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Nix-TB: Testing a Cure for XDR-TB


Earlier this year, TB Alliance and partners launched a unique and groundbreaking clinical trial, known as Nix-TB (New Investigational Drugs for XDR-TB), to evaluate a completely new combination therapy for XDR-TB (extensively drug-resistant tuberculosis). The all-oral regimen is comprised of drugs with minimal pre-existing resistance, and has the potential to shorten, simplify, and improve treatment for XDR-TB. Nix-TB has successfully been enrolling patients in sites in South Africa. Positive results could lead to the expansion of the trial to other sites around the world, and ultimately to approval of the regimen.

Currently, XDR-TB treatment s complicated and expensive, and results in high rates of death; there are no regulatory-approved XDR-TB treatments. People with XDR-TB can be on treatment for two years or longer, subjected to thousands of pills and injections, extensive side effects, and little success. In a recent review of XDR-TB therapy South Africa, after two years of treatment a mere 16 percent of XDR-TB patients were cured. The Nix-TB regimen aims to achieve high cure rates in nine months of well-tolerated therapy, while reducing the cost and pill burden of therapy by more than 90%.

View more information on Nix TB clincal trials.

Financing Demystified
Figure 1 shows the how much money different sources provided for SRHR in 2012. From Financing Demystified, IPPF, October 2015.

Figure 1 shows the how much money different
sources provided for SRHR in 2012. From Financing Demystified, IPPF, October 2015.

From International Planned Parenthood Federation (IPPF) and Reproductive Health Supplies Coalition (RHSC)

Financing Demystified is the last in a series of advocacy tools on financing for reproductive health supplies and Sexual Reproductive Health & Rights (SRHR). With support from RHSC Innovation Fund, IPPF is implementing the National Action for Financing (NAF) project to work with stakeholders to position funding for reproductive health as a critical element in the new development financing architecture.

This publication aims to enable stakeholders to understand the implications of the changes and challenges to reproductive health funding, and suggests key messages for advocates.

Health Workers Count in Leadership and Management

This blog was cross-posted from the Leadership, Management & Governance Project, and written by Jason Wright, Project Director. 

On September 22 in New York, I represented Management Sciences for Health (MSH) and the Leadership, Management, and Governance (LMG) Project at a Johnson & Johnson (J&J)-sponsored event entitled “Leadership and Management Training: Unlocking the Potential of Health Workers.” J&J Director of Corporate Contributions, Michael Bzdak, made introductory remarks, and Rutgers University Center for Organizational Development and Leadership Executive Director, Brent Ruben, facilitated the discussion.


Participants included LMG Project consortium partner Amref Health Africa‘s new Chief Executive Officer, Githinji Gitahi, and Executive Director, Bob Kelty. Githinji discussed our joint work on the African Health Leadership and Management Network (AHLMN) hosted at Amref. He announced that Amref will launch its International University in 2016, and Bob discussed our joint work with midwives.

Other participating institutions included Accenture Development Partnerships (ADP), the Aga Khan University (AKU), Duke University, the General Electric (GE) Foundation, the Ghana Institute of Management and Public Health (GIMPA), the Global Business School Network (GBSN), IntraHealth, the Office of the U.N. Secretary-General’s Special Envoy for Financing the Health Millennium Development Goals (MDGs) and for Malaria, Sigma Theta Tau International Honor Society of Nursing, the University of California, Los Angeles (UCLA), the University of Cape Town (UCT), and the Wharton School of the University of Pennsylvania.

GE Foundation Director of Global Health Agha Varghese previewed an upcoming announcement on September 25 of the foundation’s $25 million Global Safe Surgery Initiative.

There were three breakout sessions to address the following questions:

  1. In terms of your leadership development efforts/experience, how do you define and measure success? Have you seen any practices in your work/experience?
  2. What is the role of e-learning and digital health in leadership and management training? Have you seen any good examples of blended learning?
  3. What opportunities do you see for collective/collaborative efforts to advocate for, promote, and/or expand leadership and management training as a health systems strengthening intervention?

I participated in the third breakout session facilitated by Michael Bzdak.

During the session, I discussed my experience with the graduation and transition of countries from development assistance from USAID (I worked as USAID Donor Coordination Advisor and Multilateral Team Leader in 2002-2011); the Global Fund to Fight AIDS, Tuberculosis, and Malaria (I served as USAID Liaison to the Global Fund for many years and currently serve on the Developed Country NGO Board delegation); and Gavi.

Githinji and I discussed the need to shift leadership, management, and governance (L+M+G) interventions from in-service to pre-service training. I described how MSH and LMG work to push down (i.e., from headquarters to the field) and out (i.e., from us to regional and national partners) the capacity to provide technical support as we have through Amref and our other consortium partner the International Planned Parenthood Federation (IPPF) and its African Regional Office and Member Associations (MAs).

I noted the underinvestment in L+M+G and warned of the false dichotomy posited by some between L+M+G interventions and service delivery results. There was great interest from other participants in an LMG Project study of the added value of our Leadership Development Program Plus (LDP+) for postpartum family planning service delivery results in Cameroon. I promised to share results with participants when they become available.

Michael Bzdak cited the need for participants to advocate for L+M+G investment including through presentations at international conferences. He highlighted that MSH is one of the few organizations to provide evidence of the efficacy of L+M+G interventions. I noted that the LMG Project would be presenting its work at the International Conference on Family Planning (ICFP) in Indonesia and the International Conference on AIDS in Asia and the Pacific (ICAAP) in Bangladesh both in November 2015.

Participants were provided copies of a theme issue of the journal World Health & Populationentitled “The Global Health Workforce: Striving for Equity.”

