Originally published by Global Health NOWCOVID-19’s lethal invasion in late 2019 has turned the world inside out. Yet, another disease, tuberculosis, has been plaguing humans since the Upper Paleolithic era, some 20,000 years ago. In fact, many infection-prevention precautions promoted for the coronavirus—coughing etiquette, distancing, and hand washing—originated as TB-control measures in Victorian times.
A recent Management Sciences for Health (MSH) study conducted with mental health patients in Afghanistan revealed that people being treated for mental illness were almost 20 times more likely to have tuberculosis (TB) than the general population. Years of conflict, poverty, stress, and illicit drug use have led to Afghanistan’s high rates of mental disorders, including depression, anxiety, and post-traumatic stress disorder. Studies have shown depression and anxiety rates as high as 72% and 85%, respectively, among Afghan adults.
by Barbara K. Timmons, PhDTuberculosis (TB) is the pandemic that won’t go away. This ancient disease, the leading infectious cause of death in the world, kills more than a million people every year. One-third of the world’s population lives with latent TB infection. Despite being a preventable and curable disease, TB has been difficult to eradicate in part because of the stigma around the infection, preventing people from getting tested and continuing treatment. Ethiopia is among the 30 countries with the highest burden of TB in the world.
This op-ed was originally published in The Hill.Twenty-thousand years ago, at the peak of the last ice age, early human ancestors were migrating from their origins in Africa to East Asia. Shards of the earliest known pottery found in a cave in China suggest that our progenitors were dabbling in cooking. The Upper Paleolithic era led to more than domestication, however. It also likely gave rise to the bacteria that are common ancestors to modern day tuberculosis.The disease has been plaguing humans ever since. Egyptian mummies show signs of TB.
Meet Daniel Gemechu, MSH Regional Director for the USAID-funded Challenge TB Project in Ethiopia. MSH has worked in Ethiopia since 2011 to improve the quality of TB care and prevention services. Over the past five years, treatment success rates rose above 90%, with 75% of those suffering from multidrug-resistant TB (MDR-TB) now able to beat the disease after completing their treatment regimens. We asked Dr. Gemechu to reflect on his experience working with MSH and what remains to be done to eliminate the disease in Ethiopia.Dr.
The chart above shows the good-news-bad-news scenario that is the decades-long fight against TB in Afghanistan. TB is still a crushing problem there; the country has among the world’s highest rates of the disease, which killed some 10,000 people in 2017. But if you glance at this chart and think that we haven’t made much progress, look again. We’re finding and treating more people with TB in Afghanistan than ever before. In 2001, we were missing three quarters of presumptive TB patients — that is a whopping 75% gap in case detection.
This week, for the first time in its history, the United Nations hosted a high-level meeting on TB, where world leaders agreed on a global plan to step up the fight against TB. Although the final political declaration has won approval, it is now up to countries to take action.
This story was originally published by The Hill.
During the 22nd International AIDS Conference in Amsterdam, scientists, policymakers, healthcare workers, advocates, and civil society shed light on the relationship between HIV and other urgent health crises, such as Tuberculosis (TB).
A less known, but critically important fact: TB is one of the leading causes of death among people with HIV/AIDS worldwide. To effectively address HIV, budget and policy responses must reflect the challenge of HIV-TB co-infection.
Meet Andrew Etsetowaghan, Associate Director for Technical Services with the CaTSS project in Nigeria. Fueled by a passion to help others since childhood, Andrew was determined to find a way to fulfill his dreams. He decided to pursue medicine—otherwise becoming a priest or superhero—and dedicate his career to improving health systems in his community. This interview has been edited for length and clarity.
Describe your daily work briefly.
Antimicrobial resistance (AMR) occurs when a microorganism becomes resistant to a drug that was originally effective for treating the infections it caused. It is one of the world’s most pressing global health threats and could erode progress made thus far in the treatment of HIV/AIDS, TB, malaria, and many other infectious diseases.
Management Sciences for Health’s (MSH) role in combatting AMR was recently featured in the peer-reviewed journal, Global Public Health.
Tuberculosis remains the world’s leading infectious disease killer. Ending TB will require a comprehensive approach and targeted action, rapid innovation and proven interventions, bold leadership, and intensive community engagement.
On this World TB Day, the global health community is calling for “Leaders for a TB-Free World” to work together, make history, and end TB once and for all.
The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program helped make sure that some of the world’s most vulnerable people have timely access to safe, affordable medicines and to quality services to improve their health. Funded by USAID, the program worked for six years in 46 countries to comprehensively strengthen pharmaceutical systems by addressing five interrelated functions, with a focus on medical products—governance, human resources, information, financing, and service delivery.
