Global Health News
Weekly Highlights, July 26 – August 1 2009
Published August 02, 2009 @ 04:05AM PT
Basics
Living in Central Asia, Alanna has first-hand experience with the pesky little sandflies that transmit the tropical disease leishmaniasis. Read her post Five Things to Know About Leishmaniasis to learn all about it. Also, learn about the five medical conditions that account for 80% of maternal deaths: severe bleeding, infections, hypertensive disorders, obstructed labor, and unsafe abortions.
As a first post in the series, "Things That Work," Alanna talks about Health Visitors: nurses, doctors or trained volunteers that conduct home visits and give people basic health education and care. Health visitors are one way to increase health care access, but What Does Access to Medical Care Really Mean? Alanna explains three main forms of access: geographic, financial, and cultural. And guest blogger Michael Keizer teases apart the differences between inequities and inequalities in his post The Health Equation.
News & Analysis
News broke out on Tuesday that the Cambodian government has been relocating people living with AIDS into a de facto "AIDS colony," one without clean water or sanitary facilities.
This week's Friday Futures explores Obesity. Alanna warns that, with increased meat consumption and urbanization, the developing world that is at risk for a rise in obesity. But urbanization is not just a risk factor for obesity. Given the higher population density and lack of healthcare in slums, Alanna thinks that Swine Flu is Going to Hit Megacities Hard.
Alanna has written about the Guttmacher Institute study that found withdrawal may be an effective method of birth control. In response to a New York Times article about this study, guest blogger Mara Gordon explores the tricky question, "What is a publication's responsibility when it comes to controversial health news?"
Career Advice
Alanna gives the pros and cons to Joining the Peace Corps as part of your global health career. One key point to remember is that the Peace Corps is not an international development organization, but a US public diplomacy agency. Also, you may be interested in a Very Interesting Vacancy at Center for Global Development (CGD). Alanna thinks the CGD is "the clearest, sanest voices out there on global development and health."
The G8 and Global Health
Published July 09, 2009 @ 08:36AM PT
The G8 summit began yesterday, and after their first day of meetings they issued a declaration. It's a 40-page discussion of their commitment to responsible leadership in a time of great challenges. Pages 33-35 cover global health. Here's how it came out:
The laudable but usual:
- They reaffirmed their commitment to the health needs of the most vulnerable, including women and children.
- They mention the importance of strengthening health systems. (that's a huge topic right now - check out this post from the CGD)
- They warmly support building a global consensus on maternal, newborn and child health as a way to accelerate progress on the Millennium Development Goals for both maternal and child health,
The somewhat concrete:
- They commit to "developing networks of researchers and by working with our African partners to establish a consortium of interdisciplinary centres of health innovation. As an enabling first step in developing the consortium, we will convene a planning meeting in late 2009 with African partners to establish a roadmap."
The depressingly unlikely:
- They invite partner countries to increase and effectively use their domestic financing for health in line with the principles of the Rome, Paris and Accra Declarations.
The entreatingly jargon-filled:
- They "promote a comprehensive and integrated approach to the achievement of the health-related MDGs, also maximizing synergies between global health initiatives and health systems."
- They acknowledge the work of the Leading Group on Innovative Financing for Development and the report of the High Level Taskforce on Innovative International Financing for Health Systems, which present a set of options from which countries and stakeholders can choose on a voluntary basis to mobilize resources to strengthen health systems.
Updates: Blog4GlobaHealth has several good posts on the G8 summit, and they feel that this summit has not met past commitments.
Weekly Highlights, 6/28/09 - 7/04/09
Published July 05, 2009 @ 02:29PM PT
(Photo Credit: Hugh Sturrock. Wellcome Images)
June 27 was US National HIV Testing Day. Do you know your status? Alanna tells her own Experience Getting Tested for HIV, and offers the advice, "Getting tested for HIV is hard the first time, but it gets easier. And if you do have HIV, getting tested will save your life."
