Infographic: Contraception changes everything

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Access to contraception is something we often take for granted in the United States. But 222 million women in the developing world – who have an unmet need for contraception – still can’t get it. How can contraception radically change their worlds?

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The Daily Impact: Air Pollution Claims 7 Million Lives a Year – WHO

March 26, 2014

The WHO released a new report estimating that 7 million people die each year due to air pollution. From the AP:

The agency said air pollution is the cause of about one in eight deaths and has now become the single biggest environmental health risk.

“We all have to breathe, which makes pollution very hard to avoid,” said Frank Kelly, director of the environmental research group at King’s College London, who was not part of the WHO report.

One of the main risks of pollution is that tiny particles can get deep into the lungs, causing irritation. Scientists also suspect air pollution may be to blame for inflammation in the heart, leading to chronic problems or a heart attack.

WHO estimated that there were about 4.3 million deaths in 2012 caused by indoor air pollution, mostly people cooking inside using wood and coal stoves in Asia. WHO said there were about 3.7 million deaths from outdoor air pollution in 2012, of which nearly 90 percent were in developing countries.

But WHO noted that many people are exposed to both indoor and outdoor air pollution. Due to this overlap, mortality attributed to the two sources cannot simply added together, hence WHO said it lowered the total estimate from around 8 million to 7 million deaths in 2012.

The new estimates are more than double previous figures and based mostly on modeling. The increase is partly due to better information about the health effects of pollution and improved detection methods. Last year, WHO’s cancer agency classified air pollution as a carcinogen, linking dirty air to lung and bladder cancer.

WHO’s report noted women had higher levels of exposure than men in developing countries.

“Poor women and children pay a heavy price from indoor air pollution since they spend more time at home breathing in smoke and soot from leaky coal and wood cook stoves,” Flavia Bustreo, WHO Assistant Director-General for family, women and children’s health, said in a statement.

Other experts said more research was needed to identify the deadliest components of pollution in order to target control measures more effectively.

“We don’t know if dust from the Sahara is as bad as diesel fuel or burning coal,” said Majid Ezzati, chair in global environmental health at Imperial College London.

Kelly said it was mostly up to governments to curb pollution levels, through measures like legislation, moving power stations away from big cities and providing cheap alternatives to indoor wood and coal stoves.

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Thoughts on Next Month’s Global Partnership Ministerial in Mexico City

The Mexico City meeting is part of a series that started in Rome in 2003. Subsequent meetings in Paris (2005), Accra (2008) and Busan (2011) created an ever-stronger set of principles related to the effectiveness of development interventions. As time has gone on, the donor profile at these meetings has receded as partner nations in the developing world began participating in large numbers and with growing intensity. The global development challenge will require better coordination among all constituencies and this forum more than any other has the potential to play that role.

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The Daily Impact: 1 million children infected with TB annually, says report

March 25, 2014

Roughly 1 million children, double the previous estimate, fall ill with tuberculosis every year, said a study that also gave the first tally of drug-resistant TB among the young. From AFP:

“Many cases of tuberculosis and multi-drug resistant tuberculosis disease are not being detected in children,” it said.

The team’s computer model, based on population data and previous studies, suggests 999,800 people aged under 15 fell sick with TB in 2010.

Around 40 percent of the cases were in Southeast Asia and 28 percent in Africa.

“Our estimate of the total number of new cases of childhood TB is twice that estimated by the WHO (World Health Organisation) in 2011, and three times the number of child TB cases notified globally each year,” said Ted Cohen from the Harvard School of Public Health.

The research, published in The Lancet, coincides with World TB Day, which places the spotlight on a disease that claims some 1.3 million lives each year.

The team estimated that nearly 32,000 children in 2010 had multi-drug resistant TB (MDR-TB), meaning the strain was impervious to frontline drugs isoniazid and rifampin and was thus harder and costlier to treat.

This is the first estimate of MDR-TB among children under 15, who constitute a quarter of the global population.

Children are at a higher risk of disease and death from MDR-TB, but react well to medication. They are harder to diagnose, partly because smaller children cannot cough up sputum samples needed for laboratory tests.

Reliable estimates are necessary for health authorities to assign resources for diagnosing and treating the infectious lung disease.

Commenting on the study, Ben Marais of the Marie Bashir Institute for Infectious Diseases and Biosecurity in Sydney, Australia, described it as the “most rigorous effort to date” to assess TB and MDR-TB incidence in children.

“Every effort should be made to reduce the massive case-detection gap and address the vast unmet need for diagnosis and treatment,” he said.

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The Daily Impact: Ebola strikes Guinea, killing more than 50

March 24, 2014

MSF has launched an emergency medical intervention following reports of the Ebola virus in southern Guinea, where an outbreak of hemorrhagic fever has left at least 59 people dead. From CNN:

Experts in the country had been unable to identify the disease, whose symptoms — diarrhea, vomiting and fever — were first observed last month.

