More From the Blog

  • Keeping male contraceptive research front and center

    Developing a new male contraceptive might seem like a daunting challenge. But, novel approaches, identification of new genetic targets and more expansive research on acceptability could lead to the development of a game-changing male contraceptive in our lifetime. In recognition of World Contraception Day 2016 (September 26), we are pleased to share this five-part blog series, Keeping Male Contraceptive Research Front and Center. In this series, the Contraceptive Technology Innovation (CTI) Exchange brought together experts in the field to discuss the state of the science. Over the next several months, the CTI Exchange will continue hosting other guest authors who will offer insights on this subject. The CTI Exchange is a knowledge-sharing portal managed by FHI 360 experts. 

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    Does epidemic control inadvertently reinforce inequality?

    HIV clinic in Mozambique

    An HIV clinic in Maputo in Mozambique. Photo: Talea Miller/PBS NewsHour/CC BY-NC

    Over the last two years, ministries of health in sub-Saharan Africa and other countries with a high burden of HIV/AIDS have implemented strategies that concentrate resources on high prevalence areas and key populations.

    Encouraged by their donor partners, such as PEPFARUNAIDS and The Global Fund, these strategies employ a biomedical approach that focuses on suppressing the viral load in the population in line with UNAIDS’ 90-90-90 objectives to reduce new infections and bring the HIV epidemic under control. If successful, this approach holds out the tantalizing prospect of ending the AIDS epidemic by 2030.

    Often referred to in U.S. government circles as “the pivot,” this shift in strategy reflects constrained foreign assistance budgets as well as a number of successes in fighting AIDS over the last decade. We now have more robust surveillance methods that allow us to better target disease hotspots and key populations, countries have improved diagnostic and laboratory capacity that enable more rapid and sophisticated analyses, and new therapies allow people who are HIV positive to treat HIV/AIDS as a chronic condition instead of a death sentence. Call it the triumph of the medical epidemiologists.

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  • Armed conflict and education inequality: What do we know?

    What do Ethiopia, Nepal, Niger and the Philippines have in common? Each country had episodes of conflict in the 1990s, and each bucked the global trend of declining education inequalities in a subsequent time period. Researchers have long puzzled over the relationship between inequality and civil conflict: Do grievances over a lack of access to resources or social capital actually lead people to go to war? For some academics, the question is met with skepticism, as empirical research has often led to inconclusive results. Recent changes in the way inequality is conceptualized and measured have changed the way people think about this connection.

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  • A Deeper Look: Making development more relevant and effective

    How can we make our work more relevant and effective?

    Earlier this summer, FHI 360 held its first summit on integrated development, Greater Than the Sum of its Parts. Ben Ramalingam, a researcher and the Leader of the Digital & Technology Cluster at the Institute of Development Studies, delivered our keynote address. While Ben was in town, we talked about how to maximize the effectiveness of international development and how we need a paradigm shift to generate real change.

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    Why we shouldn’t be working ourselves out of a job

    Patrick FineRecently, I heard the head of a nonprofit organization that works in Africa declare that the goal of his organization is to work itself out of a job.

    “With your support now,” he assured the audience, “in just a few years, our help won’t be needed.”

    This is an old adage among development workers and one that is especially popular with some funders, such as the U.S. Congress, who think of foreign assistance as global philanthropy to provide a short-term hand up — not a hand out.

    With this view goes the belief that if we just do a good job, then prosperous, well-governed communities will quickly take root and eliminate the need for further assistance. After all, that’s what happened in South Korea. Unfortunately, success in one country does not predict success in another, and all the evidence on social and economic development tells us we still have a long row to hoe.

    If you date the modern era of international development to the emergence of the post-World War II world order and the end of European colonialism in the late 1950s, then we’ve been trying to work ourselves out of a job for more than 60 years.

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  • The issues we must address to #EndHIV4Her

    Adolescent girls and young women continue to be at unacceptably high risk for HIV infection. UNAIDS estimates that 7,500 girls and young women, 10 to 24 years of age, become infected with HIV every week, with the highest rates in southern and eastern Africa. Girls and young women account for 71 percent of new HIV infections among adolescents in sub-Saharan Africa, highlighting the gender disparity in this age group. Despite active prevention efforts, recent clinical trials in southern Africa have measured new HIV infection rates of 4 to 6 percent per year among young women. It is imperative that we implement aggressive measures to decrease new HIV infections among girls and young women.

