IHSJ Reader, July 27, 2012

Posted on Jul 27, 2012

IHSJ Reader   Issue 28  
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FOREIGN ASSISTANCE

Hired Gun Fight (John Norris, Foreign Policy, July 18, 2012)
Rajiv Shah, administrator of the U.S. Agency for International Development (USAID), continues to push for increased local and regional procurement. Currently, American for-profit companies capture more USAID contracts, with the 10 largest receiving more than 27 percent of the agency’s overall funding. Aside from the millions of dollars American companies waste on overhead, Shah recognizes that development is impossible if there isn’t a focus on building sustainability and local capacity. Despite the slow progress, USAID still hopes to reach its target of having 30 percent of aid channeled directly to governments and local organizations by 2015.

FOOD SECURITY

U.S. Food Aid Programme Criticised as ‘Corporate Welfare’ for Grain Giants (Claire Provost and Felicity Lawrence, The Guardian, July 18, 2012)
This timely piece exposes how the vast proportion of food aid money goes to large multinational food trading corporations, just as Congress continues to debate the 2012 farm bill, which controls this international food aid. The writers contend that U.S. food aid legislation is outdated and awards over 70 percent of its contracts to only three corporations that ship food overseas in a process that is uncompetitive and incurs tremendous shipping costs. While USAID, Canadian, and EU aid programs have recently shifted away from spending aid money at home, U.S. food aid policy stands as it did in the 1950s. Contrary to an aid approach that would strengthen systems in developing countries, the U.S. approach undermines local markets and rewards large corporations, ensuring dependency on food aid for years to come.

HAITI

Cholera Vaccination Test Reached Targets in Haiti (Richard Knox, NPR, July 17, 2012)
A year and a half after cholera was first detected in Haiti, two cholera vaccination campaigns were successfully completed last month. Partners In Health, working in rural Haiti, and GHESKIO, working in Port-au-Prince, reported last week that almost 90 percent of the target population received the vaccine. The cholera vaccine campaign initially received pushback from a number of different institutions and governments, yet with dedicated training and accompaniment of each community, PIH and GHESKIO were able to prove that a complicated vaccine campaign could be successfully carried out in resource-poor areas. Though successful, the cholera vaccine is only one step in a comprehensive approach to ending the epidemic, which has killed more than 7,300 people since October 2010.

Disease Outbreaks: Support for a Cholera Vaccine Stockpile (Agnes Binagwaho, Thierry Nyatanyi, Cameron Nutt, Claire Wagner, Nature, July 5, 2012)
In May, nine patients became sick with cholera at the crowded Nkamira refugee camp in northwestern Rwanda. The camp, currently at four times its capacity, was faced with the prospect of a large-scale outbreak. However, infected patients were quickly treated and cured, other preventative measures were taken, and no further cases were reported. In a recent letter to the editor, global health advocates—including Dr. Agnes Binagwaho, Rwanda’s minister of health—commended the camp’s containment efforts and emphasized the importance of keeping a large supply of the cholera vaccine available and ready to distribute in case initial treatment methods fail.

HIV/AIDS

Barbara Lee Introduces Bill Providing Policy and Financing Framework to Achieve an AIDS-Free Generation (Congresswoman Barbara Lee, July 19, 2012)
Congresswoman Barbara Lee of California has introduced a bill called “The Ending HIV/AIDS Epidemic Act of 2012,” which is a comprehensive plan detailing the steps that can be taken to achieve a future without AIDS. The bill, H.R. 6138, lays out a five-year strategy with specific policy, action, and financing targets for the federal government. Lee calls the bill “a critical measure” in the movement to end the AIDS epidemic.

How Food and Nutrition Can Help Turn the Tide on HIV (Martin Bloem, ONE, July 19, 2012)
Martin Bloem, chief of nutrition and HIV policy at the U.N. World Food Programme (WFP), discusses the impact of providing nutritional assistance and counseling to HIV-positive patients struggling with food insecurity. For patients who begin treatment with severe malnourishment, their chance of death is increased six-fold. The WFP offers food rations and vouchers to HIV-positive individuals. Nutrition assistance serves a dual benefit—it increases the health and safety of patients and provides an incentive for them to continue receiving treatment.

