Invest in Health Workers to End AIDS

The recent focus on Ebola in West Africa has reminded us of the need for strong and resilient health systems. Behind every quality health system is an army of available and accessible health workers. However, in facilities and communities across the globe, health worker vacancies and weak support systems hamper achievement of health goals and threaten overall preparedness for future infectious diseases.

In most countries with a high HIV burden, health workforce shortages are commonplace and create significant barriers to combating the epidemic.

Much has been accomplished. USAID is incredibly proud of its significant contributions to PEPFAR’s (the U.S. President’s Emergency Plan for AIDS Relief) achievements in strengthening the health workforce to deliver quality HIV services. On World AIDS Day, Secretary Kerry announced that PEPFAR has exceeded the target of 140,000 new health care workers, which was mandated by Congress in 2008. This is a great milestone not only for PEPFAR, but also for the broader global health workforce agenda. Read more »

“I Can Improve Things”: An HIV Peer Counselor in the Dominican Republic

“It was very, very bad treatment that I received,” recalls Mercedes (not her real name), a young mother living with HIV.

Five years ago—at one of the largest maternity hospitals in the Dominican Republic—she was diagnosed as HIV-positive. Although she enrolled in the hospital’s program to prevent mother-to-child transmission (PMTCT), she felt discriminated against for her status, and that the health workers’ actions toward her lacked compassion.

But she decided her experience as a victim of stigma would not stand in her way of helping other HIV-positive pregnant women. Read more »

At the Source of Health Care, Health Workers

This post was originally published on VITAL, the blog of IntraHealth International.

Malik JafferMalik Jaffer is the deputy director of human resources for health and health systems strengthening for the IntraHealth International-led CapacityPlus project. I recently interviewed him about health worker heroes and what it’ll take to make more of them.

You’ve met a lot of amazing health workers over the past 20 years. Any who really inspired you?
Absolutely. For example, there’s a team of health workers in Soweto, South Africa, that work in a hospice. When I visited, the facility was full of men and women and a lot of children. I remember one baby that was suffering from AIDS. She looked about three months old and weighed only 10 or 12 pounds. She was tiny. But I came to find out she was a year old. Read more »

Taking the E out of PEPFAR: Commemorating World AIDS Day 2013

Amanda PuckettPEPFAR. To me, these six letters symbolize one of the most significant global health commitments in history. The US President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest response by one country to a single health epidemic. Over the past eight years at IntraHealth International, I have supported a range of PEPFAR-funded country programs that have led to improving the lives of millions. And I have observed the United States’ cornerstone HIV/AIDS global development program transform from an emergency response to one that encompasses proven prevention and treatment programs, harnesses technology and innovation, and supports ownership at the country level. So as we commemorate World AIDS Day, I want to reflect on the progress we’ve made and contemplate that “E” in PEPFAR. Read more »

Three Answers for Walking Faster and Reaching Farther in Our Response to AIDS

Last week I ppanelists at the discussionarticipated in Walking Faster and Reaching Farther: Strengthening Public Sector-NGO Partnerships in the AIDS Response, the final discussion in a four-part series on capacity development and country ownership hosted by AIDSTAR-Two.

This topic is very timely. Many local nongovernmental organizations (NGOs) and civil society organizations (CSOs) around the world depend on the Global Fund, PEPFAR, and other donor money to respond to HIV and support people living with the virus. But with diminishing donor funds expected, the funding base of these organizations is unstable. In many cases, they are not closely aligned with the Ministry of Health or other public-sector entities, and their relationships need strengthening. There are, however, some examples of local CSOs and NGOs working closely with the public sector, as well as examples of what it takes to strengthen both sectors to work together productively to assure an appropriate HIV response. Further strengthening of these partnerships is critical. Read more »

US Investments in Foreign Aid Provide a Healthy Return

This post was originally published on USAID's IMPACT blog.

What if you could take a fraction of a penny and use it to help build a health system? Believe it. It takes only a fraction of a single penny per American taxpayer dollar to train a global health workforce—a workforce that will reach millions through treatment, prevention, and counseling services.

Just ask midwife Teddy Tiberimbwaku, who had the opportunity to meet Uganda’s vice president Thursday.

Last year, Uganda’s Ministry of Health, operating with only one doctor and 13 nurses to serve every 10,000 people, was told by the Ministry of Public Service that not only could it not create any new positions, but also any unfilled positions—some 42 percent of them—would be lost. Read more »

Task Sharing, Not Task Shifting: Team Approach Is Best Bet for HIV Care

This post was originally published on the IntraHealth International blog.

By developing a more rational division of labor among HIV/AIDS health workers in developing countries, we can go a long way in “Overcoming the Last Barrier to Universal Access,” and nurses have a significant role to play in that effort.

That was the ambitious premise and title of a presentation by Dr. Kate Tulenko, senior director for health systems innovation for IntraHealth International (and CapacityPlus deputy director for clinical services and service delivery strengthening), at a satellite session I attended at the XIX International AIDS Conference in Washington, DC. Read more »

Let’s Move People

I woke up on my second day at the International AIDS Conference wanting to be moved. Not that the opening plenary speeches I attended the day before were not inspiring, but I was left wanting a more personal experience or connection. I know I’m not alone.

That day I found myself in front of a piece of art outside the main session room, a see-through column lined with small dolls. I leaned in to examine the artful beadwork on the dolls, very similar but intricately different. Orphan Tower contains 634 dolls made by local bead workers in a rural village in South Africa. Each doll represents one child living in the village whose parents died from AIDS. According to the placard, there are currently over 3.7 million AIDS orphans in South Africa alone. To represent all of them, there would need to be 5,835 of these towers. I’m left wondering who will care for these children, if they will also develop AIDS, and, if so, whether will they receive treatment. I’m also aware that these dolls could represent millions of children all over Africa, and all over the world. Read more »

Frontline Health Workers Are the Key Link to Turning the Tide on HIV

Rachel DeussomOn Tuesday’s plenary session at the International AIDS Conference, Phil Wilson of the Black AIDS Institute talked about the need for an “army of patient navigators,” people who provide the critical connection between HIV-affected individuals and life-saving health and social services.

As a Peace Corps volunteer working in Northern Cameroon, I came to know a timid collection of youth who believed that their HIV diagnosis was a death sentence. In addition to facing the stigma surrounding HIV, they must overcome the burdens of poverty, limited literacy, and in most cases being a woman in a conservatively Muslim society. 

Under the shade of a neem tree, they questioned the possibility of their dreams. How long could they live? Should they invest in going to school? Could they ever hope to have a family someday? Read more »

The Supply Chain Workforce: Key for Improving Response to HIV/AIDS

Abbie HeffelfingerIt was my intention to focus on attending events related to health workforce and supply chain management while at my first International AIDS Conference. However, with a conference program the size of a phone book, I quickly became overwhelmed and selected the first event on the list: “Improving the effectiveness and efficiency of the HIV response.” With such a broad topic, I expected the discussion could extend in a multitude of directions and I figured it would be a well-rounded first session.

Senators John Kerry and Lindsey Graham opened the session. Graham emphasized the need to remain focused on fighting the AIDS pandemic despite budget challenges in the US government. A recent minister of health from Lesotho, M. Ramatlapeng, guided the conversation toward the need to prioritize investment for impact. And when it came time for Bill Gates to share his view on the means by which to create a world without AIDS, he was quick to emphasize that we have a long way before that dream will become reality. He explained that while he sees a vaccine as the ultimate solution, it should not distract from other efforts. It remains essential to commit additional money toward research for new prevention tools and better systems of delivery. Read more »

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