Health

Time to take “neglected” out of neglected tropical diseases

Jan 30th, 2012 6:26 PM UTC
By Peter Taylor

This morning in London, 13 pharmaceutical companies, the US, UK, UAE governments, the Bill & Melinda Gates Foundation, the World Bank and other global health organisations announced a new plan to eliminate or control 10 neglected tropical diseases.

These 10 diseases disproportionally effect 1.4 billion of the world’s poorest people.

Dr Caroline Anstey of the World Bank said: “These are not neglected diseases – but rather diseases of neglected people.”

The aim is to eliminate Guinea worm, leprosy, lymphatic filariasis, blinding trachoma and sleeping sickness by 2020, and control schistosomiasis, river blindness, soil-transmitted helminthes, Chagas disease and visceral leishmaniasis. These diseases cause misery, suffering, disfigurement and death – and when they don’t kill the seriously affect the lives of many people.

At the event today $785 million dollars was pledged to support research efforts into the diseases, and to strengthen distribution to make sure the vital drugs get to the people who need them.

Bill Gates said that it was “thilling to go from an idea a year ago to this milestone event with ambitious goals”.

You can read more in depth information about the 10 diseases, and watch a recording of today’s event at unitingtocombatNTDs.org

Here’s a great Infographic that explains the problem and solution (click to enlarge):

Watch: 10 years of the Global Fund, 7.7 million lives saved

Jan 26th, 2012 3:19 PM UTC
By Peter Taylor

To celebrate 10 years of the  Global Fund to Fight AIDS TB and Malaria, they have launched a video celebrating some of their achievements over the last decade:

If you feel inspired, please share!

Required reading in Davos

Jan 25th, 2012 3:26 PM UTC
By Michael Elliott

As the world’s business, political and media elite made their annual trek to the Swiss town of Davos – blanketed in more snow than I have seen there for a decade – conventional wisdom had it they should have all the lightheartedness of a gray, winter, Alpine sky. The Eurozone crisis, the difficulty of getting tough political decisions in the United States, and worries in some of the champions among emerging markets – the chance of a property crash in China, for example, or of runaway inflation in India – were all said to contribute to a note of pessimism among Davos devotees.

But even if you think that the prophets of global economic doom and gloom are right – I don’t, as it happens, but that’s another story – there are plenty of reasons to be cheerful about the state of the world. Some of them were collected in Bill Gates’s annual letter on the work of the Bill and Melinda Gates Foundation, which should be required reading for the Davos crowd. The letter detailed some of the extraordinary advances that have been made in global health, for example, over the past decades, with the roll out of vaccines on a massive scale, tremendous progress, especially in India, on the eradication of polio, and, indeed, on the treatment and prevention of HIV/AIDS. I was particularly pleased that Bill’s letter made mention of the rotavirus vaccine that GAVI is rolling out to tackle one of the leading causes of diarrhea – an appalling killer of children, and one which has rarely gotten the public or political dissension that it deserves.

Of course, the letter pointed out how much more needed to be done so that all people, everywhere, could live lives of equal dignity. More funding needs to be devoted to research and development in agriculture – a key goal of ONE this year. Those of us who advocate for increased resources to go to the world’s poor appreciate that in tough economic times, we have our work cut out for us. But when generous funders like the Gates Foundation and taxpayers around the world have done so much to combat extreme poverty and preventable disease in the last ten years, now would be the very worst moment to give up the fight. That fight is more likely to be won, as Bill pointed out in a passage on the need for more resources for The Global Fund to Fight AIDS, Tuberculosis and Malaria that is worth quoting at length, if citizens in the rich world understood just how much could be done with comparatively few resources.

“Between 2011 and 2013, assuming that all donors honor their commitments, the Global Fund will disburse $10 billion. This is a $2 billion increase, but not nearly the $12–$14 billion that is needed and was hoped for. Citizens of donor countries should know about the difference their generosity has made. The cost of keeping a patient on AIDS drugs has been coming down, and it looks like getting it to $300 per patient per year should be achievable. That will mean every $300 that governments invest in the Global Fund will put another person on treatment for a year. Every $300 that’s not forthcoming will represent a person taken off treatment. That’s a very clear choice. I believe that if people understood the choice, they would ask their government to save more lives.”

My 2012 Annual Letter

Jan 25th, 2012 12:01 AM UTC
By Bill Gates

In this guest post, Bill Gates discusses the themes of his annual letter, which looks back on progress made and lessons learned in the fight against extreme poverty. Originally published on Impatient Optimists, blog of the Bill & Melinda Gates Foundation.

