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Archives for Global Health

USAID at Forefront of HIV Prevention

On Monday, I convened a meeting to determine the next steps following the success of the CAPRISA trial, which showed the world that a microbicide could help prevent HIV transmission in women. Together with both public and private sector colleagues, we defined a way forward over the next two years to expedite licensure and prepare for the introductory phase of the gel or other ARV-based microbicides. I will also convene an additional meeting  of technical experts in the field to discuss how to aggressively roll out microbicide treatments to those most in need.  We have a shared responsibility to build on the successes achieved to date by making smart investments that will ultimately save more lives in the future.

Pic of the Week: Commemorating 2010 World AIDS Day

Woman and boy in MozambiqueEighty percent of Mozambique‘s people live in villages and must walk on an average 12 kilometers to reach a health clinic. Here, a woman and her daughter hold the anti-AIDS medicine that keeps them alive. They worried that neighbors would see the medicine and know they had the disease. Photo is from Ben Barber/USAID.

Giving Girls a Chance Against HIV/AIDS

In Malawi, Chimwemwe Banda was abandoned by her parents when she was a young girl; she and her sister were left to take care of themselves. Without money to pay for basic needs or tuition, Chimwemwe was forced to drop out of school. In hopes of improving her situation, like many girls in Malawi, she entered into an early marriage— Chimwemwe was only 15 years old on her wedding day.  Soon after she married, Chimwemwe realized that life was not going to get better just because she had a husband.

Chimwemwe Banda is one of the many girls who has benefited from a Go Girls! community intervention. Photo Credit: Hilary M. Schwandt/AFP

Early marriage, along with behaviors such as transactional and intergenerational sex, contributes to girls’ vulnerability to HIV. Chimwemwe is just one of the 600 million girls living in poverty who are at increased risk of contracting HIV/AIDS. Similarly, girls who are orphans, early school leavers, socially marginalized, and/or migrants have a heightened vulnerability to the virus. Worldwide, women and girls bear the brunt of the HIV/AIDS epidemic; according to the World Health Organization, AIDS is the leading cause of death among women aged 15-44 worldwide.

Socio-economic factors like poverty, along with gender norms such as expectations around early marriage, can lead to increased vulnerabilities that discourage girls from asserting control over the timing and circumstances of sex, including negotiating protection against HIV and other sexually transmitted infections (STIs).

Most interventions to date have focused on individual-level behavioral change without sufficient consideration of the structural factors that fuel the epidemic. USAID is working to address this imbalance through the Go Girls! Initiative.

In fact, it was Go Girls! that stepped in to help Chimwemwe. With their assistance Chimwemwe dissolved her marriage. Her village developed a community mobilization team that recognized the detrimental effects of early marriage on girls, and advocated delaying marriage as a strategy for maintaining girls’ health and encouraging their educational pursuits.

Since the end of her marriage, Chimwemwe returned to school. She now leads a happier life and enjoys going to school everyday. “I feel good about being back in school,” she said. “If I had the opportunity to advise other girls, I would tell them not to marry early but to continue schooling because school is good. I am working hard at school every day so that I may have a brighter future.”

The 16 Days Campaign to End Violence Against Women: From 25 November to 10 December, USAID will post a blog each day that aims to prove a single point: The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. If you are moved by what you read and want to share, we’ve made it easy for you. Click here to find out how.

World AIDS Day 2010

On World AIDS Day, we commit to build upon our successes and continue to make smart investments that will ultimately save and improve millions of lives.  Join us this week as we highlight some of our successes and share stories of those helped by our programs.

If you’d like to learn more about the Go Girls! program, including how to access free copies of the Go Girls! program materials, contact ghcommunicationsteam@usaid.gov

 

Promoting Evidence and Action for Respectful Care at Birth

Exciting. Moving. Powerful.

These words are often used to describe childbirth. It can be a time of wonder and joy.

In many places, however, the experience is described differently: Humiliating. Frightening. Abusive.

Throughout the world, women are abused in subtle and overt ways during childbirth, which is also a time of intense vulnerability. The abuse – or anticipation of it — can be so extreme, in fact, that it often prevents women from seeking lifesaving care.

