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New Hope for Children with TB

This blog was written by the communications team at TB Alliance as part of Global Health Council’s Member Spotlight SeriesGlobal Alliance for TB Drug Development (TB Alliance) is a not-for-profit organization dedicated to the discovery and development of better, faster-acting, and affordable tuberculosis drugs that are available to those who need them. TB Alliance is a 2018 Global Health Council member.

Each year, 1 million children get sick with tuberculosis (TB) and about 210,000 needlessly die. Those grim statistics translate to nearly 600 children dying on a daily basis.

TB Alliance and partners are working to solve this problem. Until recently, children didn’t have access to TB medicines in the proper doses or formulations. Care providers and parents crushed or chopped adult pills to approximate the right dose for children. This makes for a daily struggle—for six long months—and creates a guessing game of whether children receive the right dose. Ultimately, this approach can negatively impact adherence, outcomes and fuel the development of drug-resistant TB.

Improved drugs are solving this problem. TB Alliance has introduced new TB cures for children in the correct dose and child-friendly forms, and health systems around the world are working to ensure that they are available widely.

Here’s where we stand today:

1) More than 700,000 treatment courses have been ordered.
2) Close to 80 countries have adopted the improved medicines.
3) The improved medicines have been prequalified by the World Health Organization.
4) A major opportunity now exists to integrate childhood TB into maternal and child health efforts.

These new medicines are having a real-world impact. In Nairobi, three-year-old Chelsea was among the first in the world to be treated and cured with them. Read her story here.

Read more about the project to develop and launch these improved pediatric TB medicines in New Pathways for Childhood TB Treatment.

As we mark World TB Day on March 24, the global health community has some cause to celebrate. But there’s still work to be done. Drug-resistant TB is a growing threat, and today’s treatments are woefully inadequate. Treating drug-resistant TB in adults and children alike means thousands of often toxic drugs and hundreds of injections for 9 months to two years or even longer.

TB Alliance is developing new drug regimens to reshape the treatment landscape for every person with TB. Political momentum is beginning to build; events like the upcoming U.N. High-Level Meeting on Tuberculosis in September present an opportunity for global leaders to make meaningful commitments to fund the research and development needed to bring about the drug, diagnostics and vaccines that can truly render TB a disease of the past.

One in 50: When It Comes To Water, Sanitation and Hygiene, Too Many Health Care Facilities Are Being Left Behind

This blog was written by Danielle Zielinski, Sanitation Policy Project Officer at WaterAid as part of Global Health Council’s Member Spotlight Series. WaterAid is an international not-for-profit determined to reach everyone, everywhere with clean water, decent toilets and good hygiene, within a generation. WaterAid is a 2018 Global Health Council member.

When you’re sick, you’re likely to visit a health center. Many of us take for granted that our local health center will have a toilet, a place to wash hands with soap and water and a system to safely dispose of medical waste.

These seem like basic requirements. But if you live in the developing world, new estimates put your chances of reaching a facility with adequate water, sanitation, hygiene and waste management at only 1 in 50—about the same chance as the average person making a half-court shot in basketball.

Hope you’re feeling lucky.

A recent study from the Water Institute at the University of North Carolina, looks at the environmental conditions in nearly 130,000 healthcare facilities across 78 low- and middle-income countries. The study—published in January in the International Journal of Hygiene and Environmental Health—offers the most comprehensive analysis to date of inequalities in healthcare.

The news is grim. Half of healthcare facilities surveyed lack access to piped water, a third are without access to improved toilets, and even more—39%—do not have facilities for washing hands with soap. A sampling of six countries showed that only 2% of facilities provide a combination of piped water, improved toilets, decent handwashing facilities and adequate waste management.

Without water and sanitation services, health care facilities can harm the patients they are supposed to help. A lack of water, sanitation, and hygiene (WASH) puts both patients and health workers at a greater risk of infection, disease and even death. The World Health Organization estimates several hundred million patients annually acquire infections in health care settings due to poor handwashing practices—due in part to the lack of available soap and water. And as we saw with the 2014-2016 Ebola epidemic in West Africa and the recent cholera outbreak in Yemen, inadequate WASH infrastructure allows deadly diseases to spread unchecked.

