This week is the ten year anniversary of the Global Fund to Fight AIDS , TB and Malaria, and the global health community is celebrating a decade of incredible impact in the fight against the three diseases. Thanks to the tireless work of the hundreds of thousands of healthcare workers supported by the Global Fund in 150 countries and to the drugs, anti-malaria bed nets and medical equipment they finance, the world has made amazing, lifesaving advances.

In just ten years, the programs the Global Fund supports around the world have saved 7.7 million lives and have: provided financing for AIDS treatment to 3.3 million people; treatment for 8.6 million cases of tuberculosis; 230 million insecticide-treated nets to prevent malaria; and helped 1.3 million HIV-positive women prevent the transmission of the virus to their babies.

Here’s where you come in: For their tenth anniversary the Global Fund are putting together a giant collage of photos of people involved in the struggle against epidemic disease, including some of the world’s leaders, and they want you alongside them. The more people they can see, the better they can show that we have a global movement for change.

Photo courtesy of ONE

Bill Gates yesterday addressed the Development Committee of the European Parliament, highlighting the Gates Foundation ‘Living Proof’ Campaign.  In his address to the committee he focused on the need to continue aid despite economic pressures at home.

He emphasised the importance of partnerships with developing countries at a time when great  progress has been made and where there is so much to lose by cutting investments.  He said: “European aid has had a tremendous impact on global health and development,” and urged “Europe to keep its promise to the world’s poorest.”
On the same day Gates published his Annual Letter To the World which outlines the advances and setbacks made in global health over the past year.  Gates noted how his Foundation’s twin focuses on equity and innovation is just as critical today as it was when they first set out to address global health in 1994.

Critically Gates’ letter addressed the Global Fund Crisis, noting that even if donors honor commitments to the Global Fund and it disburses $10 billion by 2013, there would still be a $12 billion shortfall on what is needed.  He gave a stark warning that the sums speak for themselves, $300 could put an AIDS patient on treatment, whilst $300 which is not forthcoming will take them off.  Its as simple as that.

Gates’ interventions are timely as a current funding threat to three major diseases of poverty, AIDS, TB and Malaria, has been created by donors focussing attention on how to cut their aid budgets. This is happening just as the Global Fund reaches its 10th anniversary and we find ourselves armed with the latest knowledge and scientific breakthroughs that can break the backs of all three of these epidemics, once and for all.

TB is normally treated with a six to nine month-long course of antibiotics. Resistance occurs when TB cases are inappropriately managed and doses are erratic or interrupted, enabling the TB bacteria to resurge. This has been a particular problem within the private sector in India, where private practitioners have not been prescribing the correct doses or the correct combination of drugs needed to cure TB.

Dr. Carol Dukes Hamilton of Duke University explains:

“If you don’t provide supervised second-line drugs, this is what you’re going to see. People go to practitioners who aren’t TB experts. They don’t give the right doses or make sure people take them.”

Multi- and Extensively- drug resistant TB (MDR-TB and XDR-TB) cases are extremely difficult and sometimes even impossible to treat. Furthermore, such cases cost thousands of pounds to treat, a situation that is often not affordable in developing countries.

Another problem has been identifying drug resistant TB strains. The WHO estimates that only two thirds of countries with serious drug resistance problems have enough labs equipped to diagnose these strains.

According to the WHO, countries with high TB burdens need to scale up diagnostic and treatment services, including ensuring continuous supplies of TB drugs to prevent interruptions. This comes at a time when many countries are facing funding shortfalls for TB control programmes.

Due to the economic downturn, many donor countries have failed to properly fund the Global Fund to Fight AIDS, TB and Malaria. The Global Fund provides over two thirds of all TB funding and has prevented 4.1 million TB deaths over the past decade. However, because of this lack of funding the Global Fund was forced to announce that it was cancelling its next round of grants and would have to stop making new grants for at least two years. This announcement will have serious implications for TB control and countries’ abilities to make inroads against drug resistant TB.

As we approach the Global Fund’s 10 year anniversary on the 28^th of January, we must remember that a failure to properly fund what has to date been the most successful global health effort in history will cost us thousands, and perhaps ultimately millions of lives. Donors should take this opportunity to reflect on what they can do to tangibly support the Global Fund, ensuring that we do not undermine the monumental advances we have made against this epidemic.

Education on the ground

During my first several months at site, I’ve been spending some of my time in the schools in my community – mostly in the English classrooms of the 7-12 grades.

These experiences have provided me with an invaluable firsthand look at the education system in Mali.  I’m not impressed.  From what I have seen the schools are severely in need of resources, the classrooms are overcrowded, and the teaching methods are much different, and I think less effective, than those used in my schooling.

