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A diverse look at global health issues.

HIV pill: Progress or setback?

New WHO recommendation on prevention medicine highlights debate about how to end the virus for good.
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MELBOURNE, AUSTRALIA - JULY 20: (CHINA OUT) (L-R) President-Elect of the IAS Chris Beyrer, president of the IAS Francoise Barre-Sinoussi, UNAIDS Executive Director Michel Sidibe, executive Officer of Living Positive Victoria Brent Allan, Ayu Oktariani, professor Sharon Lewin and Michael Kirby attend a press conference during the 20th International AIDS Conference at The Melbourne Convention and Exhibition Centre on July 20, 2014 in Melbourne, Australia. At least six delegates travelling to the 20th International AIDS Conference were on board the Malaysia Airlines flight MH17 which was reportedly shot down over Eastern Ukraine. (ChinaFotoPress/AFP/Getty Images)

The World Health Organization’s new recommendation that men who have sex with men should consider taking preventive medicine to help avoid HIV infection has renewed debate in the global health community about the best way to combat the disease.

In a set of guidelines on HIV treatment, care and prevention released this month, the WHO announced for the first time that among men who have sex with men, PrEP – short for pre-exposure prophylaxis – “is recommended as an additional HIV prevention choice within a comprehensive HIV prevention package.” Such a package should include monthly HIV testing, counseling and condom use, according to the report, published just ahead of the 20th International AIDS Conference, which started July 20 in Melbourne.

The announcement met a mixed response, with some AIDS experts and advocates saying that the recommendation is a step forward in HIV prevention strategies. Critics argued, however, that encouraging the use of PrEP could result in a drop in condom use and reverse existing prevention and treatment efforts.


UN reports 21.8 million infants weren't vaccinated in 2013

Reducing this figure will require improving vaccine transportation and storage and rethinking aid, health experts say.
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A Pakistani health worker administers the polio vaccine to a child during a vaccination campaign in Bannu on June 25, 2014. Pakistan launched a fresh polio vaccination drive in its restive tribal belt late last month, but officials warned that nearly 370,000 children are likely to miss out because of security problems. (A Majeed/AFP/Getty Images)

Nearly 22 million infants around the world were not vaccinated last year that should have been, according to a report released last week by the World Health Organization and UNICEF. The startling number underscores the need for innovations in vaccination storage and a critical re-think of existing vaccine aid programs, health advocates said.

Though more than 111 million infants were vaccinated last year, WHO estimates that figure accounts for only 84 percent of the world’s children – and in fact, some experts say the proportion could be even lower.


Public-private collaboration paved way for new portable TB test

Tuberculosis experts say partnerships key to development of new diagnostics and drugs in the fight against TB.
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Dr. Jeffrey Cirillo, professor at the Texas A&M Health Science Center College of Medicine, holds up a prototype of TB REaD, the portable diagnostic device he and his colleagues invented. The device is in its final clinical trials and is set to hit the market in about 18 months. (Texas A&M Health Science Center/Courtesy)

A five-inch, battery-operated black box could be the future of tuberculosis diagnosis. The device, developed this year by a team of Texas doctors, can spot tiny amounts of TB bacteria in coughed-out sputum samples in less than half an hour. That’s a fraction of the time it takes to diagnose the disease using the most common methods today.

The device, to be marketed under the name TB REaD, is “designed to be really simple and require no technical experience,” said Jeffrey Cirillo, a professor at the Texas A&M Health Science Center College of Medicine who led the product’s development. “We want this to be able to be used anywhere.”

Cirillo’s work – supported by a partnership that includes the Foundation for Innovative New Diagnostics (FIND), the Wellcome Trust, the National Institutes of Health (NIH) and the Bill and Melinda Gates Foundation – is just one example of the kind of innovation made possible by collaborations among non-government organizations, private companies and government bodies in the fight against TB.


