Category Archive for 'world health organization'

Federal funding for health is in jeopardy.

In the recent State of the Union address, President Obama announced a five-year freeze on domestic spending (aka non-security discretionary spending). On Jan. 25th, the House of Representatives approved a resolution to reduce non-security spending to 2008 levels.

We cannot balance the budget on the backs of the most vulnerable.

To avoid losing the progress that targeted spending has made in saving lives and improving health outcomes, the Senate should pass an omnibus bill that provides slight increases to FY10 levels for the majority of global health accounts. Last year’s efforts to pass an omnibus bill died in December when it became clear that 60 votes were not available to overcome a threatened Republican filibuster, the Washington Post reported. The federal budget is currently running on a Continuing Resolution that expires March 4, 2011. If the Senate fails to sustain or increase funding, this will have a direct impact on health outcomes in 2011 and the years to come.

An arbitrary freeze on spending is short-sighted and ineffective. The money saved will not adequately address the federal deficit. For example, foreign aid is a small fraction of the US budget. The International Affairs budget makes up about 1% of the overall federal budget, yet was able to fund the treatment of AIDS, TB, and malaria for millions of people. This investment is humanitarian, diplomatic, and economically sound, as it allows people to continue working and reduces the likelihood of transmission, and hence avoids increased health care costs.

A return to 2008 levels would dramatically reduce funding for the Global Health and Child Survival USAID Account (USAID-GHCS). January marked some milestones that offer a glimpse of the urgency of the need for continued investment in global health.  This month was the one year anniversary of the earthquake in Haiti and the six month anniversary of the floods in Pakistan. Yesterday, the WHO Director General, Margaret Chan, commented that increased funding is necessary and asked,

“Will progress stall? Will powerful innovations, like the meningitis vaccine, like the vaccines for preventing diarrheal disease and pneumonia, like the new diagnostic test for tuberculosis, fall short of reaching their potential? Public health has been on a winning streak. But will we still have the resources to maintain, if not accelerate, these gains?

Domestic health is also at risk. Most insiders anticipate a healthcare reform repeal vote in the Senate before long.

Please call your Senator to share your opinion. You can use this script:

I am a voter in your state. I urge you to sustain or expand funding for global and domestic health because it’s a smart investment. When it comes to health, short-term funding cuts will have long-term repercussions. We need to continue the work to make health care affordable and accessible, make prevention a priority, and ensure that women have access to the reproductive and other health care services they need. As a member of Physicians for Human Rights, I will be keeping an eye on how you vote on this issue.

You can find your senator here.

Please report your call here.

The World Health Organization has published new guidelines meant to address the health worker shortage that plague rural and impoverished regions. In a July 2010 policy recommendation paper, the WHO offers recommendations to aid worker retention and attract new health workers to overlooked areas. Strategies include altering the ways in which students are selected and trained, as well as improvements in working and living conditions.

The WHO explains that “a shortage of qualified health workers in remote and rural areas impedes access to health-care services for a significant percentage of the population, slows progress towards attaining the Millennium Development Goals and challenges the aspirations of achieving health for all.” The WHO’s recommendations come at the request of global leaders, civil society groups, and Member States. WHO recommendations fall into four categories, with greater detail and context available within the body of the Report:

  1. EDUCATION RECOMMENDATIONS
    Recommendations include targeted admission policies to enroll students with a rural background (who are statistically more likely to then practice in rural areas), exposing students to greater rural field work, and locating schools and residency programs outside of major cities.
  2. REGULATORY RECOMMENDATIONS
    Recommendations include the creation of compulsory service requirements in rural and remote areas, educational subsidies offered with enforceable agreements of return service work in rural areas, and a focus on increasing the scope of medical practice in remote regions to increase job satisfaction.
  3. FINANCIAL INCENTIVES RECOMMENDATIONS
    The WHO suggests “a combination of fiscally sustainable financial incentives, such as hardship allowances, grants for housing, free transportation, paid vacations, etc., sufficient enough to outweigh the opportunity costs associated with working in rural areas, as perceived by health workers, to improve rural retention.”
  4. PERSONAL AND PROFESSIONAL SUPPORT RECOMMENDATIONS
    Recommendations include improved living conditions for health workers and their families in remote locales, career development programs to help rural workers progress in their careers, and the creation and promotion of senior posts in rural areas so that advancing workers are not forced to leave their communities.

The WHO suggests policies should be implemented in conjunction with the country’s national health plan and should be guided by the concept of health equity. The Report states that some countries, the Lao People’s Democratic Republic and Mali among them, are already considering using WHO recommendations to inform their retention policy.

As WHO guidelines have been disseminated, an August 14 article in The Lancet registered a first critique, underlining the roles of NGOs and INGOs in the internal brain drain within struggling countries. As an addendum to the WHO report, the article offers further policy recommendations, to be implemented in conjunction with WHO strategies.

The World Health Organization’s representative to Sudan, Mohammad Abdur Rab, told reporters yesterday that 10 percent of children in Darfur and in South Sudan die before their first birthday, and that 15 percent of children in western Darfur were malnourished. This immense figure provides a quantitative background to PHR’s work on food security issues, as well as sanitation and health needs of displaced Darfuris living in UNHCR camps for the past five years.

In meetings held with members of Congress in Washington, DC last week, PHR doctors briefed co-Chairs from the House Commission on Human Rights, Congressional Women’s Caucus and Congressional Caucus on Sudan on the urgent health, food and security needs in Camp Farchana. The camp was the site of PHR’s 2008 investigation into the impact of sexual violence on survivors of the Darfur conflict (see the report here), which found high levels of malnourishment, lack of healthcare, insufficient sanitation and lack of protection for women and girls in the face of daily risk of attack.

The food security issues and the health needs are closely linked — and an integrated strategy between UN agencies and aid organizations on the ground is desperately needed — on both sides of the Sudan/Chad border. Although the World Food Program (WFP) target caloric intake of 2,100 kilocalories is formally being provided to the refugees by WFP rations, the type and quantities of food apparently are seriously inadequate.

WFP rations consist of only five items (sorghum, oil, salt, sugar, corn-soy blend) and the sorghum rations are distributed in an un-ground form, which means that the refugees themselves have to pay the cost of grinding the grain.

The lack of milk, meat or vegetables has consequences for the health needs of refugees, particularly vulnerable groups like children and pregnant women. Even where fortunate refugees receive the target caloric intake, they don’t receive sufficient nutrients because of the limited diet.

We must commit to reducing child malnutrition by providing milk and meat to pregnant women and children. PHR has been working to encouraging UN agencies to coordinate sufficiently so that refugees themselves can be involved in the solution to this issue.

Currently, women are forced to sell their meager sorghum rations for milk or meat, travelling to a local market where they receive a vastly reduced price for their sorghum due to market saturation. However, if UN peacekeepers would provide protection for women and girls outside the camps, they could collect the necessary hay and water and raise livestock around the camp. This would give them a supply of milk and meat to add to their diet, and also provide them with the opportunity to provide for their family’s livelihood.

In his briefing yesterday, Abdur Rab also mentioned that international donors need to increase their support for fragile health services in Sudan, with special attention to secondary and tertiary care centres. Next week PHR will be doing more work on the issue of Sexual and Gender-based Violence (SGV) programming, and the need to provide emergency assistance for injuries, documentation of injuries, access to HIV/AIDS prophylactic treatment, pregnancy testing, psychological and social support — none of which are currently being provided to women and girls in Darfur.