Health

  • December 18, 2014

    Can women living with HIV and taking antiretroviral therapy use hormonal contraceptive methods?

    Written by
    Chelsea Polis, Senior Research Associate, Guttmacher Institute
    Kavita Nanda, Senior Medical Scientist, Contraceptive Technology Innovation Department, FHI 360

    Extraordinary gains have been made in the last decade toward increasing access to antiretroviral therapy (ART) for HIV. With an eye toward ending the AIDS epidemic by 2030, UNAIDS recently released bold targets related to HIV diagnosis and treatment. By the year 2020, their aim is to have 90 percent of all people living with HIV aware of their status, 90 percent of people diagnosed with HIV receiving sustained ART and 90 percent of people on ART achieving viral suppression. As we move closer to these laudable public health goals, we must also consider how expansion of ART may affect and be affected by other health issues, such as prevention of unintended pregnancy among women living with HIV.

    An increasingly important issue is whether certain ART regimens are expected to have drug interactions when used with certain hormonal contraceptive methods. In theory, an interaction could affect the efficacy of either medication or cause side effects or toxicity. If contraceptive efficacy decreases, the chances of contraceptive failure, unintended pregnancy and the accompanying consequences increase. A decrease in ART efficacy could lead to treatment failure, viral resistance and greater likelihood of subsequent HIV transmission. Increases in side effects or toxicity can affect quality of life and medication adherence. Yet, despite the importance of this issue, relatively few studies (particularly those with clinical outcomes such as ovulation, pregnancy or treatment failure) have been conducted.

    Continue reading

  • December 12, 2014

    Learning from failure in global development

    Written by
    Tricia Petruney, Technical Advisor, Research Utilization, FHI 360

    One of the most promising trends in global development is the rising priority of understanding and investing in “what works.” As the funds available for international assistance have flatlined in post-recession years, everyone from donors to practitioners has become increasingly committed to making decisions that are informed by evidence. Given FHI 360’s commitment to research utilization, we’re encouraged by the attention being paid to evidence-informed development. Yet, the best-kept secret within the growing what works movement is the importance of learning not just from our successes, but also from our failures.

    Based on typical nongovernmental annual reports, scientific conferences and even social media content, one can be forgiven for forming the impression that our development efforts are nearly perfect. Successes are proudly packaged in glossy formats and heavily disseminated, whereas any objectives not achieved are relegated to the obligatory and typically short lessons learned section. Yet, this practice does not accurately represent an important reality: Development efforts do in fact fail.

    Venture capitalists and corporate investors understand that less than 20 percent of new businesses will succeed, and they invest in innovations and new ideas with a transparent acknowledgment of the high risk for failure.

    So why, by comparison, is the global development enterprise so different?

    Read the remainder of the blog here.

  • December 10, 2014

    Inextricable links: HIV and human rights

    Written by
    Kevin Osborne, Project Director, LINKAGES, FHI 360

    The AIDS epidemic has been characterized by the stigma and discrimination of people who are all too often already on the margins of society.

    This marginalization has made it more difficult for millions of people on every continent to access much-needed HIV prevention, treatment, care and support services. As we recognize International Human Rights Day on Dec. 10, we cannot lose sight of the inextricable link between HIV and human rights, which should be the cornerstone of our response to and understanding of this epidemic.

    And there is, perhaps, reason for cautious optimism. Despite some policy gains and increased global attention, HIV continues to disproportionately affect “key populations” — men who have sex with men, sex workers, people who inject drugs and transgender people. UNAIDS estimates that 40 to 50 percent of new adult HIV infections worldwide occur among key populations and their partners.

    Read the remainder of the blog here.

  • December 1, 2014

    Bringing heart and mind to the fight against HIV

    Written by
    Elizabeth Tolley, Senior Scientist, FHI 360
    Dr. Timothy Mastro, Director, Global Health, Population and Nutrition, FHI 360

    The rapid spread of the Ebola virus through human-to-human contact — compelled by the urge to embrace a family member with symptoms of infection, to transport a neighbor to the nearest clinic, to nurse the infected or bury the dead despite the lack of basic protective gear — reminds us of the complex relationship between health and human behavior.

    Like Ebola, HIV was once an emergent infectious disease. Although HIV may take years rather than days to kill its victims, similarities exist between HIV and Ebola in the conditions that facilitate their spread and the challenges to containing both diseases. Highly stigmatized, those who fear infection may avoid being tested or disclosing to loved ones; those diagnosed may face limited treatment options provided by harried health care workers within overburdened health care systems.

    Now in its fourth decade, the fight against HIV has seen tremendous breakthroughs in medical technology. A spectrum of antiretroviral (ARV) treatment options now exists and is available around the globe. Clinical studies have proven that taking a daily oral ARV-based pill can reduce a healthy person’s chance of getting the infection — and, other types of ARV prevention products (i.e., gels, rings and injections) are on the horizon. Increased testing through provider-initiated strategies has increased access to both treatment and prevention technologies. There is even some thought that we will have a cure for HIV one day.

    Continue reading

  • November 25, 2014

    Ending the AIDS epidemic

    Fast Track: Ending the AIDS Epidemic by 2030

    To mark World AIDS Day, the Joint United Nations Programme on HIV/AIDS (UNAIDS) recently launched its annual report on the state of HIV/AIDS globally. This year’s report, Fast Track: Ending the AIDS Epidemic by 2030, presents new targets to avert 28 million new HIV infections and end the AIDS epidemic as a global threat by 2030.