“Some female nurses rough you up to an extent that you can tell her to let you deliver alone. You are in pain, and all she does is give you a harsh and rude approach. That is why I don’t go to the hospital to deliver because I am not used to somebody who roughs me up,” says woman interviewed in Kenya.

While much focus has been placed on overcoming financial and geographic obstacles to connecting women with lifesaving care during childbirth, little attention has been paid to documenting and tacking significant barriers posed by disrespect and abuse of women in facilities.

A new USAID-funded report, “Exploring Evidence and Action for Respectful Care at Birth,” presents evidence of abuse of women during childbirth and documents the negative impact on women’s use of skilled care. USAID funds grants to develop and evaluate interventions addressing disrespect and abuse in childbirth, and will support future efforts to further document, confront, and tackle abuse during childbirth.

A recent report found that 34 percent fewer women die each year from complications during pregnancy and childbirth than previous international estimates suggested. Access to quality care is critical in maintaining this trend.

USAID programs support facility-based maternal health care and community mobilization approaches to ensure women’s access to appropriate care and safe delivery is not restricted.

Through the Global Health Initiative, USAID will continue to support efforts to ensure that women have access to appropriate care and safe delivery is not restricted. When women are able to access needed quality health services and protect themselves from the many health risks they face, long-term social and economic progress can be achieved.

The 16 Days Campaign to End Violence Against Women: From 25 November to 10 December, USAID will post a blog each day that aims to prove a single point: The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. If you are moved by what you read and want to share, we’ve made it easy for you. Click here to find out how.

Follow us on Twitter. When you see us tweet something interesting, retweet it!

Become a fan of our USAID for Global Health Facebook page and feel free to share stories, photos, and videos that demonstrate your support for women’s rights!

The Straight Facts: The Plight of Women

Women around the globe should be celebrated for their extraordinary contributions in all areas of society – as professionals, as bread-winners, as caregivers and caretakers.

16 Days of Activism Against Gender Violence Graphic

But we must also focus on the stark reality that women suffer disproportionately from poor access to health services, discrimination, the effects of war, and, at times, victimization by harmful traditions.  It is important to keep in mind that behind every statistic listed below, there is a heartbreaking story to be told.

  • More than 530,000 women die in childbirth every year – tragically, the vast majority of these deaths are avoidable with simple and cost-effective health interventions.
  • More than 100 million women in the developing world, about 17 percent of all married women would prefer to postpone their next pregnancy or not have any more children but are not using a modern method of contraception.
  • It is estimated that up to 100,000 maternal deaths could be avoided each year if women who did not want children used effective contraception.
  • One harmful outcome of unintended pregnancy is abortion – an estimated 18 million abortions take place each year in the developing world, contributing to high rates of death and injury.
  • In sub-Saharan Africa, approximately 58 percent of all people living with HIV are female. In some countries, girls between the ages of 15 and 19 have three to six times higher HIV prevalence than boys their age.
  • More than 80,000 women suffer complications during pregnancy including obstetric fistula.  The consequences of this condition, when untreated, are life shattering.  Many times the child dies, and the mother has lifelong reproductive and urinary complications.  But it can be prevented through expanded access to modern methods of family planning, raising the age of marriage and can be treated with proper medical attention.
  • An estimated 52 million girls under the age of 18 years of age are married off by their families each year.  Likewise, several hundreds of thousands of girls and women are trafficked every year as illegal workers and/or forced into prostitution.
  • An estimated 100 million to 140 million women and girls undergo female genital mutilation/cutting each year and thousands more are at risk.

Despite these startling statistics we know that women around the world have an undying spirit, are surmounting obstacles, and are committed to making their lives, their families, and their communities better.  President Obama stated, “…we must also recommit ourselves more broadly to ensuring that our daughters have the same rights and opportunities as our sons: the chance to attain a world-class education; to have fulfilling careers in any industry; to be treated fairly and paid equally for their work; and to have no limits on their dreams.  That is what I want for women everywhere.”

