Improving maternal health remains the most elusive of the Millennium Development Goals. Every minute, at least one woman dies from pregnancy-related causes: 99 percent of these are in developing countries. The majority of these deaths occur in sub-Saharan Africa and south Asia, and are avoidable through using standard interventions and health care which all pregnant women and their newborns need.
Equitable health services
Improving the health of mothers and babies: Breaking through health system constraints
Matthews Z: ID21Health News, August 2007
The contribution of primary health care to the Millennium Development Goals
Chan M: The World Health Organisation, 16 August 2007
The Director-General of the World Health Organisation in an opening address at the International Conference on Health for Development in Buenos Aires, Argentina on 16 June 2007 argued that to realize the great potential of health to drive human development, we must reach the poor with appropriate, high-quality care. The speech explores challenges in the role that primary health care can play in this and how to overcome major barriers, such as weak health systems, inadequate numbers of health care staff, and the challenge of financing care for impoverished people.
UN agencies unveil initiative to reduce female genital mutilation
United Nations News Service, 9 August 2007
Two United Nations agencies have launched a $44 million programme to reduce female genital mutilation/cutting (FGM/C) by 40 per cent by 2015 and to end the harmful traditional practice within a generation. Launched by the UN Population Fund (UNFPA) and the UN Children’s Fund (UNICEF), the initiative will encourage communities in 16 African countries with high prevalence to abandon the practice, which has serious physical and psychological effects. Partnering with the agencies will be Governments, religious leaders, reproductive health providers, media and civil society.
WHO releases new guidance on insecticide-treated mosquito nets
World Health Organisation, 16 August 2007
The World Health Organization (WHO) today issued new global guidance for the use of insecticide-treated mosquito nets to protect people from malaria. For the first time, WHO recommends that insecticidal nets be long-lasting, and distributed either free or highly subsidized and used by all community members. Impressive results in Kenya, achieved by means of the new WHO-recommended strategy, show that free mass distribution of long-lasting insecticidal nets is a powerful way to quickly and dramatically increase coverage, particularly among the poorest people. This is the first demonstration of the impact of large-scale distribution of insecticide treated mosquito nets under programme conditions, rather than in research settings, where, in different parts of Africa, reduction observed in overall mortality has ranged from 14 % up to 60 %.
Geographical disparities in core population coverage indicators for Roll Back Malaria in Malawi
Kazembe LN, Appleton CC, Kleinschmidt I: International Journal for Equity in Health 6:5, 4 July 2007
Implementation of known effective interventions could reduce the malaria burden by half by the year 2010. Identifying geographical disparities of coverage of these interventions at small area level is useful to inform where greatest scale-up efforts should be concentrated. They also provide baseline data against which to compare future scale-up of interventions. However, population data are not always available at local level. This study applied spatial smoothing methods to generate maps at subdistrict level in Malawi to serve such purposes.
Global tuberculosis control: surveillance, planning, financing
World Health Organization, 2007
This eleventh annual WHO report on Tuberculosis (TB) assesses whether national TB control programmes (NTP) around the world met the 2005 targets of 70 per cent case detection and 85 per cent cure, and examines the effectiveness of the Stop TB strategy. The paper finds that TB is still a major cause of death worldwide, but the global epidemic is on the threshold of decline – in 2005 the TB incidence rate was stable or in decline in all six WHO regions, and had reached a peak worldwide. Most government health services now recognise that TB control must go beyond DOTS (the recommended strategy for controlling TB), however, the broader Stop TB Strategy is not yet fully operational in most countries.
HIV and TB in the context of universal access: what is working and what is not?
International HIV/AID consultative meeting report: Stop TB Partnership, 2007
This paper reports on a meeting co-organised by the World Health Organization, UNAIDS and international organisations, to accelerate an effective and joint response to the epidemic of HIV-related tuberculosis (TB). The paper highlights the achievements of the global TB/HIV working group from the Stop TB Partnership, and discusses the concept of universal access to HIV services and its importance and contribution to TB prevention, diagnosis and treatment services. It also highlights some critical issues that have been neglected in the global response to HIV-related TB, including the optimal treatment regimens to use when treating TB and HIV at the same time.
Joint tuberculosis/HIV services in Malawi: progress, challenges and the way forward
Chimzizia R, Harries A: Bulletin of the World Health Organization 85 (5), May 2007
This article reviews the progress made on a three-year tuberculosis (TB)/HIV plan implemented in Malawi between 2003 and 2005. The objectives of the plan were to scale up HIV testing among TB patients and, for HIV-positive TB patients, to provide cotrimoxazole preventive therapy (which provides protection against bacterial infections including pneumonia) and facilitate access to antiretroviral (ARV) treatment. The paper finds that the proportion of TB patients tested for HIV increased from 15 per cent in 2003 to 47 per cent in 2005. During this time, most HIV-positive TB patients started cotrimoxazole preventative therapy.
Protective effect of measles vaccine is short-lived in HIV-infected Zambian children
Moss WJ, Scott S, Mugala N, Ndhlovu Z, Beeler JA, Audet SA, Ngala M, Mwangala S, Nkonga-Mwangilwa C, Ryon JJ, Monze M, Kasolo F, Quinn TC, Cousens S, Griffin DE, Cutts FT: The Journal of Infectious Diseases, 196:347–355, 2007
The level and longevity of protective antibodies elicited by a measles vaccine is significantly shortened by HIV infection in Zambian children. Measles still remains a significant cause of childhood mortality in sub-Saharan Africa despite the availability of a vaccine. Barriers to successful measles control by vaccination include poor logistics and insufficient resources, lack of political will, and HIV/AIDS. Successful measles control in southern Africa with a high HIV prevalence suggests that the HIV epidemic is not a bottleneck to control. The determinants of this success must be identified so that it is replicated in other regions. Specifically, how can a high population immunity be achieved in regions with high HIV prevalence so that measles can be eliminated?
Tuberculosis in sub-Saharan Africa: opportunities, challenges, and change in the era of antiretroviral treatment
Corbett EL, Marston B, Churchyard GJ: The Lancet, 2007
This article reviews how commitments to antiretroviral (ARV) treatment affect tuberculosis (TB) control and sets out the changes needed to address HIV and TB in a coordinated manner. The article examines the burden of HIV and TB in Africa and how the HIV epidemic has challenged the Directly Observed Treatment Strategy (DOTS) as a way of controlling tuberculosis. The authors argue that collaboration between TB and HIV/AIDS treatment programmes is needed, along with a unified public-health vision towards the prevention and treatment of these interacting diseases.