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Archives for Global Health

Ending Child Mortality

Originally posted as an OpEd in PoliticoActor Ben Affleck is founder and director of the Eastern Congo Initiative. Rajiv Shah is administrator of the U.S. Agency for International Development. 

More than 7 million children — most of them in sub-Saharan Africa and South Asia — are expected to die this year before reaching their fifth birthday. These kids will never have the chance to follow a passion or fulfill their potential.

In Africa, 1 in 8 children die before they turn 5But in our lifetime, we have made remarkable headway toward ending child mortality around the globe. In the past 50 years, the child global mortality rate has declined by 70 percent. In just the past 20 years, the number of child deaths has fallen by 4.4 million each year.

This progress is extraordinary. Yet there are still places, like the Democratic Republic of Congo, that these advances have yet to reach. In Congo, a country buffeted by decades of violence and political instability, nearly 465,000 children die each year from preventable diseases, like malaria, pneumonia and diarrhea. Chronic malnutrition also afflicts nearly 45 percent of all Congolese children, permanently stunting their physical and mental development.

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Strategic Help for Global Health Care

This post originally appeared in Politico

People often ask me what the global health community can do to have more impact. The answer is easy: We could be more like Tsion Berhanu.

I met Berhanu the last time I visited Ethiopia. My colleagues and I drove to the end of the road, then kept going for 15 more minutes, until we reached the Wuye Gosee Community Health Post, a tiny, three-room, concrete structure with an outhouse.

Berhanu lived in one room and worked in the other two — caring for 1,500 people in her kebele. Women came to her for contraceptives. When they stopped using birth control and got pregnant, they came for pre-natal care. When their babies were born, she gave advice about proper nutrition. When children got a little older, she immunized them. When people were sick, she treated them if she could and referred them to the district hospital if it was serious. She also advised families on how to store clean water and build sanitary pit latrines.

This is how health care is experienced and addressed on the ground. The community of donors, agencies and NGOs dedicated to better health for the poorest— including our foundation— has access to many more resources than Berhanu. What we don’t always do is drive conversation and innovation that can reflect her experience and perspective.

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1,000 Photos

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

As of today, 1,000 people around the world have posted photos of their 5th birthday in support of the Every Child Deserves a 5th Birthday awareness campaign. From Secretary Hillary Clinton and Kay Warren to Tony Hawk and Mandy Moore, government representatives, faith-based and civil society leaders, celebrity activists and athletes have uploaded photos of themselves at age five to help rally the world around the goal of ending preventable child death and ensuring all children get to celebrate their 5th birthday.

Age five is an important time. It’s when we start going to school, learning to read and making our own decisions. Age five is also an important milestone in the health and development of children.  Over the last 50 years—especially in the last two decades—child mortality has fallen by 70 percent thanks to high-impact interventions like new vaccines, improved health care practices and community health workers.

Despite this progress, more than 7 million children will die this year from largely preventable causes before they turn five.  In Africa alone, 1 in 8 children will die before they celebrate their 5th birthday.  In order to change this devastating narrative, we must do more.

Today, we have the scientific, technological and programmatic advances to dramatically accelerate progress.  Today, the Governments of the United States, Ethiopia and India are working in close collaboration with UNICEF to launch a Call to Action in Child Survival.  Designed to end preventable child death by focusing on the survival of newborns, children and mothers, the Call to Action will convene 700 prominent leaders from government, the private sector, faith-based organizations and civil society to kick off a long-term, strategic effort to save children’s lives.

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Saving Mothers & Children: The Importance of Providing a Continuum of Care

Dr. Flavia Bustreo is the Assistant Director-General - Family, Women's and Children's Health, World Health Organization

The Millennium Development Goals (MDGs) brought needed and increased attention to child survival.  Globally, significant progress has been made in reducing child mortality.  The number of under-five deaths declined from 9.6 million in 2000 to 7.6 million in 2010. Under-five mortality fell from 73 per thousand in 1990 to 57 per thousand in 2010. On average, under-five mortality has been falling at a rate of 2.5 per cent per year compared with 1.9 per cent per year over 1990–2000.

