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Archives for Health

Video of the Week: Voices of TB

This moving three-minute video features the powerful voices of TB survivors from around the world.

Handwashing Partnership Turns Five

Guest authors Katie Carroll and Patricia Mantey from the Global Public-Private Partnership for Handwashing.

For the fifth consecutive year, on October 15, 2012, hundreds of millions of people around the world will celebrate Global Handwashing Day. This year we have much to celebrate. In 2011, 600,000 fewer children under five died than in 2008, the first year Global Handwashing Day was celebrated. In 2012, Global Handwashing Day will share its fifth birthday with more than 121 million children who are also turning five this year.
Thanks to the support of USAID and other public and private partners, Global Handwashing Day has grown from a one-day celebration in a few cities to a worldwide movement for handwashing with soap. The Global Public-Private Partnership for Handwashing (PPPHW) and its partners encourage everyone to join in our fifth birthday celebration to promote handwashing with soap.

Every day, USAID promotes handwashing with soap through its Water, Sanitation and Hygiene (WASH) or WASHplus program.  The project, operated by FHI 360, CARE and Winrock International, aims to increase access to and lower the cost of water and sanitation services, and improve personal hygiene habits.  The “plus” represents the project’s efforts to combat pneumonia and other respiratory illnesses caused by indoor air pollution from inefficient or misused cooking stoves

In Zambia, a new school program called SPLASH focuses its efforts on boosting child education as it relates to good hygiene practices. They do this by working with schools to improve both access to better hygiene facilities, such as latrines and hand washing stations, and by teaching students and staff how important good hygiene practices are in making them healthier, like washing hands with soap at key times (after using a latrine or before eating). By reducing the number of days students and teachers miss school due to diarrheal diseases caused by poor sanitation, unsafe water, or the inability to wash their hands with water and soap, they have more opportunities to learn.

In Madagascar, USAID is working with communities in urban areas to provide public-private solutions that provide more options for households who can’t afford or aren’t able to build their own latrines and hand washing stations.  A growing number of communities run WASH blocks that provide latrines with sinks and soap for handwashing, as well as showers and in some cases laundry areas for anyone to use for a small fee.  Some of these blocks get as many as 200 users per day. Claudine, who is the chair of the WASH committee in her neighborhood, welcomed the construction of a WASH block for her community. “Our neighborhood is poor and our living environment is dirty, and we do not have enough water,” she said. “So the WASH block was something that the community really needed.”

Because of their weakened immune systems, people living with HIV and AIDS have an especially high need for clean water to wash their hands and safely drink, as well as access to a clean and safe latrine.  In Kenya, USAID is training partners on the ground to train their community health workers on ways that people living with HIV and their families can improve water, sanitation, and hygiene practices, including hand washing with soap to reduce their chances of getting diarrhea.  Community health workers use pictoral cards (available in both English and Kswahili) to show HIV positive clients and their caregivers or family members how to wash hands correctly, build a water saving device called a tippy tap to wash hands, and other healthy hygiene practices.

There are many examples of how Global Public-Private Partnership for Handwashing has progressed with its mission of encouraging proper handwashing.  But the more people we can get to the spread the message, the fewer people will get sick or die from diarrheal disease.

Hands Up If You Agree: Handwashing is Hands-down Essential

Guest author Joshua Briembergis a WaterAid Country Representative in Nicaragua.

Handwashing is a habit, or at least it should be if we hope to positively impact the health and well-being of the impoverished populations of Nicaragua.  Those of us who work in the water, sanitation and hygiene (WASH) sector read studies that repeatedly demonstrate the link between correct handwashing and the reduction of diarrhea, one of the leading causes of under-five preventable child deaths.  We then go further, to make the link between a reduction in diarrhea and the benefits this brings: more schooling, less malnourishment, savings on medical treatment and more productive lives, and greater happiness.

