Yesterday we were invited to sit in and meet the CEO of GSK, Andrew Witty, as he announced the new GlaxoSmithKline Open Innovation Strategy To Aid Poor Countries. The following entry is by one of our new bloggers, Sarah Searle (@sarahsearle on twitter) from the Johns Hopkins International Health program:

“Big Pharma as a Catalyst for Change”: GSK “Open Innovation” strategy

It’s estimated that one-third of the world’s population go without essential drugs–often drugs for treating diseases that disproportionately affect the world’s poorest. The pharmaceutical world proves to be especially difficult to navigate for those seeking to provide such medicines to underserved populations, however. Pharmaceutical science is a field with billions of dollars in R&D, ironclad patents and intellectual property rights that are prohibitive to making drugs available to the poor. Andrew Witty, CEO of GlaxoSmithKline, claims that he’s looking to change this nature of big pharma, in the same way that the open source movement has revolutionized the tech world.

I love the word “innovation” combined with anything related to global health, so the prospect of sitting in on a blogger’s roundtable with GlaxoSmithKline CEO Andrew Witty was exciting enough just from the topic at hand: “Breaking Down Barriers to Innovation and Access to Medicines in the Developing World.”

The ante was upped in a press conference this morning, when Andrew Witty announced GSK’s “Open Innovation” strategy to make drugs more available and break down barriers to access. This strategy includes several components.

“Open Lab” initiative
$8 million in seed funding has been provided establish an “Open Lab” at GlaxoSmithKline’s research facility in Spain. As many as 60 scientists from around the world will be able to work at this lab, which will be devoted to research for drugs that target diseases of the developing world.

13,500 malaria-combating compounds in the public domain
This is perhaps the most exciting announcement. GlaxoSmithKline has been collaborating for years with PATH and other organizations in the development of a malaria vaccine. Scientists at GSK have screened all compounds that have ever been created in their labs, and identified 13,500 compounds that successfully combat P. faciparum, the deadliest form of malaria. The big news? The chemical structures and other recorded data regarding these compounds will be open sourced, in hopes that malaria vaccine research will be accelerated.

New pricing model for GSK’s malaria vaccine candidate
GlaxoSmithKline is in the process of developing the world’s most advanced candidate for a malaria vaccine—it’s the only vaccine in Phase III clinical trials, and could be available to the public as early as 2012. Maintaining that a tiered pricing model simply isn’t feasible for a drug which is needed almost exclusively by the world’s poor, Witty announced a pricing model for the vaccine which covers the cost of the vaccine with a marginal return for GSK, all of which will supposedly be channeled back into R&D for “next-generation” malaria vaccines.

It goes without saying that some present at the roundtable were wary of the corporate world’s ability to selflessly decide change the mechanics of drug information and pricing in order to benefit the world’s poor. Witty has struck a nice balance between acknowledging that GSK is a profit-driven company but maintaining that he strives to keep a “restless” socially-conscious agenda.

And let’s be honest—GSK won’t be suffering much financially with this move. First of all, the malaria drug market isn’t very competitive to begin with, because of the very fact that it is a poor person’s disease. Secondly, GSK is already the developer of the leading candidate for a malaria vaccine. It’s unlikely that, even with the compound information made publicly available, anyone can come up with a vaccine to rival GSK’s in any short amount of time.

Indeed, as Witty acknowledged, making drugs and drug knowledge more universally available is an investment in the future. Drugs will not be provided for free, he stressed, but rather provided at a marginal price that won’t completely alienate other pharmaceutical companies from healthy competition for lifesaving drugs.

Regardless of motivation, it’s refreshing to see big pharma recognizing the issues of access to medicines for the world’s poor. Moreover, Witty’s emphasis on being in step with progressive intellectual property movements is laudable. Whether or not GSK’s initiatives will stimulate other pharmaceutical companies to follow suit remains to be seen.

Related articles by Zemanta

• Glaxo’s Witty Tries To Fix An Industry Problem (invivoblog.blogspot.com)
• Drug firm boost to malaria fight (news.bbc.co.uk)
• Glaxo offers free access to potential malaria cures (guardian.co.uk)
• GSK offers to share data to help fight malaria fight (telegraph.co.uk)
• GSK offers scientists labs, data to fight malaria (seattletimes.nwsource.com)
• Malaria researchers given crucial data (cbc.ca)
• GlaxoPfizer tieup opens new era in Aids battle (telegraph.co.uk)

The Global Forum for Health Research Forum 2009: Innovating for the Health of All took place in Havana, Cuba from 16-20 November. This is the fifth in a series of posts from the conference. Only one or two more after this one.