The rate of reduction doubled in Sub-Saharan Africa when compared with the previous decade.  There is evidence that this rate of decline is accelerating as we approach 2015.  New initiatives, such as the UN Secretary General’s Global Strategy for Women’s and Children’s Health, have added guidance and resources to the achievement of the goals.  The subsequent establishment of  the Commissions on Information and Accountability and on Life-Saving Commodities will add to the benefits for women’s and children’s health.

Still, despite accelerated progress, the global burden of maternal and child mortality is still unacceptably high.  Over 280,000 maternal lives and 7.6 million under-fives’ lives were lost in 2010.  Most of these losses would have been preventable with interventions that already exist.  We know what these interventions are and what they require to be implemented. Unfortunately, we still fail to reach a large proportion of mothers and children with them, particularly in sub-Saharan Africa and South Asia, where most of maternal and child deaths occur. We need to find the ways to ensure that every mother and child has access to these interventions and can benefit from them. 

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Protecting Mothers and Children From HIV: A Call to Action

Originally published at the Huffington Post.

At this point in history, there is no reason why children should be born with HIV. Yet 390,000 infants around the globe were born with the virus in 2010.

Science has long established that providing mothers with antiretroviral drugs can prevent them from transmitting the virus to their children — as well as keeping the mothers alive themselves. What is needed is to take this intervention, available in affluent nations to prevent mother-to-child transmission of HIV, and make it available in the developing world.

The good news is that we know we can do this, in even the most challenging settings. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has been the driver of a remarkable reduction in mother-to-child transmission in recent years. As we push toward the goal of an AIDS-free generation, the need is to broaden the participation in this effort.

This week marks an important opportunity to advance this goal: the Child Survival Call to Action, convened by the governments of the United States, India, and Ethiopia, in close collaboration with UNICEF. This high-level forum in Washington will bring together public and private partners to focus on one ambitious, yet simple, goal — to end preventable child deaths. It’s an inspiring vision.

Helping mothers give birth to HIV-free children is an essential piece of the puzzle of ending preventable child deaths. Beyond keeping the child alive, doing so provides wider benefits by keeping the mother healthy, and preventing the orphaning of other children in the household. Each dollar we invest has a multiplying impact.

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A Role for Business at the Frontier of Development

The social and economic challenges faced by Africa may seem daunting – with many communities suffering from hunger, a lack of clean water and sanitation, and little access to education or a functioning health system. However, if we work together, I believe we can overcome these challenges one-by-one and build a positive, virtuous cycle where we invest in healthcare, which in turn increases economic development.

In many parts of Africa people cannot afford to pay to see a doctor or buy medicines, and in many places they are not readily available even if they could. This results in a situation in which children are prevented from pursuing an education, and illness impedes personal, societal and economic development. We can change this.

We’ve come a long way over the past five years – in addition to medical advances, vaccines and basic healthcare services are now reaching some of the most remote areas of the world, in large part due to international aid from countries including the United States and the United Kingdom, along with generous funding from non-profit groups such as the Bill & Melinda Gates foundation. However, there is still much more to do, and moving to the next level will require a shift in mindset. It is clear than no single person or organisation can find the all answers to Africa’s problems. Only through strong partnerships and innovative collaborations will we find the strength and the resilience, creativity and energy to bring the scale of change required.

