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A diverse look at global health issues.

Building on a movement for maternal, newborn and child survival

Guest post: Two years after the launch of a global movement to end child mortality, those working on the campaign say more government leaders need to stand up and speak out for women and children in Africa
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A woman and her child at the Mbagala Rangitatu clinic in Dar Es Salaam, Tanzania on April 4, 2011. Margaret tested HIV positive in 2007. She was counselled to use ARV prophylaxis after 28 days into her pregnancy to protect her baby, who was born free of HIV. (SIEGFRIED MODOLA/AFP/Getty Images)

“It is not good enough.”

In a video interview presented at Canada’s Maternal, Newborn and Child Health Summit last month, Tanzania’s President Jakaya Kikwete shook his head. He was talking about his country’s progress in preventing deaths among children under 5 years old. Since 2000, child mortality in Tanzania has dropped significantly from 147 deaths per 1,000 live births to 54 per 1000 just last year. But to Kikwete, it wasn’t good enough.

With the 2015 deadline for the Millennium Development Goals fast approaching, Tanzania is within reach of the MDG 4 target to reduce child mortality by two thirds—to a rate below 49 deaths per 1,000 live births. Much of the East African country’s progress can be credited to the dedication and determination of Kikwete and his team who have demonstrated the will to lead on the issue. The story of Tanzania illustrates the profound importance of political leadership to the health and well-being of women and children, even in resource constrained settings.  

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High cost of vaccines complicates crisis response in South Sudan

Aid group Médecins Sans Frontières says thousands of children have missed critical vaccines because pharmaceutical companies won’t budge on price
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A South Sudanese child receives measles vaccination given by Medecins Sans Frontieres (MSF, Doctors without Borders) in an isolated makeshift IDP camp for Dinka ethnic group placed in an island betweet Bor and Minkamman on March 5, 2014. (JM Lopez/AFP/Getty Images)

In the Yida refugee camp in South Sudan, humanitarian aid organization Médecins Sans Frontières (MSF) could not provide thousands of children with a life-saving vaccine last year, as it had hoped to do—not because of a lack of syringes or medical personnel—but, because the vaccine price was too high. 

This year, South Sudanese children are continuing to go without vaccinations. That’s because for over a year, MSF has been at the negotiating table with British pharmaceutical company GlaxoSmithKline over lowering the price of the new pneumococcal conjugate vaccine (PCV), but the company hasn’t budged. The PCV vaccine can prevent infectious diseases like pneumonia, which is problematic in overcrowded refugee camps like Yida, where over 70,000 people live on a patch of land less than 5 square miles. Its lack of affordability is just one challenge faced by the organization in this volatile region, where a recent attack by the Sudanese government struck a village, hitting an MSF-run hospital and wounding six people.

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Visualizing preventable child deaths around the world

The Pulitzer Center’s latest interactive map shows where progress has— and has not—been made in the global campaign to end child mortality
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Children play silently as danger lurks in the waters in the slums of Kroo Bay on May 3, 2010 in Freetown, Sierra Leone. Diarrhea kills more young children each year than HIV/AIDS, tuberculosis and malaria combined around the world. (Dominic Chavez/GlobalPost)

Last year, the PULSE team worked closely with the Pulitzer Center on Crisis Reporting to produce an interactive map of the number of children who die each year before age 5 from preventable causes such as diarrhea and pneumonia.

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How India's hospitals fall short, in photos

Across the country, many urban hospitals are under-staffed and under-resourced—unable to meet patient demand. Photographer Sami Siva documents the challenges.

WEST BENGAL, India —Across the country, access to health care is still a challenge for many people. Most government-run primary health centers in rural areas lack good hygiene, infrastructure and the medical staff to provide first-rate treatment for patients. Such shortcomings result in the overcrowding of hospitals in urban areas. In cities like Calcutta, the bigger hospitals face such an overwhelmingly high number of patients that they have insufficient doctors and resources to provide good medical care.

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Sending deepest thanks to 18 strangers whose blood saved my life

Commentary: World Blood Donor Day is June 14. Just 8 percent of Americans eligible to give blood do so each year.
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Bags with human complete blood are filtrated and scanned at the production and logistics center of the Bavarian Red Cross (BRK) blood donation service in Wiesentheid, southern Germany, on July 24, 2012. (AFP/AFP/Getty Images)

LONDON — Donating blood is, for the most part, a comfortable experience. The clinicians are friendly. The chairs are soft. You get cookies. You get stickers. You get endless compliments on your veins.

It’s so easy to give blood that I fear it may lull donors into thinking of their gift as an anodyne act of do-goodism, the human tissue equivalent of chucking a Pepsi bottle into the recycling bin. It’s not.

Having recently been at the other end of this particular supply chain, I’d like to offer some perspective on how much these pints matter.

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Heroin epidemic takes hold of people—and politics—in India’s Punjab state

A widespread problem, with official estimates that more than 50 percent of youth are using drugs, is finally triggering government action.
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(Emily Judem/GlobalPost)

AMRITSAR, India — On a recent sweltering summer day, 27-year-old Gaurav Sharma tossed and turned on a small bed in the corner of a well-lit room. He buried his face in the pillow to try and forget the aches in his legs. A plaque hanging on the wall behind him spoke to his anguished state: “Drug addicts are not bad people who need to be made good, they are sick people who need to be made well.”