My reason for attending Forum 2009 was to participate in a session title “Innovation for Remote Populations”. This post is a about that session. What follows is taken from my recent report to the Global Forum for Health Research – edited only slightly.

Innovation for Remote Populations

Thurs-19-Nov-2009, 14:00-15:45, Global Café, Palacio de Convenciones, La Habana, Cuba

Coordinators/Facilitators:

• Patricia Mechael, mHealth and Telemedicine Advisor, Millennium Villages Project, Earth Institute, Columbia University, USA & Egypt (organizer & facilitator)
• Tim Hurson, Facilitators Without Borders (facilitator)
• Charles Gardner, Global Forum for Health Research (focal point)

Speakers (alphabetical order):

• Simon Adebola, NEPAD Council Global Health Commission, Geneva
• Najeeb al-Shorbaji, Director, Knowledge Management and Sharing, WHO
• Caren Serra Bavaresco, Student, Epidemiology, Universidade Federal do Rio Grande do Sul, Brazil
• Karl Brown, Associate Director, Rockefeller Foundation
• Arul Chib, Assistant Professor, Wee Kim Wee School of Communication, and Assistant Director, Singapore Internet Research Center, Nanyang Technological University
• Dziedzom Komi de Souza, Ph.D. Student and Research Assistant, Parasitology, Noguchi Memorial Institute for Medical Research, Ghana
• Bastiaan Hoefman, co-Founder, Text2Change
• Bernardita Labarca, Project Coordinator, Zoltner Consulting Group, Chile
• Claire O’Neill, Chairperson, Cell-Life-South Africa
• Ravi Ram, Head, Monitoring & Evaluation, African Medical Research and Research Foundation (AMREF), Nairobi Kenya
• Marco Salmen, OHR-GMCP Initiative for HIV/AIDS, Global Micro-Clinic Project, United States
• Jaspal S. Sandhu, Design Researcher, College of Engineering, University of California, Berkeley, USA
• Joel Selanikio, co-Founder and Director, Datadyne.org, USA
• Garance Upham, General Secretary, Direction, Safe Observer International, France

Additional participants – from the audience:

• Elmer Zelaya – Fundación Chica/Nicaragua
• Timothy Dye – SUNY Upstate Medical School/USA
• Jane Kengeya – WHO
• Oyewale Tomori – Redeemer’s University/Nigeria
• Lishandu/Zambia (full name/affiliation not available)
• Vargas/USA (full name/affiliation not available)

Summary:

