Lancet Editorial Makes Recommendations For Health-System Strengthening

“There is strong consensus in the global health community, among donors, recipient countries, and policy makers, about the need for health system strengthening in low-income and middle-income countries,” write the authors of a Lancet Comment. The article recommends areas in health-system strengthening that need “more attention and better analysis,” including building consensus, and responding to specific country health system needs. Future focus areas, the authors write, should include strengthening governance, involving civil society and community-based organizations and assessing health systems performance at various levels (Sundewall et al., 9/3).

Journal Of Infectious Diseases Supplement Examines Rotavrius Burden In Africa

A supplement to the Journal of Infectious Diseases looks at “Rotavirus Infection in Africa: Epidemiology, Burden of Disease and Strain Diversity.” The authors write that across Africa “the results are consistent in highlighting the tremendous burden of rotavirus disease among young children.” From 1999 to 2009, “it is estimated that [more than] 2 million children have died from rotavirus disease on the African continent alone,” and the continent accounted for 50 percent of global deaths from rotavirus in 2004. The supplement also reviews rotavirus studies on Africa, vaccine development efforts and economic studies related to rotavirus burden (Neuzil et al., 9/1).

Blog: Experts Debate HIV Counseling, Testing Among HIV-Discordant Couples

A post on USAID’s “Impact Blog” examines a debate on HIV counseling and testing “among couples in which only one of the two partners has HIV.” On one side of the debate, researchers “argued that couples testing and counseling was an evidence-based and cost-effective intervention, which should be scaled up to prevent large numbers of new infections.” On the other side, researchers “concluded that a majority of new infections emerge from multiple and concurrent partnering practices and therefore that a majority of prevention funding should not be utilized for addressing sero-discordance among long-term stable partnerships,” according to the post. The debate is part of a series which will examine “emerging and sometimes controversial issues in HIV prevention,” sponsored by the USAID and the World Bank’s Global HIV/AIDS Program (9/1).

Blog: MCC Candidate Report Classifies Countries By Income

The Millennium Challenge Corporation (MCC) released a candidate report (.pdf), which “classifies countries according to income status and lists countries that are legally prohibited from receiving MCC funds,” according to a post on the Center for Global Development’s “Rethinking U.S. Foreign Assistance” blog. “This fiscal year there are 55 low-income countries (LICs) and 29 lower-middle income countries (LMICs) as compared to 56 LICs and 31 LMICs in FY2010.” The post offers a “quick breakdown” of countries that have changed status in the past year including countries moving from LIC to LMIC – Egypt, Kosovo and Sri Lanka – and countries “moving down” from LMIC to LIC status – the Philippines and the Republic of the Congo. Among countries “prohibited from funding,” are Burma, China, Iraq and North Korea. The author also explains that the report “provides a first glimpse at which countries might be selected as [MCC] eligible in FY2011” (Dunning, 9/1).

NEJM Editorial: Diagnosing TB With Improved Health Technologies

A New England Journal of Medicine editorial addresses the importance of advancing TB diagnostics after decades of “little effort to improve techniques.” The authors look at the study results of a new faster and more accurate test, writing that it “and others that are likely to follow have the potential to revolutionize the diagnosis of tuberculosis. Thus, in the coming years, rapid diagnosis and targeted treatment will provide the greatest opportunity for stopping the tuberculosis epidemic.” The editorial discusses some of the factors that can improve access to better diagnostics, such as reduced cost and health system efficacy, writing that “even the most promising diagnostic test will have only limited impact if it does not reach the patients who need it.” The authors suggest ways “[t]o realize the potential of improved technologies,” including the roles that scientists, policymakers and donors can play (Small/Pai, 9/1).

Study Examines Emergency Seed Aid Distributed After Haiti’s Earthquake

“A major study [.pdf] of agriculture in Haiti after this year’s earthquake has found that much of the emergency seed aid provided after the disaster was not targeted to emergency needs,” according to a press release from the University of East Anglia. The research took place “across 10 regions of Haiti in May and June” and examined “how the earthquake affected the resources and activities of farming households in the seasons immediately following the disaster,” including changes in labor, crops and related commercial activities. “The team recommended that emergency seed aid should only be used to address emergency problems. Aid organisations should ensure the seed they make available is adapted to local conditions, fits with farmers’ preferences, and is at least as good as what they normally use,” the press release states. The researchers also recommended using vouchers more widely to give farmers a choice and support local markets (9/1).

