HIV/AIDS

Invest in Health Workers to End AIDS

Sarah Dwyer — Wed, 14 Jan 2015 14:06:30 +0000

The recent focus on Ebola in West Africa has reminded us of the need for strong and resilient health systems. Behind every quality health system is an army of available and accessible health workers. However, in facilities and communities across the globe, health worker vacancies and weak support systems hamper achievement of health goals and threaten overall preparedness for future infectious diseases.

In most countries with a high HIV burden, health workforce shortages are commonplace and create significant barriers to combating the epidemic.

Much has been accomplished. USAID is incredibly proud of its significant contributions to PEPFAR’s (the U.S. President’s Emergency Plan for AIDS Relief) achievements in strengthening the health workforce to deliver quality HIV services. On World AIDS Day, Secretary Kerry announced that PEPFAR has exceeded the target of 140,000 new health care workers, which was mandated by Congress in 2008. This is a great milestone not only for PEPFAR, but also for the broader global health workforce agenda.

Author's name:

Diana Frymus

Publication Date:

January 2015

“I Can Improve Things”: An HIV Peer Counselor in the Dominican Republic

Carol Bales — Tue, 03 Jun 2014 18:17:07 +0000

“It was very, very bad treatment that I received,” recalls Mercedes (not her real name), a young mother living with HIV.

Five years ago—at one of the largest maternity hospitals in the Dominican Republic—she was diagnosed as HIV-positive. Although she enrolled in the hospital’s program to prevent mother-to-child transmission (PMTCT), she felt discriminated against for her status, and that the health workers’ actions toward her lacked compassion.

But she decided her experience as a victim of stigma would not stand in her way of helping other HIV-positive pregnant women.

Author's name:

Ángela Diaz Fermin and Alex Collins

Publication Date:

June 2014

At the Source of Health Care, Health Workers

Carol Bales — Wed, 04 Dec 2013 20:53:51 +0000

This post was originally published on VITAL, the blog of IntraHealth International.

Malik Jaffer is the deputy director of human resources for health and health systems strengthening for the IntraHealth International-led CapacityPlus project. I recently interviewed him about health worker heroes and what it’ll take to make more of them.

You’ve met a lot of amazing health workers over the past 20 years. Any who really inspired you?
Absolutely. For example, there’s a team of health workers in Soweto, South Africa, that work in a hospice. When I visited, the facility was full of men and women and a lot of children. I remember one baby that was suffering from AIDS. She looked about three months old and weighed only 10 or 12 pounds. She was tiny. But I came to find out she was a year old.

Author's name:

Carol Bales with Malik Jaffer

Publication Date:

December 2013

Taking the E out of PEPFAR: Commemorating World AIDS Day 2013

Carol Bales — Mon, 25 Nov 2013 19:56:26 +0000

PEPFAR. To me, these six letters symbolize one of the most significant global health commitments in history. The US President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest response by one country to a single health epidemic. Over the past eight years at IntraHealth International, I have supported a range of PEPFAR-funded country programs that have led to improving the lives of millions. And I have observed the United States’ cornerstone HIV/AIDS global development program transform from an emergency response to one that encompasses proven prevention and treatment programs, harnesses technology and innovation, and supports ownership at the country level. So as we commemorate World AIDS Day, I want to reflect on the progress we’ve made and contemplate that “E” in PEPFAR.

Author's name:

Amanda Puckett

Publication Date:

November 2013

Three Answers for Walking Faster and Reaching Farther in Our Response to AIDS

Carol Bales — Wed, 03 Jul 2013 13:16:03 +0000

Last week I participated in Walking Faster and Reaching Farther: Strengthening Public Sector-NGO Partnerships in the AIDS Response, the final discussion in a four-part series on capacity development and country ownership hosted by AIDSTAR-Two.

This topic is very timely. Many local nongovernmental organizations (NGOs) and civil society organizations (CSOs) around the world depend on the Global Fund, PEPFAR, and other donor money to respond to HIV and support people living with the virus. But with diminishing donor funds expected, the funding base of these organizations is unstable. In many cases, they are not closely aligned with the Ministry of Health or other public-sector entities, and their relationships need strengthening. There are, however, some examples of local CSOs and NGOs working closely with the public sector, as well as examples of what it takes to strengthen both sectors to work together productively to assure an appropriate HIV response. Further strengthening of these partnerships is critical.

Author's name:

Malik Jaffer

Publication Date:

July 2013

US Investments in Foreign Aid Provide a Healthy Return

Carol Bales — Tue, 05 Mar 2013 14:45:38 +0000

This post was originally published on USAID's IMPACT blog.