New mothers and newborns are especially vulnerable. Every minute, a newborn dies from infections caused by a lack of safe water and an unclean environment. Sepsis and other infections due to unhygienic conditions are also a leading cause of preventable maternal deaths.

People shouldn’t have to roll the dice when they enter a health facility. They shouldn’t have to worry that the place they come to for care might make them sicker. Healthcare workers should have a safe and quality environment in which to do their jobs, to the benefit of us all. It’s time to start closing these gaps. And it starts with treating WASH as a fundamental part of health systems.

The US Global Water Strategy includes a key outcome around decreased mortality/morbidity from causes linked to lack of WASH and plans from USAID and the CDC which call out improving WASH in health care facilities. This is a good start. But it requires support from Congress through funding and policy, and must not be undermined by current efforts to reorganize USAID or other political tug-of-war. After all, epidemics like Zika and Ebola don’t respect national borders. More advocacy is needed to ensure the strategy lives up to its potential, and truly informs practice and program implementation.

Citizens around the world are also speaking up and taking action. In Burkina Faso, citizens and journalists recently questioned their health minister about sanitation in health care facilities during a live broadcast, leading to promises of improvement. In Cambodia, advocacy has led to cross-sectoral commitments to improve WASH in health centers. The Ministry of Rural Development has set targets for 70% access to improved WASH in health centers and schools by 2025, and the Ministry of Health has set targets for 95% of health facilities to have basic water supply and 90% of health facilities to have basic sanitation by 2020.

And in Malawi, WaterAid is leading efforts to address infection prevention and control in 16 health centers across Kasungu, Nkhotakota and Machinga districts. Work includes training health care workers and modeling improvements like solar-powered water systems, inclusive toilets and bathrooms and repairing septic tanks and incinerators for waste management.

It is up to all of us to work toward better data, plans, funding, and action to ensure health facilities meet WASH standards. The UNC study is a sobering reminder of the sheer volume of work left to be done. But the good news is we don’t need to wait for new technology or medical advances to get started. We have the tools we need right now to save lives.

Safe water. Decent toilets. Soap for handwashing. In every health facility.

Let’s not leave anything to chance.

Esther Elias and her new born baby at Nyarugusu Dispensary, Nyarugusu, Geita District, Tanzania, September 2017. (WaterAid/ Sam Vox)

Pressing for Progress: An Interview With Dr. Roopa Dhatt on Women in Global Health

This post originally appeared on Global Health Corps blog AMPLIFY and was written by Lanice Williams, a 2016–2017 Global Health Corps fellow at Global Health Council. Follow Lanice on Twitter and join the International Women’s Day conversation using the hashtags #IWD2018 and #PressForProgress.

Women marching for gender equality. (Source: UN Women National Committee Aotearoa New Zealand)

On Thursday, March 8, the world celebrates International Women’s Day (IWD). Today, women and girls around the globe will join together to reflect on women’s accomplishments and celebrate the acts of courage shown by women who are playing a role in shaping their communities and advocating for efforts around gender equality. This year’s theme of “Press for Progress” is focused on the need to keep momentum going to ensure that we achieve gender parity. This theme is also right in line with the recent news and media attention surrounding women who have been speaking out about sexual harassment and assault. Many women are standing in solidarity and saying “no more,” as demonstrated by the #MeToo campaign that was originally started by an activist named Tarana Burke. Burke created this campaign to reach sexual assault survivors in underserved communities and encourage women globally to speak up about their experiences.

Roopa Dhatt, MD,
Co-Founder & Executive Director of Women in Global Health
(Source: Women in Global Health)

To mark the occasion of IWD and continue the #MeToo discussion, I sat down with Dr. Roopa Dhatt, the Co-Founder and Executive Director of Women in Global Health. We discussed her reflections on International Women’s Day, efforts to integrate violence against women initiatives into global health, and why closing the gender gap in global health leadership matters so much.