System For Boosting Vegetable Yields To Be Rolled Out In Sahel

The “African Market Garden” system, which combines drip irrigation with crop management to increase vegetable yields, will be employed with “about 7,000 small-scale farmers at 100 locations in Niger, Benin, Burkina Faso and Senegal,” according to a press release from the Consultative Group on International Agricultural Research (CGIAR) that adds details on how the system operates. “Support for the expansion comes from the governments of Israel, Italy, Switzerland and the USA and from the International Fund for Agricultural Development (IFAD), the World Bank, and various international foundations and NGOs,” the release adds. William Dar, director general of the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), said “The African Market Garden has proved its worth. To scale up the system, we need to prevail on governments, the private sector, NGOs and aid agencies to help create the conditions for success – including better technical support for farmers and more efficient markets for inputs and produce” (8/31).

Despite Good Intentions, U.S. Food Aid Can Harm

An article in the Atlantic examines the impact of food aid from the U.S., which spends “about $2 billion in taxpayer money each year.” The “good intentions” of the U.S., the author writes, “are directed not toward the suffering masses but to American farmers and shippers whose voices are heard most clearly in Washington.” The majority of food aid is produced in and shipped by the U.S. and the system is “shamefully rife with inefficiencies and misplaced priorities.” The author also examines the “damage our food aid causes to farmers in developing countries,” including rice farmers in Haiti, arguing the U.S. should “simply [buy] food from farmers in the countries affected” (Duffy, 8/31).

Blog: Providing Safe Water Through Technology

In advance of World Water Week, a blog on the Huffington Post writes, “Providing safe, reliable, piped-in water to every household is an important goal that yields optimal health gains. It is also a goal that is expensive to achieve, and requires a long timeframe. In the meantime, simple and inexpensive technologies exist that provide clean, safe drinking water at the home, through easily used and affordable methods of treatment and storage.” The post discusses a program that trains people to treat their water at home with a system called WaterGuard. Through the home treatment approach, global health non-profit PSI enables “17 million people around the world to drink a glass of clean water every day” (Hofmann, 8/31).

Emerging Economies Need To Invest In Their Own NTD Control

A PLoS Neglected Tropical Diseases editorial examines neglected tropical disease (NTD) control in the “Post-American World”: “We cannot expect the United States and the United Kingdom to shoulder the entire financial burden of global NTD control.” The author calls for countries with emerging economies – specifically Brazil, Russia, India, China (BRIC), Nigeria and Indonesia – to commit to “controlling their own NTDs,” which “would likely double the impact of the current U.S. commitment.” Based on the high NTD disease burden of the BRIC countries, he estimates that “roughly 20% of the world’s burden of intestinal helminth infections, lymphatic filariasis, and trachoma could be reduced,” if BRIC countries had greater control and elimination efforts. The editorial notes that the U.S. currently provides around “US$100 million annually for NTD control, with plans to possibly double this amount by 2011” (Hotez, 8/31).

Melinda Gates Blogs On MDG Progress Ahead Of TEDxChange Event

Ahead of the Bill & Melinda Gates Foundation’s TEDxChange event, which will focus on the progress made towards achieving the Millennium Development Goals (MDGs), Melinda Gates writes this week about the MDGs on the foundation’s blog. The entries include: “Celebrating the Simple, Lifesaving Act of Breastfeeding”; “Saving Women’s and Children’s Lives by Controlling Malaria”; “Immunization – A Key to Reducing Child Deaths”; and “Ghana’s Incredible Path Out of Poverty and Hunger” (8/30 – 9/2).

Blog: USAID Programs Impact Maternal Health In Afghanistan

A post on USAID’s “Impact Blog” looks at maternal health programs funded by the agency in Afghanistan. USAID’s Health Services Support Project, along with the government and a partner organization, has trained women to assist during birth, helping to increase the number of trained midwives to 2,000 from around 450 since the fall of the Taliban. “The success of USAID-funded projects in Afghanistan has also led to the training of 8,500 community health workers and the formation of a professional midwife’s association, which includes 1,600 members,” the author writes, noting that the percent of births with a skilled attendant in Afghanistan “increased from 8 percent in 2003 to 19 percent in 2006” (8/30).

Zambia May Face ‘Massive’ HIV Funding Gap As It Seeks ART Scale Up  

Zambia may face a “massive” $57.6 million gap in funding for antiretroviral therapy (ART) by 2015, the Center for Global Health Policy’s “Science Speaks” blog writes, citing a USAID-funded Deliver Project analysis. The report, which studied the funding needed to “reach country targets for expanded access to antiretroviral therapy,” also shows a gap of $8.2 million for 2011. The post notes that Zambia hopes “to increase the overall number of patients receiving ART by about 24 percent from 2010 to 2015,” including expanding therapy to more mothers and infants, which could be hampered because of the funding gap. Additionally, “[p]rospects for U.S. support for scale up are unclear” because the PEPFAR framework for Zambia is still being finalized. The post also addresses Zambia’s relationship with the Global Fund to Fight HIV, Tuberculosis and Malaria (Bryden, 8/27).