This wee, guest blogger Michael Keizer shows how Global Health and Human Rights are Made for Each Other; better health improves human rights, and ensuring human rights improves health.
In light of the bad economy, many people are flocking to graduate school, but Alanna spells out for us When Not to Go to Grad School. Also, if you have trouble getting things done, check out Alanna's useful tips for Being Productive.
In last week's "Friday Futures," Alanna predicted The End of the Physician. She expanded her thoughts a bit further in her post, Supporting Physicians to Improve Health Care, arguing that healthcare needs to be a team effort between physicians, non-physician clinicians and technology. And in this week's "Friday Futures", Alanna warns of The Growing Threat of Malaria.
In her post, Fear, Sex, and Pandemic - Part One, guest blogger Carol Dunn comments on the initial over-reaction, and the current under-reaction to swine flu, stating that pandemic risk communicators need to understand the irrationality of human reaction to threats.
Alanna gave an overview on a recently released report on Innovative Financing for Health Systems, concluding that that there's No Magic Bullet for getting more money for health.
For more global health reading, check out this week's Recommended Readings to learn about Disability-Adjusted Life Years (DALYS), a new female condom effort in Uganda, swine flue resistance, and more.
Innovative Financing Mechanisms for Health Systems, But No Magic Bullet
Published June 30, 2009 @ 10:17AM PT
To follow up on yesterday's post on innovative financing mechanisms for health systems, I looked into the first two innovative mechanisms mentioned, the mandatory solidarity levy on airline tickets and expanding the use of the International Financing Facility for Immunization and other approaches to ensure predictability.
The mandatory solidarity levy, (that's a mouthful of a name, isn't it? From now on I'll just say "the levy") as currently conceived, is a tax placed on airline tickets to raise money for development programs. Imposed by a country's government, the levy is added to the cost of airline tickets and the funds raised go directly to a dedicated account for international development programs. The logic is that air travel benefits most from globalization, and that a mandatory levy has little effect on travel patterns. The idea was pushed heavily by the French government, but has not gained much traction so far. The US refused to sign on; so far only seven countries have - Chile, Côte d'Ivoire, France, Republic of Korea, Madagascar, Mauritius and Niger. The levy has, however, funded 72% of the budget for UNITAID in 2008.
The International Financing Facility for Immunization raises money for vaccination by issuing bonds based on donor pledges of future aid. This lets recipient countries receive their aid more quickly, and as lump sums rather than over a period of years. (more detail here) They repay the bondholders using the aid as it comes in.
I really like the idea of innovative financing mechanisms for health. I really do. But I think we're looking for magic bullets where they don't exist. You don't get money from nothing. The mandatory solidarity levy seems close to neutral in its impact. I think that the International Financial Facility for Immunization may actually be harmful. Recipient countries get their money sooner, but they get less of it, and I am not sold on the advantages of a big infusion of money as fast as possible.
Recommended Readings, June 20, 2009
Published June 20, 2009 @ 08:52AM PT
Some great evaluations have come out in the past few days, taking on some of the sacred cows of global health.
We saw a new evaluation of the Global Fund to fight AIDS, Tuberculosis, and Malaria. Impressively, it was commissioned by the global fund itself. The evaluation is not kind; the Center for Global Development Blog has an excellent summary of the report. One thing that comes up in the evaluation is the failure of the Country Coordinating Mechanism to oversee implementation of grants. Based on my own experience with the CCM, that's dead on. You can't expect what is basically a group of disparate volunteers to add unpaid oversight of complex grants to their workload.
Next, the Lancet published a major story on health resource flows. It looked at who funds global health and what that funding supports. The article takes a new approach to estimating global health aid, looking at disbursements rather than commitments, and also at aid from US based NGOs. The Center for Global Development, however, has noticed some weaknesses in the methodology. (Yes, that is two CGD links in two paragraphs. That's because their global health policy blog is amazing. They are especially good on things like this - summarizing and analyzing new reports on global health.) Myself, I wonder if the report doesn't double count some aid. If USAID gives money to World Vision for a health program, does that funding get counted as USAID funding and World Vision funding?
