One Project in Ethiopia Shows Us That Investing in Health Systems Pays Dividends  Over the past five years, the Ethiopian government and MSH have been working shoulder to shoulder to improve and expand the country’s tuberculosis services with the goal of alleviating the burden of the disease. If you wonder whether foreign assistance is money well spent, just look at the remarkable progress we’ve made in Ethiopia, where only a few years ago the stock out rate for TB drugs was as high as 20 percent. That number today is about two percent.

MSH will host and support events in five countries this week to honor World TB Day. Observed March 24, World TB Day raises awareness and mobilizes support for efforts around the world working to end tuberculosis (TB). The World Health Organization (WHO) has designated this year’s theme as “Unite to End TB: Leave No One Behind,” and many of the day’s activities will focus on addressing stigma, discrimination, and marginalization.

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.

Thirty MSH staff coordinated 2 workshops and 7 symposia and contributed 13 oral and 53 poster presentations to the 47th Union World Conference on Lung Health in Liverpool from October 26 through 29—a historic presence at this event. USAID and WHO experts called the MSH-led symposia on multidrug-resistant TB (MDR-TB) and urban DOTS “outstanding.” In the area of urban DOTS, presenters described the successful approaches that MSH has used in Kabul and Kampala under Challenge TB/Afghanistan and Uganda Track TB.

"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.

When my daughter got sick, I took her to a clinic in my neighborhood. They gave her cough syrup for seven days. I thought she was getting better, but it was apparent that she was still ill. After another examination, they referred her to St. Paul Hospital in Addis Ababa where they put her on oxygen and started taking blood sample after sample and injection after injection for a month. Her condition did not get better so they gave her another medicine. The doctors then decided to take blood from her back… only then did they know it was tuberculosis.

“When we started our project in 2011, there was no system in place to identify multidrug-resistant tuberculosis (MDR-TB),” explained Muluken Melese, project director for the Help Ethiopia Address the Low Tuberculosis Performance (HEAL TB) project. However, since then, the five-year USAID-funded project, implemented by Management Sciences for Health (MSH), has expanded access to TB services to over half the population of Ethiopia and led a 15-fold increase in the number of MDR-TB patients on treatment.

This blog post is a web-formatted version of the Global Health Impact newsletter: Stronger Health Systems Stop TB and Save Lives (December 2015). (View or share the email version here.) We welcome your feedback and questions in the comments or email us. On social media, use hashtag #GlobalHealthImpact and tag @MSHHealthImpact.  Subscribe

This week, at the 46th Union World Conference on Lung Health (hashtag #WCLH2015), the US Agency for International Development (USAID)-funded and Management Sciences for Health (MSH)-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program is launching a new tool to improve how the safety and effectiveness of medicines is monitored in low- and middle-income countries.

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.

MSH's May 2015 newsletter highlights the global health impact of pharmaceutical management: Ensuring access to affordable, quality medicines saves lives (subscribe). Introduction 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.

Health workers throughout the developing world provide vital services and improve the lives of the people they serve, and yet they are often invisible. These men and women conduct community outreach, provide key prevention messages in the community, and deliver clinical care, treatment, and follow-up. In Uganda, the US Agency for International Development (USAID) TRACK TB project, led by Management Sciences for Health (MSH), supports 52 community linkage facilitators to help increase tuberculosis (TB) case detection and treatment success rates.

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?

Cross-posted with permission from Science Speaks Blog. The Value of Patient Support

This post originally appeared on the SIAPS website.

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. 

Successfully combating the tuberculosis (TB) epidemic requires that national TB programs (NTPs) prevent new infections and ensure that current patients are cured. Although the treatment for drug-sensitive TB is very effective, curing the disease requires that patients adhere to a strict daily regimen of multiple pills for six to nine months. Adding to the challenge is the fact that treatment for drug-resistant TB is longer, more toxic, and less effective.

Azmara Ashenafi, a 35-year-old woman from the Amhara region of Ethiopia, was diagnosed with tuberculosis (TB) and placed on treatment. She was fortunate. Many people with TB are missed by health systems altogether. But Azmara’a treatment wasn’t helping. Despite taking medicine for months, her symptoms persisted and became more severe. In many places, her story would have a sad ending—TB is one of the top three leading causes of death for women 15 to 44 in low- and middle-income countries.