    The new UNAIDS “fast-track” approach emphasizes the need to focus on the counties, cities and communities most affected by HIV and recommends that resources be concentrated on the areas with the greatest impact.

    The report also contains the latest data on the state of the epidemic globally.

    More details about the report are available, including a press release, a fact sheet, infographics and social media messaging.

    Follow #FastTrack and @UNAIDS to join the conversation.

  • November 21, 2014

    UNFPA’s State of World Population 2014 report

    SWOP2014The United Nations Population Fund (UNFPA) recently launched the 2014 State of World Population report, which focuses on the vital role of adolescents and youth in the economic and social progress of developing countries. The Power of 1.8 Billion: Adolescents, Youth and the Transformation of the Future makes the point that young people matter.

    According to the report, nine in 10 of the world’s 1.8 billion young people live in less developed countries, where the young encounter obstacles to education, health and a life free from violence. Without intervention, many of these young people may never realize their full potential.

    Follow #SWOP2014 to join in the conversation.

    Learn more about The State of World Population 2014.

  • November 12, 2014

    A private-sector intervention addresses leading cause of child mortality

    An Interview with
    Saikat Mukhopadhyay
    How has DAZT’s partnership with the private sector led to better health outcomes in maternal and child health?

    In India, it is important to reach patients through the private sector. At the onset of the project, we conducted a survey that showed that only approximately 67 percent of the people afflicted with diarrhea sought medical treatment, and of this population, more than 80 percent went to a private practitioner. Moreover, in rural and impoverished areas there is a lack of formal medical facilities for those seeking care and treatment for diseases such as diarrhea.

    We are trying to ensure that rural populations receive the best treatment for diarrhea. In order to do that, we must reach the private, rural medical providers (RMPs) who are providing the majority of patient care, especially at the bottom of the economic pyramid. RMPs are not formal doctors, but follow doctors’ patterns for prescribing medicine. They frequently do not have up-to-date information on the most effective ways to treat diarrhea in children. They often prescribe only antibiotics and antidiarrheals, which can be harmful.

    To change this, we started by encouraging formal doctors to prescribe zinc and ORS. We then worked with RMPs to change their prescribing behavior.

    Continue reading

  • November 11, 2014

    Multiple pathways to women’s economic empowerment

    Written by
    Andrea M. Bertone, Director, Gender Department, FHI 360

    Andrea BertoneAt FHI 360, we take a 360-degree perspective to addressing the most complex human development needs. We envision many pathways to girls’ and women’s economic empowerment — through education; training; access to resources; and the elimination of social, political and gender-related barriers.

    To increase equality between girls, boys, women and men, we believe that a gender perspective has to be integrated into every aspect of all development programs.

    FHI 360 supports women and girls living in poverty, through cutting-edge interventions in health, nutrition, education and economic development interventions. Not only are we implementing some of the U.S. Agency for International Development’s (USAID’s) flagship projects on HIV care, prevention and support — we are also working with multiple donors implementing girls’ education projects as a pathway out of poverty.

    We are addressing women’s poverty in value chains, small and medium businesses, and micro-lending and savings and loan activities. Equally important, we work to engage men and boys as partners and agents of positive social change.

    Why prioritize attention on women and girls? For FHI 360, it comes down to three simple reasons:

    • It is the right thing to do.
    • It improves project outcomes.
    • FHI 360 has strong political will to do so at all levels of the organization.

    We aim to impact in the short, medium and long term the lives of women and girls in many countries. We want to improve women’s and girls’ current access to resources, their economic empowerment, their levels of education and their resiliency in the face of hardship.

    Continue reading

  • November 7, 2014

    Technology alone is not enough

    Written by
    Patrick Fine, Chief Executive Officer, FHI 360

    In 1879, Thomas Edison unveiled his incandescent light bulb. Within six years, electric power had spread across the nation and ignited an explosion of invention that created new industries and thousands of jobs and transformed every aspect of society. A century later, in 1978, Steve Jobs introduced the Apple personal computer and unleashed another wave of innovation that reaffirmed our faith in the power and potential of technology to drive human progress.

    I was reminded just how high our expectations are for technology at two events in September: the U.S. Agency for International Development’s Frontiers of Development conference and the Clinton Global Initiative’s annual meeting, each of which showcased inventions, tools and concepts to improve public health and raise living standards. A few of the breakthrough innovations highlighted at these events or in recently announced grants include:

    Continue reading

  • November 7, 2014

    Making the connection between vasectomy, family planning goals and development

    Written by
    Dominick Shattuck, Scientist, Social and Behavioral Health Sciences, FHI 360

    Dominick ShattuckWorld Vasectomy Day offers an opportunity to consider how vasectomy can contribute to development. This underused contraceptive method is particularly important as countries work toward achieving the Family Planning 2020 goals, which include providing an additional 120 million women and girls in the world’s 69 poorest countries with access to voluntary family planning information, services and supplies by 2020.

    The number 120 million is a lot of women and girls to reach, and it raises an important question: What role do men play in achieving this target?

    Robust family planning initiatives protect women’s and children’s health, help fight HIV infection, reduce abortion and give women control over when they become pregnant.1 When experts and leaders from 150 countries gathered for the 2012 London Summit on Family Planning, they recognized that providing comprehensive access to contraceptives is both beneficial and achievable. They identified metrics to measure their success.

    Vasectomy programs can make a strong contribution to fulfilling the Family Planning 2020 goals while allowing men to more fully participate in family planning. Vasectomy is safe, effective and one of the least expensive contraceptive methods.2 Vasectomies are provided more quickly — and are safer— than female sterilization.3

    Continue reading