Lanice: You are the Co-founder and Executive Director of Women in Global Health, which was established in 2015. What was your motivation for starting the organization?

Roopa: Through my personal and student leadership journey, I discovered gender bias — unconscious and conscious — and realized how women leaders are judged by different standards. I felt passionate that the next generation of global health leadership must be different — more diverse, inclusive and representative of the world. I was also inspired and encouraged by other women leaders in global health, both peer leaders and pioneers in the field, to work together to ensure that women’s contributions no longer go unrecognized and that women are perceived as thought leaders and decision makers in improving the health and well-being of their communities and the world.

As an Indian-American from Punjab state, I have seen how women in my culture have weak power and influence, limited access to higher education and work, and are not allowed to choose their own partners. Due to the lack of visibility and recognition of women leadership in global health, a group of like-minded young women and I co-founded Women in Global Health, a movement striving to bring greater gender equity to global health. Our movement was conceived by a group of four young women in Spring 2015, each of whom found her own unique pathway to global health, but was asking the same question: what more can we do to elevate female leadership and bring it center stage in global health for greater gender equity?

Lanice: This year the theme for International Women’s Day is #PressforProgress. What does that mean to you, and what progress have you seen so far in achieving gender equity in global health leadership?

Roopa: “Press for Progress” is about uniting and advancing the global movement for gender equality, women’s rights, and empowerment in our own spheres of influence. We cannot stand by waiting for change; we each have a responsibility to advance the dialogue, shift mind-sets, change institutional policies and transform societies for greater gender equality. In global health, we have seen significant leadership on gender equality. At the top of the list is WHO Director General, Dr. Tedros, who not only made gender equality a top priority in his leadership, but also acted on those commitments, both by achieving gender parity in his senior leadership cabinet (two-thirds majority posts held by highly qualified, geographically diverse and talented women) and integrating this into the WHO’s 13th Global Program of Work over the next five years. Yet, even at the WHO, the work is only starting. Transforming organizational culture at the global, regional and national levels requires much more commitment and action from all of the WHO and member states that govern it.

We also have seen the academic community coming together to raise the visibility of women’s leadership in global health. 2017 marked the inaugural Women Leaders in Global Health Conference, hosted by Stanford Global Health, where Women in Global Health served as an implementing partner. That brought together 500 women and men from nearly 70 countries, and 250 organizations on this theme. Moreover, we are also seeing greater leadership from the private sector on women’s leadership; an example is GE Healthcare and Women in Global Health’s Heroines of Health, an honorary recognition of women who are at the frontline, taking on the toughest global health challenges in their communities. We also must recognize the thought leadership that Ilona Kickbusch provided to global health by launching the #WGH100 lists, which recognize women leaders and experts in global health.

Lanice: Over the course of last year and so far in 2018, we have seen many women speak up about experiencing sexual violence and sexual harassment. How important is it that the global health community addresses this violence against women, which affects about 35% of women globally?

Roopa: The challenges facing the global health community are centered on gender dimensions. Since 71% of the health and social care workforce globally are women, and unpaid care represents half of women’s contribution to global wealth, resilient health systems and Universal Health Coverage cannot be achieved without consideration of the gendered aspects of the health workforce. When we look closely at the health sector from a gendered lens, women are often under-resourced, underpaid or unpaid, under-trained, and not formally recognized. Moreover, they face greater harassment — sexual and physical- than men, including gender-based violence (GBV).

At the 4th Global Human Resources for Health Forum in Dublin, we hosted a storytelling evening, Lives in their hands, where we heard about the personal safety concerns of female health workers– whether it was Miatta Gbanya from Liberia, who delivered a baby by the roadside at night, or Rushaana Gallow, who faces sexual assault and death every day as she enters the “red zone” in the Cape Flats in South Africa as a first responder. These gender dimensions and personal safety concerns are the reason the WHO and Women in Global Health launched the Gender Equity Hub in the Global Health Workforce Network. We seek policy-oriented solutions to address gender inequities in the health and social care workforce — with a key priority to promote employment free from harassment, discrimination and violence.

