Stepping up fight against malaria in Asia to protect gains made everywhere

A mother from Myanmar and her child waiting to be seen at the Wang Pha clinic near Mae Sot, Thailand, near the Thai–Myanmar border. Her son has symptoms of malaria. Photo: Mark Tuschman 

This was originally published on Global Health TV on August. 31, 2018

The future of malaria in sub-Saharan Africa and everywhere else may depend on whether we can stop drug resistant malaria in five countries of the Greater Mekong subregion of Southeast Asia and whether new vaccines will work against it.

Great progress has been made against malaria on both continents. The incidence rate of malaria has decreased 18% globally between 2010 and 2016, according to the World Health Organization. The WHO South-East Region recorded the largest decline (48%) followed by the African Region (20%). Malaria cases worldwide have fallen from 237 million in 2010 to 216 million in 2016.

Two years ago, Sri Lanka became the first country in the region to eradicate malaria. Six more countries (Bhutan, China, Malaysia, Nepal, South Korea, and Timor-Leste) are on track to eradicate it by 2020 and the other 15 nations are targeting 2030. But a few of those 15 countries are struggling – malaria cases increased in six of them in 2016. India has the third largest burden of malaria in the world, accounting for 89% of malaria cases in the Southeast Asia Region.

“We’ve made extraordinary progress in the Asia-Pacific Region,” says Dr. Ben Rolfe, CEO of the Asia Pacific Leaders Malaria Alliance based in Singapore. “Malaria has been halved, and then halved again. Even Myanmar has made extraordinary progress in the most difficult of circumstances. The downside is that we have only bitten off the easy fruit. We are now getting down to dealing with remote communities with very little access to health services. It gets exponentially harder to reach those places.”

New book "Factfulness" asserts that world is much better than most believe

This was originally published on Global Health TV on August 6, 2018.

I first saw Hans Rosling deliver a presentation on facts and fiction on global health in New York in 2010. Like many of his fans, I was swept away by his stunning visual presentations of data, his charming Nordic folksiness and his ability to shed light on some glaring misconceptions of global health and development that he has been working to rectify the last two decades.

He was shocked to discover that people get basic facts on population, health and development wrong, and not just the general public but also highly educated people, even at the World Economic Forum in Davos and Nobel laureates. So this Swedish professor of global health set out to educate people, primarily through his TED talks, which have been viewed more than 35 million times (check out “Let my dataset change your mindset” and “How not be ignorant about the world”), to such an extent that he became a nerdy global health rock star.

In September 2015, Hans and his son Ola Rosling and daughter-in-law Anna Rosling Rönnlund decided to write a book to explain why people do not see the world as it really is, and why we get so many basic facts so wrong. Five months later, he received a diagnosis of incurable pancreatic cancer, and was told he had two or three months to live. He threw himself into finishing this book to such an extent that he was going over printed copies of the latest draft from his hospital bed in the days before he died in February 2017.

Trump's expansion of Global Gag Rule sows chaos in global health

One of Donald Trump’s first acts as U.S. president was the re-imposition of the Global Gag Rule (GGR), also called the Mexico City Policy, a policy that denies healthy options to women and girls, not just safe abortion and contraception but potentially all areas of global health. 

Trump changed its name to “Protecting Life in Global Health Assistance,” but most global health advocates call it the Global Gag Rule because it silences health providers from providing comprehensive reproductive health options to women and girls.

The global gag rule is a failed, outdated and deadly policy,” writes Serra Sippel, the president of the Center for Health and Gender Equity (CHANGE), in the comprehensive new report Prescribing Chaos in Global Health: The Global Gag Rule from 1984 to 2018.

“Throughout this report, CHANGE seeks to document the breadth of the GGR’s impacts on civil society and health systems. For example, CHANGE provides evidence that the GGR under President George W. Bush had consequences outside family planning programs, and that it adversely impacted a wider range of health services provided by foreign NGOs. Some of these impacts were mitigated when President Barack Obama rescinded the policy, but the harmful effects have been shown to linger, particularly as each iteration has become more oppressive, culminating now with the Trump GGR.” 

The policy is having exactly the effect the Trump Administration intended it to have – women are losing health services, programs are being down-sized or closed and advocacy work disrupted. Because of poor communication and miscommunication coming from the U.S. government and prime partners, the CHANGE report says, many organizations are over-interpreting the policy, and going further than they really need to go, out of fear of losing funding and alienating an important donor (the U.S. government).

Brazil anti-tobacco forces score yet another victory but work is not yet done

ACT and their anti-tobacco coalition after an advocacy activity at the National Congress in Brasilia. Photo: ACT Promoção da Saúde

This was originally published on Global Health TV on May 30, 2018.

RIO DE JANEIRO, Brazil — This country has one of the best tobacco control programs in the world, resulting in a series of laws to protect non-smokers that the Brazilian government been put into place over 20 years. During this time, cigarette smoking has fallen by more than half.

And yet smoking is still a huge problem. Almost 15 percent of adult Brazilians still smoke, according to the Ministry of Health, causing 156,000 deaths per year. Every day, second-hand smoke kills seven Brazilians.

Though smoking has fallen dramatically among both men and women, there are still 21.5 million smokers in Brazil, which puts it in the top 10 countries in terms of number of smokers. And for every success achieved by the tobacco control movement – and there have been many – the cigarette industry fights back with all of the considerable resources at its disposal.

Obesity is rising almost everywhere, spurring a rise in chronic disease

This shows MyThali (My Plate), a new campaign of Arogya World to show urban Indian women a healthy diet in order to fight obesity and associated non-communicable diseases. Photo: Arogya World

This was originally published on Global Health TV on April 27, 2018.

The picture above shows the ideal, healthy plate of food for an urban adult woman in India – one cup of vegetable, one cup of rice, one and a half pieces of chapatti, one cup of protein (meat, lentil or sambar) and a half cup of yogurt. 

But too often this is not the typical meal of an Indian. Some people eat too much and become overweight or obese, particularly in urban areas. Obesity increases people’s likelihood of developing diabetes, to which Indians are predisposed. Meanwhile, some people, particularly rural adolescent girls, eat too little putting themselves at risk when they become pregnant at an early age.

So Arogya World, a U.S.-based organization committed to changing the course of non-communicable diseases (NCDs) in India, created MyThali (“My Plate”), inspired by the U.S. Department of Agriculture’s “My Plate” campaign and using the guidelines from India’s National Institute of Nutrition to encourage them to make healthier choices. Arogya World is aggressively implementing this campaign in workplaces across India.