COVID-19 will impact the prevention and treatment of many diseases, and there are particularly grim possibilities for tuberculosis (TB), which could set back our progress toward its elimination. Fortunately, our emphasis on strengthening local health systems is helping to build resilience against this kind of shock. We reached out to MSH technical experts leading three new global and national TB programs to learn what’s on their minds as their teams begin implementation under a COVID-19 reality. They all agree: COVID-19 reminds us why we cannot become complacent, and when it comes to the global fight to eliminate TB, it is no longer business as usual. Read what Ersin Topcuoglu, Daniel Gemechu, and Ehsanullah Darwish had to say about how we can fundamentally improve the way countries fight TB.
Globally, more than 230,000 children died of TB in 2019. According to the World Health Organization (WHO), children under the age of 14 accounted for 12% of the people who developed TB in that year. In any given year, millions of children are infected with TB, which affects especially the most vulnerable, such as those who are malnourished. This tragedy is made worse because TB tends to be difficult to diagnose in children, and they are more likely to develop serious forms of TB. Many cases of childhood TB are missed, and access to services has been further compromised by the COVID-19 pandemic.
by Barbara K. Timmons, PhDTuberculosis (TB) is the pandemic that won’t go away. This ancient disease, the leading infectious cause of death in the world, kills more than a million people every year. One-third of the world’s population lives with latent TB infection. Despite being a preventable and curable disease, TB has been difficult to eradicate in part because of the stigma around the infection, preventing people from getting tested and continuing treatment. Ethiopia is among the 30 countries with the highest burden of TB in the world.
This op-ed was originally published in The Hill.Twenty-thousand years ago, at the peak of the last ice age, early human ancestors were migrating from their origins in Africa to East Asia. Shards of the earliest known pottery found in a cave in China suggest that our progenitors were dabbling in cooking. The Upper Paleolithic era led to more than domestication, however. It also likely gave rise to the bacteria that are common ancestors to modern day tuberculosis.The disease has been plaguing humans ever since. Egyptian mummies show signs of TB.
Meet Daniel Gemechu, MSH Regional Director for the USAID-funded Challenge TB Project in Ethiopia. MSH has worked in Ethiopia since 2011 to improve the quality of TB care and prevention services. Over the past five years, treatment success rates rose above 90%, with 75% of those suffering from multidrug-resistant TB (MDR-TB) now able to beat the disease after completing their treatment regimens. We asked Dr. Gemechu to reflect on his experience working with MSH and what remains to be done to eliminate the disease in Ethiopia.Dr.
Antimicrobial resistance (AMR) occurs when a microorganism becomes resistant to a drug that was originally effective for treating the infections it caused. It is one of the world’s most pressing global health threats and could erode progress made thus far in the treatment of HIV/AIDS, TB, malaria, and many other infectious diseases.
Management Sciences for Health’s (MSH) role in combatting AMR was recently featured in the peer-reviewed journal, Global Public Health.
Tuberculosis remains the world’s leading infectious disease killer. Ending TB will require a comprehensive approach and targeted action, rapid innovation and proven interventions, bold leadership, and intensive community engagement.
On this World TB Day, the global health community is calling for “Leaders for a TB-Free World” to work together, make history, and end TB once and for all.
We’re excited to bring you this month’s edition of Leading Voices, a series that features the incredible talent that makes up MSH.
We’re chatting with Degu Jerene, our project director in Ethiopia. Degu hails from Addis Ababa and has a passion for stopping the spread of infectious diseases like tuberculosis, malaria, and HIV. He’s responsible for leading the USAID-funded Challenge TB project in Ethiopia. Degu will be representing MSH this week at the Union World Conference on Lung Health in Guadalajara, Mexico.
What do you think makes MSH different?
“When we started our project in 2011, there was no system in place to identify multidrug-resistant tuberculosis (MDR-TB),” explained Muluken Melese, project director for the Help Ethiopia Address the Low Tuberculosis Performance (HEAL TB) project. However, since then, the five-year USAID-funded project, implemented by Management Sciences for Health (MSH), has expanded access to TB services to over half the population of Ethiopia and led a 15-fold increase in the number of MDR-TB patients on treatment.
