12 Women (and one man) who are inspiring change

To mark International Women’s Day this year, our partners at Marie Stopes compiled a list of 12 women and one man who’ve inspired change and helped to improve the lives of women either in their community or at a global level. Each day this week, they’ve revealed two names on the list, in the build up to International Women’s Day, which is coming up on Saturday, March 8.

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The Daily Impact: Second US Baby HIV-free following Aggressive Treatment

March 6, 2014

One year ago, doctors from Mississippi revealed they cured a baby born with HIV. It has now happened a second time, reports the New York Times.

When scientists made the stunning announcement last year that a baby born with H.I.V. had apparently been cured through aggressive drug treatment just 30 hours after birth, there was immediate skepticism that the child had ever been infected in the first place.

But on Wednesday the existence of a second such baby was revealed at an AIDS conference here, leaving little doubt that the treatment had worked. A leading researcher said there might be five more such cases in Canada and three in South Africa.

And a clinical trial in which 50 babies who are born infected will be put on drugs within 48 hours is set to begin within three months, the researcher added.

If that trial works – and it will take several years of following the babies to determine whether it has – the protocol for treating all the roughly 300,000 babies born infected each year will no doubt change.

The second baby – a girl born in Long Beach, Calif. – is now 9 months old and apparently free of the virus that causes AIDS.

Pediatricians at Miller Children’s Hospital in Long Beach had heard of the first baby, born to a mother in Mississippi with advanced AIDS who had not taken any drugs to protect the fetus. The California doctors tried to replicate that first treatment.

They immediately gave the baby three antiretroviral drugs — AZT, 3TC and nevirapine — at the higher doses normally used for treatment rather than for prevention, and never previously recommended for newborns.

It would be wrong to describe the Long Beach baby as “cured” or as “in remission” because she is still on antiretroviral drugs, said Dr. Deborah Persaud, a virus specialist at the Johns Hopkins Children’s Center who has been involved in both cases. She describes the baby as “sero-reverted to H.I.V.-negative.”

The baby was treated nine hours after being born – as soon as her first H.I.V. test came up positive – and now even ultrasensitive tests can find no virus in her blood or any tissues.

“Last year, when we described the Mississippi baby, the report was received with some skepticism,” Dr. Persaud said. But since viral DNA and RNA were found in the Long Beach baby’s blood and spinal fluid, “this baby was definitely infected,” she added, “and now we are unable to detect replication-competent virus.”

The Mississippi baby, now 3 years old and known as the “Mississippi child,” is healthy and still virus-free, Dr. Persaud added.

That baby, whose name and sex have not been disclosed, was born to a mother who got no prenatal care and was unaware that she was infected. When it was suspected that the baby was infected, it was transferred to the University of Mississippi Medical Center and started on aggressive antiretroviral treatment about 30 hours after birth by a pediatrician who felt that the regular prophylactic regimen would not save a baby at such high risk.

Then, 18 months later, the mother stopped seeing doctors and stopped giving her baby the drugs for five months. When she then took the baby back in, alarmed doctors assumed that it would be teeming with virus. Instead, to their astonishment, they found none. And samples taken by Dr. Persaud and tested with ultrasensitive assays at her Hopkins laboratory have found none.

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Let’s talk about the Best Buys for Global Health

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Starting today and culminating on March 19th at the Center for Global Development, we hope you’ll join a conversation along with experts from implementing agencies, governments, research institutions, and the private sector to  discuss and debate what makes a “best buy” in global health.

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The Daily Impact: Tens of Millions in Southern Africa have no Access to Safe Water and Sanitation

March 5, 2014

More than 40 million people in Southern Africa who should have received access to safe drinking water by 2015 will miss out, says a Water Aid report. Another 73 million will go without basic sanitation. AlertNet reports:

Only two out of 15 Southern African countries – Botswana and Seychelles – are set to meet their 2015 Millennium Development Goal (MDG) targets to reduce by half the number of people without access to clean water and sanitation, said the report by Water Aid.

The cost of getting those countries that have fallen behind back on track would be $3.6 billion per year, said the international development NGO.

“Southern African governments must meet their past promises on water and sanitation and, together with donors, invest at the levels needed to put an end to the crisis that causes hundreds of thousands of children’s lives to be prematurely and needlessly extinguished,” Robert Kampala, Water Aid Head of Region for Southern Africa, said in a statement.

Some 120,000 children under the age of five die every year in the region from diarrhoea, which is primarily caused by lack of access to clean water and sanitation.

Almost two thirds of the population, 174 million people, do not have access to sanitation and over 100 million do not have access to safe drinking water.

“The high number of people living in Southern Africa who still do not have access to basic sanitation is a shocking figure,”  John Garrett, one of the lead authors of the report, told Thomson Reuters Foundation in a phone interview from London. “The social indicators show that challenges in tackling basic services like access to water and sanitation still remain.”

