Rwanda

AIDSRelief: giving patients hope

Nov 10th, 2011 11:42 AM UTC
By ONE Partners

Leia Isanhart Balima works for Catholic Relief Services where she serves as Chief of Party for AIDSRelief Rwanda.

Last week, I visited the Bungwe Health Center, a small clinic nestled in the hills about two hours outside Rwanda’s capital city, Kigali. The center is part of AIDSRelief, a program that has been providing HIV care and treatment in Rwanda since 2005 with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).   My employer, Catholic Relief Services, is the lead agency for AIDRelief in 9 countries.

During my visit I met a nurse named Cecile and her 12-year-old patient, Jean Claude.  His mother is an AIDSRelief patient and Jean Claude had come to the health center to find out his own status. He’s been sick for quite some time.

Cecile counseled and tested Jean Claude, then talked with him about his results. To my surprise, he smiled. When asked what he will do now that he knows his HIV status, he said he will go to school to become a doctor.  Jean Claude knows that with antiretroviral therapy and good medical treatment, he can live a long, productive life.

There are thousands of such stories across PEPFAR-supported countries. Through programs like AIDSRelief, PEPFAR is bringing training and materials to health professionals like Cecile, giving patients hope instead of the death sentence they would have faced just a few years ago.

But a unique, and also remarkable, story is how Rwanda’s Ministry of Health has taken ownership of the program.  Six years ago, Catholic Relief Services and partners began AIDSRelief with the intention of someday transitioning it to a local entity. The Ministry of Health stepped up and showed it was ready, willing, and capable of taking over the project.  After two years of intensive preparation, the transition is complete. The Ministry now directly receives PEPFAR aid, sustaining the work AIDSRelief has begun.

U.S. foreign aid programs like PEPFAR are making a difference in the lives of people all over the world. These programs transition to local ownership in a meaningful, sustainable way and encourage partner countries to share responsibility for building strong health systems.

As our partners step forward, they still need our support. In the coming days and months, Congress faces more painful budget discussions and some people believe that poverty-focused international assistance isn’t worth saving.  But now is not the time to dial back successful programs that are building strong national systems to lift millions of people out of poverty and illness.

With sustained U.S. foreign aid, nurses like Cecile will continue to receive training and resources via the Ministry of Health. And Jean Claude will get the treatment he needs to realize his dreams of giving hope to others the way Cecile gave hope to him. And that’s something to celebrate and advocate for.

Rwanda is Proud to Pioneer the Pneumococcal Vaccine

Nov 9th, 2011 10:16 AM UTC
By ONE Partners

In this guest blog for World Pneumonia Day on the 12th of November Dr. Agnes Binagwaho, Minister of Health, writes on Rwanda’s partnership with the GAVI alliance to pioneer the Pneumococcal Vaccine.

In April 2009, Rwanda became the first low-income country to rollout the pneumococcal vaccine (PCV7) through a partnership with Wyeth. This was a great moment for us, for after having achieved dramatic reductions in malaria incidence, pneumococcal disease had stood as the new leading cause of death among Rwandan children. And it was the dedicated work of our partner, The GAVI Alliance for Vaccines, that ensured the pneumococcal vaccine would be both accessible and affordable for use in our country.

Pneumonia remains the single largest cause of death among children under five around the world. Every 20 seconds, a child dies of this preventable disease.

On November 12, 2011, Rwanda will join other countries in observing the third World Pneumonia Day, a day to celebrate the power of immunization to save lives when access is assured.

The PCV7 vaccine also prevents against pneuomoccal meningitis, a debilitating disease that leaves children who survive it with lifelong mental and physical disabilities.

Certainly immunization is not the only way to prevent pneumonia; breast-feeding, improved nutrition, and the reduction of indoor air pollution are also essential, and children must have access to effective antibiotics when they do fall sick. But immunization removes the burden of hospitalization and treatment on the health system and diminishes the time . This is a major economic advantage in countries like Rwanda, where the time lost by parents lose from work in caring for their children. For immunization to work, it needs to be integrated fully in health and community services. This is what we did in Rwanda.

Last year, the pneumococcal vaccine was scaled up in 16 countries. By 2015, GAVI expects that 58 countries will have introduced the latest generation pneumococcal vaccines nationwide, covering another 90 million children. With sustained commitment among all partners, including both GAVI countries and donor countries, we can achieve remarkable progress in the fight against preventable deaths among children.

The number of lives saved by GAVI is a major contribution towards the world’s pursuit of the fourth Millennium Development Goal, but we must sustain the momentum. In Rwanda today, more than 80% of children have access to the pneumococcal vaccine. The children whose lives are being saved through our partnership with GAVI will help to build a Rwanda where health for all is not simply a dream but one of the foundations of a strong, peaceful nation of tomorrow.

