Pakistan: Unsafe drinking water causes disability among children worldwide

9 April 2014 KARACHI:

Toxically germ-infested unsafe drinking water is causing different form of disability among children globally, mainly caused by teratogens. 

The excessive use of medication and consuming polluted water results in the development of abnormal cell tissue in unborn as well as newly born babies particularly during foetal growth, yielding a multiplex of physiochemical defects in the foetus. Improper and untreated disposal of sanitary water and untreated industrial waste is resulting in contamination of sub soil water threatening the nature. 

Principal Investigators of South Asian Association for Regional Cooperation (SAARC) Sector’s Academic Alliance for Subsoil Water Toxicity Research Initiative Prof Qadhi Aurangzeb Al Hafi and Pro-Vice Chancellor of Dow University of Health Sciences (DUHS) Prof M Umar Farooq were of the view this was the first time Pakistani researchers’ study has been recognised at United Nations (UN) and Pakistan takes the historic edge of launching the first ever model of Terato-kinetc Research in the recorded history of medical sciences.The groundbreaking research document has been primed for over 1,700 international esteemed universities of the globe, in accordance with the UN mandates and conventions on the subject. 

The first categorical research model was demonstrated at Higher Education Commission (HEC) Pakistan in continuum of the multi academia polygonal scientific colloquia the UN ‘International Observance Day for Disability’, at Dow University of Health Sciences Karachi followed by its academic sessions and scientific symposia at Punjab University and Higher Education Commission of Pakistan. The multi-academic colloquia consist of 9 scientific orientations, 17 confluences, 10 symposia and 19 demonstrations worldwide. 

[Courtesy of Daily Time]

YAOUNDÉ, 26 March 2014 (IRIN) – Three new polio cases have been confirmed in Cameroon over the past two weeks, making it the country’s first outbreak since 2011 and causing alarm among health officials who link the virus’s spread to weak vaccine campaign coverage and displacement following violence in neighbouring northeastern Nigeria and the Central African Republic (CAR).
Cameroon has confirmed seven polio cases since 2013. Just one case is enough to instigate emergency country-wide vaccination measures under the national health policy. It last experienced a polio outbreak in 2009, the strain also identified in Nigeria and Chad.

The World Health Organization (WHO) has said the virus is at a “very high risk” of crossing borders, and one polio case of the same strain as in Cameroon has just been confirmed in Equatorial Guinea, which saw its last case in 1999.

Cameroon has put in place emergency measures to try to contain the virus, but weak or non-existent monitoring in the cross-border areas with Nigeria and CAR is seriously hampering any national efforts, said Paul Onambelle, a doctor at the Cité Vert district hospital in Yaoundé.

The estimated 100,000 refugees in Cameroon who have fled violence in Nigeriaand CAR make control efforts even harder, said Elisse Clarisse Onambany of the National Expanded Program on Immunization (EPI), who insists refugee children must be included in any immunization campaign, “which means the supply and resources needed must increase”, she said. Half of the refugee population is made up of children aged 11 or under, according to the health authorities.

Immunization in the Far North Region has been extended to include some of the children in the Nigerian refugee population, but thousands of children are still not being accessed because of insecurity in the border area with Nigeria, families being continually on the move, and difficult terrain, said Maria Enjema, a nurse at Far North district hospital of Maroua. “Despite continuous effort by the government to reduce the risk of polio in the north, it is very difficult for health workers to reach all the children, particularly those living along the borders with Nigeria because of the high risk [of Boko Haram-related violence] involved,” she told IRIN.

Meanwhile, ongoing polio campaigns have not always successfully reached the 90 percent of children (aged 0-5 years) needed to eliminate the disease. Some 43 percent of children in Cameroon have not received the three doses required for immunity, and 30 percent have never been vaccinated, said health officials.

The government and partners issue regular polio campaigns for children aged 0-5 in the three northern regions: Far North, North and Adamawa, where the risk of infection is high, but cultural resistance in these areas has limited campaign efforts, said Onambany. “People have different beliefs when it comes to maternal care. Some communities with various religious standpoints on the vaccine say the body is sacred and does not need any chemical to feel better, while some Cameroonians see it as some sort of a public plot.”