MSH staff are commemorating World TB Day through awareness-raising activities around the globe, including in Afghanistan, Cambodia, Ethiopia, Ghana, Indonesia, and Nigeria. Here are photos (some from 2013) with activities this year. Afghanistan - TB CARE I

I never thought that being sick with tuberculosis (TB) for a decade would lead me to this purpose: being an advocate to fight and eliminate this disease--not just in my country, the Philippines, but all over the world. I was recently invited by RESULTS Japan to represent TB patients' perspectives in the call for continuous funding from the Japanese government to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). The advocacy activities, led by Results Japan, were in support to the Global Fund Fourth Replenishment which aims to secure financing for the years 2014-2016.

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."

This edition of MSH's Global Health Impact e-newsletter (subscribe) explores our worldwide work supporting healthy communities, families and kids, including:Mobilizing communities to care for orphans and vulnerable children in Lesotho;Empowering Ugandan couples with information and access to modern family planning;Training community health workers to provide TB services in rural Afghanistan;Supporting Kenya's efforts to utilize mobile technology for pharmacovigilance reporting; andCommunicating strategically to influence health-seeking behaviors (i.e. proper use of bed nets).

In recent years, commitments from the government and major donors have led to improved tuberculosis (TB) control in Indonesia, with reductions in both prevalence and incidence.

After South Sudan gained independence from Sudan in 2011, disagreements over oil-sharing between the two nations caused fighting and high economic inflation in certain regions. Desperate for security, over 110,000 Sudanese refugees escaped to South Sudan and now reside in camps in Maban County. Bounj Hospital: Diagnosing and treating residents and refugees These refugees, and the county’s 40,000 residents, are served by Bounj Hospital, the only TB diagnostic and treatment center in the district. This hospital is currently treating 75 patients for TB, 56 of whom are refugees.

The state of tuberculosis (TB) is in a tug-of-war as current challenges threaten to undo past successes. One of the primary hurdles currently facing TB prevention and cure is the emergence of strains that are resistant to at least two of the most effective medicines (rifampicin and isoniazid).So-called drug-resistant (DR)-TB arises when patients are unable to complete a full-course of appropriate, high quality anti-TB medicines.

Stop TB in my lifetime. This global call to action---the Stop TB Partnership's theme for March 24, World TB Day 2013---is as relevant now as it was over a hundred years ago. Progress toward reducing the global burden of tuberculosis (TB) has been impressive in recent years: TB mortality has fallen by 41 percent since 1990. Yet, TB remains one of the world’s leading causes of death, killing more than 1.4 million people per year, including 70,000 children. In 2011, 600,000 people died of TB in Africa alone---including many people with HIV.

Silenat Yihune, a 40-year-old woman, mother, and housewife, lives in a remote region of Huletejuenesie District, Ethiopia, which is approximately 20 kilometers from the closest health facility. For nine months Silenat suffered from a cough, chest pain, fever, and weight loss, but was unable to receive treatment. As is common among Ethiopian families, Silenat was economically dependent upon her husband. He refused to pay for her travel to the distant health facility.

When I worked in Smallpox eradication in the mid-1970s, I traveled all over northern India and Bangladesh. I never took malaria prophylaxis, because malaria had been cleared from those areas. Likewise, I did not take malaria prophylaxis when I worked in the Brazilian Amazon in the late-1970s. At that time, malaria was found only in gold miners in isolated tributaries of the Amazon.

Seven-year-old Makasi, an HIV-positive orphan in Tanzania, was diagnosed with advanced tuberculosis (TB) and started on curative treatment. Clinicians at a local health center used standardized TB guidelines to overcome the difficulty of identifying TB in children co-infected with other diseases. In Afghanistan, sixteen-year-old Hamida provides for her family while trying to complete school. Hamida was visited by a community health worker, who identified her TB symptoms, and helped her access appropriate diagnosis and treatment. Steady Progress Against Daunting Challenges

Chronic diseases --- notably cancers, cardiovascular diseases, chronic lung diseases, and diabetes --- now account for nearly 35 million deaths annually. The human and economic burden of chronic diseases are staggering, especially in developing countries. Left unchecked, by 2030 the epidemic will kill twice as many people in low- and middle-income countries as it does today.One year ago, the world came together to address this emerging global epidemic.

“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.

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.

In the 1990s many Brazilian patients infected with tuberculosis (TB) were not being cured, despite starting treatment. Some patients stopped taking their medication, which led to the reemergence of TB. In 1993, the World Health Organization declared that TB was a global emergency.

Cross-posted from the K4Health Blog.As the mHealth Summit gets underway this week in the Washington D.C.

 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.

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.

The World Health Organization (WHO) recently endorsed a new and novel rapid test for tuberculosis (TB), especially relevant in countries most affected by the disease, and is calling for widespread use of this test and its incorporation into national plans.MSH applauds the research and development experts who developed this new TB test and the WHO for endorsing it so quickly.

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.

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.