The Lancet is clearly on a roll; they also have a fascinating article on who influences global health. Conclusion: the UN's influence is shrinking and that's not a good thing.
Deadly Roads Are Not Just a Metaphor
Published June 18, 2009 @ 09:15AM PT
(photo credit: richardmasoner)
Take a guess at the answer to this question: What kills 1.3 million people worldwide each year, 90% of them in developing countries?
The hot-button issues probably crossed your mind: AIDS, perhaps malaria. If you're a global health junkie (and regular reader of this blog), maybe you'd guess tuberculosis. When we think about large numbers of mortalities, we tend to think of the "big name" diseases. Editor's note: If you are a very diligent reader of this blog, you might already know the answer.
The answer, however, isn't even a disease, let alone one with a Global Fund and celebrity spokespeople to address it. It's traffic accidents. That's what kills hundreds of thousands of people in the developing world every year.
Earlier this week, the World Health Organization released its first Global Status Report on Road Safety. The statistics are chilling, especially considering how little international attention this issue receives. Very few countries have comprehensive road safety laws, and those that do rarely enforce them. Perhaps the scariest statistic of all: the WHO predicts that traffic fatalities will be the fifth leading cause of death by 2030.
Why doesn't road safety garner the same kind of developed-world sympathy - and aid dollars - that infectious diseases do? I've done a lot of thinking about this, particularly because road accidents have directly affected me and several of my friends in Africa.
The WHO statistics indicate, by any account, a bona fide public health threat. Yet it's rare to encounter any international NGOs working on the issue, let alone idealistic aid workers trucking off to new parts of the globe to fight for better seatbelt laws instead of HIV medication.
A few thoughts:
- Road accidents happen at home, too. A car crash doesn't seem exotic to an American in the same way that many tropical diseases do. I'm not trying to undermine the importance of prevention and treatment for infectious diseases, but sometimes the ordinary problems don't seem as noble to fix.
- We can't deliver a commodity to treat it. As a donor, it feels good to imagine your money putting a tangible object in somebody's hands: an anti-malarial bednet, a nutritional supplement for a child. We can't prevent car accidents with a deliverable product.
- Addressing the problem means uncovering many, many more. Road safety in poor countries is a result of many complex, interconnected factors - safety standards for vehicles, unenforced traffic laws, shortages of trauma centers. A drug can't cure it.
Take a look at the WHO report and let me know what you think. Where do we start?
Recommended Readings: June 16, 2009
Published June 16, 2009 @ 10:43AM PT
(photo credit: Science Speaks)
Ruth Levine talks about Advance Market Commitments for vaccines on the Center for Global Development blog. CGD has every right to be proud of this; they were a major player in making this happen. Now that it's finally - finally - going to happen, read all about it.
Physicians for Human Rights has a new report out about the targeting of physicians in Kosovo. It's ugly stuff. "in the period 1998 and early 1999, Serbian police and paramilitary forces targeted Kosovar Albanian physicians for allegedly providing care to members of the Kosovo Liberation Army. This persecution breached the requirements of human rights law and the Geneva Conventions by failing to respect physicians' ethical obligation to provide medical care to patients..."
The Science Speaks blog has several great posts from the recent 2009 HIV/AIDS implementers meeting in Namibia. I especially liked this post from Dr. John Idoko, Director General of Nigeria's National Agency for the Control of AIDS, on cost effectiveness, and this detailed look at HIV prevention. For highlights of the meeting overall, this post is useful.
This week the WHO declared swine flu to be a pandemic. (see my other post today). Maryn McKenna reminds us that we could have caught the spread of H1N1 a lot faster if anyone had been doing surveillance in pigs. That's a problem not just for swine flu, but for all diseases that pass from animals to humans.
