A new pilot project in Cambodia is allowing more than 3,000 volunteer health workers to use a special mobile phone text messaging service to report new cases of malaria, in addition to providing no-cost testing and treatment “in remote parts of the impoverished nation, where access to health services can be difficult,” Agence France-Presse reports. When a person tests positive for malaria, health workers begin them on treatment immediately and send a text message with the patient’s age, gender, type of malaria, and location “to the district health center, provincial health officials and a national malaria database in the capital Phnom Penh — a process that used to take a month,” AFP notes. “The information is also fed into Google Earth to create a map of reported cases and of potential hotspots of [malaria drug] resistance,” a problem in western Cambodia, according to the news service. “Together, the data helps officials track each case and make sure the right treatment is available or that more medication is supplied when stocks are running low,” AFP writes, adding, “Some 230 volunteers have used the mobile phone service so far and there are plans to eventually include all volunteers in the project,” which is being implemented by the Malaria Consortium (Se, 9/17).
Quality of Care
“The non-communicable disease [NCD] community always talks about the importance of prevention; many consider it the Holy Grail in the fight against NCDs. Why was it so hard to also accept treatment as part of the solution?” Princess Dina Mired, director general of the King Hussein Cancer Foundation in Amman, Jordan, asks in the Huffington Post “Impact” blog, noting only one target of the 2011 U.N. High-Level Meeting on NCDs “deals with treatment, the target on ‘essential medicines and basic technologies for treatment.'” She continues, “Treatment and prevention are heavily interrelated. The success of one is directly related to the other.” She adds, “A person in the developing world will not buy in to the importance of prevention if there is no treatment option available should that person get the disease.”
“Following criticism over a spate of patient deaths from adverse events during clinical trials, India has begun tightening up rules for clinical research and compensation as well as expanding its pool of medical experts,” SciDev.Net reports. A health ministry official said the ministry would submit to Parliament amendments to existing laws with the aim of strengthening the approval process for clinical trials, according to the news service. In addition, the Central Drugs Standard Control Organisation (CDSCO) is expanding its pool of experts, “has asked ethics committees for tougher inspection regimes,” and in August “issued guidelines on compensation to be paid in case of clinical trials-related death or injury,” the news service notes. According to SciDev.Net, “These steps follow the report of a parliamentary committee, in May 2012, which found that a large number of imported drugs had been cleared without trials,” “includ[ing] drugs that had failed to be cleared for use in the parent countries” (Sreelata, 9/12).
“As many as 200 million children across the world fail to reach their full potential because their early brain development is held back by poverty, disease and malnutrition, global health experts said on Thursday,” Reuters reports (Kelland, 9/13). The Canadian government-funded Grand Challenges Canada on Thursday “announced $11.8 million CAD [$12 million] in funding over two years for 11 bold ideas from innovators in the developing world, to address health conditions causing diminished cognitive potential and stunting,” according to a Grand Challenges Canada press release (9/13). The projects, which will be implemented in developing countries such as Thailand, Pakistan, Bangladesh, and Colombia, “include plans to encourage so-called ‘kangaroo mother care,’ where low-weight newborns are held skin to skin rather than put into incubators, and ways of combating maternal depression to boost interaction between mothers and babies,” Reuters notes (9/13).
The Center for Strategic and International Studies (CSIS) on Thursday hosted a panel discussion focusing on the policy implications of findings published by the Lancet in a special series on HIV/AIDS and men who have sex with men (MSM), the Center for Global Health Policy’s “Science Speaks” blog reports (Barton, 9/7). Chris Beyrer, a professor of international health at the Johns Hopkins Bloomberg School of Public Health and a contributor to the Lancet series, explained two factors are affecting the expansion of the HIV epidemic among MSM worldwide, according to Inter Press Service. First, HIV “is far more efficiently transmitted through the gut, hence leading to a far higher transmission probability in anal sex, for either a man or a woman — around 18 times more likely than through vaginal transmission,” the news service writes. Second, “because gay men can switch sexual roles in a way that is impossible among heterosexual couples — acting as both the acquisition and transmission partner — the efficiency of transmission among MSM networks appears to be far higher than previously understood,” IPS adds, noting, “These two factors, the new research suggests, account for a full 98 percent of the difference between HIV epidemics among MSM and heterosexual populations.”
