USAID Impact Photo Credit: USAID and Partners

Archives for Global Health

Putting Orphans and Vulnerable Children First on the Path to an AIDS-Free Generation

Today marks the 10th anniversary of World AIDS Orphan Day – and an important opportunity to highlight stories of children affected by HIV and AIDS.

Despite many gains in the fight against AIDS, children still lag far behind adults in access to important medical services, including HIV prevention, care, and treatment.

At the end of 2010, approximately 16.6 million children lost one or both parents to AIDS – 14.9 million of whom live in sub-Saharan Africa.

And the number of children who are orphaned or made vulnerable by AIDS continues to rise.

Children like Ashley from Zimbabwe are living proof of how orphans and vulnerable children can thrive if given the opportunity.

Ashley is six years old and lost her parents to AIDS several years ago. She currently lives with her siblings and cousins under the care of her grandmother, Juliana, who struggles to maintain all 13 children in her care.

But thanks to the support of a local organization, J.F. Kapnek Trust, and the US Agency for International Development (USAID), Ashley is now enrolled in a program at a nearby early childhood development center where she receives critical nutrition, health, education, and protection services.

Today, Ashley is healthy, happy, and active. She recently graduated from the ECD program and has started first grade, where she is performing at the top of her class.

We need more success stories like Ashley’s.

Under the President’s Emergency Plan for AIDS Relief (PEPFAR), USAID is working to make children like Ashley, and others who are affected by HIV and AIDS, a priority.

By partnering with national governments, communities, and other organizations, USAID is committed to improving the lives of children orphaned and made vulnerable by AIDS – a critical step in the path to achieving an AIDS-Free generation.

But our work is far from over.

“We are committed to and have a unique opportunity to join together to provide care and support for children affected by HIV and AIDS and ensure that no child has to grow-up with HIV,” said Roxana Rogers, Director of the Office of HIV/AIDS at USAID.

To do that, we need to step-up our early intervention efforts for children under five years old – a time of critical development for young children.

We also need to work with families to help them become more economically stable so they can access essential services and better provide for their children.

By thinking long-term and investing in efforts to strengthen systems of care and support, including social services, we can improve the lives of children around the world.

With a special focus on these strategies, we will achieve President Obama and Secretary Clinton’s goals to turn the tide against HIV and finally see the beginning of the end of AIDS.

Every Birthday Starts with the Golden Minute

Members of the Helping Babies Breathe Global Development Alliance

Every child deserves a fifth birthday. To reach five years, though, a child must take his or her first breath of life in the first minute following birth. The World Health Organization estimates approximately one million babies die each year from birth asphyxia, a condition in which babies who do not breathe on their own immediately following delivery.

Developed by the American Academy of Pediatrics, the Helping Babies BreatheSM (HBB) initiative was designed to equip birth attendants in developing countries with the skills they need to successfully resuscitate babies born without the ability to breathe on their own. At the center of HBB is the concept of The Golden MinuteSM: within one minute of birth, a baby should be breathing well or should be ventilated with a bag and mask.

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Celebrating Success in Saving the Lives of Mothers

Ordinary women make extraordinary contributions as caregivers and caretakers, as breadwinners and bread-makers to families and societies.  And even so, we know that women will not be able to thrive, unless they survive.  On Tuesday, the U.S. Government celebrated remarkable country-level success in saving the lives of women during pregnancy and childbirth.

Health ministers from Afghanistan, Cambodia, Dominican Republic, and the head of maternal and child health from Rwanda took center stage on Capitol Hill. And each told a unique and personal story.

Dr. Suraya Dalil spoke of overcoming illiteracy among Afghan women, a lack of roads and transportation, shortages of female healthcare providers, poor quality health services to tackle the reproductive risk of pregnancy and child birth.   “You need to eliminate child marriage, space child births and provide basic services,” she said.  “Now mothers are surviving and families are thriving.”

Maternal mortality reduction was once viewed as an insurmountable problem. And for two decades after the Safe Motherhood Initiative was launched in Nairobi in 1987, there was no documentation that motherhood was safer, as promised.

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Global Motherhood: Perils And Promise In Ghana

Guest Blogger: Dr. Orin Levine, Department of International Health, Johns Hopkins Bloomberg School of Public Health; Executive Director, International Vaccine Access Center (IVAC).

