August 2013

{Photo credit: Reavis/MSH, Malawi}Photo credit: Reavis/MSH, Malawi

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. While most patients don’t show symptoms of disease at these higher CD4 counts (a measure of immune system strength), the new guidelines responded to evidence that an earlier start improves long-term clinical outcomes and that ARV treatment dramatically reduces patients’ likelihood of transmitting the virus to sexual partners.

International breastfeeding symbol

This week the global health community celebrates World Breastfeeding Week (August 1-7). Breast milk is nutritious, clean, available, natural, and does not require special preparation or handling. Let’s take a moment to consider some of the numerous benefits of breastfeeding to baby and mom:

  1. Breastfeeding is the world's most effective solution to reducing child deaths
  2. Breastfeeding could save the lives of nearly 1 million children per year
  3. Breastfeeding reduces deaths to pneumonia and diarrhea
  4. Breastfeeding and nursing promote closeness for baby and mom
  5. Nursing reduces mom’s risk of breast and ovarian cancer later in life
  6. Nursing contributes to reduction in maternal mortality by helping moms space their births and prevent unintended pregnancy
  7. Nursing helps lower rates of obesity among women

In addition to the individual benefits to baby and mom, breastfeeding can help the global community achieve Millennium Development Goals 4 (reduce child mortality), 5 (reduce maternal mortality), and 1 (reduce poverty and hunger).

 {Photo credit: Charles Fred via flickr}HIV poster in Vietnam.Photo credit: Charles Fred via flickr

This post includes portions of the introduction, questions, and answers from the English edition of "Transition Forward, Issue 1, June 2013" (PDF). 

Vietnam has made significant progress in re­cent years responding to the country’s HIV & AIDS epidemic. Under the ongoing leadership of the Government of Vietnam (also known as Viet Nam), the interna­tional community has provided significant technical and financial support to the HIV & AIDS program. As country leadership and ca­pacity to address the HIV epidemic has been strengthened, and as Vietnam’s economy grows stronger, increasing emphasis is being placed on transitioning to a sustained country-led response.

This includes strengthening the health system and civil society, particularly to reach those most at risk.

{Photo credit: LMS Haiti/MSH}Photo credit: LMS Haiti/MSH

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.

Adolescents and young men and women need access to quality, affordable reproductive health services. In the developing world, 52 million never-married women, aged 15-24, are sexually active and in need of reproductive health and HIV prevention services and information. Yet, adolescent girls often face greater barriers than adult women in accessing them. In the sub-Saharan Africa region, only 21 percent of married adolescents are using a modern contraceptive method; and the adolescent birth rate in the region is four times the rate in Europe and Central Asia. In the Latin America region, teenagers have doubled their proportion of the fertility rate from 8.5 percent in 1955 to 14.3 percent in 2005, despite a steady decline in overall fertility numbers.

{Photo credit: Genaye Eshetu/MSH}Photo credit: Genaye Eshetu/MSH

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.

So, how will high-burden, low-resource countries respond to the new World Health Organization (WHO) guidelines that recommend starting HIV treatment earlier? Will the global AIDS movement join forces with those calling for universal health coverage (UHC) targets post-2015? How are civil society organizations working with countries on the HIV & AIDS response---and how can we strengthen their capacity?

The July/August edition of MSH's Global Health Impact Newsletter (subscribe) answers these questions and more, combining thought-provoking editorials and first-hand accounts from MSH countries around the world.

{Photo credit: Todd Shapera, Rwanda}Photo credit: Todd Shapera, Rwanda

OVCsupport.net, a global knowledge sharing website, is announcing its second annual writing contest, open to all those who have a story to tell about working with children affected by HIV and AIDS. The annual competition is one component of OVCsupport.net’s efforts to facilitate the exchange of ideas and experiences between people who are working in the field of orphans and vulnerable children (OVC). The top three submissions will be featured on the site and in the August edition of the site’s electronic newsletter.

According to UNAIDS, more than 14 million children worldwide have lost one or both parents to HIV. The thousands of organizations that provide services to these children often do not have the mechanism to share experiences or receive information on best practices from one another. OVCsupport.net provides a way for these organizations to connect with one another and have access to cutting edge information. The annual writing contest is an opportunity for local organizations and writers to make their voice heard in the global forum.

 {Photo credit: Todd Shapera.}A Rwandan mother and newborn rest under a bed net.Photo credit: Todd Shapera.

Over one hundred years ago on this date, (August 20, 1897), British scientist Sir Ronald Ross discovered that infected female mosquitoes transmit malaria between humans. (Like any vector borne disease, the malaria-causing parasite, Plasmodium, needs a specific host: in this case, the mosquito. The female mosquito needs blood to nourish her eggs; the male just eats nectar.) Dr. Ross received the Nobel Prize for his discovery that year. Today, we mark the day, August 20, as “World Mosquito Day.”

What’s all the buzz about?

A child in sub-Saharan Africa dies every minute as a result of malaria—more than 1,400 children globally every day. Malaria affects about 220 million people, with 80 percent of all cases occurring in just 17 countries. The World Health Organization (WHO) estimates that 660,000 people died from the disease in 2010; most in Africa. Two countries—Democratic Republic of the Congo (DRC) and Nigeria—hold 40 percent of the burden of malaria mortality. Despite these challenges, progress is being made: since 2000, malaria mortality rates have dropped 33 percent in Africa, and 25 percent globally (more on malaria from WHO).

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.

In 2011, despite the global initiative to eliminate mother-to-child transmission of HIV, 330,000 new pediatric infections were added worldwide to the existing pool of 3.4 million children living with the virus. Children are more vulnerable to HIV infection and have higher morbidity and mortality. Without treatment, half of those children infected will die before the age of 2 years, yet only one third of those eligible for treatment are currently receiving antiretroviral therapy.

 {Photo by Aurélie Jousset.}Elina Jean-Baptiste and her newborn daughter, Dadeline who was at the Cazale following its reopening.Photo by Aurélie Jousset.

On July 4, 2013, 26-year-old Elina Jean-Baptiste of Cazale, Haiti began experiencing painful contractions as she prepared to deliver her child. Realizing she was going into labor, Elina walked to the Cazale health center and with the help of trained nurses and a doctor, delivered a healthy baby girl named Dadeline. “The labor and delivery were very painful, but as soon as I arrived at Cazale, I knew I was in good hands,” she said.

For the past decade, the town of Cazale has lacked a functioning health center despite high rates of maternal and infant mortality and increasing rates of infectious diseases. Women often delivered at home in the absence of a skilled healthcare provider, thus increasing their risk of injury or death due to pregnancy-related complications. 

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