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  • Keeping up the momentum to control TB

    Dr. Timothy Mastro

    Dr. Timothy Mastro
    Photo: Leanne Gray/FHI 360

    World TB Day 2016 comes at a watershed time in the history of the tuberculosis (TB) epidemic and the broader global response to health and development. In recent years, we have expanded access to more sensitive TB diagnostic services, increased awareness about the important role of infection control within health care settings and have new treatment options for individuals with multidrug-resistant (MDR) TB. But, there is much work still to be done.

    TB now rivals HIV as the top global infectious disease, yet we have not applied the same vigor to controlling TB as we have to controlling the HIV epidemic. That time is no longer. We have the opportunity to mirror the advances gained toward ending the HIV epidemic, largely based on evidence, driven by ambitious targets and linked to well-designed guidance.

    In many parts of the world, HIV poses a particular challenge to TB control, which we cannot ignore. We have developed HIV prevention and treatment tools that will allow us to end the HIV epidemic, and we must add urgency to align these with TB control efforts. Doing so will assure successful outcomes in the fight against HIV and TB coinfection. The urgency comes from World Health Organization reporting that indicates mortality from TB eclipses mortality from HIV. The tremendous research and program advances from unprecedented investments in the HIV response must be leveraged to take control of TB morbidity and mortality.

    Dr. Carol Dukes Hamilton

    Dr. Carol Dukes Hamilton
    Photo: Leanne Gray/FHI 360

    This moment in time is particularly important as we transition to the Sustainable Development Goals (SDGs) that will guide policy and funding over the next 15 years and are linked to a pledge to end poverty, everywhere, permanently. While health is now only one of 17 goals, the shift in focus may bode well for control of TB, which is a disease of poverty exacerbated by malnutrition, overcrowding and poor hygiene.

    FHI 360’s TB initiatives strategically align with the SDGs. Our projects provide technical assistance to governments to yield evidence-based solutions to their local TB situations. We assist governments with improved disease surveillance so they can invest in ways that will yield the greatest impact by providing curative treatment and limiting new infections. We promote an approach that focuses on those most vulnerable in society because TB concentrates in the most marginalized populations of any given society. A human rights-based approach that engages affected communities is the basis for a sound, effective response.

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  • Accelerating progress on Zika through better family planning

    In a statement declaring the clusters of birth defects that appear to be linked to Zika virus infection in Brazil “a public health emergency of international concern,” the World Health Organization recommends important measures for tackling this emerging infectious disease threat: improving surveillance, developing better diagnostic tests, intensifying vector control efforts and carrying out other prevention and treatment measures.

    More remarkable were calls from public health officials in Colombia, Ecuador, El Salvador and Jamaica for women to postpone pregnancy until more is known about the association between the Zika virus and microcephaly, a severe birth defect affecting the brains of newborns. Salvadoran health officials have even advised women to delay pregnancy until 2018, when the risk of being infected with Zika may be lower.

    The spread of Zika in the Americas adds urgency to the need to help all women — and their male partners — avoid unintended pregnancies. But, women and couples in countries affected by Zika face formidable barriers to achieving their fertility intentions, including lack of access to contraceptives and other reproductive health services, some of the world’s most restrictive abortion laws and high rates of sexual violence.

    Placing the burden of protecting unborn children from the virus’ effects solely on women who have limited reproductive rights and contraceptive options is discriminatory and unsustainable. Expanding access to reproductive health services must be part of a comprehensive response to the Zika virus, and these services should be supported in ways that protect and strengthen the reproductive rights of women and girls.

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  • The age of integration

    The Sustainable Development Goals adopted by the United Nations in September provide an expansive vision of what we can accomplish over the next 15 years. Unlike the previous global development agenda, they include goals for all countries, not just poor ones, and more consideration for protecting our planet. The language also emphasizes that the new goals are integrated and indivisible, something the authors explain as win-win cooperation among the social, economic and environmental domains.

    Now that the new global agenda is officially launched with slick logos and celebrity endorsements, and as the cheers (and some boos) start to die down, it’s time to talk about the hard stuff: How do we actually operationalize an integrated development agenda?

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