1. Diverse users and uses: The speakers presented a variety of mHealth/eHealth applications involving a wide variety of users, including both the health workforce and community members, e.g. educating teenagers about HIV/AIDS in South Africa (O’Neill), Internet access in western Kenya to improve uptake of HIV VCT (Salmen), mobile emergency response systems in Aceh (Chib), electronic IMCI in Tanzania (Brown), text-based health education and health service promotion in Uganda (Hoefman), training for health workers as a downloadable game package for phones in Kenya (Ram), telemedicine to improve the skills of health workers at primary levels in Brazil (Bavaresco), delivery of health information to communities in Chile (Labarca), a general set of tools for mobile data collection being used worldwide (Selanikio), and handheld computers to support rural healthcare delivery in Mongolia (Sandhu).
2. mHealth/eHealth is about enabling access: A common theme across diverse applications was that information and communication technologies are being used to enable access to health information and services in places where access is difficult because of remoteness and/or cost.
3. Coordination among the various players: Coordination among donors and projects is necessary to avoid unnecessary duplication of effort and to share what works. This is the role of the mHealth Alliance, supported by Rockefeller Foundation among others (Brown). While there were questions from the program side as to what data donors want (Chib), there was a simultaneous sentiment that donors need “stepwise” guidance (al-Shorbaji).
4. De-emphasizing technology: The mHealth Alliance has recently been discussing development of an “mHealth Toolkit”, to provide a common technical architecture and platform for those planning to implement mHealth programs (Brown). The existence of free technology platforms – in this case DataDyne’s tool – enables programs to focus on developing health content (Labarca). It is important to have a generalizable tool, as DataDyne has done, that can be used by anyone; if individual governments must approve technology “you’ve lost the battle” (Selanikio). Programs must focus on understanding people and applications more than technology; in response to a question from Dye about the use of ethnography in this field, three examples were given: ethnography of teen chat rooms in South Africa (O’Neill), multi-year ethnographic fieldwork as the basis for the program in western Kenya (Salmen), and design ethnography of the information management practices of rural health workers in Mongolia (Sandhu).
5. Defining good evaluation: There are challenges to seeing change in population health outcomes (Chib). It is difficult to measure behavior change (Hoefman) and to evaluate systems that provide health content to people (Labarca). Ethnography should be considered more seriously as a complementary evaluation strategy in mHealth (Sandhu). In evaluation, the metrics should match the intervention – mHealth is another intervention; in addition, we want to see the unintended effects of technology (Ram).
6. New modalities of engaging people: Mobile phones enable fundamentally new ways of engaging with people. As opposed to mass communication that is often used in social marketing, phones allow for interpersonal communication that can be tailored and cost-effective (O’Neill). There are two modalities, moving messages out to people and demand-driven services, where people demand the information that they need (Ram). Salmen lent his support to the importance of demand-driven services and argued that phones will bring more equity. This is all supporting the shift to citizen-centered healthcare (Mechael).
7. Cautions moving forward: In natural disasters, the cellular network is the first to go (Zelaya). An open question: Who owns the data? (al-Shorbaji). Nobody is thinking about “real sustainability” (Adebola). Reliable phone networks are a challenge (Lishandu). We should be careful that we don’t become too dependent on one tool (al-Shorbaji).
8. Need to think more creatively: We should be bolder with approaches; if we are, poor countries “could leapfrog” in health and development terms (Upham). Many of the applications discussed focused on SMS and telephony capabilities; we should think about leveraging more advanced capabilities of mobile phones (Kengeya).
9. Who should design technology? There is an assumption that Africans cannot develop software, but that is not true (Adebola). DataDyne software was already developed by Africans (Selanikio). Africans should develop software, but they shouldn’t redesign what has already been built (Brown).

Conclusions/Recommendations:

1. There is a need for increased knowledge-sharing about mHealth/eHealth within the global health community. This should definitely include policymakers. As Prof. Tomori elegantly stated, while we are thinking about how to reach remote populations, we should think about “hard-to-reach” African leaders.
2. While there was discussion of both eHealth and mHealth, the discussion focused primarily on the latter.
3. There is a need for a continuing dialogue about mHealth. It is unrealistic to expect policy recommendations to come out of this meeting given the state of the field (many open issues) and the limited engagement at the meeting.
4. Major mHealth topics to be discussed at future meetings: definitions; standards, including how to conduct evaluation; and successes and failures from the field.
5. The value of the meeting was threefold: (1) it helped extend the network of those working in mHealth; (2) it provided those outside the field with an understanding of the opportunities and challenges of using mobile phones to improve population health; and (3) it placed a much-needed emphasis on prioritizing people and applications over technology.
6. Mechael suggested reviving the Mobile Metrics and Evaluation Group as a means of maintaining an active mHealth community discussion outside of official meetings.

Other observations:

1. The fishbowl format was successful in eliciting relevant commentary from a large group of speakers as well as from the audience. Time was an issue, though, as several invited speakers only spoke once and several audience members had comments or questions that they were unable to share.
2. One key issue that was not explored – as I stated at the end of the session – was the link between social entrepreneurship and mHealth. This is especially relevant to issues of demand, incentivization, and sustainability.
3. There is a need for an ongoing discussion of these issues at Forum 2010 and beyond – while the conversation will continue in other settings, the Global Forum for Health Research should continue to be involved because of its systems focus, its emphasis on actionable research, and the unique mix of parties (policymakers, donors, implementers) it brings together.

In my work in the field, I am no longer surprised to see test stockouts, essential medicines stockouts, supply stockouts, broken or missing diagnostic machines, or patients who are afraid of healthcare workers. It is a complete tragedy, and as I work to help, I think of all the people who are sick or die because of failures of the healthcare system, who cannot tell anyone their stories. For those who do not work in the health system, or haven’t had an experience of health system failure, transparency and data on implementation is practically invisible – so there’s no public awareness of the issues.

So I was thrilled to see recent developments in accountability – the Stop the Stockouts campaign, and the creation of the Budget and Expenditure Monitoring Forum in South Africa.