From the outset, Malian students struggle because they enter school speaking only local languages (Bambara, Dogon, Bomu, etc.), rather than the language that they need to know to be educated (French).  According to USAID, adult literacy in French in Mali is 29 percent; only 23 percent of boys and 10 percent of girls can read a simple sentence in French by the end of grade four; and only about half of the teachers in Mali receive coaching in the teaching of reading.

Because French is the language in which the government operates, the language in which business is conducted, and the language that enables Malians to communicate with peoples in other parts of the world, it is alarming that so few Malians are literate in the language.

Most Malians can also not write in their local languages.  Adult literacy centers in Mali not only have to try to teach Malians how to read and write but also how to hold a pen.

To best illustrate what I see as the educational situation for most of the young children in my town, I’ll describe the story of a fictional student, Kadja:

Let’s say Kadja is a 13 year-old girl living in rural Mali.  Her mother is illiterate in both the local language, Bambara, and in French.  Her father finished 6^th grade, and although he is illiterate in Bambara and French, he does speak basic French.  In Kadja’s home, she, her parents, and her 7 brothers and sisters speak Bambara and her only exposure to French is during school.

We have to acknowledge that because Kadja is a girl she is very lucky to be in school in the first place.  Also, as a student in the 8^th grade, she has passed the national exam after 6^th grade that enables her to enter the 7^th grade.  For reference, about 80 percent of the students in my cercle that took this national exam, passed.

Kadja walks to school, after helping with the morning chores at home, and enters a classroom of 70 students, 20 girls and 50 boys.  The classroom is basic – a chalkboard, desks and open windows to provide light and fresh air.  In hand, she carries a simple 100-page notebook and a pen that she will use for all of her classes during the day.  The teacher makes it to class today (although sometimes he doesn’t) and starts the lesson by writing a text on the board.  This is necessary because Kadja and the other students don’t have books.  Usually there is only one textbook for each teacher, or about one book per 70 students.

Once the material is written on the board and Kadja has written it in her notebook, about half of the class time has elapsed and not a minute of teaching has occurred.  The teacher starts the instruction by reading the material on the board and having one or two students do the same.  New vocabulary words are written on the board, but little information is provided to explain what those words mean in Bambara.  If there is time, a question or two about the text is asked of the class and the whole room erupts with students snapping their fingers.  Because Kadja is too shy, she doesn’t raise her hand to answer the questions.  When she leaves the classroom she has not spoken a word, nor has she understood much of what was written on the board or repeated by her fellow classmates.

Kadja heads home for lunch and is told that she can’t go back to school this afternoon because she is needed around the house to help with chores – cooking, sweeping the concession, washing dishes and taking care of her younger siblings.  After these chores are finished, the sun is falling and she is tired.  Because she doesn’t have electricity, she looks at her notes from class using a flashlight, but still does not really understand what she has written.  Unlike a child in the United States, she doesn’t have access to the Internet to look up additional materials and, because her parents are illiterate, they are unable to help her study.

Even if they could help her, they know that her fate will not be determined by how much she studies, but rather by Allah.  Her parents also believe that sending her to school this long has likely been a waste, because she will soon be married and her ability to cook and clean well will be far more valuable to her husband than her ability to speak French.

Kadja, like many students in Mali, doesn’t pass the exam necessary to enter high school (within the school systems in my cercle a mere six percent passed the exam last year).  Because her French is basic, she will likely not be able to get a well-paying job; she will attend speeches given by the elected officials in her area and not understand what they are saying because they are speaking in French; and she will probably have very little interaction with people outside the Malian society, unless they are aid workers.

This is a bleak picture, but one that is the reality for many young people in my village and all over Mali.  Kadja may later have the opportunity to open a street food stand, make crafts or shea butter, or start a garden to sell products in the market.  Likely though, she will get married, have anywhere from five to 10 children, and will depend on her husband to make money and take care of the needs of the family.

Many NGOs and international aid organizations recognize the need for educational development in Mali.  Peace Corps Mali volunteers are working regionally with educational leadership and parent-teacher associations to build sustainable leadership locally.  A fellow volunteer in my stage is working withBuildOn, an organization that builds schools in Mali and links Malian students to urban youth in the United States to build relationships and foster cultural exchange.  Several volunteers in my stage are working with the USAID program, PHARE, which harnesses the widely-available national radio to broadcast interactive French language lessons in classrooms across the country.

Although I have always appreciated the value of education, my time in Mali has solidified a strong belief that education is a fundamental pillar of development.  My experience in Malian classrooms has also enabled me to fully grasp how lucky I am to have completed my educational career in the United States.  We have much to work on to increase equality in education throughout the United States and to push for higher standards.  With that said, I think we should give ourselves a pat on the back for a job pretty-well done.

