One of the first books to take a solutions oriented approach to global health was published last year. Millions Saved is wonderful book documenting success in public health. Considering the previous post on the TIME magazine cover story I thought it would be good to discuss what works. I highly recommend this book:

“Millions Saved: Proven Success in Global Health is about part of that success story: 17 cases in which large-scale efforts to improve health in developing countries have succeeded – saving millions of lives and preserving the livelihoods and social fabric of entire communities.”

SUCCESS STORY
“In 1977, diarrheal diseases among children was identified as the cause of at least half of all infant deaths in Egypt.”

“Intervention or Program: The National Control of Diarrheal Disease Project of Egypt was established to promote the use of locally manufactured oral rehydration salts, which reverse the course of dehydration. The program sought to distribute the salts, along with information about the appropriate treatment of children with diarrhea, through public and private channels. The program reached mothers through mass media, including television.”

“Impact: The program succeeded in increasing the production of oral rehydration salts, increasing mother’s correct use of these salts, and changing feeding behavior.”

Full case here. Enjoy.

This is a good article on diarrhea that just came out today in Time Europe (cover story), not sure why Time USA is not covering it. While there is a cheap and easy “low tech” solution this article discusses the problems plaguing this issue that is similar to many others – lack of education, attention, potentially misguided priorities & infrastructure:

“A Simple Solution -
Diarrhea kills more young children around the world than malaria, AIDS and TB combined. Yet a simple and inexpensive treatment can prevent many of those deaths. The treatment is a simple mixture of salt, sugar and water. So why isn’t more being done to fight diarrhea?”

From the middle of the article:

Diseases that have high profiles and vocal activists — such as aids, tuberculosis and malaria — attract far more interest and money from big donors and governments, based partly on the mistaken belief that they kill the most children. Celebrities don’t host concerts to fight diarrhea. Of 29 child-health specialists at major international development agencies surveyed by the Rotavirus Vaccine Program — a charity based in Seattle, Washington — 40% named aids, tuberculosis and malaria as the three greatest childhood killers. In reality, the top three are pneumonia, diarrhea and malaria. “This problem isn’t getting the attention it deserves…”

“Many family members don’t know how to prepare a life-saving remedy that can be assembled for just a few pennies: a large pinch of salt and a fistful of sugar dissolved in a jug of clean water, the simplest recipe for oral rehydration solution. “To save the life of a person with diarrhea is probably the cheapest health intervention you can think of…”

Read the article here.

Causes of Death (under age 5, source WHO)

The BBC reported today that mobile phone technology is being developed to help manage the spread of diseases such as HIV and bird flu.

“The software is designed to allow field workers using handsets to send and receive data on disease outbreak along with patient and drug information.”

“When a disease is spreading rapidly, health authorities need information that is bang-up-to-date“

“This means a doctor working in the field can send information to a central database about how many people are affected by a disease, patient status, drug inventory levels and receive information such as alerts, treatment guidelines or lab test results…The efforts of the international health community to control pandemics, by getting life-saving drugs to those in need, depend heavily on a comprehensive and accurate picture of what is happening on the ground.”

Here is an upcoming conference part of larger one dedicated to various ICT issues. “There is a significant action, which is taking place in the sphere of e-Health globally …to fully harness the benefits available through convergence of the Internet and health care… There is a lot more which can be done in the health sector for providing better health care and services, especially for the poor communities.” I picked this up from the I-Quench site. ABSTRACT DEADLINE: Nov 2006

“A simple, $150 device can save the lives of thousands of women around the world who are at risk from dying during childbirth. Suellen Miller explains the ‘life wrap’, which looks like a wet suit, and tells us how it can save lives.” Mother Jones Radio recently covered this story (begins at the 11:11 minute mark).

From the broadcast: “25-60% of death related to pregnancy is due to hemorrage…and 85% of women in poor countries deliver at home” meaning some of these women could die within 2 hours if they start hemoragging (the #1 cause of maternal mortality in US) but they are often times 2 days journey away from a hospital. According to the broadcast, in the past thirty years until now there has been no improvement made in maternal mortality, but this could provide a major solution. The Life Wrap device is now in trials.

The price of the suit is expected to come down dramatically. The suit can be used up to 50 times which at current prices is $2-$3 per usage. I encourage you to read more here and here.

