USAID Impact Photo Credit: USAID and Partners

Archives for Global Health

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.

Up Close and Personal With Our Global Health

I recently traveled to Senegal, Ethiopia, and Mozambique to visit a wide range of global health programs supported by USAID and other U.S. Government Agencies including the Centers for Disease Control, Department of Defense, and the Peace Corps.

My colleague, Zeke Emanuel, from the White House Office of Management and Budget, blogged extensively during this two-week trip about President Obama’s Global Health Initiative.  This whole-of-government effort encourages a more integrated approach to global health — building upon historic efforts under the Bush Administration through PEPFAR and PMI with a renewed focus on child and maternal health, TB and other diseases.  It also strengthens health systems to ultimately save more lives.

Is funding for global health a never-ending waste of money in which billions are spent but nothing gets better? Or are we being selfish and grossly unethical, because we are unwilling to spend a few hundred dollars more per year in order to save a life of a poor person half way around the world?

These are tough questions, and Zeke addresses them in his first blog entry, now featured at The New Republic.

Democratic Republic of Congo Joins Malaria Initiative

On Tuesday, November 16th, the Democratic Republic of Congo (DRC) became the 16th focus country of the President’s Malaria Initiative (PMI) and one of the most important. DRC is the second largest and third most populated country in Sub-Saharan Africa. Nearly 95 percent of the population – some 69 million people – live in malaria endemic areas and suffer nearly 30 million cases of this treatable and preventable disease. Malaria accounts for nearly half of the deaths of the 620,000 children in DRC who die before their fifth birthday.

The launch of PMI was held in Mbuji Mayi, capital city of East Kasai. Admiral Timothy Ziemer, U.S. Global Malaria Coordinator, U.S. Ambassador to DRC James Entwistle, and USAID Mission Director Stephen Haykin joined thousands of Congolese for the public launch of the program, which included distributing long-lasting insecticide-treated nets (LLINs) and preventive malaria treatment to pregnant women. Next year, PMI will procure 2 million LLINs to support the universal coverage strategy in Katanga Province, which is part of the National Malaria Control Program’s (NMCP) five-year strategic plan for universal coverage. PMI will procure another 645,000 LLINs for routine distribution in 112 health zones in the four provinces where USAID works, which will be part of the NMCP’s distribution plan for 2009-2014.

With its large population, geographic size, and heavy burden of malaria, the DRC presents a major challenge to reducing morbidity and mortality attributable to malaria in Africa. As with other PMI focus countries, the goal of PMI in the DRC will be to expand malaria control efforts to reach large areas of the country, achieving a 50 percent reduction in malaria burden by targeting those most vulnerable to malaria – children under the age of five and pregnant women. PMI will work with the NMCP to provide LLINs and antimalarial drugs, help strengthen health systems, and integrate malaria control and prevention activities with other health programs in 112 health zones in the four target provinces. PMI will also help identify and fill gaps in other malaria interventions in close collaboration with other partners, including donors, civil society organizations, faith-based groups, and the private sector.

Malaria prevention and treatment is a core component of the U.S. Government’s development policy and the Administration’s Global Health Initiative (GHI). Rather than attack diseases individually, GHI focuses on tying health programs together, creating an integrated and coordinated system of care. For example, PMI is expanding efforts to support health systems strengthening and to integrate with USAID’s maternal and child health (MCH) programs and the President’s Emergency Plan for HIV/AIDS Relief (PEPFAR). Given that malaria control is essentially a maternal and child health program, PMI has been working to ensure that all its activities at the health facility level are integrated with the MCH program.

The Global Health Initiative and the President’s Malaria Initiative share a common focus on women — improving their health status benefits women, as well as their families and communities. By expanding women’s access to care, increasing the focus on women’s health outcomes, and incorporating women’s perspectives into health systems, the GHI and PMI will impact women, their children, and their families.

The United States Government has supported malaria control in DRC during the past 10 years as a key component of the health program supported by USAID in almost half of the country, including Katanga, South Kivu and East and West Kasai provinces. During the past two years, the DRC has conducted mass distribution of LLINs in Kinshasa, Equateur, Orientale and Maniema provinces. Similar campaigns are planned in Katanga and East and West Kasai in the near future. These life-saving bed nets are also being provided for routine distribution through antenatal and child health clinics. As a result of these programs, since 2008, nearly 30 million LLINS have been brought into the country by the government of the DRC and the donor community.