Originally published to the Huffington Post

Today in Ghana, I had a personal reminder as to why our work to prevent disease is so perilous, and why disease control so promising in Africa. Visiting the storied Princess Marie Louise Children’s Hospital in Accra, I watched as an eight-month-old boy, Isiah, struggled against severe pneumonia. Isiah was receiving supplemental oxygen from a cylinder, yet was still struggling to breathe. Even on oxygen therapy, his saturation was terribly low and his prognosis was poor.

But mostly, I watched Isiah’s father. He shook his son — not roughly, but just enough to keep him from closing his eyes — and he shouted at him with encouragement, urgency and longing, not reproach. I couldn’t understand his language, but as a father of two kids myself, I could not help but put myself in his shoes. I imagined he was imploring his boy to stay alive, to fight a little longer, and to stay strong so he could return home, grow bigger, and live to see another birthday.

In the United States, we can practically start planning our kids’ birthdays from the day they come home from the hospital; deaths in childhood are quite rare. In Ghana, though, you can’t take a child’s fifth birthday for granted. Last year approximately 50,000 young children – nearly seven out of every 100 — died before their fifth birthday.

This fact is unimaginable for those of us lucky enough to have children in the United States. If we in the U.S. had the same rate of child mortality as Ghana, 300,000 children would die annually. That’s the equivalent of half of the children in New York City dying before their fifth birthday every single year.

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Something to Celebrate in Ghana

Jeffrey Rowland is the Director of Media and Communications at GAVI alliance. This piece originally appeared in the GAVI Alliance blog.

Under the sweltering sun in Accra’s immense Independence Square, hundreds of Ghanaian mothers and their newborn babies gathered this morning with the country’s First Lady, Ministry of Health officials, my boss GAVI Alliance CEO Seth Berkley and international partners and donors to celebrate the nationwide introduction of vaccines that protect against the biggest causes of pneumonia and severe diarrhoea.

A sea breeze from the Bay of Guinea and brightly festooned tents provided respite to the crowd, which included tribal chiefs and queens colourfully clad in traditional dress.

After the playing of the national anthem and a purposeful pause, a prayer served as a poignant moment of reflection for all those in attendance who have worked so hard to make today a reality.

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USAID in the News

Weekly Briefing (4/23/2012 – 4/27/2012)

April 22: In the Huffington Post, USAID Administrator Dr. Rajiv Shah previewed a new global campaign to end preventable child deaths.“Every Child Deserves a 5th Birthday” will focus on raising awareness ahead of the Child Survival Call to Action event in June, when the governments of the United States, India, and Ethiopia will join together with UNICEF to mobilize the world to end preventable child deaths.

April 23: Today at the Kaiser Family Foundation, USAID Administrator Dr. Rajiv Shah launched the “Every Child Deserves a 5th Birthday” campaign to end preventable child deaths. Administrator Shah spoke with The Guardian and the UN Dispatch, which highlighted the launch. The Global Post also wrote a story on the 5th Birthday campaign.

April 24: On the eve of World Malaria Day, US Global Malaria Coordinator Rear Adm. Tim Ziemer published an op-ed in The Hill, discussing the importance of malaria intervention and his first-hand experience distributing malaria bed nets in Ghana.

April 25: In an interview with Federal News Radio, Assistant Administrator Mark Feierstein discussed USAID’s focus on strengthening its investments in local intuitions and working with previous aid recipients. For example, Feierstein cited Brazil, a long-time receipt of aid and now the sixth-largest economy in the world, as a USAID partner for agricultural development in Haiti and Mozambique. “Hopefully, we’ll see places like Mozambique and Haiti and elsewhere achieve the kinds of successes Brazil has in recent years,” Feierstein said.

U.S. and Russia Explore Cooperation on the Global Fight against Malaria

Last week, I travelled to Russia with Dr. Bernard Nahlen, the Deputy Coordinator of the President’s Malaria Initiative. We had very productive talks with the Russian Ministry of Health and Social Development and the Martinovsky Institute of Medical Parasitology and Tropical Medicine. We discussed potential U.S. – Russian cooperation in the global fight against malaria. USAID has started to work with Russia to address global development challenges around the world. Last year, we agreed to work together to help eradicate polio. We are now exploring how we could cooperate to control malaria in Africa and the Asia Pacific to save children, improve maternal health, improve maternal health, reduce suffering, and promote economic development.