Management Sciences for Health (MSH) joined more than 1,000 attendees, including global and local businesses and governments, at the Corporate Council on Africa (CCA)’s 10th Biennial US-Africa Business Summit, hosted in partnership with the African Union and the Federal Democratic Republic of Ethiopia, in Addis Ababa, this week. Established in 1993 to promote business and investment between the US and nations of Africa, CCA serves as a neutral, trusted intermediary connecting its members with essential government and business leaders.
“I started feeling this coughing… so I went to the health center and got tested. It was positive for TB,” says Grace*, a young Ugandan woman. She started on medicines, but after two months, she stopped adhering to treatment.They told me to continue with the drugs for five more months, but I stopped.I thought I was ok.She started coughing again, went to the hospital, and was diagnosed with multidrug-resistant TB (MDR-TB). MDR-TB cannot be treated with two of the most powerful first-line treatment anti-TB drugs. Her treatment regimen?
When Mearege gets really sick, her husband leaves town. Bedridden and in the care of her parents, Mearege gets tested and learns she--and her daugther--are HIV-positive. Through the support of mother mentors, trained by the Ethiopia Network for HIV/AIDS Treatment, Care and Support Program (ENHAT-CS), Mearege finds solace, guidance, and healing -- and decides to have another child.
Today, over 500 organizations and individuals worldwide are celebrating the first-ever Universal Health Coverage Day (UHC Day). All week, Management Sciences for Health (MSH) bloggers have shared stories, analysis, photos, and videos, in support of UHC Day and health for all: Partnering to Make UHC a Reality "For UHC to succeed worldwide, the global health community must generate what’s still missing: a fully-fledged roadmap for UHC efforts and an architecture for global UHC governance," blogs Jonathan Jay in Devex.
Staff contributors at Management Sciences for Health (MSH), a founding member of the UHC Day coalition, are blogging this week about universal health coverage, including sharing fresh videos, photos, and analysis, inspired by the five reasons to support health for all. Each day we also include how you can take action right away to support health for all.
Today, we highlight reason two ("Because UHC is attainable") with video and stories from Ethiopia, Kenya, and Nigeria--countries working toward UHC.
Because Universal Health Coverage (UHC) is Attainable
“MSH is like my mother,’’ said Yimenu, a young medical professional from East Gojam, a place about 600 kilometers from Ethiopia’s capital, Addis Ababa. “I have been suffering for five years and it was because of MSH that I started living all over again.”
Yimenu is the voice of thousands: the symbol of partnership that contributed significantly to the country’s increasingly strengthened health sector to save lives.
“I ask no more than an opportunity to help others,” said Yimenu looking at the crowd with complete joy.
My name is Tiglu. I was born and raised in Bahir Dar. When I first learned that I am living with the [HIV] virus, my mind went blank. I was depressed. After that, I started taking antiretroviral treatment. Then they found TB in me... Meet Tiglu, a living example of how partnering for stronger health systems saves lives. In Ethiopia, about 790,000 people are living with HIV. Tiglu, a patient at the Bahir Dar Health Center in the Amhara Region of north-western Ethiopia, discovered he is HIV positive three years ago, and started on antiretroviral treatment (ART).
It came as a surprise to many attending the symposium—health insurance in Ethiopia had been talked about in the media for a while, but most didn’t know the preparations had gone this far. It was at a high level session that the Acting Director General of the Ethiopian Health Insurance Agency, Dr. Mengistu Bekele, explained the work the government has been doing to start the implementation of the twin health insurance schemes. Dr.
This post originally appeared on the Frontline Health Workers Coalition blog.
Ayelew Adinew was working as a pharmacist in a large public hospital in Addis Ababa, Ethiopia. He looked around and saw that the 100-year old pharmaceutical system was broken.
This post originally appeared on Devex on November 14, World Diabetes Day (#WDD).
During her third pregnancy, Eden Bihon visited the Mekelle Health Center in Tigray, Ethiopia. Although a routine prenatal visit, it held great importance for Eden, as she had recently lost her second child, who died from unknown causes at the age of just one year.
Unknown to her at the time, this visit would have lasting implications for Eden and her baby. A 23-year-old mother, Eden, like most Ethiopian women, had concerns about her pregnancy and well-being. But gestational diabetes was not one of them.