My job is to learn about global health and development—and to travel to poor countries to meet farmers who can’t grow enough food, mothers who can’t keep children healthy, and heroes in the field who are doing something about those emergencies. Very few people can devote the time to really understand these complex problems. Even fewer can actually meet the people who are struggling to overcome them. That is why I write an annual letter every year.

I want people to know about the amazing progress we’ve made. I also want them to see how much more progress it will take before we live in a truly equitable world.

In this year’s letter, I focus on food and agriculture (though I also provide updates about all the global health and U.S. education work we do). When I was in high school, a popular book called The Population Bomb painted a nightmarish vision of mass starvation on a planet that has outgrown its carrying capacity. That prediction was wrong, in large part because researchers developed much more productive seeds and other tools that helped poor farmers in many parts of the world multiply their yields. As a result, the percentage of people in extreme poverty has been cut in half in my lifetime.  That’s the amazing progress part of the story, and not enough people know it.

But there’s the progress-yet-to-come part, and people need to know that, too. There are still more than 1 billion people who live in extreme poverty. They are located primarily in South Asia and sub-Saharan Africa, and they live on the edge of starvation. There is an irony in this, because most of them are farmers. We can help these 1 billion achieve self-sufficiency, just like we helped billions before them, but we stopped trying. At a certain point, the sense of crisis around food dissipated, and the proportion of foreign aid dedicated to agriculture dropped from one-fifth to less than one-twentieth.

My hope for my annual letter is that it helps people connect to the choice we all have to make. Relatively small investments changed the future for hundreds of millions of small farm families. The choice now is this: Do we continue those investments so that the 1 billion people who remain poor benefit? Or do we tolerate a world in which one in seven people is undernourished, stunted, and in danger of starving to death?

In times of tight budgets, we have to pick our priorities. It’s clear that in this particular time, we’re in danger of deciding that aid to the poorest is not one of them. I am confident, however, that if people understand what their aid has already accomplished—and its potential to accomplish so much more—they’ll insist on doing more, not less. That is why I wrote my letter. I hope you’ll take the time to read it and share it with your friends and family.

I’ve invited students from around the world to write their own annual letters too. You can send your letter, or any questions you have for me, to annualletter@gatesfoundation.org. I’ll be answering and talking about the ideas in your letters in a live webcast on February 2 on my Facebook page.

India celebrates one year polio-free

Jan 13th, 2012 12:02 PM UTC
By Erin Hohlfelder

Friday the 13^th is a day known for superstition, fear, and bad luck.  But today, the global health community in India attained a milestone that will ensure that we remember this Friday the 13^th as a day of progress and hope.  As of today, India has gone an entire year without a case of polio. In technical-speak, this means that India has officially interrupted transmission of the virus and is no longer considered an endemic country, leaving only three countries (Pakistan, Afghanistan, and Nigeria) remaining in the world with endemic status.

Experts have long considered India to be one of the toughest places in the world to fight and eradicate polio.  After all, India is neither a small nor homogenous place, and just two years ago, India had 741 cases of polio—the most in the world.  How did they achieve this milestone?

• They immunized, and they immunized again: India held two National Immunization Days (NIDs) in 2011, and during each NID, an amazing 2.5 million vaccinators delivered polio vaccines to more than 172 million children.  For children who weren’t reached by the NIDs, India organized 7 Sub-National Immunization Days to focus in on more remote and high-risk areas.
• They innovated: Indians didn’t just rely on traditional vaccine education and delivery methods.  They met parents and children where they were—at bus stops, in construction sites, on motorbikes.  They also fostered pressure and incentives for their health care workers, ensuring accountability and consistency in their delivery program.
• They fought stigma and misconception: Particularly in Muslim sections of India where concerns about vaccines were more common, polio eradication programs engaged religious leaders at all levels to build trust among parents for this safe, effective health intervention.
• They led from within: Though the role of groups including the GPEI partners and the Gates Foundation can’t be overstated, India is a success story because Indians have also stepped up.  Since the National Polio Surveillance Project was established in 1997 by the Indian Government and the WHO, the program has grown, become more effective and targeted, and has built a platform that now allows for greater progress on other diseases. Local stakeholders including teachers, religious leaders, and health workers have been on the front lines of the fight. And critically, the Indian government has financed the vast majority of the eradication effort with its own resources—an example for other emerging economies to follow.

