We have a long history of addressing malnutrition and it remains one of our top priorities.
Check out our current work at Feed the Future.
Archives for Health
We have a long history of addressing malnutrition and it remains one of our top priorities.
While in Moscow last summer, I visited the M.P. Chumakov Institute of Poliomyelitis and saw the history of collaboration between the U.S. and Russia on polio research. I saw opportunity to advance our cooperation to address new challenges and work with Russian experts to eradicate polio for good enabled by the Obama Administration ‘reset’ policy and the U.S.-Russia Bilateral Presidential Commission.
Today, USAID Administrator Raj Shah joined Dr. Nils Daulaire, Director of the Office of Global Health Affairs at the U.S. Department of Health and Human Services, and Dr. Veronika Skvortsova, Deputy Minister of Health and Social Development for the Russian Federation, in signing a Protocol of Intent that will deepen cooperation between American and Russian health experts to eradicate polio around the globe.
It’s fitting that Administrator Shah signed this Protocol while visiting Geneva to serve on the World Health Organization’s Commission on Information and Accountability for Women and Children’s Health. Polio is a highly infectious disease that mainly affects children under the age of five. One in 200 infections leads to paralysis and among those paralyzed, 5-10% die. Polio is easily preventable with available vaccines, as evidenced by the success of the Global Polio Eradication Initiative to reduce polio by 99% worldwide since the Initiative started in 1988. However, recent years have seen outbreaks in several countries.
It pains me to think of the children that unnecessarily suffer from a disease that can be prevented for 14 cents. It’s incredible that we’re so close to ridding the world of this disease once and for all. I believe that, working with our international partners, we can finally live in a polio-free world.
I am excited by the impact that we can have on lives around the world working together as global partners.
As featured in the White House Blog
Last week, USAID Administrator Dr. Rajiv Shah gave a major address to over 200 non-governmental organizations, think-tanks, academics, and international development leaders hosted by the Center for Global Development. The text of the speech as prepared for delivery can be found here. Dr. Shah’s speech on The Modern Development Enterprise addressed the current state of development and formally announced the Agency’s 50th anniversary.
In his speech, Dr. Shah recognized the important role of religious and community groups in providing assistance to those most in need around the world. I thought you’d be especially interested in the excerpts below:
- American Values: When we prevent violence in Southern Sudan, we’re not just avoiding future military involvement; we’re also expressing America’s values. When schoolchildren organize bakesales to pay for anti-malarial bed nets, they are expressing America’s values. When more American families gave money to the Haiti relief than watched the Super Bowl, they were expressing America’s values. When church groups across America raise money and volunteer to support children orphaned by AIDS, they are expressing America’s values.
- Communities of Faith: I’m proud to know that USAID is one of CRS’s largest supporters. But I’m also proud to know that we support a wide-range of faith-based organizations, from Samaritan’s Purse to the American Jewish World Service. Organizations of faith not only express the moral values of millions of Americans, they also provide some of the most dependable support systems for millions in the developing world. In Kenya for example, 30% of all healthcare services are provided by Christian Hospitals. Our success depends on listening to communities of faith, connecting with them deeply, and supporting the vital work they perform around the world.
- Food Security: Instead of merely providing food aid in times of emergency, we are helping countries develop their own agricultural sectors, so that they can feed themselves. We launched Feed the Future – bringing together resources across the federal government and engaging in deeper partnerships to extend the impact of our efforts. We are now leveraging more investment from countries themselves and from other donors. Firms ranging from General Mills to local African seed companies are all doing more. As a result, in just five of our twenty focus countries we will be able to help nearly 6.5 million poor farmers – most of them women – grow enough food to feed their families and break the grip of hunger and poverty for tens of millions of people.
- Global Health: In our Global Health Initiative, instead of a scattered approach that fights individual diseases one at a time, we are pursuing an integrated approach that will generate efficiencies and strengthen health systems. We are now working with partners such as the NIH, CDC and PEPFAR to leverage recent advances in science and technology, especially in high return areas such as vaccinating children, preventing HIV, malaria and TB and focusing on childhood nutrition during pregnancy and the first two years of life.
- Smart and Transparent Investments: I want the American taxpayer to know that every dollar they invest in USAID is being invested in the smartest, most efficient, and most transparent way possible.
- 50th Anniversary: This year, USAID will celebrate its 50th anniversary. Our legacy is filled with incredible accomplishments. Throughout those fifty years, we have contributed greatly toward ending an incomprehensible measure of human suffering, and I urge you to learn more about our Agency’s rich legacy through our newly launched anniversary Web site, http://50th.usaid.gov. But if I am lucky enough to live another 50 years, I hope I am also lucky enough not to witness our centennial. Instead, I hope we will be commemorating the success of USAID’s mission.
Ari Alexander serves as Deputy Director at the Center for Faith-based & Community Initiatives and the Coordinator of Global Engagement.