On the eve of the 20th International AIDS Conference (AIDS 2014), Rachel Hassinger, editor of MSH’s Global Health Impact Blog, spoke with Dr. Scott Kellerman, global technical lead on HIV & AIDS, to discuss his latest research on prevention of mother-to-child transmission (PMTCT) of HIV and pediatric HIV & AIDS. Kellerman and colleagues will be attending AIDS 2014, July 20-25, in Melbourne, Australia. (Read more about the conference.)
We will sprint in the last round like our athletes. That is the Ethiopian style. So says the famous Ethiopian comedian Dereje Haile. His team is lagging behind in the first round of the popular Ethiopian Television (ETV) game show, Question and Answer Competition.
Four Ethiopian HIV-positive mothers received 2014 REAL Awards for their outstanding contributions to the fight against HIV, particularly prevention of mother-to-child transmission of HIV (PMTCT), at a ceremony in Addis Ababa, Ethiopia, on April 10, 2014. Created by Save the Children and the Frontline Health Workers Coalition, the REAL Awards are designed to develop greater respect and appreciation for health workers and the lifesaving care they provide globally, as well as in the United States.
Meet Tsegay, Haile, Alemayehu, and Derebrew
Azmara Ashenafi, a 35-year-old woman from the Amhara region of Ethiopia, was diagnosed with tuberculosis (TB) and placed on treatment. She was fortunate. Many people with TB are missed by health systems altogether. But Azmara’a treatment wasn’t helping. Despite taking medicine for months, her symptoms persisted and became more severe.
In many places, her story would have a sad ending—TB is one of the top three leading causes of death for women 15 to 44 in low- and middle-income countries.
MSH staff are commemorating World TB Day through awareness-raising activities around the globe, including in Afghanistan, Cambodia, Ethiopia, Ghana, Indonesia, and Nigeria. Here are photos (some from 2013) with activities this year.
Afghanistan - TB CARE I
This post originally appeared on The Lancet Global Health Blog.
A strong civil society is essential for realizing the lofty goal of achieving universal health coverage (UHC). While the ongoing global discussions around UHC have largely focused on the role of government and development partners in designing and implementing risk pooling mechanisms that have the potential to improve access to essential health services, there has been little discussion on the key role that local civil society organizations (CSOs) play to ensure various communities support UHC and hold governments accountable.
This special January 2014 edition of the Global Health Impact Newsletter (subscribe) features 12 stories from 2013 highlighting how MSH is saving lives by strengthening health systems at all levels--from the household to the community to the health facility to national authorities. The stories were selected through an internal storytelling contest (available in print soon).
We are also pleased to share a post from President and CEO Jonathan D. Quick outlining our vision for 2014.
A Note from Dr. Jonathan D. Quick
Vision 2014: UHC and the Opportunity for a Healthy Life
It was sudden and unexpected. It was also funny: the ball exploded and deflated right under Teferi's foot. But everybody started to worry when the director screamed: “We can’t shoot the next scene without the football! Somebody get me a new one!”
I looked at the young boy actor. Tears were about to wash his gloomy face as the ball changed into a useless piece of flat plastic right before his cloudy eyes. "This is bad!" I said to myself. "The kid might not be willing to act anymore; we might be forced to start the production all over again!"
Knowledge is power, so the saying goes.
No one understands that more than Teberih Tsegay, Almaz Haile, Jember Alemayehu, and Yeshi Derebew, of Korem Town, Ethiopia, who have used their knowledge to save the lives of babies in their community. "Some years back there was no one to teach us, so we gave birth to HIV-positive children. But now we can teach others so no child will be born with the virus," said Jember.
November 14 is World Diabetes Day. This year’s theme, “Protect our future,” emphasizes the importance of engaging and inspiring local communities to promote awareness and education on the effects of diabetes and its preventable risk factors.
We call on you to celebrate the girl child, read and support the Girl Declaration—a call to action for the post-2015 development agenda to prioritize girls and stop poverty before it begins—and help educate and empower the girl child in all of us. Many of us are shaped by what we experience as children. For those in high-income countries, the world of the girl child is often full of possibilities and options. However, for many in low- and middle-income countries, the girl child lives in a world fraught with harsh realities and limited choices. To understand the journey of women, we must look at the girl child not only as a period in one’s life but as one which continues to live in all of us as we reach adulthood and beyond. "I was not put on this earth to be invisible."
