Discussion of climate change typically involves natural phenomena: raging wildfires, record flooding, ruinous drought. Less frequently examined, but equally important, is the effect of our warming planet on a child’s right to education.
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The global resurgence of tuberculosis (TB) over the past decades has been fueled by emerging drug resistance, co-infection with increasingly prevalent HIV and decreasing investments in public health systems. These challenges call for innovative, strategic approaches and more efficient, cost-effective programs. TB CARE I is a coalition of seven international TB control organizations, each with offices in most of the TB-priority countries for the U.S. Agency for International Development (USAID).
FHI 360 is the lead coordinating partner in Cambodia, Mozambique and Zambia and a collaborating partner in Indonesia and Nigeria. The program focuses on specific technical areas, including early case detection, improved laboratory capacity, management of drug-resistant TB, HIV/TB co-infection and health systems strengthening. FHI 360 and TB CARE I assist countries to move toward universal access to TB treatment by working with communities most at risk to reduce morbidity and mortality through increased case detection and treatment.
The three videos below produced by TB CARE I are great visual portrayals of how TB has affected lives in Cambodia and the Dominican Republic. Visit TB CARE I’s website to see other videos like these, and to learn more about the project.
Triumph Over MDR-TB
Multidrug-Resistant TB or MDR-TB is a serious form of TB which is resistant to at least the two most powerful TB drugs. As MDR-TB is difficult to cure, it requires treatment for a minimum of 20 months with drugs which often have severe side-effects. In this video Yim Chann (Cambodia) will tell you about his triumph over MDR-TB
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In hot pursuit: Don’t stop now!
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This year began on an optimistic note for scientists, policy makers and those most affected by tuberculosis, with the licensing of a drug that represents the first new approach to treating the disease in more than 40 years. This year’s World TB Day gives us an opportunity to reflect on the progress we have made in confronting this ancient but persistent disease, as well as the challenges that remain. This year, with budget issues threatening the immediate future of medical research, the approval of a new tuberculosis treatment sheds light on the path ahead.
The newly licensed drug, known as bedaquiline or Sirturo, is important because it has shown promising results against tuberculosis that has become resistant to other treatment – often called multidrug-resistant (MDR) tuberculosis. I served on the [U.S. Food and Drug Administration] FDA advisory panel that recommended approval of the drug and I was happy that the agency concurred. However, we need not just one, but several new drugs to put together in successful combination if we are to avoid the mistakes of the past and avoid a future where tuberculosis is again a highly fatal, untreatable disease. Now is the time to put our foot on the accelerator, not the brakes.
In the middle of the last century, tuberculosis was considered conquered. Today, it is the world’s second leading infectious disease killer, taking nearly 2 million lives each year. Furthermore, a frightening proportion of new cases of tuberculosis in China, Eastern Europe, India, Russia and South Africa are resistant to current first-line drugs. With air travel, cross-cultural exchanges and immigration, patterns of resistance are steadily making inroads in the United States as well. HIV has fueled tuberculosis across Africa, Asia and Eastern Europe, while the drugs and diagnostics have become increasingly outdated. The disease, in short, has evolved faster than the tools developed in the last century to fight it. Now, it is estimated that more than 1,000 people infected with HIV die every day from tuberculosis, a curable disease.
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FHI 360’s Julia Rosenbaum discusses the power of small doable actions in water supply, sanitation, and hygiene (WASH) programs. FHI 360’s WASHplus program, funded by the United States Agency for International Development (USAID) supports healthy households and communities by delivering interventions that lead to improvements in access, practices and health outcomes related to WASH and indoor air pollution. For more information on WASHplus, please visit www.washplus.org.
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March 14, 2013
Today, the United Nations Development Programme released its 2013 Human Development Report. The theme of the report is The Rise of the South: Human Progress in a Diverse World and examines the rapid progress made by many developing countries toward improving the lives of their citizens by bringing millions out of poverty.
“The rise of the South has resulted not from adhering to a fixed set of policy prescriptions, but from applying pragmatic policies that respond to local circumstances and opportunities — including a deepening of the developmental role of states, a dedication to improving human development (including by supporting education and social welfare) and an openness to trade and innovation.”
Read the report here.
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Having multiple sexual partners, particularly when relationships overlap in time, is a major driver of the HIV epidemic. Overlapping, or concurrent, relationships increase the number of people who are connected in a “sexual network,” and HIV spreads more quickly the larger the sexual network. Although young people report having multiple sexual partners, few HIV prevention programs for youth tackle this topic.
FHI 360, on behalf of USAID’s Interagency Youth Working Group, recently helped address this gap with a new publication, Promoting Partner Reduction: Helping Young People Understand and Avoid HIV Risks from Multiple Partnerships. The late Dr. Doug Kirby of ETR Associates was a major contributor.
