Health

  • My first stop when I arrived in Nakasongola, Uganda, on a hot day in 2004 was the small hospital that served this rural district north of Kampala. I was paying a courtesy call to the District Medical Officer, Dr. Gerald Ssekito. He looked tired when I arrived, explaining that he and other hospital staff had not slept the night before. A pregnant woman had been brought in on the back of a motorbike in the middle of the night. She had delivered the first of her two twins the day before in her remote village, but continued laboring at home unable to birth the second. Finally, after 24 hours, her family put her on a motorbike for the long journey to the hospital, but she bled heavily and died on the way to the hospital.

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  • #NextGenFP: Envisioning the future of family planning

    This week, more than 3,700 participants will gather in Kigali, Rwanda, for the fifth International Conference on Family Planning (ICFP). What is at stake? The lives and well-being of an estimated 214 million women of reproductive age in developing countries who want to avoid or delay pregnancy but are not using an effective form of modern contraception.

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  • Preventing and responding to infectious disease outbreaks

    Are we prepared for the next infectious disease outbreak?

    In this episode of A Deeper Look, I speak with Dr. Jonathan Quick, Senior Fellow Emeritus at Management Sciences for Health and author of the new book, The End of Epidemics: The Looming Threat to Humanity and How to Stop It.

    A leader in epidemic prevention and control, Jonathan talks about the diseases we should worry about the most and why, the success stories and lessons learned in responding to epidemic and pandemic outbreaks, and what we need to do to be prepared for the next outbreak.

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  • Two perspectives on the life-changing DREAMS partnership

    The Determined, Resilient, Empowered, AIDS-free, Mentored and Safe women (DREAMS) partnership aspires to reduce HIV infections among adolescent girls and young women in 10 sub-Saharan African countries. These countries alone accounted for more than half of the HIV infections that occurred among adolescent girls and young women globally in 2015.

    DREAMS reaches beyond the health sector to address the direct and indirect factors that increase girls’ HIV risk, such as poverty, gender inequality, sexual violence and inadequate education. Interventions can include paying school fees, providing bicycles to girls who would otherwise walk long distances to school, supplying sanitary napkins for menstrual hygiene management and offering mentoring to help girls avoid early pregnancy, gender-based violence and discrimination. DREAMS is supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare.

    Two young women who participate in DREAMS projects attended FHI 360’s 2018 Gender 360 Summit and discussed how DREAMS is making a difference in their lives. Here are their stories.

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  • New journal supplement on key populations is here!

    A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.

    JIAS July 2018 issue coverThe USAID– and PEPFAR-supported LINKAGES project is excited to announce the arrival of a new supplement in the Journal of the International AIDS Society (JIAS) titled Optimizing the Impact of Key Population Programming Across the HIV Cascade.

    A collaboration among LINKAGES, USAID, CDC, amfAR, and JIAS, this supplement contributes new evidence and data-driven strategies for improving programming with men who have sex with men, sex workers, transgender people and people who inject drugs. It contains 14 original articles that represent a range of multidisciplinary efforts from diverse geographies to advance key population science and practice across the HIV prevention, care and treatment cascade.

    As HIV services are scaled up in pursuit of 90-90-90 targets, investments to address the epidemic among key populations must be central to these efforts. Global data indicate that gains made among key populations lag substantially behind those made in the general population. This supplement aims to accelerate progress toward controlling the epidemic by bringing visibility to new evidence and approaches that can make key population programming smarter and more effective.

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  • A future without AIDS begins and ends with key populations

    A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.

    “We will only achieve HIV/AIDS epidemic control if we reach the UNAIDS 90-90-90 targets for all ages, genders, and at-risk groups, including key populations.”

    – Ambassador Deborah L. Birx, MD, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, June 2018

    In 2013, UNAIDS set out to establish new global targets for HIV testing, care and treatment. Stakeholder consultations were conducted at country and regional levels around the world, ultimately resulting in the creation of the ambitious 90-90-90 targets to help bring an end to the AIDS epidemic:

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  • Achieving HIV epidemic control: Going the last mile and beyond

    The focus of the global effort to end the HIV/AIDS epidemic, now 37 years on, is epidemic control, which the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) defines as limiting the annual number of new HIV infections in a country to less than the number of deaths among people living with HIV.

    Sub-Saharan Africa, home to 26 million (70 percent) of the global total of 36.9 million people living with HIV, is where the battle must be won. To succeed and sustain the gains achieved in the past 15 years, countries in Africa will need to assume greater responsibility for managing their epidemics.

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  • Reducing commodity costs when scaling up contraceptive implants … A classic chicken vs. egg dilemma

    A version of this post originally appeared on Exchanges, the Contraceptive Technology Innovation Exchange blog. Reprinted with permission.

    Listen to an interview with Markus Steiner and Kate Rademacher on the reductions in the prices of implant commodities.

    Contraceptive implants have been available for over 30 years and are one of the most effective methods available. Until recently, however, international donors did not procure significant quantities, and use of the method in developing countries was very low. This access barrier was largely due to the high cost of implant commodities. The situation mirrored the classic, paradoxical question: which came first, the chicken or the egg? In this case, without lower commodity prices, procurements of implants would not increase in many international settings. But without higher volumes, manufacturers couldn’t lower their prices and still achieve a sustainable business model.

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  • There’s no more time to waste: Let’s find the missing cases of TB

    Tuberculosis (TB) has now overtaken HIV as the world’s leading cause of mortality. There were about 10.4 million TB cases in 2016, despite the fact that TB is an old and often curable disease whose incidence declined in industrialized countries long before the introduction of the TB vaccine and anti-TB drugs. TB continues to disproportionately affect low-income countries. For those of us who work in public health, this is tragic — we ought to be moving forward at a much faster pace to end TB for good.

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  • Building the case for contraceptive technology innovation

    Why do women who do not want to get pregnant choose not to use modern family planning methods? While this question is not bounded by geographies, the most recent Guttmacher Institute report, which focused on the low- and middle-income countries, is most illuminating. The two most common answers given by married women were health reasons/side effects or fear of side effects (26 percent) and claims of infrequent sex or not being sexually active (24 percent). Among unmarried women, infrequent sex (49 percent) was the top reason.

    Equally informative are recent FHI 360 findings from a user preference study in Uganda and Burkina Faso showing that 75 percent of women currently using a method would be open to trying new technologies. It quickly becomes clear that existing methods do not satisfactorily address the changing needs of women throughout their 30- to 40-year reproductive journey.

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