Tag Archives: Global Fund

Parliamentary delegation examines Zambia’s progress on TB and child survival

RESULTS UK recently led a delegation to Zambia with four parliamentarians from the UK’s three largest parties to examine how the country is addressing the global health challenges of Tuberculosis (TB) and child survival.

7UV2usmPeCrvL4WGKLYl78NesHGMYrmGpGeLgODiq6UZambia is an interesting case study in health: it is a Lower Middle Income country, which has had a growth rate of between 6% and 10% for the last decade, but its population of 15 million is dispersed over a wide geographic area the size of France and Spain put together and many people continue to live in poverty.  It has made some progress in meeting health indicators but has lagged behind in others, which in turn has held back its social and economic development.

For example, Zambia has met the MDG target to reduce child deaths by two-thirds with child mortality falling from 193 deaths per 1000 live births in 1990 to 21 in 2013; yet, 51,000 children under 5 continue to die each year.  Similarly, the TB incidence rate has gone from 793 people per 100,000 population in 1995 to 410 in 2013, but 60,000 people still develop TB annually and 12,000 die as a result.  Two-thirds of those with TB are also living with HIV.  TB-HIV co-infection is a major problem, with TB being the biggest killer of people living with HIV around the world.

Of course behind these statistics are individuals and the purpose of our delegation was to meet with patients and the health workers who assist them to better understand how progress has been made and how the remaining gaps can be closed.

Together with RESULTS UK, Stuart Andrew MP, Lisa Cameron MP, Oliver Colvile MP and Kate Osamor MP visited national and community-based health programmes in Zambia’s capital city, Lusaka, and in more rural settings around Chongwe District.

We witnessed a lot of good practice: local communities in Lusaka benefiting from the TB and HIV expertise of staff at the nearby ZEHRP HIV vaccine laboratory, including couples counselling; integrated TB and HIV services at St Luke’s Mission Hospital near Chongwe, and procedures in place to prevent mother-to-child HIV transmission; and Unicef staff working to ensure that children in hard-to-reach locations – including in the rural communities around Kanakantapa in Chongwe District – receive the vaccinations and treatment they require.

Towards the end of our delegation, we met with Zambia’s Health Minister, Joseph Kasonde, who outlined his ambitious Elimination Agenda to end infectious diseases and avoidable deaths in Zambia; and, in the shorter term, his aim that healthcare be ‘clean, caring and competent’.

Notwithstanding the excellent work that we saw, it is clear that there are pressures on the delivery of healthcare in Zambia that will only become more apparent as efforts are scaled up.

Each health centre had long queues of patients waiting hours to be seen; we were informed at one clinic that one doctor was responsible for 1,200 there. Zambia faces an acute human resources challenge, especially in rural locations, with many of its facilities relying on the efforts of volunteers to deliver services at clinics and in the community.  We heard some really inspiring accounts from people who had attended clinics to receive treatment for TB and HIV, but who had now become volunteers helping to break through the stigma in their local communities.

It can be incredibly difficult to access healthcare in remote communities, despite the substantial investment that there has been in infrastructure.  We heard of one father who had carried his sick son for two days, only for him to die as he approached the entrance of St Luke’s Mission Hospital near Chongwe.

In a bid to tackle the problems presented by staffing and geography, the Government has commissioned the creation of 650 health posts throughout the country.  Each post is staffed by a Community Health Assistant who provides local residents with advice on disease prevention, diagnosis and treatment of common illnesses like diarrhoea in children, and refers more serious cases to health centres.

AX5EMr-ql-9Iz9fcg58Y6_psj5zuvXXNgyrmlptDb8sDFID has financed the recruitment, training and deployment of Community Health Assistants and they are expected to be on the Zambian Government’s payroll by next month.  At Kanyongola, we met 24-year old Elias Lungu, Community Health Assistant at the local health post.  As with most other Community Health Assistants, Elias lived in the community before he completed his year of training, which means that he has local knowledge and the people know and trust him.

