IHSJ Reader, September 30, 2011

IHSJ Reader     September 2011     Issue 9         

Note: Triple asterisk (***) indicates subscription-only sources.

NON-COMMUNICABLE DISEASES

UN Launches Global Campaign to Curb Death Toll From Non-Communicable Diseases (UN News Service, September 19, 2011)
On September 19, the UN General Assembly approved by consensus the Political Declaration to address non-communicable diseases (NCDs). The Political Declaration acknowledges the disproportionate burden that NCDs have on the poor and the importance of strengthening health systems in low-income countries. The World Health Organization will now lead the charge in developing specific targets and indicators for reducing the impact of NCDs. Partners In Health will continue advocating for comprehensive health care for the poor until prevention, detection and treatment are available and affordable for all.

HIV/AIDS and Chronic Diseases – Learning From Each Other (PlusNews, September 20, 2011)
HIV/AIDS and NCDs are usually viewed as separate challenges, but by encouraging an integrated approach to prevention, detection and treatment through health systems that were developed to treat HIV/AIDS, resources and health outcomes can be maximized.

Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis*** (The Lancet, 15 September, 2011)
Results from this article show that the number of breast and cervical cancer deaths has nearly doubled over the last thirty years. This increase is disproportionately felt in developing countries where education, screening and treatment are not yet widely available.   With poorer countries seeing a rise in breast cancer cases of more than 7.5 percent per year, it is time to integrate cancer care into comprehensive health care. In a recently formed public-private partnership, George W. Bush hopes to push the integration of cervical and breast cancer treatment into the existing health systems established by PEPFAR.  Read more about this initiative at:  Bush Effort Targets Cervical Cancer in Developing World*** (Betsy McKay, Wall Street Journal, September 12, 2011).

HAITI

Halting Cholera’s Rampage in Haiti (Washington Post, September 22, 2011)
Cholera has killed nearly 6,500 people and almost 5 percent of the country’s population has been reported to be infected over the past 11 months. As Haiti continues to focus on improving access to water and sanitation, educating communities about the disease and how to prevent it as well as treating cholera patients, this piece highlights the importance of a nationwide vaccination campaign.

MATERNAL MORTALITY

Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis  (The Lancet, Lozano R. et. al, September 2011) 
Refined modeling with data from 163 countries suggests that maternal mortality declined from 350,000 deaths in 2010 to 275,000 deaths in 2011. Though the updated analysis is encouraging, additional analysis of the data is important.  MDG 5 is still the farthest off track to be reached by 2015. Nearly all maternal deaths could be prevented with targeted interventions at the community, clinic, and hospital level.  Partners In Health is committed to reducing maternal mortality by removing barriers to care and improving the quality and availability of proven interventions such as prenatal care, family planning services, safe delivery with skilled attendants, and emergency obstetrical care. 

INTERNATIONAL FINANCIAL INSTITUTIONS

Austerity Measures Threaten Children and Poor Households: Recent Evidence in Public Expenditures from 128 Developing Countries (UNICEF, Isabel Ortiz et. al, September 2011)
A new UNICEF study warns of the "irreversible impacts" of International Monetary Fund (IMF) austerity measures on children and poor households. The authors argue that excessively restrictive policies undermine IMF pledges to build social safety nets to protect the vulnerable. Instead of increasing investments in life-saving health, education and other social programs, in 2010, more than a quarter of developing nations were struggling to reduce spending to pre-2007 levels IMF-imposed fiscal policies must be carefully reviewed and replaced with alternative policies aimed at strengthening the social safety net for the most vulnerable.

RWANDA

In Rwanda, A Disconnect In Choosing GHI Focus(GlobalPost, Gregory Branch, September 23, 2011)
When the Global Health Initiative (GHI) launched in 2009, US government officials stated the need to increase country ownership over US–funded health programs. In Rwanda, the GHI strategy highlighted gender-based violence as one of its priority areas—an area that is not a large part of the national health plan. The U.S. Government should join other donor countries in supporting true country ownership of programs and support carefully developed national plans. US foreign assistance rules should be changed to allow for direct support to recipient governments’ public health systems so they are strengthened and able to fund their self-identified health priorities.