Power to the People: Stop the Stockouts

Stop the Stock-outs , a multi-country Africa campaign, is using text messages sent by activists and members of the public to expose stock-outs of essential medicines at public health facilities and put pressure on governments to address the issue. It was launched in Kenya, Uganda, Malawi and Zambia by Health Action International (HAI) Africa. During Pill Check week in June, facilities were surveyed, and a map of stockouts was created. The image below incorporates July 2009 data. It was found that many government health facilities were routinely running out of, or just not stocking essential medicines to treat common diseases such as malaria, pneumonia, diarrhoea, HIV and tuberculosis (TB).

“We were finding availability levels in rural, lower-level health facilities of 40 or 50 percent for essential medicines,” said Christa Cepuch, a pharmacist at HAI Africa. Read more from IRIN here

Show me the Money: HIV Policy AND the Budget and Expenditure Monitoring Forum in South Africa

With a new government in South Africa as of May, there have been some very positive signs. Read the rest of this entry »

Mayo Clinic, Global Health and Design Thinking. You might be wondering what those three terms have to do with each together. This is my partial recap on time spent at the Mayo Clinic this past week where I saw one potential vision of what the future of healthcare might look like. It was a great privellege to hang out at the Mayo Clinic for what was the best conference I have attended in a long long time or maybe ever (Amy Tenderich at Diabetes Mine also has a recap that I encourage you to read). The Mayo Center for Innovation hosted a TED style event – Transform, a collaborative symposium on innovations in health care experience and delivery, all the videos are online (highly recommended viewing). It is going to take me a few months to digest what happened there and wrap my mind around everything I heard. There were over 430 people from 23 states, 7 countries and over 1,350 tweets. The caliber and just genuine niceness of every person I interacted with was on some other level, the conversations were rich, deep and thoughtful. The conference organizers *created an open purposeful environment* that led to an incredible experience. The folks at Mayo certainly shaped and designed a great space to achieve the symposium goals (this all reminded me of the Winston Churchill quote – “We shape our buildings and afterwards, our buildings shape us”).  Let me stop before you think I have joined a cult. The direct connection to global health here – it was discussed by keynote speakers and my first tweet from Mayo was “this place reminds me of Aravind (Aravind Eye Care System). Jaspal, Mahad and I have written several articles and cases studies on Aravind and I continue to believe it is a premiere model for innovation and care delivery. More on this in a bit.

The Global Health Convergence: “Design Thinking” and Innovation
There were many things that made this event great, however, in terms of extending your horizons and making you think, one of the most refreshing things was to see some convergence of disciplines and people from a variety of backgrounds. This is very hard to do and cannot be underrated. We all live in a sea of fragmentation,  in systems, in professions and fragmentation in how we solve problems. This is even reflected on a micro level – look at the mainstream peer reviewed journals in healthcare where you see severe fragmentation amongst the physician, nursing and pharmacy focused journals (some of this is for good reasons and some of it’s not). This conference was in part about ditching that fragmentation and about a convergence of ideas, people and relationships working collaboratively. In addition to innovative projects, new models of delivering care and how the process of innovation can be conceptualized, managed, and enabled was discussed. Much of this was encompassed under the umbrella of Design Thinking (innovating and problem solving using various methods). Tim Brown, CEO of IDEO, was a headliner on this front and re-emphasized a call for design to big, an ethic of design for social impact/change, which Jaspal and I have covered on this blog before (see our previous post – 8 Links for Design and Global Health).

If you were too look at the methods of design thinking you would see an amalgamation and convergence of mostly existing methods from a variety of disciplines (from engineering to ethnography to epidemiology to psychology to health services research to name a few examples). As Tim Brown said in his talk: “Design thinking begins with integrative thinking which is the ability to hold opposing constraints and opposing ideas and from those create  new solutions…this means balancing societal needs (desirability) with what’s possible (feasibility) and what’s sustainable (viability)“. When Tim Brown said “Design should not be left in the hand of designers” he hit the nail on the head – design thinking can be incorporated by non-”designers” to help innovate and solve problems. What we do has to be a participatory, collaborative effort. Tim Brown wrote more about this participatory perspective (How to Design a Participatory System in a post crisis economy world). There are many critically important reasons why this is a key factor, one of which goes back to Paulo Freirean educational tenets – people who participate in their own education, become engaged in the transformation of their own world. The other reason is because even though as brilliant as Tim Brown is, (and all the people working at organizations like his) he doesn’t have all the answers, or even the correct ones (read his other piece at FastCompany on HSAs where his point is highly debatable about the solution and at best has over simplified the problem).