Onambany said lack of resources also limited ongoing polio campaign coverage.

Many parents do not understand or believe that three oral vaccinations are required and so they drop out after the first or second round.

Loveline Penda, a mother of five in Yaoundé, told IRIN: “The numbers of vaccines keep increasing and I doubt sometimes what the difference will be if my child does not take a vaccine. Sometimes I miss out but I don’t have to worry because I just believe that my child will be fine.”

The government must take cultural resistance and lack of understanding more seriously and “work to change people’s opinions and knowledge [on polio],” said Idris Haman, a researcher at the University of Yaoundé.


Cameroon health officials are expanding the region-specific immunization campaign nationwide in April, May and June 2014, with the help of partners, said Onambany.

The National EPI will also soon launch an intensive awareness-raising campaign about the vaccination.

“The upcoming campaigns will ensure that the quality of campaign is improved by reaching children three times. We will also intensify communication and sensitization effort so that no family is left untold of the dangers of missing out vaccinations,” Onambany told IRIN.

Over recent years the government has stepped up its surveillance and response to polio, working through networks of trained staff in district hospitals, as well as with community-based monitoring networks and NGO partners. Without support from development partners like WHO and the UN Children’s Fund (UNICEF), containment issues would be lagging far behind, said the EPI.

But unless surveillance steps up across borders, the risk that the polio virus could continue to spread remains a top concern, said Onambelle.

[Courtesy of IRIN Africa]

Mental Health in Africa

As African countries strive to meet the UN Millennium Development Goals (MDGs) by 2015 and plot a new development agenda thereafter, health experts are gathering evidence across the continent to make a case for a greater focus on its millions of mentally ill.

Experts say investing in mental health treatment for African countries would bolster development across the continent, but national health priorities have been overtaken by the existing MDG structure, which has specific targets for diseases like malaria and HIV, placing them higher on countries’ agendas than other health issues.

“Everyone is putting their money in HIV, reproductive health, malaria,” says Sheila Ndyanabangi, director of mental health at Uganda’s Ministry of Health. “They need also to remember these unfunded priorities like mental health are cross-cutting, and are also affecting the performance of those other programmes like HIV and the rest.”

Global experts celebrated the passing of a World Health Assembly action plan on World Mental Health Day in May, calling it a landmark step in addressing a staggering global disparity: The World Health Organization (WHO) estimates 75-85 percent of people with severe mental disorders receive no treatment in low- and middle-income countries, compared to 35-50 percent in high-income countries. The action plan outlines four broad targets, for member states to: update their policies and laws on mental health; integrate mental health care into community-based settings; integrate awareness and prevention of mental health disorders; and strengthen evidence-based research.

In order for the plan to be implemented, both governments and donors will need to increase their focus on mental health issues. As it stands, the US Agency for International Development (USAID), the world’s biggest bilateral donor, will only support mental health if it is under another MDG health priority such as HIV/AIDS. Meanwhile, mental health receives on average 1 percent of health budgets in sub-Saharan Africa despite the WHO estimate that it carries 13 percent of the global burden of disease.

“Mental health hasn’t found its way into the core programmes [in developing countries], so the NGOs continue to rely on scraping together funds to be able to respond,” Harry Minas, a psychiatrist on the WHO International Expert Panel on Mental Health and Substance Abuse and director of the expert coalition Movement for Global Mental Health, told IRIN. “Unless we collectively do something much more effective about NCDs [non-communicable diseases], national economies are going to be bankrupted by the health budgets.”

According to a May report from the UN Secretary-General’s High-Level Panel of Eminent Persons on the Post-2015 Development Agenda, the MDGs have overseen the fastest reduction of poverty in human history. Yet it also acknowledges that they have done little to reach the world’s most vulnerable. The report says the MDGs were “silent on the devastating effects of conflict and violence on development” and focused too heavily on individual programmes instead of collaborating between sectors, resulting in a largely disjointed approach to health. Experts say without a more holistic approach to global health in the new development era, the world’s most vulnerable will only be trapped in that cycle.

