Thursday, May 12, 2016

In West Africa, progress on family planning but millions not treated for HIV

Women gather for the launch of the national family planning campaign in a low-income neighborhood of Bamako, Mali in April.
This was originally published on Global Health TV on April 26, 2016.

BAMAKO, Mali — Last year, there were several reports of how West Africa, after decades of seriously lagging behind the rest of the world (and Africa) in family planning, was finally starting to embrace it. IntraHealth International covered this topic extensively on its Vital blog, and I wrote about my own views of family planning in Mali here at Global Health TV.

Senegal, in particular, emerged as a family planning leader in West Africa and provided hope for the rest of the region. The three main reasons for Senegal’s success were strong political will, better coordination and collaboration and innovative approaches, according to Babacar Gueye, IntraHealth country director in Senegal.

New programs here in Mali, like Keneya Jemu Kan (USAID Communications et Promotion de la Santé, in the Bambara language), are making a major push to increase health indicators beyond the anemic progress of the past three decades. For example, the percentage of married women using any modern method of family planning in Mali has only increased from 1.3% in 1987 to 9.9% in 2013, and Keneya Jemu Kan is working to bend that rate upwards. (Full disclosure: I work as a consultant for Keneya Jemu Kan).

But a disturbing new report from Médecins Sans Frontières (MSF), or Doctors Without Borders, claims that similar progress is not being made in HIV/AIDS. On the contrary, MSF claims that millions of people in West and Central Africa are being left out of the global HIV response despite globally agreed goals to curb HIV by 2020, and is calling on the international community to develop and implement an urgent plan to scale up antiretroviral treatment for countries where critical medicines reach fewer than one-third of the population in need.

Monday, May 9, 2016

Brazil struggles to contain damage of mosquito that transmits Zika virus

Dr. Sylvia Lordello of Saúde Criança speaks to a group of parents about Zika.

This was originally published by Global Health TV on March 31, 2016.

RIO DE JANEIRO, Brazil — A group of about 20 poor parents (mostly women) from the slums gathered this month in the offices of Saúde Criança (“child health” in Portuguese), a social enterprise that works with impoverished children and their families in a holistic way. After a meditation, they got down to the main point of the meeting — the Zika virus and how to avoid it.

These poor young mothers are prime candidates for Zika. Aedes aegypti, the mosquito that transmits Zika, will suck anyone’s blood — rich or poor. But they thrive in the densely populated favelas of Rio and other Brazilian cities where few people have screened windows and where even mosquito repellant may be a luxury. Many people have water cisterns on their roofs, usually not covered, which makes an ideal breeding ground for Aedes aegypti.

Dr. Sylvia Lordello, a medical doctor on staff at Saúde Criança, told the parents that prevention starts at home and reviewed a series of steps that could be taken to make their homes less hospitable to mosquitoes, such as covering their cisterns and not leaving water in the plates under house plants.

“If the whole country fights Zika, the mosquito cannot win,” Dr. Lordello told the parents. “Zika is not stronger than the country.”

Saturday, May 7, 2016

Amid a flurry of high-tech approaches, some find merit in low-tech techniques

DKT street theater provides family planning information in Bihar.
This was originally published on Humanosphere blog on March 7, 2016.

Because of the meteoric rise of the internet and cell phones in many developing countries, many global health programs have been rushing to embrace these technologies as efficient ways of reaching large numbers of people with information on such issues as family planning, HIV prevention and maternal and child health.

This is happening in countries like India, Tanzania, South Africa, and Ethiopia, where technologies like the internet, mobile phones, social media and geographic positioning systems are bringing health delivery into the 21st century.

But some programs are eschewing high tech and sticking with low tech as the best way to bring vital health information to their low-income consumers, at least for now.

Tuesday, March 1, 2016

Faith community steps up its commitment to family planning

Twelve faith leaders read a statement of support for family planning from a larger group of faith leaders attending the International Conference on Family Planning in Indonesia in January 2016.
This was originally published on Global Health TV on Feb. 23, 2016.

NUSA DUA, BALI, Indonesia — To some, it may have been an incongruous image — twelve faith leaders, representing all the major religions of the world, standing on the stage at the closing ceremony of the International Conference on Family Planning (ICFP) here. After all, everyone knows that most religious leaders are against family planning, right?

That was never true, and now it’s becoming even less true. The twelve leaders represented 85 religious leaders and representatives of faith-based organizations (FBOs) who came to Bali from 26 different countries to discuss best practices and scaling up services to help families achieve what they like to call “the healthy timing and spacing of births” during a two-day Faith Pre-Conference.

It might surprise some to know that this support is not just for natural family planning, but extends to all forms of modern contraception with the single exception of sterilization, which is not approved by all types of Islam. All other modern methods are acceptable to all the religions represented at ICFP — Buddhist, Christian, Confucian, Hindu, Jewish and Muslim.

Saturday, February 6, 2016

In Indonesia, spicy IUD TV ads try to boost long-acting, reversible contraception

This was originally published on the Maternal Health Task Force Blog on Jan. 21, 2016.

“How does it feel after you get an Andalan IUD?” a woman says in the opening line of a ground-breaking new TV spot (above) in Indonesia promoting intrauterine devices to married women. “Now we can do it anytime. For sure, my husband is more content and obedient now,” she says with a mischievous smile.

A second spot targeting married men poses the same question about how it feels after their wives got an IUD. “Now, every day, I just want to return home quickly,” he says with a broad grin. This deals with a widespread myth held by Indonesian men that IUDs dampen sexual pleasure.

Such ads used to be unheard of in Indonesia, where family planning is normally promoted from a population control and public health perspective. Sex is never mentioned. In a country that values discretion, these commercials link IUDs with sexual pleasure and other benefits of using a long term, reversible method.

Friday, January 15, 2016

Can polio and Guinea worm both be eliminated in 2016?

Nuru Ziblim, a Guinea worm health volunteer in Ghana, educates children on how to use pipe filters to avoid the parasite when they go to the fields with their families. Credit: The Carter Center
This was originally published on Global Health TV on January 14, 2016.

Only once in history has a human disease has been eliminated from the face of the earth. That was smallpox, eradicated in 1980.

There is a reasonable chance that in 2016 two diseases could be eliminated  polio and guinea worm.

We won’t eradicate either disease this year. Eradication requires that several years pass with no new cases being detected. But it does look like 2016 is the year we could eliminate both diseases.

To be sure, we have been close before with polio, and then lost ground. The World Health Organization (WHO) says that “failure to stop polio in these last remaining areas could result in as many as 200,000 new cases every year, within 10 years, all over the world.” So there is little room for error.

Tuesday, December 29, 2015

The biggest global health stories of 2015, and one untold story

A billboard warning about Ebola in Bamako, Mali.
This was originally published on Global Health TV on December 17, 2015

There seemed to be a lot of good global health news in 2015, especially when compared to 2014, when Ebola was ravaging West Africa and scaring the rest of the world. In the last 12 months, Ebola has mostly passed, progress was made against malaria and AIDS and the climate deal in Paris raised hopes that less climate change could improve global health.  Here are what I consider some of the top global health stories of the year, not necessarily in order of priority:

Ebola on the Decline: A year ago, Ebola was raging. As of Dec. 16, there have been 11,315 deaths and 28,640 cases of Ebola. But Ebola has not disappeared entirely. It re-emerged in Liberia after having earlier been declared Ebola-free. Dr. David Nabarro, the UN special envoy on Ebola, said that he expects transmission in Guinea to finish before the end of 2015 and in Liberia in early 2016. Here’s an update on Ebola in an interview with Dr. Nabarro.