USAID Impact Photo Credit: USAID and Partners

Archives for Global Health

Proof that the U.S. Government, NGOs and Activists are Working Together on Nutrition

During the first week of June, IMPACT will be highlighting the role of nutrition in Global Health

This originally appeared on the ONE Campaign blog

This morning, USAID Administrator Raj Shah joined a Google+ Hangout – a group video chat – with ONE’s U.S. Executive Director Tom Hart and a group of ONE members and agriculture policy experts from Feed the Future, GAIN, Thousand Days and Future Fortified.

USAID Administrator Raj Shah with ONE’s U.S. Executive Director Tom Hart. Photo credit: ONE.org

Tom gave Administrator Shah a fat stack of 100,336 petition signatures from ONE members across the US. Their ask? End chronic malnutrition for 25 million children by 2016. Administrator Shah heard them loud and clear, with two ONE members, George Houk and Vanessa Avila, as witnesses and representatives of our U.S. membership.

One of the highlights of the Hangout was hearing Administrator Shah talk about how global food security is in fact in America’s best interest.

“We know that this [nutrition] is an issue that touches on the economic prospects of countries that will be our trading partners in the future, it touches on our national security in places ranging from Afghanistan to Somalia, where far too many children die of core underlying malnutrition, and most importantly, we know it just touches on our moral consciouness because we cannot live in 2013 knowing that hundreds of millions of children go hungry and that that hunger prevents them from learning in school, from fighting disease, from surviving a simple bout of diarrhea or pneumonia and of building a better future for themselves,” he said.

After handing off the petition signatures, the conversation turned to our agriculture policy experts, Tjada McKenna, Deputy Coordinator for Development at Feed the Future, and Lucy Sullivan, Executive Director of 1,000 Days, and guest foodie activist, Chef Candice Kumai, a nutrition champion for Future Fortified. Adrianna Logalbo from GAIN moderated a lively discussion on the importance of agriculture, some of the successes and progress the world has made on nutrition, and how everyday citizens can get more involved.

Watch the full Google+ Hangout here:

Administrator Shah will be off to the pre-G8 Summit event, Nutrition for Growth, next week, with your petition signatures in hand. Stay tuned to ONE.org for updates on this important and critical event.

Learn more about USAID’s work on improving nutrition

Follow USAID (@USAID) on Twitter and use #GHMatters to join in the conversation.

Video of the Week: The Powerful Women of Kenya Fortified

During the first week of June, IMPACT will be highlighting the role of nutrition in Global Health

In 2012, as East Africa recovered from record drought, we called on the Future Fortified community to help invest in good nutrition in Kenya. And thanks to them, we achieved our goal and right now we are reaching over 20,000 children in southern Kenya with home nutrition packets – small packets filled with the essential nutrients children need to live, grow and learn.

Kenya Fortified is possible because of an incredible network of powerful, local women — community leaders, health workers and mothers — working together to help nourish the future.

Follow USAID (@USAID) on Twitter and use #GHMatters to join in the conversation.

This is not an endorsement of Future Fortified and individuals must make their own choices. 

Women Deliver: Bold Visions for Women’s and Girls’ Health and Rights

Robert Clay serves as deputy assistant to the administrator for Global Health. Photo credit: Robert Clay

I’ve just returned from an inspiring and thought-provoking week in Kuala Lumpur, Malaysia where leaders and advocates from 149 countries gathered for the Women Deliver 2013 conference. My USAID colleagues and I were proud to participate in one of the decade’s largest conferences on the health and rights of girls and women.

One of the most memorable parts of the week for me was speaking on a panel at the Ministerial Forum with Yemurai Nyoni, a youth representative from Zimbabwe. He was a strong and articulate voice for youth and urged that young people be included in program design and implementation of youth-focused programs. It’s people like Yemurai that give us hope for the future. And with 1.8 billion youth in the world today, it is vital that we listen and include them in our development work.

Women Deliver served as a pivotal opportunity to renew commitment to meeting the needs of girls and women across the globe. USAID places women and girls at the center of our global health programs because we know improving women’s and girl’s health is critically important to almost every area of human development and progress. We’re helping countries acquire the resources they need to improve health outcomes through strengthened health systems and integrated services. This week in Kuala Lumpur I discussed the bold visions we have for our future to end preventable child and maternal deaths and create an AIDS Free Generation. Bold visions inspire action, and action paves the way for progress.