My hope is that within the two years I am here, and into the coming years, education will rise to the top of the agenda in Mali and through its development the country will use its collective educational capital as a ladder out of poverty.

Tony Cunningham with visiting pupils. Image courtesy of Mark Chilvers/ActionAid

This week an exhibition in the House of Commons showcased artwork from children in schools across the UK, as part of an international campaign to support global education for all. The exhibition includes just a small sample of the artwork created during the 2011 Send My Sister to School campaign, in which over half a million young people in the UK took part to show their support for girls’ education worldwide.

The 2011 Send My Sister to School campaign was organised by the Global Campaign for Education (GCE), and focused attention on the 67 million children in the developing world missing out on a primary education, a disproportionate number of whom are girls. Through the campaign pupils learnt about the importance of education, the lives of their peers in other countries and how to participate in the democratic process.

The Westminster Exhibition was hosted by Sheila Gilmore MP, on behalf of the All Party Parliamentary Group (APPG) for Global Education for All.

Speaking at the opening ceremony on 18^th January, Tony Cunningham MP, Shadow Minister for International Development, praised both the determination of young children living in poverty to go to school, and the passion of young people in the UK in helping them achieve this. APPG member Mark Williams MP also highlighted the passion and enthusiasm shown by children in the UK and the poignant messages on display in the exhibition, and encouraged colleagues to help take this work forward by adding their own pledges to support global education for all.

Yasir Yeahia, and Navdeep Bual, the Young Ambassadors of the 2011 Send My Sister to School Campaign were also present at the launch, and spoke to MPs about their own experiences in Guatemala, where they saw first-hand the barriers that are preventing children from gaining an education.

The Ceremony was extremely well attended by MPs, as well as representatives from civil society and pupils from some of the schools whose work was on display. A number of other schools have also taken the opportunity to organise visits to Parliament, to see their work on display and have a tour with their MP.

As a result of the Exhibition, over 35 MPs have already pledged to take action to support girls’ education worldwide, for example by joining the APPG on Global Education for All or visiting a school as part of the 2012 GCE Campaign “Going for Gold!”.

The event served as a timely reminder of the need for world leaders to deliver on their promises to support universal basic education, and the crucial work that still needs to be done to get every child into school by the MDG deadline in 2015.

photo courtesy of Mark Chilvers/ActionAid

My name is Jonatane Bidiaka Budiaki and I joined RESULTS UK’s Education Team on3rd January 2012.

Being the Education Campaign Intern, I shall be assisting throughout the next three months on various aspects regarding the Global Campaign for Education (GCE) such as the APPG Exhibition Opening Ceremony taking place in January 2012 and the UK MP delegation to Nigeria taking place mid February 2012.

Prior to joining RESULTS UK, I was most recently the African Education and Project Manager for Global Graduate, an international education consultancy.

Prior to that I worked part time for London South Bank University – Foundation Campus (LSBU-FoC) as the Centre Administrator and Student Information Systems Coordinator while interning first with Student Action for Refugees (STAR) as its Higher Education Project Intern and later gaining the opportunity to be Plan UK’s Development Education Researcher.

Additionally, I have worked in South Africa with the Friedrich Naumann Stiftung fur die Freiheit (FNF) at its regional office in Johannesburg as its Regional Assistant and Translator (English – French).

I hold an LLB (Law) and LLM in International Law with International Relations both from the University of Kent and am currently undertaking an MSc in Development Studies and Social Anthropology from Birkbeck College, University of London.

I look forward to learning from RESULTS UK within the next three months and gaining a much needed insight in UK’s policy strategies concerning education overseas and the logistics required for a coalition to push forward a crucial global agenda.

If you wish to contact me, please do so via jonatane.budiaki@results.org.uk

Jonatane.

Gareth Thomas MP Image courtesy of DFID

On Tuesday 10th January a Westminster Hall Debate on ‘government policy after the MDG’s’, which end in 2015, was held by former shadow secretary of state for international development Gareth Thomas MP. Mr Thomas said he had secured the debate to find out what the government was doing to help galvanise international action to secure global agreement for 2015, to find out what they are doing to engage European governments and to get their views of the proposals and goal ideas in circulation at present.

Stephen O’Brien MP, Parliamentary Under-Secretary of State for International Development stated that the MDG’s were at the heart of government policy and that securing global agreement on the post MDG agenda was a major priority for the Government.

It is important to remember that with families in the UK being squeezed, it might seem strange to be debating what new targets there are to address poverty in poor countries, but as Mr Thomas points outs tackling poverty in the world’s poorest counties is “surely not just morally right, but fundamentally in Britain’s long-term interests”.  We are after all talking about some of the poorest people on the planet.