As well as diagnosing and treating patients who contact him, Elias goes out into the community two days a week to conduct home visits where he informs families how to improve their living conditions and prevent ill-health.  We visited a family with him who had made improvements to their latrine and cooking area after a previous visit.  Such improvements can also help reduce the risk factors for more serious conditions like TB, which is exacerbated by overcrowding, poor ventilation and sanitation.

DFID’s investment in Community Health Assistants is a clear example of UK Aid being used to help meet Zambia’s health challenges.  In addition, UK funding helps the other projects that we visited through DFID’s substantial contributions to the Global Fund and GAVI.

As Zambia’s economy continues to develop, however, the sustainability of services will become more precarious.  Its status as a Lower Middle Income Country will negatively impact the medium and long-term financing of health from multilateral donors, such as GAVI and the Global Fund.  Meanwhile, in 2001 the African Union agreed that national governments should spend 15% GDP on healthcare, but the Zambian Government does not currently meet this target.

Last month RESULTS UK published its report Who Pays for Progress, a case study of Kenya’s transition from Low Income to Lower Middle Income status and the impact of this on financing for healthcare.  Zambia is a different country from Kenya with a different set of challenges, but the issue of financing healthcare in a Lower Middle Income Country is common to both.  In line with that report’s findings, it appears there will have to be greater Domestic Resource Mobilization in Zambia if the country is to build on its progress in tackling diseases like TB and improving child health, alongside continued support from donors. It is very clear that even with dramatic scale-up in domestic resources, donors have a vital role to play given the scale of the challenges in ensuring healthcare reaches everyone.

But the commitment of volunteers and staff like Elias is helping ensure that healthcare in Zambia is ‘clean, caring and competent’, and it was heartening to see such passion to ensure that everyone has access and to close the gaps.

Steady Progress in Cambodia: Report of a Parliamentary Delegation to Cambodia

Earlier this year, RESULTS UK led a cross party parliamentary delegation to Cambodia, and today we launch Steady Progress in Cambodia, a report which outlines our findings and recommendations from our experiences in South-East Asia.

The trip explored in detail some of the remaining health challenges in Cambodia’s, particularly its high rates of TB and under-five child mortality. The delegation was attended by Baroness Alison Suttie, Mark Pawsey MP, Michael Connarty MP and Nic Dakin MP, as well as RESULTS staff members Megan Wilson-Jones and Steve Lewis. Then Health Advocacy Officer Jess Kuehne and RESULTS board member Reg Davis also attended the delegation.

CambodiaRep_Nov14_web.1

Cambodia is a nation that has made significant progress since its health system and infrastructure were devastated by Khmer Rouge rule in the 1970s. From a workforce of 600 doctors, there remained only 50 after the fall of the regime. This report details how progress has been made, but also highlights that significant challenges remain.

The delegation visited a number of sites in connection with the health and education challenges faced in Cambodia, including community health centres working with TB patients through projects supported by TB REACH and the Global Fund to Fight AIDS, TB and Malaria (GFATM). The site visits illustrated Cambodia’s continuing struggle as one of 22 high burden TB countries and showed the importance of continuing the international aid that has seen 40,000 individuals diagnosed and treated for the disease since 2003. The report also details findings from the delegation’s visit to the Samdech Ov Hospital, where participants learned about the importance of Gavi, the Vaccine Alliance’s work in increasing rotine immunisation coverage from 60% to 95% in just 10 years (2002 to 2012). Despite this, there are still 14,000 children under the age of five in Cambodia who die from mostly preventable and treatable disease every year, a challenge that must be addressed.

The delegation’s visit to the Ang Suong Primary School in Cambodia’s Takei Province, an institution supported by the Global Partnership for Education (GPE), is also discussed in the report.  Cambodia has received $38 million of funding since 2006 from the GPE to improve the country’s education system, which has helped to reduce the number of out of school children in Cambodia by 60,000 in just five years (2006 to 2011). Again, progress has been remarkable, but challenges remain. In the case of education, it is not only about getting children into school, it is also critical that the quality of education is high.