Over the past decade, we’ve seen wonderful success in reductions of maternal and child deaths and improved access to family planning. But despite all the good we have done, millions around the globe still do not receive the reproductive, maternal, newborn, and child health services they need. Every year 6.9 million children die of preventable causes and 287,000 women lose their life in pregnancy or childbirth. Some 222 million women who want to avoid pregnancy are not using a modern method of family planning.  Closing this access gap to family planning information and services would reduce maternal deaths by 30 percent and could save the lives of 1.6 million children annually (PDF).

After a week of renewed commitments, sharing lessons learned, and listening to those pioneering the way forward on women’s health and rights, I feel inspired to do my part in leading USAID to achieve our global health goals and improve women’s and girl’s health and rights across the globe.

Learn more about USAID’s work at Women Deliver and share with us your thoughts below.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Healthy People, Healthy Environment: Family Planning and Integrated Development in Tanzania

Filmed in the northern coastal region of Tanzania, the short documentary “Healthy People, Healthy Environment showcases an innovative approach to development that combines efforts to conserve natural resources with reproductive health services and sustainable economic opportunities, such as clean cook stoves and seaweed farming.

In the film, three women from the Pangani and Bagamoyo districts – Rukia, Mahija, and Fidea – show how integrated population, health, and environment (PHE) projects empower them to help their families, their communities, and their environment.  Family planning and women’s empowerment are key to this long-term, holistic approach to the problems of environmental degradation and food insecurity.

“When you have a large number of children, there are two consequences: children can get malnutrition as a result of inadequate nutrition in their diet because the family is large. Second, when there are many children, the environment can be affected because it might be necessary for you to cut down trees in order to feed the children,” says Fidea Dastani Haule, a peer educator in Pangani district of Tanzania. “Therefore, the main thing we encourage is that a family plans their number of children so that you can adequately feed, clothe, and educate them.”

Watch Healthy People, Healthy Environment: Integrated Development in Tanzania here.

About the Film

“Healthy People, Healthy Environment” was produced by the Woodrow Wilson Center’s Environmental Change and Security Program with support from USAID’s Office of Population and Reproductive Health. To request a screening, please contact Sean Peoples at sean.peoples@wilsoncenter.org

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

DRC Making Great Strides in Child Survival

This week, the Congolese Government’s National Steering Committee for Health  is meeting to officially launch the National A Promised Renewed (APR)’s acceleration framework to reduce infant and maternal mortality in the Democratic Republic of the Congo (DRC).  Following the Minister of Health’s participation in the Child Survival Call to Action in Washington June 2012 and at the African Leadership for Child Survival in Addis Ababa in January 2013, the DRC Government has made great strides in developing a strategic country-specific plan to move towards accelerated reduction of maternal and child deaths. This Action Framework aims to reduce under-five mortality by 48 percent and maternal mortality by 31 percent, saving the lives of 430,000 children and 7,900 mothers by 2015.

Part of the action framework includes a national scorecard which will serve as a monitoring tool to better track successes at the provincial level.

"Birth - Growth - Progress" for every woman and child. Photo Credit: UNICEF

USAID’s current health portfolio directly aligns with the objectives of the Ministry of Health’s APR plan and efforts to intensify the reduction of maternal and child deaths. USAID has worked with the DRC to improve access, availability and quality of health services in 80 health zones through the Integrated Health Project, led by Management Sciences for Health. This $144 million five-year project spans the spectrum of essential health services and provides support to the government’s Health Systems Strengthening Strategy (SRSS) and the National Health Development Plan (PNDS).

In support of A Promise Renewed, USAID and UNICEF are collaborating to promote essential maternal and child health services through a package of high impact interventions in 27 health zones, where access to health centers faces the greatest barriers and the risk of child mortality is highest. A thorough LiST (Lives Saved Tool) analysis identified these interventions, which will target children under five and pregnant women with vouchers that subsidize care. Some of the key activities will focus on pre-packaged family kits that will be distributed to prevent, diagnose and treat malaria, diarrhea, and respiratory infections and to provide basic emergency obstetrical and neonatal care in health centers. If this approach is successful, there are plans to scale it up nationwide, impacting those most at risk throughout the DRC.