I have visited a number of health facilities during site visits, and I feel great pride when I hear of the positive impact of our assistance in improving health in rural communities, particularly mothers and children. The stories about rural nurses like Alina Hovhannisyan are especially touching. Alina is a community nurse in Haykavan village in Shirak province and a graduate of USAID/Armenia’s Safe Motherhood Clinical Skills training. The knowledge and skills she gained from the course enabled her to help a village woman deliver her baby when she was in premature labor, The nearest maternity hospital was 12 km away and there was no time to wait for the ambulance. There are many other children, like little Mariam born that day, that our programs and trainings help to promote a healthier future for Armenia.
Quality and accessible health care has been USAID’s long-standing priority in Armenia. In 2004, the Mission initiated Project NOVA to assist the Armenian Ministry of Health in their efforts to improve the quality of reproductive health, family planning, and maternal and child health services in the country. Through this project USAID assistance helped extend free primary health care (PHC) and maternity services by equipping and renovating two-thirds of Armenia’s neediest rural health facilities, as well as training 25% of Armenia’s PHC physicians. New systems of health care financing and monitoring were established such as the Open Enrollment system, whereby people choose their own health care provider (85%-90% of resident population are now enrolled). Quality Assurance and family medicine practices were introduced. The primary cause of maternal death in Armenia – post-partum hemorrhage rates – was reduced by over 60% from 5.4% in 2005 to 1.7% in participating facilities.
In January 2010, building on the accomplishments of this five year project, USAID launched the one-year Maternal and Child Health Improvement Project (NOVA 2) to follow on former activities in five southern regions and to expand assistance to five additional northern regions of Stepanavan, Akhuryan, Ijevan, Martuni, and Hrazdan.
NOVA 2 reached over 500,000 people in these ten regions and benefited 270 primary and secondary level facilities, supporting over 8,000 births.
Five Schools of Motherhood were added to the existing twelve set up by predecessor Project NOVA. These schools provide pregnant women with free counseling, physical and psychological instruction on childbirth, information on the delivery process, and a wealth of information on the importance of a healthy lifestyle during and after pregnancy. Future fathers are also encouraged to visit. Indicative of the Schools’ popularity and high demand, the number of women who attended the classes in project-supported regions increased from 12.8% to 59.7% in less than a year.
The project, which marked its completion this month, was implemented by a consortium of international organizations headed by the Research Triangle Institute (RTI), in partnership with IntraHealth International and Save the Children, and in close collaboration with the Republic of Armenia Ministry of Health, regional health departments, healthcare facilities, Yerevan State Medical University, Erebuni State Medical College and select local NGOs.
In Indonesia, we will hold the opening of the much anticipated IMULAI 3.0 innovation competition. iMULAI is a national competition program for innovation in information technology (IT) software applications. The program seeks to promote the importance of IT innovation among businesses and the general public, achieve public awareness of USAID and Microsoft Indonesia’s social and economic goals and improve Indonesia’s IT competitiveness and the local software economy.
In Elbasan, Albania we will open a Tourism Information Office. Joseph C. Williams, USAID/Albania Mission Director will join the Mayor of Elbasan and other local government officials along with local businesses to launch the site. USAID will travel to Elbasan to participate in a series of site visits and events to highlight USAID assistance to the city and business community there. Among the activities will be a ribbon-cutting for the city’s first Tourism Information Office, made possible through a public-private partnership with a local business, a visit to a major infrastructure investment project made possible with the support of USAID’s DCA for municipal borrowing, and a meeting with the Mayor and Small Business Association to raise awareness of a public information and sticker campaign to support tax payments by small businesses.
In Tajikistan, we will hold the USAID Safe Drinking Water Project opening to celebrate the completion of the water system renovation project. Opening speeches by the Ambassador and local government officials will be made, followed by a visit to a Safe Drinking Water Project site. There will be a total of eight launches in eight different villages.
While we often think of the importance of doctors, nurses, community health workers and even politicians as being the key to strong health systems, it is just as critical to have lawyers, accountants, and governance experts who understand the technical aspects of ensuring that doctors and nurses have what they need to be successful by managing resources responsibly.
The U.S. Global Health Initiative is a government-wide effort, seeking to save lives and improve health outcomes through strategic integration and supporting countries’ own efforts. Its goals – dramatic reductions in maternal and child mortality, are ambitious but achievable. Its overall success — and a brighter future for children, families, communities and countries, — will depend on improvements in everyday issues like buying and tracking expenditures.
So for the GHI’s goals, having a diverse team assess the ability of our partners to manage and deliver health interventions is key to reforming the way we do business in development.
