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A diverse look at global health issues.

New US global AIDS coordinator has a roadmap to eliminating the disease

Commentary: US commitment is largest a nation has ever made to combating a single disease.
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Photo taken on November 28, 2013 shows staff members of the Themba Lethu Clinic in Johannesburg, the largest antiretroviral treatment site in the country, posing behind candles commemorating World Aids Day (December 1). South Africa has been hailed as a model for HIV treatment, but some now fear its very success may be breeding complacency and making people less careful about infection. (ALEXANDER JOE/AFP/Getty Images)

WASHINGTON — News broke last week that South Africa has the fastest growing rate of new HIV infections of any country in the world, underscoring the urgency of the fight against HIV/AIDS and the fragility of our progress to date. It also underscores a perpetual truth: leadership matters and we need bold, innovative and affirmed commitment to end this disease.

Early this year, the Obama administration nominated Deborah Birx as the next US Global AIDS Coordinator and first woman to assume the role. Last week, the Senate voted to confirm her appointment. In this position, Birx will oversee the President’s Emergency Plan for AIDS Relief (PEPFAR), the largest commitment a nation has ever made to combat a single disease. Our hope is that she uses this leadership role to work with diverse groups to promote the health and rights of all people and to expand the integration of family planning and HIV services.

We have come a long way in the fight against HIV/AIDS through PEPFAR and other programs. Yet as South Africa’s news illustrates, troubling disparities, stigma, and discrimination persist and women often bear the brunt of the burden. These challenges require immediate programmatic and policy attention.

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In fight for gender equality in Africa, clean water plays a key role

Fetching water is a household chore traditionally delegated to women and girls in Africa. Reducing the need for it holds not only health benefits, but also the potential for social change.
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A woman carries heavy jugs of water through a muddy pond where she filled the plastic containers July 17, 2012 in Jamam refugee camp, South Sudan. (Paula Bronstein/Getty Images)

CAMBRIDGE, Mass. — An average woman in Africa spends about 60 percent of her day fetching water for her household. The chore not only forces women to walk miles to the nearest water source—which is highly likely to be contaminated—but it also prevents them from using that time to pursue educational or job opportunities instead.

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Expectations: A long wait to see the doctor in São Paulo

Patience is required for women visiting a government-run clinic.
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(Emily Judem/GlobalPost)

This is the second post in a blog series called “Expectations" written by deputy editor of global health Marissa Miley. Expecting a child herself, Miley is reporting in Brazil to better understand how women experience pregnancy and childbirth. Read Part I.

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Expectations: A mother-to-be heads to Brazil to report

Deputy editor of global health Marissa Miley is reporting in Brazil to better understand how women experience pregnancy and childbirth.
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(Emily Judem/GlobalPost)

SÃO PAULO, Brazil – “How are you feeling?” is a question I get a lot these days.

It’s the first one my doctor asks when I sit down on the examination table. It’s often the first that friends and family ask as soon as we hug hello. And it’s certainly the first that anyone asks – a colleague in the elevator, a neighbor on the plane, a fellow guest at a party – when they confirm that I am, indeed, pregnant.

As a journalist covering health, this is an unfamiliar exchange. I’m usually the one asking others how they are feeling. But pregnancy has flipped many of my usual habits on their heads.

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Global health leaders, corporations push public-private partnerships

The first Public-Private Partnership Forum brought together leaders from government agencies and major corporations.
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UNICEF aid workers unload boxes of vaccines for children displaced by drought and famine in Mogadishu, Somalia. (John Moore/Getty Images)

Katie Taylor, an administrator in USAID’s global health bureau, is optimistic when she envisions the year 2020.

“I think we will have halved newborn deaths, we will have virtually eliminated pneumonia and diarrhea, and we will have made significant ongoing progress on malaria,” Taylor said Monday at a forum organized by the nonprofit PYXERA Global, livestreamed from the Newseum in Washington, DC. “We can only do that if we do it together — it’s the alignment between public and private,” she said.

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How Rwanda went from genocide to global health model

In 20 years, the country has made a historic turnaround that has the attention of health pioneers like Paul Farmer.
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An infant receives a vaccine at the Nyamata Health Center in the Bugasera District of Rwanda. (Shannon Jensen/AFP/Getty Images)

After the 1994 genocide in Rwanda, many wrote the country off as a lost cause when it came to public health. Up to one million people had perished, and millions more were displaced. Hospitals and clinics lay in shambles. Most health workers had been killed or had fled. Widespread rape disseminated HIV, and a massive cholera epidemic swept refugee camps. Fewer than one in four children were vaccinated against measles and polio.