This is an exciting time for the DRC, and the USAID Mission here in Kinshasa is committed to working closely with UNICEF to support the DRC Ministry of Health on implementing the country plan to drastically improve child survival.

The injection advantage: Reaching more women with an effective and convenient family planning method

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. This week we are focusing on family planning. 

The women are about 25 to 30 years old. They’re married with two, or as many as nine, children. They’re tired. They may have miscarried, more than once. They want a break.

This is how community health workers in Senegal describe the women who visit village health huts for family planning. “Some are educated and some are not,” one health worker said, “but they are smart. They worry about the health consequences of multiple pregnancies.”

Small, light, and easy to use, Sayana Press is well-suited for community health workers. Credit: PATH/Patrick McKern

These women know what they want: the chance to choose an effective family planning method that meets the reality of their lives.

When convenience and privacy are important

For many women, injectable contraceptives have tremendous advantages: one shot of the popular Depo-Provera® protects for three months. It is safe and effective, with almost no risk of unintended pregnancy.

Injectables have other advantages—with no pills to take daily, they are discreet. “This is a small village,” explained another Senegalese health worker. “Everyone knows what everyone else is doing.”

Partnering to reach more women

Depo-Provera is very popular in sub-Saharan Africa and has great potential to reach millions more women. In Senegal, injectables not only account for one-third of contraceptives used—one-third of women who intend to use family planning say they’d prefer injectables, too.

Typically, trained health workers give the injections in clinics, so women in remote villages have to travel long distances to get them. To quote one more health worker: “Sometimes, having to go all the way to the health clinic is enough to discourage women from doing family planning.”

A new initiative announced at the London Summit on Family Planning in 2012 aims to address this gap in access. USAID, the Bill & Melinda Gates Foundation, DFID, UNFPA, and PATH will bring up to 12 million doses of a new form of Depo-Provera, called Sayana® Press, to women in sub-Saharan Africa and South Asia.

A new form of Depo-Provera goes remote

Sayana Press is packaged in the Uniject™ autodisable injection system—each prefilled dose is administered in the abdomen, upper thigh, or upper arm. Small, light, and easy to use, the system is well-suited for community health workers.

USAID, PATH, and our partners are engaging countries interested in piloting the method and learning if and how it could enhance their family planning programs. We’ll be collaborating with ministries of health to introduce Sayana Press, aiming to achieve their goals for increasing access to family planning and meeting women’s needs. We will rigorously evaluate the product’s impact on contraceptive use and costs so that donors and governments have the information they need to make future decisions about use of Sayana Press.

Health worker quotes are from a Sayana Press acceptability study conducted by FHI 360 with support from the USAID PROGRESS project and PATH.

Sayana Press and Depo-Provera are registered trademarks of Pfizer, Inc. Uniject is a trademark of BD.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Contraceptives Save and Improve Lives

Each year an estimated 74.4 million unintended pregnancies occur in the developing world; primarily among women who had an unmet need for effective contraception. Family planning programs, which provide counseling, services and contraceptive supplies, empower couples to make important decisions about the timing and spacing of their children. By choosing the healthiest times for childbirth, mothers give themselves and their children a better chance to live long, healthy lives. This week at the Women Deliver conference, I join public health professionals from around the world who are discussing family planning as one of the core strategies to save women’s lives.

A woman and her children after a family planning consultation at Kalingalinga Clinic in Lusaka, Zambia, 2009. Photo Credit: Arturo Sanabria

When we think about who plays a role in improving access to family planning, we often think of the nurses, doctors and other healthcare workers who administer contraceptives. Warehouse managers and truck drivers, on the other hand, might not immediately spring to mind. However, these individuals play a vital role in ensuring contraceptive security, which exists when every person is able to choose, obtain, and use quality contraceptives and condoms whenever he or she needs them.

On the USAID | DELIVER PROJECT we work alongside USAID and other partners every day to strengthen health programs by improving the supply chains in-country. In our work we often say “No Product. No Program.” What we mean by that is ensuring an adequate supply of contraceptives is critical to the success of family planning programs. These programs are most effective when healthcare providers have commodities on hand for women who want and need them.