From the Field

In Pakistan, we will hand over medical equipment to 1500 female health workers.  These practitioners will receive a set of equipment to create makeshift health units and provide health services in flood-affected areas of Pakistan.

In the Democratic Republic of Congo, we will launch The President’s Malaria Initiative (PMI).  Under the 2008 Tom Lantos and Henry J. Hyde Global Leadership against HIV/AIDS, Tuberculosis, and Malaria Act (Lantos/Hyde Act) funding for PMI was expanded to two additional countries – DRC and Nigeria becoming the 16th and 17th focus-countries.

In the Philippines, we will hold a Clean Energy Business Plan Competition.  USAID will partner with the Private Financing Advisory Network (PFAN); a global public-private partnership that matches innovative clean energy projects with sources of financing.

Pic of the Week: Rapid Diagnostic Test for Malaria

(At left) Mr. Moussa Diagne, Entomologist with the Parasite Control Service in Senegal, performs a Rapid Diagnostic Test (RDT) for malaria on Dr. Zeke Emanuel, Special Advisor on Health Policy to the Director of the White House Office of Management and BudgetMr. Moussa Diagne (left), Entomologist with the Parasite Control Service in Senegal, performs a Rapid Diagnostic Test (RDT) for malaria on Dr. Zeke Emanuel, Special Advisor on Health Policy to the Director of the White House Office of Management and Budget, during the first leg of a three-country visit to health programs in Africa. RDTs, which were introduced in late 2007, have proven to be a more scientific method for identifying malaria cases. Last week, a report released by the international partnership Roll Back Malaria announced that in just one year, Senegal has managed to reduce the number of cases of malaria by 41%. Senegal is a focus country of the President’s Malaria Initiative. Photo is from Nicole Schiegg/USAID.

Midwives from Afghanistan Gather for Capacity Building Training in Alexandria, Egypt

On October 21, USAID/Egypt Director James Bever and Dr. Hassan Sallam, Director of the Suzanne Mubarak Regional Center for Women’s Health and Development (SMC) participated in the graduation ceremony of a mix of 31 Afghan Midwives of various ages and from various provinces. The Midwives attended the training program at the SMC in Alexandria and it was funded through the Health Services Support Project, implemented by USAID/Afghanistan.

Afghan midwives with their Egyptian trainer at the end of the USAID/Afghanistan funded capacity building training held in Egypt. Photo Credit: USAID/Egypt

Afghan midwives with their Egyptian trainer at the end of the USAID/Afghanistan funded capacity building training held in Egypt. Photo Credit: USAID/Egypt

The SMC was selected as a training provider for its excellent results in the areas of women’s health and development in Egypt and in neighboring countries. The SMC is the lead partner organization for the USAID/Egypt funded Global Initiative for Breast Cancer Awareness. The training focused on the development of knowledge, skills, and attitudes necessary to provide care to Afghani women with the ultimate goal of ensuring safe motherhood.

In his remarks during the event, the USAID/Egypt Director lauded Egypt as it has achieved its Millennium Development Goal Number 4 of reducing the under-five mortality rate by two thirds between 1990 and 2015 and it is approaching the achievement of MDG 5 in reducing the maternal mortality ratio by three quarters between 1990 and 2015.  “Egypt is now leveraging those achievements by hosting training programs like these where our Egyptian counterparts can share valuable lessons learned and effective practices with efficient health practitioners from Afghanistan to improve health not only in Egypt, but around the world.”

U.S.-India People to People Conference: Building the Foundation for a Strong Partnership

This originally appeared on Dipnote.

Tomorrow, the Department of State will host the U.S.-India People to People (P2P) Conference. Ahead of President Obama’s visit to India, this event will highlight the crucial role of Indian-Americans in the U.S.-India relationship. Secretary Clinton has been clear that connecting with all citizens, not just government officials, is essential to cultivating long-term relationships. While government cooperation remains essential, it is the myriad people-to-people connections that continue to define and further deepen the U.S.-India partnership.

The P2P conference will provide a grassroots discussion forum on four areas important to both countries: renewable energy, global health, education, and economic empowerment. By bringing together innovators and thinkers in these fields, this conference seeks to strengthen the personal networks that spark innovation. We aim to continue working with Indian Americans and others to strengthen and leverage such networks for the mutual benefit of both our countries. Tomorrow’s conference is only the start of our conversation, and we look forward to following up with all the conference attendees and participants.