The 16 Days Campaign to End Violence Against Women: From 25 November to 10 December, USAID will post a blog each day that aims to prove a single point: The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. If you are moved by what you read and want to share, we’ve made it easy for you. Click here to find out how.

The Freakonomics of “The Girl Effect”

What would happen if you applied economic theory in an unconventional way to try and understand how a girl might change the course of humanity?

At my desk one morning, I watched Nike’s “The Girl Effect” campaign videos on YouTube hoping to find inspiration for new Impact blog topics. The videos instantly reminded me of Steven Levitt and Stephen Dubner’s award-winning book, Freakonomics. The collaboration between a leading economist and the author/journalist explores the application of economic theory to diverse and seemingly unrelated topics. Most know it as the butterfly effect, or chaos theory, where small changes in an initial condition can produce large variations in future outcomes of a dynamic system.

It dawned on me, the incredible synergies between the campaign, the book, and the work we do here at USAID.  It put into perspective the reason we ensure all of our programs are women-centered.

There’s no denying the abundance of gender inequality around the world, particularly in developing nations. There is no denying the billions of dollars in lost productivity due to the fact that millions of women are denied the right to education and the ability to work outside the home. Women’s rights are more than just a moral imperative; they are the key to progress.

So how might a girl change the course of humanity?

Assume this initial condition: A 13 year old girl stands at a crossroads with two choices before her: school or child marriage. The problem is it’s not usually a choice.

Married, she is more likely to die from childbirth at an early age; she is more susceptible to sexually transmitted diseases; she is more prone to become a victim of partner violence; she never receives an education; and she is unable to contribute to society in a way that has a larger social impact and helps to push the human race forward.

With an education she marries later in life—to someone she chooses. She decides the timing of her children and is in a position to make decisions about her own health. She invests money in her children’s health and education, and is able to contribute to society in a meaningful way. Other people recognize her value and contributions, and begin to understand that all girls have value.

Multiply that scenario by the 600 million girls in the developing world and it’s easy to comprehend how a small change in an initial condition is capable of determining the course of humanity. That is powerful.

The 16 Days Campaign to End Violence Against Women: From 25 November to 10 December, USAID will post a blog each day that aims to prove a single point: The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. If you are moved by what you read and want to share, we’ve made it easy for you. Click here to find out how.

The Story Behind the Statistics: Victims of Rape in Benin Find Justice

The Statistics: In Benin, more than 75 percent of women are victims of violence, and 44 percent are sexually abused.

The Story: Déborah and her husband Djobo live in the village of Guiguiso in northern Benin. On the night of September 9, 2009, three men assaulted the couple while they slept. Djobo was left bleeding and unconscious and Déborah was raped. After Djobo regained consciousness, he alerted the village. The coordinator of a USAID project, which aims to reduce violence against women and girls in all of Benin’s 77 municipalities, promptly informed the police commissioner and project facilitator in nearby Bassila. With the help of the entire population of Guiguiso, the three men were tracked down and taken into custody before sunrise.

Déborah and Djobo sought medical attention from the Bassila hospital and, with medical certificates in hand, they went to the police commissioner. After hearing the accused, the victims, and the witnesses, the commissioner presented the case to the prosecutor. Today, the three accused men await trial from jail.

In Benin, more than 75 percent of women are victims of violence, and 44 percent are sexually abused. Since 2007, USAID has helped to not only promote greater recognition and acceptance of women’s rights in Benin but also get more women victims of violence to seek help from the Benin Government’s Social Service Centers and the justice system.

“The injury we suffered as a result of this gang rape may pass with time,” Déborah said weeks after the assault, “but I dare not imagine what life would be like had we not received help from USAID, all the way from the hospital, the police station, and down to the prosecutor’s office to press charges.”

From November 2007 to September 2010, the U.S. Government has assisted in 2,782 cases of physical and sexual violence of which 996 reached the Courts of First Instance. This is nearly seven times the number planned for the life of the project, as it is very difficult for Beninese women to press charges against the men who abused them.

“Before,” a Beninese judge said, “we would attempt to resolve cases of gender-based violence ‘amicably’ and out-of-court. This is no longer the case because of USAID programs which help the victims understand and pursue their cases in the court system; and mounting pressure from the media, which act as essential partners in the cause of justice for women.”