In fiscal year 2012, on behalf of USAID, the project supplied a range of contraceptive methods to 45 countries, including over—

  • 751 million male condoms
  • 64.6 million oral contraceptives, and
  • 36.3 million injectables
  • 1.6 million IUD’s
  • 1 million implants

Coupled with comprehensive counseling and services, these commodities prevented an estimated 15,000 maternal deaths and 230,000 infant deaths.

Despite major gains, we know that 222 million women still have an unmet need for family planning, meaning they want to delay or avoid pregnancy but aren’t using a modern method of family planning. Meeting this need for modern contraceptives will save 79,000 mothers and 1.1 million infants. Ensuring and sustaining contraceptive availability at this scale is a substantial task that requires more effective and efficient supply chains, coordination among the public, private and NGO sectors, engagement of civil society organizations, a willingness to go beyond ‘business as usual,’ and leadership and commitment on the part of national and international partners.

Staff load family planning and other health commodities into a truck as part of the Delivery Team Topping Up system in Zimbabwe. 2009. Photo Credit: USAID | DELIVER PROJECT.

While meeting the family planning needs of women around the world happens one woman at a time, making contraceptives available to each of those women requires the concerted and coordinated efforts of individuals and organizations around the world.

View a new infographic by the USAID | DELIVER PROJECT on the important role contraceptives play in saving and improving women’s lives.

Allowing Women to Nurture Themselves and Their Children Before Giving Birth Again

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. This week we are focused on family planning. 

In too many places around the world, women lack the access to contraception or the decision-making ability to seek services.

Mother in Ethiopia. Photo Credit: Jhpiego

Eighty million unintended pregnancies were estimated to have occurred in developing countries last year. Of these, 63 million occurred among the 222 million women with an unmet need for modern contraception.[1]And in sub-Saharan Africa, one in four women in is unable to decide when and how many children she will have.

The importance of healthy timing and spacing of pregnancies cannot be underestimated. According to the World Health Organization, short birth-to-pregnancy intervals—the time between the date of a live birth and the start of the next pregnancy—greatly affect maternal, newborn, and child health and mortality outcomes. In low-resource settings, preventing another pregnancy by using family planning and waiting to get pregnant again for 36 months can reduce under-five child mortality by 25%.  For neonates in the developing world, this number is even greater—findings indicate that mortality is reduced by approximately 40% for preceding birth intervals of 3 years or more, compared with intervals of less than 2 years.[2]

The likelihood of miscarriages and stillbirths are also much higher for extremely short birth-to-pregnancy intervals. Women who become pregnant 15 to 75 months after a preceding pregnancy are less likely to miscarry or have a stillbirth baby than those with shorter or longer inter-pregnancy intervals.1

Family planning can help women ensure that pregnancy occurs at the healthiest times of their lives. Research shows that positive health outcomes for both mothers and newborns occur when pregnancy happens:

  • 24 months after a live birth (an almost three-year birth-to-birth interval);
  • 6 months after an induced abortion or miscarriage;
  • To women who have had fewer than four live births; and
  • To women between the ages of 18 and 34.

Family planning, including healthy timing and spacing of births, has been recognized as one of the most cost-effective global health interventions. For every $1 spent on family planning, $6 are saved on other interventions. And with a better-spaced family, there are more opportunities for members to grow, remain healthy, and be better educated.

Here at USAID’s flagship Maternal and Child Health Integrated Program (MCHIP), we are working around the world to save and improve lives through increased use and understanding of family planning. In India, for instance, the Program has worked with the Ministry of Health to help prevent nearly 100,000 unintended pregnancies during the extended postpartum period through our work with the postpartum IUCD.  This is just one example of our work in more than 50 countries, but is illustrative of our efforts to scale up results to reach as many women as possible.