The report highlights a number of key findings from the delegation and includes recommendations for both the UK Government and the Cambodian Government. It is vital that the progress seen in Cambodia does not stall and that investment in health spending, especially to address TB and under-five child mortality, remains a priority. The linked nature of health and education is also a key aspect of the report, and it is made clear that future progress in the health, well-being, and economic status of the people of Cambodia relies on a comprehensive and cross-cutting approach to development.

You can read the report here.

Follow Megan Wilson-Jones or Steve Lewis on Twitter.

RESULTS welcomes Sveta to the Team

Hello everybody, my name is Sveta McGill and I have just joined RESULTS UK as Health Advocacy Officer. I originally come from Kiev, Ukraine, but have been in the UK since 2010 doing a PhD at Queen Margaret University in Edinburgh. My PhD thesis researched the impact of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) on HIV prevention policies and services in Ukraine which has the leading HIV rates in the European region.

svetaMy job of is now more focused on TB, and I am contributing to the Russian-language activities of the TB Europe Coalition (TBEC) – a network of activists and CSOs formed to increase the level of awareness, commitment and political will within the European Union and European Commission to fight TB. I bring to the job 15 + years of experience of working in the ex-Soviet region in public health, HIV/AIDS, TB, as well as gender policy and NGO development. I have also published a Russian-language journal “Aktualnye Infekcii” from 2007 to 2012 based in Kiev that focused on health care policy in HIV and TB, as well as programmes implemented by international donors in the region.

I am generally easy going and responsive, and try to stay positive at all times, work as a team and have an effect in everything I do. I like travel, music and musicals, walking, cooking, and spending quality time with family and friends. My favourite book is ‘Master and Margarita’ by Mikhail Bulgakov and my favourite composer is Tchaikovsky.

Historic Replenishment of the Global Fund to Fight AIDS, TB and Malaria Only a Starting Point

The ACTION partnership thanks world leaders for the unprecedented commitments they have made to scale up the global fight against AIDS, tuberculosis, and malaria.

Today, world leaders gathered in Washington D.C. to commit a total of US $12 billion over the next three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the largest amount ever committed to fighting the three diseases. These pledges represent a 30% increase from pledges secured in the previous Global Fund Replenishment.

“This is an unprecedented starting point,” said Kolleen Bouchane, ACTION Director. “But it’s just that — a starting point. If we accept the challenge of U.S. President Obama to not leave U.S. ‘money on the table’, an additional $3 billion needs to be mobilized.” The U.S. pledged to contribute $1 to the Global Fund for every $2 contributed by other donors – up to $5 billion over the next three years.

A fully-funded Global Fund will allow the scale-up of lifesaving programs, including tuberculosis (TB) treatment. The Global Fund provides nearly 90 percent of international donor financing for TB, and its programs have put 11 million people on TB treatment. The World Health Organization recently called the Global Fund “essential” to fighting TB and beating back the spread of drug-resistant TB.

Highlights from the Global Fund’s replenishment among ACTION partners include:

  • The U.S. Administration will commit up to US $5 billion over the next three years – a potential $1 billion increase from the Administration’s previous pledge.
  • The United Kingdom made a historic commitment of up to £1 billion, more than doubling its commitment from the previous three years.
  • Canada affirmed its leadership in the fight against the diseases by increasing its pledge to CAN $650 million, an increase of 20 percent.
  • Japan committed US $800 million.
  • France committed €1.08 billion, maintaining its pledge level but only thanks to innovative financing mechanisms like the air tax levy and the financial transaction tax.
  • The European Union pledge of €370 million represents an increase of 12 percent over their previous pledge – although this is still less than ambitious given the EU is collectively the second biggest development donor in the world.
  • Australia pledged AUD $200 million.

A key highlight of this replenishment was pledges by recipients of Global Fund investments. India pledged US $16.5 million and Kenya made a first-time contribution of US $2 million.