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Reflecting on International Women’s Day: Progress made by the international development community
An Interview with
Andrea Bertone, Gender Expert, FHI 360
The theme of International Women’s Day 2013 is The Gender Agenda: Gaining Momentum. How have we made progress on gender equality?
We have made a lot of progress since Hillary Clinton has been in the leadership position of Secretary of State. Clinton pushed to have the development, diplomatic and even the defense communities pay attention to gender in the U.S. foreign policy arena. In addition, last year the U.S. gender policy was updated for the first time in thirty years. That was a big step forward. Gender is not only about women and girls. Gender is about the relationships between men and women, as well as the social dynamics and the norms that frequently lead to women and girls being at a disadvantage in many societies.
How does FHI 360 integrate a gender perspective into its work?
We developed a Gender Integration Framework, which is a set of guidelines that encourages FHI 360 staff working on programs and research to take gender issues into consideration from the start of a project through implementation. We formed a gender advisory council, which includes representatives from all of our major business units. We are also looking strategically at how we can include gender issues in proposals, provide technical assistance to our projects and more effectively talk about gender to our external audiences. I would say there is a lot of momentum and commitment to implementing our Gender Integration Framework.
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Addressing grievances and giving everyone a voice are key to peacebuilding
An Interview with
Elizabeth Hume, Technical Director for Peacebuilding and Conflict Mitigation, FHI 360
Anne O'Toole Salinas, Program Director for Peacebuilding and Conflict Mitigation, FHI 360
How does conflict affect a country’s long-term development?
Violent conflict sets a country’s development back decades, especially when it is protracted as it was in Sri Lanka and as it is currently in the Casamance region of Senegal. Even countries that create peace agreements but do not address the grievances or the sources of conflict are more likely to experience conflict again within 10 years. It is critical to work on mitigating and managing conflict in countries. Otherwise, we are simply pouring hundreds of millions of development dollars into a country and seeing those gains wiped out by violent conflict. That is why working on conflict is so critical.
How do we deal with conflict?
The first step is understanding the grievances that led to the conflict. Grievances can arise in a number of areas and can be found across many sectors. Because we are a global organization that works across sectors — such as health, education, economic development and the environment — we are able to address specific grievances in these different sectors.
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It is no secret that those who face poverty are the most vulnerable to disease. Disparities are widespread, especially in health, here in the United States and around the world. We know that the reasons for this are multifaceted and that to tackle the topic of poverty and health requires a multilevel, multidisciplinary conversation, where ideas are shared with the goal of sparking innovation and generating new ways to improve global health.
The Impact of Poverty on Health is one of twenty challenges our friends at TEDMED are tackling through their Great Challenges program. So many health challenges are complex. They have medical and non-medical causes and affect the well-being of millions of people around the world. These knotty problems are not susceptible to simple cures, magic bullets or one-size-fits-all solutions.
I had the opportunity to moderate the first TEDMED Google hangout on poverty and health, where leaders from around the world came together online to initiate an open dialog. Questions such as how to integrate the social determinants of health as a “must have” discussion among medical students, and the ways access to education plays a vital role in people’s understanding of health, were discussed. The Google hangout format allowed hundreds to listen via live video and participate by sending their questions and ideas through Twitter and Facebook. It brought people from different backgrounds and perspectives together to discuss health equity, which affects us all in one way or another. Although solving the issue was not the main goal, I think that solutions may already be brewing in the hearts and minds of those who participated.
You can also participate in this dialog by watching the session below. Add your thoughts on Twitter by using the hashtag #greatchallenges.
TEDMED Great Challenges is a program sponsored by the Robert Wood Johnson Foundation.
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The evolution of implants
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2013 marks the 30th anniversary of the initial approval of Norplant®, the first long-lasting, reversible contraceptive implant. An innovation in contraception, the Norplant system consisted of six rods implanted in a woman’s upper arm that provided up to five years of pregnancy prevention – offering women the same discrete, highly effective, long-term, and reversible contraception offered by the IUD, without the need for a pelvic examination.
Inserting and removing six rods proved cumbersome, however, so Norplant never gained much traction globally. In the 30 years since its introduction, contraceptive implant technology has continued to evolve. Norplant’s successor, Jadelle offers the same level of pregnancy prevention but only entails two silicone rods.
Excitingly, Jadelle has played a pivotal role in bringing implants to the developing world after being approved by the (US) FDA in 2002. In 2006, another implant came onto the market. Implanon offers three years of pregnancy prevention in a single rod implant. Like Jadelle, Implanon has made an impact in the developing world. Because its delivery system is uniquely “preloaded”, health extension workers in developing countries are able to easily insert the implants.