Dr. Timothy Mastro, FHI 360’s Chief Science Officer, offers his perspective on where we’ve been, where we’re going and what’s at stake in human development.
The global pandemic and ensuing social and economic disruptions have led to significant uncertainty about the future and the need for global actors to adapt. While we may not have a crystal ball to show us what is to come, this month’s guest on A Deeper Look podcast, Lars Gustavsson, may be the next best thing. Lars studies global issues and phenomena to predict megatrends and their accelerants, so that we can effectively plan for and respond to them.
For the past six years, FHI 360 has worked with community schools in New York City and Hempstead, Long Island. When COVID-19 hit earlier this year, the way we did our work immediately shifted away from focusing on in-person supports for students and families. Our first hurdle was bridging the digital divide, that gap between who has access to technology and the internet— and the skills to use them — and who doesn’t.
Antimicrobial resistance — when bacteria stop responding to and become resistant to antimicrobial medications — is a global public health emergency with a substantial economic impact. Resistant bacteria, sometimes called superbugs, already claim 700,000 lives annually worldwide. If left unchecked, the death toll could reach 10 million per year by 2050, according to a recent United Nations report. The World Bank estimates associated global health care costs could increase more than $1 trillion per year by 2050.
Even before the onset of a global pandemic, societies were grappling with rapid, disorienting change. The COVID-19 pandemic, with its public health emergency and economic and social crises, has reshaped how development priorities and operations work. These extraordinary times have brought into focus that human development challenges are not unique to poor countries, and that the current conditions are going to amplify and accelerate the need for transformational relationships to address the global challenges confronting the international community.
The impact of the COVID-19 pandemic in the United States has been unlike anything most of us have seen in our lifetimes. Conditions such as stay-at-home orders, wearing masks in public and the highest unemployment rate since the Great Depression affect all of us in different ways.
Digital communications and media are now part of everyday life for many people around the world. But while people have turned to smartphones for entertainment, socializing and commerce, the health community is still working to make services, outreach and treatment digitally accessible. Examining successful applications allows us to understand what approaches might be possible for digital health services. During the COVID-19 pandemic, it is more crucial than ever that digital health resources provide support for people to access from their homes.
Around the world, more than 1.2 billion children are out of the classroom due to the COVID-19 pandemic. Living rooms have transformed into classrooms. Lesson plans have gone virtual. What are the challenges that parents, students and teachers are facing as they suddenly shift to remote learning? How have, and how will, the adaptations that school systems are making to continue operating during a pandemic shape education in Africa in the future?
More than ever, American Indians and Alaska Natives face some of the greatest challenges in the United States. Resources — including food, housing, medical care and family support services — have been inaccessible or nonexistent for years. During the COVID-19 pandemic, those resources have become even scarcer. According to researchers at the Harvard Project on American Indian Economic Development, the COVID-19 crisis is “devastating tribes’ abilities to fund their governmental services and forcing tribes to make painful decisions to lay off employees, drop workers’ insurance coverage, deplete assets and/or take on more debt.” At the same time, some Native communities have experienced disproportionately high numbers of COVID-19 infections and deaths.
While much progress has been made to end the HIV epidemic, not enough has been done to put the power of prevention directly in women’s hands. The dapivirine ring, a flexible silicone ring inserted monthly into the vagina, can change this. If approved by regulators, the ring would be the first discreet, long-acting HIV prevention tool available specifically for women. The ring would complement daily oral HIV pre-exposure prophylaxis (PrEP) as another biomedical tool in the fight against HIV.
Recent evidence suggests significant acceptability of and demand for vaginal rings as a drug-delivery platform among women who used the dapivirine ring during clinical trials — and also among policymakers and other stakeholders in countries with a high HIV burden. To better understand these perspectives, the OPTIONS Consortium interviewed policymakers, implementers and civil society leaders in seven sub-Saharan African countries about possibilities for introduction and scale-up of the dapivirine ring. An analysis of the interviews shows widespread enthusiasm for the ring as part of comprehensive HIV prevention programming.
The increased pressure on public health systems to respond to the COVID-19 pandemic affects all routine health care, including the provision of essential HIV services. People living with HIV require regular access to treatment, but crowded public health facilities carry increased risk of exposure to COVID-19. Routine treatment sites also may be harder to reach because of stay-at-home orders, curfews and public transportation shutdowns. To maintain gains in HIV epidemic control, we must ensure that people needing antiretroviral therapy (ART) continue to receive medication uninterrupted.