Health Actions for Women

fpadresourceFrom Hesperian Health Guides, a nonprofit health information and health education source that supports individuals and communities in their struggles to realize the right to health

Health Actions for Women is an innovative resource for women, girls, and their allies working to educate, advocate, and mobilize their communities for women’s health and rights. This chapter, “Protecting Women’s Rights with Family Planning”, provides proven strategies and activities to help communities organize for increased access to family planning methods for women.

Accountability in Global Health: What works, what doesn’t, and what we need to do about it

A side-event at the UN General Assembly, and two new reports, shine the light on accountability processes at the global, regional, national, and sub-national levels. Spoiler alert: civil society engagement in countries is critical.

Christine Sow, President and Executive Director, Global Health Council
Lola Dare, President and Chief Executive, CHESTRAD
Nejla Liias, Founder and President, Global Health Visions

AccountabilityblogDuring this week of the UN General Assembly, New York’s streets are buzzing with global health and development leaders moving from one event or meeting to the next, discussing a host of important issues, and fighting for the chance that “their issue” might break through the noise. But, as we embark upon a new set of global Sustainable Development Goals (SDGs) to improve the lives of people and our planet, there is one theme which is relevant across all of the issue areas, and critically important to the achievement of the SDGs: accountability. Without accountability for goals and commitments, there is little point in making them.

As global health advocates, we share a passion for accountability because it means that decision makers will follow through on their promises to improve the health and well-being of all people, especially the most vulnerable. And, beyond that, we share an even greater passion for ensuring that advocates, government representatives, parliamentarians, health professionals, and other stakeholders understand how to put accountability into practice, calling for action to reward, mitigate unintended negative effects or implement sanctions as each matter might require: What’s working? Who’s making it work? What’s not working?  

We are not alone in this quest: partners at all levels are more interested than ever in getting the accountability piece right. While we all bask in the excitement of the UN’s adoption of the post-2015 development agenda, as advocates we ultimately have one thought on our minds: what are the means of effective implementation and accountability? 

Specifically, how are we going to hold duty-bearers accountable? How will we hold governments—and yes, we’ll say it— development partners, to their commitments to improve the health of women, children, and communities? How can we translate press releases into policies, policies into practice, and practice into healthy lives?

Yesterday’s event on accountability at the Rockefeller Foundation, organized by Global Health Council, together with CHESTRAD International, Global Health Visions, Action for Global Health, and International AIDS Alliance, revolved around precisely these questions. Global Health Visions shared the results of a provocative new report Engendering Accountability: Upholding Commitments to Maternal and Newborn Health, which profiles accountability processes at the regional, national, and sub-national levels, outlining what’s working, what’s not, and what changes we need to make to help country accountability efforts flourish. It contains in-depth landscape analyses of India, Nigeria, and Uganda, as well as detailed findings and recommendations that apply to accountability efforts across the board.

Additionally, CHESTRAD’s new report Amplifying Whispers and Enabling Action: Global Accountability in the Sustainable Development Goals, released in collaboration with Global Health Council, is a critical contribution to the field of accountability, examining lessons learned from the MDGs on accountability, improving the technical and supply sides including goals, indicators, measurement, data availability and quality. The report explores the role of stakeholders (including civil society) and calls for increased investment in demand-side functions on accountability to reduce fragmentation and promote alignment. It identifies an urgent need to incentivize political will for behavior change among development partners, technical agencies and global programs. It further calls for greater motivation to enable the watchdog role of civil society at the country level, to hold to account within the multi-layered, multi-sector accountability framework for global health in the Sustainable Development Goals.

With so many key players in accountability in one place, Thursday’s event served as an important touch point for the week, and the years ahead, to remind stakeholders that accountability must be a critical part of the conversation, to discuss how to make accountability work effectively, and to ensure that civil society plays a central role. As we move towards key milestones in accountability – including immediate ones like the PMNCH “Accountability Breakfast” and the launch of the new Global Strategy for Women’s, Children’s and Adolescents’ Health, and longer term ones, such the High Level Political Forum’s 4-yearly Summits to review progress on the SDGs – we want to take this opportunity to raise our voices in support of accountability practices that make targets, indicators and partner behaviors matter.

The takeaways from yesterday’s event are clear:

  • We need to empower civil society to do this important work – they must be at the center of local, national, regional, and global accountability efforts, within an inclusive, supportive accountability framework. But they can’t do it alone. Many need resources, support and technical assistance, and capacity building. And first things first – let’s do a better job making sure they have a meaningful seat at the table.
  • Top-down approaches need to go the way of the dinosaur – start We need to shift our strategic focus towards national and sub-national partners. The disconnect between commitments at the global level and awareness of commitments among stakeholders at the country level is holding us back.
  • To that end, we need to monitor fragmentation and improve partner behavior. Alignment and coordination at the country level matter more than ever before to achieve the 17 goals and 169 targets of the Sustainable Development Goals.  Political will for improved processes and behavior change are critical, shifting incentive systems from attribution to contribution and through meaningful, resourced and enabled civil society engagement in accountability frameworks across programs and at all operational levels.
  • We all know data is important – but it is just not enough. There are many efforts focused on the collection and perfection of data. We need to work to connect data to action to achieve the change we want. Even “imperfect” data can be a part of the solution, especially when it is local, user-centric, and accessible in real time. At the same time, scaled investments in measurement, performance, data quality and dialogue are required to balance demand and incentivize political will for behavior change and action.
  • Collaboration is key. There are sucessful accountability efforts out there, and what they tend to share is robust cooperation between stakeholders—government, civil society, lawmakers, healthworkers. Let’s start to share these successes and work to scale them up.

When it comes to creating rich, constructive accountability mechanisms that give voice to the most vulnerable and ensure that people everywhere can live healthy lives, we have our work cut out for us. The good news is that today we have a lot more evidence and information on which to base our path forward.