The National Library of Medicine, the world’s largest medical library, has a new exhibit -Against the Odds: Making a Difference in Global Health. I haven’t had a chance to fully check it out yet, but I wanted to share this info.
Located on the campus of the National Institutes of Health (just outside of Washington, DC), the exhibit examines the revolution in global health taking place in towns and cities around the world. Free of charge and open to the public, this exhibition introduces some of the scientists, advocates, communities, and organizations who have made a difference—working together, against the odds, for the benefit of all.
Prior to the public opening on April 17th, the Library held an opening program featuring a global health panel moderated by CNN medical correspondent Elizabeth Cohen featuring young activists and health advocates featured in the exhibit. A webcast of the panel is available for viewing here: http://videocast.nih.gov/Summary.asp?File=14435
The approximately 4,000 square foot exhibit is comprised of six different sections including:
Food for Life; Brazil and its citizens are featured in this area of the exhibit as the country is currently facing an epidemic of obesity as well as a lingering crisis of hunger and malnutrition.
Action on AIDS; In the face of discrimination, negligence, stigma, and ignorance, advocates for health and human rights have fought against the spread of the disease.
An End to Violence; Physicians and campaigners have used evidence gathered by medical personnel and the testimony of witnesses to highlight the terrible toll of warfare. This work has led to treaties banning the use of landmines and agreements against nuclear weapons testing.
The exhibit web site also contains interactive features for those not able to visit such as:
* Games and instructional resources for students and educators
* Global health perspective database, where readers can join in the dialogue
* Monthly columns from global thought leaders
The UN Foundation and the Vodafone Foundation released a new report this week - Mobile Technology for Social Change: Trends in NGO Mobile Use. Thanks to Mark over at the UN Dispatch blog for telling me about this in the first place. Credit for the below description goes to an email I recieved (thanks very much Adele!) from folks at the UN Foundation, which is reproduced below:
Case studies exploring use of ‘mobile activism’ for public health projects include:
Mobile health data collection systems ( Kenya and Zambia ): Collecting and tracking essential health data on handheld devices, in countries where statistical information was previously gathered via paper and pencil, if recorded at all.
Monitoring HIV/AIDS care ( South Africa ): Using mobile devices to collect health data and support HIV/AIDS patient monitoring in a country with the world’s highest HIV/AIDS infection rates, and where rural populations often otherwise go unassisted.
Sexual health information for teenagers (US and UK ): Connecting youth to important information on sexual and reproductive health via anonymous text messaging, to empower young people to make informed sexual health decisions.
Continuing medical education for remote health workers ( Uganda ): Providing medical updates and access to vital information via mobile phones for doctors and nurses working in some of the most destitute regions, where continuing medical education services are lacking.
A total of 11 case studies identify emerging trends in ‘mobile activism,’ and investigate both the promise and challenges of innovative use of mobile technology to meet international development goals.
Richard Smith at the BMJ Blog wrote about last week’s Private Sector Health Systems conference [program PDF] in Wilton Park. The full text is at the BMJ, but here’s my summary. In many developing countries, the poor are much more likely to use private providers than public sector, if they use healthcare at all.
People in Bangladesh get 80% of their healthcare from the private sector. Across Sub-Saharan Africa it’s 60%, and the proportion is increasing. The poorer people are the more likely they are to receive private care, and the middle classes consume more publicly funded care than the poor…Much of the private care that the poor receive in developing countries is, of course, of low quality. It is often provided by unqualified practitioners and is undermined by corruption, but there are - a McKinsey study in Africa showed - “islands of excellence.”
As Smith indicates, private healthcare in many low-income countries isn’t the only sector suffering from highly inconsistent quality.
government provided health care is also commonly poor, throughout Africa public health systems are derelict, and governments cannot fund, provide, and regulate care.
Smith’s intended audience of high-income country donors and policymakers may be reluctant to engage with private sector actors. Some caution is understandable but the need for practical solutions to dramatically improve healthcare provision leads to private sector mechanisms (for a good review of competitive contracting, performance-based finance and similar tools check out “Getting Health Reform Right” by Roberts, Hsiao, Berman, and Reich). The interesting thread I don’t hear as often, but have run across in my own work, is the challenge that low-income governments will have regulating the purchase private sector healthcare. Smith didn’t address it at length but the comments that followed focused on government’s regulatory role. The first response from Nigeria Health Watch blogger Chikwe Ihekweazu got to the point.