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.

Tweeting with Paul Kagame

Feb 7th, 2011 1:57 PM UTC
By Joseph Powell

Understandably the last few weeks have seen a surge in debate around the influence of the internet and social media on the popular protests in Tunisia and Egypt. Here in Uganda – when wondering if a similar situation could arise after the Presidential elections on February 18 – people often mention the growing proportion of the population that is online every day.

However, political leaders in Africa are also using the internet to communicate directly with their people and interested observers. One such leader is President Paul Kagame of Rwanda, who is one of very few Heads of State to operate their own Twitter account. Seeing him online last week I decided to contact him. And amid persistent speculation that he would seek to amend the Rwandan constitution to stand for a third term in office in 2017, I asked what plans he had for a successor?

To my surprise he responded immediately over three tweets:

@josephpowell. It s alwz going to be a complicated questn…while I can stand for what I say n do- it s hard to do that for smbody else..

@josephpowell but I want n i kno others want to see things continue in good direction..in Rw. So it s in my interest n duty to work with..

@josephpowell ..with others to manage well that succession process…and we will!

So a clear commitment from one of Africa’s most prominent leaders that he will step down in 2017 and hand over to a successor – a move that would surely cement his legacy in re-building Rwanda from the point of destruction to arguably one of the continent’s better functioning states. And all of this over Twitter. A sign, perhaps, that the increasingly diverse range of communications tools will not just be used for coordinating protest in Africa.

Rwanda becomes top global reformer for making business easier

Sep 11th, 2009 12:31 PM UTC
By Mikiko Imai

In the IFC-World Bank Doing Business 2010 report released yesterday, for the first time a sub-Saharan African country—Rwanda—was named the world’s top reformer of business regulations, based on the number and impact of reforms implemented. Doing Business is an annual report that ranks economies based on 10 indicators of business regulation that record the time and cost to meet government requirements for starting and operating a business, trading across borders, paying taxes, and closing a business.

In Rwanda, it now takes an entrepreneur just two procedures and three days to start a business. Imports and exports are more efficient, and transferring property takes less time thanks to a reorganized registry and time limits. Investors have more protection, insolvency reorganization has been streamlined, and a wider range of assets can be used as collateral to access credit.

Mauritius, ranked 17 globally, is the top sub-Saharan economy for the second year in a row in terms of the overall regulatory ease of doing business.

However, despite these advances, more reforms are needed in Africa. The average rank for sub-Saharan African countries remain the lowest of any region.

Globally, the report shows that despite the financial and economic crisis, a record 131 economies reformed business regulations between June 2008 and April 2009. Singapore is the top-ranked economy on the ease of doing business for the fourth year in a row, but most of the action occurred in developing economies. Two-thirds of the reforms recorded in the report were in low- and lower-middle-income economies.

-Mikiko Imai

Meet Catherine Namugala

May 29th, 2009 1:51 PM UTC
By Jessica Gomez-Duran

Two of my colleagues were in Rwanda last week for a conference of African Ministers on climate change and whilst there they caught up with Catherine Namugala, the Zambian Minister of Tourism, Environment and Natural Resources.

She did a little video for ONE, talking about climate change in Zambia. She says that the adverse effects of climate change are definitely being felt in Zambia, most notably for subsistence farmers and others living off the land. Changing rainfall patterns as part of climate change are leading to increased flooding and drought for example.

Namugala goes on to say that even though her country does not contribute significantly to climate change, Zambia is focussing on raising awareness amongst the general population and also looking at ways to adapt to the effects of climate change. Emphasising that it’s a question of morality, Namugala concludes with a call to developed countries to do their bit as the major contributors of global warming.

-Jessica Gomez-Duran

Touring A Rwandan Clinic

Jul 30th, 2008 11:19 AM UTC
By TomGavin

Another video and post from ONE’s Tom Gavin from last week’s trip to Rwanda.

Monday, July 21:

The U.S. launched PEPFAR – the American global AIDS strategy – at the Masaka Clinic in 2004, so it made for a good place for the ONE delegation to visit and assess how things are going. Our delegation met with doctors, nurses, local officials, and patients seeking treatment and counsel from the clinic’s staff. We heard, time and again, the difference that America’s partnership in health care was making in Rwanda and throughout Africa.

The DATA Report, which ONE released earlier this year, shows the progress being made. It points out that, across Africa, nearly 2.12 million people were on antiretroviral therapy by last December, a huge jump from the 50,000 people on treatment in 2002. That means 30 percent of Africans in need of treatment are receiving it. But there remains a major challenge ahead. An additional 1.7 million Africans became infected with the HIV virus in 2007.

After touring the Masaka Clinic, some of the ONE delegation discussed the site visit and the overall trip with reporters.

-Tom Gavin