“We thank world leaders for these tremendous commitments,” said Allan Ragi, Executive Director of the Kenya AIDS NGOs Consortium (KANCO), an ACTION partner. “Citizens in countries that benefit from Global Fund investments will continue to work with our governments to ensure commitments reach the people who need them most and continue to save lives.

Recording of June conference call now available

We are pleased to announce that a recording of our June conference call is now available for download.

The call represents the launch of our June action which focuses of building public pressure on the UK government to secure an announcement of money for the Global Fund to Fight AIDS, TB and Malaria.

The Fund is the single largest provide of funding for the three disease in the world and is approaching replenishment in the second half of 2013.

Our guest speaker on the call was Laurindo Garcia, an ambassador with the Here I Am Campaign and a passionate HIV/AIDS activist. Here I Am is a campaign which uses the personal stories of people directly affected by the work of the Global Fund.

Click here to listen again or read more about our action here.

Undernutrition and Malaria: A Vicious Circle

Malaria and malnutrition are closely related, as malaria usually affect families that are both poor and malnourished.  The months of the ‘hunger gap’, when malnutrition is at its peak, often coincides with the rainy season, when mosquitoes breed and the number of malaria cases shoots up. The diseases combine in a vicious circle: malnourished children have weak immune systems, so their bodies are less able to fight diseases such as malaria, while children sick with malaria are more likely to become dangerously malnourished.

Credit: These O Duke

Credit: These O Duke

Evidence shows that investing in nutrition is tremendous value for money in the fight against child mortality.  The example of malaria prevention shows that integrating nutrition programs into other development initiatives delivers even greater benefits.

The most underweight children have the highest risk of dying from malaria but if children are deficient in essential micronutrients, such as zinc, Vitamin A, iron and folate, they face dying from malaria even if they are not underweight. Large numbers of children less than five years old suffer and die from malaria due to lack of protein energy, zinc, vitamin A and other micronutrients.

Unlike many causes of death and disability, with appropriate nutritional support these deaths are entirely preventable. With the advances in nets and other simple malaria technologies there is massive potential to bring down child deaths through increased investment in these simple solutions.

Studies have demonstrated that malaria-control programs will have limited success if they do not also address undernutrition.[1]  Nutritional counseling and education of mothers followed by feeding programs have to specifically focus on improving the health of the malnourished. This, alongside malaria-control measures, could reduce deaths from malaria on a large scale if built into a long term programme.

Medicins San Frontiers (MSF) is one of the organisations in the field that is addressing both malnutrition and malaria as public health problems and integrating their prevention and treatment into the set of basic health measures aimed at all young children.  They are currently employing this approach in Niger[2]

The effort being made to treat malnutrition in Niger is tremendous, and this needs to be supported,” says José Antonio Bastos, president of MSF in Spain. “The problem in 2012 was that a massive plan for treating malnutrition was prepared and implemented, but it excluded other health needs, in particular malaria prevention and immunisations. It failed to take account of the fact that even if you provide children with appropriate nutrition, you can still lose them to malaria or a respiratory infection. There is a need for an integrated response, rather than for pushing one response to the exclusion of others.”

So measures to improve nutrition, if sustained over a number of years, increase the success of other development interventions.  In the UK there is an opportunity to promote this lesson on 8th June, when the Prime Minister is hosting a second ‘Hunger Summit’, co-hosted by the Childrens Investment Fund Foundation (CIFF).  The UK government can take the lead by giving a significant pledge, of £150 million per year, for the next five years. This has been calculated as the UKs ‘fair share’ of the funding gap, according to World Bank figures, and will encourage other donor countries and leverage major contributions from private foundations.

[1] “Malaria, Anemia, and Malnutrition in African Children—Defining Intervention Priorities” Erdhart, et. al. July 2006. http://jid.oxfordjournals.org/content/194/1/108.full.pdf

[2] http://www.doctorswithoutborders.org/press/release.cfm?id=6739&cat=press-release

World TB Day 2013: Media round-up

Following our blogpost yesterday you may well have been aware that yesterday was World TB Day. Leading media outlets in the UK certainly took note and here we provide a round-up of what some of them have been saying about the growing threat of TB both domestically and globally.

