Story by Samy Rakotoniaina and Misa RahantasonMalaria is one of the leading causes of mortality among children under five in Madagascar. Atsimo Andrefana is one of Madagascar’s regions most severely impacted by endemic malaria. More than half of the population in this region lives more than five kilometers from the nearest health facility, putting Community Health Volunteers (CHVs) on the front lines in the fight against malaria.Retsilake is one of the 6,000 high-performing CHVs supported by the USAID-funded Accessible Continuum of Care and Essential Services Sustained (ACCESS) project.
A conversation with Dr. Bernard Nahlen, Director of the Eck Institute for Global Health at the University of Notre Dame and member of the MSH Board of Directors Dr. Bernard NahlenSome countries are entering peak malaria transmission season over the next few months, overlapping with the COVID-19 pandemic. How might the crisis affect ongoing malaria eradication efforts? One issue is case management. As a reminder, there were more deaths due to malaria than to Ebola in West Africa in 2014, because people were reluctant to go to clinics for treatment for fevers and aches.
Meet Hortense Kossou, Principal Technical Advisor for the USAID-funded Integrated Health Services Activity (IHSA) in Benin. Hortense previously served as the national malaria coordinator for the Ministry of Health in Benin and today leads IHSA’s malaria-related activities on the ground. In this issue of Leading Voices, she presents the challenges that the country faces in its fight against malaria and the actions being taken to combat it.
Elimase Kamanga is a mother, a midwife for more than 15 years, and the Senior Technical Advisor for Maternal and Newborn Health for the USAID-funded Organized Network of Services for Everyone’s (ONSE) Health Activity, led by MSH. Chisomo Mdalla, ONSE’s Chief Communications and Knowledge Exchange Officer, talked with Kamanga about her work to improve the quality of care for mothers and newborns in Malawi. This interview was edited for length and clarity.
Elimase, can you tell us about how you got to where you are today?
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.
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 the late 19th and early 20th centuries, Poliomyelitis, or polio, was a greatly feared scourge of the industrial world. It would paralyze hundreds of thousands of children every year. Once effective vaccines were introduced in the 1950s the number of cases of polio dropped dramatically and the virus was eliminated in many countries, but in some places, it still remains a real threat.
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.
(Cross-posted on the Global Health Council website).
Between 2000 and 2015, great strides have been made in fighting malaria. Globally, malaria case incidences declined by 41% and mortality rates by 62%. However, approximately 212 million people were infected and 429,000 people died in 2015, with the majority being children under the age of 5 in sub-Saharan Africa. Malaria also places a great financial burden on individuals and health systems. In sub-Saharan Africa alone, the annual cost of case management related to malaria is estimated at USD 300 million.
Malaria in pregnant women contributes to several negative outcomes including miscarriage, premature birth, labor complications, low birth-weight babies, anemia, and maternal and newborn death. In Sierra Leone, malaria in pregnancy and child mortality rates are especially high: the disease contributes to nearly 40 percent of deaths of children under the age of five.
We have made great strides in ridding the world of malaria, but there’s still work to be done—and the time is right to finish the job. New technology is helping communities around the world prevent, diagnose, and treat malaria in new and innovative ways. In Mozambique, the Malaria Consortium has developed a phone app that helps community health workers diagnose and treat malaria. In Zanzibar, Tanzania, local health facilities can use text messages to report malaria cases.
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.
This post, first published on The Huffington Post, is part 5 in the MSH series on improving the health of the poorest and most vulnerable women, children, and communities by prioritizing prevention and preparing health systems for epidemics. Join the conversation online with hashtag #HealthSystems.
The No More Epidemics campaign convened a multi-sectoral panel on “Advancing the Global Health Security Agenda” at the 69th World Health Assembly in Geneva, Switzerland on May 25, 2016. Keynote speaker, Mark Dybul, MD, Executive Director of The Global Fund to Fight AIDS, Tuberculosis and Malaria, expressed enthusiastic support for strategies combating epidemics.
This post appears in its entirety on HuffPost Impact.
