Health

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

Building the movement: Global Health Corps

Feb 10th, 2011 9:40 AM UTC
By ONE Partners

Global Health Corps is excited to expand to 70 emerging leaders working in Burundi, Malawi, Rwanda, Uganda and the USA in our upcoming 2011 to 2012 fellowship class.

Global Health Corps aims to mobilize a global community of emerging leaders to build the movement for global health equity. GHC does this by providing young leaders year-long paid fellowships with outstanding organizations working on the front lines of the fight for global health equity.

We currently have 36 fellows working on projects ranging from developing electronic medical record systems with Partners In Health in Malawi, to counseling homeless youth in New Jersey, to constructing a world-class hospital in rural Rwanda with CHAI.

To truly shift the tide of global health challenges, young leaders from all backgrounds and skill sets must be engaged. GHC employs managers, communicators, architects, supply chain analysts and other exceptional young people from non-clinical disciplines important to building strong health systems. For example, Ameet Salvi, a GHC fellow who previously managed supply chains for the Gap, used his skills to upgrade the drug supply chain in Tanzania during his fellowship.

Applicants must be under 30 years of age, have earned an undergraduate university degree by July 2011, and be proficient in English. Interested individuals can apply here on our website.

-Barbara Bush, CEO and co-founder, Global Health Corps

How do you prevent mother-to-child transmission of HIV?

Sep 17th, 2010 5:01 PM UTC
By Erin Hohlfelder

From online petitions to angry baby protests, it’s hard to miss ONE’s focus on the Global Fund and our goal to ensure that virtually no child is born with HIV by 2015. But throughout this campaign, many of you have rightfully asked, “How does this exactly work?”

It’s a miracle of modern medical technology that we’re able to prevent the mother-to-child transmission of HIV (PMTCT).

An HIV-positive mother can pass HIV on to her baby any time during pregnancy, labor, delivery and breastfeeding, so the transmission of the virus must be blocked at each stage. The 2010 World Health Organization guidelines recommend that HIV-positive pregnant mothers should go on a regimen of three antiretroviral drugs (ARVs) as soon as possible — and stay on these drugs until their infant is born and breastfeeding has concluded.

As soon as the infant is born, the baby should take nevirapine — a very inexpensive drug — daily for six weeks. The infant should be formula-fed rather than breastfed if possible, but it’s recognized that formula feeding is both expensive and difficult to do safely in resource-limited settings, so the mother is recommended to breastfeed her child exclusively for six months while continuing to take ARVs. In a recent study conducted by Harvard University in Botswana, mothers who adhered to this regimen reduced transmission of HIV to their babies by an amazing 99 percent.

These prevention guidelines have evolved over the years as scientists have learned more about how to most effectively reduce the risk of transmission while also working to minimize drug resistance for our most effective treatment tools. Many policymakers stress that access to effective contraception to prevent unintended pregnancies is also important for women who are HIV-positive.

For more details on the PMTCT process, including a chart that maps which drugs are used when and in what settings, visit AVERT’s handy guide. Also, be sure to check out WHO’s global strategic vision for 2015.

The W8 shows that change is possible

Mar 18th, 2010 3:13 PM UTC
By David Cole

Dorothy Ngoma © Oxfam

Dorothy Ngoma is head of the National Organisation of Nurses and Midwives of Malawi and she’s telling leaders to help the world’s poorest people.

Dorothy is a member of the W8, a group of 8 extraordinary women from all 4 corners of the world who are campaigning for health and education for all.

As Dorothy puts it:

“Health and education have been recurrent themes in my life. I feel these issues personally. I’ve seen many women dying due to the weak health system in my country. Poverty is a massive problem in Malawi. 14 million people live in Malawi and 70% live below 1 dollar per day, they struggle to survive. There are only 200 doctors in the whole country. When I told that to a press conference in France a gasp went round the room.

Because of a lack of skilled midwives and doctors 16 women die daily due to problems related to pregnancy and delivery. 22 people die daily due to TB, while TB is a curable disease. Malawi has 1 doctor for 65,000 and 1 nurse for 3,500 people. An impossible task.

People often don’t go to hospital until they have something really serious, simply because they don’t have the money. Sometimes, people don’t even have money to get on the bus to get to hospital.

In Malawi we fight against any sort of diseases: TB, malaria, HIV/AIDS, cholera, dysentery, we have the problem of dirty water. It’s a sick community. Nurses are working 16 hours a day, seven days a week. We have to lobby for more nurses and we have to work hard to stop nurses leaving the industry or leaving Malawi, due to the heavy job.”

Along with the other members of the W8, Dorothy is working to spread this message and let others, especially decision makers, know about the issues. Better education and health for all is possible, but only with more resources. More doctors, more nurses and more midwives.

As Dorothy says, “We need to speak up both at the local level and at international level. We need to tell people what’s wrong and how to change it.”

Thanks to Dorothy and the other members of the W8 we know that change is indeed possible.