And in Africa, where the PPIUD has been slower to gain acceptance, we’re seeing signs of hope. At a regional PPIUD meeting co-hosted by MCHIP last month in Zambia, 60 enthusiastic champions from professional societies, service delivery, INGOs, donors and governments representing 10 countries[3]convened to share their successes and challenges implementing PPIUD programs. But while these international and regional experts will surely help to advance integration of PPIUCDs into maternal health services in their respective contexts, we must multiply this number by a factor of 10—or even 100—to reach all the women who need PPFP to space their pregnancies at the safest intervals. Given the lack of understanding of return to fertility after a birth or miscarriage in much of Africa, as well as elsewhere, coupled with early return to sexual activity after delivery and short periods of amenorrhea, the role of PPFP/PPIUCD is critical to healthy timing and spacing of pregnancies. Raising awareness to dispel myths and misconceptions among clients and service providers is also key to improving PPIUCD uptake.

In our own lives, many of us have had the luxury to determine when and if we will have children. We cannot forget the millions of women in developing countries who do not have this same freedom—and who desire more time before becoming pregnant again, facing the risk of death with every pregnancy. Healthy pregnancy spacing is a cost-effective intervention that can reduce both maternal and childhood mortality and excessive population growth. Investing in women’s reproductive health and autonomy improves not only the health of the individual, but also the welfare of the whole family and, ultimately, the larger society. This investment is modest in relation to the dramatic returns it yields.


[1] UNFPA World Population Report, 2012

[2] Setty-Venugopal V, Upadhyay UD. Birth spacing: three to five saves lives. Baltimore: Johns Hopkins University, Population Information Program, 2002.

[3]Ethiopia, Kenya, Liberia, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe

 

Women Deliver Conference Focuses Attention to Women’s Health and Rights

During the month of May, IMPACT will be highlighting USAID’s work in Global HealthThis week we will be focusing on Family Planning. 

This week leaders and advocates from nearly 150 countries are gathering in Kuala Lumpur, Malaysia for Women Deliver 2013, one of the largest conferences of the decade focused on the health and wellbeing of girls and women. USAID is proud to participate in Women Deliver 2013 and highlight the Agency’s strong support and dedication to improving the health and status of women and girls across the globe. A number of our technical experts are presenting at the conference on topics covering family planning, maternal, newborn and child health, and other programming that address the needs of women and girls.

With support from USAID, Masreshah delivers reproductive health information and services to households in the Amhara region of Ethiopia. Photo Credit: Pathfinder International

The discussions in Kuala Lumpur are sparking a larger global conversation on how and why we all must work together to improve access to reproductive and maternal health.  Last night, USAID participated in the launch of WomenDeliver+Social Good, a movement that brings together social entrepreneurs and new media connectors around the world with the leaders who are shaping policies and programmes around women’s health and economic empowerment.  Watch USAID’s Health Development Officer, Judy Manning, present at the launch event where she spoke about the development of new contraceptive technologies as a solution to saving women’s and children’s lives.

Coinciding with the Women Deliver conference, USAID is highlighting our work in family planning this week on IMPACT as part of our Global Health blog series this month.  Family planning plays a critical role in meeting our goals of ending preventable child and maternal deaths and creating an AIDS Free Generation, and is crucial to improving people’s lives across the globe.  We know that family planning enables women and couples to choose the timing and spacing of their pregnancies, resulting in incredible health and economic benefits for families.  A USAID analysis found that, by preventing closely spaced births, family planning could save the lives of more than 1.6 million children under five annually.  Satisfying the global unmet need for family planning could reduce maternal deaths by 30 percent. And enabling young women and girls to avoid early pregnancy allows them to stay in school longer, increasing their economic opportunities.

Check back here all week as we highlight the importance of Millennium Development Goal (MDG) 5b, Universal Access to Reproductive Health.  Keep up with USAID’s participation at Women Deliver by following USAID for Global Health on Twitter for live updates and visit our webpage dedicated to the conference.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

 

PEPFAR: Ten Years of Saving Millions of Lives

Originially appeared on Huffington Post

Ten years ago today, the United States Congress, in a remarkable display of compassion and bipartisanship, passed overwhelmingly legislation that established an historic and transforming global health program now known as PEPFAR– the President’s Emergency Plan for AIDS Relief.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is in its 10th year of helping HIV and AIDS-infected and -affected populations get access to prevention, care and treatment services. PEPFAR, the largest effort by any nation to combat a single disease, is working to achieve former Secretary of State Clinton’s vision of creating an AIDS-free generation. Photo Credit: EGPAF/James Pursey