Pandemics are back on the agenda for the 2016 G7 Summit, which convenes this week in Ise-Shima, Japan. The Group of Seven is expected to further its commitments to global health security. Look what has happened in less than one year since the G7 last met (June 2015), just after the Ebola crisis peaked at over 26,300 cases, 10,900 deaths.
When 18-year-old Ianka Barbosa was 7 months pregnant, an ultrasound showed the baby had an abnormally small head, a dreaded sign of microcephaly due to Zika infection. Upon hearing the news, Ianka’s husband fled. In her poor neighborhood of Campina Grande, Brazil, Ianka soon became a young mother alone.
As Ianka’s baby Sophia grows, she may never walk, or talk. She could develop seizures before she reaches six months. By the end of the year there may be a staggering 3,000 Sophias in Brazil – mostly in the poorest places.
Many child deaths in developing countries are preventable: Children die from treatable conditions, such as pneumonia, diarrhea, and malaria, because families in rural, hard-to-reach, or conflict-ridden areas can’t access or afford the treatments. The Sustainable Development Goals (SDGs), launched in September 2015, set ambitious targets of ending preventable child deaths by 2030 and reducing mortality among children under age five to at least 25 per 1,000 live births.
Four-year-old Amina is why I work on malaria. I met her in Basse District, The Gambia, last year when I was visiting the team distributing lifesaving malaria treatment to children under five. Words can’t describe the feeling of seeing this young Gambian girl, who had been severely ill with malaria, now beaming with joy, literally running to me for her fourth treatment.
Management Sciences for Health (MSH) celebrated 10 Years of Improving the Health of Women and Children in Nigeria with 250 stakeholders and supporters at a special event in Abuja on March 31, 2016. Distinguished guests included the chairman of the Nigerian House of Representatives, director of the Federal Ministry of Health in Nigeria, high-level representatives from state governments and partner organizations, and more.
"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.
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.
Join us online for the global launch of the No More Epidemics campaign, November 12, 2015, 11:00 am - 1:30 pm SAST (4:00 am – 6:30 am ET) from the Nelson Mandela Centre of Memory in Johannesburg, South Africa.
Visit NoMoreEpidemics.org to watch the Live Stream
Follow on Twitter at #NoMoreEpidemics.
This post originally appeared on the Frontline Health Workers Coalition blog.
I grew up in a village in northwestern Democratic Republic of the Congo (DRC), and although I’m now a doctor and live in Kinshasa, I remember those days well.
I know what it’s like to live 23 kilometers from the nearest health center and to navigate forests and floods to get there. I know how a lack of something simple like antibiotics can cause a quick death. I’ve lost many peers from the village over the years and a lot of family members.
In fact, that’s why I became a physician.
On Sunday, September 27, 2015, Management Sciences for Health (MSH), and its partners Save the Children US and International Medical Corps (IMC), along with African Field Epidemiology Network (AFENET), committed to bringing together key partners from the global public health, private, public, and civil society sectors to build the No More Epidemics™ campaign that will advocate for stronger health systems with better disease surveillance and epidemic preparedness capabilities to ensure local disease outbreaks do not become major epidemics.
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.
In the Geita District in Tanzania’s Lake Zone, some 10 kilometers from the nearest health facility, a one-year-old girl child wakes up crying with a severe fever. “We used to walk more than 10 kilometers to present our sick children to Geita Regional Hospital,” says Joyce Bahati, the girl’s mother.
"Let this be a loud call to action for greater investment in strong local health systems and global networks to prevent, detect and respond to public health threats. We know how to prevent the next local outbreak from becoming the world’s next major epidemic," says MSH President & CEO Jonathan D. Quick in a Letter to the Editor, published today in The New York Times.
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 the Bill & Melinda Gates Foundation Blog, Impatient Optimists.
Primary health care has many different definitions, but can be defined simply as the first place where people seek care. Within this definition, private sector providers constitute an important source of primary health care in many parts of the world.