And why, as an Africa-focused organization, should we pay so much attention to this achievement?  For many in the global health community who often feel like the challenges are endless, this shows that real progress is possible—and not just in the “easy” places.  This milestone should rejuvenate global efforts to eradicate polio, including from the last remaining endemic country in Africa (Nigeria) as well as other countries which had once eliminated the disease but have seen a resurgence in recent years (including Angola, Chad, and the DRC).  At a time when vaccination rates are on the decline in some regions, each successful immunization campaign—and the press generated around it—also helps to reinforce the safety and value of vaccines for parents around the world.  The tactics India used to achieve this goal should also serve as a lesson for other countries and other global health challenges; persistence, innovation, and country ownership are fundamental to effective development programs, and will remain so long after polio is eradicated.

Please join me in congratulating the millions of people who have dedicated time, resources, and political will toward making this a momentous—and happy—Friday the 13^th!

ONE Africa Award 2011: Demanding the right to health care in Ghana

Nov 2nd, 2011 11:06 AM UTC
By Edith Jibunoh

It’s time to announce our second finalist in the 2011 ONE Africa Award.

After Togo, we went on to Accra, Ghana to meet the Alliance for Reproductive Health Rights (ARHR). The alliance was established by a group of NGO’s in 2004, and evolved from a defunct Save the Children program on sexual and reproductive health. ARHR Executive Director, Ms. Vicky Okine, is the former Save the Children program manager, and recognized the importance of the continuation of this program. It builds on the potential of community health organizations to empower their communities and drive the demand for better access to sexual and reproductive health care. The alliance coordinates the community organizations, arms them with the patients rights charter, and provides training in the area of reproductive health care. Through the alliance, local organisations have been encouraged to come together and share their experiences in the community, learn from each other and organize.

ARHR works from a rights based approach, which is their basis for empowering communities to demand for health care services from the government. Ghana adopted a free maternal health policy that was generally disregarded at the village level where the lack of information allowed health officials to get away with low levels of service delivery in many communities. With the assistance of the alliance, organizations have hosted advocacy and training at a grassroots level to get people to understand their rights, complain about poor health services and organize themselves to agitate for change. In a recent advocacy effort, beneficiaries were able to secure a meeting with the district health officers to demand better service delivery.

ARHR’s model is unique because this rights based approach provides a response to the demand and supply side of delivery of social services. It provides the information that people need to demand for services and it also influences public health policy. ARHR also develops materials to help educate people on government policies and works with the Ministry of Health to feed back information gathered at the grassroots level to influence policy modifications.

ARHR has used the media, including radio and television, in their advocacy work and stakeholders are now more aware of Ghana’s progress in efforts to meet the health Millennium Development Goals. Earlier this year, ARHR produced a documentary called “The Lights Have Gone Out Again”, which was aired on Ghanaian television and popularly drew mass attention to the problems associated with sexual and reproductive health care service in the country.

Through all of their efforts, ARHR has successfully influenced the way government is doing business and improvements can already be seen in the health service with increased access to health care. Community residents, armed with information from the alliance, are no longer turned away from health centres when refused service. They stand their ground and demand their right to health care.

Good luck to the Alliance for Reproductive Health Rights!

Donor funding for AIDS dips 10 percent

Aug 24th, 2011 2:32 PM UTC
By Erin Hohlfelder

Last week, the Kaiser Family Foundation (KFF) and UNAIDS released their annual report on donor funding for AIDS — and the news this year wasn’t great. Measuring disbursements (money out the door) rather than just commitments or pledges, KFF and UNAIDS found that funding from donor governments for AIDS in low- and middle-income countries fell for the first time, down 10% from 2009 to 2010.

Seven of the 15 governments surveyed — Australia, Germany, the Netherlands, Norway, Spain, Sweden and the United States — reported a year-over-year decrease in their disbursements as measured in their own currencies. An accompanying press release pointed to three main factors leading to the $740 million decrease: actual reductions in development assistance; currency exchange fluctuations; and a specific slowdown in the pace of US disbursements, which was not a budget cut but was instead largely the result of new Congressional requirements for PEPFAR disbursements.

This overall decrease marks a stark reversal in trends for AIDS spending. Previous KFF and UNAIDS reports cited a six-fold increase in disbursements between 2002 and 2008 before leveling in 2009, which allowed for impressive gains in the treatment and prevention of AIDS.

