Under the East Africa Public Health Laboratory Networking Project, diagnostic capacity has been strengthened through the construction of state of the art laboratories. © Miriam Schneidman / World Bank Group 2018
My interest in public health began in childhood and was marked by my experiences growing up in a low-income country with limited public health infrastructure. I felt firsthand the impact of an inadequate public health system when a beloved cousin succumbed to AIDS. My mother suffered a prolonged, resistant infection with complications after invasive surgery, and my family constantly battled malaria due to drug resistance or counterfeit drugs.
I personally felt mental health’s deep-rooted importance when I returned home to Rwanda in 1996, just after my people were traumatized by the 1994 Tutsi genocide. At a time when we needed mental health services the most, there was only one psychiatrist in the entire country.
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The World Bank’s new President Jim Yong Kim caught the attention of many as the first head of this development institution to speak at the opening of a global conference on HIV/AIDS, where he called for applying the moral energy and practical lessons of the global AIDS movement to the global fight against poverty. Yesterday he returned to the 19th International AIDS Conference now underway in Washington D.C.’s massive Convention Center to join Bill Gates, US Global AIDS Coordinator Eric Goosby, and former Lesotho health minister Mphu Ramatlapeng on a panel that discussed how developing countries can achieve greater effectiveness and efficiency in the fight against HIV/AIDS.
Globally, there has been a lot more money invested in this fight over the past decade than ever before. As a direct result, thousands of lives have been saved and new infections averted, including among newborns whose mothers received treatment. But in today’s challenging financing environment, an increasingly effective and efficient HIV/AIDS response is needed to help countries to sustain their gains, prevent new infections, and continue to get treatment out to people already living with the virus.
President Kim said the Bank's main strengths are its broad involvement across many sectors—spanning health, education, social safety nets, and more—and its close engagement with national policymakers in developing countries, as well as with private sector investors. This breadth of operation positions the Bank to be, as the President said, “a very good partner” in improving health delivery systems that address not only diseases like HIV/AIDS, but also other urgent health needs such as good healthcare for mothers and children.
The quest for an accurate, timely and affordable medical diagnosis remains elusive in many developing countries. In East Africa, laboratories are often poorly staffed; ill-equipped; and lack quality systems. Obsolete equipment clogs up limited space. Clinicians often resort to presumptive diagnoses rather than requesting lab confirmations. Individuals suffering from infectious diseases, such as tuberculosis, run the risk of going undetected and transmitting the disease to others, or being misdiagnosed, which in turn leads to compromised care and higher health care costs.
Many laboratories are not adequately prepared to respond during public health emergencies, yet their services are critical to detecting new pathogens and containing disease outbreaks.
World Laboratory Accreditation Day, observed recently, offers a good opportunity to draw attention to the critical role of laboratories in health, and the importance of accreditation in promoting quality. Accurate and reliable laboratory services are critical for conducting clinical diagnosis, guiding treatment, and responding to disease outbreaks. There’s a growing recognition of the importance of laboratory services, and several important initiatives have been launched, including the WHO-AFRO Stepwise Laboratory Improvement Process towards Accreditation (SLIPTA).
This week, the governments of India, Ethiopia and the United States will host a Child Survival Call to Action summit, with the participation of country and global leaders. This is a timely and critical event, aimed at further strengthening global and country commitment and country accountability for MDG4, to reduce child mortality. Though we’ve seen substantial improvement on this goal, the countries that need our support and partnership most may not reach it by 2015.