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2017 GLOBAL HEALTH BRIEFING BOOK LAUNCH: PHOTO GALLERY

On February 15, 2017, GHC launched the Global Health Briefing Book on Capitol Hill.  Global Health Works: Maximizing U.S. Investments for Healthier and Stronger Communities is an online resource for members of U.S. Congress and their staff. This biennial publication provides a comprehensive set of statistics and impact stories illustrating how the United States has been a leader in global health over the past decade. There are 18 briefs in total that address some of the most pressing global health issues, from maternal and child health to global health security. This resource builds the case for global health across multiple priorities and stakeholders. To learn more about the briefing book, read the press release.

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Promoting Women’s Leadership in Resource-Poor Settings

This guest post was written by Dr. Adnan A. Hyder of Johns Hopkins School of Public Health and originally appeared on the university website.

Dr. Adnan A. Hyder was one of the keynote speakers at the 7th International Womens Leaders Summit presented by New World Concepts in Karachi, Pakistan. He is Professor and Associate Chair, Department of International Health; Director of the Health Systems Program; and Director of the International Injury Research Unit at the Johns Hopkins Bloomberg School of Public Health. He has 20 years of global health experience in low- and middle-income countries. With this background, Dr. Hyder leads a team of experts to conduct groundbreaking research on health systems strengthening and capacity building.

 
Women’s health has long been a central focus in the field of public health. It is well-known that many health disparities exist between men and women all over the world due to unequal access to basic health care and education. While certainly not specific to resource-poor settings, women tend to experience more discrimination and mistreatment in low- and middle-income countries (LMICs), where there are also higher rates of preventable deaths and disease. Because of societal structures and social pressures, women can have unequal power in sexual relationships, economic decision-making, and navigating reproductive and child health services (1). One of the most effective ways we can reduce this inequity is by promoting, supporting and fostering the next generation of women leaders in low- and middle-income countries.

Equity in leadership is desired in all fields, but it is especially important in the field of health and medicine where saving lives and reducing global health burdens is a core and urgent task. Women leaders are more likely to implement policies that target women and children, and are more likely to support antenatal care, health facilities and immunizations (2). When it is quite literally a matter of life and death, I believe that it is critical to address the gender gap in health leadership, especially when there is strength in working collaboratively and added value in community-building and diversity.

Lack of easily accessible female role models and difficulties balancing career and personal life contribute to the inequity in global health leadership (3). Women are put under enormous pressure to maintain a balance between family life and professional life, a burden that is even heavier for women in LMICs where they are often expected to prioritize family over education. Women in resource-poor settings also face the added challenges of abiding by social-cultural norms often set my men, facing daily hurdles in mobility, and unfriendly work environments.

In order to tackle some of the most pressing health issues, we need to encourage and support women’s leadership in health, especially in the most vulnerable parts of the world. It is crucial to do this work in a meaningful way by incorporating the views and lived experiences of those in the ‘global south’ into our policies and decision-making process, and by considering local priorities in ensuring equal access to education and resources. Gender equality is not just an issue for women but an issue for everyone and if we don’t strive to achieve it, we will continue to struggle with the burden of death, disease and disability worldwide.

References:

1 Deborah Derrick. Empowering women and girls: the impact of gender equality in global health.The Lancet Global Health Blog, 2014 Aug 8
2 Jennifer A. Downs, Lindsey K. Reif, Adolfine Hokororo, Daniel W. Fitzgerald. Increasing Women in Leadership in Global Health.US National Library of Medicine, 2015 Aug 1
3 Kelli Rogers. Why do women hold less than 25 percent of global health leadership roles?Devex, 2015 Feb 3

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Greater Transparency Called for in Global Health Security

This guest post was written by GHC Board Chairman Dr. Jonathan Quick and was originally published on The Huffington Post website.

GHC Board Chairman Dr. Jonathan Quick

No More Epidemics (NME) is calling on all countries to publish their completed assessments of national capacities to prevent, detect and respond to epidemic threats, known as the Joint External Evaluation (JEE). Ethiopia, Liberia, Peru, Uganda, UK, and the US have openly shared theirs.