“The MDGs were essentially a set of vertical programmes which were essentially in competition with each other for resources and for attention,” said Minas. “We’ve gone beyond that, and now understand we’re dealing with complex systems, where all of the important issues are very closely interrelated.”

Poverty and Mental Illness

In Africa, where many countries are dealing with current or recent emergencies, WHO sees opportunities to build better mental health care.

“The surge of aid [that usually follows an emergency]combined with sudden, focused attention on the mental health of the population, creates unparalleled opportunities to transform mental health care for the long term,” say the authors of the report Building Back Better: Sustainable Mental Health Care after Emergencies, released earlier this month.

In a study published in the Journal of Affective Disorders in July, researchers in northern Uganda – which, starting in the late 1980s suffered a two-decade long war between the government and the rebel Lords’ Resistance Army – monitored the impact of group counselling on vulnerable groups such as victims of sexual and domestic violence, HIV-infected populations, and former abductees of the civil war. It found that those groups who engaged in group counselling were able to return and function markedly faster than those who did not receive counselling, while reducing their risks of developing long-term psychiatric conditions.

“We need to be mentally healthy to get out of poverty,” Ethel Mpungu, the study’s lead researcher, told IRIN.

The link between mental illness and persisting poverty is being made the world over. According to a 2011 World Economic Forum report, NCDs will cost the global economy more than US$30 trillion by 2030, with mental health conditions alone costing an additional $16 trillion over the same time span.

“It really is around issues of development and economics – those things can no longer be ignored,” says Minas. “They are now so clear that ministries of health all around the place are starting to think about how they are going to develop their mental health programmes.”

Putting mental health on the agenda 

As mental health legislation is hard to come by in most African countries, Uganda is ahead of most on the continent with its comprehensive National Policy on Mental, Neurological and Substance Use Services, drafted in 2010. The bill would update its colonial era Mental Treatment Act, which has not been revised since 1964, and bring the country in line with international standards, but is still waiting to be reviewed by cabinet and be voted into law.

Uganda is also part of a consortium of research institutions and health ministries (alongside Ethiopia, India, Nepal and South Africa) leading the developing world on mental health care. PRIME – the programme for improving mental health care – was formed in 2011 to support the scale-up of mental health services in developing countries, and is currently running a series of pilot projects to measure their impact on primary healthcare systems in low-income settings.

Research shows that low- and middle-income countries can successfully provide mental health services at a lower cost through, among other strategies, easing detection and diagnosis procedures, the use of non-specialist health workers and the integration of mental healthcare into primary healthcare systems.

Although a number of projects have shown success in working with existing government structures to ultimately integrate mental health into primary health care, the scaling up of such initiatives is being hindered by a lack of investment, as the funding of African health systems is still largely seen through donor priorities, which have been focused elsewhere.

“Billions of philanthropic dollars are being spent on things like HIV/AIDS or water or malaria,” said Liz Alderman, co-founder of the Peter C. Alderman Foundation (PCAF), which works with survivors of terrorism and mass violence. “But if people don’t care whether they live or die, they’re not going to be able to take advantage of these things that are offered.”

[Courtesy of IRIN]

Africa:Major Progress in Fight Against Malaria

24 December 2013
Geneva/ Washington DC — Global efforts to control and eliminate malaria have saved an estimated 3.3 million lives since 2000, reducing malaria mortality rates by 45% globally and by 49% in Africa, according to the World Malaria Report 2013 published by the World Health Organization (WHO).

An expansion of prevention and control measures has been mirrored by a consistent decline in malaria deaths and illness, despite an increase in the global population at risk of malaria between 2000 and 2012. Increased political commitment and expanded funding have helped to reduce incidence of malaria by 29% globally, and by 31% in Africa.

The large majority of the 3.3 million lives saved between 2000 and 2012 were in the ten countries with the highest malaria burden, and among children aged less than five years – the group most affected by the disease. Over the same period, malaria mortality rates in children in Africa were reduced by an estimated 54%.