Strengthening health systems at all levels is the core of MSH’s response to the HIV epidemic. We build organizational capacity to implement innovative HIV, prevention, care, and treatment interventions in over 35 countries---from Côte d'Ivoire to Ethiopia to Vietnam.
All involved with women’s health and gender wish that access to quality health care for women and girls was easy to achieve at scale. But the attitudes and expectations of many societies limit women’s and girls’ access to resources and skills associated with better health.
Sunday, March 24, 2013, is World TB Day, and MSH staff and partners are promoting global efforts to stop TB throughout the week.Here are highlights from some of our activities around the world:The Afghanistan TB CARE I team is working with the national TB program (NTP) to conduct celebration events at 290 health facilities and communities in 13 USAID-supported provinces. TB messages will be aired through local telephone companies to approximately one million people throughout the nation.
The Health for All campaign was officially launched in Ethiopia at an event on March 14 in Addis Ababa. Over 100 participants, including partners, government representatives, and contributing artists, attended the colorful ceremony at Harmony Hotel. A children’s band entertained the guests with music, and a community theatre group, Music Mayday, portrayed the importance of health insurance for all.Hiwot Emishaw, the coordinator of the Health for All campaign, opened the ceremony.
Silenat Yihune, a 40-year-old woman, mother, and housewife, lives in a remote region of Huletejuenesie District, Ethiopia, which is approximately 20 kilometers from the closest health facility. For nine months Silenat suffered from a cough, chest pain, fever, and weight loss, but was unable to receive treatment. As is common among Ethiopian families, Silenat was economically dependent upon her husband. He refused to pay for her travel to the distant health facility.
Private sector companies, like McDonald's and General Electric, have successfully been using internal universities or academies for decades. So how can programming for health service managers be better, more cost effective and more sustainable? Embed programming within special “Leadership Academies” based in ministries of health.
I was circumcised when I was eighty days old, as is the tradition in Ethiopia. My sister was three. My mother had tried to spare us, but her aunt discovered that we were not circumcised and took it upon herself to have us circumcised.
http://www.youtube.com/watch?v=I2Y7y-EfIHM&feature=youtu.beUSAID Administrator Rajiv Shah welcomes attendees to the African Leadership on Child Survival meeting in Ethiopia via this video.RelatedUSAID IMPACT blog: Ethiopia Hosts African Leaders to Accelerate Gains in Child SurvivalUNICEF: Ethiopia hosts African Ministers of Health and world experts to spur gains in child survival10 Steps Toward Child Survival
The October edition of MSH's Global Health Impact newsletter (subscribe), features stories of people, communities, and countries on the road toward universal health coverage (UHC).
The vital role of the essential package for health impact "Universal health coverage has two fundamental goals: maximizing health impact and eliminating — or at least reducing — impoverishment and bankruptcy due to healthcare costs," blogs MSH President Jonathan D. Quick.
Seven-year-old Makasi, an HIV-positive orphan in Tanzania, was diagnosed with advanced tuberculosis (TB) and started on curative treatment. Clinicians at a local health center used standardized TB guidelines to overcome the difficulty of identifying TB in children co-infected with other diseases. In Afghanistan, sixteen-year-old Hamida provides for her family while trying to complete school. Hamida was visited by a community health worker, who identified her TB symptoms, and helped her access appropriate diagnosis and treatment.
Steady Progress Against Daunting Challenges
The prospect that we may see the end of AIDS in our lifetime has never been greater. Over the last decade, the global HIV & AIDS community has achieved stunning successes, including a steady decrease in new HIV cases, a massive scale-up of antiretroviral therapy (ART), and proof that treatment is prevention. As we begin the XIX International AIDS Conference, we are also excited by new scientific advances in prevention and treatment, such as Option B+ for prevention of maternal-to-child transmission (PMTCT).
Cross-posted on TB-CARE I.World TB Day, March 24th, was commemorated in many countries around the world last week to acknowledge the accomplishments made in the fight against tuberculosis (TB), and to call attention to the work that still needs to be done.Voices of TB, a unique event organized by USAID, featured former TB patients speaking about their personal fight against TB.
The 16th International Conference on AIDS and Sexually Transmitted Infections (ICASA) opened today, December 5, 2011, at the newly refurbished Millennium Hall in Addis Ababa, Ethiopia, with a colorful and lively music and dance production by the Ethiopian National Theatre and Traditional Music Group and the Addis Ababa Youth & Children’s Theatre.UNAIDS Executive Director Michel Sidibé gave an impassioned welcome speech remembering the last 30 years of AIDS and the 24 million African lives lost to the epidemic.