Still, during a forum of WASH professionals to discuss progress in sanitation a year ago, a secret survey of the participants as they left the toilet facilities showed that less than 60 percent of both men and women practiced handwashing at this critical moment.  These are alarming results, especially since the participants had access to a clean hotel washroom with amenities in a capital city.  Not long after, at a meeting at the Ministry of Health headquarters precisely to discuss a handwashing campaign, one participant noted that there was no soap to enable proper handwashing practice in the washroom facilities.

In the villages and poor urban slums where WaterAid focuses its attention, most of the general public who we work with on a daily basis is able to identify handwashing as a good hygiene habit.  But there is a big difference between knowledge and practice, and this is the challenge WaterAid’s hygiene promotion programs seek to address.

According to the Nicaragua Ministry of Health, acute diarrhea illness in 2008 affected 572.1 of every 10,000 inhabitants (or 5.7% of the population) with a death rate of 4.3 per 100,000 inhabitants (total population), and 20.8 per 100,000 inhabitants in children under age five.

Sure, the minimal conditions are often lacking: running water, soap, hand towels, and adequate provision for wastewater drainage.  Schools, kitchens and toilets are often built without handwashing facilities and when they are, the handwashing facilities are typically not conveniently located, which is important to the process of teaching good habits.

As these problems are addressed by WaterAid with low-cost provision of handwashing facilities next to toilets, within classrooms, and near to areas for food preparation and eating, leading by example remains a powerful tool. During all of our vocational and professional development training sessions with municipal WASH technicians, community water user association operators, teachers and health workers, the rules of order go beyond those of mutual respect, punctuality, and other common meeting ground-rules, to include good hygiene practices. Handwashing before eating and after using the toilet is at the top of the list.

As we saw at the sanitation conference, old habits often die hard.  No matter what facilities are available it can take time and plenty of reinforcement for the habit of handwashing to become ingrained, so repetition of hygiene promotion messaging is vital.

Children tend to be the most receptive audience for handwashing promotion.  Without a lifetime of habits to unlearn, they are generally a lot more amenable to new ideas.  In Nicaragua and around the world, WaterAid works with schools to develop fun hygiene promotion programs, which help kids to understand the health benefits of handwashing and untap their potential to act as ambassadors of good hygiene within their families and the wider community.

But you too can be a handwashing ambassador.  Global Handwashing Day is October 15—on this day and every day, remember to wash your hands, and model healthy behaviors that will last a lifetime!

Pounds of Prevention – Focus on West Africa Cholera

In this USAID Pounds of Prevention article, we examine the problem of cholera in West Africa. Cholera is a communicable disease that affects millions of people worldwide each year. In West Africa, its appearance is usually linked to the onset of the rainy season when the risk for transmitting waterborne diseases rises. USAID is working with many partners, most notably the U.N. Children’s Fund (UNICEF), to tackle cholera and limit the disease’s impact.

By supporting regional efforts, like UNICEF’s emergency rapid response mechanism, USAID is improving how public health actors tackle outbreaks. USAID is also focusing attention on providing water, sanitation, and hygiene training for local organizations, a critical element to stopping transmission of this disease.

Read the full article at Pounds of Prevention: Focus on West Africa Cholera.

Results, Results, Results

Originally posted at 1,000 Days

Last week at the High-Level Meeting on Scaling Up Nutrition in New York City, United Nations Secretary-General Ban Ki-moon commended the progress being made by the 30 countries that have committed to putting nutrition at the heart of their approach to development.  The 30 SUN countries are home to 56 million children suffering from stunted growth due to chronic malnutrition, representing more than one-quarter of the world’s stunted children.

Secretary General Ban Ki-moon addresses the 2nd Annual High-level Meeting on Scaling Up Nutrition. Photo credit: John Gillespie UNIC

Putting nutrition front and center

The Secretary General stressed the importance of boosting global efforts to end “the hidden disgrace of stunting.” His comments were echoed by Anthony Lake, Chairman of the SUN Lead Group and Executive Director of UNICEF, who noted that stunting is one of the most under-recognized and under-attended issues in the world today, yet it can be prevented for approximately $15 per child.

