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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. The earthquake has been devastating for Haiti and its people, but in the health sector there were many good things going on before the earthquake and some real strengths to build upon. The government of Haiti, at both the national and department level, has been playing a strong leadership role.

MSH first began working in Haiti over 30 years ago. Over the last decade our nearly all-Haitian staff has worked intensively to develop leadership, management, planning, and service delivery skills within the Ministry of Health and Population, nationally and at the departmental and local levels. We also work to strengthen over two dozen service delivery NGOs.

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. The lack of official reports on HIV among men who have sex with men might enable governments to avoid prioritizing or even offering interventions, and HIV programmers can fail to reach those most in need.

Without the data and analysis of MSM issues it is easy for governments and HIV/AIDS programmers to not develop MSM programs and interventions as: (a) no data means it can look like MSM is not a problem and therefore not a priority and (b) lack of recognition of the issue means that it is easy for governments'/programmers' own homophobia to get in the way of developing programming.

With sometimes impenetrable terrain and limited infrastructure, Yemen presents a very challenging environment for delivering health services to rural areas. Basic health services do not reach most women; rural areas lack health facilities; and Yemen’s conservative cultures do not allow women to receive health services from men, or to freely come and go from their home.

In Yemen, through a pilot program, the Extending Service Delivery (ESD) Project supported the Basic Health Services (BHS) Project to assist midwives with setting up private practices in rural communities where facilities did not exist or were too far away. Midwives are generally respected in Yemen communities and, most husbands allow their wives to visit the midwives in their homes.

At the Global Health Council Conference, I attended an interesting event, “Impact of Schistosomiasis and Polyparasitic Infections on Anemia, Growth and Physical Fitness in Children in Coastal Kenya” presented by  Dr. Amaya Bustinduy of Case Western Reserve University which focused on neglected tropical diseases (NTD).

Schistosomiasis remains one of the most serious and prevalent neglected tropical diseases worldwide.  According to Bustinduy, the WHO estimated that there are 235 million cases of schistosomiasis with 732 million to be at risk for contraction. 89% of  all cases live in the less-developed areas of rural sub-Saharan Africa and South America.

Schistosomiasis is associated with diseases such as anemia, growth impairment in children, and mental retardation.  The focus of Dr. Bustinduy’s ongoing study in Kenya is to “address those morbidities as part of a larger study examining the ecology of transmission of Schistosomiasis.”

The Group of Eight (G-8), holding their annual summit last weekend in Muskoka,Canada, announced a Canadian-led Muskoka Initiative on Maternal, Newborn and Under-Five Child Health (Muskoka Initiative). The Group of 20 (G-20) summit held immediately after in Toronto, resulted in no additional commitments to maternal and child health. MSH believes the G-20 missed an opportunity to support global health when the group did not endorse the G-8’s maternal and child health initiative announced the day before. The G-20 is a group of key finance ministers and central bank governors that meets semi-annually on matters relating to the international financial system.

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 the world by leveraging current resources and integrating programs for greater health impact. Integrating HIV & AIDS services with other health services such as reproductive health (including family planning), TB, malaria, or maternal and child health increases effectiveness and ultimately sustainability. 

One of the most striking admissions I heard during the Women Deliver 2010 conference in Washington DC (June 7-9) was that the major challenge facing maternal health improvement is a lack of political will. Kathleen Sebelius, the US Secretary for Health and Human Services, suggested that the problem with improving maternal mortality lay not with the lack of knowledge or interventions, but the political will to put that knowledge to action, the will to make maternal mortality a priority of governments, the will to stand up and say that the lives of women matter, and we MUST do something about it.

“Songs brought by foreigners do not last long at the dance.”  So goes a Kenyan proverb that supports the concept that countries should own their development. The development community knows this, but we aren’t yet making it happen on a broad scale. On the opening day of the Global Health Council conference last week, Management Sciences for Health (MSH) teamed up with Oxfam America to host a panel on country ownership and how to successfully achieve it.

To a standing room only audience the panelists from civil society, NGOs, local government, and US government discussed country ownership models from a varied perspectives. Highlights from the interesting conversation are below:

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).

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