Russia has long and deep experience with malaria. The disease was first reported in Russia in the 14th Century. In the 19th and 20th centuries, Russian and later Soviet scientists were involved in research that led to breakthroughs in malaria diagnostics and control efforts. The Martinovsky Institute was established in 1921 and after many years of effort malaria was eliminated from the former Soviet Union in the 1960’s. As in the U.S., the Soviet military and government continued research into fighting malaria in tropical areas around the world. Today, the Marinovsky Institute carries on this legacy. It even continues to train foreign doctors including some from Africa.

In talks with Russian officials, we discussed collaborating on training and capacity building, evaluation, operational research, advocacy and resource mobilization in support of national malaria control plans in third countries. We are exploring joint participation or co-leadership in international and national forums such as the Asia Pacific Economic Cooperation (APEC), the Roll Back Malaria Initiative and regional or global health meetings. The Russians are particularly interested in ending preventable child deaths from malaria and reducing the burden of malaria during pregnancy. The talks were fruitful and we should see progress on this cooperation very soon.

Delivering Nets to those who Need them Most

The following post is by Amanda Makulec, Monitoring and Evaluation Associate, John Snow, Inc.

Malaria continues to be one of the leading causes of child deaths around the world, despite the availability of low cost interventions to prevent those deaths. According to USAID, the disease causes an estimated 700,000 deaths annually, with nearly 90% of the illness and death caused by malaria occurring among children under five years of age in sub-Saharan Africa.

A young girl in Timor-Leste carries home an insecticide treated net from a distribution site for the USAID Timor-Leste Health Improvement Project. Copyright JSI.

From the Nothing but Nets campaign to the WHO’s Roll Back Malaria Initiative, we’ve all heard about the impact a $5* bednet can make in the life of a child or a pregnant woman. The Institute for Health Metrics and Evaluation reported in September 2011 that homes owning at least one bednet were associated with a 23% reduction in child mortality. Other simple commodities, such as rapid diagnostic tests (RDTs) and the drugs used to treat malaria—a million ACTs—headline advocacy campaigns less frequently, but are essential for providing low-cost diagnosis and treatment of malaria.

As important as the $5 that buys the net is the part of the story often simplified to a sentence or two: how is that bednet transported from a storage facility and distributed to populations that need it most? Without a robust logistics system, bednets could easily remain unopened and packaged for transport, rather than hanging over the beds of small children and pregnant women in rural Uganda or elsewhere; ACTs may not be delivered to rural health facilities and remain in a warehouse; and RDTs may never be provided to community health workers to enable them to rapidly diagnose malaria in a child’s blood using only a small sample.

Responsibilities for procuring malaria commodities for the US President’s Malaria Initiative delivering them through effective supply chains, and, in turn, strengthening in-country supply chains to best manage malaria commodities are at the core of one task of the USAID | DELIVER PROJECT, implemented by John Snow, Inc. and various partners. The project purchases bednets, ACTs and RDTs and supports the supply chain systems to distribute the commodities to sites around the world. USAID | DELIVER PROJECT also works to overcome the challenges in procuring and transporting malaria prevention and treatment commodities to the populations that need them most, including global shortages of ACTs and questions of quality assurance around the safety and efficacy of various commodities. From 2007-2011, the team procured 22.4 million bednets, 17.5 million RDTs, and 47.6 ACTs for the prevention and treatment of malaria, which were delivered through both facility and community based programs.

On this World Malaria Day, let’s celebrate the achievements that have been made not only in the number of bednets procured and distributed, but also the immense achievements of the people and programs who make it possible to get the bednets and other commodities to the places they’re most needed. Achieving reductions in malaria morbidity and mortality worldwide—and meeting the ambitious goal to end preventable child deaths in a generation—will continue to require not only quality commodities, but also insightful problem solvers, creative thinkers, and skilled logisticians, all of whom make it possible for that $5 bednet to be delivered to a girl in Timor-Leste, like the one pictured above.

Interested in learning more about supply chains and logistics systems that take a bednet or a drug from a storage facility to a community? You can learn more about the USAID | DELIVER PROJECT, and review the findings of the recent External Evaluation of the President’s Malaria Initiative.

*USAID estimates the actual cost of a bednet is between $4 and $5.