Sex Workers at Risk: Condoms as Evidence of Prostitution in Four U.S. Cities (Human Rights Watch, July 19, 2012)
This report examines how the use of condoms as evidence in prostitution charges ties the hands of sex workers and transgender women, those at highest risk for contracting HIV. Reluctant to carry condoms in case they are confronted by police, they are unable to fully claim their right to protect their own health, leading them to engage in sex without protection and putting them at risk for infection. Based on this study’s findings, Human Rights Watch denounces the criminalization of HIV prevention as both an endangerment to the public health and a breach of rights, and calls for a bar on the use of condoms as evidence in criminal proceedings.

Eliminating Mother-to-Child HIV Transmission Will Require Major Improvements in Maternal and Child Health Services (Health Affairs, July 2012)
Over the past decade, efforts to eliminate mother-to-child HIV transmission have dramatically increased, yet meeting the Millennium Development Goal of reducing HIV infections in children by 90 percent by 2015 will be impossible without ensuring that mothers in low- and middle-income countries have access to HIV care. Recent results from modeling research show that if current treatment and prevention programs in resource-poor communities are not expanded to increase access to care, mother-to-child HIV transmission will not decrease. In addition, comprehensive, wrap-around services provided in rural communities need to be expanded to provide sufficient support to HIV-positive mothers.

MENTAL HEALTH

Fighting Depression, One Village at a Time (Tina Rosenberg, The New York Times, July 18, 2012)
This article highlights how the community health worker model has been effective at treating depression in resource-poor settings. Even though three-quarters of the world's mental health disorders are in developing countries and while depression creates the largest health burden in the world today, only recently has attention been brought to treating mental health in the developing world. In several studies, community health workers and interpersonal support groups are delivering impressive results. The success of this model is bringing more attention and funding to the fight for mental health care in low- and middle-income countries.

WOMEN’S HEALTH

Gates Foundation Contraceptive Funding Will Save Lives, Improve Health for Millions (Seattle Times, July 14, 2012)
This editorial applauds the Bill & Melinda Gates Foundation's plan to target $1 billion over eight years to increase access to contraceptives for poor women. Although the emphasis on birth control may be controversial with religious and conservative groups, a recent Johns Hopkins study demonstrates that access to contraception may reduce maternal mortality by nearly a third. The Gates Foundation has chosen to emphasize family planning, following efforts to combat childhood mortality with vaccines and other strategies.

SOCIAL JUSTICE MOVEMENT

Beyond Charity: Helping NGOs Lead a Transformative New Public Discourse on Global Poverty and Social Justice (Martin Kirk, Ethics and International Affairs, July 2012)
Despite lofty goals of driving permanent social change, nongovernmental development organizations (NGOs) often resort to a paradigm more rooted in charity than in social justice. While many of these NGOs have significant marketing power, they often struggle to shift public attitudes toward development in a manner that is compatible with real social change. The author advocates for increased collaboration between academics and NGOs, particularly through the group Academics Stand Against Poverty, to use theory and evidence to increase the effectiveness of the NGO sector.

MULTIMEDIA/ADDITIONAL RESOURCES

AIDS Turning Point (John Donnelly, et. al., GlobalPost, July 2012)
John Donnelly and a group of reporters have teamed up on a project investigating the turning point in reversing the HIV epidemic. This website provides extensive coverage of the epidemic, from stories of people living with HIV across the world to treatment successes as a result of community health worker accompaniment.

Journal of Acquired Immune Deficiency Syndrome Supplements (JAIDS, July 2012)
The Journal of Acquired Immune Deficiency Syndrome released three supplements in advance of this week’s International AIDS Conference. Each supplement contains a different focus—from National Institute of Health reports to the vision and essential steps for reaching an AIDS-free generation.

AIDS 2012: XIX International AIDS Conference Online Coverage (Kaiser Family Foundation, July 2012)
For those who were unable to attend events in Washington, D.C., around the International AIDS Conference this week, recordings of plenary sessions and select press conferences are available from the Kaiser Family Foundation.

Dr. Paul Farmer sharing a friendly moment with one of his staff.

Paul's Promise

As we mourn the passing of our beloved Dr. Paul Farmer, we also honor his life and legacy.

PIH Founders - Jim Kim, Ophelia Dahl, Paul Farmer

Bending the Arc

More than 30 years ago, a movement began that would change global health forever. Bending the Arc is the story of Partners In Health's origins.