Finally, equal numbers of women and men in leadership in global health and other sectors will reduce sexual harassment at work; this is because sexual harassment and violence is almost always committed by men and is a misuse of male power. A critical mass of women in the workplace makes it possible to change organizational culture and outlaw such abusive behavior. A critical mass of women in the workplace also makes it more likely that women will report abuses and be believed. The UN has recognized, for example, that more female peacekeepers and female police will reduce sexual violence against vulnerable populations in emergencies and conflicts. Sexual abuse and violence exist in the shadows as we have seen from #MeToo reports from many sectors. It is an issue for men just as much as women. To solve it, men must also take responsibility for stamping out abuse and making male colleagues accountable, not least because sexual harassment and violence in global health has serious costs for everyone.

Lanice: The 8th UN Secretary General, Ban Kai-Moon, stated, “There is one universal truth, applicable to all countries, cultures and communities: violence against women is never acceptable, never excusable, and never tolerable.” What are your reflections on that, and on what does that means for prioritizing action?

Roopa: I 100% agree! Action is needed; prioritizing action is not a choice, but a must. For us to reach our maximum potential as a society, women and girls must be able to live full lives without fear and violence. Without that, everything we are doing is failing at least half the population and negatively impacting all genders.

Lanice: Your mission statement notes that you work on “building a global movement that brings together all genders and backgrounds to achieve gender equality in global health leadership.” Can you tell me more about the WGH mission and the role you see women leaders playing to ensure that more violence prevention initiatives are incorporated into global health programs?

Roopa: Our vision is to achieve gender equality in global health leadership, as we know that gender equality leads to smarter global health. Our mission is based on the role of leadership–women, men and all genders practicing gender transformative leadership. Our approach is based on our foundation of being a movement and engaging all people, stakeholders, and sectors, at global, regional, and local levels, to achieve our vision. Everyone has a sphere of influence that can shape individual, interpersonal, institutional, societal, community and policy environments. We recognize this and tap into this potential using a holistic approach for greater gender equality in global health leadership.

Women as leaders have the opportunity to be gender transformative and create programs and policies that are enabling for all genders. We know that gender-based violence (GBV) impacts every aspect of society from an early age to ageing populations. Regardless of which silo of global health one’s work is in, gender is crosscutting and so is GBV. Therefore, there is an opportunity to address GBV. In one’s individual leadership role there are a few simple practices that can be integrated:

  • Build Momentum: Raise the profile of GBV in your sphere of influence — bring attention to the issue through stories, data and other evidence.
  • Create Enabling Environments: Look into your organization’s gender impact assessment tools and see whether there is a GBV component.
  • Sustain Change: Integrate it into your policy and program priorities and link your efforts to larger global initiatives.

Lanice — In what ways can the global health community work together to ensure that more violence against women prevention programs are integrated into global health programs?

Roopa — In Women in Global Health, we propose applying a gender lens and using a gender transformative approach in one’s leadership. The global health community, closely linked to the development community, is recognizing more and more how interlinked health and wellbeing are to broader determinants of health, especially gender. Women and men are impacted differently, particularly in changing socio-political environments, as a result of gender social norms, roles, and other axes of identity and inequality (i.e. age, poverty, literacy, geography, disability, and sexuality). Gender inequalities contribute to violence against women, with key factors of violence being linked to institutional and behavioral factors. Moreover, in the context of violence against women, the dialogue needs to be broader and discussed as gender-based violence (GBV).

All genders have a role to play in deconstructing the power structures that promote inequities based on gender. Men, similarly to women, have a responsibility to learn about the socially constructed gender norms and roles, and the inequalities these norms create in limiting health and well being for all people. By being aware, people can begin to address their own biases and the barriers around them, and design context-specific solutions at multiple levels to shift the drivers that are promoting GBV.

