January 11, 2010

From: PneumoALERT at preventpneumo.org

Call to USAID to Take Action on Pneumonia and Diarrhea

Dear Colleagues,


I am excited to tell you that on January 7, 2010, Dr. Rajiv Shah was sworn in as USAID Administrator. This is a great opportunity to welcome Dr. Shah to his new leadership position and to call on him to take up the cause of pneumonia and diarrhea, the world's two leading causes of child mortality.

Dr. Shah has led and worked with many of the initiatives that are defining best practice in the field of development, including the Global Alliance for Vaccines and Immunization, the Global Fund for AIDS, TB and Malaria, the Alliance for a Green Revolution for Africa, and the Bill and Melinda Gates Foundation. His tireless efforts to immunize children around the world have helped save countless lives.

The latest in gifts that last a lifetime


Originally published December 21, 2009 at 7:05 a.m., updated December 21, 2009 at 7:05 a.m.

MCT FORUM

www.victoriaadvocate.com

By Bill Frist and Orin Levine

(MCT)

Think it's impossible to find a child a hot, new gift for a modest price? If you're hunting for one of those trendy electronic hamsters, you might be out of luck. But take heart: $10 or $15 can still go a long way - and even save a child's life.

New vaccines at those prices can prevent the two biggest killers of young children - pneumonia and diarrheal disease. As a nation we have a great opportunity to extend a spirit of generosity to the world's children with the highest risk of dying.

In a season when gathering with family is a joyful tradition, reflect on the nearly 9 million families that lost a child under 5 this past year to preventable and treatable diseases.

Almost all these families live in the developing world. Unfortunately, they didn't have access to the new vaccines or the even less expensive treatments - like antibiotics or oral-rehydration fluids - that have been around for years. Yearly, pneumonia and diarrhea kill nearly 4 million small children. Preventable neonatal infections and malaria are the other major killers.

AIDS, the focus of nearly three-quarters of current U.S. global health funding, accounts for less than 3 percent of these child deaths worldwide. It's truly inspiring that over the past several years the United States has granted 2 million people living with HIV and AIDS a new lease on life through access to drug treatments. Amazingly, for just a fraction of the $5.7 billion we'll spend fighting AIDS this year alone, we could deliver life-saving services to tens of millions of children who lack access to basic health care.

We can do both.

We would dramatically reduce the number of children who die needlessly each year.

The United States already has an admirable track record in saving children's lives. We've helped make measles and tetanus vaccinations and life-saving oral rehydration therapy widely available around the world - preventing millions of child deaths. In Bangladesh, Nepal, Mozambique and Ethiopia, broad-based, U.S.-funded programs have been integral in cutting child mortality rates by more than 40 percent since 1990. These programs work, and they have shown that making affordable and effective health interventions available can save lives, even in very poor countries.

Such scientifically proven, remarkably cheap options include oral rehydration solution and zinc, low-cost drugs to treat pneumonia and malaria, and breastfeeding counseling. Add the new vaccines for pneumonia and diarrhea to the mix and we now have the tools to achieve revolutionary reductions in under-5 deaths.

In May, President Obama pledged to emphasize basic health care for mothers and children as part of his new global health initiative. But he didn't ask for much more money this past year, and last week Congress approved only a modest $54 million increase for maternal and child health care, as well as $400 million more in AIDS and malaria funding that will in part benefit children.

Using figures published in The Lancet medical journal, experts estimate that $1 billion in increased funding for child and maternal health could save 1 million children's lives a year. U.S. leadership would inspire other wealthy nations to join the cause. And, by working with developing nations to ensure health interventions reach children and families on the margins, the U.S. would help those countries strengthen their national health systems to improve the children's health for generations to come.

Let's encourage President Obama to be as bold in exercising U.S. leadership on global health as he has been in responding decisively to the global hunger crisis. In this season when children anxiously await their gifts and we their smiling faces, Americans can all be part of the greatest gift for children everywhere - the chance to survive and thrive.