    Our current HIV prevention package of HIV testing, behavioral risk reduction, management of sexually transmitted infections and condom use is inadequate because young women often lack the ability to control their risk. The evidence is clear that the source of HIV infection for most girls and young women in southern Africa is older men. For young women, a complex mix of economic dependency, limited educational opportunity, gender inequality, unequal power dynamics and social norms leads to a lack of choice of how and with whom to have sex.

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  • A conversation on coming to terms with the high cost of human development

    How do we measure nonprofit organizational effectiveness?

    I was delighted to have a conversation with Jeri Eckhart Queenan, Partner & Global Development Practice Head at the Bridgespan Group, about the challenges in financing development. This was a great opportunity to discuss emerging trends in how organizations manage their programs in order to deliver the most effective results while maximizing value for their stakeholders, especially the beneficiaries of their work.

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  • Does evidence tell us that integrated development approaches work? It depends!

    ID Summit logoWhen we tackle complex, global challenges and their many root causes, intuition tells us that development initiatives need to be more holistic — the approaches may need to be as interconnected as the problems. Even the Sustainable Development Goals (SDGs) agenda states its aims are integrated and indivisible. Yet, the critically important question, “What evidence supports integrated development in practice?” can best be answered through the saying “context is king.”

    Integration is an umbrella phrase that can describe thousands of different cross-sector approaches — from health and microfinance, to nutrition and education, to conservation and livelihoods. Consider how evidence showing huge impacts in the integration of savings groups with girls’ education would be relevant for people trying to decide whether to integrate agriculture and environmental conservation. Context matters. A lot. What is being integrated with what? How? For what purpose?

    Global development decisionmakers must resist the temptation for a simple, universal answer to whether integration works. The notion that any one gold-standard study on its own will answer the integrated development hypothesis is false. Evidence for cross-sector approaches will always depend on the specific sectors, geography and people in question.

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  • What do AIDS 2016 in Durban and integrated development have in common?

    A version of this post originally appeared on Huffington Post. Reposted with permission.

    As FHI 360 and the global health community prepare to travel the “Road to Durban” to the 21st International AIDS Conference (AIDS 2016), it is poignant to reflect on how far we have come since the AIDS 2000 meeting held in Durban, South Africa. I recommend taking the time to read a recent message from the conference organizers titled, The Return to Durban: A Critical Moment in History.

    After reading the piece, I was reminded of what a critical role the entire development community, including organizations like FHI 360, has played in the global response to HIV. I am inspired every day to witness how the broad global response has rallied around the concept of building on the available evidence and advancing integrated development solutions — which is why we continue to make real and sustainable progress in battling HIV.

    As part of FHI 360’s deliberate approach to advancing integrated development solutions, we will be hosting a summit June 13, 2016, in Washington, DC, titled, Greater than the Sum of its Parts: The Power of Integration. The event will be a space for innovative thinking, learning and dialogue that will focus on the “how” to achieve the Sustainable Development Goals. The discussions will include global development leaders and practitioners, policymakers, donor organizations and other change-makers.

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  • Integrated development approaches are challenging but resonate with clients

    Tamimah grew up in Nakuru, a community in Kenya’s Rift Valley where the rate of HIV infection is high and where many young people don’t graduate high school. Tamimah’s early home life was precarious: Her mother left her and her three younger siblings, and her father provided limited support. The children were raised primarily by their grandmother.

    Before Tamimah turned 13, her grandmother died, leaving the children without primary support. Tamimah and her two sisters and brother struggled to take care of themselves, stay in school and be healthy. It was “very hard to grow up in this place,” Tamimah said.

    Things began to shift, however, when they were recruited to take part in APHIAplus, an FHI 360 project focused on improving health care delivery and multisector services to vulnerable populations in the Rift Valley. Through APHIAplus, which is funded by the U.S. Agency for International Development, Tamimah gained access to health education and services. She also received support to cover the costs of her school fees and supplies.

    From these multipronged activities, there was a ripple effect: She was able to stay in school. Upon graduation, Tamimah studied tailoring through a vocational program also offered through APHIAplus and was able to provide for her siblings. After a year, she saved enough to open Al Hamis Café, named after her brother.

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