Health

  • November 30, 2015

    Want a Healthy World? Let the HIV Response Lead the Way

    Written by
    Dr. Timothy Mastro, Director, Global Health, Population and Nutrition, FHI 360
    Mitchell Warren, Executive Director, AVAC
    Dr. Timothy Mastro

    Dr. Timothy Mastro

    World AIDS Day 2015 comes at a watershed moment in the fight for the health of people living with HIV and for the health of all the citizens of this planet. The two are intimately related: HIV has, for the last three decades, defined the landscape of ambitious, collaborative and innovative responses that marry science, rights, community-based responses and structural change. Ultimately, these responses can be leveraged to improve health everywhere, but only if we continue to make real progress in battling HIV.

    In recent years, collaborations between research teams and thousands of volunteers in clinical trials have yielded insights into how to use HIV prevention and treatment options to end the epidemic. These insights have led to the Joint United Nations Programme on HIV/AIDS (UNAIDS) “Fast-Track” approach to ending the epidemic, which sets ambitious targets for a range of interventions, including 27 million voluntary medical male circumcisions by year 2020, three million people on daily oral pre-exposure prophylaxis (PrEP) annually, major reductions in violence against women, improvements of human rights and, of course, the 90-90-90 targets for 2020: 90 percent of all people living with HIV will know their HIV status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (ART) and 90 percent of all people receiving ART will have viral suppression.

    Mitchell Warren

    Mitchell Warren

    The world has gotten this far because of massive investments in the HIV response. To actually end the epidemic, though, it is imperative that we resist complacency, cutbacks in funding and a sense that, on any level, our work is done.

    Over the last 15 years, the Millennium Development Goals guided the global response to development. Health, including controlling HIV, figured prominently in these goals. In September, the members of the United Nations adopted the Sustainable Development Goals (SDGs), which will guide policy and funding for ending poverty everywhere over the next 15 years. Health is one of 17 goals. To meet it, funders, implementers and country governments will need to be smarter with investments in HIV/AIDS. This means working side by side with people living with and most affected by HIV to develop rights-based approaches and efficient and community-supported service delivery models. And, it means thinking beyond any single health issue and toward integrated approaches that both fight HIV and contribute to ending poverty, hunger and inequality.

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  • October 26, 2015

    Five ways to make universal access to family planning a reality

    Written by
    Lucy Wilson, Monitoring and Evaluation Advisor, FHI 360
    Ward Cates, Distinguished Scientist and President Emeritus, FHI 360
    Young woman smiling

    Photo: Jim Daniels/FHI 360

    World leaders recently ratified the 17 Sustainable Development Goals, which set 169 ambitious targets to be achieved by 2030. Reaching these goals would greatly improve the lives of people worldwide. Women and girls have much to gain, especially because two of the targets call for ensuring universal access to sexual and reproductive health services, including family planning.

    Given the contributions that family planning can make to nearly all 17 of the goals, we think that universal access to family planning could be a Sustainable Development Goal of its own. Still, the global community has taken a big step in the right direction.

    Now, how can we ensure that universal access to family planning becomes a reality? Here are five ways.

    1. Bring new and lower-cost contraceptive methods to market.

    More than 225 million women in developing countries want to avoid or delay pregnancy but are not using an effective method of family planning. For many of these women, the currently available products do not meet their needs and preferences.

    Some popular methods in the United States, such as the levonorgestrel-releasing intrauterine system (LNG-IUS), remain largely unavailable to women in developing countries because of cost. The introduction of more affordable products, such as the new LNG-IUS from Medicines360 and Sino-implant (II), can be game changing for diversifying the method mix accessible to women.

    Researchers are also developing novel methods of long-acting, highly effective contraception, such as a biodegradable implant and a longer-acting injectable.

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  • September 29, 2015

    Beyond the health benefits, what does family planning have to do with the SDGs?

    Written by
    Tricia Petruney, Technical Advisor, Research Utilization and Integrated Development, FHI 360

    A version of this post originally appeared on K4Health. Reposted with permission.

    The international community is abuzz with excitement about the new global development agenda, the Sustainable Development Goals (SDGs). Officially being launched this month, the aims laid out are more ambitious and all encompassing than ever before. As such, they’ve generated an expectedly broad, diverse and loud chorus of suggestions for their implementation. Everyone seems on the hunt for the best new idea or technology to carry the agenda forward. Yet, after decades of work and untold millions of dollars in investments in research and ideas, surely we must know something useful today that could be put to good use? Perhaps while smartly pursuing innovations that keep pace with our changing world, we can also put some real investment behind some of even the simplest things that we already know to be true and which might just need a little more traction before we can finally benefit from their full potential impact.

