After a long overdue absence, The Week in African Health is back. Subscribe to the blog to continue to get the latest news and innovations related to health and health care across the African continent.
Alanna reminds us all that if we overlook the intricate relationship between poverty and ill-health then we are set to misunderstand global health. “If you can read this, that’s not you. By definition, you speak English and you have access to the internet. You earn more than a dollar a day. You can’t understand.” For all the talk, analysis, and good intentions – we must remember that it is the poor who know best what interventions will work for better health around the world.
The guidelines emphasize testing for effective treatment. The WHO cites in 2008 that only 22% of suspected cases were tested in 18 of the reporting African countries. Thanks to new quality assured Rapid Diagnostic Tests (RDTs) that use a dip stick, testing is easier and quicker.This emphasis on testing will assist in stemming drug-resistance issues with quick and effective treatment.
South Africa has launched a massive HIV Testing campaign that marks a definite reversal from its past HIV/AIDS initiatives more focused on denial.
Beginning on April 15th, everyone who enters a clinic will be offered an HIV test, regardless of history or symptoms. Every health facility “should” be prepared to test by April, but the larger problem will then be access to medications and clinics have not yet been certified to distribute ARVs, especially those located in remote or peri-urban areas.
With 80% of all disease transferred by contaminated or dirty water, this MDG is a critical piece to improving health. Some countries are even set to exceed this goal by 2015. On the flip side the UN reports that unless “huge efforts” are made most countries will fail to achieve the sanitation MDG. This could be an unfortunate setback as clean water sources require proper sanitation to remain clean.
This is one of the lessons learned by young students in one of Namibia’s HIV/AIDS after-school courses. The primary student ended by saying, “People with AIDS should keep to themselves.” Some of the teaching may be misguided, but the program offers much needed psychosocial assistance to young children who have difficulty coping. One student learned he was HIV-positive 3 years ago at age 8, but that hasn’t ended his dreams of becoming a doctor someday.
A new program in East and Central Africa has printed 20,000 road maps that pinpoint the locations of roadside clinics where truck drivers can go for help with HIV/AIDS. One driver said, “Many of us want treatment but at times you might not know where to get it when you are on the road but these maps can help us now.” The wellness centres and clinics have been constructed in areas where high-risk populations converge.
The UN has selected a group of 24 social media envoys to tweet for malaria control. The WHO says that 3.3 billion people (half the world’s population) is at risk for malaria and sub-Saharan Africa is the epicenter where 90% of malaria deaths occur.
Nyala, Kalma camp, South Darfur - March 2007 (MSF Photo Blog)
The impact of conflict on the environment and then the subsequent, direct effect on human health cannot be overlooked. This internally displaced peoples (IDP) camp in Sudan shows the seriousness of that impact.
Everyone in the global health sector is writing about the incredible reach of SMS technologies working for health in developing countries, and rightly so. Hope Phones has partnered with FrontlineSMS to provide old cell phones to communities in need through SMSmedic partner organizations. More: Your Old Phone Can Change the World
TeleMed
A service that I just recently came across is one that is not being as widely talked about. TeleMed is different from FrontlineSMS: Medic because it connects local health care workers directly to patients in need via SMS technology. SMS: Medic is focused on health infrastructure. TeleMed does not have a website up yet, but is definitely one to watch:
The other big talk within global health is whether Paul Farmer will take a job within the US government. Some have expressed great hope for potential reform others voice their plea with him to continue his incredible community based work outside the bureaucracies. My opinion is that Partners in Health has developed into a strong organization and does not depend on Paul Farmer to further their work. If he wants to take on the inefficiencies and inadequacies of the US government and global health, then all the more power to him.
Broken promises abound as the economic crisis deepens and the right to health falters, but activists are coming together to ensure that funding for health and HIV are not cut. International donors are expected to slash budgets for health due to the economic crisis and health experts fear that this will lead to, “less food security and quality of nutrition, which will in turn put more stress on already weak health systems.” Paula Akugizibwe, regional treatment literacy and advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia demanded, “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.” Tanzania was the first sub-Saharan country to announce a 25 percent cut of its annual HIV/AIDS budget. Other budget cut impacts: Guinea: Medicines Running Out
On Wednesday, the Livingstone High Court was supposed to hear a ground breaking case about whether mandatory testing for HIV and discrimination solely on the basis of HIV status is constitutional in Zambia. Unfortunately two days later news came that the trial was postponed until mid-July. Be sure to keep watching this story. More: Trial postponed until 15 July
Mara Gordon writes on Change.org’s Global Health Blog about a direct campaign in Tanzania discussing behavior change. “This campaign is partially paid for by the President’s Emergency Plan for AIDS Relief, U.S. government money to fight HIV that’s notoriously had lots of conservative strings attached. Had I seen this ad a year ago, I probably would have dismissed it as unrealistic abstinence-only propaganda. But behavior change works. Behavior change – in combination with access to condoms, comprehensive sexual education, open discussion about HIV and sexually transmitted infections in general, all that good liberal stuff.” More: Changing Human Behaviors: Sexual and Social
During a course on Africa’s environmental history I wrote about the need for changing human behavior in both the sexual and social arena to make a real impact in HIV prevalence. The major social change is the response from Western institutions and organizations in how they talk about HIV/AIDS and Africa while seeking to change sexual behavior. Lesotho: Cultural Beliefs Threaten Prevention of Mother-Child HIV Transmission
Health workers note an encouraging response to the PMTCT program. The number of facilities providing PMTCT has risen from nine in 2004 to 166 by the end of 2008. The number of women who received PMTCT and subsequent antiretroviral (ARV) treatment increased from 421 in 2004 to about 5,000 by end of last year, according to 2009 National AIDS Council statistics. “The primary health care coordinator at St. James Mantsonyane Mission Hospital, Khanyane Mabitso, says stigma and cultural beliefs make it difficult for medical personnel to follow up on HIV-positive mothers and their babies.”
Many advances have been made in health. Some argue that these advances have been dwarfed by the HIV/AIDS epidemic, the economic crisis, or the failures of African governments. The WHO report shows that the only statistic with concrete results was the number of children dying before the age of five. Is this a solid example of the failure of big plans and blanket goals for development?
The Anti-Corruption Committee report provides a number of recommendations for reform all focused on improving the health care delivery services in Sierra Leone and eliminating the risk of corrupt practices in the health services across the country. More on health service scale-up: Chad: Paving the Way for Better Obstetric Care
Government meetings with UNICEF to help scale-up of health services for better obstetric care across the country.
Speaking at a gala reception in Washington marking the beginning of “Africa Week,” Carson said: “Most of the Obama administration’s Africa team is in place, and we are gearing up. We will continue to build on and strengthen the strong bipartisan consensus in Congress and among the people of America that has motivated U.S. policy towards Africa. Over the next four years, we will be focusing our efforts on strengthening democracy, promoting sustainable development, resolving or mitigating conflict, and dealing with transnational issues such as climate change and agriculture,” he pledged. While Obama has built a great team, the White House has yet to announce any Africa Policy, greater control and influence for the Bureau of African Affairs, or take any serious (or effective) action for the continent. More: Tanzania: Obama, Kikwete Meet in Oval Office on Africa’s Conflicts
Zimbabwe owes the World Bank and the African Development Bank more than $1bn, how much potential does renewed aid really hold for the country. If the debt is not forgiven there will be no way the country will be able to rebuild necessary infrastructures for health, water, etc. There are countless case studies to show this historical fact. It must also be noted that Western sanctions were a huge detriment to a country in need, maybe this marks a turnaround?
