Rapid response to Ebola outbreak

There are concerns that the latest Ebola outbreak in the Democratic Republic of Congo may not fizzle out as has happened with the other most recent outbreaks there. This time the outbreak is near the Congo River, a transport route to Kinshasa. Officials are worried this could lead to a rapid and more widespread outbreak of the disease. In response, the DRC and U.N. agencies have begun deploying rapid response teams to prevent the spread of Ebola.

Devex reports that early funding pledges have also been announced in response to the outbreak of Ebola.

The United Kingdom government pledged 1 million British pounds ($1.36 million) on Thursday through the Joint Initiative on Epidemic Preparedness, with the Wellcome Trust committing a further 2 million pounds to support rapid response to the outbreak. The funds will be made available to the DRC government and WHO for research to support the operational response, according to a statement from the Wellcome Trust.

WHO released $1 million from its Contingency Fund for Emergencies to support response over the next three months, with the goal of preventing the disease from spreading to surrounding areas.

may 15, 2018

Two bug killers better than one

Mosquito nets infused with two pesticides work much better against malaria than those with only one, reports the British Medical Journal (BMJ). The nets, investigated in a recent study reduce prevalence in children by 44 percent.

As a result of the findings, published in The Lancet last month, the World Health Organization has used them in areas where mosquitoes have developed resistance to the first-line insecticide. The new nets contain pyrethroids, a class of chemicals used in nets for over a decade, along with the newer compound, piperonyl butoxide, which blocks mosquitoes’ ability to break down pyrethroids. (It is sometimes called a “pesticide synergist.”)

“It is hard to find new insecticides suitable for nets, because they must kill or repel mosquitoes and yet be safe for the babies and youngsters who sleep under them. The insecticides also must be able to stand up to washing and intense sunlight”, reports the BMJ.

may 7 2018

Health care for all

As the World Health Organization (WHO) is working to accelerate universal health care (UHC), The Economist writes that this idea of health care for all is affordable.

“A country need not wait to be rich before it can have comprehensive, if rudimentary, treatment. Health care is a labour-intensive industry, and community health workers, paid relatively little compared with doctors and nurses, can make a big difference in poor countries. There is also already a lot of spending on health in poor countries, but it is often inefficient. In India and Nigeria, for example, more than 60% of health spending is through out-of-pocket payments. More services could be provided if that money—and the risk of falling ill—were pooled.”

Chile and Costa Rica spend about an eighth of what America does per person on health and have similar life expectancies. Thailand spends $220 per person a year on health, and yet has outcomes nearly as good as in the OECD. Its rate of deaths related to pregnancy, for example, is just over half that of African-American mothers. Rwanda has introduced ultrabasic health insurance for more than 90% of its people; infant mortality has fallen from 120 per 1,000 live births in 2000 to under 30 last year.

Research led by Dean Jamison, a health economist, has identified over 200 effective interventions, including immunisations and neglected procedures such as basic surgery. In total, these would cost poor countries about an extra $1 per week per person and cut the number of premature deaths there by more than a quarter. Around half that funding would go to primary health centres, not city hospitals, which today receive more than their fair share of the money.”

“So long as half the world goes without essential treatment, the fruits of centuries of medical science will be wasted”, writes the Economist. Universal basic health care can help realise its promise.

april 30, 2018

A place where sex workers can be safe

Senegal is the only place in Africa where sex workers are regulated by the state. Identification cards confirm the women as sex workers and give them access to some free health care, condoms and education initiatives.  The Economist asks why this small west African state is so different.

The Senegalese system has its roots in the country’s colonial legacy. French legislation that regulated prostitution in order to prevent the spread of sexually transmitted diseases was kept on the books after independence in 1960, when many other Francophone countries dropped it. In the 1980s Senegal responded to the HIV epidemic sweeping across the continent by establishing a range of policies to counter the threat, and to target vulnerable populations. One measure involved revamping the regulation of sex work, which under the French had required sex workers to register with the authorities. The system was reinforced after the HIV epidemic and the authorities tried to get as many women as possible to sign up.  

Today, the law enshrines a woman’s right to work in the sex trade if she is over 21. Health check-ups are mandatory and in fact a woman can have her sex worker identity card declared invalid if she does not go for regular check-ups.

In most other African states, sex work is criminalized, which leads to higher HIV infection rates, because women are reluctant to visit health care facilities.

april 23, 2018



Factfulness: Why Things Are Better Than You Think 

He challenged the doom-and-gloomers in global health by challenging preconceptions and misconceptions. Now, a year after his death, a book by Hans and Ola Rosling and Anna Rosling Rönnlund, gives us ten reasons why we’re wrong about the world. In the book, Factfulness: Ten Reasons We're Wrong About the World--and Why Things Are Better Than You Think, the authors ask why so many people — including Nobel laureates and medical researchers — get the numbers so wrong on pressing issues such as poverty, pandemics and climate change. The book isolates the ten instincts that lead to what Rosling calls the “overdramatic worldview”: that pervasive, generally pessimistic global perspective that often cancels out significant progress made in the face of vast challenges.

Rosling also covers five risks that we “should worry about”: global pandemic, financial collapse, a new world war, climate change and the extreme poverty that still afflicts 700 million people. 

The book ends with a plea for a factual world view. Rosling was optimistic that this outlook will spread, because it is a useful navigational tool in a complex world, and a genuine antidote to negativity and hopelessness.

(This is a shortened version of an article, Swansong of Hans Rosling, data visionary, by Jim O’Neill published in Nature).

April 11, 2018

Beer promotion and health - not a good mix

The Global Fund is pulling out of a partnership with beer company Heineken – just weeks after the controversial deal was made.