“This remarkable progress is no cause for complacency: absolute numbers of malaria cases and deaths are not going down as fast as they could,” says Dr Margaret Chan, WHO Director-General. “The fact that so many people are infected and dying from mosquito bites is one of the greatest tragedies of the 21st century.”

In 2012, there were an estimated 207 million cases of malaria, which caused approximately 627 000 malaria deaths. An estimated 3.4 billion people continue to be at risk of malaria, mostly in Africa and south-east Asia. Around 80% of malaria cases occur in Africa.

Malaria prevention suffered a setback after its strong build-up between 2005 and 2010. The new WHO report notes a slowdown in the expansion of interventions to control mosquitoes for the second successive year, particularly in providing access to insecticide-treated bed nets. This has been primarily due to lack of funds to procure bed nets in countries that have ongoing malaria transmission.

In sub-Saharan Africa, the proportion of the population with access to an insecticide-treated bed net remained well under 50% in 2013. Only 70 million new bed nets were delivered to malaria-endemic countries in 2012, below the 150 million minimum needed every year to ensure everyone at risk is protected. However, in 2013, about 136 million nets were delivered, and the pipeline for 2014 looks even stronger (approximately 200 million), suggesting that there is real chance for a turnaround.

There was no such setback for malaria diagnostic testing, which has continued to expand in recent years. Between 2010 and 2012, the proportion of people with suspected malaria who received a diagnostic test in the public sector increased from 44% to 64% globally.

Access to WHO-recommended artemisinin-based combination therapies (ACTs) has also increased, with the number of treatment courses delivered to countries rising from 76 million in 2006 to 331 million in 2012.

Despite this progress, millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems. The roll-out of preventive therapies – recommended for infants, children under five and pregnant women – has also been slow in recent years.

“To win the fight against malaria we must get the means to prevent and treat the disease to every family who needs it,” says Raymond G Chambers, the United Nations Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria. “Our collective efforts are not only ending the needless suffering of millions, but are helping families thrive and adding billions of dollars to economies that nations can use in other ways.”

International funding for malaria control increased from less than US$ 100 million in 2000 to almost US$ 2 billion in 2012. Domestic funding stood at around US$0.5 billion in the same year, bringing the total international and domestic funding committed to malaria control to US$ 2.5 billion in 2012 – less than half the US$ 5.1 billion needed each year to achieve universal access to interventions.

Without adequate and predictable funding, the progress against malaria is also threatened by emerging parasite resistance to artemisinin, the core component of ACTs, and mosquito resistance to insecticides. Artemisinin resistance has been detected in four countries in south-east Asia, and insecticide resistance has been found in at least 64 countries.

“The remarkable gains against malaria are still fragile,” says Dr Robert Newman, Director of the WHO Global Malaria Programme. “In the next 10-15 years, the world will need innovative tools and technologies, as well as new strategic approaches to sustain and accelerate progress.”

WHO is currently developing a global technical strategy for malaria control and elimination for the 2016-2025 period, as well as a global plan to control and eliminate Plasmodium vivax malaria. Prevalent primarily in Asia and South America, P. vivax malaria is less likely than P. falciparum to result in severe malaria or death, but it generally responds more slowly to control efforts. Globally, about 9% of the estimated malaria cases are due to P. vivax, although the proportion outside the African continent is 50%.

“The vote of confidence shown by donors last week at the replenishment conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria is testimony to the success of global partnership. But we must fill the annual gap of US$ 2.6 billion to achieve universal coverage and prevent malaria deaths,” said Fatoumata Nafo-Traoré, Executive Director of the Roll Back Malaria Partnership. “This is our historic opportunity to defeat malaria.”

[Courtesy AllAfrica News]

Draconian Law setback for Uganda’s HIV response

Kampala, 23 December 2013 (IRIN) -
The draconian Anti-Homosexuality Bill passed by Uganda’s parliament on 20 December would deliver a major blow to the response to HIV/AIDS if it was enacted by President Yoweri Museveni, activists have warned.
Those found guilty of homosexual acts can be jailed for up to 14 years under the new law, a sentence that increases to life in “aggravated” cases, such as those committed by an HIV positive person, or those involving minors, the disabled and serious offenders.