Reflections from the Global Health Community: Changing the Way We Operate

By Melissa Chacko, Policy Associate, Global Health Council

As global health organizations in Washington, DC are preparing to hit quarter one goals, they are juggling advocacy around both the Fiscal Year 2018 and 2019 U.S. budgets as well as advocating for global health legislation and policy. This robust agenda requires the global health advocacy community to stay one step ahead of possible roadblocks. But sometimes, it’s worth stepping away from the routine and reflect on how our community operates, which gives us the opportunity to understand the “why” of how we work and if our approaches are appropriate in the current global health landscape.

While there are multiple perspectives on this topic, we spoke with a few members of the global health community and compiled five ways that the community can change how it operates. These perspectives range from rethinking global health assistance to working toward bold goals. While these interviews do not represent the perspectives of the entire community, it springboards discussions about how we can think outside of the box to reach our advocacy goals.

1.) Putting LMIC Priorities First

“The global health community needs to embrace a new way of operating in global health assistance. Global health assistance is primarily framed around donor priorities, and low – and middle – income countries (LMICs) then work to develop a plan for using related funds. While we have seen successes in priority areas, particularly around HIV/AIDS, malaria, and child health, these efforts have not transformed health systems. To transform health systems we need to change how we engage with LMICs, especially those experiencing economic booms. Many middle-income countries have transformed their health systems by prioritizing primary health at the community level. Donors should collaborate with these countries to help other LMICs improve their health systems through South-South partnerships. The United Nations defines  South-South cooperation as a broad framework of collaboration among countries of the South in the political, economic, social, cultural, environmental and technical domains. Triangular cooperation occurs when traditional donors facilitate such initiatives. The global health community should support these types of partnerships and donors should leverage them to ‘work ourselves out of a job.’ ”


Tiaji Salaam
Global Health Specialist
Congressional Research Service

2.) Rethinking Public-Private Sector Partnerships

 “In addition to changing the way we operate with countries we need to reconsider how we use the term ‘public-private partnerships.’ At the moment, most public-private partnerships supported by donors in the health sector are collaborations between industrialized nations and large private companies based in those respective countries. The global health community could benefit from broadening those partnerships and including more frequently entrepreneurs and private companies in LMICs. Engineers in Cameroon and Uganda, for example, have developed inexpensive devices for expanding access to cardiologists and diagnosing pneumonia, respectively. We need to increase our support for local private companies. Broader use of innovative technologies developed in the field can increase sustainability, decrease costs, and may be more suitable for the local environment, both culturally and technologically.”


Tiaji Salaam
Global Health Specialist
Congressional Research Service


3.) Building Equal Gender Representation in Global Health Leadership

“One of the moments in 2017 that I believe pushed the global health community to do better and change the way we operate was the lack of equal gender representation in global health leadership. An example of this was the photo taken of global health leaders at the Universal Health Coverage Forum in Japan that perfectly depicted the lack of equal gender representation in global health leadership, where only one leader was a woman. This lack of representation is evident throughout global health, as women make up 75% of the health workforce yet occupy less than 25% of the most influential leadership positions. We can change the way we operate by identifying these discrepancies in global health leadership and push for equal representation in global health leadership.”


Roopa Dhatt
Executive Director
Women in Global Health


4.) Breaking Out of Silos

With the UN High-Level Meeting on Tuberculosis (TB) taking place later this year, I think there is a worldwide understanding that Tuberculosis cannot go any further as the leading global infectious killer. As a global health community, we need to break out of our silos and understand what it takes in terms of resources and programs to stop the TB epidemic from growing.”

“While it’s easier said than done, there are opportunities to break out of our silos and work together. From a science perspective, there are naturally sort of communities that find themselves as key stakeholders on cross-sectoral global health issues. For example, we know that TB is the leading cause of death for people living with HIV. Knowing this, the TB and HIV/AIDS communities often work together to share best practices and tactics based on historic wins from both the domestic and global level. However, some connections are not as obvious as HIV and TB and it is up to organizations to have the courage to cut through the red tape that limits the NGO space and cooperate better. For example, Treatment Action Group (TAG) connected with the maternal and child health community to collaboratively lead advocacy on a federally-mandated task force on the inclusion of pregnant and lactating women who have tuberculosis in clinical trials who for unfound reasons are often categorically excluded. TAG and other grassroots activists saw this is as opportunity to put pregnant women with TB on the map and connect with maternal and child health stakeholders and understand how TB affects maternal and child health issues.”