Particularly now — in a year that saw major breakthroughs in the potential for AIDS treatment as prevention, increased efficacy of female microbicides, and a renewed focus on bending the AIDS epidemic curve — it is disappointing to see donors fail to meet this growing momentum with appropriate increases in funding. Of course, the last year also saw a major uptick in global enthusiasm for maternal and child health issues, including vaccines (and the increased energy and funding were welcome). But with millions still in need of treatment for AIDS, simply prioritizing other health issues or citing the difficult economic environment are not sufficient excuses for slowing down funding for programs that work effectively and save lives.

For more on country-specific disbursements, as well as to see breakdowns between donors’ multilateral spending for AIDS (primarily through the Global Fund) and bilateral spending, visit KFF’s website for detailed slides.

Malaria: We are making progress

Jul 7th, 2011 7:55 PM UTC
By Nadeem Javaid

How is this for some Living Proof – MORE THAN 500 MILLION PEOPLE HAVE BEEN REACHED WITH ANTIMALARIAL BEDNETS IN THE PAST 2 YEARS ALONE.

It’s easy to read, but here is a nice little interactive map by our friends at the Bill and Malinda Gates Foundation that visually represents the statistics. It shows how far the international community has come, for example saving 580,547 lives in Nigeria, and how much work we still need to do to completely eradicate this deadly yet preventable disease.

There are 3 main components to this infographic: you can view the progress of individual countries, an explanation of the life saving methods that are used, and a comparison of the number of global lives saved with and without increased interventions such as bed nets, case management and anti-malarial drugs.

You can find the interactive infographic here. Please take a look and pass it on to your friends and family.

Rwanda takes on cervical cancer

May 14th, 2011 4:00 PM UTC
By ONE Partners

Dr Agnes Binagwaho, Minister of Health of Rwanda and Dr Fidel Ngabo, Director of MCH in the MoH of Rwanda and Ms Cynthia Kamikazi of the GAVI Alliance discuss a comprehensive new program to eliminate cervical cancer in Rwanda.

In 2002, the Rwandan government set up a strategy to tackle priority diseases that were the major killers of both adults (HIV/AIDS, tuberculosis and malaria) and children (gastroenteritis, pneumonia, malaria, meningitis and HIV).

For the past few years, anti-retroviral coverage for HIV patients in need of treatment has increased from 10 percent in 2003 to 82% in 2010. The rate of coverage for prevention of maternal-to-child transmission services has reached 78% of pregnant women. Malaria incidence has declined by 70% between 2001 and 2010. In 2010, the cure rate for tuberculosis treatment was 87%. For multi-drug resistant tuberculosis, the cure rate was 91 percent.

During the same year, 98% of TB patients were tested for HIV. Other indicators of progress include 94% of children vaccinated against pneumococcal disease, and community health workers treating gastroenteritis without delay at village level.

Having met most of the targets set in regards to infectious diseases, as well as achieving improvements in the heath system more generally, Rwanda has noted an increase in life expectancy. As the population has begun to live longer, chronic, non-communicable diseases, such as cancer, rheumatic heart diseases, diabetes and hypertension are becoming more visible. And as a result, the Ministry of Health has initiated a new strategy of tackling priority chronic and non-communicable diseases, so as to continue to provide a better and longer life to the Rwandan population. Cervical cancer is one of such diseases.

According to research conducted in Rwanda, cervical cancer accounts for 27% of all the women’s cancer in the two university hospitals. The World Health Organization has reported that the incidence of cervical cancer in Rwanda is 49 per 100,000 in the population.

Knowing the magnitude of cervical cancer, and the fact that cervical cancer is one of the few cancers that can be fully prevented through vaccination and screening, and treated in its early stages, the Government of Rwanda decided to start their fight with a comprehensive program against cervical cancer.

In light of this, the Ministry of Health, in collaboration with its partners, has developed a national plan for prevention, screening and treatment of cervical cancer in Rwanda. This comprehensive plan includes HPV vaccination of girls aged 11 to 15, early detection of women aged between 35 to 45 years, as well as building in country the capacity to treat any stages of cervical cancer according to different levels of the health system. Through the work of the first lady, the Ministry of Health has negotiated with partners to support this first ever national comprehensive plan for cervical cancer. As a start, MERCK has donated 2 million HPV vaccine doses while QIAGEN has donated 250,000 HPV DNA-tests for screening.

It is in this light that on April, 26, the Government of Rwanda officially launched a Rwandan comprehensive cervical cancer program. The program started with vaccination of school girls in Primary 6, beginning with the Kanyinya sector in Nyarugenge District, followed by 2 days of vaccination in all primary schools in Rwanda, as well as a national summit on women’s cancers.

In collaboration with the MINEDUC, the Ministry of Health has made the HPV vaccine available to all health centers; and because 95% of girls are enrolled in school during the ages targeted, all primary schools have been identified as vaccination sites.