Friday saw some fantastic coverage in the Financial Times with a four-page health supplement entirely dedicated to TB. Articles covered topics ranging from the fight against HIV/TB co-infection, the problems surrounding TB in children and the need for funding for vaccine research.

The lead article states ‘Tuberculosis has failed to capture imaginations in the same way as HIV’ and, as a result, there has been a serious lack of financial commitments in fighting the second biggest infectious killer after AIDS. The article also highlights the vital role played by The Global Fund to Fight AIDS, TB and Malaria and the urgent need for renewed funding commitments from donors.

The BBC made note of the call from an international group of doctors and scientists for visionary leadership if we are to tackle TB effectively. Reporting on an article in The Lancet, the article highlights the growing problem of drug resistant TB strains largely as a consequence of complacent and neglectful governments worldwide.

It is so important that there is a complete shift in our thinking, particularly at a political level, about TB in order to ensure that we make significant strides in tackling TB and saving millions of lives. Along with this piece featured on the BBC, The Lancet has also published a Series of papers on TB to commemorate World TB Day 2013 that are well worth a read.

There was an informative piece in The Independent warning of the rise in the number of drug-resistant TB cases in the UK. The article notes that if the rise in TB continues at its current rate then by 2015 Britain will have more new cases each year than in the whole of the US. Somewhat encouraging is the fact that a government task force will be set up to tackle the problem. Dr Paul Cosford, director for health protection at Public Health England, has also said “TB will be a major priority for Public Health England”.

Finally, our friends at ACTION have also put together this great blog outlining a selection of stories and events leading up to World TB Day yesterday. To take a look at ‘the drumbeat to World TB Day’ just click here.

World TB Day 2013: New funds desperately needed to tackle growing tuberculosis threat

For World TB Day, the World Health Organisation and the Global Fund to Fight AIDS, Tuberculosis and Malaria released a joint statement urgently stating the need for US$1.6 billion a year in international financing to prevent the spread of TB.

According to the joint statement, US$1.6 billion would fill a funding gap that would enable full treatment for 17 million TB and multi drug-resistant TB (MDR-TB) patients and save 6 million lives between 2014-2016.

The TB Europe Coalition (TBEC) has also issued a statement calling on the European Commission to increase public health funding to fight the resurgence of tuberculosis (TB) in Europe and eradicate its deadly strains.

According to TBEC, TB is Europe’s ticking time bomb. The World Health Organisation reported an estimated 76,000 cases of multi-drug resistant TB in the WHO European Region in 2011, accounting for a quarter of the global TB burden. Controlling and treating TB costs European Union member states €15 million every week and €750 million every year.

The numbers offered by both statements seem to speak for themselves, but they also don’t communicate the very real human impact of this disease on the residents of Europe.

RESULTS UK interviewed Oxana Rucisineanu, a former TB patient from Moldova on her personal experience with multi drug-resistant TB. Her story is compelling and should encourage us all to do what we can to ensure that TB receives the attention and funding it so desperately needs.

Before being diagnosed Oxana explains she was leading what most of us what refer to as a standard life. Between working and socializing Oxana began to suspect something was wrong when she began to lose weight and was persistently bothered by a pain in her chest. Unfortunately for Oxana it was confirmed she has TB – a diagnosis she described as being “one of the most painful things”.

Stigma remains a substantial issue for TB patients. In a story that is all too commonly heard, the “shame” that Oxana felt meant it took her months to accept her diagnosis and move on. In Moldova, as is the case in many social settings, Oxana explains that the perception of TB is one that makes it incredibly difficult to advocate for and be associated with. It is considered an illness of “the homeless, alcoholics, drug users and former prisoners”. As a result, “there are very few former patients who would like to stay involved in TB advocacy” instead choosing to “forget about this nightmare”.