Civil society activists fear that high-risk groups such as men who have sex with men (MSM) and sex workers – whose HIV prevalence is 13.7 and 33 percent respectively – will see their already limited access to prevention and treatment further eroded.

Amnesty International called the law “a grave assault on human rights [which] makes a mockery of the Ugandan constitution.

“President Museveni should avoid the trap of scapegoating a vulnerable minority in the interests of short-term political gain,” said Daniel Bekele, Africa director at Human Rights Watch.

“He should recognize that this repugnant bill is of no benefit to Ugandans – that it only serves to jeopardize basic rights – and reject it.”

The United States government has also called for the bill not to be enacted.

Here is a selection of reactions from those working on the front-line of the response to HIV/AIDS:

Pepe Julian Onziema, programme director, Sexual Minorities Uganda (SMUG), a local rights group

“It’s with deep disappointment that I receive the news of the Anti-Homosexuality Bill passing in our Parliament.”

“If the bill is assented to, the Act would spell a major setback for Uganda’s gains against HIV/AIDS as it will compromise doctor-patient confidentiality, which will push affected LGBTI (lesbian, gay, bisexual, transgender and intersex) persons further underground for fear of prosecution.”

Asia Russell, Director of International Policy, Health GAP

“This harmful and blatantly unconstitutional bill will deal a devastating blow to evidence-based efforts to end the AIDS epidemic in Uganda – a country that is almost unique among aast and southern African countries in that it has rising rates of new HIV infections. Why? Because existing criminalization provisions have meant prevention and treatment services aren’t reaching populations like MSM, who have much higher HIV prevalence.”

“Under this new bill, providing those services would now be illegal – we will see new infections continue to rise as populations get excluded further and further from life-saving treatment, prevention, information and support.”

Milly Katana, veteran activist and board members of the Global Fund to Fight HIV, Tuberculosis and Malaria

“Totally disheartening! It is one of those moments where as a country we move one step forward in realizing civil liberties and public health common sense, [then] we take 10 steps back.”

“The little achievements of the Ministry of Health starting to think of making services available to people who are most at risk of contracting HIV are put in total jeopardy. I hope the president, who has announced himself as a champion for HIV prevention by encouraging Ugandans to test for HIV and knowing their status, will see the non-wisdom in this Act and not assent to it.”

Alice Kayongo, Regional Policy and Advocacy Manager, AIDS Healthcare Foundation – Uganda Cares

“The effects of this (bill) will be felt in almost all sectors but most especially in the health sector and particularly for HIV/AIDS where over 80 percent of the AIDS response is funded externally.”

“Even with amendments, the proposed law will have an impact on the quality of healthcare and health education to be provided to gay people living with HIV for the fact that treating someone or providing them with HIV related information will be seen as a promotion act, yielding to imprisonment. While there have been indications of forward movement in this country’s AIDS response, we are at risk of losing so much of what we have gained in the recent past.”

“Evidently, with such developments in the political and legal environments, Uganda is miles away from attaining [the UN-backed target of] zero new HIV infections, zero AIDS-related deaths and zero discrimination. It will not be a surprise if Uganda’s prevalence rate stagnates around 7.3 percent in 2017. However, we still have some hope, His Excellency President Yoweri Kaguta Museveni should reject the passing of this bill into law and everything else will fall into place.”

Flavia Kyomukama, director of the Global Coalition on Women and HIV/AIDS in Uganda

“At a time when the country is trying to implement the national HIV prevention strategy that has underscored the sex workers and MSM as key in the reduction of the epidemic, the legislature thinks it’s a waste of time to have these people access services.”

“A mother, a teacher, a health worker, an employer is by obligation expected to report any LGBT within 72 hours of notice and confirmation that someone is LGBT.”