Despite a 2008 commitment by African Union countries to spend at least 5 percent of their GDP on sanitation and hygiene, none of the governments has kept the promise.

The report called on governments to dedicate revenue from natural resource extraction towards water and sanitation.

“Botswana in Angola are on track for the MDG (sanitation) target and what they’ve managed to do is to dedicate a lot of resources that they’ve captured from their natural resource wealth for basic services like water and sanitation,” said Garrett. “There’s opportunity for other countries in the region to make better use of their natural resource base in order to expand public spending on water and sanitation.

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Twitter can locate HIV outbreaks

A team of researchers mapped over 9,800 tweets with sexual and drug-related themes and found that their locations were a good predictor for established statistics on HIV-prevalence. “Because of the growing amount of social media data, researchers and public health departments will soon be able to build upon these methods to more accurately monitor and detect health behaviors and disease outbreaks.”

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The Daily Impact: Promising Advances and Emerging Challenges in Malaria Control

March 4, 2013

The global fight against malaria has come a long way in the past decade, but there are some serious concerns, including resistance, that lay ahead, reports IRIN. An excerpt:

“The news is exceptionally good,” said Desmond Chavasse, who is responsible for the malaria and child survival programme at Population Services International. “We have a one-third reduction in incidence and a halving of malaria child mortality since 2000. In sub-Saharan Africa, about 42 percent of people now have access to treated mosquito nets, so some really fantastic progress there.”

But there has been one serious change for the worse. ACTs – which have underpinned this success – have stopped working in areas around the Thailand-Cambodia border, an area where drug resistance often first appears. So far, the resistant strains have been contained, but Chavasse warns that the recent successes are “exceptionally fragile”.

“Resistance will get us in the end,” he said, “whether it is insecticide or drug resistance, so we need an elimination goal, and that means we have to do different things, we can’t just do more of the same.”

Chavasse was speaking at an event in London to mark 10 years of work by the Malaria Consortium, which was founded in 2003 by teams from the London and Liverpool schools of tropical medicine. At the half-day meeting, debate focused on some of the issues that remain unresolved today: the proper use of volunteers to diagnose and treat malaria in the community, the best way to work with the private sector, and concerns surrounding drug resistance and elimination.

The Consortium has worked a lot with community volunteers, which Nichola Cadge, a health advisor on malaria at the UK’s Department for International Development (DFID), says is essential because there is no way government health staff can fight malaria on their own.

“We all know that human resources are the biggest expenditure of any health system,” she said. “We all know that the greatest proportion of people with fever treat themselves at the community level, and we all know that there aren’t enough fixed-point facilities to provide care for all. So there is a big role for community health workers to play… But I do feel sorry for them. We are pretty demanding. We ask them to do so much, with often very little incentive.”

Some speakers suggested that use of volunteers should be seen as a stopgap measure, with curative work being handed back to professionals when health systems are stronger.

Franco Pagnoni, from the World Health Organization’s (WHO) Global Malaria Programme, disagrees. “If we move towards paid cadres, we would miss the key element of community case management, which is having a member of the community, who lives next door, providing the treatment, someone who the mother can easily approach and talk to. But we do run the risk of overburdening volunteers with more and more tasks. And nobody now, in 2014, is ready to work for a T-shirt.”

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When evidence is not enough

An interesting meta-ethnography recently published in open-access, peer-reviewed online journal PLoS OnE analyzed evidence of barriers and facilitators for prevention and health promotion activities. While there is much evidence in favor of primary prevention and health promtion activities, healthcare professionals are not able to conduct as much of those activities as they ideally would. It’s frustrating for them, and certainly a loss for the rest of us.

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The Daily Impact: Looming Food Crisis in the CAR

March 3, 2014 The UN’s humanitarian coordinator warned that a food crisis is looming in the Central African Republic. From Al Jazeera: Funds pledged to help the crisis in January have not materialised, Abdou Dieng, the United Nations’ humanitarian coordinator said, with only one-fifth of the $500m promised at a donor conference in Brussels coming in to […]

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USAID and P&G kick-off Global Development Alliance to improve health in Myanmar

Parents and children of North Okkalapa Township, outside Burma's capital Rangoon on Feb. 27, 2014, listen intently to a demonstration on proper safe water and hygiene practices. In Burma USAID and Procter and Gamble partner to provide clean drinking water and promote sanitation practices for some of the country's most vulnerable. (Image credit: Kelly Ramundo/USAID)

Administrator Raj Shah this week helped deliver the first liter of clean drinking water under a Global Development Alliance (GDA) between the US Agency for International Development (USAID) and Procter & Gamble (P&G) to improve health in Myanmar.

Over the next two years, USAID and P&G will make joint investments of at least $2 million on health projects aimed at providing clean drinking water through provision of P&G Purifier of Water packets, promoting better hygiene behaviors;,and building capability to deliver improved health services to mothers and children. These projects will be implemented on the ground by PSI.

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