This year is not only MSH’s 40th anniversary; it is also 30 years since the first reported cases of HIV. Thirty years ago HIV was considered a new, always-fatal disease. ...Today 6.6 million people—nearly half of those in need—will take life-saving antiretrovirals.
Lucia Afiki and Esther Goodson are living positively with HIV. They are counselors for family planning and HIV & AIDS at Salima District Hospital in Malawi, where they openly tell their clients that they are HIV-positive. “When we are open with them about our status,” says Afiki, “people say, ‘Come closer, we want to learn from you.’” Goodson adds: “They say, ‘What should I do to look as good as you?’” The counselors tell them to visit a doctor and join a support group. This is an approach that saves lives.
Thirty years ago, we learned of a disease that began with a few cases and quickly transformed into an epidemic the world had not seen before. We were not exactly sure what it was, how it was spread, or how to care for people who had it. HIV & AIDS has had a dramatic impact on the world – and especially on people in low and middle income countries.
This blog post originally appeared on the US Agency for International Development's IMPACT blog. As a procurement specialist with PEPFAR’s SCMS (the Supply Chain Management System) project, I am one of a growing number of women working in supply chain management in Ethiopia. I manage procurements of HIV/AIDS commodities---including the complex procurement of specialized medical equipment used to treat HIV/AIDS---as well as the vehicles that distribute those commodities.Well planned, strategic procurement is a smart investment.
Aberu Hailu is a 31 year old, mother of four living in Hidmo, Ethiopia a rural community 8 kilometers south east of Adigodum town in Tigray. Two years ago, she visited the Adigodum Health Center to be tested for HIV, a disease she had learned about through community health education. She discovered she was HIV-positive and informed her husband that he should be tested, but he refused.Two months later, Aberu became pregnant and found herself in despair.
One hundred years ago on March 8, a handful of countries celebrated the first International Women’s Day. Today it is celebrated around the world as an opportunity to look back on women’s accomplishments and look forward to the realization of their full economic, political, and social rights.
Today, MSH teams around the world observed World AIDS Day by participating in national commemorations and offering HIV testing, counseling, and prevention messages.In Guyana, the GHARP II team announced the winners of a contest among journalists and media houses for the best projects to reduce stigma and discrimination.In Honduras, AIDSTAR-Two supported its partner NGOs in a variety of special events, including puppet shows, health fairs, and HIV rapid test promotion.In Ethiopia, HCSP is having an exhibition booth at the national celebration displaying Information Education Communication
Part one of the blog series: Spotlight on Global Health Initiative Plus CountriesGender Mainstreaming in EthiopiaWith the announcement of the “GHI Plus” countries, we have a major opportunity to move the gender agenda beyond the rhetoric. The new guidelines clearly show that this issue is not only important, but also one of the major pillars for global health. The mandate has been given and the challenge now is to build on this legitimacy that has been hard earned and continue to seek opportunities, design interventions, and diligently document best practices.
In mid-June the United States Government continued to show its commitment to global health by announcing the first Global Health Initiative (GHI) Plus countries: Bangladesh, Ethiopia, Guatemala, Kenya, Malawi, Mali, Nepal, and Rwanda. The GHI is a six-year, $63 billion initiative to help partner countries improve measurable health outcomes by strengthening health systems and building upon proven results.
Global Health TV visits Ethiopia’s capital, Addis Ababa, to see how MSH’s systems approach at the community level results in better lives for people living with HIV & AIDS. Management Sciences for Health, an international nonprofit organization, uses proven approaches developed over four decades to help leaders, health managers, and communities in over 60 countries build stronger health systems for greater health impact.Watch the video.
Today, the 37th annual Global Health Council Conference “Goals and Metrics” begins in Washington, DC. MSH is pleased to be a Silver Sponsor of the conference.MSH is sponsoring two auxiliary events:“Can Country Ownership Work? Field Perspectives on Health Systems Strengthening” Today, June 14, 2-4pm, Governors Room, Omni Shoreham Hotel, Washington, DC A panel discussion co-hosted by MSH and Oxfam on how “country ownership”—the management of donor funds by a national government—works in practice.