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7 wins for global child health in 2013

This year's most notable achievements in the field of child health.
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(Antler)

In the battle against child mortality, the global health community gained some ground in 2013. Here are seven political and scientific developments that gave us reason to hope this year.

1. Millions of lives saved. UNICEF’s annual report on child mortality published in September brought encouraging news: child deaths have declined by nearly 50 percent since 1990. Most of the 6.6 million children who die before age 5 die of preventable causes, but the global health community is making headway against the deadliest diseases. Deaths from diarrhea, which is responsible for 9 percent of child fatalities, have declined by 50 percent. Pneumonia and malaria deaths have dropped by a third.

Still, the world isn’t on pace to meet the Millennium Development Goal set by the United Nations, which aims to decrease child mortality by two thirds by 2015.

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Why Madagascar's children have the most at stake in Friday's presidential election

Madagascar’s children have borne the highest costs of the nation's social and economic turmoil since the 2009 coup d'etat. And it will be up to the new president to refocus government priorities.
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Children carry bricks on December 19, 2013 in Antananarivo, ahead of the upcoming presidential election. (Alexander Joe/AFP/Getty Images)

ANTANANARIVO, Madagascar — As the east African island nation of Madagascar picks a president on Friday, five years after a coup d’état sent the country spiraling into crisis, the political dynamics will be closely scrutinized. Will there be post-election violence? How will the impasse between the toppled former president Marc Ravalomanana and his successor, Andry Rajoelina, resolve itself? Will the government shed its pariah status among the international community?

But those with the most at stake will play no role in the political intrigue. Amid unprecedented social and economic turmoil since the 2009 coup, Madagascar’s children have borne the highest costs.

“It’s what you would see in countries like DRC,” says Steve Lauwerier, the UNICEF country director. Except, he adds, “We didn’t have a war. There was no big economic crisis. There was no reason that this should happen.”

What has happened is a peacetime humanitarian collapse of startling proportions. While other African nations have progressed rapidly in health and education, Madagascar has stagnated or regressed. Half of children under 5 suffer from chronic malnourishment, or “stunting,” the fourth-highest rate in the world. At least 1.5 million children do not attend school — which the world bank estimates could be an increase of 600,000 since 2009.

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How patent rules could keep new hepatitis C drug from saving 'millions of lives'

While affordable medicine advocates in India prepare to fight the patenting of a new hepatitis C drug, the US works to strengthen pharmaceutical patents through an international trade deal.
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An Indian patient sits in a roadside make-shift shelter outside The Tata Memorial Hospital in Mumbai in April, 2013, after India's Supreme Court rejected a patent bid by Swiss drug giant Novartis in a landmark ruling that activists say will protect cheap generic drugs and save lives in developing nations. (Punit Paranjpe/AFP/Getty Images)

Doctors are calling Gilead Sciences’ new hepatitis C drug a “game changer.” The pill, called sofosbuvir, is more effective than comparable drugs, works more quickly and makes treatment less painful.

“Suddenly, it’s realistic to think we can cure most patients with hepatitis C,” said Dr. Greg Fitz, president of the American Association for the Study of Liver Diseases, in a news conference where Gilead presented research on sofosbuvir. 

But patient rights advocates argue that the drug’s price tag — an estimated $84,000 per treatment — puts sofosbuvir out of reach for many.

The Food and Drug Administration gave the go-ahead on Dec. 6. Gilead will own the market in the United States for at least 20 years before generic drug producers can get in the game and bring prices down.

But in India, advocates for affordable medicine are fighting to block the pharmaceutical company’s patent. If they win, the country will be able to crank out low-cost copies of the drug for millions in India and other developing countries.

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Q&A: How a new healthcare model could save thousands of children in Mali

GlobalPost spoke with physician Ari Johnson, co-author of a new study that documents a rapid, tenfold decline in child mortality.
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Community Health Workers learn to conduct rapid antigen diagnostic testing for malaria, in Yirimadjo, Mali, 2013. They are training to provide proactive Doorstep Health Care, which includes actively searching for patients door to door. (Muso/Courtesy)

With enough resources and the right approach, ending preventable child deaths may be attainable much sooner than expected, according to a newly released study conducted in Mali. 

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Could treating drug companies like restaurants improve global health?

Academics consider the value of rating companies’ global health “footprints.”
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A Manhattan restaurant rated with a Health Department 'A' grade on March 7, 2011 in New York City. (Mario Tama/GlobalPost)

BOSTON — If prominently displayed grades in restaurant windows in New York City and Los Angeles can lead to healthier kitchen practices, could similar ratings on products — say, a special label on a box of Advil — do the same for global health?

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Female genital mutilation on the rise among Southeast Asian Muslims

More than 90 percent of women surveyed in Malaysia have been circumcised, and experts say increasing regional Islamic conservatism may be the reason why.
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(Emily Judem/GlobalPost)

Though World Health Organization reporting in 2011 indicated a decline in the practice of female genital mutilation — also known as female circumcision — experts say it is actually being practiced at much higher rates among Southeast Asian Muslims than previously thought.

The rise, they suggest, correlates directly to increasing conservative attitudes throughout the region.