Data transparency and accountability are vital to address global health threats. Unless these documents are made public it will be impossible for civil society to either hold governments accountable for their obligations under the International Health Regulations (IHR), or to support governments in their compliance efforts.

More than 55 nations have joined the effort to combat highly infectious disease by signing on to the Global Health Security Agenda (GHSA), and a number of participating countries have undergone the multi-sectoral JEE and developed five-year national country roadmaps to address gaps in health infrastructure and capabilities. A number of countries have already completed a JEE. Another 27 countries are planning to undergo a JEE by May – yet, only 13 finalized JEEs and 12 country roadmaps are available online to the public.

Knowledge of baseline data provided by the JEE will result in more effective programming, prevention and detection of infectious disease outbreaks and early response. The JEE and roadmap processes are critical tools for civil society to use in developing appropriate and adequate programming to help countries close health systems gaps and become IHR-compliant. Transparency and accountability are vital in addressing global health threats.

No More Epidemics urges all countries carrying out their Joint External Evaluations to make the results publically available and for these to be made available on the World Health Organization’s Strategic Partnership Portal, the online repository for tracking funding, donor profiles and country level data.

ABOUT NME
No More Epidemics is a five-year global campaign to encourage governments and key stakeholders to better prevent, prepare and respond to infectious disease epidemics. Established in 2015 by Management Science for Health, International Medical Corps, Save the Children and the African Field Epidemiology Network, the Campaign was officially launched in November 2015 in South Africa. The Campaign seeks to ensure the development of national preparedness plans that include community protection and mitigation; ensure all States comply with the International Health Regulations; and increase international and national funding levels for epidemic preparedness, prevention and response.

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Cervical Cancer vs. Womankind: Game, Set, Match

A girl in Than Hoa, Vietnam, reads the leaflet provided to her before receiving the cervical cancer vaccine, as her mother anxiously awaits the procedure. © 2010 Amynah Janmohamed, Courtesy of Photoshare.

Receiving a cancer diagnosis is a life-altering experience that can be summed up in one word — fear. Irrespective of an individual’s geographic location, socioeconomic status, gender, education, religion, or ethnicity, cancer provokes this universal response.

Today cancer remains one of the most frightening diagnoses for a patient. This is primarily because even with all the advances in medicine and health care over the last century, when it comes to dealing with most cancers, successful management still seems to boil down to a great degree of luck. Luck that the cancer is identified in time; luck that the cancer is less aggressive than the treatment; luck that an individual even has access to treatment; and luck that one is in the right physical shape to see the fight to the finish.

Indeed luck carries a great deal of weight in beating most cancers, but this should not be the case with cervical cancer – a battle that should be over before it even begins. Cervical cancer is almost exclusively the consequence of long-term infection by two strains of the human papilloma virus (HPV). Modern medicine has provided a safe and effective vaccine that can be administered to adolescent girls and young women, offering them adequate protection before they ever come into contact with HPV. Yet despite this remarkable intervention, the World Health Organization (WHO) and several other sources report that cervical cancer is still the second most-common cancer among women in poor countries; and the fourth most-common cancer among women universally.

Robust screenings, effective treatments, and HPV vaccinations have contributed to cervical cancer rates dropping dramatically in many high-income countries over the past 30 years. Progress has been much slower in low- and middle-income countries (LMICs), which account for more than 90% of the mortality from cervical cancer that occurs today. This huge disparity is mostly  due to competing health demands in the developing world, such as: infectious diseases, WASH, and maternal and child health, which often take priority over cancer and other noncommunicable diseases (NCDs) during budget allocation.

Only 5% of global cancer resources are spent in LMICs; however, current trends make a compelling case for governments in poor countries to increase investments towards the overall management of NCDs. By 2030, NCDs, including cancer, are expected to overtake mortality from infectious diseases in developing countries.