I just returned from two weeks in Nepal where I joined such a team, comprised of USAID colleagues from Washington, India, Bangladesh and Nepal. Our goal was to look at how the Agency can work with more and varied partners to empower the Nepali people to care for themselves. We were looking specifically at how USAID can invest in the government, through existing public financing mechanisms. This includes broadening the civil society partner base, and strengthening private sector capacity. This strategy is part of a larger effort at USAID, known as USAID Forward.
One of the most interesting experiences during the trip was sitting in a small District Public Health Office. Having visited municipal level health offices all over the world, my initial impression was very positive. The facility was in great shape: our meeting room had electricity, decent furniture, a landline telephone, and fax machine. The health superintendent had a strong commanded of his health office. Although I had a hard time following all of the discussion with the strong accents of the local staff, and my own lack of financial acumen, after the first half of our meeting it seemed as though there was a solid, basic system of accounting in place, and appropriate management and oversight controls. Our Team Leader, the Chief Financial Officer for USAID, even seemed impressed.
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“An informal, but very insightful, first-person account of how cell phones are rapidly changing the way USAID implements health programs in the field. With a bit more focus and targeted resources, USAID could dramatically accelerate the mainstreaming of mHealth interventions, helping us achieve our GHI targets more rapidly, and leaving behind a legacy with enduring returns.”- Adam Slote, USAID/Global Health
By: Natalie Campbell, Management Sciences for Health
The most important item in Amon Chimphepo’s medical kit is a small cell phone. This single piece of technology has proved to be a lifeline for people living in one of the most remote regions of Malawi. Its power to reach and initiate help immediately from the closest hospital is saving lives and improving health outcomes. In fact, I met a woman, alive today, because Mr. Chimphepo and his cell phone were there to make an emergency call to the district hospital and get an ambulance.
I traveled to Malawi in December to take a closer look at our pilot project — K4Health Malawi — we launched in February 2010. One of its main interventions equips community health workers with cell phones and solar chargers. In his capacity as a community health worker, Mr. Chimphepo makes regular door-to-door visits in his area delivering HIV tests, and health and hygiene counseling. We knew this kind of outreach provides important health support in remote areas but had no idea how the rapid response component of cell phone communication was transforming health outcomes across the area.
Fast changes in health status are rare in this line of work. My background is food security and nutrition programs, and my timer was set to long-term changes from poor nutrition into better health status and, with any luck, the slow parallel development of sustainable food sources. Timeframes run in years. That a knowledge management project could lead to fast, life-saving aid and an immediate improvement in health and well being across this hard-to-reach population was highly impressive.
21st Century Communication Saves Lives in Remote Areas
When you connect community health workers by cell phone to the people, information and resources of a hospital you open a conduit of immediate aid that can save lives. Time telescopes — what took days and weeks before wireless communication, now takes minutes and hours. Visiting with Mr. Chimphepo, we were able to meet the people and hear the stories of injuries and conditions and sicknesses treated quickly and correctly because Mr. Chimphepo has access to professional advice and direct health services through the district hospital.
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By: Clydette Powell, MD, MPH, FAAP
It was the best of times; it was the worst of times. January 12’s earthquake, epicentered in Port-au-Prince, killed over 200,000 people, but also mobilized one of the largest humanitarian disaster responses in the Western Hemisphere in the last 60 years. As Medical Officer at USAID/Washington, I was part of that response.
They lay in adjacent incubators – two of Haiti’s newest citizens – one born in Port-au-Prince, the other born on a ship in the harbor. Both premature, weighing in at some three pounds. Catherine was born one day before the earthquake. Barely 24 hours old on January 12, 2010, Catherine and her mom were suddenly homeless. Her mom could not breastfeed, and Catherine became dehydrated and ill. After days of wandering the streets of Haiti’s capital city, Catherine’s mom was found by a medical triage team who sent them both to the US Navy hospital ship, the USNS COMFORT, which had just arrived in the harbor. On board, Isabella Rose, her incubator neighbor, had just been born by C-Section. Her mom had been severely injured during the earthquake, and went into premature labor. Again, another triage team sent Isabella Rose’s mom for emergency obstetrical care on the USNS COMFORT, and Isabella Rose took her first breaths on board a US Navy hospital ship.
On the evening of January 12, I had seen the broadcasts of the earthquake’s devastation and the misery it brought to people of a country where I had worked for USAID on numerous short term assignments since 2001. Without hesitation, I volunteered to be part of USAID’s response to this disaster. Being the civilian-military liaison for our Health Office within the Bureau for Global Health, the medical officer in the Infectious Disease Division, and a member of the Haiti Health Team provided the foundation for quick deployment. Invited by the Commanding Officer to serve on the USNS COMFORT, I sailed down with its crew and found myself in several roles, including as neurologist in the Pediatric Intensive Care Unit, when Catherine and Isabella Rose arrived.