Private providers of primary health
The unprecedented outbreak and spread of the Ebola virus in three West African countries (Guinea, Liberia, and Sierra Leone) continues to wreak havoc on the lives, economy, and already-strained health systems of the region. The outbreak is particularly high in Liberia with 2,413 people killed by the disease to date.
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.
This post originally appeared on the SIAPS blog. Many countries in Central and South America have made significant progress toward eliminating malaria. Between 2000 and 2012, 13 countries in the Americas saw malaria incidence rates drop by more than 75 percent. Argentina, Belize, Costa Rica, Ecuador, El Salvador, Mexico, and Paraguay have all reached the pre-elimination phase, a designation given by the World Health Organization (WHO) when countries meet certain critical steps in eliminating the disease and preventing its reintroduction.
April 2014 is an important month for malaria control. On April 25, the global community commemorates World Malaria Day 2014, with a theme of: "Invest in the Future: Defeat Malaria". Earlier this month, April 7, the theme of World Health Day highlighted the "small bite, big threat" of vector-borne diseases.
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?
Hepatitis is a personal disease for me. Some years ago, I spent two weeks leading training workshops for faculty at the University of Costa Rica in San Jose, Costa Rica. The work and the participants were delightful, as we worked together to improve medicine prescribing practices. Every day I ate lunch at a local seafood restaurant, often joined by a colleague. One Friday, two weeks after returning home, I felt exhausted—so tired that I could not continue working. By Sunday I was orange as a pumpkin, unable to walk or keep food down.
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.
To me, malaria is a very personal disease.I first came face to face with malaria during the war of my time: Vietnam. I was plucked out of residency after my first year, with only an internship under my belt, and sent as a Navy Medical Officer to war.
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.
Management Sciences for Health (MSH) invites you to attend the following sessions and poster presentations at the Global Maternal Health Conference in Arusha, Tanzania --- whether in person at the Arusha International Conference Center, or watching via archived videos online. (All times are listed in Eastern Africa Time: UTC/GMT +3 hours.
A hurricane superstorm slams the Caribbean and the eastern seaboard of the United States, flooding Manhattan’s subway system, leaving lower Manhattan and Brooklyn without electricity for days and destroying much of Staten Island. The storm kills hundreds of people, destroys thousands of homes, and causes over $65 billion in damage. Prior to October 2012, this scenario read like the plot of a Hollywood blockbuster.
Cross-posted on USAID's IMPACT blogMy most vivid early childhood memory is waking up to excruciating pain in my throat, and seeing the goldfish swimming in the aquarium of the pediatric surgical ward. Although penicillin had been discovered 30 years earlier, doctors had not learned yet that treating "strep throats” with penicillin was better than operating. I didn't need the tonsillectomy. But, I was lucky to receive quality care in a health facility, close to my home.Millions of children today are not so lucky.
Today, April 25th, Management Sciences for Health (MSH) joins the global community marking World Malaria Day. "Sustain Gains, Save Lives: Invest in Malaria" -- the theme of this year's World Malaria Day -- recognizes this crucial juncture in the global fight against malaria.Significant gains have been made in the last ten years; since 2000, malaria mortality rates have decreased 25 percent globally, and 33 percent in Africa.
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.
The future is indeed bright for public health in Nigeria, judging from what Dr. Muhammad Ali Pate, the Honorable Minister of State for Health of the Federal Republic of Nigeria, said at the Africare House in Washington, D.C. on September 21. The event, Innovative Approaches to Expanding Health Care Services, was co-sponsored by Management Sciences for Health (MSH), fhi360, the Anadach Group, and hosted by Africare.
If you grow up in places like Kasungu district in rural Malawi, you learn that when your wife is pregnant, you should not have sex outside marriage---because you will lose the “expected gift” through miscarriage. Male promiscuity during a partner's pregnancy is a taboo that many believe will bring a curse on the family.Patricia Patrick says that after she miscarried in November 2008 “People talked in the village, and people talked within the household.
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.