Ugandan Parliamentarians Threaten To Hold Up National Budget Unless More Funding Committed To Health Care
In Uganda, where “there are fewer than two health workers for every 1,000 people — a level the World Health Organization defines as a severe shortage” — the nation’s parliamentary “social services committee, which has initial oversight of the country’s health budget, pushed a resolution through parliament last week threatening to hold up approval of the entire budget unless funding to recruit and retain new health workers is increased,” VOA News reports. “Committee members, with support from the Women’s Parliamentary Association, called for a specific increase of at least $103 million to the sector,” the news service notes. “In addition to the funding increase, the parliamentarians are calling for an end to a wage freeze for current employees and a ban on recruiting new health workers,” as well as “demanding a supplementary pool of money to improve health care in communities that are particularly short staffed,” according to the news service.
In a 200th anniversary article for the New England Journal of Medicine, Salmaan Keshavjee of the Department of Global Health and Social Medicine at Harvard Medical School and Paul Farmer of Partners in Health “seek to elucidate the reasons for the anemic response to drug-resistant tuberculosis [TB] by examining the recent history of tuberculosis policy,” they write. The authors outline the history of TB drug development and how the disease became resistant to myriad drugs, and write that by the 1970s, “[t]uberculosis, whether caused by drug-susceptible or drug-resistant strains, rarely made even medical headlines, in part because its importance as a cause of death continued to decline in areas in which headlines are written. They continue, “In the United States, federal funding for tuberculosis research was cut; consequently, drug discovery, development of diagnostics, and vaccine research ground almost to a halt.”
“Kenya has launched an investigation after researchers claimed HIV-positive women were being routinely sterilized without their consent in government hospitals,” the Guardian reports. The African Gender and Media Initiative issued a report “based on interviews with 40 women, suggest[ing] the practice was widespread and ongoing,” according to the newspaper. “The report also includes examples of coercive tactics used by medical staff to obtain consent — for instance, threatening to withhold antiretroviral medication or baby milk if the woman did not agree to the procedure,” the newspaper writes. “‘These allegations are very serious and the Kenya Medical Practitioners and Dentists Board is going to investigate them before appropriate action is taken,’ Shariff Shahnaz, the director of public health, told the Daily Nation newspaper,” the Guardian reports (Mojtehedzadeh, 9/4).
Approximately one-third of children under the age of five in southern Afghanistan, about one million, have acute malnutrition, “with a level of deprivation similar to that found in famine zones, a government survey has found, despite the hundreds of millions of dollars in foreign aid that has been poured into the region,” the Guardian reports. The U.N.-supported “Afghanistan Multiple Indicator Cluster Survey (MICS) found 29.5 percent of children are suffering from acute malnutrition there,” the newspaper states, noting that a level of more than 30 percent is one indicator of famine, as are death rates and families’ access to food.
“Despite pledges from governments across Eastern Europe and Central Asia to fight HIV/AIDS — one of the eight Millennium Development Goals — the region has the world’s fastest-growing HIV epidemic,” Inter Press Service reports in an article examining challenges to stemming the spread of the disease, particularly among injection drug users. “Punitive drug policies, discrimination and problems with access to medicines and important therapy are all driving an epidemic which is unlikely to be contained, world experts say, until governments in countries with the worst problems change key policies and approaches to the disease,” the news service writes. According to experts and activists, a lack of opiate-substitution therapy (OST) and needle-exchange programs, as well as discrimination against and “active persecution” of drug users who try to access therapy programs, contributes to the spread of HIV, IPS notes (Stracansky, 9/3).