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ABOUT THE WRITERS

Former U.S. Senate Majority Leader Bill Frist, a physician, is the chairman of Save the Children's Survive to 5 campaign. Orin Levine is executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health.

This essay is available to McClatchy-Tribune News Service subscribers. McClatchy-Tribune did not subsidize the writing of this column; the opinions are those of the writers and do not necessarily represent the views of McClatchy-Tribune or its editors.

___

(c) 2009, Save the Children

Distributed by McClatchy-Tribune Information Services

Raj Shah and America's Development Future
Dec. 17, 2009, 12:12 p.m.
By Bill Frist
Special to Roll Call

________________________________________
In most years, Senate deliberations over a nomination for administrator of the United States Agency for International Development, which leads American efforts to fight poverty and disease in the developing world, would pass without note.

This year is different. American efforts to improve the lives of the world's poorest people have never been so important. The Senate Foreign Relations Committee voted last week to refer the nomination of Dr. Rajiv Shah for USAID administrator to the floor for a full vote, which is expected soon. Dr. Shah should be confirmed without delay for three key reasons.

First, successful outcomes to our most pressing national security challenges, including the war in Afghanistan and instability in Pakistan, depend just as much on our ability to provide health services and economic opportunity to struggling people as on our combat operations or diplomatic efforts. Both President Barack Obama's new Afghanistan strategy and the Kerry-Lugar-Berman Pakistan aid package make substantial new commitments based on this idea.

Second, the global fights against HIV/AIDS and other deadly diseases have reached a turning point. U.S.-led programs such as former President George W. Bush's Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria, have helped poor families and communities move from a moment of crisis toward a moment of opportunity. We need to work twice as hard to maintain and build on this progress.

Third, the Obama administration and bipartisan Congressional leaders are in the midst of a transformative debate about how to make U.S. foreign assistance more effective and accountable. The unprecedented momentum in this debate is on the side of those who believe we need a new development strategy and a more efficient foreign assistance system that produces greater returns for recipients and taxpayers alike.

Given the gravity of these issues and the costs of inaction, Dr. Shah's development leadership is needed now. He is a medical doctor and health economist who led the Bill and Melinda Gates Foundation's $1.5 billion vaccine fund and played a key role in launching its global development division, which now disburses hundreds of millions of dollars for agricultural security and financial services for the poor. These experiences, coupled with the fact that he came of age professionally as revolutionary new programs like PEPFAR, the Global Fund, and the Millennium Challenge Corp. drove landmark progress on global poverty and disease, prepare him well to manage America's development future.

If confirmed, Dr. Shah will face resistance from entrenched bureaucrats in USAID and the dozens of other government offices that oversee development programs. With political support from the Obama administration and Congress, he will need to assert himself immediately to gain control of this fragmented system, or risk being swallowed by it. To do so, Dr. Shah should assume a visible leadership role on foreign assistance reform and help drive it to a successful conclusion, but he must also focus on other specific issues.

For example, U.S. support for PEPFAR and the Global Fund has helped create massive new systems for prevention, testing, and treatment of HIV/AIDS, TB and malaria in poor countries. These systems have greatly enhanced the ability of developing countries to meet the needs of their people, and we must figure out whether we can effectively expand them to offer even more life-changing services such as comprehensive family health care, entrepreneurship education and small-business loans. The Obama administration is taking initial steps in this direction through its marquee food security initiative ‹ developed in part with Dr. Shah's leadership at the Agriculture Department ‹ which focuses on linking food security, a development priority, to nutrition, a global health priority. This is a promising sign.

We must also direct our precious development resources to more effective, low-cost health interventions such as vaccines, breast-feeding and increased access to skilled family care in rural communities. And we must invest our development dollars in programs that are showing measurable results, including multilateral efforts such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the GAVI Fund, and the Alliance for a Green Revolution in Africa.