It is 5:30 a.m. on a Thursday morning in the town of Mwene-Ditu, located in the Eastern Kasaï Province of the Democratic Republic of Congo. The skies are still dark as the crieur, the town crier, makes his rounds, calling out to the community that today is the start of the three-day national vaccination campaign against polio.As the local residents begin their day, health workers are finalizing preparations for the massive door-to-door effort to immunize children under age five years old from this crippling disease.
Malaria is preventable and curable, yet every year it kills more than a million people throughout the world and tens of thousands in Southern Sudan alone. Malaria infection remains the highest cause of morbidity and mortality in Southern Sudan. Every year, thousands in Southern Sudan die unnecessarily due to lack of access to appropriate prevention and treatment. In the wake of nearly 50 years of civil war, the country is hastening towards independence and a future with unlimited potential.
My recent field visit has given me a great perspective on one of MSH’s major activities - the costing of health services. MSH has extensive costing experience in East Asia & Pacific, Latin America & the Caribbean, Southern Africa, and West Africa.MSH developed and has helped manage multiple applications of the CORE Plus (Cost and Revenue Analysis Tool Plus). CORE Plus is a tool that helps managers and planners estimate the costs of individual services and packages of services in primary health care facilities as well as total costs for the facilities.
Malawi has some of the worst health statistics in the world, ranking 166 out of 177 countries. This is the result of HIV & AIDS, food insecurity, weak governance, and many human resources challenges. Health care vacancies range anywhere from 30-80%, and Malawi only has 252 doctors in the entire country. The health system is regularly plagued with stock outs of key medicines and supplies, as a result of poor procurement and distribution practices.
The West African nation of Benin faces many challenges in achieving Millennium Development Goal 4---reducing child mortality. In the rural communities in Benin (91% of the population live in rural areas), access to health care and treatment is inadequate in relation to the vast need. Very few people have the appropriate skills and capacity to deliver care in these areas.
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.
In late October 2010, the USAID Supply Chain Management System project (SCMS) distributed close to 50,000 lbs of essential products including oral rehydration salts, antibiotics, lab supplies, water treatment and ringer lactate to support Haiti's response to the cholera epidemic. The commodities came from existing stock in the SCMS warehouse as well as products available on the local market. SCMS also provided international procurements of 60,000 IV solution units and 20,000 IV sets.Antoine Fadoul is the Supply Chain Management System Country Director in Haiti.
Reeling from ShockEstama Murat, Director of the Drouin Methodist School, cautiously hopes to reopen: “This obviously will not come easy," he says, "because we have many children still sick and other pupils have fled the village.”Drouin is in Grande Saline, where the cholera virus was first discovered in the Artibonite department last week. The population of 17,000 is still in shock. Many of them left for the chief town of Gonaives, Mr.
The Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project Chief of Party, Agma Prins, and Dr. Serge Conille are in the Artibonite department to support the MSH response to the cholera outbreak. They continue to coordinate with the Ministry of Health and other international and local partners. MSH is working with Pure Water for the World to educate communities about hygiene and provide access to clean water through bio-sand filters.Additionally, MSH Sr. Technical Advisor, Dr.
The Management Sciences for Health Haiti staff continues to work tirelessly alongside local partners to mitigate the cholera outbreak. A sample of today’s work is outlined below.MSH in the Affected RegionsMSH partner, Hospital Claire Heureuse, is dispatching a “battalion” of community health workers throughout the rural areas where many people are dying before reaching health facilities. The community health workers are stocked with megaphones, soap bars, water purification tablets, and oral rehydration sachets.
Yesterday the Direction of Civil Protection and Disaster in Haiti confirmed a cholera outbreak in two departments (districts) of the country resulting in 1,498 cases managed in health facilities and 135 cholera related deaths.The USAID-funded, MSH-led Santé pour le Développement et la Stabilité d’Haíïti (SDSH) project is working closely with Haiti’s Ministry of Health and other local and international partners to coordinate a community-level response to the cholera outbreak.SDSH is mobilizing its established network of over 4,000 community-base
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.
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.