Over the past year, countries in the SUN movement have set themselves clear targets, scaled up programs targeting women and children, and put into place the necessary resources to begin to tackle to problem of malnutrition.  At the meeting, several leaders highlighted new or intensified commitments to scale up nutrition, including:

  • Peru’s First Lady, Nadine Heredia, who indicated that tackling child malnutrition is a critical pathway to breaking the cycle of poverty between generations in Peru and highlighted that the Peruvian President has signed a commitment to protect a $1 billion budget allocation for fighting child malnutrition.
  • Tamar Manuelyan Atinc, World Bank Vice President for Human Development, announced that the World Bank committed to increase investments in nutrition from $100 million per year to $560 million over the next two years which would expand the Bank’s reach into 36 countries, where 70 percent of the world’s stunted children live.
  • Dr. Rajiv Shah, USAID Administrator, committed to decrease stunting by 20% over five years in 14 of the 30 SUN countries:  Bangladesh, Ethiopia, Ghana, Guatemala, Haiti, Malawi, Mali, Mozambique, Nepal, Rwanda, Senegal, Tanzania, Uganda and Zambia.  He also highlighted results achieved with U.S. funds to date.  In Uganda, U.S. funding has meant that 50 million children received vitamin A supplementation last year, along with a 90% increase in the use of cooking fortified with Vitamin A.  Collective efforts in Tanzania have encouraged the government to hire more than 100 district nutrition officers, leading teams that have the potential to reach more than 20 million people.  An initiative with the Government of Bangladesh, CARE and 44 local organizations has created a 30 percent reduction in stunting for children under age five.

While progress at country-level to scale up nutrition has indeed accelerated since the SUN movement was born in 2010, the focus is now on results, results, results.  From now until 2015—the next critical benchmark for the SUN movement and the year the world takes stock of its progress against the Millennium Development Goals (MDGs)—success will depend on the ability to translate political will into tangible and lasting improvements in rates of malnutrition.  The road ahead will likely be a challenging one as global economic problems persist, and food price crises and climactic shocks continue to threaten progress toward curbing chronic malnutrition.  This is precisely why now, more than ever, the global community must rally to mobilize unprecedented resources behind ending the “hidden disgrace” of chronic malnutrition.

Social Good: Igniting Passion and Innovation for a Better World

Originally posted at

Anjana Padmanabhan Photo Credit:

Last week, global leaders gathered in New York City to discuss a wide spectrum of international issues at the highly anticipated annual United Nations General Assembly . But just days before the U.N. Assembly, New York and the Twitterverse were buzzing with another important global conversation sparked by the third annual Social Good Summit.  Hosted by Mashable , 92nd Street Y, the United Nations Foundation, Ericsson, the United Nations Development Programme, and the Bill & Melinda Gates Foundation, the Summit was in full swing from September 22-24. Bloggers, social media wonks, and health and development experts alike crowded together to discuss how new media technologies can be applied to tackle some of the world’s most pressing challenges.

We’re living at a time where anyone can be a diplomat. All you have to do is hit send.”  –United States Secretary of State Hillary Rodham Clinton, September 22, 2012.

The electricity at the Summit was palpable. Passionate minds were immersed in discussion around one common goal: how can we unlock and maximize today’s social media tools to empower women, combat climate change, increase access to life-saving medicines and health education, end human trafficking, as well as promote peace?

This year, the Summit expanded the dialogue by hosting hubs in Beijing, China and Nairobi, Kenya. There were also meetups scheduled in 264 cities across the world, and people in over 150 countries tuned in to the livestream. It was no surprise that by the second day of the Summit the hashtag #SGSGlobal was used over 60,000 times and trended across Twitter with tweets in over 50 languages.

As the social media advisor for a major U.S. global health initiative, The U.S. Emergency Plan for AIDS Relief (PEPFAR), I was looking forward to learning about new technological platforms that governments, civil society organizations and entrepreneurs were using to expand their online presence and encourage a two-way dialogue with their constituencies.

There were a few sessions in particular that resonated with me.

