Towards Sustainable Systems of Health Care

One certainty of global health meetings is that you will hear a version of: "we have affordable interventions that save lives; we just don't deliver them to people." Panelists at today's afternoon sessions urged everyone present to move beyond this hand wringing. Norway's Prime Minister Stoltenberg, who today pledged $1 billion for maternal and child health, encouraged other governments to match his country's effort of giving nearly 1% of GDP to development assistance. Alice Albright from the Global Alliance for Vaccines and Immunization (GAVI) said that, "People working in public health should think about taking more risks," to get needed services to people. Asked to identify a cost-effective health intervention, Helene Gayle, who runs CARE answered: "political leadership."

There was a proliferation of good ideas waiting to be hooked up with funders, like helping women learn to provide birthing care to others in their villages. "We can turn any home into a pediatric ICU," says Abhay Bang from SEARCH. "In India, a community health worker can be trained and employed for a year with $250."

Between the two health sessions I ran into Eric Goosby who runs Pangaea Global AIDS Foundation. Hearing him describe his organization's approach to delivering ARVs in China, it's clear that what sounds like a vertical (disease-specific) program may actually be more horizontal in practice. Eric says Pangaea's approach in China is to work with the Ministry of Health and existing health centers, and train health care workers who are already in the community. The strategy takes time, but the goal is to keep the response indigenous and sustainable, and support the larger health system.

But emergency responses are needed in much of the world. AIDS is different in different places, and in many places in Africa, millions face imminent death unless they receive treatment. The challenge for the leaders here, as well as donors, and governments, is to mobilize emergency responses and deliver effective programs with an eye to broader, sustainable systems of health care.

Chris Collins is a health policy consultant who lives in New York City.







Dear Chris, Thank you for

Dear Chris,

Thank you for your perspective on affordable health care availability to developing countries. I've recently relocated to NYC and would enjoy connecting with you to discuss your work.

I've been working with Real Medicine as part of their Team Whole Health to initiate holistic based, cost effective, sustainable education models for Physical Therapists to enhance treatment efficacy for a wide range of musculoskeletal conditions which the 2006 WHO Disease Control Priority Report lists as the leading cause of chronic disability in these countries. The model leverages education and the low cost of local labor in countries where pharmaceutical interventions are cost prohibitive to create sustainability.

While the model has been implemented in Sri Lanka for three years for conditions such as chronic pain, post traumatic stress and neuromuscular disorders such as Parkinson's disease, it has been considered for treatment and rehabilitation of sexually abused and raped women in Africa and other post war regions who are in need of healing the acute psychophysical wounds associated with inappropriate touch and personal boundary violation. For more information please visit: - see fact sheets pain control

Please feel free to contact me. Thank you in advance

I am just a mom who was

I am just a mom who was watching Martha Stewart today with Bill Clinton on it. I loved the story about the surgical equipment that is able to be used by other countries and can't be used in the US.

My daughter was adopted in the US. When she was a week old, we found out that her mother had Hepatitis B. There was an injection called the "H-Big" (I don't know the real name for it). This drug was regulated by the government and had to be given in the first week of life. We went through unbelieveable red tape to get a vial of this drug for my daughter. When we did get it, I saw that only a tiny bit of the vial was used for my daughter, and they threw away the vast majority of the medication. I was shocked that this was so valuable that it was tightly controlled, but it was being thrown away. I have since learned that most any innoculations and injectable medications can only be used for a single dose per vial, even though it is a sterile needle being inserted into the vial. The rest is just thrown away and wasted. I wish that someone who is able to make a change in this would be able to send this unused medications to other countries who might be able to save lives using drugs that we throw away. It is so sad to think that we are throwing away large amounts of drugs because a vial can only be used once, while billions of people in other countries simply don't have access to the drugs they need.

I pray that someone might see this and find a way to export this unused resource instead of wasting it.

Chris, may I have your email

Chris, may I have your email address? Please see the homepage for information on Pocantico II meeting. Best Regards.


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