Using the national network of three community health workers per village and the commitment of the local leaders, girls who did not attend schools during the two days of vaccination have been identified at home and vaccinated in the community. As a result, 94% of girls have received their first dose of HPV vaccine while the rest will receive it during the catch-up phase in collaboration with CHWs.

This comprehensive cervical cancer program will avail prevention, screening and treatment for the entire population at risk. All of this will be done for a period of 3 years, while Rwanda works on its sustainability plan after this period.

The parents and community members interviewed during the vaccination days were very happy to have an opportunity to prevent cancer among their daughters, and there was an excellent adherence to this program on a voluntary basis.

Rwanda is the first country in the world to offer a comprehensive plan to eliminate cervical cancer despite social and economic challenges. The Rwandan plan is for the country to be free from cervical cancer within 40 years (by 2050) as a result of consistent vaccination, regular screening and timely treatment.

African health ministers go ‘on the record’ about vaccines

May 13th, 2011 3:00 PM UTC
By Erin Hohlfelder

We’ve been doing a lot of talking about vaccines this spring. You’ve heard from ONE in your email inbox. You’ve heard from little kids in our new video. You’ve heard from parent advocates, vaccine developers and Bill Gates — all of whom (we hope) have been motivating, or at least have made you think.

A toddler and her mom wait at a community vaccination day clinic in Narena, Mali.

But until now, we haven’t shared the perspectives of those who perhaps most clearly understand the value of vaccines: the ministers of health from Africa who run immunization campaigns in their countries and whose countries benefit from GAVI directly. Our senior Africa Outreach Manager Edith Jibunoh and Africa director Dr. Sipho Moyo recently met up with a number of ministers of health in Togo and Namibia, and they documented the ministers’ on-the-record accounts of just how important vaccines are.

Ghana
“It is unacceptable and against the principles of fundamental human rights that children who are the future generations continue to die of diseases for which there are known cost effective interventions. The introduction of vaccines for the prevention of childhood killer disease has indeed made tremendous positive impact on the health of our children.

Ghana is currently implementing a program of vaccination against nine childhood killer diseases. Three additional vaccines namely, pneumococcal, rotavirus and conjugate meningococcal A vaccines are expected to be introduced in the very near future. Ghana appreciates the support and would continue to strengthen partnerships with GAVI to deliver these essential services to our children”
Joseph Yieleh Chireh (MP)
Minister for Health, Ghana

Nigeria
“The absolute and surest means of disease prevention remains the effective and efficient deployment of vaccines. Key to the reduction of child mortality is an expanded immunization programme. Nigeria needs the continued support of GAVI to impact positively on the health of her children”
Professor C.O. Onyebuchi Chukwu
Hon. Minister of Health, Federal Republic of Nigeria

Rwanda
“The whole of GAVI deserves to be supported for making vaccines accessible and preventing diseases. Prevention is a worthwhile investment because as we know it is cheaper than curing diseases, prevents suffering, avoids the cost of treatment and disrupting families. GAVI’s replenishment therefore deserves to be supported.”
Dr. Agnes Binagwaho
Minister of Health, Rwanda

Sierra Leone
“Vaccination supported by GAVI is an effective and efficient process towards diseases prevention in Sierra Leone. We are very grateful to be in partnership with GAVI, an organization that is making a difference in the lives of a special population, including adolescents and young people. GAVI is a vital organ in promoting health; it needs continued support to strengthen the related health MDGs.”
Hon. Borbor Sawyer
Deputy Minister of Health and Sanitation

The Gambia
“Immunization Campaigns have saved many lives in the Gambia which holds a record 86% coverage. The government of The Gambia is committed to expanding further immunization programs in order to maintain and complete our outreach to meet our nation’s visionary goals. If GAVI is successfully supported in June, we will be on our way to achieving MDG 4.”
Hon. Fatim Badjie
Hon. Minister of Health and Social Welfare

Togo
“Immunization campaigns save lives in Togo and for us to achieve our MDG Goal 4, GAVI must be successfully supported in June. All children have a right to be vaccinated. We commit to doing our part to prioritize immunization programs in our health budgets”
S.E. Komlan Mally
Minister of Health, Togo

Thanks to the French NGO Agence de Medecine and to the leadership at the West African Health Organization for facilitating our access to these inspiring leaders in Togo.

Photo credit: 2008 Adrian Brooks/Imagewise, Courtesy of IVAC at Johns Hopkins School of Public Health