On December 20, 2012, the United Nations General Assembly unanimously accepted a resolution on the elimination of female genital mutilation, saying that the practice affects between 100 and 140 million women and girls worldwide. But nearly a full year later, it appears the ban has had little to no effect in the southernmost tip of Southeast Asia.

More from GlobalPost: Debunking 5 misconceptions about female genital mutilation

A 2012 study conducted by Dr. Maznah Dahlui, an associate professor in Malaysia’s University of Malaya’s Department of Social and Preventive Medicine, found that 93.9 percent of Muslim women surveyed had been circumcised. In Indonesia, a 2010 Population Council study of six provinces indicated that between 86 and 100 percent of teenage girls had undergone the procedure. In both studies, 90 percent of Muslim women surveyed expressed support for the practice, claiming that it fulfills a religious obligation and fosters purity in women by controlling their sexual desire.

“Many people are doing it because they believe it is wajib or mandatory in Islam - a belief that was reinforced by a 2009 fatwa by Malaysia’s Islamic council that made it religious obligation,” said Suri Kempe, an activist from Muslim feminist organization, Sisters in Islam. “Yet there is nothing in the Qur’an that states that female circumcision is required. The bottom line is that Islam is not supposed to cause harm.”

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China looks to a new industry: global vaccines

Opinion: For the first time, a Chinese vaccine manufacturer has been approved to sell a vaccine to international agencies. This could be a game-changer for the industry.
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A nurse inoculates a child against Japanese encephalitis, at a local hospital in Guangzhou, southern China's Guangdong province. (STR/AFP/Getty Images)

BEIJING — Last month the World Health Organization issued an obscure ruling with the potential to transform China’s vaccine industry – and with it, the health of the world’s poorest children.

China National Biotec Group (CNBG), a Beijing-based firm, became the first-ever Chinese vaccine manufacturer to receive WHO “pre-qualification,” a global seal of approval for quality, safety and efficacy. This designation allows CNBG to sell its vaccine against Japanese encephalitis to international agencies that purchase vaccines for people in low-income countries.

The milestone represents a leap forward for control of a mosquito-borne disease that kills 15,000 children each year and causes permanent brain damage in thousands more. But the vaccine has the potential to be an even bigger leap for Chinese industry.

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Right to food wins 'defensive battle' in World Trade Organization deal

Opinion: The Bali meeting yielded a flawed 'trade facilitation' agreement that still mostly benefits international trade firms.
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Fake dice are placed by activists from La Via Campesina while they hold a protest against the WTO at the 9th World Trade Organization (WTO) Ministerial Conference in Bali. (Adek Berry/AFP/Getty Images)

BALI, Indonesia — A tense and acrimonious four-day standoff ended Saturday morning at the World Trade Organization meeting in Bali.

A last-minute objection by Cuba and three Latin American allies held up the agreement Friday night, with Cuba objecting to the hypocrisy of a “trade facilitation” agreement – one part of the so-called Bali package – that ignored the United States’ discriminatory treatment of the island nation under the US trade embargo.

Overnight, text was added to reflect Cuba’s concern even if it did nothing to resolve the issue. Call it the story of the WTO.

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How to achieve an AIDS-free generation? Ghana has a few ideas

In the last four years, mother-to-child transmission of HIV in Ghana declined by 76 percent. What's the secret to this success?
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A man walks in Accra past a Ghanaian volunteer campaigning against AIDS. (Kambou Sia/AFP/Getty Images)

New statistics from the United Nations released on World AIDS day this week have global health experts speculating about the possibility of an AIDS-free generation. 

Their hope lies in the cradle.

The number of children who contract the disease at birth from HIV-positive mothers dropped by more than half between 2005 and 2012, from 540,000 to 260,000, according to the report.

The decline in HIV among infants has been dramatic in a number of countries. Namibia cut infection by 58 percent between 2009 and 2012. Zimbabwe, Malawi, Botswana, Zambia and Ethiopia all reported reductions of at least 50 percent.

But “Ghana is the true leader in the fight against AIDS,” wrote Erin Hohlfelder, global health policy director for the nonprofit ONE, in a recent report. In the last four years, mother-to-child transmission of HIV in the country declined by 76 percent. 

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In the Philippines, hope and despair are found among the rubble one month after Haiyan

Commentary: The international aid response to Typhoon Haiyan has been generous but needs to expand fast to help the millions struggling to cope.
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A man reconstructs his house at the bay of Tacloban, Leyte province on November 27, 2013. (NOEL CELIS/AFP/Getty Images)

BASEY, Philippines — Elegario Ocdol’s home has become rubble. Most of the house and its contents have vanished. Only jagged pieces of fabric, metal and crockery lie strewn across the stone floor — traces of a life reduced to a memory.

Ocdol, a 38-year-old elementary school teacher, used to lead a fairly ordinary life. He worked hard to provide for his wife Maricar and their five children, worried about his debts and went crab fishing regularly to help feed his family.

But on Friday, Nov. 8, his life — and the lives of millions of others — changed forever when Typhoon Haiyan struck the central Philippines. Nearly a month later, I drove with a team of Oxfam colleagues to the expanding front line of a crucial but challenged relief effort.

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