New Partners Initiative: Empowering Civil Society, Faith-based Groups, and Communities to Fight HIV

By Elizabeth Baldwin, Analyst/Activity Manager for the Office of HIV/AIDS

Earlier this year, I attended two meetings in Johannesburg and Kampala to celebrate the end of the HIV/AIDS New Partners Initiative (NPI) – an interagency President’s Emergency Plan for AIDS Relief (PEPFAR) program totaling $200 million and spanning Africa, Asia, and the Caribbean.

Helping build capacity among 55 prime partners and over 200 sub-partners in 14 countries, NPI – in its five years of existence – has strengthened and leveled the playing field for many organizations, building their capacities to implement HIV/AIDS care and support programs for those in communities hardest hit by the epidemic.

Thanks to NPI, grantees have provided nearly 1 million people with counseling and testing and prevention of mother-to-child transmission services; provided several million people with behavior change and prevention outreach; and reached over 340,000 children affected by HIV/AIDS.

The two meetings provided a remarkable opportunity to bring all of the partners together, to celebrate their incredible successes and to create a platform where they could share their unique stories and lessons learned under the Initiative.

Despite marking the end of the project, the tone and energy of the meetings were overwhelmingly celebratory. In both cities, the meetings kicked-off with exuberant performances by local cultural groups: the Mlisada Dance Troupein Uganda and the Arekopaneng Cultural Group in South Africa, which were preceded by opening remarks by USAID and the Centers for Disease Control and Prevention (CDC).

The conference plenaries featured powerful key note addresses from Dr. Kelvin Storey, the Executive Director of the Regional AIDS Training Network in Kampala, and Justice Edwin Cameron of the Constitutional Court of South Africa in Johannesburg.

Dr. Storey, an expert in economic and social policy, gave a personable and compelling speech – speaking directly to the partners and urging them to take forward the tools and ideas developed under NPI. Equally thought-provoking, Justice Cameron spoke courageously about stigma and what it means to be an HIV-positive man living in South Africa.

Throughout the two days, partners exchanged best practices and lessons learned through informal breakout sessions and covered a range of topics such as resource mobilization, country ownership, and community partnerships.

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Every Child Deserves a 5th Birthday

In the last 20 years the world has saved over 50 million children’s lives and reduced maternal mortality by one third. The American people and their partners can feel very proud of their contributions to these extraordinary achievements. With prospects for ending preventable child and maternal deaths, an AIDS-free generation, and the foundations for universal health coverage, future generations will look back at this period as a turning point in the history of global health.

Ariel Pablos-Méndez as a small child. Photo: USAID

Today, USAID Administrator Dr. Rajiv Shah will launch the Every Child Deserves a 5th Birthday campaign to educate Americans on the disparity in child survival rates and make them more aware of our incredible capacity to save children’s lives. We also hope to rally the child survival community – bringing together the various partnerships and initiatives that are the backbone of child survival – to mobilize the world toward the goal of ending preventable child deaths.

While global under-five mortality has been declining, about 7 million children under the age of five still die annually. Roughly 40 percent of these deahs occur in the first month of life, among highly vulnerable newborns. Many children, at greatest risk of dying before their fifth birthday live in remove villages or in underserved urban areas. USAID focuses its work on 24 countries that account for more than 70 percent of child deaths. Nearly half of all child deaths occur in just five of these countries: India, Nigeria, the Democratic Republic of Congo, Pakistan, and Ethiopia.

USAID focuses on saving lives at birth and ending preventable child deaths. Family planning and birth spacing for the mother, providing prophylaxis and treatment for malaria, tuberculosis, and HIV to mothers who have experienced the impact of these diseases, and safe labor and delivery will all enhance the health of children. Advancements in vaccines, better management of chronic conditions affecting the mother and child, such as malnutrition and HIV, and improvements in environmental factors such as poor sanitation will further accelerate needed progress in child mortality. To protect children in the first five years of life, USAID will increasingly rely on low-cost, easy-to-use interventions that achieve highest impact by preventing and treating the leading causes of child death: pneumonia, diarrhea, prematurity, asphyxia, malaria, and newborn sepsis. Strengthening health systems will save lives and secure development gains by ensuring access for all to appropriate health services at an affordable cost.

USAID has recently released its Global Health Strategic Framework, which sets the direction of the global health sector for FY 2012-2016. It incorporates the principles of the Global Health Initiative (GHI), which form the foundation of our work, is set within USAID’s core development mission and priorities, and promotes an inclusive and integrated approach to global health across the U.S. Government for a more effective and efficient approach to sustainable global health outcomes.

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