The major problem in many African countries in addition to the resistance of the concept is ‘management’ and ’strategic thinking’ in the health sector. In Nigeria, where I am from, there is a proliferation of private health care facilities at all levels with no regulation, no accountability and no governance. …the private sector has a huge role to play…but only if there is the strategic leadership by governments to drive and regulate this.
As has pointed out more and more in the literature, private healthcare deals in volume in many low-income countries, but for these schemes to succeed governments need to lead and donors ought to be willing to invest in building effective public management of broad (diagonally funded?) health systems.
This is an interesting story GE redesigning an EKG machine (the last one of which they made in 1999) for a place like India. The have also been advertising a lot on TV - I was able to find the ad on YouTube which is pretty cool. Four things immediately struck me:
1) The accomplishment - Cost reduction from $10,000 to $1500 in under 2 years and weight from 15lbs to 3lbs!
2) The original machine took 3.5 years and $5.4 million to develop. Compared to drug development this is minuscule. Making devices is generally orders of magnitude cheaper, far quicker to develop and face far fewer regulatory hurdles (FDA). So why didn’t this happen sooner?
3) This is great for India, but what about for use in the US (especially for community clinics and in rural areas)?
4) Let’s not forget that the introduction of any “new” technology will have unintended social consequences which are sometimes horrendous, here is another example from GE and their ultrasound machine.
EKG Story:
“GE Healthcare engineer Davy Hwang’s marching orders were straightforward. Take a 15-lb. electrocardiograph machine that cost $5.4 million and took three and a half years to develop. Squeeze the same technology into a portable device that weighs less than three pounds and can be held with one hand. Oh, and develop it in 18 months for just 60% of its wholesale cost. ‘He thought I was crazy’…” Crazy or not, Hwang pulled it off…The result: The new MAC 400, GE’s first portable ECG designed in India for the fast-growing local market.”
It’s worth taking a departure from the usual business on Friday’s for the fun geekiness below. These videos shed light on how some Berkeley students are easily distracted from their dissertations (I won’t mention any names, Ben, Jaspal and Mahad ). This is for all you grad and former grad students out there. Thanks to Ben for sending this along from Chris Blattman’s blog. Check out the very funny remake of the Rolling Stones hit, I can’t write no dissertation and an even better second video. The production quality is excellent, enjoy:
These were the words of Forest Whitaker (academy award winner for his leading role in The Last King of Scotland) on tonight’s inspired 2nd annual two and half hour Idol Gives Back show which raised funds for six causes. Forest was the ambassador for Malaria No More, and definitely gave an emotional appeal for people to call in and donate money.
Earlier today I was lucky enough to be on a conference call with the medical director (Steven Phillips) for ExxonMobil’sfoundation which is a major supporter and funder of the malaria component of tonight’s American Idol show. Phillips traveled to Angola twice this year, once with American Idol contestants and winners and the second time with Forest Whitaker to get them involved in combating malaria. I was joined on the call by Bill Brieger, professor at Hopkins and an expert in malaria, definitely check out his blog - Malaria Matters. Rob Katz of NextBillion and the Acumen Fund fame was the other “blogger” on the call.
According to Phillips, ExxonMobil teamed up with American Idol because they are the most watched TV show with over 30 million viewers and because their first experimental show last year was a huge hit. Exxon is reaching out to of course let their work be known and also because he feels that “one of major issues with malaria is that it (malaria) had historically been among one of most neglected diseases.” Their funding breakdown is: 25% for advocacy, 10% for R&D (e.g partnerships with MVI, MMV, others), and 65% for disease control (goes to African NGOs or iNGOs).
The Idol show had a blockbuster lineup, some of the celebs included: Bono, Alicia Keys, Heart, Brad Pitt, Robin Williams (who was beyond awful), Gloria Estefan, Mariah Carey, Celine Dion and many others. One of the highlights was Gordon Brown, prime minister of the UK, making an appearance to announce the equivalent of $200 million in funding for bednets. The three presidential candidates were also supposed to make an appearance, but perhaps this got cut. For a great recap of the show check out Kristin’s post.