Many working in public health had been highly critical of the partnership, entered into by the new executive director of the Global Fund to Fight AIDS, TB and Malaria, Peter Sands. Alcohol abuse is closely associated with health and behavioral risks.

For weeks, The Global Fund defended the decision. In a short statement the Global Fund says Heineken is being cut off because of ‘the company’s use of female beer promoters in ways that expose them to sexual exploitation and health risks’…”.

april 3, 2018

Addressing poverty could be just as effective in tackling TB as drugs and vaccines

A study looking at the links between people living on less than $1.90 a day and the coverage of various social programmes in 192 countries found that eradicating extreme poverty would lead to an 84% reduction in tuberculosis (TB) cases by 2035.

Nine scientists and policymakers carried out research examining incidences of TB for a study that appears in Lancet Global Health. The conclusions were reached by looking at the links between people living on less than $1.90 a day and the coverage of various social programmes in each country. Researchers then related this to the current levels of TB, projecting the associations forward 20 years. More than 95% of deaths from TB occur in low- and middle-income countries, so the association between poverty and TB are well established. However, researchers say the latest findings are significant in providing new evidence of the links.

“This study is important to show that preventative measures have great impact,” explained Daniel Carter, research fellow at the London School of Hygiene and Tropical Medicine.

Tuberculosis is among the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB and a further 1.7 million died from the disease.

march 26, 2018

Tipping point for control of TB

A senior WHO official in Southeast Asia has good news to share about a recent push to end tuberculosis (TB) as a public health threat. Dr. Poonam Khetrapal Singh, the Regional Director of WHO Southeast Asia, says the drive to end TB has reached a tipping point.

In TB-affected countries, including those of the Southeast Asian region, domestic funding for TB programs has increased dramatically. In some countries – such as India – it has trebled. That political will was reinforced this week, when, at a TB summit in New Delhi, India, ministers of health and representatives of the WHO Southeast Asia Region – the world’s most TB-affected region – developed and adopted a Statement of Action – a manifesto that will intensify momentum to end TB’s unconscionable burden, both in the region and across the world.

Also, to date, global support for national and regional initiatives has been strong. Last year’s Ministerial Conference on TB in Moscow is a good example. There, ministers of health from across the world expressed their desire to get things done – to make TB a vestige of history, exactly as it is in much of the developed world, with donors pledging to provide the resources needed to chart bold progress.

Critical to present momentum is WHO’s recently elected leader, Dr. Tedros Adhanom Ghebreyesus. He has made it his personal mission to combat, with renewed vigor, the heartbreaking afflictions that destroy the lives of millions of people across the world, with a special focus on harnessing the full power of health coverage for all. Importantly, those afflictions include TB.

Dr. Singh says the momentum must be maintained to bring real change to the lives of millions of people and, in the process, create a healthier, more prosperous, and secure world.

"The drive to end TB has reached a tipping point. Now is the time to accelerate it".

The full artivle can be found in The Diplomat.

March 19, 2018

From #MeToo to Mothers and the link between health and wealth

Women are on the agenda this week at the 62nd session of the Commission on the Status of Women being held at the United Nations Headquarters in New York from 12 to 23 March 2018.

This week, The Lancet writes: “No one could have failed to notice the rise of women in the collective consciousness over the past year: their under-representation at the highest levels in the workplace, their discrimination in terms of pay, and their ongoing subjection to power-related assaults in the form of physical, psychological, and sexual violence and harassment.

"The World Economic Forum's latest Gender Gap Report shows a chasm between the countries with the greatest gender parity (Iceland, Norway, Finland, Rwanda) and those with the least (Chad, Syria, Pakistan, Yemen)."

Simply put: the poorest countries are also the ones with the greatest gender gaps.

In a comment, also in The Lancet, The Gambia Women in Science Working Group highlight how gender barriers still exist on a much more fundamental level in regions such as Africa. The perception of women and men as intellectually equal (by both men and by women themselves) is still not a given, and flexible working hours, parental benefits, and quality daycare (both for young children and elderly parents) are a distant dream to many.

Journalists can make a difference by highlighting these issues and finding stories of women who are breaking through these barriers.

Read the full article here: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30105-0/fulltext

March 13, 2018

Prosperity Hinges on Health Security

Advocates for global health security hoped that the 2014 West African Ebola outbreak would be the game changer that would finally spur meaningful, coordinated investment in health security—and break the recurrent cycle of panic and neglect towards epidemics. There is compelling evidence that epidemics can push back years of progress in development gains, as was seen with the Ebola-affected countries.

Indeed, in the immediate aftermath of Ebola, there were significant investments in health infrastructure. The moral argument is clear-cut: epidemics cost lives—in some countries, much more than others. Some of the most epidemic-prone countries are the least prepared to address epidemic threats. However, moral arguments are not always the most effective means to sway policy makers, as highlighted by the recent drop in bilateral investments in global health security. With complacency creeping up, and the scaling back of bilateral support for disease surveillance and preparedness programs in “hotspot" countries, we once again face a heightened risk for another pandemic.

In this climate, there is a pressing need to strengthen the investment case for health security. But how? At the World Economic Forum (WEF) in Davos, Switzerland, pandemics were on the agenda. They should always be, alongside other prospective economic issues for the 21st century, like job security, cross border trade, and economic growth. Global financial stakeholders must proactively acknowledge the critical links between economic prosperity and global health security. Before the powerful men and women return to Davos for the next WEF Annual Meeting, we hope to see a place reserved for the economic risks from infectious threats. The overarching message is clear—outbreaks, whether they happen at home or abroad, pose a threat to economies everywhere.

(This is a shortened version of an essay in GlobalHealthNow, a publication of the Johns Hopkins Bloomberg School of Public Health).


March 3, 2018