GAVI’s Julian Lob-Levyt talks to ONE

Mar 2nd, 2010 2:30 PM UTC
By Carola Bieniek

Last week GAVI Alliance CEO Julian Lob-Levyt visited Berlin to talk to German politicians, NGO representatives and the media about GAVI’s work, the success it has achieved over the past ten years, and the challenges lying before us in the fight against preventable disease such as pneumonia and diarrhea.

Launched in 2000, the GAVI Alliance is a global health partnership representing stakeholders in immunisation from both private and public sectors.

Whilst he was in town Julian took a few minutes out of his busy schedule for an interview with ONE’s Gisela Glimmann:

Primary health care in Ethiopia

Jan 12th, 2010 11:11 AM UTC
By David Cole

Dr Gebreab Barnabas, Head of the Regional Health Bureau in Tigray province, talked to ONE recently about a primary health care programme that has been running in Ethiopia.

The scheme, which started 5 years ago, involves the training 30,000 female health extension workers nationally, including 1,800 in Tigray. Supported by the Ethiopian government, the Global Fund to Fight AIDS, TB and Malaria, UNICEF and other partners, it also involves the building of more than 3000 heath centres.

Programmes such as this help put health care in the hands of the local community. Not only is primary health care less costly, but its impact can be huge. By eliminating the risk of the disease it helps reduce the costs of diagnosis, treatment and follow up.

Hear what Dr Barnabas had to say:

Bono’s Latest New York Times Column: “Ten for the Next Ten”

Jan 4th, 2010 10:25 AM UTC
By Kathy McKiernan

ONE co-founder Bono’s most recent column for the New Year Times, on 10 ideas for the next 10 years, was published over the weekend. I wanted to share it because it calls attention to a few ideas that are in our area of work, including the rotavirus vaccine and the upcoming World Cup in Africa.

Below is an excerpt. You can read the full column here.

Happy New Year!

-Kathy McKiernan

Taking the Fight to Rotavirus

The thing is, they exist, these vaccines. They’re not a mere hope, like an AIDS vaccine. And one of the brightest bits of news in 2009 is that rotavirus vaccines have been shown to work not only in nations with low child mortality, but in the poorest countries, where diarrhea (not a killer in our house) caused by rotavirus infections takes the lives of 500,000 children a year. The World Health Organization just this summer issued a strong recommendation that rotavirus vaccinations be part of every nation’s immunization program. From this vantage point, I like the look of the next decade.

The World Cup Kicks Off the African Decade

It’s getting easier to describe to Americans the impact of the World Cup — especially the impact it will have in Africa, where the tournament is to be held this summer. A few years ago, Ivory Coast was splitting apart and in the midst of civil war when its national team qualified for the 2006 jamboree. The response was so ecstatic that the war was largely put on hold as something more important than deathly combat took place, i.e. a soccer match. The team became a symbol of how the different tribes could — and did — get on after the tournament was over.

This time round, for the 2010 World Cup, naysayers thought South Africa could not build the stadiums in time. Those critics should be red-faced now. South Africa’s impressive preparations underline the changes on the continent, where over the last few years, 5 percent economic growth was the average. Signs point to a further decade of growth to come. Canny investors will put more capital there. This in turn has the potential to shore up fragile young democracies across the continent.

It would be fitting if Nelson Mandela, who has done more than anyone for Africa’s rising, would kick off the opening ceremonies. If he shows up, the world will weep with joy.

Nigeria: A Year Without Guinea Worms

Dec 16th, 2009 9:29 AM UTC
By Rena Pacheco-Theard

There have been a lot of successes in global health – could the elimination of Guinea worm worldwide be next?

After 12 consecutive months without a single worm detected, Nigeria is moving closer to the eradication of Guinea worm. Two more years are needed for the WHO to make it official, but it appears that Nigeria, once the worst-affected country (653,000 cases in 1989), is free of worms.

This progress, led by the Carter Center’s Guinea Worm Eradication Program, is being achieved without the assistance of a vaccine or medicine to treat or prevent Guinea worm. Preventative measures come in the form of health education and low-technology actions to influence behavior change, like filtering the fleas out of drinking water with fine-mesh filter cloths or pipe filters.

Guinea worm, dracunculiasis, is contracted by drinking pond water infested with microscopic fleas that harbor the worm larvae. The larvae grow for a year inside a person’s body, becoming worms up to three feet long, which exit the body through painful blisters in the skin.

Ethiopia, Ghana, Mali and Sudan are the only countries that still have the worms, down from 20 affected countries in 1986 when the Carter Center began its campaign against the disease.

Spurred on by the eradication of smallpox in 1977, the Carter Center’s International Task Force for Disease Eradication has identified seven diseases as potentially eradicable: dracunculiasis, poliomyelitis, mumps, rubella, lymphatic filariasis, cysticercosis, and measles. Nigeria’s success in combating Guinea worm offers hope for Guinea worm’s full eradication.