I enjoyed listening to “Unleashing the Power of Open Innovation in Government,” led by Todd Park, Chief Technology Officer of the United States. The ever-enthusiastic Park took to the stage and reinforced the government’s commitment to making information and data transparent and accessible to the American people.  Park holds regular “hack-a-thons” and “datapaloozas” geared towards bridging the gap between tech entrepreneurs and government is an example of the fruits of that labor, providing raw and aggregate data to help foster healthier communities across the United States. Park taught us that the word “innovation” can be synonymous with “government.”

The Social Good Summit was also the launching pad for a new public-private partnership created by The Global Fund to Fight AIDS, Tuberculosis and Malaria  in conjunction with The Huffington Post. The campaign named “The Big Push”  will use technological platforms to rally global support to achieve major health goals. The Huffington Post has launched a dedicated webpage for the campaign where it will collect articles, stories and testimonials on the progress toward meeting these goals. The initiative is also backed by major Hollywood stars like Charlize Theron and Bono. The centerpiece to the campaign is, “a wall of portraits, in which citizens around the world add photos of themselves holding signs that demonstrate their commitment to fighting these diseases.” This is an exciting new way to gather people from across the world and allow them to be a part of the response. We need more campaigns like that that reach people at the grassroots level.

An initiative focused on child survival was also at the top of my list for notable sessions at the Social Media Summit. Launched by UNICEF, A Promise Renewed  is an ambitious program that will unite governments and partners globally to advance the UN Secretary General’s movement Every Woman Every Child to end preventable child deaths and allow children to make it past their fifth birthday. Audiences rapidly shot off tweets and Facebook messages as Anthony Lake, Executive Director, UNICEF; Raj Shah, Administrator, USAID; and Dr. Tedros Adhanom, Minister of Health, Ethiopia gave us statistics on the progress made and the challenges that remain to improving the lives of children worldwide.  An initiative like “A Promise Renewed” encourages people to use technology to hold governments accountable for creating effective and sustainable programs that will bring us closer to reaching Millennium Development Goal targets by 2015.

Overall, the Summit demonstrated to me that we no longer need buy-in for why advancing social media is important. Today, the world is on board.

The Summit might be over, but I’ll continue doing my part using social media to share the successes and stories of lives saved through PEPFAR and fostering dialogue so that together, we can achieve an #AIDSfreeGeneration.

Addressing Malnutrition – Turning Commitments into Action

As the Olympics came to a close last month, British Prime Minister David Cameron opened the doors of 10 Downing Street to a small gathering of world leaders.  They met to announce new initiatives addressing the global challenge of malnutrition, which affects two billion people worldwide.  Perhaps the most promising pledge to emerge from this Hunger Summit was the commitment to greater cooperation between governments, civil society and business.

Mother feeding a child in Kenya. Photo credit: Sight and Life

While we share the same goal—healthy, well-nourished families and communities—too often, agencies, ministries, donors and businesses operate in silos, hindering action and missing key opportunities for collaboration that could improve the health and lives of millions.

We have made tremendous progress in the last five years in terms of prioritizing the issue, and we now have a number of global commitments to address malnutrition.  It would, therefore, seem that we are no longer lacking political will.  In addition, we now know just how cost effective it is to invest in nutrition: there is literally no greater investment we can make in health and development. The Copenhagen Consensus named micronutrient solutions the single smartest way to allocate global aid dollars, with every $1 spent generating $30 in benefits. The fact is combating malnutrition is at the top of the list because its impact can be felt across sectors—from health to agriculture to the economy. Improving nutrition is the most effective way to secure a better future.

Although conversations like the UK Hunger Summit are important in tackling malnutrition, preventing stunting and improving the life chances of millions of children, ultimately, we won’t have the impact we seek to achieve through conversations alone. Yes, we need to convene and collaborate—but the reality is we need to come away with concrete actions clearly outlining how we will all work together across sectors, and be held accountable for our commitments. Cameron and fellow host Michel Temer, Vice President of Brazil, urged the world to take decisive action on malnutrition before the 2016 Olympic Games inRio. That’s just four years away. Between now and then, partnerships between governments, civil society and business have to move from talk to action—that is, effective nutrition programs in countries.