At the time that PEPFAR was conceived of and then established during the George W. Bush administration, the world was witnessing first-hand the destruction of an entire generation of individuals in the prime years of their lives and the reversal of remarkable health and development gains, particularly in sub-Saharan Africa and to a lesser extent in other developing nations. Rates of new HIV infections were rising rapidly, and hospitals, communities, and families were often too under-resourced and overwhelmed to cope with the enormity of this burden. At that time in 2003, despite the availability of life-saving antiretroviral therapy (ART) in most countries in the developed world, in southern Africa and other regions of the developing world, an HIV diagnosis meant a virtual death sentence, since few had access to such drugs.

Today, as we mark the 10th anniversary of PEPFAR, the situation has changed dramatically. Plummeting life expectancy rates in much of Africa have been reversed; HIV-infected, but healthy, fathers and mothers who are receiving therapy are able to return to work, care for their families, and spur economic development. Doctors, nurses, and community health workers, who once had little to offer their patients beyond a more dignified death, are delivering life-saving ART to millions of people. AIDS-related mortality has declined by more than 26 percent since its peak in 2005. Where despair once cut a devastating swath through so many communities and countries, hope has been renewed.

With regard to the prevention of HIV infection, globally, in the decade since PEPFAR began, new HIV infections have declined by nearly 19 percent. Between 2009 and 2011, new HIV infections among children, still an important component of the epidemic in many southern African countries and other regions in the developing world, declined by 24 percent globally, compared to a 23 percent decline in the previous six years. Not only is progress happening, but its pace is accelerating.

According to a recent report evaluating PEPFAR by the Institute of Medicine, “PEPFAR has played a transformative role with its contribution to the global response to HIV.” As of the end of September 2012, PEPFAR was directly supporting 5.1 million people on ART — a more than three-fold increase in just the past four years. Last year alone, PEPFAR reached more than 750,000 pregnant women living with HIV with antiretroviral drugs to prevent mother-to-child transmission (PMTCT), allowing an estimated 230,000 babies who would have otherwise been infected to be born without HIV.

One key driver of this progress is the development and implementation of a combination prevention program. Just as it became clear that multiple HIV medicines, when used in concert, more effectively control replication of the virus in the body, it was shown that multiple prevention interventions, when implemented together, can more effectively reduce new HIV infections at the population level. This evolution in our thinking and approach to preventing HIV infection has reflected scientific innovation together with practical implementation. Landmark scientific advances, coupled with lessons learned from a decade of implementing programs under PEPFAR, have given us the tools, knowledge, and experience needed to achieve an AIDS-free generation.

Recent statistics show that the promise of an AIDS-free generation is truly within our reach, as President Obama powerfully articulated in his State of the Union address earlier this year. More countries than ever before have reached, or surpassed, the programmatic tipping points in their HIV epidemics — the point at which the annual increase in adult patients receiving treatment exceeds the number of annual new adult HIV infections. Reaching this tipping point is a key indication that a country is on the path to achieving an AIDS-free generation — and the more countries that achieve this goal, the closer we will be to ending the HIV/AIDS pandemic.

While PEPFAR is certainly the largest and most successful foreign health assistance program in history, it is clear that the United States cannot be alone in this endeavor… Other partners, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, to which the U.S. is the largest contributor, multilateral organizations, the private sector, civil society, and host countries must all share in the responsibility. And, as PEPFAR enters its second decade, countries with a high burden of HIV disease must assume greater ownership for addressing the health needs of their own people by building strong and sustainable health systems.

PEPFAR represents the very best of America — the extraordinary generosity and compassion of the American people. Through PEPFAR, we are helping to deliver a better future to millions around the globe. Although much remains to be done in the future, the 10th anniversary of PEPFAR is something to celebrate now.

Ambassador Eric Goosby is the U.S. Global AIDS Coordinator and head of the State Department’s Office of Global Health Diplomacy. Dr. Anthony Fauci is the Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.

Follow Ambassador Eric Goosby, MD on Twitter:www.twitter.com/@PEPFAR

 

Page 10 of 42:« First« 7 8 9 10 11 12 13 »Last »