Sharma had not had any heroin for 24 hours. The withdrawal symptoms had begun.

“When it is really bad, it feels like I’m drowning and can’t breathe,” he said.

Drug use has become an epidemic here in the city and throughout the northern Indian state of Punjab, with officials estimating that more than 50 percent of people between 18 and 35 are using illegal drugs, including heroin and prescription opiates. More than two-thirds of the state’s rural households have at least one drug addict. 

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Partnering to protect women from HIV

Guest post: Women and girls continue to bear a disproportionate and unacceptable burden of HIV. A new public-private partnership could ensure they have the tools to protect themselves from infection.
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New HIV prevention technologies on the horizon, pursued in the new public-private partnership by International Partnership for Microbicides and the Janssen Pharmaceutical Companies of Johnson & Johnson, include monthly rings and gels that deliver ARVs and that could be combined with contraceptives. (Andrew Loxley/Courtesy) (Andrew Loxley/Courtesy)

The world is making tremendous progress to curb the course of the global HIV/AIDS epidemic. Since peaking in 2005, AIDS-related deaths have decreased by nearly one-third, and new HIV infections in children have fallen by more than half since 2001.

But not everyone is benefitting equally from these advances. Women and girls continue to bear a disproportionate and unacceptable burden of the disease. A new public-private partnership agreement announced last week between our organizations – the International Partnership for Microbicides (IPM), a nonprofit product developer, and the Janssen Pharmaceutical Companies of Johnson & Johnson, a major research-based pharmaceutical company – could help address this and ensure women have the tools to protect themselves from infection.

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How do journalists and policy analysts choose what to cover in global health?

Deputy editor Marissa Miley joined a panel discussion about “the story behind the story” for global health reporting at the annual meeting of the Consortium of Universities for Global Health.
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Elina Makopo, left, and her 12-month-old daughter, Jane, visit with community health worker Elizabeth Kafumo at the Kamupundu Primary Health Care Unit in Lufwanyama, Zambia. (Marissa Miley/GlobalPost)

WASHINGTON — How can a start-up global health NGO get its work featured in the press?

(Answer: Don’t use “academese,” but do send your peer-reviewed paper.)

How can medical students seeking to do video reporting get their foot in the door?

(Answer: Pick a narrow topic, make sure editorial and technical standards are up to par.)

And why doesn’t veteran reporter Don McNeil tweet? (Answer: He’s concerned his candor would be too much.)

These were among the questions raised by audience members at a panel discussion called “How the Media Chooses Global Health Stories” held on Monday at the Consortium of Universities for Global Health (CUGH) meeting

It’s not often I get the chance to step outside of my day-to-day role as journalist and editor to reflect on how I cover global health—or to connect with those who are making similar editorial decisions every day. But participating in the panel, I was able to do just that.

Joining me for the discussion were New York Times global health correspondent McNeil, NPR senior health editor Joe Neel, and Kaiser Family Foundation director of global health and HIV policy Jen Kates. The conference was organized by CUGH, a coalition of universities seeking to share expertise and best practices in order to better address global health problems.

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International Nurses Day: A time to call for medical neutrality

Commentary: It's time that the world’s health organizations and governments adopt and implement protections for all medics — demanding medical neutrality bylaws and amendments to the Geneva Convention of 1948.
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(Emily Judem/GlobalPost)

MANAMA, Bahrain — In February of 2011, when the Bahraini government violently cracked down on peaceful pro-reform protesters in Pearl Roundabout, I immediately knew what I had to do.

As a nurse who had spent 18 years training and working in the United States, I decided to go and assist in the emergency room at Salmaniya Medical Complex, the main public hospital, which was flooded by injured protesters hurt by government forces during the demonstrations. Although, at the time, I was an assistant professor and head of an emergency nursing program, president of the Bahrain Nursing Society and not a staff member at Salmaniya, I saw that the doctors needed all the help they could get.

Many of my colleagues and I could not have known that our decision to uphold our medical duty would place us in danger. Several weeks later, I was blindfolded and handcuffed upon entering a government building. During the nightmare days of my five months of detention I was beaten, shocked with stun guns, sexually harassed and threatened with rape.

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A Daughter's Journey: Reflections on Mother's Day

Moms making a difference when it comes to HIV
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(Emily Judem/GlobalPost)

I remember the day my mom died. The night before, we’d fallen asleep together in her room. I was wrapped up tight in my Princess Jasmine sleeping bag at the foot of her bed as she slept delicately next to my grandmother.

Then everything changed.

I woke up the next morning in a panic on the floor of my own bedroom, still zipped in my sleeping bag, while my dad slept on my bottom bunk. When I got up and ran for the door my dad suddenly awoke. He tried to stop me, but before he could say a word, I’d already run down the hallway into my parents’ room. She wasn’t there. I stared at her empty bed for what seemed like forever.

No one had to say a word. I knew she was gone.

Today is Mother’s Day. It is also my 25th birthday. And it is 20 years since I stood in the doorway of my parents’ bedroom not understanding why my 35-year-old mother had just died from AIDS.

Even now I can’t say that I fully understand why she died or why my father and I are HIV free, but I can say that I am learning to answer questions about the life my mother may have lived had she been diagnosed at a time when HIV wasn’t a death sentence.

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