To exacerbate the social stigma, more and more people are being diagnosed with MDR-TB. MDR-TB emerges as a result of improper treatment, something all too common given that many national governments either lack the resources or political will to tackle TB appropriately.

I am told that the physical consequences of taking MDR-TB drugs is virtually impossible to comprehend it is so bad. Indeed, when I ask Oxana about her experience with MDR-TB drugs she states that “the only thing I would like to say is that I would never wish that experience on my greatest enemy!”. Side effects include vomiting, diarrhea, dizziness, anxiety, depression and suicidal ideation — to name just a few.

Drug-resistance is an alarming problem. Not only are the drugs incredibly toxic for patients, but treatment also costs over a hundred times the amount compared to treatment of standard TB. Failure to act now would mean we face a future of unparalleled costs in tackling TB as well as millions more suffering through the stigma, debilitating side effects and the loss of many more lives. I ask Oxana if she would like any final words. She urges the world not to forget that TB is more than just a medical issue. It is also social and economic and we must ensure that in order to consolidate the results of successful treatment there must be ongoing support to guarantee ex-patients a decent, social and secure life.

You can watch Oxana explain the importance of the Global Fund to Fight AIDS, Tuberculosis, and Malaria in this video from the Here I Am Campaign

Countering HIV stigma and creating support in Ethiopia

The following post is brought to you by Steve Lewis, our Global Health Advocacy Manager. Following on from our delegation post, Steve describes our visit to one of Addis Ababa’s health centres:

In February I travelled to Ethiopia with RESULTS staff and five UK parliamentarians to see health programmes and assess the effectiveness of UK support for poverty reduction in the country. The trip was a fascinating mixture of meetings with the ‘highest’ and the ‘lowest’ in the chain of support for poverty-related health programmes.

We met with DFID officials, the Ethiopia Minister of Health and officials at the Africa Union (AU). The meeting with the AU took place in their sleek new building constructed the Chinese government.  But while these meetings provided us facts and figures, it was hard to understand the impact of the work on the ground level.

We were able to see how this work affected communities during a site visit conducted by AMREF to local water and sanitation projects as well as to a local health centre in a poor and crowded urban area of Addis Ababa, the capital of Ethiopia. Queues of patients waited on benches in the open air, waiting to be seen by nurses and staff who work to diagnose and treat common illnesses such as tuberculosis, pneumonia and stunting (malnutrition). The health centre had no actual doctor on site – Ethiopia has an acute shortage of doctors and most other senior health personnel.

I found the most encouraging part of the visit to be a meeting with a support group of women with HIV/AIDS. On previous visits to Africa a few years ago, I had seen high levels of stigma against people living with HIV. No one wanted to admit it, and no one wanted to know. But in this health centre a crowded group of women in multi-coloured dresses sat around a table and waited patiently to tell us their stories.  They told us they meet every Wednesday morning, and their numbers are growing.

As children crawled around the floor, the women were not shy to tell us about their lives. The health centre has diagnosed them with HIV but now provides daily drugs to keep the impact at bay (anti-retrovirals or ARVs). Some years ago a woman would have had to take around a dozen pills a day, with severe side effects, but now they take just three pills.

“What about the side effects?” I asked.

A confident young woman told us she suffers no side effects and feels perfectly healthy. “These ARVs have kept me alive,” she said simply.

The ARVs are bought in bulk for Ethiopia by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM). Our UK delegation were proud that the UK is one of the biggest donors to the Global Fund.

The other huge advance in medical technology has been vast improvements in ‘Prevention of Mother to Child infection’ (PMTCT). Only ten years ago most babies born to HIV positive women would have been born HIV-positive themselves and would have quickly died. Now, a simple regimen of check-ups and a daily pill at the crucial time means nearly all babies are born HIV-negative. They do not have HIV and have the chance to grow up healthy. This health centre provides 46 women with anti-retrovirals and 44 of them have given birth to healthy children. Two were born with HIV, of which one baby passed away. The HIV-positive child comes with his mother to this support group.

