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{The USAID MTaPS Program is supporting the Philippines in responding to the COVID-19 pandemic and ensuring the availability of quality health commodities in communities. Photo credit: MTaPS staff}The USAID MTaPS Program is supporting the Philippines in responding to the COVID-19 pandemic and ensuring the availability of quality health commodities in communities. Photo credit: MTaPS staff

Andre Zagorski of the MSH-led, USAID-funded MTaPS Program talks about the program's urgent work to help contain the virus in more than a dozen countries.

{Andre Zagorski} Andre ZagorskiHow did you and MTaPS rally to support USAID’s call for a rapid response to COVID-19 in a dozen countries? What were the challenges? 

MTaPS is the USAID Global Health Security Agenda (GHSA) go-to program for infection prevention and control (IPC), and we have been implementing activities to strengthen health systems for stronger IPC programs in 10 countries since the MTaPS award in 2018. We have offices and small but strong professional teams in these countries and have established productive working relations with national stakeholders and partners.

Story by Samy Rakotoniaina and Misa Rahantason

Malaria is one of the leading causes of mortality among children under five in Madagascar. Atsimo Andrefana is one of Madagascar’s regions most severely impacted by endemic malaria. More than half of the population in this region lives more than five kilometers from the nearest health facility, putting Community Health Volunteers (CHVs) on the front lines in the fight against malaria.

Retsilake is one of the 6,000 high-performing CHVs supported by the USAID-funded Accessible Continuum of Care and Essential Services Sustained (ACCESS) project. ACCESS is implemented by Management Sciences for Health (MSH), in partnership with a consortium of international and local organizations, and alongside Madagascar’s Ministry of Public Health. The project is partly funded by the U.S. President’s Malaria Initiative (PMI).

Retsilake diagnosed and treated nearly 2,000 children from his village and the surrounding area during a particularly severe malaria outbreak in 2015. He understands the impacts of malaria on children's health and this keeps him motivated to serve his community.

{Retsilake, a community health volunteer in Madagascar, uses a mobile app to carry out epidemiological surveillance of malaria and other diseases at the community level. Photo Credit: Samy Rakotoniaina/MSH}Retsilake, a community health volunteer in Madagascar, uses a mobile app to carry out epidemiological surveillance of malaria and other diseases at the community level. Photo Credit: Samy Rakotoniaina/MSH

A conversation with Dr. Bernard Nahlen, Director of the Eck Institute for Global Health at the University of Notre Dame and member of the MSH Board of Directors  

{Dr. Bernard Nahlen}Dr. Bernard NahlenSome countries are entering peak malaria transmission season over the next few months, overlapping with the COVID-19 pandemic. How might the crisis affect ongoing malaria eradication efforts? 

One issue is case management. As a reminder, there were more deaths due to malaria than to Ebola in West Africa in 2014, because people were reluctant to go to clinics for treatment for fevers and aches. And in many areas communities began to protest that, while their children continued to become ill and die of malaria, suddenly there was a single focus on Ebola. We may see something similar with COVID-19. 

{Raian Amzad in the Control Room. Photo credit: MSH}Raian Amzad in the Control Room. Photo credit: MSH

Raian Amzad, a technical advisor with the DFID-funded Better Health in Bangladesh (BHB) project, and her colleagues took time away from their regular work to help Bangladesh’s central response to COVID-19. Here’s how the project and the country are handling the pandemic threat. 

Can you tell me about your recent work assignment related to COVID-19? What did your typical day look like?

On March 17, the Directorate General of Health Services opened a temporary Integrated Control Room for COVID-19 response. Fifteen different groups are working there. I was in one with other developmental partners.

The control room guides, supervises, and monitors the entire country in responding to COVID-19; facilitating meetings with donors; disseminating awareness messages and myth busters for the public; developing guidelines for the health workforce; and coordinating logistics, commodities, and media outreach. I have been engaged in all sorts of tasks, and it was enlightening to work so closely with the government health system. 