The bottom line that I took away is that we need more of a participatory system, we should be open to new ways of approaching problems (“design thinking”) and we can provide some structure to the process of innovation. Besides design thinking the other major theme I want to point to is global health – as I said above in the keynote presentations global health made an apperance. Both Clay Christensen and Tim Brown mentioned the Aravind Eye Care System and Jaspal spoke entirely about global health. We have said on this blog before that there are many lessons that can be learned from outside our system where innovation is taking place due to extreme necessity, it’s not a choice (a lot of this is taking place over the web and with mHealth – mobile phones for health). In Global Health, there are hundreds, maybe thousands of innovative experiments going on using a wide area of technology (devices, drugs, the web, mobile phones, etc.), however, how we track these experiments, talk about failure, and share what has been learned seems to be highly inefficient and lacking.  We have covered a lot of this ground over the past three years, the easiest summary of examples can be found in this post:

42 “Extremely affordable” Innovations in Global Health

Clay C, Tim B, and Jaspal all pointed to global health as a place we can learn from. While there are some serious limitations, there is a ton to learn from the use of mobile phones in developing countries and how that might apply here – because overseas usage of phones is far beyond what is being done in the US. The other area to keep an eye on is chronic diseases. In some places, there is going to be an explosion of chronic conditions and new models will have to be devised to handle that tidal wave. I would love to see Amy Tenderich and her community do a brainstorming session on design for diabetes in developing countries. On this front see two previous posts:

1. Reverse South to North innovation – Borrowing innovation: health services, financial services, and clean tech
2. A massive wave of chronic disease in India and China

Let me leave you on a note of caution, a “design thinking” approach (remember using existing methods) can offer some powerful alternatives. However, there can also be something seductive about design thinking and a rapid approach (we’ve cautioned this on the graphics/visual side before). If you fall into that seduction, then this is just a fad for you, it’s on us to be rigorous, thoughtful and corrective when need be:

“The myth of innovation is that brilliant ideas leap fully formed from the minds of geniuses. The reality is that most innovations come from a process of rigorous examination through which great ideas are identified and developed before being realized as new offerings and capabilities.” IDEO website.

I have many more thoughts on this, if I get the time I’ll jot down a few more notes and quotes from the conference, in the meantime, it is well worth watching the videos from Transform.

Beyond the current debate on US health reform, which has us all posting on Facebook “No one should die because they cannot afford health care, and no one should go broke because they get sick “, the fact of the matter is that the accident of your birth largely determines your future health.

And no, it isn’t fair. If you are born in Sierra Leone, 1 out of 6 babies do not survive. In the developed world, 1 out of 10,000 babies die.

The WHO released a landmark report last August on health equity “Closing the gap in a generation”

Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others….Within countries there are dramatic differences in health that are closely linked with degrees of social disadvantage. Differences of this magnitude, within and between countries, simply should never happen.

With a rapidly urbanizing world – projections of 60% of people will live in cities by 2015. Most of these people are escaping rural poverty, and will live in informal settlements in the developing world.

Guidelines must be developed to ensure health equity, but we also need tools to help us plan.

Read the rest of this entry »

Is the below story an opportunity for a design change in healthcare? Notice the attachment to the symbolism of the doctor white coat, it won’t be so easy to get rid of or change (tradition and old habits die hard, never underestimate social factors):

The AMA To Consider Whether Hospitals Should Adopt “Bare Below The Elbows” Dress Code.   In the Wall Street Journal Health Blog, Laura Yao wrote, “One of the policy questions that AMA delegates will consider at their annual conference next week is whether doctors should forgo their iconic white coats for something a little more casual — and a little less dangerous for patients.” Under the proposal, hospitals would be urged “to adopt dress codes of ‘bare below the elbows,’ to avoid carrying bacteria between patients via coat sleeves.” Although “there has been no conclusive evidence linking infected cuffs” to the number of patient deaths “from infections contracted in hospitals,” supporters “argue that as long as there’s the slightest potential of transmission, everything possible should be done to avoid it.” Still, some physicians “prefer the professionalism the white coat implies.”