What if you could take a fraction of a penny and use it to help build a health system? Believe it. It takes only a fraction of a single penny per American taxpayer dollar to train a global health workforce—a workforce that will reach millions through treatment, prevention, and counseling services.

Just ask midwife Teddy Tiberimbwaku, who had the opportunity to meet Uganda’s vice president Thursday.

Last year, Uganda’s Ministry of Health, operating with only one doctor and 13 nurses to serve every 10,000 people, was told by the Ministry of Public Service that not only could it not create any new positions, but also any unfilled positions—some 42 percent of them—would be lost.

Author's name:

Dr. Ariel Pablos-Méndez and Pape Gaye

Publication Date:

March 2013

Task Sharing, Not Task Shifting: Team Approach Is Best Bet for HIV Care

Sarah Dwyer — Tue, 28 Aug 2012 18:27:25 +0000

This post was originally published on the IntraHealth International blog.

By developing a more rational division of labor among HIV/AIDS health workers in developing countries, we can go a long way in “Overcoming the Last Barrier to Universal Access,” and nurses have a significant role to play in that effort.

That was the ambitious premise and title of a presentation by Dr. Kate Tulenko, senior director for health systems innovation for IntraHealth International (and CapacityPlus deputy director for clinical services and service delivery strengthening), at a satellite session I attended at the XIX International AIDS Conference in Washington, DC.

Author's name:

David J. Olson, guest blogger

Publication Date:

August 2012

Let’s Move People

Carol Bales — Fri, 27 Jul 2012 20:05:48 +0000

I woke up on my second day at the International AIDS Conference wanting to be moved. Not that the opening plenary speeches I attended the day before were not inspiring, but I was left wanting a more personal experience or connection. I know I’m not alone.

That day I found myself in front of a piece of art outside the main session room, a see-through column lined with small dolls. I leaned in to examine the artful beadwork on the dolls, very similar but intricately different. Orphan Tower contains 634 dolls made by local bead workers in a rural village in South Africa. Each doll represents one child living in the village whose parents died from AIDS. According to the placard, there are currently over 3.7 million AIDS orphans in South Africa alone. To represent all of them, there would need to be 5,835 of these towers. I’m left wondering who will care for these children, if they will also develop AIDS, and, if so, whether will they receive treatment. I’m also aware that these dolls could represent millions of children all over Africa, and all over the world.

Author's name:

Carol Bales

Publication Date:

July 2012

Frontline Health Workers Are the Key Link to Turning the Tide on HIV

Sarah Dwyer — Thu, 26 Jul 2012 15:27:46 +0000

On Tuesday’s plenary session at the International AIDS Conference, Phil Wilson of the Black AIDS Institute talked about the need for an “army of patient navigators,” people who provide the critical connection between HIV-affected individuals and life-saving health and social services.

As a Peace Corps volunteer working in Northern Cameroon, I came to know a timid collection of youth who believed that their HIV diagnosis was a death sentence. In addition to facing the stigma surrounding HIV, they must overcome the burdens of poverty, limited literacy, and in most cases being a woman in a conservatively Muslim society.

Under the shade of a neem tree, they questioned the possibility of their dreams. How long could they live? Should they invest in going to school? Could they ever hope to have a family someday?

Author's name:

Rachel Deussom

Publication Date:

July 2012

The Supply Chain Workforce: Key for Improving Response to HIV/AIDS

Sarah Dwyer — Wed, 25 Jul 2012 12:09:17 +0000

It was my intention to focus on attending events related to health workforce and supply chain management while at my first International AIDS Conference. However, with a conference program the size of a phone book, I quickly became overwhelmed and selected the first event on the list: “Improving the effectiveness and efficiency of the HIV response.” With such a broad topic, I expected the discussion could extend in a multitude of directions and I figured it would be a well-rounded first session.

Senators John Kerry and Lindsey Graham opened the session. Graham emphasized the need to remain focused on fighting the AIDS pandemic despite budget challenges in the US government. A recent minister of health from Lesotho, M. Ramatlapeng, guided the conversation toward the need to prioritize investment for impact. And when it came time for Bill Gates to share his view on the means by which to create a world without AIDS, he was quick to emphasize that we have a long way before that dream will become reality. He explained that while he sees a vaccine as the ultimate solution, it should not distract from other efforts. It remains essential to commit additional money toward research for new prevention tools and better systems of delivery.