Changes like these are never easy. But we can't let inertia drag us down at this moment in time ‹ a moment when the future of the world's so-called bottom billion, and our own American future, hangs in the balance. Dr. Shah has what is needed to carry on President Bush's global health legacy and fulfill President Obama's extraordinary development vision. The Senate should confirm him, and the Obama administration should give him the political support and resources he needs to succeed. Millions of lives will be affected by this choice.

Former Senate Majority Leader Bill Frist (R-Tenn.), a heart surgeon, is a member of the Millennium Challenge Corp.'s board of directors.

 

This week one of my prenatal patients that I had been caring for since I first arrived here in Xela had her baby. She was a gestational diabetic, so although she had had her last 5 children at home with a comadrona she agreed to go to the public hospital for the delivery. She borrowed a cell phone from her neighbor to call me when she started went into labor and decided to go to the hospital. I met her there as soon as a finished seeing my patients at the clinic. I couldn't play any major role at the hospital, but I think it was good to see a familiar face; she cried when she saw me at the OB triage station.
Nyamata, Rwanda

The last few weeks I have been leaving the Nyamata Hospital to work in the community health centers. Getting to the centers often entails a few hours of travel in a four-wheel drive over rough, dirt roads. There are 11 centers in the Burgessa district and more than 400 in Rwanda.

These health centers are the front line healthcare for most Rwandans. Each center is responsible for a population of roughly 20,000 people. Patients using the public hospitals must start at these community based centers. If the case is complicated, they are transferred to a district hospital like Nyamata. The staff care for sick patients, deliver babies, provide vaccinations, distribute food given from the government and non-governmental organizations. They also have daily classes on topics such as family planning, gardening for nutrition, and proper sanitation and food preparation. These centers are truly the best hope the country has in the areas of disease prevention and early intervention.
Do you remember the story of Olken Foncime? He was the Haitian orphan who had congenital heart disease and received surgery from Dr. Christian Gilbert in October.

We just received a photo and an update. His doctor reports that since the surgery, he has gained 10 lbs. and has a remarkable increase in activity. He's doing really well.

Thanks to Dr. Gilbert for the update!
December 1, 2009

by Jenny Dyer, Ph.D.

Last night, Senator Frist spoke at Vanderbilt University's Student Life Center to over 250 friends, students, faculty, and guests in honor of World AIDS Day. The title of the talk: "Celebrating Life, Mourning Death: Continuing the Fight against Global AIDS" focused on where we've come from and where we're going, especially in terms of policy. Recounting his personal experiences in Africa with the AIDS pandemic and how he was able to use those experiences to shape and inform President Bush's decision to move forward to commit historic funding to fight a single virus, the Senator relayed the beginning of the President's Emergency Plan for AIDS Relief (PEPFAR) in 2003.
I have now transitioned to working with the physicians. Each physician is responsible for admitted patients on one of the floors and seeing patients in the outpatient consultation area. This change has been eye-opening.

Each morning starts at 7:00 with prayers, singing, and a short sermon. Watching my colleges sing and dance is an incredible way to start the day. By 7:30 we start rounds. There are usually about 40 patients to see and it has to be finished by 9:30 when the outpatient consulting begins.
Everyone in Xela is getting geared up for Christmas and consequently the patient load throughout the clinic is winding down. This week marks the last week of women's group meetings for the year. They will start again in January. I lead the closing project with the Tierra Colorada Baja group today. We made fertility necklaces out of brown, black, cream and red wooden beads. The placement of the different colors on the necklace indicate when the woman is most fertile and can be used either for family planning or to help conceive. The project was a big hit, but most importantly it sparked some interesting conversation and important questions.
Belmont University hosted an event today with Senator Bob Corker announcing his co-sponsorship of the Paul Simon Water for the World Act of 2009. Joining Senator Corker included water activists Dan Haseltine and Jars of Clay with Blood: Water Mission, Dave Barnes with Mocha Club, and Bill Hearns of EMI for Healing Water International.

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