Social enterprise for health, Brazilian style

With the leaders of Saúde Criança at their headquarters in Rio de Janeiro.

This was originally published on Global Health TV on April 27, 2014.

RIO DE JANEIRO, Brazil — One is poised to become the condom market leader in Brazil, with 40 variants in its Prudence condom line. Its newest offering features the flavor and scent of caipirinha, the iconic Brazilian cocktail made from cachaça, lime and sugar. DKT believes it prevented over 9,000 HIV infections in 2013.

Another rescues the poorest and unhealthiest children from the urban slums of Rio de Janeiro, Sâo Paulo and other cities, and nurses them – and their families – back to health.  Since its creation, an estimated 50,000 people have benefitted from its work.

They are very different global health organizations, with very different operating models, but both call themselves social enterprises, Brazilian style, and both were created in 1991.

Tuberculosis finally catching up to 21st century

This was originally published on Global Health TV on March 24, 2014.

Tuberculosis (TB) treatment, which had been lost in a time warp for a century, seems to be finally joining the 21^st century.

Until recently, there were no new TB drugs on the market in half a century, little progress in the treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) forms of TB and virtually nothing new on pediatric TB, according to David Greeley, the president and CEO of Accordia Global Health Foundation, who previously worked for the TB Alliance. The current vaccine, developed more than a century ago, is largely ineffective, he said. TB diagnostics were ancient, too, as is TB itself, which has been around since 4,000 B.C. Current treatment was cheap and sometimes effective but took a long time and misses a lot of people  (like children, and MDR and XDR patients).

Which is why the Stop TB Partnership has made those missing people the theme of this year’s World TB Day on March 24: “Reach the 3 Million.” That’s the number of TB patients the World Health Organization (WHO) estimates are “missed” by public health systems out of the 8.6 million who fall ill of TB each year.  Many of those 3 million live in the world’s poorest, most vulnerable communities and include groups such as migrants, miners, drug users and sex workers. Over 95% of TB deaths occur in low- and middle-income countries. India and China are the countries with the most TB patients.

In 2014, will family planning be able to sustain the euphoria of London and Addis Ababa?

Young Ethiopians partake in traditional coffee ceremony at the International
Conference on Family Planning.

This was originally published on the website of Global Health TV on Feb. 19, 2014.

2012 was a watershed year for international family planning, with the UK government and the Bill & Melinda Gates Foundation holding the high profile London Summit on Family Planning where new commitments of $2.6 billion were secured, enough to provide contraceptives for 120 million more women and girls in 69 very poor countries by 2020.

In 2013, this effort morphed into a global partnership dubbed Family Planning 2020 (FP2020). The process received a further moral and financial boost in November at the 3^rd International Conference on Family Planning in Addis Ababa, where five countries made new commitments (Benin, Democratic Republic of Congo, Guinea, Mauritania and Myanmar) and FP2020 released its first progress report on successes realized since the London Summit. Ethiopia was chosen as the conference site because of its status as an emerging family planning success story in Africa.

Movers, shakers, thinkers, doers converge on former N.C. mill town

This was originally published by the Huffington Post on April 9, 2014.

One is a British mobile phone guru who has become a storyteller of "reluctant innovators," propelling some of the most exciting social innovations outside the traditional development system.

Another is an architectural wunderkind from Togo in West Africa who leads a team that recycles old plastic bags into building materials.

And a third is a San Francisco Bay Area global health tech innovator who is building a web platform to help African countries make better decisions about HIV drug procurements. He speaks English, Punjabi, Spanish and Mongolian.

The three are very different but have at least two things in common: First, they are hellbent on changing the world. Second, they are converging on the tiny former mill town of Saxapahaw, North Carolina later this month to share their distinctive world views with hundreds of other global thinkers and doers.

In Ethiopia, the beat goes on, in music and health

Global youth dance at the beat making session at the International Conference on Family Planning in Addis Ababa. Credit: Laura Hoemeke/IntraHealth

This was originally published in the Huffington Post on Dec. 11, 2013.

ADDIS ABABA, Ethiopia -- In November, in a chilly outdoor amphitheater at the African Union headquarters here, Stephen Levitin, aka Apple Juice Kid, asked an audience of mostly young Africans and North and South Americans to suggest the best type of beat.

"Afro beat," one young African called out.

"Slow and sexy Afro beat?" Levitin asked. "Or fast and danceable?"

The consensus was fast and danceable. Then a percussive sound was chosen, and several of the young people -- each in his or her mother tongue -- recorded brief health messages of personal relevance to them.

And when they combined it all, the result was an original song. The group jumped to its feet and danced away the chill. Not a PowerPoint slide was to be seen anywhere.

Ethiopia: An emerging family planning success story

Delegates at the International Conference on Family Planning pose for a photo in front of DKT Ethiopia's coffee ceremony tent.

This was co-written with Andrew Piller and originally published on Impatient Optimists on Dec. 10, 2013.

When global family planning practitioners gathered in November for the Third International Conference on Family Planning, there was a timely relevance for meeting in Ethiopia. Over the last two decades, Ethiopia has become a family planning success story, one of only a handful of countries in Africa to achieve that status.

 Positioning of population and family planning at the center of development is critical.In 2000, Ethiopia’s contraceptive prevalence rate for modern methods was only 6.3 percent, which, at that time, was lower than any other country in Eastern and Southern Africa except Eritrea. By 2011, the rate had increased to 27.3 percent. Over the same period, the total fertility rate (the average number of children born to a woman in her lifetime) had decreased from 5.5 to 4.8.

Young people should lead efforts to improve sexual health

Members of a youth group in Addis Ababa meet regularly to debate sexual and reproductive health issues. Photo: Sheikh Rajibul Islam/duckrabbit

This was originally published on Impatient Optimists on Nov. 19, 2013.

ADDIS ABABA, Ethiopia -- A young Ethiopian woman went to a health clinic and found out she was pregnant. She was asked to take an HIV test and found out she was HIV positive. She told her husband she was pregnant but not about being HIV positive, and she suggested they be tested together. He refused, and said he would leave her if she got tested. She decided to have an abortion and went to a health professional who advised her against it. At that point, she decided to have her baby despite the fact that she had no support from her husband. 

That story was acted out in a session at the International Conference on Family Planning held here from November 12-15, but is based on a true story. It is one of many such storylines being played out in real life by the five million young people aged 15-24 living with HIV, especially by young women living with HIV, young sex workers, young men who have sex with men, young transgender people and young people who use drugs. This is true because they are the people least able to access sexual and reproductive health services, including family planning. They also face stigma and discrimination based on age, gender, HIV status and sexual orientation.