The 16 Days Campaign to End Violence Against Women:

From 25 November to 10 December, USAID will post a blog every day to bring much needed attention to the reality of millions of women around the world who are victims of violence and abuse.  Our blog posts will focus on the root causes of violence and individual stories of women and girls who lived through it.

Follow us on Twitter. When you see us tweet something interesting, retweet it!

Become a fan of our USAID for Global Health Facebook page and feel free to share stories, photos, and videos that demonstrate your support for women’s rights!

Gender Equality: The Development Community’s Key Ingredient to Realizing a Positive ROI

Return on Investment (ROI) is a popular metric used by organizations to determine if what they spend is adding value to their bottom line. For-profit organizations typically measure the bottom line in numerical terms; the bottom line for the U.S. Agency for International Development is measured in progress toward the betterment of the human condition.

What exactly does it mean to invest in gender equality; and how does it contribute to USAID’s bottom line?  Our programs focus on women and girls because it is a goal that has intrinsic merit and because long-term social and economic progress requires that women have the same legal protection under the law as men, especially when it comes to critical access to health services that protect them from the many health risks they face in their lifetime.

Advancing rights and providing support to women and girls is a high-yield investment that trickles down to the foundation of a strong and stable society. For example, a recent study in Zambia showed that every dollar spent in family planning saved four dollars in other development areas. This ROI was similar to that found in studies completed in another 28 countries. With smaller, more sustainable populations, governments are able to spend more money on education, maternal health, immunization, water sanitation, and a multitude of infectious diseases.

The barriers that block the road to progress for billions of women in developing countries are a key focus of development organizations like USAID.  For decades our programs have been dedicated to ending the practice of gender-based violence, sex trafficking, childhood marriage, and reducing maternal deaths which needlessly claim the life of one woman every minute.

USAID will continue to support programs that work to unlock the tremendous potential of women as economic and social catalysts. Achieving a positive ROI will allow for the recovery of billions of dollars in lost productivity and healthcare expenses around the world. USAID feels the bottom line should be a hard line against the injustices inflicted upon women. The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. The tested and undying spirit of women is transcendent—and so is this opportunity to get it right.

The 16 Days Campaign to End Violence Against Women:

From 25 November to 10 December, USAID will post a blog each day that aims to prove a single point: The human race cannot progress when half of the world population lives without the same rights and respect afforded to its male counterpart. If you are moved by what you read and want to share, we’ve made it easy for you. Click here to find out how.

Follow us on Twitter. When you see us tweet something interesting, retweet it!

Become a fan of our USAID for Global Health Facebook page and feel free to share stories, photos, and videos that demonstrate your support for women’s rights!

USAID Supports Innovative “Survive” Partnership To Reduce Breast And Cervical Cancers In The Republic Of Georgia

On Monday, November 22, Dr. Nino Berdzuli, at a presentation before representatives of the Susan G. Komen for the Cure and staff members of the United States Agency for International Development (USAID), highlighted the Survive Project, a public private partnership supported by USAID and implemented by JSI Research & Training Institute, Inc (JSI), to improve awareness, screening ,and prevention of cervical and breast cancers in the Republic of Georgia.  Dr. Berdzuli is a trained OB-GYN from Georgia and serves as Maternal and Reproductive Health Technical Advisor at JSI.

In the Republic of Georgia, breast cancer is the single leading underlying cause of death for women aged 15-49.  Within cancers, cervical cancer is the second leading killer.  These were the findings of the recent Georgian Reproductive Age Mortality Survey (RAMOS) conducted through Georgian Centers for Disease Control (CDC), U.S. CDC, and Georgia’s Ministry of Health to investigate the deaths of women of the reproductive age (15-49) who died in 2006.  The results were published in 2009.

A young woman and her daughter attend the ‘Race for the Cure’ in Georgia. Photo Credit: JSI

From its inception, the Survive Project has received strong support from First Lady of Georgia Sandra Roelofs, the Municipality of Tbilisi, UNFPA, and other civil society groups.  It also has benefited from advocacy campaigns such as the Race for the Cure. Under the patronage of the First Lady, the National Screening Center was established and began providing Georgia’s first organized breast and cervical cancer screening and treatment of precancerous diseases for women residing in Tbilisi.