Mother's helper? Text messages deliver health advice to South African women

A US-backed mobile health program signs up young mothers at their local health clinic. Global health reporting fellow Sara Jerving reports from South Africa.
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Outside the Esselen health clinic in Johannesburg, South Africa in June 2014. The Esselen clinic participates in the Mobile Alliance for Maternal Action (MAMA) program, a US-backed public-private partnership. (Sara Jerving/GlobalPost)

JOHANNESBURG, South Africa – I walked into the Esselen clinic in Hillbrow, Johannesburg on a recent morning to find around 40 women and their newborn babies crowded together on rows of wooden chairs. They were waiting for a health worker to call them into another room where a chorus of cries could be heard — the sound of babies being stuck with vaccination needles.


Legal restrictions lead to 'DIY abortions' in Texas and Argentina alike

As Texas limits access to abortion, it is walking down a road well-tread by Argentina, where abortion is illegal but half a million women still terminate their pregnancies each year.
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Supporters of Texas women's right to reproductive decisions rally at the Texas State Capitol on July 1, 2013 in Austin, Texas. It was the first day of a second legislative special session called by Texas Gov. Rick Perry to pass an restrictive abortion law through the Texas legislature. The first attempt was defeated after opponents of the law were able to stall the vote until after first special session had ended. (Erich Schlegel/AFP/Getty Images)

HOUSTON, Texas and BUENOS AIRES, Argentina — The plane descended and just beyond the city limits, the clouds gave way to a view of the expansive territory Texas is known for. We had landed, the flight attendant announced, in Houston — the most populous city in the Lone Star State.

We were on our way from Boston to Buenos Aires, where we will be reporting for the next two weeks on the country’s high abortion rate and the legal and religious institutions that surround it.


Making agriculture 'sexy and sustainable' in Mali: Q&A with Salif Niang

A Malian entrepreneur attempts to reduce farmer losses in his country by helping privatize the rice industry.
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Malian entrepreneur Salif Niang co-founded Malo SARL to bring the private sector into the country’s rice industry in an attempt to reduce farmer losses in his country. Photo credit: Aspen Institute New Voices Fellowship. (Courtesy)

ASPEN, Colo. — At last year’s World Food Prize, Nigeria’s Minister of Agriculture, Akinwumi Adesina, presented on the state of the African agriculture industry. He repeatedly said, “We need to see agriculture in Africa as a business. That is the only way it will grow.”

Seeing agriculture as a charitable activity to alleviate poverty, he claimed, has not worked. In some African countries, up to 80 percent of the population works in food production. Despite this, under-nutrition is still responsible for an annual 3.5 million child deaths across the continent.


Q&A with UN adviser Amina Mohammed: MDGs 'not deep enough'

As the 2015 deadline for the Millennium Development Goals nears, the special adviser to the United Nations' Secretary-General reflects on the 'unfinished business' left to tackle
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Amina Mohammed, the United Nations' Special Advisor of the Secretary-General on Post-2015 Development Planning, speaks at the The Partnership for Maternal, Newborn & Child Health conference in Johannesburg, South Africa in June 2014. (Tracy Jarrett /GlobalPost)

With the United Nations Millennium Development Goals—the eight international development goals established to promote global health, eradicate poverty, and achieve universal education—set to expire in 2015, questions remain on how successful implementation of the goals have been on the ground.


UN: Millennium Development Goals leaving some regions behind

The United Nations and development advocates praise strides made over the last 14 years, but say more needs to be done to achieve development goals — especially those around health.
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Mothers and children wait to meet the United Nations Secretary General Ban Ki-Moon at Kalembelembe Pediatric center in Kinshasa, Democratic Republic of the Congo. Ban Ki-Moon said he chose the DRC to start his African tour to 'pay tribute to the courage and determination of the Congolese people.' (Don Emmert/AFP/Getty Images)

The United Nations praised progress made around the world toward achieving the eight Millennium Development Goals (MDGs) in an official report released today. Targets for reducing poverty, increasing access to clean water and ensuring environmental sustainability have already been reached in advance of the 2015 deadline, and others are on their way to being achieved, according to the Millennium Development Goals Report 2014.