This week, as world leaders gather at the UN General Assembly (UNGA), we have the opportunity to again meet as a global community under the banner of the Scaling Up Nutrition (SUN) Movement, and to outline how we will strengthen current partnerships and explore new ones to accelerate implementation. Global convenings, like the Hunger Summit and UNGA, provide us with the space to create and sustain dialogue, and share knowledge. But then it’s up to each of us, as organizations and individuals, to carry the torch. Together, we can improve nutrition and give millions of children the opportunity to grow, thrive and reach their full potential.

Klaus Kraemer, Ph.D. is Director of Sight and Life, a not-for-profit nutrition think tank of DSM, which cares about the world’s most vulnerable populations and exists to help improve their nutritional status. Acting as their advocates, Sight and Life guides original nutrition research, disseminates its findings and facilitates dialogue to bring about positive change.

Have a Coke and Some Life-Saving Medicine

Lifesaving medicines are frustratingly unavailable to millions of women and children each year. Frank Naqvi, Photoshare

When was the last time you heard a woman say, “I went to the hospital to have my baby, but they sent me to the drug shop down the street to buy supplies?” Or a health worker say, “I knew what medicine my patient needed, but I haven’t had that medicine for months?”

If you live in the U.S. or any other developed country, you’ve probably never heard this, or would think this woman and health worker were joking. But for women, families, and providers in developing countries, these stories and others are all too common…and it’s definitely not a joke.  As my colleague, Mary Ellen Stanton, eloquently captures in her post earlier this week on Saving Mothers, Giving Life, lifesaving medicines are frustratingly unavailable to millions of women and children each year.  It is unimaginable that simple and affordable medicines could save millions of lives, yet are still so far out of reach for millions.

The medicine oxytocin is needed to prevent and treat severe bleeding after childbirth. Oral rehydration salts (ORS) and zinc are needed to prevent deaths from childhood diarrhea.  And family planning commodities are needed to ensure women and their families can decide when or whether to have children – all key factors in maternal and child survival.

Over the past few years, I’ve been working on access to maternal health medicines or commodities. During this time, I’ve learned that the issues related to lack of availability, access, and demand for maternal, newborn, and child health and family planning commodities have many causes, including lack of manufacturers; lack of quality control at many points in the supply chain; providers are unfamiliar with or untrained in newer medicines or equipment; supplies don’t reach the “last mile” to remote health centers; and people don’t know that treatments are available.

But I’ve also learned that these are not insurmountable challenges. Commodities of various types do reach distant and hard-to-reach areas. One often cited example is Coca-Cola, a beverage enjoyed by millions every day, which is both affordable and available even in the most remote villages. You can actually get a Coke in remote Tshikaji, DRC!

And now, we are seeing renewed commitment among donors, country governments, and other stakeholders to make lifesaving health commodities accessible, affordable and available to millions of women, children and families around the world.

Today, the UN Commission on Life-Saving Commodities for Women and Children released 10 bold recommendations which, if achieved, will ensure women and children will have access to 13 life-saving commodities.

USAID’s long term, strategic vision looks to integrate these life-saving commodities as part of the next steps to other key efforts, like the Child Survival Call to Action and London Summit on Family Planning, in order to increase the speed at which we scale-up in host countries. It is important that we learn from our experiences and successes in getting vaccines and malaria, HIV/AIDS, and family planning commodities into the hands and homes of those most in need. Additionally, we need to integrate systems across commodities to better and more efficiently serve women and children everywhere, and scale up programs to have nation-wide impact.

Country leadership is also a vital component to successfully addressing many of the Commission’s recommendations.  Getting pallets of commodities in warehouses is just one step.  Medicines and drugs must reach people, and health care workers have to be present and skilled to administer them.