The women give each other emotional support to come to terms with living with HIV. But they hold their heads up and seem happy to talk to strangers about their lives. Our parliamentarians asked many inquiring questions but the women were not fazed.

–          “How many children do you have?”

–          “Two, and that’s enough…”

–          “Do you husbands come to the support group meeting?”

–          “No, and that’s the way we like it.”

–          “What hopes do you have for your daughter when she grows up?”

–           “I would like her to be a doctor.”

The visit provided an excellent example of how Ethiopia is dealing with tough health challenges and effectively demonstrated that UK aid money is being put to good use.

RESULTS UK leads delegation to Ethiopia

Last week, RESULTS led a cross-party parliamentary delegation to Ethiopia to explore how the country is dealing with key health issues affecting international development. The country continues to face enormous health challenges that include the spread of infectious disease and malnutrition. Yet, in light of this, Ethiopia is making impressive strides towards improving key health indicators and come up with innovative ways of responding to its health worker crisis.

RESULTS was joined by parliamentarians from all three major parties – Sir Tony Cunningham MP, Heather Wheeler MP, Kevin Barron MP, Baroness Hooper and Lord Hussain. The parliamentarians were able to attest that aid works – over the past ten Ethiopia has cut its infant mortality rate in half and it is on track to meet Millennium Development Goal 4 to reduce under-five mortality rates by two thirds. It has also created a model for dealing with its health worker crisis, which has successfully delivered TB care and treatment to the population.

The Global Fund to Fight AIDS, TB and Malaria

The delegation was able to visit one of only two hospitals in Addis Ababa that treats multidrug-resistant TB (MDR-TB). With support from the Global Fund, the most successful health financing mechanism to date, the hospital is providing MDR-TB treatment to patients from all over the country. MDR-TB is a form of TB that does not respond to the standard treatment using first-line drugs and is extremely difficult and expensive to treat. The Global Fund grant covered the cost for renovating the hospital’s MDR-TB ward and provides all second-line drugs needed to treat MDR-TB.

Innovative Reponse to the Health Worker Crisis

Ethiopia is one of 57 countries worldwide that faces severe shortages in their healthcare workforce and lacks doctors, nurses, midwives and other health workers needed to deliver healthcare to its population. In response to this crisis, Ethiopia has developed an innovative model called their Health Extension Programme (HEP).

The HEP shifts tasks to less specialised health workers called Health Extension Workers (HEWs) in order to deliver essential healthcare to communities that would otherwise not have access to such services. HEWs are women from the local community aged at least 18 years with 10 years of schooling who are provided with one year of healthcare training encompassing family planning, water and sanitation, and control of infectious diseases, including TB. Two HEWs are placed in each local health posts that provide primary care to their communities.

Health Extension Workers Delivering TB Care

The delegation was able to meet with HEWs in both Addis Ababa as well in more rural settings around Awassa in the south of the country. We were able to visit sites supported by TB REACH, a funding mechanism that finances projects to carry out TB diagnosis and treatment in areas with limited or no access to TB care.

The TB REACH grant currently allows HEWs to collect sputum samples from individuals with TB symptoms and provides local health centres with motor bikes to collect these samples and transport them to the lab for diagnosis. TB diagnosis has more than doubled since the project started, more people are being treated for TB and fewer people are dying or failing to complete their treatment.

Improving Child Survival Rates

Ethiopia’s HEWs have also been trained to treat the diseases that needlessly kill more than hundreds of thousands of children under five each year: malaria, diarrhoea, pneumonia, as well as malnutrition. Within the HEW programme’s first five years, malaria death rates in Ethiopia decreased by more than half and new HIV infections fell by 25 percent. In addition, mortality of children under five dropped by 28 percent, a lauded outcome.

The UK Government is a key donor supporting the Ethiopian Government to carry out health interventions that are working. The delegation heard time and again about how effectively and transparently the Ethiopian Government is using UK aid to reach the most vulnerable, making a real difference in the lives of some of poorest. The delegation validated that UK aid equals excellent value for money.