A trained counselor in Nepal provides family planning advice to women at a Sun Quality Health clinic. (USAID photo)

August 10, 2010

Eight of 20 countries chosen to lead “GHI Plus” capacity-building program

By Cheryl Pellerin
Science Writer, Department of State

Washington — As part of the United States’ Global Health Initiative (GHI), up to 20 countries will receive technical and management resources that will help them quickly implement innovative health solutions. The first eight countries have been chosen and work has begun.

The GHI is a six-year, $63 billion initiative focused on preventing illnesses in a unified, sustained manner.

GHI investments will help strengthen health systems, improve maternal and child health, address neglected tropical diseases and increase research and development. Programs range from efforts to strengthen country health care systems to working more closely with country governments and international partners to focus on patients rather than diseases.

“We cannot simply confront individual preventable illnesses in isolation,” President Obama said in May 2009 when he launched the GHI. “The world is interconnected and that demands an integrated approach to global health.”

GHI activities are being implemented in more than 80 countries where U.S. government global health dollars are already at work.

Also included in the initiative is expanding small, successful programs to larger audiences.

Building on a decade of success in fighting malaria, tuberculosis and HIV/AIDS, Anne-Marie Slaughter, the State Department’s director of policy planning, said during a July 29 briefing, GHI will “translate the outcomes of programs focused on single diseases, moving to create larger systems that will improve health outcomes across the board and that will be more sustainable over the longer term.”

The eight countries — Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal and Rwanda — are “GHI Plus”nations, meaning the United States will give extra effort and attention to try to build their systems and spread the programs they develop more broadly around the world.

GHI investments will help strengthen health systems, improve maternal and child health, address neglected tropical diseases and increase research and development.

“GHI Plus is a mechanism by which we hope to achieve a great deal of learning,” said Dana Hyde, senior adviser to Deputy Secretary of State Jacob Lew. “But we are committed to all countries where we maintain these health investments. As our capacity grows, we are very much going to be working all across the globe in all of those countries.”

PARTNERS IN INNOVATION

Mayan women are joined by one man as they receive family planning counseling at the health center in Chimaltenango, southern Guatemala. Men’s participation in these sessions is increasing rapidly. (USAID Photo)

A focus on collaboration will improve coordination among U.S. agencies engaged in global health, including the three agencies whose top officials lead GHI ? the U.S. Agency for International Development, led by Dr. Rajiv Shah; the Office of the Global AIDS Coordinator, led by Dr. Eric Goosby; and the Centers for Disease Control and Prevention, led by Dr. Thomas Frieden.

Private global organizations are also GHI partners. They include the Global Fund to Fight AIDS, Tuberculosis and Malaria; the Global Alliance for Vaccines and Immunisation; the World Bank; the wide range of United Nations agencies; the Bill & Melinda Gates Foundation; PATH; and other international organizations.

The principle behind prioritizing innovation, Slaughter said, is to identify, evaluate and implement entrepreneurial approaches to public health. Examples include the following:

• Integrated prevention and treatment of diarrheal disease and pneumonia, including encouraging the use of breastfeeding, vitamin A and zinc supplements, household sanitation and point-of-use water purification, oral rehydration therapy, and rotavirus and pneumococcal vaccines.

• Community-based programs to help communities encourage women and children to use health services.

• Financing innovations to increase the use of health services, including vouchers, incentives for screening and adherence to treatment, community mobilization and behavior-change communications.

Innovations can range from simple to sophisticated, said Dr. Tadataka Yamada, president of the Global Health Program at the Bill & Melinda Gates Foundation. One of the simplest innovations is called kangaroo mother care, named for the way kangaroo mothers keep babies in their pouches.

Among the leading causes of death of newborns is preterm labor, he said. “In the U.S., a baby born before term is put in an incubator, given oxygen. Rarely do they have to die. In the developing world, there is no such thing. But the best incubator is a mother’s chest,” he said.

A simple strap keeps the baby on the mother’s chest, allowing baby and mother to bond, making breastfeeding easier and keeping the baby warm.

“But science has also told us there’s another unique advantage,” Yamada said. “Healthy people have healthy bacteria on their skin and these bacteria prevent bad bacteria from growing on the child’s skin, preventing the child from dying from sepsis [bacterial blood infection]. A simple tool, and now we’re beginning to understand the scientific basis for why it’s important.”

NEW IDEAS

The Bill & Melinda Gates Foundation is also searching for really new ideas, Yamada said. “In malaria, for example, I’ll give you a glimpse of what some of these ideas look like.”

In the malaria parasite there is a pigment (a substance that gives a structure color) that forms a crystal, he said. The crystal can vibrate if it is exposed to certain kinds of microwaves ? the kind of microwaves people are exposed to when they pass through an airline security station. The hypothesis is that this will cause the crystal to vibrate and set up a program of cell death that will kill the parasite.

“So imagine,” Yamada said. “You take a whole village, pass them through an airline security counter, and the malaria is cured. Does that seem far-fetched? They’ve got some evidence that it might work, and they’ve got $100,000 from us to test it. If it does work, what an incredible advance it would be. That’s innovation.”

###

Stories of Hope :

Bangladesh: Families Start Talking About Health

Nepal: Empowering Individuals, Treating Communities

Ethiopia: Preventing HIV in Newborns

Kenya: “Colors of Life” Program Brings Hope To Women Living With HIV

Malawi: Treating Malnutrition Closer to Home

Mali: Treated Nets Improve Overall Health

Rwanda: Reducing the impact of HIV/AIDS on orphans

Guatemala: Improving Family Health and Wellbeing

  Print