Author's name:

Abbie Heffelfinger

Publication Date:

July 2012

Global Health: A Historic and Momentous Movement

Carol Bales — Fri, 11 Nov 2011 13:37:44 +0000

This post was originally published on the IntraHealth International blog.

I just returned from listening to a brilliant and inspiring speech by Secretary of State Hillary Clinton. Secretary Clinton traced the history of the HIV/AIDS pandemic, from the dark days of the 1980s, when little to nothing was understood about the disease and how to fight it, to today, when, armed with the tools made possible by science, great strides are being made in bringing HIV/AIDS under control. As she correctly pointed out, United States (US) leadership and investment have been at the forefront every step of the way. Investments in science led to understanding the virus, developing treatment, and building evidence-based prevention programs. The result has been a marked decline in the incidence of the disease, millions of infections prevented, and millions under treatment. Many institutions and people have contributed to this remarkable change. That said, the contribution of the US government to the fight against HIV/AIDS has been essential to the progress achieved. The US contribution to the cause of fighting HIV/AIDS, and global health more generally, has been a pillar of US leadership in the world.

Author's name:

Maurice Middleberg

Publication Date:

November 2011

Making Work Safe for Health Workers

jennifer — Thu, 28 Apr 2011 15:49:47 +0000

During my medical residency, several of my friends stuck themselves with used needles while caring for patients. I remember their anxiety as they waited for the blood tests to arrive that indicated whether they were at risk for HIV, hepatitis B, or hepatitis C. More than a decade later, I now have an opportunity to help improve working conditions for health workers worldwide.

Exposure to infection
April 28 is World Day for Safety and Health at Work. We need to think about the health of the three million health workers who receive injuries that expose them to blood-borne pathogens—three million to hepatitis B and C and 170,000 to HIV. These injuries may result in 15,000 hepatitis C, 70,000 hepatitis B, and 500 HIV infections. More than 90% of these infections occur in developing countries both due to the higher incidences of these diseases and the lack of training, protective equipment, and proper disposal receptacles.

Author's name:

Kate Tulenko

Publication Date:

April 2011

Global Health Workforce: A Household Name

jennifer — Fri, 07 Jan 2011 18:49:47 +0000

It’s impossible to forget a woman caring for five kids, in a cockroach-infested plywood house, in 90-degree weather. She has no access to clean water or adequate health care.

I was fortunate as a teenager to have experienced the health and quality of life conditions in the developing world firsthand. On a 10-day school trip to Matamoros, Mexico, this image was ingrained in my mind and in the minds of 12 other high school students. (In case you’re unaware of Matamoros’s location, it’s barely five miles from the US border.)

Public opinions
Diseases and issues such as HIV and AIDS, malaria, malnutrition, and access to clean water are often cited as the biggest public health concerns for developing nations. While these issues are rightfully at the center of the public and government discourse, I wanted to see how the global health workforce stacked up against these other widely recognized problems.

Author's name:

Adam Buzzacco

Publication Date:

January 2011

Deploying an Integrated Human Resources for Health Approach to Achieving the Millennium Development Goals

Sarah Dwyer — Mon, 11 Oct 2010 14:15:19 +0000

The global health workforce crisis demands a strategic investment in a long-term solution. Given the limited human resources for health (HRH) available in many countries, an integrated, systems-based approach is necessary if countries are to achieve all the health-related Millennium Development Goals.

The Center for Global Development’s (CGD’s) recent report argues that donors must evolve from the emergency approach required to scale up vertical HIV/AIDS programs to a more sustainable approach that plans for, develops, deploys, and retains a health workforce responsive to the population as a whole.

A call to donors
Based on research conducted in Mozambique, Uganda, and Zambia, the CGD report examined how AIDS programs leveraged health workers, their financial and programmatic inputs into health worker training and deployment, and the effects of these actions on health services.

Author's name:

Sara Pacqué-Margolis and Crystal Ng

Publication Date:

October 2010

Preventing AIDS Deaths Need Not Be a Fight: A Health Systems Approach

jennifer — Mon, 02 Aug 2010 18:18:42 +0000

In the Washington Post article “Rage, panic in AIDS fight,” David Brown alleges that the goal of health systems strengthening is “hard-to-define.” In fact, it is not.

Whatever the disease or health sector priority—be it HIV/AIDS, malaria, family planning, labor and delivery, or pneumonia—six components of the health system must be functioning and integrated in order for health impacts to be maximized. These components are:

Service delivery
Medical products, vaccines, and technology
Financing
Health information systems
Leadership and governance
The health workforce—arguably most important of all.

Author's name:

Sara Pacqué-Margolis

Publication Date:

August 2010