But the UN, along with human rights groups, said that the results are uneven and called for continued efforts to fight disease, pollution and inequality. More attention should be given to regions such as South Asia, sub-Saharan Africa and Oceania, where conflict, underdeveloped rural areas, continuous population growth and economic volatility have made for slower growth, they said.

“The concerted efforts of national governments, the international community, civil society and the private sector have helped expand hope and opportunity for people around the world,” UN Secretary-General Ban Ki-Moon wrote in the report’s foreword. “But more needs to be done to accelerate progress. We need bolder and focused action where significant gaps and disparities exist.”

Four of the eight MDGs – those seeking to eradicate extreme hunger and poverty, promote universal primary education, preserve environmental sustainability and build a global partnership for development – have already been achieved or are close to being achieved, particularly in east and central Asia, Latin America and the Caribbean and northern Africa, according to the new report. Health-related goals have been harder to attain, however, as many regions continue to struggle with improving maternal health, fighting disease and reducing child mortality.


Hobby Lobby ruling inspired 100 more cases in less than a week

The Supreme Court said it is "highly unlikely" that more corporations will go after religious freedom claims, but already groups taking up suits and looking to get out of a pending LGBT discrimination order.
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Sister Caroline (L) attends a rally with other supporters of religious freedom to praise the Supreme Court's decision in the Hobby Lobby, contraception coverage requirement case on June 30, 2014 in Chicago, Illinois. Oklahoma-based Hobby Lobby, which operates a chain of arts-and-craft stores, challenged the provision and the high court ruled 5-4 that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom. (Scott Olson/Getty Images)

It’s been just days since the Supreme Court granted religious exemption to Hobby Lobby and other closely held corporations, ruling that the insurance they provide their employees does not have to cover contraception, as stipulated by the Affordable Care Act (ACA), and already Justice Ruth Bader Ginsburg’s prophetic dissent is manifest.

Following a blistering and sometimes-sarcastic 35 pages of opposition, Ginsburg, perhaps now somewhat famously, concluded: “The Court, I fear, has ventured into a minefield.”

Indeed, it seems as though it has.

While President Obama vowed to restore the lost coverage to women, a host of other religious groups and institutions have decided not to wait around and see what kinds of new regulations might come into play.

According to the Becket Fund, the religious law firm that represented Hobby Lobby, there are already 49 pending federal cases in which for-profit companies have claimed “religious objections to the ACA and another 51 that involve nonprofit organizations.”

Additionally, the Supreme Court has ordered three appeals courts to reevaluate challenges made by companies that also objected to the contraception stipulation, but which objected to all contraceptive methods and not just the four addressed in the Hobby Lobby case.


How is a US-backed mobile health program helping mothers in South Africa?

Kaiser Family Foundation reporting fellow Sara Jerving heads to Johannesburg to learn more about MAMA, a public-private effort to improve maternal health
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Mthandazo Ntini, 21, holds her 6-week-old daughter, Luyanda Grace, and checks messages on her phone after her visit at the Esselen Clinic in Johannesburg, South Africa. (Sara Jerving/GlobalPost)

JOHANNESBURG, South Africa – After landing in Johannesburg following a 19-hour flight from New York, I hop in a taxi heading towards the city center. As I look out the window, the nation’s largest city seems calm. The streets are clean, children are playing in the parks, and family homes and business complexes dot the landscape. The grass is parched a golden hue as winter rolls in. People stroll down the streets, shielding themselves from the cool weather with winter caps and sweaters.

But the quiet calm conceals a troubling concern in this nation of over 52 million people. South Africa is failing its mothers and newborns. Across the country, 4,300 women die each year as a result of complications that arise during pregnancy and childbirth. For babies, it’s even worse. Some 20,000 are born stillborn and another 23,000 babies die within their first month, according to UNICEF. Yet another 75,000 children don’t make it to their fifth birthday. While the South African government has made efforts to improve maternal and child health outcomes in the nation, still over 60 percent of deaths of children under 5 years old are avoidable, due to failures of the health system, such as poor assessment and management of care in hospitals.