Browsing articles in "Health System Strengthening"
20 February 2016
Shawn Clackett

Abd Al Gader’s Story

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Abd Al Gader could barely walk when he arrived at a refugee camp in Jordan fleeing the war in Syria. After receiving treatment for TB, the 12-year-old is strong enough to play football and attend one of the camp’s schools.

Read Story on the Global Fund Website

Abd Al Gader, a 12-year-old with big, dark eyes, could barely walk when he arrived at the Zaatari refugee camp in the Jordanian desert after escaping the war in Syria. Suffering from tuberculosis and having run out of medicine, Abd Al Gader fled with his family from their farm east of Damascus with the few belongings they could carry and embarked on a dangerous journey towards safety.

Abd Al Gader’s cough worsened as the family trekked for days, sleeping in the open during cold, February nights and enduring shelling and thieves, before finally reaching the border. “We lost our crops and our house was destroyed,” said the boy’s father, Awash. “I feared for his life. That is when I decided we had to leave.”

In Zaatari, the family settled into a tentAbd Al Gader resumed his TB treatment at the camp’s clinic. Today, cured of the disease, he is strong enough to play football with his friends in a dusty pitch and to attend one of the camp’s schools.

In cooperation with local and international partners, the Global Fund is supporting the provision of essential TB prevention, diagnosis and treatment services to Syrian refugees in Lebanon and Jordan. The assistance comes from the Global Fund’s Emergency Fund, a special initiative to provide quick, flexible access to funds to respond to HIV, TB and malaria in acute emergency situations.

Tuberculosis, a highly infectious disease spread from person to person through the air, can move quickly in close quarters like a crowded refugee camp. Stopping TB is necessary, not only to protect refugees immediately at risk, and also to free up critical resources within refugee settings to treat basic illnesses, which are chronic in emergency situations like the Syria crisis. Since the outbreak of the conflict, more than 4 million Syrians have sought shelter in neighboring countries, mostly in overcrowded camps like Zaatari and in informal settlements with no or limited access to health services. Infectious diseases such as TB are increasing the burden on already overstretched public health systems.

“To defeat these diseases we must follow the people wherever they are, regardless of their status, circumstance, or ethnic and religious background,” said Mark Dybul, Executive Director of the Global Fund. “Partnerships like this give us the flexibility to respond quickly and better serve the people in need.”

Global Fund grants in the region are funding interventions that include TB diagnostics and treatment, screening of refugees upon arrival, strengthening referral services, training of health workers and raising awareness of the disease. The International Organization for Migration is implementing the programs in collaboration with WHO and the National Tuberculosis Programs of Jordan and Lebanon.

Since the program started, there have been more than 400 confirmed cases of TB in Jordan and Lebanon and four cases of multidrug-resistant TB in Jordan (according to 2014 data, the latest available), and the success rate of TB treatment among Syrian refugees is 90 percent. The Global Fund is extending emergency interventions in Lebanon and Jordan, and providing funding for TB services for Syrian refugees in Iraq.

The Zaatari camp now houses 79,000 refugees. Like most refugees, Abd Al Gader’s family first moved into tents, later replaced by prefabricated shelters. The father has built a kitchen and bathrooms, but dreams of returning to Syria one day. Abd Al Gader’s cough is now gone, but needs to pause to catch his breath when he plays football. When asked what he wants to do when he grows up, his eyes light up: “I want to be a football player for Barcelona FC.” He pauses, then adds: “Or maybe an architect and rebuild Syria.”

6 February 2016
Shawn Clackett

Priorities for India’s Health Policy

Brookings
By Shamika Ravi and Rahul Ahluwalia

India’s health care sector is poised at a crossroads, and the direction taken now will be critical in determining its trajectory for years to come. In a recent Brookings India paper on the Indian government’s health care policy, we argue that it should prioritize expanding and effectively delivering those aspects of health that fall under the definition of “public goods’” for example, vaccination, health education, sanitation, public health, primary care and screening, family planning through empowering women, and reproductive and child health. These are all aspects of health with significant externalities and thus cannot be efficiently provided by markets.

Large gains in the nation’s health, and particularly the health of the poorest and most marginalized, can be made with this limited focus. As just one estimate, a 2010 World Bank study showed that India lost 53.8 billion USD annually in premature mortality, lost productivity, health care provision and other losses due to inadequate sanitation. Importantly, these gains can come very cost effectively, as demonstrated by India’s neighbors Bangladesh and Sri Lanka, which spend less as a percentage of GDP on health than India, but have better outcomes. It is not an expansion in spending that is critical for improving health outcomes. Instead, India needs to set appropriate goals and reform the public health care sector’s governance and management systems so that it is able to deliver on those goals. Evidence gathered globally and within India suggests that without good governance, additional spending would be worth little.

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Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.

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