You can stay connected to the conference by following the Bureau of South and Central Asian Affairs on Facebook and Twitter.

The People-To-People Conference will be hosted by the U.S. Department of State in cooperation with the Indian American Leadership Council (IALC) and the American India Foundation (AIF) in the Loy Henderson Auditorium from 12:30 p.m. to 5 p.m. on October 28, 2010. The program will consist of panel discussions related to the five pillars of the U.S.-India Strategic Dialogue, specifically Renewable Energy, Global Health, Education and Economic Empowerment. Under Secretary of State for Economic, Energy and Agricultural Affairs Robert D. Hormats will provide opening remarks. USAID Administrator Dr. Rajiv Shah will give the keynote address and Indian Ambassador to the U.S. Meera Shankar has been invited to give closing remarks. Other senior U.S. government officials will also be in attendance and participating in the various conference sessions. Click here for more information.

USAID Provides Training to Masons in Haiti

A reception in a downtown hotel in Port-au-Prince is buzzing with excitement. Fellow classmates are chatting about their plans after graduation. Many are dressed in their Sunday best to mark the proud day.

One hundred and fifty newly trained masons successfully graduated a joint program sponsored by USAID/KATA and CEMEX, a building materials company.  The program trained young people living in poor neighborhoods on how to create quality masonry blocks.  Of 150 graduates, 75 of them are people living with or affected by HIV/AIDS.

“The program helps them learn valuable skills and empowers them to improve their lives and the lives of their families,” said CHF International’s Haiti Director Alberto Wilde.

The graduates underwent a three month training that exposed them to masonry best practices and techniques. They also learned entrepreneurial skills to help them start micro enterprises. All students received molding, cement, sand, and a masonry guide at the end of the program.

“When I was working under somebody else I was making 2,500 gourdes ($62.50). But with my own business I make about 5,000 gourdes ($125). Of these 5,000 gourdes I have reinvested half in order that my business grows further. Now, I am planning to have a laborer in order to have even bigger productivity,” said Alcide Delcy, age 23.

The small business created by the USAID/KATA and CEMEX graduates can help support Haiti’s economic recovery. Their training also helps support the country’s efforts to build back better as homes and other buildings are constructed using higher quality blocks.

At the ceremony, CEMEX Representative Linda Gaillard said to the graduates, “You have the training in your heads and the tools in your hands. Now go out and do your best work.”

These words were met with loud cheers and big smiles.

Focus on Nutrition: Creating Inclusive Partnerships and Deepening our Knowledge

This originally appeared on DipNote.

Recently, I visited Bangladesh to find out how you feed a country that has half the population of the United States squeezed into an area the size of the state of Iowa. One thing is for certain: no one can do it alone. During my trip, I witnessed how partnerships among a broad range of stakeholders — the Rome-based UN agencies, the Government of Bangladesh, donor countries, civil society and the private sector — are coming together to change the way we address chronic hunger. The U.S. government is supporting partnerships that deliver food, including fortified vegetable oil, in conjunction with health and other interventions that help ensure our programs translate into better nutrition outcomes.

Good nutrition is crucial during the first 1,000 days — from the mother’s pregnancy through the child’s second birthday — because it affects lifelong mental and physical development, IQ, school achievement, and, ultimately, work capacity and income generation. Thus, nourishing children not only enables individuals to achieve their full potential, but creates the conditions for nations to grow and prosper. This is one of the reasons why nutrition is the critical link between Feed the Future and the Global Health Initiative, the game-changing Presidential initiatives that address global hunger and maternal and child health as part of a broader strategy to drive sustainable and broad-based growth.

We know that we have to look at child malnutrition in new ways to accelerate progress toward the first Millennium Development Goal of halving poverty and hunger by 2015. We know that better targeting and implementation of nutrition programs can greatly increase the effectiveness of our assistance and, most importantly, the ability of all children to thrive. We also know, as Secretary Hillary Rodham Clinton stated at the “1,000 Days: Change a Life, Change the Future” event in New York last month, that prevention is better, and less expensive, than treatment.