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For companies, investing in women can mean better health, education — and business

But experts say there is still work to be done to translate good theories into results.
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Nepalese farmer Meena Maharjan works in a field in the village of Khokana on the outskirts of Kathmandu on March 3, 2014. Thirty-five year old Meena who has one daughter spends the majority of her time in the fields with her husband also a farmer. Waking up at 5am preparing food for the family then either working on the farm or selling her produce in the market, she averages a monthly income of Nepalese Rupees 5000 (USD 50). (PRAKASH MATHEMA/AFP/Getty Images)

Ishrat Hussain’s decision to enroll in a Nestle job-training program that would kick-start a career in the dairy industry set her neighbors in rural Pakistan talking. For one month, the 20-year-old learned how to increase milk production through proper livestock feeding and care before Nestle helped her launch a veterinary business to service many of the company’s local milk producers. Such dirty work, people in Hussain’s conservative village said, wasn’t “good” for a young woman. But she carried on, she later told Nestle, because “I knew it would help me and my family out of poverty.”

Hussain’s new business could accomplish much more than that. A growing body of research from leading global institutions, including UNICEF and the World Bank, suggests economically empowering women not only lifts families out of poverty and stimulates the economy, but also leads to better community education and health.

Fueled, in part, by such data, experts say women’s empowerment has emerged as one of the more popular areas for corporate philanthropic investments. The benefits of women’s economic participation have seized America’s heart and imagination to an extent that, “any consumer-facing brand would be foolish to ignore,” said Racheal Meiers, a gender expert at the corporate responsibility consultancy BSR.

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When stereotypes get in the way of addressing HIV

More than 30 years after the first HIV case was reported in the United States, two recent incidents remind us that around the world, there is still misinformation around the disease.
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(Emily Judem/GlobalPost)

No one thought she could have HIV. She was a middle class mayoral aide, a heterosexual woman, and she had me, a perfectly healthy toddler. She was not an injection drug user. That wasn’t the kind of person who got HIV—the gay man’s disease.

These stereotypes kept my mom from being correctly diagnosed with the virus in the early 1990s. The thought that it might be cancer, the copious amounts of medication, the endless questions and confusion—it all amounted to wasted time that ultimately cost my mom her life. All because no one thought to test her for HIV, because she did not fit the stereotype.

More than 30 years since the first case of HIV was reported in the United States, the same misinformation that prevented my mom from receiving an accurate diagnosis still runs rampant throughout the world. 

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Southern African countries commit to address mineworkers’ TB

Following World TB Day, regional ministers signed a framework to address a century-old crisis that crosses borders
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A medical worker is pictured at a mobile testing facilities for tuberculosis (TB) at Driefontein Gold Mine in Carletonville, South Africa on March 24, 2012. Deputy President Kgalema Motlanthe launched a national TB control plan amongst gold miners, beginning with a programme to test workers. (Alexander Joe/AFP/Getty Images)

In 1902, Lord Alfred Milner, Britain's administrator in South Africa, appointed a commission to find out why so many workers in the territory’s lucrative gold and diamond mines were developing tuberculosis. Breathing in silica dust — abundant in mines and quarries — was the main culprit, the commission found. It said there was “urgent need” for reform to protect workers.

More than a century later, the fatal infectious disease has not eased its grip in the region. Miners in South Africa and neighboring countries have the highest TB infection rates in the world. In South Africa, the incidence of the disease was more than 1,000 out of every 100,000 people in 2012, and the country’s 2.5 million current and former mineworkers are most at risk. 

But new efforts are underway to tackle the epidemic at a regional level and involve more mining companies in addressing the crisis.

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Global health aid to fight HIV/AIDS boosts US’s image abroad, says new study

PEPFAR has improved public opinion across the developing world, according to a recently published paper.
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U.S. Secretary of State John Kerry speaks during the 10th Anniversary Celebration of the Presidents Emergency Plan for AIDS Relief (PEPFAR), at the State Department, June 17, 2013 in Washington, DC. The Presidents Emergency Plan for AIDS Relief is a U.S. Government initiative created to help save the lives of those suffering from HIV/AIDS around the world. (Mark Wilson/Getty Images)

As Congress debates the global health budget in coming months, some will argue that the funding improves security. Many will call it a moral imperative. And others will say that it boosts the nation’s image abroad.

Until now, there hasn’t been much solid data to back up the last claim. But a new study provides strong evidence that at least some forms of global health aid improve public opinion about the United States in the countries that receive it.

The study, published earlier this month in the Quarterly Journal of Political Science, found that the government’s main program for addressing HIV and AIDS has significantly improved public perceptions of the US across many developing countries.

The program, known as the President’s Emergency Plan for AIDS Relief (PEPFAR), was launched under the Bush Administration in 2003. Since then, it has channeled more than $52 billion to more than 80 countries to address the HIV/AIDS epidemic. It’s the single largest expenditure in the US government’s global health budget.

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