, and high-burden communicable and chronic diseases. While the panel recognized that universal access to basic health services will be necessary to achieve these goals, it did not recommend an explicit target for increasing healthcare access or coverage.

Management Sciences for Health (MSH) is pleased to announce the availability of the 2012 edition of the International Drug Price Indicator Guide (the Guide). MSH has published the Guide since 1986 and updates it annually.

The Guide provides a spectrum of prices from 23 sources, including pharmaceutical suppliers, international development organizations, and government agencies. The 2012 edition includes prices for about 1,100 products, including nearly 50 new items. The therapeutic classes with the most new entries this year are anti-infective medicines, cytotoxics, and diagnostics.

{Photo credit: MSH}Photo credit: MSH

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.

In April 2001, the Heads of State and Government of the African Union signed the Abuja Declaration after undertaking a critical review of the rapid spread of HIV and AIDS on the continent. The Declaration cited practical strategies to deal with the menace. It also urged governments of member states to increase funding for health to at least 15% of the national budget. 

The Nigerian government and the African Union (AU) will co-host the Abuja +12 Special Summit of the AU Heads of government from July 15 to July 19 to review the 2001 Abuja declaration. The Summit intends to focus on the unfinished work of the health-related Millennium Development Goals. It will serve as an avenue to review the progress made on the implementation of the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Communicable Diseases. It will also propose a framework for post-2015 development agenda for Africa. 

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

My family’s story exemplifies how access to reproductive health and family planning in a low-income country can have tremendous economic and life-transforming impact for young people and a whole generation—beyond the reduction in fertility and improvements in health.

My parents got married in the 60s, at a time when Profamilia, The International Planned Parenthood Federation (IPPF) affiliate in Colombia, was pioneering the country’s path through successful demographic transition. My father, the youngest child of a family of nine, and my mother, the oldest of seven, never went to college. Instead, they worked through their teen years, struggling to help their families.

My mother (influenced by distant women relatives who were educated) had made up her mind to give her children the education she never had. She convinced my father (in spite of the macho, progenitive culture) that the only way to pursue their dreams was to secure a way out of poverty through hard work—and a small family. Sure enough, I, their oldest child, was the first one in the 70-plus extended family to graduate from college and medical school. My two sisters continue to benefit from the education they received.

{Photo credit: MSH}Photo credit: MSH

Experts in global health and chronic diseases, policymakers, patient groups, and more, are assembling in Johannesburg, South Africa, for the second one-day event hosted by The Economist on "New Approaches to Non-Communicable Diseases" July 16. Following on a successful October 2012 meeting in Geneva, this year's theme is "Accelerating Progress in Prevention and Control." Moderated by The Economist Group editors, the discussions will focus on the rise in chronic diseases in low- and middle-income countries and on developing solutions together through innovative cross-sector partnerships. 

 {Photo provided by Ayyaz Kiani of DEV-NET.}(Left to right): Dr. Khalid Saeed, President of the Pakistan Pharmacists Association; Dr. Sania Nishtar, Founder and President of Heartfile; Dr. Ejaz Qadeer, NTP Manager; Dr. Azhar Hussain, Director of Pharmacy, Hamdad University, Islamabad; and Dr. Gul Majeed Khan, Chairman of the Department of Pharmacy, University Quaide Azam, Islamabad.Photo provided by Ayyaz Kiani of DEV-NET.

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."

" href="https://twitter.com/SaniaNishtar">Dr. Nishtar, keynote speaker at the "Engaging Pharmacists in TB Care and Control in Pakistan" stakeholders' meeting last week in Islamabad, Pakistan, highlighted the importance of involving all care providers in tuberculosis (TB) diagnosis and treatment. The meeting of key stakeholders included representatives from the Ministry of Health, universities, and pharmaceutical manufacturers, among others.

{Photo credit: Lola Akinmade, Nigeria. Courtesy of Photoshare}Photo credit: Lola Akinmade, Nigeria. Courtesy of Photoshare

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.

Fortunately, in May 2012, the PEPFAR-funded, USAID project, Community-Based Support for Orphans and Vulnerable Children (CUBS) in Nigeria held an event in Sinachi’s village to raise HIV awareness and enroll vulnerable children in support programs. When Sinachi attended the event and explained her situation to the CUBS staff, they immediately referred her to the State Ministry of Women Affairs and Social Development.

The Ministry’s commissioner helped Sinachi advocate for support from Chima by meeting with him to discuss the children’s needs and his responsibilities. Swayed by the authority of the commissioner, Chima now pays his children’s schools fees and calls them frequently to inquire about their well-being. Recently, Chima also gave Sinachi money to rent a better home and start a small business.

{Photo credit: MSH staff}Photo credit: MSH staff

Cross-posted with permission from UHC Forward.

I walked into a pediatric unit of a teaching hospital in Nigeria a few years ago to review a patient. On the first bed was a lifeless child. He was brought in dead a few minutes earlier by his parents. His mother, "Bisi", wept uncontrollably. While in tears, she recounted how difficult it was for them to borrow money to get to the hospital. Although they got some money from a chief in the community, the two-year-old baby died before they got to the hospital.

Kunle’s story touched me deeply. Kunle’s case typifies the plight of many poor people in Nigeria and the rest of sub-Saharan Africa: The financial burden of illness makes many families poorer. People are afraid to go to hospitals because they may not be able to afford the cost of the health services they need. They prefer to buy drugs over the counter, or visit a local herbalist, who will charge little or nothing to provide poor health service.

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