“How do I report my son? As a teacher how do I report my student who comes to me in confidence? And as a health aide how do I abuse the confidence of the patient? All of us are going to be imprisoned.”
“If the proponents of the bill claim homosexuality is a mental disorder, is it logical to [give] life imprisonment? The [logical] approach would be counseling and treatment.”

And here are some reactions from champions of the new legislation:

Simon Lokodo, Uganda’s state minister for ethics and integrity

“This bill is going to cater for the lacuna which has been existing in the current law and legal frameworks in Uganda concerning this unnatural act. Having passed this bill, a lot has been done to protect our children and innocent victims who would be lured into these western cultures and behaviours, which are totally unacceptable to us.”

“The law is going to condemn any recruitment, promotion and financing of the activities related to these malpractices.”

“On the threats from donors and development to withdraw their financial assistance over this bill, we don’t care and are not bothered at all. We prefer to lose that money than our culture and people.”

“We have an obligation as a sovereign state to protect our people against this unnatural act.

Michael Lulume Bayiga, shadow health minister

“I am happy and excited this bill was passed. We are waiting for the president to assent to it in order for it to become a law. I am particularly happy with the provision that bans the promotion of this cult (homosexuality). This provision will ensure this act will doesn’t take root in our country.”

“No health worker asks patients whenever they seek treatment from a health facility about their sexual orientation, unless he/her chooses to do so. For all the years I practiced medicine, I have never known any sexual orientation of my patients. There is no discrimination in the health service provision.”

[Courtesy of IRIN]

Africa: Does Democracy Improve Your Health?

18 Nov 2013

Back in the 1990s, the Nobel-prize winning economist Amartya Sen famously wrote that “no famine has ever taken place in a functioning democracy”, coining an argument has shaped thinking across countless sectors – and none more so than healthcare.

If governments face open criticism and are under pressure to win elections, we assume, they are incentivised to improve the health of their populations. Dictators are not.

“Democracy is correlated with improved health and healthcare access … Democracies have lower infant mortality rates than non-democracies, and the same holds true for life expectancy and maternal mortality,” Karen Grépin, assistant professor of global health policy at New York University, wrote in a 2013 paper. “Dictatorship, on the other hand, depresses public health provision.”

She argues that democracies entrench longer-term reforms than their dictatorial counterparts – often involving universal healthcare or health insurance schemes.

“The effects of democracy are more than a short-term initiative, such as an immunisation programme, which don’t always have lasting effects,” she said in a telephone interview. “Democracy can bring larger-scale reforms that create new things or radically transform institutions.”

But does that theory hold water in Africa?

Ghana, one of the continent’s deepest democracies, is doing well. According to Gallup data, 75 percent of its population consider its elections to be honest, compared to a median of 41 percent over 19 sub-Saharan countries. Correspondingly, it was also one of the first countries in Africa to enact universal health coverage laws.

In 2003, roughly a decade after entering a multi-party democratic system, the west African country hiked VAT by 2.5 percent to fund a national health insurance programme.

Voters who had been overstretched by the previous ‘cash-and-carry’ system happily swallowed the tax increases, and the scheme was so popular that when the government unexpectedly changed in 2008, it survived the transition.

The country still has a way to go to attain universal coverage. According to the National Health Insurance Authority, by the end of 2010 34 percent of the Ghanaian population actively subscribed to the scheme. But the institutions are now in place, laying the foundations for the future.

Similar schemes are being rolled out in other democracies like South Africa. But this isn’t a simple equation. There are plenty more multi-party systems which have failed to enact meaningful reform – think of the pitiful performance in Kenya, where the government changed earlier this year – while some more autocratic regimes are performing well.

“Several of the countries that are seen as the big success stories in public health are not very democratic,” argued Peter Berman, a health economist at the Harvard School of Public Health.

Take Rwanda. Led by Paul-Kagame’s decidedly authoritarian Rwandan Patriotic Front, the country is considered “not free” by Freedom House. In the run up to 2010 presidential elections Human Rights Watch alleged political repression and intimidation of opposition party members against the leadership.

Yet the government has a strong developmental track record. “Rwanda started out with somebody who is autocratic, but who genuinely wants to see these indicators change,” Grépin said.