This debate on doctor’s white coats reminds me of the research from a few years ago showing that doctors ties can harbor lots of bacteria. Considering the evidence is not conclusive on the design of doctors white coats, I am wondering if getting rid of the sleeves might actually make matters worse because then patients and doctors would be exposed directly to more of the human skin which harbors tens of thousands of bacteria (see link for a great NPR report on this).

This morning I attended “On the Move: Mobile Health” (session D2). From the conference website:

Presenters Discuss: the overall strategic approach to mHealth taken by the Millennium Villages Project and use the experiences of pilot testing and implementing mHealth activities and applications in Ruhiira Uganda (Uganda, Africa Region); the present use of mobile phone technology in the microfinance industry (MFI) and new and expanded applications for mobile-based services (India); why the mHealth Alliance was created and how it will develop and incubate the framework and solutions for the nascent mHealth sector (global); and how rapid HIV tests and handheld technologies are being used for population-wide door-to-door HIV screening (Kenya).

The cast:

• Moderator: Neal Lesh, PhD – D-tree International

Presenters and talk titles:

• Anita Katusiime – Millennium Villages Project-Uganda, Mobile Health Implementation Experiences
• Janine Schooley, MPH – Project Concern International, Connecting India to Disconnect Poverty and Improve Health
• Mitul Shah – United Nations Foundation, Inc., Development of a Mobile Technology Alliance for Health [multi-country]
• Martin Were, MD – Regenstrief Institute, Inc and Indiana University, Incorporating Technological Advances In Population-Wide HIV Screening [Kenya]

The issue of trust came up explicitly during two of the four presentations. In the Millennium villages project, one of the major challenges was CHWs “failure to explain the tool to household members”. In India, PCI found that the majority (~70%) of beneficiaries of a microfinance program felt the mobile phone based solution would increase trust.

During the Q&A Ashifi Gogo probed further – he asked about the perceptions people had about their health information when it was collected using mobile devices. The panel answers were largely focused on technological measures to safeguard the data, so I thought it appropriate to mention Karen Cheng’s Angola study, last featured in the Bulletin of the WHO. I’m happy that I did because Patricia Garcia brought up a recent study she co-authored (Bernabe et al., 2008), a study that I didn’t know about, and a study that showed the opposite result. This Peruvian study examined the quality of data using PDAs to collect sensitive data compared to paper-based surveys. The results: there was a high level of agreement among PDA and paper-based responses and there were fewer inconsistencies within individual respondent surveys. [Note: I've only skimmed the paper this afternoon and plan to read it more carefully soon.] 

One of the key challenges Mitul Shah highlighted during his talk was better understanding the relation between people and technology. In his words, we need more “basic market research” and “impact evaluations”. Understanding how cultural perceptions of technology impact social desirability bias seems to be a critical gap since we’ve focused so many of our efforts on issues like cost-effectiveness, efficiency, and technological interoperability. That the Cheng and Bernabe studies showed such different results indicates that context matters. It’s not just a matter of phone (PDA) vs no-phone (np-PDA) – culture, age, gender all matter, too. If we can begin to understand these local factors, we can plan accordingly – e.g. how we train data collectors to prepare survey respondents – to achieve the gains we want in efficiency and cost.

No network in the big conference hall this morning, so no #GHC36 tweets from the Hans Rosling plenary. If you don’t know who he is, check out Gapminder.org and his TED talk. Here’s what I would have tweeted (rough transcription, emphasis is Rosling’s):

• “We need to be more thoughtful [in global health]“
• “Macro levels are always dangerous”
• “War does not explain the high rates [of HIV in Africa]“
• “We have to start to use data in global health”
• “People should be forbidden from talking about ‘HIV in Africa’”
• “There’s no such thing as ‘HIV in Africa’ – it’s so different from country to country”

For a different type of approach see this animated short on the promotion of sanitation in Pakistan at the Sanitation Updates blog.

Ever since the President announced his global health funding goals, polite turf battles have erupted between those in the AIDS funding camp and everyone else, so this LIVE webcast on Thursday might be interesting (details at the end of the post).  There are some applauding this fundingand some who are not. For example just last week the managing director of the Global Network for NTD (thanks to Clarissa for this quote), stated:

Good Obama – “We applaud the President’s decision to include funding for neglected tropical diseases in his
Global Health Budget.  The return on investment for the American people will be enormous.  Cost-effective investment in life-saving medicine for the world’s most vulnerable populations will not only improve health but strengthen our
relationships with countries in strategic parts of the globe.”

Read the rest of this entry »