With our host country partners in the lead, we are working to strengthen supply chains for commodities, which include use of mHealth solutions; support local market shaping; improve the quality of medicines; and increase demand by mothers for necessary medicines.  This needs to happen if we are to ensure the poorest and most vulnerable women and children have the commodities they need.

These two themes, integration and country ownership, form the cornerstones of our work. My hope is that someday soon, I’ll walk past a market in a remote part of Africa with fully stocked shelves of Coke, and into a health clinic fully stocked with life-saving commodities and medicines.

Working Together to Save Moms & Kids in Afghanistan

A decade ago, Afghanistan’s health system collapsed, leaving crumbling and neglected infrastructure, widespread prevalence of malnutrition, infectious disease, and some of the highest maternal mortality rates the world had ever seen. Over the last decade, the Ministry of Public Health, in a strong partnership with the international community, has made major progress in improving the health of Afghan mothers and children. National programs to improve the quality of, and increase access to, basic health services and essential hospital services, along with programs to increase the number of trained female providers including midwives, and improved community-based healthcare, contributed to these significant achievements.

In Afghanistan, USAID is working with the Government to build capacity in its Ministry of Health, among midwives, and in local hospitals, and have helped to increase health coverage from eight percent to over 60 percent of the people over ten years.  This progress has helped the country realize an incredible drop in infant, child and maternal mortality rates, and the global community move the dial on Millennium Development Goals 4 and 5.

Watch Dr. Suraya Dalil, Minister of Public Health in Afghanistan, talk about this incredible milestone.

MDG Countdown: Working to Fulfill A Global Promise

Susan Reichle is the Assistant to the Administrator for USAID's Bureau of Policy, Planning and Learning. Credit: USAID

We all have a deadline in 2015 that can be easily lost amid our busy day-to-days and crowded lists of to-dos.

In 2000,189 nations made a promise to free people from extreme poverty and to extend hope and opportunity to millions across the developing world – all by 2015.  Under the United Nation’s umbrella of the Millennium Development Goals (MDG), the 189 countries committed to eight development goals that were  ambitious in scale and yet vital.

That’s why this week, USAID and our counterparts at the UK Department for International Development are once again drawing attention to the MDGs at an event in New York,during the UN General Assembly.

The good news is that great progress is being made towards achieving the MDGs, and the global community can be inspired by the innovations and successes we are seeing around the world.

Poverty has been cut by 50 percent globally and the proportion of people with no safe drinking water has been cut in half, ahead of the 2015 deadline..   

As evidenced at the New York event this week, USAID is also making a significant contribution to meet the MDG’s:

  • In El Salvador, we work with the Salvadoran Ministry of Education to not only improve the quality of teaching and learning, but also partner with local communities to keep students in school and to recruit children who were not attending classes.  (MDG 2)
  • In Afghanistan, we work with the Government to build capacity in its Ministry of Health, among midwives, and in local hospitals, and have helped to increase health coverage from eight percent to over 60 percent of the people over ten years and helped the country realize an incredible drop in infant, child and maternal mortality rates.   (MDG 4 and 5)
  • In Indonesia, where only 40 percent of citizens receive water from a household tap, we worked to vastly improve the water and sanitation systems.  While our effort has scaled down, the program legacy lives on in private and public sectors’ support for clean water and sanitation, and proof that local and the central governments are willing to commit funds to the utilities to improve performance and expand services if a clear and compelling justification is presented.  (MDG 7)

Still, with only 15 months until the deadline we still have the other six goals to meet.  USAID is applying its resources more strategically than ever to enable countries to achieve the MDGs.  As outlined in USAID’s County Development Coordination Strategies, we are implementing the President’s Policy Directive on Global Development by focusing on those development imperatives that are priorities for the host country and USAID investment can make a difference.  These strategies are informed by evidence, rather than anecdote and lead to stronger projects designed in cooperation with host country counterparts, including government and civil society.

The challenges involved in meeting the MDGs by 2015 remain daunting, yet USAID along with our global partners are making significant strides.  Using breakthrough innovations, integrated approaches, and strategic partnerships we can achieve unprecedented progress in the years to come.

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