A closer look at the role of Community Based Health Insurance in Rwanda's success (Ranu S Dhillon M.D., Global Health Check, September 16, 2011)
This blog post takes a critical look at Rwanda’s mutuelle program, and argues that community health insurance cannot be singularly credited with spurring Rwanda’s excellent improvements in health access and indicators. Those analyzing the success of Rwanda’s health programs should consider other complementary factors including a five-fold increase in health spending, effective public administration, and economic growth. Though insurance co-payments are less onerous than user fees, they still constitute an inequitable financial barrier for many Rwandans.

HIV/AIDS

An End to AIDS is Within Our Reach (Desmond Tutu, Washington Post, September 20, 2011)
In this powerful op-ed, Archbishop Desmond Tutu calls upon President Obama to “make a game-changing impact on the war against AIDS” by increasing PEPFAR’s treatment goal from 4 million to 6 million people by 2013.  New research shows that increasing access to antiretroviral treatment not only saves lives, but also reduces the chance of passing HIV to an uninfected sexual partner by 96 percent. “The world finally possesses affordable tools and scientific knowledge that could stop HIV/AIDS in its tracks. President Obama has a profound opportunity to lead the world to this conclusion. He must take it.”

Cost-Effectiveness of Early Versus Standard Antiretroviral Therapy in HIV-Infected Adults in Haiti (Serena Koenig, Heejung Bang, Patrice Severe, et. al., PLoS, September 20, 2011)
The results of a recent study with data from Haiti show that treating HIV patients earlier than previously recommended by the WHO is cost-effective. A comprehensive cost analysis over a three-year period proves that early treatment (initiated with patients’ CD4 counts between 200-350) is considered a cost-effective intervention under World Health Organization criteria (cost is less than three times the country’s per capita gross domestic product).

MENTAL HEALTH

Mental Health Not Getting Enough Attention from UN (Joanne Silberner, The World, September 19, 2011)
Depression ranks as the number one cause of disability worldwide, yet the estimated 450 million people who suffer from mental disorders aren’t included in most strategic global health funding plans. The Millennium Development Goals say nothing about treating mental illness despite the global cost of these diseases exceeding $2 trillion. If the United Nations and others recognized the critical need to address the global burden of all diseases, including mental disorders, the funding gap for comprehensive health care could finally be tallied, acknowledged and addressed.

FOOD SECURITY

4.5 Million Haitians in Situation of Food Insecurity (Haiti Libre, September 26, 2011)
The National Coordinating Committee for Food Security reports that nearly 50 percent of Haitians face food insecurity. A coordinated policy needs to be developed that focuses on increased investment in the agricultural sector, job creation and nutrition education. To learn how U.S. food aid contributes to Haiti’s food insecurity, and to find practical solutions to improving food security in Haiti, please see “Sak Vid Pa Kanpe: The Impact of U.S. Food Aid on Human Rights in Haiti.” 

Bringing Agriculture to the Table: How Agriculture and Food Policy can Play a Role in Preventing Chronic Disease (The Chicago Council, September 2011)
This report focuses on the links between agriculture and health, specifically, the relationship between recent trends in agriculture and food production and the increase in non-communicable diseases. Health and nutrition are intrinsically linked, but when developed and developing countries alike face a dual burden of malnutrition and obesity, it is crucial to include agriculture and food systems as part of the comprehensive solution.

MULTIMEDIA AND ADDITIONAL RESOURCES

Partners In Health Program Management GuidePartners In Health, September 2011)
Partners In Health published the Program Management Guide – a guide to managing healthcare programs in resource-poor settings. From our Training Director, Jill Hackett:  “Based on PIH’s experiences over the last 25 years, this guide offers an approach to starting, revamping, or expanding a healthcare program in resource-poor settings. PIH has received many inquiries from nascent organizations and established practitioners who are working to promote a rights-based approach to care. This guide discusses complex challenges that implementers commonly face, and shares lessons we have learned and the strategies that have helped us implement programs in collaboration with a wide range of partners.” Congratulations to the PIH Training Team and all those who supported them in writing this incredibly helpful and needed guide.