The objectives of the Survive Project were: 1) improving the knowledge and skills of health care providers on evidence-based cervical cancer prevention and breast and cervical cancer screening practices; 2) increasing utilization of cervical cancer screening and breast cancer early detection practices by strengthening existing health care facilities and programs and by building a  referral system; and 3) advancing cervical and breast cancer early detection through informed and empowered health consumers. Screening statistics from the National Screening Center showed progressive increases in the number of women screened for breast and cervical cancer.

Under the Survive Project, a total of 445 providers (366 family doctors and 79 OB/GYNs) completed cervical and breast cancer training courses.  Screening statistics from the National Screening Center showed an 89.7 percent increase in the average number of women screened monthly in the Center.  During the activity, the percentage of women diagnosed in early stages of cancer (vs. late stages when the cancer is more difficult or impossible to treat) increased three-fold in Tbilisi.  The vast majority of women (75%) that underwent screening reported that they learned about the screening program through the TV and outreach awareness raising campaigns.  The Survive Project also conducted large-scale educational campaigns covering television, radio, targeted mailings, text messages and events such as the “Race for the Cure” and the “Pearl of Wisdom” campaign against cervical cancer.

As Dr. Berdzuli noted during her presentation, “Survive was able to accomplish significant results over a short period of time due to the leadership of the First Lady of Georgia and the Tbilisi Municipality, the enthusiasm, confidence and commitment of local NGO partners, and the strong coalition of public and private donors supporting the effort.”

Learn more about USAID’s health programs.

USAID Commends Major Advance in HIV Prevention Research

Results released today from the Pre-Exposure Prophylaxis Initiative (iPrEx) study confirmed that daily oral use of a combination antiretroviral (ARV), Truvada, reduced the risk of HIV infection by 44 percent among men who have sex with men. This historic iPrEx trial provides the first proof of concept that oral PrEP of an ARV can prevent HIV transmission.

The U.S. Agency for International Development (USAID) congratulates the National Institute of Allergy and Infectious Diseases (NIAID) of the U.S. National Institutes of Health (NIH), the Bill & Melinda Gates Foundation, Gladstone Institute of Virology and Immunology-UCSF, and most importantly, the 2,499 pioneering participants who volunteered for this important clinical trial on the promising results from iPrEx.  Global iPrEx is the first large efficacy study to evaluate the use of pre-exposure prophylaxis (PrEP) in men who have sex with men in Africa, Asia, and North and South America.

These promising results also encourage other research partners to continue working on more PrEP and microbicide options which may lead to new tools for HIV prevention.  The AIDS pandemic calls for a dynamic variety of HIV prevention methods to ensure those at risk have choices to use the one that best suits the needs of their lifestyle.

According to new UNAIDS estimates, women worldwide account for more than half of all HIV infections, and in sub-Saharan Africa continue to bear the brunt of the AIDS epidemic, USAID will continue critical research and development work in PrEP for women at high risk.  The FemPrEP clinical trial—led by FHI with support from USAID—is designed to test the safety and effectiveness of a daily dose of Truvada for HIV prevention.  Close to 4,000 HIV-negative women who are at higher risk of HIV are being enrolled in five sites in four countries: Kenya, South Africa, Tanzania, and Zimbabwe; results are expected 2012.

Based on the positive results from the CAPRISA 004 trial which were released in July, USAID will continue to support the regulatory approval of 1% tenofovir gel after further confirmation of its effectiveness.  USAID is committed to ensuring the launch of a new generation of products designed expressly for women and capable of preventing the transmission of HIV.

Finding a woman-controlled method of prevention is critical in the fight against HIV/AIDS.  In line with President Obama’s Global Health Initiative, USAID is committed to focusing on the needs of women and girls in its health programming worldwide.

USAID continues to build on a solid foundation of robust science and new technologies, enabling innovation to redefine and strengthen U.S. development assistance globally.

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