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A diverse look at global health issues.

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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To end hunger, global policy can't be 'business as usual'

Analysis: As the UN leader on the right to food steps down, he urges policymakers to think about sustainability. Will a new model for food security arise?
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UN Special Rapporteur on the right to food, Olivier De Schutter speaks during a press conference on April 5, 2012 in Nairobi following a meeting of more than 45 food experts in the Kenyan capital Nairobi that discussed food security in Africa. De Schutter said that incorporation of a right to food in national constitutions was a necessity in the fight against food insecurity in Africa. "Food insecurity is not only due to climatic events that have increasingly affected the region adversly in the last decade", he said adding that it is also due to lack of accountability of governments, and the inability of non-governmental or parliamentary controls that governments put in place to reduce food insecurity." (TONY KARUMBA/AFP/Getty Images)

International food prices have fallen since 2008, when agricultural commodity prices doubled, pushing millions around the world from bare subsistence to hunger and raising the number of food insecure people to nearly one billion

Is the crisis over, then? Far from it, according to Olivier De Schutter, the UN Special Rapporteur on the Right to Food. As he told the UN Human Rights Council earlier this month, global policymakers have yet to address the structural causes of the crisis. In particular, they have failed to recognize that industrial agriculture is not the ultimate solution to global hunger — and that it is, instead, part of the problem.

In part, De Schutter drew his conclusions from his official mission to Malawi last year. As I toured the country last month, it was easy to see what he saw: the promise and allure of hybrid seeds and synthetic fertilizer, as well as their limits.

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USAID's partnership with GE in Kenya will help health facilities buy high-tech equipment

Under the financing agreement, the medical equipment — including ultrasound and MRI machines — has to be purchased from General Electric.
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A picture taken on December 19, 2013 at a hospital in Nairobi shows a Kenyan nurse attending to four newly born babies squeezed in an incubator due to doctors and nurses strike. Kenya health workers went on strike on December 10 protesting the government decision to devolve services, including their pay, to 47 counties. (Simon Maina/AFP/Getty Images)

Health care providers in Kenya will soon have a much better shot at getting a bank loan to buy high-tech medical equipment — as long as the machines are made by General Electric.

Earlier this year, the US Agency for International Development (USAID) announced a partnership with the industrial behemoth that will make up to $10 million in credit available for Kenyan health facilities to buy its medical products, including ultrasound and MRI machines. It’s the first time the agency has partnered with a multinational company to extend credit guarantees that unlock local financing.

USAID says the partnership will help smaller clinics and hospitals get much-needed equipment to expand diagnostic and other essential health services. 

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