While many will see 2015 as a long way off this debate is an important starting point, as achieving international consensus on an issue as critical as the post MDG agenda takes a significant amount of time and effort. It is important discussions start now. The United Nations (UN) has begun to prepare wok on the UN’s vision and roadmap for post-2015 and the UN Secretary-General is expected to appoint a high level panel of eminent people to advise on the post-2015 framework.

The UK is uniquely placed to inform the debate around this issue as it has a robust and well respected track record on development. Often countries look to the UK for policy guidance on development and the UK has added legitimacy with the Government’s commitment to spend 0.7% of gross national income on overseas development from 2013.

We must ensure that the UK uses its standing to ensure that important issues that were not included in the MDG’s like access to education for disabled children for example are included in any post MDG agenda, but also that the targets are ambitious, but achievable.

A case in point is a disease of poverty like tuberculosis, which was included in MDG 6 to ‘combat HIV, AIDS, Malaria and other diseases’ with the target of halving TB prevalence and deaths by 2015. This was achieved by most countries some time ago. While clearly there is a fine balancing act to keep the goals simplistic and measureable, we also need to ensure they are ambitious enough.

While it is unlikely that a target of zero deaths from TB would be included in the post MDG agenda or likely be achieved in a similar timeframe (15 years), It is critical that the TB community as a whole aspire to zero deaths from this treatable and curable disease and work in solidarity to accomplish it.

We are looking for one project intern to come and help us with our work on the Advocacy to Control TB Internationally project, working with our TB folks on our domestic and international advocacy. Click here for full info.

Sitting by a makeshift immunization booth in Baramati Taluka, Maharashtra, India, in an old government owned off-road vehicle with 4 vaccine carrier boxes, I was not thinking of halting wild polio transmission in India.

On that hot dusty day in 1995, it all seemed to be a great big “tamasha¹”, especially to a newly minted medical graduate on his first field experience – running around with additional vaccine carrier boxes, checking the labels, ensuring all babies under 5 were being counted, coaxing people to come to the booth… yes, polio was preventable, with just a drop of the vaccine; indeed it needed to be, but did we have to do all of this? And in all of India at one go?

The answer slowly sank in: Yes, and much more, as the last 17 years of work has taught us. Tackling polio on a massive scale in a country that was not doing too well on its universal immunization program seemed counter-intuitive, but it has demonstrated what well thought out and funded programs can achieve at the grassroots level.

On the way, it enabled a better understanding of how communities need to be engaged in health programs, and how clear and honest communications formed the bedrock of relationships between a public health program and the beneficiary communities.

It also paved way for innovations in delivery of health services, from the use of micro-planning techniques, GPS technologies to track teams and vaccine consignments, team building and retention of talented people, and dedicated funding within the national budget. It showed what Indians and their government could do if they put their will to it. Through Rotary, thousands of middle class Indians came out onto the streets to be part of the delivery mechanism on pulse polio Sundays.

The proof is here today to see: A year has passed by since the last wild polio case was detected in India. Indian investment and global support have brought things so far, a critical watershed moment. The next challenge is to maintain another 24 months of polio free status to truly be able to say that endemic wild polio transmission in India is a thing of the past, and to use the experience and infrastructure to raise the rates of immunization coverage among all children for the other diseases for which vaccines are available.

Meeting this challenge with enthusiasm, both for maintaining wild polio free status and covering other vaccine preventable diseases will set India up on the path to reducing its infant mortality numbers.

Dr. Bobby John - Global Health Advocates India

Read the original post here

Tuberculosis continues to kill 1.4 million people worldwide every year, and until we have an effective vaccine, TB cannot be eliminated as a global public health threat. The current vaccine in use today, the BCG, has several limitations. It protects children from severe forms of TB, such as TB meningitis, but provides less protection from the more common pulmonary TB, which affects the lungs. In addition, the BCG vaccine is not safe to give to people who are HIV positive because of their weakened immune systems.

Jim Connolly, President and CEO of Aeras said:

“The synergy created by bringing together our scientific and manufacturing expertise could have a substantial impact on efforts to advance innovative candidates in TB vaccine development. We look forward to working with the largest biotech corporation in a country with the skills, resources and TB disease burden to play a major role in overcoming the complex challenges of TB vaccine R&D.”

China has the world’s second largest burden of TB in the world and is one of 22 high TB burden countries that account for 80 per cent of the world’s TB cases.  Every year, 1 million people in China develop TB and 54,000 die from it. Development of new, safe and effective TB vaccines would help curb this tremendous loss of life and the drain TB causes on people’s livelihoods.