Over the last decade, Rwanda has registered some of the world’s steepest healthcare improvements. After the 1994 genocide – when national health facilities were destroyed and disease was running rampant – life expectancy stood at 30 years.

Today, citizens live to an average of almost double that. Deaths from HIV, tuberculosis and malaria have each dropped by roughly 80 percent over the last 10 years, while maternal and child mortality rates have fallen by around 60 percent.

Part of its success stems from the fact that its healthcare services reach rural citizens. The leadership hands responsibility to local government and authorities and holds them accountable for their efficiency; and almost 50,000 community health workers have been trained to deploy services to marginal populations.

Like Ghana, Rwanda runs a universal health insurance scheme, though it has fared better in its roll out. Upwards of 90 percent of the population is covered by the community-based Mutuelles de Santé programme, which has more than halved average annual out-of-pocket health spending.

“By decreasing the impact of catastrophic expenditure for health care we increase the access,” explained Agnes Binagwaho, minister of health, from her Kigali office.

The benefits of that programme are clear to see at the bustling Kimironko Health Centre, which is a 20-minute drive from central Kigali and deals with most of the suburb’s non-life threatening medical complaints.

As dozens of men, women and children queue to hand over their health cards, a young nurse named Francine Nyiramugisha explains that “Ever since the Mutuelles de Santé was introduced, there has been a huge difference. You pay 3,000 RwF ($4.50) per year and then you get treatment.”

In the reception, thirty-year-old Margaret Yamuragiye, a slender sociology student who has been diagnosed with malaria, waits patiently for her prescription. “Before I got my Mutuelles card I would fear that I could not go to the clinic because it would be too expensive. Today if I have simple cough or flu, I come to the doctor, I don’t wait to see if it gets worse,” she said.

Nearby in Ethiopia, another autocratic regime registered by Freedom House as “not free” is also clocking significant health improvements. Like Rwanda, leaders in Addis Ababa have little time for political opposition, but are registering impressive developmental gains.

“They’re not very democratic but they have the power and authority to allocate resources towards population health needs,” Harvard’s Berman said.

There’s no universal coverage scheme in Ethiopia, but government has opted to focus on deploying basic healthcare services across hard-to-reach rural areas.

Starting from a pitifully low base, it has spent a decade training a network of around 40,000 extension workers to bring care to rural communities. Over ten years, the nation registered a more than 25 percent decline in HIV prevalence, according to a 2012 progress report. Under-five mortality has declined to 101 deaths per 1,000 live births in 2009/10, from 167 in 2001/2. Infant mortality halved in the same period.

Those examples should be evidence enough that the relationship between democracy and improved healthcare isn’t a simple one. “There are autocratic governments that care about the people and there are autocratic governments who don’t. There are democracies where politicians respond to a broad public demand, and then there are democracies where the politicians respond to narrower interest groups,” Berman said.

“There is no simple equation between democracy and caring about public health.”
[Courtesy of This is Africa]

Uganda: Mothers in New HIV Campaign

16 November 2013
Uganda’s first lady, Janet Museveni will join the Kampala Capital City Authority (KCCA) to launch a new campaign to end mother-to-child transmission of HIV/Aids.

The campaign is coordinated by the Uganda Aids Commission. UAC Director General David Kihumuro Apuuli said last week, over 1.5 million people in Uganda were living with HIV/Aids, most of them the result of the mother-to-child transmission.

He told journalists in Kampala the campaign was critical to inform HIV-positive women that they could give birth to HIV-negative children. According to 2012 national HIV/Aids indicator survey, at least 16,000 babies were born with HIV in 2011 alone.

Kihumuro hopes that with the campaign, this number will reduce, in the next year. According to the commission, 140,000 people were infected with HIV between 2011 and 2012, down from 160,000 in 2010/2011, a 13 per cent reduction.

Dr Sarah Zalwango, the HIV/Aids focal person at KCCA, said a number of activities such as male circumcision, cancer screening and counselling would take place on that day and urged people to come in huge numbers.
[Courtesy of AllAfrica News]]