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.

Monday, December 28, 2015

The social marketing legacy of Phil Harvey

This originally appeared on the Huffington Post on December 15, 2015.

From 1992 to 2001, I did some of the most important – and fun – work of my life: I managed social marketing programs for the nonprofit PSI in Zambia, Bangladesh and Paraguay. Social marketing is a technique that uses the tools of social marketing to achieve a social outcome – in PSI’s case, that outcome is improved health. The programs I worked on were HIV prevention, family planning and child health but social marketing can also be applied to other disciplines as well.

I owe that singular experience to Phil Harvey, who founded PSI in 1970 to promote family planning through the social marketing mechanism. In 1989, he founded DKT International, another social marketing organization more tightly focused on reproductive health mainly in very large countries (in order to have cost-effective impact at greater scale). Harvey has also served, and continues to serve, for many years on the board of directors of Marie Stopes International, another organization that uses social marketing.

Phil Harvey is introduced as “a visionary, pioneer and titan in the world of social marketing” in this new video interview. Harvey describes his early work in India, the roots of social marketing, his creation of two social marketing organizations, his legal battle with the State of New York over reproductive health issues (that went all the way to the U.S. Supreme Court) and the impact of social marketing.

Thursday, December 24, 2015

Social marketing contributes 20% of all contraception in developing countries (excluding China)

A DKT Indonesia midwife counsels a client in her clinic in Jember, East Java. In 2014, this network of nearly 5,000 midwife clinics helped DKT Indonesia become the Number 1 contraceptive social marketing program in the world.
This was originally published on the Huffington Post on December 1, 2015.

If there was still any doubt about social marketing’s ability to make a major contribution to family planning and HIV prevention, those doubts were dispelled in 2014, when 84 social marketing programs in 62 countries delivered 69 million couple years of protection (CYPs), according to the 2014 Contraceptive Social Marketing Statistics just published by DKT International. DKT says these 69 million CYPs represent an estimated 20% of all women using modern contraception in the developing world, excluding China. (A “couple year of protection” is the amount of contraception needed to protect one couple for one year).

“These are remarkable numbers and a testament to the many organizations and individuals who strive to make a wide range of health products and services available to women around the world,” said Chris Purdy, president and CEO of DKT International.

The report provides details of these 84 contraceptive social marketing programs, all of which are helping provide modern contraception and reduce unmet need for family planning among women and families in their countries, largely through the private sector.

Wednesday, December 23, 2015

Killing 5 million a year, diabetes becomes major menace to global health

This was originally published on Global Health TV on November 23, 2015.

Over the last 25 years, diabetes has emerged as a major threat – and growing consumer of precious global health resources – in the developing world. In 1990, according to the Institute for Health Metrics and Evaluation (IHME), it was not even in the top ten leading causes of death globally.  Now it is number nine on the list.

In the seventh edition of its Diabetes Atlas, the International Diabetes Federation (IDF), an umbrella organization of over 240 national diabetes associations, says that diabetes kills almost 5 million people every year and that every six seconds a person dies from diabetes. This compares to those who die each year from AIDS (1.5 million), tuberculosis (1.5 million) and malaria (600,000).

The latest version of the Diabetes Atlas, which will be published on Dec. 1, calls diabetes “one of the largest global health emergencies of the 21st century.” Currently, 415 million people have it (1 in 11). By 2040, if current trends continue, 642 million will have it (1 in 10).

Monday, December 21, 2015

Diarrhea deaths are falling but ORS use still stagnant

This was originally published on Global Health TV on October 28, 2015.

I’m grateful to Chelsea Clinton for her admission that she is “obsessed with diarrhea,” and her total lack of embarrassment in bringing it up repeatedly. In an interview with Fast Company, it was the first thing she wanted to talk about.

I’m grateful to her because she is, as far, as I know, the only well-known public figure to champion the prevention and treatment of diarrhea, the world’s second biggest killer of children under five years old, even though we have cheap and effective ways of dealing with it.

“It’s completely unacceptable that more than 750,000 children die every year because of severe dehydration due to diarrhea,” said Clinton last year. “I just think that’s unconscionable.”

We need more champions of the diarrhea issue.

Four years ago, I wrote a blog bemoaning the fact that oral rehydration therapy (ORT) seemed to be on life support, even though The Lancet once called it “the most important medical advance of the 20th century.” ORT and its practical application, oral rehydration solution (ORS), have long been found to be both effective and cost-effective in treating the dehydration caused by diarrhea.

Thursday, December 17, 2015

How does global health fare in the Sustainability Development Goals?

This originally appeared on Global Health TV on Sept. 28, 2015.

Last weekend in New York City, world leaders formally approved the Sustainability Development Goals (SDGs), which will guide development efforts over the next 15 years. They replace the Millennium Development Goals (MDGs) that were signed in 2000 and expire on Dec. 31, 2015.

The MDGs were terrific for global health, both in raising money, and raising its profile on the global agenda.

Eight goals made up the MDGs, and three of them were entirely focused on health. In addition, two other goals included health-related targets. Eight (38%) of the 21 total MDG targets were health-related, and seven of those targets were numerical (i.e. reduce maternal mortality by three quarters).

Between 2000 and 2014, $228 billion was allocated to address the three health-related MDGs, according to the Institute for Health Metrics and Evaluation (IHME) 

More importantly than how much was raised, serious progress was made on many of these health fronts. For example, two weeks ago, the World Health Organization announced that malaria death rates have plunged by 60% since 2000 and that the malaria target to have halted and begun to reverse the incidence of malaria by 2015 has been met “convincingly.” Most people think the Target 1A to halve the proportion of people living on less than $1.25 has been met.

But where is health in the SDGs? The answer to that question contains both good and bad news for global health advocates.