Our USAID/Haiti Health team, themselves survivors of the earthquake, and our team on board the COMFORT quickly established communication links. We worked in tandem to triage, transport, and care for the most severely injured. During the course of two months, the ship-based and the land-based teams collaborated in the care of over 1,000 patients. More than 2,000 helicopter flights transported patients and teams between ship and land. Public health priorities and support for the stewardship role of the Haitian Ministry of Health became daily (and nightly) discussions of both the ship and USAID land-based teams. As the relief effort grew, so did the complexities of patient management, the coordination of care, and the optimization of public health disaster relief responses. Yet on a microcosm, there were still the Catherines, the Isabella Roses, and other children—the displaced, the orphans, some likely restaveks—and injured adults, all of whom sought emergency medical care on board the USNS COMFORT.
As I look back to one year ago, representing USAID in the Haiti earthquake response generated in me a renewed sense of patriotism, increased admiration for our USAID/Haiti team, greater esteem for the US Navy, lasting gratitude for my medical and public health skills, and an even deeper respect for the Haitian people. In the worst of times/best of times perspective, Catherine received her angel wings, to use the Navy parlance, but Isabella Rose bloomed. One of Haiti’s newest citizens, she became a symbol of her people’s resilience, and a tiny testimony to the effective collaboration of USAID, the US Navy, and the non-governmental organizations when all things can work together for the good.
By Maria A. Miralles, PhD, USAID’s Senior Pharmaceutical Management Advisor
At the moment of using a medicine, do we trust that the product is of good quality and will not cause us any harm? For those who live in countries with competent regulatory agencies and functioning systems, the answer is yes and this trust is generally well-placed. This is pretty amazing when you consider the myriad of opportunities for problems to arise, from product development through to manufacture, distribution and use. So, not many people were alarmed in April 2010 when the FDA informed the manufacturers of Children’s Tylenol® of violations in its Pennsylvania manufacturing plant affecting several dozens of products. The company immediately issued a voluntary recall, products were withdrawn from the market, potentially related morbidities and deaths were subsequently monitored.[i] Unfortunately, many developing countries lack the capacity to protect their citizens in this way, much less to protect them from unscrupulous drug manufacturers and vendors. What should be a matter of trust is more like a tragic game of chance with devastating odds.
Many of us can remember the deaths of 138 Panamanians who consumed tainted cough syrup in 2006 and the 84 children in Nigeria in 2008 that were exposed to a teething medicine made with a counterfeit ingredient. In both cases, investigations determined that these deaths could have been avoided had the responsible systems and authorities been vigilant and the systems sufficiently responsive.[ii] Deaths are not the only sign of potential product quality and patient safety problems. Antimicrobial medicines with sub-therapeutic quantities of active ingredients have contributed to the rise in resistant strains of various infectious diseases rendering existing cheaper products useless and prolonging treatment periods. There is no question that there are likely to be many others cases we will never know about because they have occurred in places where there was no system in place to properly document them.
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Food and nutrition are important elements across all cultures. In America there is a renewed sense of instilling good nutritional habits in children through the First Lady’s campaign against childhood obesity and the newly signed Healthy, Hunger-Free Kids Act. At USAID, we are concerned with not only feeding those in need around the world, but making sure they have access to healthy and nutritious meals on a regular basis, as well as a sustainable livelihood.
But for many people living with HIV/AIDS (PLWHA) like Thabit Obed, a farmer from Uganda, managing one’s health is no easy task. The infection causes or aggravates malnutrition through reduced food intake, increased energy needs, and poor nutrient absorption. Malnutrition weakens the immune system, which can hasten the progression of HIV, increase susceptibility to opportunistic infections, and reduce the effectiveness of treatment. Since food and nutrition support is such a critical component of successful HIV/AIDS care and treatment, USAID has an invested program to help those in need.
Thabit is a recipient of support from the USAID-funded program, NuLife—Food and Nutrition Interventions for Uganda, a program managed by University Research Co., LLC (URC) that works to improve the health and nutritional status of people infected and affected by HIV/AIDS through integration of nutritional assessment, counseling, and support (NACS) into HIV/AIDS services.
In addition to producing and prescribing food, such as RUTAFA a ready-to-use therapeutic food, the program also works to provide opportunities for farmers in Uganda to expand their businesses.
Thabit, an active community volunteer, became one of more than 4,000 farmers to grow groundnuts as input for RUTAFA. He was trained to support other PLWHA and raise awareness about HIV testing, counseling and treatment.
Through this program and similar partnerships, USAID NuLife has been able to help ensure HIV positive individuals who have recovered from malnutrition through treatment with ready-to-use therapeutic food are being offered an opportunity to earn a living, support their families’ and maintain a healthy nutritional status.
USAID/Uganda designed a program that not only reaches HIV positive clients with critical services and supports local industry and individual farmers, but connects those clients to sustainable livelihood opportunities producing inputs for the very product, RUTAFA, which can support their health and that of their fellow PLWHA.