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Make Every Mother and Baby Count

In early May, we witnessed a spectacular commitment to “making every mother and baby count” here in Dhaka, Bangladesh.  The United States Agency for International Development (USAID), through their Maternal and Child Health Integrated Program, and in partnership with the Bangladesh Ministry of Health and Family Welfare (MOHFW), convened an important series of meetings focused on saving the lives of mother and their babies.  We wanted to tally for you the numbers that express just how much every mother and baby count:

  • Participation included more than 275 international maternal and newborn health professionals;
  • With over 29 countries represented;
  • Including over 100 individuals from Bangladesh.
  • But why?  Because just 1 maternal or child death is more than just a tragic occurrence. It affects the entire family, it affects social cohesion, and it dampens the economic growth of the countries. Data shows that after a mother dies there is an increased risk of death for surviving children.
  • Here in Bangladesh, about 20 women die every day from childbirth, about half of these due to 2 main causes, postpartum hemorrhage that is to say excessive bleeding and eclampsia (high blood pressure leading to convulsions). These are the very 2 factors that kill 50% of mothers in developing countries around the world.

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Zimbabwe’s Great Leap Toward Preventing HIV in Children

Photo Caption: Josephat was born HIV-negative because of PMTCT in Zimbabwe, and recently celebrated his fifth birthday. Photo Credit: EGPAF/James Pursey

As featured on the Huffington Post

This week, I witnessed a milestone in the fight to end HIV/AIDS in children — and it happened in Zimbabwe.

Much of the news from Zimbabwe over the past decade has been around political and economic challenges, overshadowing a resounding public health success story.

Zimbabwe is one of the key countries to watch in the drive to eliminate pediatric AIDS in Africa.

On Monday, I attended a ceremony at Harare Central Hospital to launch Zimbabwe’s national strategy to prevent new pediatric HIV infections. I joined representatives from government, international partners, donors, health workers and people living with HIV.

It was a diverse group, but all dedicated to a common cause — that no child should be born with HIV — not in Zimbabwe, nor in any other country.

In June 2011 at the United Nations, a Global Plan was introduced to eliminate mother-to-child transmission of HIV by 2015. Zimbabwe was among the first of many countries to answer the call, but its commitment on this issue was evident long before that.

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PMTCT and 5th Birthdays: Not Without the Mothers

The prevention of mother-to-child transmission (PMTCT) of HIV is taking center stage this week during USAID’s 5th Birthday campaign — and rightly so.  Preventing mother to child transmission of HIV is one of the most critical, effective tools to helping kids reach their fifth birthdays.

Ambassador Eric Goosby and UNAIDS Executive Director Michel Sidibé have called for the elimination of pediatric HIV by 2015. Touted as one of the HIV prevention interventions with the most “bang for our buck” by the Copenhagen Consensus Center, there is significant momentum behind continuing scale up of mother to child transmission reduction programming towards elimination of mother to child transmission. But, current recommendations requiring a CD4 test before initiating some sort of ARV prophylaxis for HIV-infected pregnant women may not be the most effective way to prevent MTCT, fully treat the mother, and help kids reach their 5th birthdays.

We can move closer to the goal of eliminating pediatric HIV by 2015 by treating the mother, treating the baby, and continuing to treat the mother.

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Winning the Fight Against HIV in Children

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

Originally published at Blog.AIDS.gov.

Over thirty years ago, when the fight against HIV first began, the outlook for tackling the pandemic was bleak. Across the world, AIDS was seen as a death sentence. Within just a few years, it had devastated communities from the United States to South Africa.

But the world continued to fight, and the past three decades have seen tremendous progress in HIV research, prevention and treatment, thanks in large part to the leadership of the United States. Today, we can build on that strong legacy to answer President Obama and Secretary Clinton’s call for an AIDS-free generation.

The 19th International AIDS Society (IAS) conference will be an opportunity to renew our commitment to this incredible goal. It also marks an historic moment, as the United States hosts the conference for the first time in over 20 years now that people living with HIV and AIDS are able to visit the U.S. to attend in-person.

We know that we have a long way to go to win the fight against HIV–especially for children.

Through the President’s Emergency Plan for AIDS Relief (PEPFAR)–the largest international commitment to a single disease by any individual country–the U.S. Agency for International Development (USAID) and other U.S. government agencies provide lifesaving HIV and AIDS services to millions of children, women, and families worldwide. 

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