IHSJ Reader     May 2012     Issue 22         
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Cash Transfer Schemes and the Health Sector: Making the Case for Greater Involvement (Ian Forde, Kumanan Rasanathan, Rudiger Krech, Bulletin of the World Health Organization, April 11, 2012)
Cash transfer schemes are widely recognized as important contributors to human development. Though they impact health systems and health sector priorities, health officials are rarely involved in their design or implementation. Furthermore, Ministries of Health seldom consider cash transfers as a core policy option for advancing health equity.  In this publication, authors make the case for more substantive collaboration across the health, development, social protection, and education sectors in the design, delivery, and monitoring of cash transfer schemes.

The Free Health Care Initiative is Making a Difference in Sierra Leone (President Ernest Bai Karoma, Huffington Post, May 5, 2012)
Two years ago, facing one of the highest rates of infant and maternal mortality in the world, the government of Sierra Leone eliminated user fees for pregnant women, new mothers, and children under five years old.  The successes of the Free Health Care Initiative include a 214% increase in children receiving clinic-based care and a 61% decrease in the number of women dying from pregnancy-related complications at health facilities.  In this article, President Ernest Bai Karoma calls upon the G8 and other international donors to prioritize initiatives aimed at reaching the poorest and most vulnerable people. Sierra Leone is an example of how to provide free health care with good planning and financial backing from political leaders and international donors.



Haiti’s Fight for Transparency (Jake Johnston, Caribbean Journal, May 3, 2012)
More than two years after the earthquake flattened much of Port-au-Prince and surrounding communities, less than half of the donor pledges have been disbursed. Specifically, the author focuses on aid delivered by the United States Agency for International Development (USAID) and challenges its transparency. Of the over one billion dollars disbursed by USAID, only 0.02 percent of contracts have been awarded to Haitian firms. The author and PIH recommend that USAID and other donors focus on increasing local procurement as a sustainable way to improve the Haitian economy and health and development outcomes.

CDC Study Shows Haiti Cholera Has Changed, Experts Say It Suggests Disease Becoming Endemic (Associated Press/Washington Post, May, 3, 2012) + CDC study   
Over 530,000 Haitians have been sickened by the cholera epidemic during the past 18 months. A recent report released by the US Centers for Disease Control and Prevention indicates that the current strain of cholera has adapted that the disease is becoming endemic to the country.  Those who were previously infected with cholera will no longer have full immunity to the new strain. Fortunately, the vaccine that is being administered to 100,000 Haitians by Partners In Health and Gheskio provides protection to both strains of cholera.



A Controlled Study of Funding for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome as Resource Capacity Building in the Health System in Rwanda (Donal Shepard, Wu Zeng, et. al, The American Journal of Tropical Medicine and Hygiene, May 2012) 
This six-year investigation in rural Rwanda brings fresh evidence to the debate over whether donor investments in the fight against HIV/AIDS have strengthened broader health systems. In the 25 rural health centers randomly selected for the study, the expansion of HIV/AIDS services did not divert resources from other disease programs, and in fact helped spur improvements in overall preventative care including delivery of childhood vaccinations. By providing robust support for HIV/AIDS programs, donors and host governments can help diagnose, treat, and prevent HIV/AIDS—an infectious disease which killed 1.8 million people in 2010 alone—while simultaneously strengthening weak health systems.

Don’t Stop Now: How Underfunding the Global Fund Impacts on the HIV Response (International HIV/AIDS Alliance, May 2012)
This recent publication by the International HIV/AIDS Alliance draws on data collected from numerous countries to illustrate why the Global Fund to Fight AIDS, Tuberculosis, and Malaria must act urgently to replenish funding. The report specifically provides three recommendations to the Global Fund and its donors to help maintain critical HIV services and scale up treatment and support for key populations at higher risk of HIV infection.

Excellent Clinical Outcomes and High Retention in Care Among Adults in a Community-based HIV Treatment Program in Rural Rwanda (M. Rich, A. Miller, A. Niyigena, et. al, Journal of Acquired Immune Deficiency Syndromes, March 2012) 
This study from Partners In Health, Inshuti Mu Buzima, and Rwandan Ministry of Health colleagues demonstrates that incorporating both community health worker accompaniment and social supports into HIV programs helps keep patients healthy and alive. Instead of requiring patients to travel long distances for care, PIH/IMB/MOH trains and compensates community health workers to monitor health problems, identify potential barriers to treatment adherence, provide social supports such as food, accompany patients as they take their medications, and attend clinic visits for the first four months of treatment and as needed after that period. Patients who received community health worker accompaniment in addition to facility-based care were less likely to die and drop out of treatment when compared to patients who received facility-based care only. PIH/IMB will use this evidence to advocate that community health workers and social support be integrated more widely in HIV/AIDS treatment programs.



Insight: Cancer in Africa: Fighting a Nameless Enemy (Reuters, May 1, 2012)
Cancer kills the poor too. Unfortunately the burden of disease is disproportionally felt in developing countries where access to oncologists is extremely limited. By 2030, the World Health Organization predicts that 70 percent of the world’s cancer burden will be in poor countries such as Ghana where there are currently only six trained oncologists to serve 24 million people. The types of cancer that are pervasive in developing countries are those caused by infections that are largely preventable including Human Papillomavirus. Focusing efforts on preventing these infections is critical to tackling the looming cancer epidemic.



Three Years After L’Aquila: Are the G-8 on Track to Fight Hunger?(ActionAid, May 2012)
At the 2009 G8 Summit in L’Aquila, Italy, G8 countries agreed to “act with the scale and urgency needed to achieve sustainable global food security.” In advance of the 2012 G8 Summit, Action Aid calls upon leaders to sustain and expand efforts to combat hunger by: (1) expanding financial pledges with a goal to enable 50 million people to rise out of poverty over the next three years; (2) investing in national agricultural development plans, such as those developed through the Comprehensive Africa Agriculture Development Program (CAADP); and (3) a focusing on local participation by farmers and civil society. 

Food Aid in the Farm Bill: One Step Closer to Reform (Eric Munoz, Oxfam, April 30, 2012) 
The 2012 Farm Bill recently passed out of the US Senate Agricultural Committee with modest reforms for US food aid programs. Key improvements include increased funding for local and regional purchase and efforts to reduce the “monetization” of food aid which is both inefficient and often harmful to local farmers. Though insufficient in scope or scale, even incremental reforms to Title II food aid programs are an important step towards aligning US food assistance programs with human rights and aid effectiveness principles.  



No Mother’s Day (Every Mother Counts, May 2012)
Ninety percent of the deaths caused from pregnancy and childbirth complications are preventable. Every Mother Counts launched their second annual Mother’s Day campaign to raise awareness about women who die each year during pregnancy and childbirth. This video invites mothers to participate in “No Mother’s Day” and disappear on Mother’s Day in an act of solidarity with mothers around the world. 

Two Years On: Celebrating the Success of the Free Healthcare Initiative (Save the Children, YouTube, April 30, 2012)
This moving video looks at the impact of user fee abolition in Sierra Leone, illustrating how women’s and children’s lives change for the better after accessing life-saving care free of charge. For more information on removing user fees from health care, please see PIH fact sheets.

Global Child Survival Efforts: Every Child Deserves a Fifth Birthday (Kaiser Family Foundation, April 23, 2012)
This Kaiser Family Foundation briefing on ending child death coincided with USAID’s kick-off of the “Every Child Deserves a Fifth Birthday” campaign. In June, the US Government, in partnership with India, Ethiopia, and UNICEF, will launch a global call to action for a new way forward to eliminate preventable child deaths.