Health

  • Should PEPFAR be renamed the “President’s Epidemiologic Plan for AIDS Relief”?

    The full version of this post originally appeared on R&E Search for Evidence. Reposted with permission.

    The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is a remarkable success story built on the effective use of data. The achievements of this landmark initiative have played a central role in getting us to the point where we can finally talk about controlling the HIV epidemic and creating an AIDS-free generation.

    Through 2016, US$70 billion has been invested in this unprecedented disease control effort. The accomplishments to date have been extraordinary and unimaginable just a few years ago: In 2016 alone, 74 million people were tested for HIV infection; since the start of PEPFAR, 2 million babies were born HIV-free due to women receiving prevention of mother-to-child HIV transmission (PMTCT) treatment; 12 million voluntary medical male circumcisions have been performed; and PEPFAR accounted for 12 million of the 18 million people globally receiving life-extending antiretroviral therapy (ART).

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  • Global health in the age of the SDGs

    Over the past 15 years, we have witnessed major declines in child and maternal mortality and progress in the fight against HIV, tuberculosis and malaria in countries around the world. Still, an estimated 5.9 million children under 5 died in 2015, mostly from preventable causes. That same year, 2.1 million people became newly infected with HIV, and an estimated 214 million people contracted malaria.

    In this podcast, I speak with Dr. Muhammad Ali Pate, an eminent physician and CEO of Big Win Philanthropy, an independent foundation that invests in children and young people in developing countries to improve their lives and to maximize demographic dividends for long-term economic growth.

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  • Let’s acknowledge that gender-based violence also affects transgender people and other key populations

    This blog also appears on the LINKAGES blog.

    Last year, a friend and colleague, Beyonce Karungi, wrote about what it is like to be a transgender woman in Uganda. She talked about being rejected by family members and about being beaten up and burned with cigarettes for being transgender. She described being harassed by police who wanted to make her a “proper man.” She recounted being raped at gunpoint by a client when she was a sex worker, because she insisted that he use a condom. Beyonce wrote that “… from the standpoint of a transgender woman like myself — our human rights and unique challenges are not addressed and not given the attention they deserve.”

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  • Keeping girls in school in Malawi means better health and a brighter future

    Mary Mittochi

    Photo: Ed Scholl/FHI 360

    In this Q&A, Mary Mittochi, the project director for DREAMS: Malawi Communities Investing in Education for Child Health and Safety, discusses how this new project will reduce the acquisition of HIV by adolescent girls and boys. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) named FHI 360 as one of the winners of the DREAMS Innovation Challenge. The DREAMS partnership, led by PEPFAR with support from the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare, is helping adolescent girls and young women become Determined, Resilient, Empowered, AIDS-free, Mentored and Safe.

    As one of the 56 DREAMS Innovation Challenge winners, how will FHI 360 help adolescent girls and young women become Determined, Resilient, Empowered, AIDS-free, Mentored and Safe?
    FHI 360’s DREAMS: Malawi Communities Investing in Education for Child Health and Safety project will focus on integrated, community-led efforts designed to ensure that education, health and economic drivers for staying in school and completing secondary education are simultaneously addressed and strengthened. Over time, this will reduce the incidence of HIV in adolescent girls and boys. By keeping girls in school and connecting them to a comprehensive range of services and supports, we aim to equip them and their communities with the knowledge and agency they need to make more informed choices about their health and their future.

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  • Trickle-down health care

    Do investments in private hospitals and clinics catering to the wealthy strengthen primary health care systems in poor countries?

    At a recent roundtable discussion in New York City, a representative of a private equity group presented plans to build private hospitals in emerging markets, such as Kenya, as one of the best ways to strengthen primary health care delivery. For most of us who have worked on strengthening health systems, investing in hospitals that cater to the well-off doesn’t sound like the best way to meet the health needs of the poor.

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  • What does it take to control an epidemic? Learning from Thailand’s experience

    Earlier this summer, the HIV/AIDS effort achieved a notable accomplishment that the rest of the public health community may have overlooked, missing an important learning opportunity. In June, the World Health Organization certified that Thailand achieved what was inconceivable just 20 years ago: elimination of mother-to-child transmission of HIV. Thailand is the first country with a generalized HIV epidemic to achieve this milestone, one that is crucial to epidemic control.

    Two decades ago, the HIV epidemic was expanding in Thailand. Use of antiretroviral drugs to prevent mother-to-child HIV transmission was an expensive, newly discovered intervention that had barely been implemented in areas of the world where resources were limited and the disease burden was greatest.

    Despite these challenges, only 85 children were born with HIV infection in Thailand in 2015, compared to 1,000 children in 2000. This remarkable achievement resulted from a combination of essential factors:

    • Strong national leadership
    • A solid, functional health care system
    • A commitment to extending health care services to all people in the country, including undocumented individuals

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  • 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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  • 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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  • 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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  • Women and girls deserve better

    How can an adolescent girl succeed in school if she is not protected from sexual violence inside the classroom? How does a child thrive when his mother must choose between buying medication or nutritious food? We know that poverty, lack of access to education, poor health and violence are intimately linked, and how we tackle these problems is a global issue with important implications for the way the United States funds international development programs for women and girls. At the moment, we tend to compartmentalize our efforts in top-down, single-issue solutions, not because that is the most effective way to meet the needs of women and girls, but because it meets the needs of funders and their implementing partners. As we enter the new era of the Sustainable Development Goals (SDGs), we need to do better.

    There is an obvious starting point.

    We need to be a lot more deliberate and get a lot better at integrating efforts to improve the well-being of women and girls. Given the siloed nature of how we organize development work, especially in terms of funding and specialized expertise, we tend to think and act with narrowly predetermined notions of cause and effect. As a result, we miss vital connections and opportunities for action and impact. For example, I recently asked an African Minister of Health what was the biggest obstacle to women’s and girls’ health, and he immediately responded, “access to transport” to get to health facilities and obtain medicines. And yet, how often does transport come up as a priority when funders and development agencies plan health programs?

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