Suraj Madoori
U.S. and Global Health Policy Director
Treatment Action Group


5.) Working Toward Bold Goals through Incremental Improvements

In our interactions with policymakers, their staff, and others who shape key funding and legislative decisions that affect global health, we need to keep striking the right balance of being passionate advocates for our issues, deeply committed to solving big problems and savvy partners who can propose targeted policy solutions that are workable in a challenging environment. We can continue working towards big, bold goals through measurable, incremental improvements. The maternal and child health advocacy community’s effort to pass the Reach Every Mother and Child Act is a great example. This bill sets an incredible goal – to end preventable child and maternal deaths globally – and outlines specific, targeted steps the U.S. government can take to contribute to achieving it: by focusing on the poorest and most vulnerable populations; improving coordination among U.S. government agencies, foreign governments, and international organizations; and requiring a coordinated strategy with ambitious, measurable targets annually reported to ensure accountability and maintain the pace of progress towards our goal – a world where no mother or child dies needlessly. As advocates, we’re able to accomplish tremendous things when we’re smart, strategic, and persistent, with an eye towards the steps we can take year by year to continue progress towards goals with decades-long horizons.”


Emily Conron
Senior Advocacy Associate
World Vision US

Be the Catalyst!

When we question how we operate, we are also challenging our community to do better by addressing the “elephant in the room” and thinking strategically of who we are missing in our discussions. However, it is important to emphasize that these conversations, while fruitful, can end in wishful thinking when we do not follow them with action. Moving from discussion to action requires courage and the ability to work beyond our comfort zones and hold each other accountable. But when we do it, we become catalysts and more effective global health advocates.

Get Involved with North Carolina’s Vibrant Global Health Community

This post was written by Emily Kiser, Program Coordinator, Triangle Global Health Consortium as part of GHC’s Member Spotlight series. The Triangle Global Health Consortium is a non-profit member organization representing institutions and individuals from the pharmaceutical and biotechnology industry, the international health development NGO community, the faith community, and academia. The Consortium’s mission is to establish North Carolina as an international center for research, training, education, advocacy, and business dedicated to improving the health of the world’s communities. To learn more, visit Triangle Global Health Consortium is a 2018 GHC member.

North Carolina is a leader in global health, housing more than 220 organizations, companies, and academic institutions that work in more than 185 countries to improve the health of people around the world. Each year the Triangle Global Health Consortium is honored to recognize just a few of our many incredible global health leaders here in North Carolina. On the evening of Wednesday, May 2 the global health community will gather in Chapel Hill, NC for our Annual Award Celebration. Please save the date and plan to join us for a night of dinner, drinks, and inspiration! Awards to be presented include:

1) Ward Cates Emerging Leader Award
– awarded to an emerging leader in North Carolina who has demonstrated significant promise and a commitment to improving the health of the world’s communities
2) Corporate Impact Award – awarded to a company in North Carolina that has made a significant impact on improving the health of the world’s communities
3) Global Health Champion Award – awarded to a North Carolina global health leader in recognition of life-long commitment to advancing global health.

2017 Triangle Global Health Award Winners. Photo credit: Kelley Bennett Photography

We are proud to celebrate the incredible global health sector that calls North Carolina home. Our community is growing rapidly and there are constantly new opportunities to work within global health in the Tar Heel State. To connect global health professionals with these career opportunities, the Triangle Global Health Consortium is pleased to announce to launch of our new Global Health Career Center.

Our Global Health Career Center allows job-seekers to:

1) Search and apply
to the best global health jobs,
2) Upload an anonymous resume so employers can contact the job-seeker directly, and
3) Receive an alert every time a job becomes available that matches the job-seeker’s personal profile, skills, interests, and preferred location(s).

Member organizations of the Consortium post unlimited positions for free and non-member organizations are able to purchase job postings.

Check out the Global Health Career Center today – your next opportunity could be waiting!