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.
Management Sciences for Health’s (MSH’s) significant TB work was recognized as some of the best during this year’s 48th Annual World Conference on Lung Health that took place in Guadalajara, Mexico from October 11-14, 2017.
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.
We’re excited to bring you this month’s edition of Leading Voices, a series that features the incredible talent that makes up MSH.
We’re chatting with Degu Jerene, our project director in Ethiopia. Degu hails from Addis Ababa and has a passion for stopping the spread of infectious diseases like tuberculosis, malaria, and HIV. He’s responsible for leading the USAID-funded Challenge TB project in Ethiopia. Degu will be representing MSH this week at the Union World Conference on Lung Health in Guadalajara, Mexico.
What do you think makes MSH different?
How health workers use technology to combat illness
Treatments for diseases like tuberculosis (TB) and HIV are lengthy and complex. Medications need to be taken regularly and for extended periods. Interruptions come at a high cost for patients, their families, and the health systems that treat them.
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.
Tuberculosis (TB) kills more people each year than any other infectious disease. It severely strains health systems and local, regional, and national economies. And, like many health crises, the disease disproportionately affects vulnerable populations. Many families incur catastrophic costs, aggravating poverty in communities.
This World TB Day, we reflect on the progress we've made and the challenges we still face in the fight to end TB. The key moving forward is to work together to ensure we don't leave anyone behind.
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.
This article was originally published on LillyPad, a blog run by the global health care company Eli Lilly, on February 16.
Antimicrobial resistance (AMR) is a global health crisis. In his AMR review, renowned economist Jim O’Neill estimates a loss of US$100 trillion in global productivity by the year 2050 if swift, comprehensive action to fight AMR is not taken. The publication acknowledges multi-drug resistant tuberculosis (MDR-TB) as a “cornerstone of the global AMR challenge.”
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.
Today, April 7, we celebrate World Health Day, started by the World Health Organization (WHO) to mark its founding in 1948.Amid Ebola, Zika, maternal and child mortality, and other global health challenges, WHO chose diabetes, for the first time, as its World Health Day theme (“Stay super. Beat diabetes”).
"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.
Tuberculosis (TB) has surpassed HIV and AIDS as the number one infectious killer worldwide, and in many countries, TB remains a major cause of death, sickness, and poverty. Major challenges to TB care and control include increases in drug-resistant TB (DR-TB) and reductions in donor funding.
It is crucial, therefore, that governments develop sustainable TB care and control delivery and financing mechanisms in the context of universal health coverage (UHC) programs.
“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.
Tuberculosis (TB) is now the leading infectious cause of death worldwide -- ahead of HIV. While major advances in the diagnosis and treatment of TB have been made since 1990, children suffering from this disease have remained neglected and vulnerable. An estimated 1 million children become ill with TB each year, and at least 200 children die each day from TB around the world.
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
An estimated two billion people worldwide are infected with mycobacterium tuberculosis, more commonly known as tuberculosis, or TB. Despite major successes reducing global TB prevalence and mortality rates, TB is the single greatest infectious disease killer globally, surpassing HIV & AIDS. In 2014, 1.5 million people died from TB, including about 400,000 who also had HIV.
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.
Picture a scenario where infections become totally untreatable because none of the available antimicrobial agents work. This is not imaginary, but is likely to happen very soon if we don’t act urgently, intensely, and consistently to tackle the rising tide of antimicrobial resistance (AMR).
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.
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.
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.
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.
“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.I thought I was ok.She started coughing again, went to the hospital, and was diagnosed with multidrug-resistant TB (MDR-TB). MDR-TB cannot be treated with two of the most powerful first-line treatment anti-TB drugs. Her treatment regimen?
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?
The US Agency for International Development (USAID)-funded Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program, led by Management Sciences for Health (MSH), in collaboration with the Stop TB Partnership Global Drug Facility, will host a technical conference titled, “Building the Post-2015 Agenda: Novel Approaches to Improving Access to TB Medicines and Pharmaceutical Services” from March 2-6, 2015 at the Conrad Bangkok Hotel in Bangkok, Thailand.
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).
Guaranteeing that patients have uninterrupted access to anti-tuberculosis (TB) treatment begins with national TB programs (NTP) making complex calculations about how many cases to expect in the future. Vigilant stock management, accurate number of cases started on each type of treatment along with forecasting the expected number of patients that will be enrolled on treatment, are vital to ensure that medicines are available to all patients who need them.
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.
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.