Microbicide development is interesting for many many reasons (novel therapeutic, targeting women, development is via public-private partnerships, etc.). We would definitely like to post more about Microbocides considering their importance and potential revolutionary power. Here is a start:

September 29, 2006
Duke University biomedical engineers have developed a computer tool they say could lead to improvements in topical microbicides being developed for women to use to prevent infection by the virus that causes AIDS. By applying fundamentals of physics and chemistry, the researchers developed a computer model that can predict the effectiveness of various microbicidal recipes in destroying human immunodeficiency virus (HIV) before it reaches vulnerable body tissues.

The HIV pandemic continues to overwhelm current preventative measures as an estimated 12,000 people contract the infection each day, the researchers said. Increasingly, a disproportionate number of women are becoming infected…

“In many cases, women lack control over their abilities to protect themselves against the virus,” Katz said. “Microbicide development is a response to the demonstrated need for new female-controlled methods for HIV prophylaxis.”

FULL ARTICLE

Sept. 28, 2006
– High-tech Web connection beams Hopkins medical experts across the globe in seconds

Imagine Johns Hopkins faculty members performing microsurgery in Tanzania from a computer terminal in a Baltimore operating room, or health care experts in Vietnam presenting an avian influenza patient to medical students gathered in the Hopkins outpatient center. These are some of the possible applications of a high-tech Internet communication system that will be used for the first time next week to link Johns Hopkins faculty with clinicians in India.

Internet2 is a high-speed, high-bandwidth, dedicated Internet network developed in 1996… On Tuesday, Oct. 3, Johns Hopkins faculty members will use this technology to conduct an interactive clinical education program on HIV/AIDS, with leading health care professionals in India.

“This is a major advancement in global medical education,” says Robert C. Bollinger M.D., M.P.H., professor of infectious diseases at The Johns Hopkins University School of Medicine and director of the Center for Clinical Global Health Education. “This technology will allow us to bring Hopkins’ expertise in clinical education to some of the most resource-limited settings in the world, and it will give Hopkins the opportunity to learn from experts in the field, thousands of miles away…You could never perform these procedures with a standard connection,” says Bollinger.

Read more here…
I found this on story on a site that is a great resource for ICT, Health & India

Oprah, Bono Fight AIDS With Shopping
Thursday October 12, 2006
Oprah Winfrey, Bono Promote New Clothing Line and IPod to Fight AIDS in Africa

CHICAGO (AP) — Dozens of “(Product) Red” items will go on sale in the coming weeks by Gap Inc., Apple Computer Inc., Motorola Inc., Converse Inc. and Emporio Armani. Portions of the product sales will go to The Global Fund, an organization that fights AIDS, tuberculosis and malaria.

“Some people won’t put on marching boots, so we’ve got to get to people where they are at, and they’re in the shopping malls,” Bono said in a phone interview. “Now you’re buying jeans and T-shirts, and you’re paying for 10 women in Africa to get medication for their children with HIV.” “We’ve moved from the philanthropy budgets to the marketing budgets, and guess what, there’s no comparison in size,” Bono said. “We now have some of the most creative people in commerce — Steve Jobs, the marketing people at Gap and Motorola — all working for the world’s poor. That is so so cool.”http://www.joinred.com

OCT 29th, NYC. This is a great thing to get young people mobilized and to capture their ideas:

“The NYU Global Health Review and Americans for Informed Democracy are hosting a Young Leaders Summit on Global Health with the theme: “Innovative Solutions to Healthcare in Low Resource Settings.” The summit will be a forum for discussions on the healthcare crises such as the AIDS pandemic that impact the developing world and indigent areas of the developed world, innovative options for alleviating these crises, and the manner in which sustainable infrastructure can be built for long-term healthcare improvement.”

“The handsets, wholesale-priced at under $30, are targeted for markets such as India, South Africa, Nigeria, Bangladesh, Thailand, the Philippines, and Yemen…To get below US$30 per handset is a milestone achievement…and will bring the benefits of mobile communications to a huge swathe of people in developing countries.”

Dramatic cell phone growth has occured over the past decade (graph from MIT). For those in the public health realm who are unaware of the tremendous impact of mobile phones across the world, it’s worthwhile considering the following two facts – there are now 2.5 billion mobile phone connections and 59% of mobile phone users are now in developing countries. Already people are trying to use this ICT (information and communication technology) for various health related reasons (medication reminders, data entry and transmission, pandemic tracking, etc.). ICTs (e.g. internet, phones, radios, etc) will have a profound impact on global health. I picked up this story from NEXTBILLION.NET (here and here). Also tipped off from next billion, you can read more about Africa and mobile phones here.