    For example, right now we have a tool available to us that spans almost every SDG. It’s a relatively inexpensive solution that can simultaneously improve global outcomes in education, health and wealth. It can help preserve our environment and ensure food security for people around the world. You may be wondering why you have not heard of this amazing tool, but it’s far from new. Drumroll … it’s fully meeting the global demand for contraception. That’s right — sound evidence from around the world tells us several things.

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  • September 14, 2015

    Srey Sros: Addressing the needs of transgender populations in Cambodia

    Written by
    Amy Weissman, Associate Director, HIV Prevention and Innovation, FHI 360
    Srey Sros model

    A transgender model promotes the Srey Sros program. Photo: Graphic Roots Studio, Cambodia

    I have three long-haired boys, and wherever we go in Cambodia, people are confused, certain they are girls. We are constantly asked, “Why?” The answer is simple: They like having long hair. My boys’ push against traditional gender expressions is perhaps acceptable only because Cambodians have come to expect odd behavior from foreigners.

    Yet, it is a different matter for a Cambodian transgender individual with long hair. Transgender individuals in this setting face many acute challenges, and their unconventional appearance is only one of them.

    Transgender individuals in Cambodia carry a high burden of HIV. According to a study conducted by FHI 360 in select urban centers of the country, transgender individuals have an HIV prevalence of 4.15 percent (compared to 0.6 percent for the general population). Despite this striking percentage, they have historically been left out of HIV prevention and care programs. When they were included, they were incorrectly targeted as men who have sex with men. This means that there were no distinct behavior change communications or services for this group.

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  • August 21, 2015

    Youth and long-acting, reversible contraception: Confronting the myths with truth

    Written by
    Ward Cates, Distinguished Scientist and President Emeritus, FHI 360
    Marta Pirzadeh, Technical Officer, FHI 360

    Youth and contraception: two words that when used together excite visceral responses throughout the world. The response is even more fraught when we consider long-acting, reversible contraceptives (LARCs) for youth. Both intrauterine devices (IUDs) and implants are LARCs, and the challenges for young people who wish to use them — lack of access, myths and misconceptions, provider bias and community stigma — are pervasive. We have to understand more about these challenges in order to overcome them.

    In late May 2015, FHI 360 and partners — U.S. Agency for International Development, PSI, MSI and Pathfinder International’s Evidence to Action project — sponsored a symposium, called “For Youth, a Healthy Option With LARCs” in Washington, DC. The meeting convened more than 100 experts from around the world, including program advisors and implementers, researchers, health providers, donors and advocates, as well as young people themselves. The meeting’s goal was to encourage participants to share experiences, tackle tough questions and advocate for wider access to LARCs for young women.

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  • July 21, 2015

    Two landmark studies provide evidence to recommend earlier initiation of antiretroviral therapy

    Written by
    Leanne Gray, Communication Specialist, FHI 360

    Final results from two research studies presented at IAS 2015 yesterday demonstrated clear scientific evidence on the benefits of early initiation of antiretroviral therapy (ART). Building on early results of HPTN 052 released in May 2011 that then showed a 96 percent reduction in HIV transmission, the study results presented yesterday provide conclusive evidence that ART should be provided to all HIV-positive people as soon as they are diagnosed for the benefit of both themselves and their sexual partners.

    Jens Lundgren of the University of Copenhagen presented the initial results of the Strategic Timing of AntiRetroviral Treatment (START) study, a randomized trial looking at whether starting ART in people with CD4+ cell counts above 500 cells/mm3, rather than waiting for CD4+ cell counts to drop below 350 cells/mm3, reduces the occurrence of serious morbidity and mortality. START was recently unblinded by the international Data & Safety Monitoring Board (DSMB) 18 months early due to data that showed very clear benefits of immediate treatment versus delayed treatment. Previous studies and guidance from the World Health Organization (WHO) suggested that ART should not be given to patients unless they had symptomatic HIV and/or CD4+ counts that were below 350 cells/mm3. The interim results from START show that ART is safe and effective for all HIV-infected persons regardless of CD4+ count.