The highest rate of multi-drug resistant (M) and extensively drug-resistant (XDR) cases of tuberculosis (TB) is found in the World Health Organization (WHO) European Region. The Consolidated Action Plan to Prevent and Combat M/XDR-TB in the WHO European Region specifies that, by the end of 2013, all member states assure provision of an interrupted supply of quality first- and second-line medicines for treatment of all TB and M/XDR-TB patients.
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.
"At the Duka" tells the story of a Systems for Improved Access to Pharmaceuticals and Services Program (SIAPS) project to increase early detection of tuberculosis in Tanzania.
SIAPS partnered with the Tanzanian National Tuberculosis and Leprosy Program to train drug dispensers on the symptoms of TB, so that they could refer clients with these symptoms to TB diagnostic and treatment centers for follow up.
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
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.
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.
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.
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."
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.
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).
Mildred Fernando lives and works in the Philippines for the USAID-funded, MSH-led, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program. Mildred spoke at several World TB Day events in Washington, DC, including at a senate briefing and an event honoring TB survivors and advocates (watch video). The interview below first appeared on the SIAPS blog.It all began in November 2001 for Mildred Fernando when she was diagnosed with tuberculosis (TB), a preventable and curable disease which caused the death of 1.4 million people in 2011.
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.
Tuberculosis (TB) is a leading cause of death in Democratic Republic of the Congo (DRC), partly due to a low case detection rate within the health system, compounded by little knowledge or awareness among patients of the disease’s symptoms. In the province of Sud Kivu, where people have relied on traditional healers for generations, those who were suffering from the persistent, painful coughing that is one symptom of TB were advised by traditional healers that they had been poisoned, and they were not referred to health centers.
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.
Tuberculosis (TB) control in Ghana is challenging: detection of TB cases is low, and TB mortality rates high. In many communities, like Lower Manya Krobo District, these challenges are compounded by the popular belief that TB is a spiritual disease. Many Ghanaians who contract TB seek healing in prayer camps and shrines, rather than going to health facilities for testing and treatment. By the time these patients seek medical care, it often is too late to recover and avert death.
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.
Sunday, March 24, 2013, is World TB Day, and MSH staff and partners are promoting global efforts to stop TB throughout the week.Here are highlights from some of our activities around the world:The Afghanistan TB CARE I team is working with the national TB program (NTP) to conduct celebration events at 290 health facilities and communities in 13 USAID-supported provinces. TB messages will be aired through local telephone companies to approximately one million people throughout the nation.
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.
In Myanmar, 50 years of military dictatorship left behind a seriously underdeveloped health system, serving barely one in twenty of the country’s 60 million people. You might expect that the first minister of health under civilian rule would be despondent. But on my recent trip I found the opposite: Dr.
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.
Cross-posted from the MSH at the Union World Conference on Lung Health 2012 blog. Management Sciences for Health (MSH) presented at several symposia and workshops throughout the 43rd Union World Conference on Lung Health (read more).Friday’s symposium on November 16 dealt with: Saving lives in areas of conflict or disaster: partnering for results (PDF). Dr. Eliud Wandwalo of MSH Tanzania coordinated the session along with Morgan Richardson.First up was Dr.
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
This is the advice that Esther Wahome, a registered community health nurse in a Kenyan health facility, gives to her clients when they come to the tuberculosis (TB) clinic. Within a short time, Esther dispenses the drugs to the patient, provides health care advice and updates her records.Esther’s TB clinic clients are usually referred to Kayole II sub-district hospital from Toto Bora and other smaller health care centers.
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.
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. Over nearly 40 years of working in fragile states, Management Sciences for Health (MSH) has identified best practices, lessons learned, and appropriate interventions for a myriad of situations in fragile states.
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.
Cross-posted on TB-CARE I.World TB Day, March 24th, was commemorated in many countries around the world last week to acknowledge the accomplishments made in the fight against tuberculosis (TB), and to call attention to the work that still needs to be done.Voices of TB, a unique event organized by USAID, featured former TB patients speaking about their personal fight against TB.
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.
The images of tuberculosis patients from the developing world are often painful to look at: the outlines of rib cages taut against skin; arms and legs no thicker than wiffleball bats; a wild-eyed look of fear from sunken eyes. But the image of Mildred Fernando, captured here by photographer Riccardo Venturi, turns heads toward her.
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.
It was an exciting and insightful week of discussions at this month’s Global Health Council meeting on how to address the drastically growing burden of non-communicable diseases (NCDs), such as cancers, diabetes, and heart and lung disease, in advance of the UN High Level Summit on NCDs in September. Speakers made a strong case for including NCDs as a priority on the global health agenda. The intertwining of these diseases with communicable diseases such as HIV, TB and malaria are striking.
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.
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.
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.
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.
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.
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.
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.
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.