“Poor hospital care poses a risk to the lives of many patients in the developing world,” according to a study published in the British Medical Journal (BMJ) on Tuesday, BBC News reports (McGrath, 3/13). For the study, which was supported by the WHO, researchers from the New York City Health and Hospital Corporation “looked at patients from 26 hospitals altogether across eight countries” — Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen — and “found that harm to patients caused by their health care rather than their disease is a major public health problem and consistent with previous reports from the developed world,” according to a BMJ press release.
Health Workforce & Capacity
PlusNews examines the challenges and concerns surrounding Zimbabwe’s plan to conduct a door-to-door HIV testing campaign, which has not yet begun but “is already being met with skepticism by activists who feel this is not a priority for the country, especially with global HIV/AIDS funding on the decline.” National AIDS officials say the country’s “AIDS levy — a three percent tax on income — has become a promising source of funding”; in 2010, $20.5 million was collected, with most of that going to purchase antiretroviral drugs (ARVs), PlusNews notes. Of the estimated 1.2 million people living with HIV in Zimbabwe, 347,000 access ARVs through a national program, and another 600,000 people “urgently” need them, according to the news service.
PlusNews examines challenges and concerns over an announcement by the Zimbabwean government that it plans to train nurses to prescribe and administer antiretroviral drugs (ARVs) to people living with HIV in the country. “Previously, nurses were allowed only to administer the drugs after a doctor had prescribed them,” the news service writes, adding, “Now, changes made in the job descriptions of nurses by the Nurses’ Council of Zimbabwe will see them prescribing the medication.” Owen Mugurungi, director of the HIV/AIDS and TB unit in the Ministry of Health and Child Welfare, said, “I need to point out that it’s not enough that a professional council allow nurses to administer drugs; this should be followed up with measures to capacitate nurses to do this work correctly,” according to PlusNews. The news agency looks at how the possibility of work overload for nurses, a government hiring freeze on nurses, and ARV availability could affect the country’s plan to reach 85 percent of the population in need of HIV treatment by the end of this year (10/16).
U.S. Global AIDS Coordinator Ambassador Eric Goosby is “expected to announce a new initiative between the U.S. government, the Rwandan Ministry of Health and 14 American medical schools at a press conference Monday in Kigali, Rwanda,” the New York Times reports. “The Human Resources for Health program will send 100 faculty members from eight medical colleges, five nursing and midwifery schools, and one health management school to Kigali where they will train health professionals and medical students, according to a statement from the Clinton Global Initiative,” the newspaper writes. “The two governments, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the universities have committed $152 million to the seven-year program,” the newspaper notes (Lau, 10/14).
Emergency Obstetric Care Reduced Maternal Mortality Rates Up To 74% In Two African Projects, MSF Reports
According to a new briefing paper (.pdf) from Medecins Sans Frontieres (MSF), access to emergency obstetric care, including ambulance service, could help save the lives of up to three quarters of women who might otherwise die in childbirth, AlertNet reports (Batha, 11/19). In two projects, one in Kabezi, Burundi, and the other in Bo, Sierra Leone, MSF showed “that the introduction of an ambulance referral system together with the provision of emergency obstetric services can significantly reduce the risk of women dying from pregnancy related complications,” according to an MSF press release. The services, which cost between $2 and $4 per person annually, are offered 24 hours a day, seven days a week, and are free of charge, the press release notes (11/19). The projects “cut maternal mortality rates by an estimated 74 percent in Kabezi and 61 percent in Bo,” Reuters writes, adding, “The charity hopes its model could serve as an example for donors, governments and other aid agencies considering investing in emergency obstetric care in countries with high maternal mortality rates” (11/19).
As part of its “Blueprint” series discussing the creation of a U.S. global AIDS blueprint called for by Secretary of State Hillary Clinton in July, the Center for Global Health Policy’s “Science Speaks” blog features an opinion piece by Salmaan Keshavjee of Harvard Medical School and Partners In Health. With an estimated 1,000 people with HIV dying of tuberculosis (TB) every day, “[i]t is clear that our current approaches to addressing the global tuberculosis pandemic are inadequate,” he writes. Keshavjee says, “First, bold targets for reducing tuberculosis incidence and zero TB-HIV deaths must be prioritized in the blueprint. … Second, known strategies for stopping the spread of tuberculosis have to be actively implemented. … Lastly, any effective strategy has to ensure that HIV advocates at the community level are educated about the threat of tuberculosis,” and he describes each of his points in detail. He concludes, “The United States has shown visionary leadership in the area of HIV treatment and changed the lives of countless people for the better. It is time to take on tuberculosis with the same moral and pragmatic vigor” (Barton, 10/31).
The “grand experiment” of the Affordable Medicines Facility-malaria (AMFm) — a pilot program that aims to get artemisinin-based combination therapies (ACTs) into rural areas of several African nations — “seems likely to end, its successes underrated and potential improvements not yet explored,” a Nature editorial says. In October, “an independent evaluation found that it had performed remarkably well on the main benchmarks of success, increasing the number of outlets stocking ACTs and lowering prices,” but last week “the Global Fund to Fight AIDS, Tuberculosis and Malaria decided to end the AMFm as a stand-alone program, by integrating it into the fund’s core system for awarding malaria-control grants to countries,” the editorial notes, adding, “This integration probably spells the end for AMFm, because there will be no new money for the program after the end of next year.”
The Guardian on Sunday published the winning article and a number of shortlisted articles from its International Development Journalism Competition. The winning article, Medicine versus myth in Sierra Leone, examines how a “lack of medical staff results in many preventable deaths” in the country. Shortlisted articles examine maternal mortality in Uganda, domestic abuse in Timor-Leste, and health worker shortages in Malawi, among other issues (11/25).
Polio Vaccination Campaign In Darfur Shows Immunizations Possible In 'Emergency And Conflict Settings'
In an Inter Press Service opinion piece, Siddharth Chatterjee, chief diplomat and head of strategic partnerships at the International Federation of Red Cross and Red Crescent Societies, and Sam Agbo, an independent public health adviser in the U.K., write about the unstable situation in Darfur, Sudan, in 2004, and how “UNICEF and WHO in Sudan along with important NGO partners started planning with local authorities on how best to immunize all children in Darfur.” They outline the major challenges, including staff safety, and discuss how multi-agency teams were able to vaccinate 10,000 children in two immunization rounds. Chatterjee and Agbo add, “The polio immunization campaign was the driver for a wider process of improving and ramping up assistance to communities and this made the campaign attractive to mothers to bring their children to the immunization hubs that were established.”
Doctors in Kenya on Wednesday were striking for the 17th day to protest poor conditions in some of the nation’s public hospitals, where “[e]mergency rooms … frequently don’t have gloves or medicine, and power outages sometimes force doctors to use the light from their phones to complete a procedure,” the Associated Press reports. Last week, “Kenya’s government fired 1,000 of the 2,000 striking doctors … despite a shortfall of skilled medical practitioners,” the news service writes, noting Kenya has one doctor for every 6,250 people and the WHO recommendation is one for every 100 people. “Attempts to hold talks this week with officials from the Ministry for Medical Services failed, prompting the doctors to flood social media with tell-all stories about deplorable conditions in public hospitals,” the AP states.