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  • July 8, 2015

    Connecting the dots: Advancing contraceptive R&D through partnerships and knowledge sharing

    Written by
    Laneta Dorflinger, Distinguished Scientist, Director of Contraceptive Technology Innovation, FHI 360
    Kate Rademacher, Technical Advisor, Contraceptive Technology Innovation, FHI 360
    Lucy Wilson, Monitoring and Evaluation Advisor, Contraceptive Technology Innovation, FHI 360

    To optimize opportunities to make groundbreaking advances in contraceptive research and development (R&D), the global health community must help connect the dots to facilitate new partnerships between groups that often work in silos. For example, there is the company in the United States that is developing a promising drug delivery platform but hasn’t yet considered applying the research to contraceptive products. There is the university scientist who has an idea for a new contraceptive product but is unsure whether similar investments are being made in the private sector. There is the small company based in the global South that wants to enter the international market but lacks experience registering its contraceptive products in sub-Saharan Africa.

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  • June 29, 2015

    Improving adolescent sexual and reproductive health in Bangladesh through the Sustainable Development Goals

    Written by
    Kathrin Tegenfeldt, Bangladesh Country Director, FHI 360
    Kate Plourde, Technical Officer, FHI 360

    In mid-June, we had the opportunity to attend a national consultation with members of Parliament in Bangladesh on integrating sexual and reproductive health and rights into the proposed Sustainable Development Goals (SDGs). The consultation was hosted by the Family Planning Association of Bangladesh with support from the International Planned Parenthood Federation.

    Bangladesh has made impressive strides toward achieving the Millennium Development Goals. It has met the gender parity goals for primary and secondary education and is on track to fulfill the tertiary education goals. Bangladesh has also met the under-five mortality-reduction rate goal and is likely to reach the goal of reducing maternal mortality.

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  • June 19, 2015

    Saplings and contraceptives: Results from a population, health and environment project in Kenya

    Written by
    Theresa Hoke, Director, Health Services Research, FHI 360

    East African countries like Kenya have made great strides in recent decades in increasing access to modern contraception, leading to marked declines in fertility rates. But disparities remain.

    The 2014 Kenya Demographic and Health Survey showed that rural women have a total fertility rate of 4.5 children per woman versus 3.1 for urban women, and the poorest women have more than twice as many children on average than the wealthiest. Meanwhile, unmet need for contraception among poor and rural Kenyan women is higher than any other groups. Clearly, innovative solutions are needed to support women and couples in poor, remote rural areas in achieving the number and timing of pregnancies they desire.

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  • June 12, 2015

    Advancing a no-missed-opportunities approach through integrating family planning and immunization services

    Written by
    Chelsea Cooper, Social and Behavior Change Communication (SBCC) Advisor, Jhpiego
    Kate Rademacher, Technical Advisor, FHI 360
    Rebecca Fields, Senior Technical Advisor, Immunization, John Snow Inc. (JSI)
    A no-missed-opportunities approach recognizes that every service contact presents an opportunity to comprehensively address women’s and children's health needs. Credit: Chelsea Cooper, MCHIP

    A no-missed-opportunities approach recognizes that every service contact presents an opportunity to comprehensively address women’s and children’s health needs. Credit: Chelsea Cooper, MCHIP

    When Lorpu*, a mother in Liberia, brought her baby to a clinic to receive routine immunizations, she was also counseled about family planning and offered a contraceptive method. Lorpu expressed relief about having received same-day provision of both family planning and immunization services: “When I go for [my child’s] vaccine, I can also get family planning. I don’t have to leave and come back.”

    Lorpu received these integrated services as part of a pilot program in Liberia implemented by the U.S. Agency for International Development’s (USAID) predecessor flagship Maternal and Child Health Integrated Program (MCHIP) and the Liberian Ministry of Health and Social Welfare. In participating clinics, women who brought their infants for routine immunization services were provided brief messages about family planning by the vaccinator and offered a referral for same-day services. This approach, now used by MCHIP’s successor program, the flagship Maternal and Child Survival Program (MCSP), has led to substantial increases in family planning uptake, and women have expressed positive feedback about the convenience of having access to both family planning and immunization services during the same visit.

    Integrated health care delivery is critical in the year after childbirth, when there are numerous opportunities to reach women and their infants with services — including postnatal care, immunization, growth monitoring and family planning. A no-missed-opportunities approach recognizes that every service contact presents an opportunity to comprehensively address women’s and children’s health needs.

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