Health Minister Remy Lamah said Saturday initial test results confirm the presence of a viral hemorrhagic fever, which according to the U.S. Centers for Disease Control and Prevention refers to a group of viruses that affect multiple organ systems in the body.

In a written statement, UNICEF said at least 59 out of 80 people who contracted Ebola have died. At least three of the victims were children.

“In Guinea, a country with a weak medical infrastructure, an outbreak like this can be devastating,” the UNICEF representative in Guinea, Dr. Mohamed Ag Ayoya, said in the statement.

UNICEF has prepositioned supplies and stepped up communication on the ground to sensitize medical staff and local populations on how to avoid contracting the illness, Agoya added.

The Guinean Health Ministry warned that the disease is mainly spread from infected people, from objects belonging to ill or dead people, and by the consumption of meat from animals in the bush.

So far, most of the cases have been in the forest area of southern Guinea, and health officials say they are offering free treatment for all patients.

They’ve urged people to stay calm, wash their hands and report all cases to authorities.

The international medical charity Medecins Sans Frontieres announced on Saturday it was reinforcing its medical and logistics teams in Guinea in response to the epidemic.

It is also flying in 33 tons of medicines and equipment and setting up isolation units in the three affected areas in the country.

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Let’s go the distance: Investing in partnerships for a healthier future

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By Karl Hofmann, President & CEO, PSI; Steve Davis, President & CEO, PATH; and Raj Kumar, president, Devex.

Knowing where to invest time, resources and funding to have the greatest impact in this complex environment can be difficult. To inform these decisions, Devex, in partnership with PSI and PATH, conducted a survey to highlight smart investments in global health. We surveyed nearly 1,500 experts working in global health to learn what they think are the smartest investments — or “best buys” — to achieve our public health goals.

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The Daily Impact: China halves TB cases, a blueprint for other nations

March 21, 2014

A new report shows that China’s adoption of WHO policies on TB reduction have worked well and could prove hope for other countries. From the BBC:

The Lancet report reveals what progress China has made on reducing this burden, based on a 20-year-long analysis of national survey data.

Between 1990 and 2000, levels of TB were reduced in provinces where the WHO-recommended directly observed treatment, short-course (DOTS) programme – rapid detection and cure of infectious tuberculosis patients living in the community – was adopted.

By 2010, TB prevalence in China fell by 57%, tripling the reduction of the previous decade.

The increase of known TB cases treated using DOTS rose from 15% in 2000 to 66% in 2010.

Lead researcher Dr Yu Wang, from the Chinese Centre for Disease Control and Prevention in Beijing, said: “One of the key global TB targets set by the Stop TB Partnership aims to reduce tuberculosis prevalence by 50% between 1990 and 2015.

“This study in China is the first to show the feasibility of achieving such a target, and China achieved this five years earlier than the target date.”

The 2014 World Health Assembly will look at eliminating TB and setting ambitious new targets which could include a 50% reduction in tuberculosis prevalence between 2015 and 2025.

Giovanni Battista Migliori from WHO said: “The results from China show the feasibility of achieving such a target by aggressively scaling up the basic programmatic elements of tuberculosis control both within and outside the public sector.”

He said other countries could learn from China’s example.

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Best Buys for Global Health: Event video and conversation

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Marking the launch of the Spring edition of PSI’s Impact Magazine, “The Best Buys Issue: Where to Invest in Global Health in 2014,” two panels of global health industry leaders gathered to discuss what are the best buys for global health. View the video of the full event, and the conversation on Twitter.  Here’s more information about the event, hosted in partnership with PATH, Devex, and the Center for Global Development, with support from the Merck for Mothers Program.

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The Daily Impact: Hemorrhagic fever outbreak kills 23 in Guinea

March 20, 2014

There are twenty-three people reported dead in Guinea due to a mysterious hemorrhagic fever outbreak, reports the New York Times.

At least 35 cases have been recorded by local health officials, said Sakoba Keita, the doctor in charge of the prevention of epidemics in Guinea’s Health Ministry.

“Symptoms appear as diarrhea and vomiting, with a very high fever. Some cases showed relatively heavy bleeding,” Keita said.

“We thought it was Lassa fever or another form of cholera but this disease seems to strike like lightning. We are looking at all possibilities, including Ebola, because bushmeat is consumed in that region and Guinea is in the Ebola belt,” he said. No cases of the highly contagious Ebola fever have ever been recorded in the country.

Keita said most of the victims had been in contact with the deceased or had handled the bodies. He said those infected had been isolated and samples had been sent to Senegal and France for further tests.

More than half of the mineral-rich nation’s 11.4 million people live on less than $1 a day and many lack access to basic medical facilities and qualified medical staff.

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The Best Buys in Global Health: Striking an Effective Balance

To have real and lasting impact, we must step back from the intervention level of analysis to understand how we can mold entire ecosystems to better serve the health of broad populations. Sometimes this is called ‘health systems strengthening’, and sometimes it might be seen under the even broader rubric of ‘capacity building’.

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