As it stands, the majority of LMICs are ill-prepared and too poorly financed to cope with the heavy burden of cancer that is projected to double every five years due to dramatic changes in lifestyle, increasing urbanization, and aging populations. Poor countries already face severe challenges in managing the existing load of cancer patients today, including: a shortage of specialized health workers and inadequate healthcare infrastructure. This makes preventative measures for highly prevalent malignancies like cervical cancer all the more urgent.

According to Centers for Disease Control and Prevention (CDC), only 67 countries globally had introduced HPV vaccinations in their national immunization programs by October 2016. Coverage rates for most of Southeast Asia and Africa, where the highest prevalence exists, still remain very low. Periodic roll-outs of cervical cancer screening and HPV vaccination campaigns have shown promising results in reaching more women, but it is imperative for governments to establish more routine and consistent access to services by integrating and enhancing HIV/AIDS and family planning programs to include cervical cancer prevention and management efforts.

Several of GHC’s member organizations are at the forefront of implementing sustainable programs for cervical cancer prevention and expansion of screening services. Jhpiego has done tremendous work in Côte  D’Ivoire and Botswana; reaching tens of thousands of women with its low-cost screen-and-treat approach. PATH’s HPV vaccination projects in India, Peru, Vietnam, and Uganda laid the groundwork for effective vaccine introduction and contributed to a decision made by the Vaccine Alliance (GAVI) to subsidize the HPV vaccine for poor countries.

In 2013, GAVI made strong commitments to accelerate HPV vaccine uptake, with the aim of vaccinating over 30 million girls in more than 40 countries by 2020. Vaccinating this large portion of the population will strengthen the immunity of the entire population.

As we commemorate World Cancer Day on February 4, we celebrate the tremendous strides that have been made in tackling cancer globally while also recognizing the work ahead. With more political will, resource mobilization, task-shifting, and collaboration, we have a rare opportunity to take one battle to the finish line. Let’s end cervical cancer for all of womankind!

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PQM Increases the Supply of, and Affordability of, Life-Saving Anti-TB Medication

This guest post was provided by GHC member United States Pharmacopeial Convention (USP).

The United States Pharmacopeial Convention (USP) promotes and supports end-to-end quality assurance across health systems in partnership with regulatory authorities, policymakers, donors, and other key stakeholders. Through multiple programs, USP provides technical assistance, workforce development, and sets standards to improve access to quality-assured, life-saving medicines that protect patients. USP’s longstanding partnership with United States Agency for International Development (USAID) has led to significant advancements in medicine quality in priority regions, with key activities currently implemented through the Promoting the Quality of Medicines (PQM) program in 34 countries.

Most tuberculosis (TB) cases can be treated with first line, or preferred, medicines. However, bacteria that cause TB can become resistant to first line medicines, which causes a condition known as multi-drug resistant TB (MDR-TB). In 2015, the World Health Organization (WHO) estimated that of the 580,000 people requiring multi-drug resistant tuberculosis (MDR-TB) treatment, only 20% were enrolled in therapy. For individual patients, this form of TB can mean longer, less effective, and more expensive treatment, which is inhibited further if the medicine provided is not quality-assured. Therefore, increasing supply of and access to quality-assured second line MDR-TB medicines is a high priority in treatment efforts.

Kanamycin is one of the key second line medicines used for treatment of MDR-TB. In 2016, to help increase the availability of quality-assured kanamycin, PQM negotiated the purchasing price with manufacturers based on the costs incurred by the producer in exchange for technical assistance. This intervention had two significant results: the price of quality-assured kanamycin fell, becoming available in liquid form for widespread distribution for the first time to the Global Drug Facility, WHO’s procurement mechanism. The price of 1-g kanamycin solution made available through PQM’s intervention is 73% less than the same product from other suppliers; the intervention also set the lowest price benchmark for 0.5-g and 1-g kanamycin injection solutions on the global public health market, which is expected to drive down the price of kanamycin produced by other manufacturers as well. Ultimately this will enable donors and national TB programs to save millions in public health funding, allowing more efficient and widespread service delivery.

 

 

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