The U.S. government is leading programs that focus on preventing malnutrition before it occurs. Core components of this new approach aim at improving the quality and use of health services, caretaker behaviors and dietary intake. Pregnant women and lactating mothers attend monthly pre- and post-natal services and nutrition education sessions while children up to 24 months are weighed and provided with basic care. Sick or malnourished mothers and children are treated or referred for additional care. Mothers and babies receive supplementary food in addition to a household food ration. As the international community recognizes, we need comprehensive approaches that draw from a broad toolbox in order to prevent and treat malnutrition effectively.

In addition to working to improve our programs on the ground, we are increasing the quality and scope of our food assistance commodities. We recently established a pilot effort to introduce and field-test new or improved micronutrient-fortified food aid products. We are also pursuing innovation around the nutritional content, product composition, and packaging of food products delivered through humanitarian assistance programs. Congress made $14 million available to support these two efforts in fiscal year 2010.

The American people will continue to provide emergency food aid assistance to vulnerable populations. And we are working with top researchers to help ensure that the food aid provided has a high nutritional value. With Tufts University’s School of Nutrition, we are examining nutritional needs and how we can best meet those needs — be they in Bangladesh or the Great Lakes of Central Africa — where I’ve seen incredible work being done. The study includes a scientific review of current enrichment and fortification technologies, a review of methods for delivery of micronutrients and an active consultative process that involves industry, academic and operational experts. Ultimately, it will provide recommendations on how to meet the nutritional needs of vulnerable populations with food aid assistance in a cost-effective manner.

While we expect that some time will be necessary to implement the recommendations, make the necessary changes in formulations, and test new products, our purpose is clear: We are committed to delivering high-quality, nutritious food assistance to people in need. As reaffirmed in the Committee on World Food Security nutrition side event last week, nutrition science has pointed the way to interventions that are basic, low-cost and effective. There is political will to scale up nutrition, align our efforts and measure our results. As Secretary Clinton has emphasized, we must use this remarkable opportunity to make a measurable impact on child hunger and malnutrition.

Millions Soap Up to Commemorate Global Handwashing Day

Water is everywhere — covering almost three-quarters of the earth’s surface — yet nearly one billion people in the world do not have safe water. In addition, inadequate sanitation destroys lives, increases disease and infections, undermines economic growth, and prevents children from attending school.

On October 15th,  we celebrate Global Handwashing Day with the great hope of a healthier future for children and families.

Children washing their hands in celebration of Global Handwashing Day. Photo Credit: USAID/Indonesia

Studies have shown that handwashing with soap can cut deaths from diarrhea by almost 50 percent and deaths from acute respiratory infections by 25 percent – saving more lives than any single vaccine or medical intervention. Washing ones hands with soap could reduce world-wide rates of diarrhea by almost half and save at least one million lives.

People all over the world wash their hands with water. But washing hands with water alone is significantly less effective than washing hands with soap in terms of removing germs, and handwashing with soap is seldom practiced.

Handwashing with soap works by interrupting the transmission of disease. Hands often act as vectors that carry disease-causing pathogens from person to person, either through direct contact or indirectly via surfaces. When not washed with soap, hands that have been in contact with human or animal feces, bodily fluids like nasal excretions, and contaminated foods or water can transport bacteria, viruses and parasites to unwitting hosts.

USAID works in partnership with host countries to reduce diarrheal disease prevalence and improve child survival through sustainable improvements in three key hygiene behaviors: hand washing with soap, safe feces disposal, and safe storage and treatment of drinking water at the household level. These health-focused interventions complement community and municipal water supply infrastructure programs by empowering households with the tools to protect their own health.

For the greatest impact, hands should be scrubbed with soap for at least 20 seconds. Hands should always be washed with soap after using the toilet, cleaning a child’s bottom, and before eating or handling food.

On December 1, 2005, the Senator Paul Simon Water for the Poor Act made access to safe water and sanitation for developing countries a specific policy objective of U.S. foreign assistance programs. As a result, the U.S. has strengthened our response to water, sanitation and hygiene challenges in developing countries.  Promoting Global Handwashing Day is essential to advancing the goals of the Act.

Last year, the United States invested about $774 million for all water sector and sanitation-related activities in developing countries, and as a result, some 5.7 million people received improved access to safe drinking water and 1.3 million received improved access to sanitation. We want to continue to build on these efforts and those of our partner countries.

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