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Originally published by Global Health NOW

COVID-19’s lethal invasion in late 2019 has turned the world inside out. Yet, another disease, tuberculosis, has been plaguing humans since the Upper Paleolithic era, some 20,000 years ago. In fact, many infection-prevention precautions promoted for the coronavirus—coughing etiquette, distancing, and hand washing—originated as TB-control measures in Victorian times. The COVID-19 response can draw on more challenges and lessons from TB programs that emphasize investments in research and rapid uptake of new diagnostic, prevention, and treatment tools for universal health coverage.

{Doctors visit with patients in Rabia Balkhi Hospital, Kabul, Afghanistan. Photo Credit: Afghan Eyes/Jawad Jalali}Doctors visit with patients in Rabia Balkhi Hospital, Kabul, Afghanistan. Photo Credit: Afghan Eyes/Jawad Jalali

A recent Management Sciences for Health (MSH) study conducted with mental health patients in Afghanistan revealed that people being treated for mental illness were almost 20 times more likely to have tuberculosis (TB) than the general population. 

Years of conflict, poverty, stress, and illicit drug use have led to Afghanistan’s high rates of mental disorders, including depression, anxiety, and post-traumatic stress disorder. Studies have shown depression and anxiety rates as high as 72% and 85%, respectively, among Afghan adults. Afghanistan’s high incidence of TB is similarly linked to high rates of poverty and illegal drug use. Both TB and mental disorders may also be associated with poor nutrition, inadequate housing, and other manifestations of poverty. 

The MSH study, which screened 8,073 patients at six mental health facilities (five public and one private) in Herat, Jalalabad, Kabul, Kandahar, and Mazar-e-Sharif provinces found that 3.4% of patients suffered from TB. The incidence rate among Afghanistan’s general population is 189 per 100,000 people.

{Photo credit: MSH}Photo credit: MSH

by Barbara K. Timmons, PhD

Tuberculosis (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. One TB patient in Eastern Ethiopia, a woman from the small city of Dire Dawa, told researchers from Management Sciences for Health (MSH), “My husband’s family stigmatized me a lot. Since they knew that I am a TB patient, they didn’t sleep in our house. They sleep outdoors. They are not also willing to eat with me. . . . Before I was infected with TB, our social life with other people was great. The social life of Dire Dawa community is well known. But after they knew that I am a TB patient, only one of my neighbors sometimes comes to visit me.”

A community volunteers provides free HIV tests at a local market in Eyokponung, Nigeria. Photo Credit: Gwenn Dubourthournieu/MSH

This article was originally published in The Daily Trust

Following the economic recession of 2016, the Nigerian government developed an Economic Recovery and Growth Plan for 2017-2020 with three broad strategic objectives: restoring growth; investing in human capital; and building a globally competitive economy that achieves agriculture and food security, industrialization, improved transport infrastructures and energy sufficiency. Of these three objectives, one stands out: recognizing the importance of investing in human capital.

This represents a major shift by the government, as it previously focused mostly on developing infrastructure—a move that came at the expense of other sectors, including healthcare. Nigeria’s healthcare spending as a percentage of GDP remains one of the lowest in the world: about 0.6% of GDP in 2016, according to the World Bank. Per capita health spending by the Nigerian government is US$11, well below the recommended US$86 for low- and middle-income countries to deliver basic health services.

Photo Credit: Samy Rakotoniaina/MSH

This article was originally published in NextBillion.

What does scalable innovation in global health look like?

It could be a piece of software that provides faster access to blood supplies in Cameroon, an m-health platform that links virtual health coaches to people facing chronic illness in Nigeria, or an app that lets people use points to buy and exchange health products in Senegal, helping them save for out-of-pocket expenses. Or it might be a primary care service that reaches underserved people in India via telemedicine, or a microscope app that can diagnose breast and cervical cancers in remote areas in sub-Saharan Africa, where some 400,000 women die each year because they cannot access screening services.

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