Last year the show raised $76 million, it will be interesting to see what happens after tonight. Despite various criticisms and those much more cynical than I, credit has to be given to all the corporate sponsors for reaching out… I’ll post more on this if I get a chance this weekend.
Okay, we have taken a bit of a hiatus here and have all been swamped. Jaspal is just getting back in the swing of things after being in Mongolia for a year and similarly, Ben recently returned from Uganda. In any case Christine over at the global health group at Families USA (seems like everyone is starting some sort of global health team these days) prompted me to get back into it. Thanks to Christine for sending over their efforts on TB. The below screen shots say it all, click on the pics to check out what they are doing. They have launched this interactive game to educate people and admittedly I don’t know what the effectiveness of this is, but I have to give them a lot of credit for trying something new (a sometimes rare thing in public health). GO Play Whack TB! –
The Stop TB campaign is also worth checking out here.
A C.K. Prahalad speech was recently profiled by a Wharton newsletter, in that lecture he spoke about Indian farmers paying 13 cents a month for health insurance which allowed:
Narayana Hrudayalaya, a pediatric heart hospital in Bangalore, to operate upon 25,000 farmers and to offer free medical consultation to 85,000 more. “This year we have increased the monthly contribution by farmers to Rs 10 (25 cents) a month, but still, we hope to cover 13 million individuals using the world’s largest telemedicine network to deliver critical health services to rural areas…
This displays the power of pooled community based insurance. The first thing that came to my mind is that this has a shot of working because India is a place with massive volume, human resources and technological capacity. These are sweeping generalizations, but they are worthing thinking about when comparing India to other developing regions that do not have the same capacity on these three fronts. Never-the-less this is a great example and experiment that may hold powerful lessons.
I belatedly discovered podcasts in my final weeks in Mbarara (Uganda) last December. Two series, PRI radio programs on Health and Technology, have short stories that may interest readers. The Health coverage includes a subset of HIV-specific podcasts.
One story from March 2007 reported on the new life insurance market for HIV+ residents in South Africa signaling a dramatic shift in access to HIV treatment. Interestingly, life insurance can be one requirement for securing a home mortgage. According to the report, until recently without a life insurance policy, even well-off HIV+ individuals would have had a more difficult time trying to buy a home.
Responding to concerns raised by Indonesia and other developing countries, the WHO has instituted an electronic tracking system to track H5N1 isolates submitted, and what is done with them. Vietnam and Indonesia have provided the most isolates, but are concerned that private companies that are developing vaccines from these isolates will market vaccines that are too expensive for developing countries to purchase in the event of an outbreak. In 2007, as a result of these concerns, Indonesia withheld samples for 5 months.
A country-by-country list of submissions has been created, and the tracking system permits anyone to search for particular isolates by date of submission, source country, host species, and several other variables. The system provides a page of detailed information for each isolate, including a list of all the laboratories to which the virus has been distributed, including pharmaceutical companies.
This week’s KaiserNetwork report just hit the two hottest topics for me on HIV right now: male circumcision (Rwanda now has a formal program) and the flattening of vertical HIV funds into primary care, 30 years after the Alma Atta conference had called for a universal primary care package.
“In the two decades since AIDS began sweeping the globe, it has often been labeled as the biggest threat to international health. But with revised numbers downsizing the pandemic — along with an admission that AIDS peaked in the late 1990s — some AIDS experts are now wondering if it might be wise to shift some of the billions of dollars of AIDS money to basic health problems like clean water, family planning or diarrhea.”
“If we look at the data objectively, we are spending too much on AIDS,” said Dr. Malcolm Potts, an AIDS expert at the University of California, Berkeley, who once worked with prostitutes on the front lines of the epidemic in Ghana.
Here’s your opportunity to influence the global health research agenda: the WHO is asking for global input on their agenda for the 2008 Global Ministerial Forum on Research for Health via meetings with stakeholders, an on-line consultative questionnaire, and will be holding a structured e-forum in Spring 2008 to discuss the agenda. The call for conference papers will be sent out in February 2008, and the Lancet will publish an issue on global health to complement the conference - article submissions for inclusion are due in June 2008. The conference will be held in Bamako, Mali from 17-19 November 2008.
PURPOSE AND MEETING IMPACT
“From Mexico to Mali: a new course for global health” in the 12 January 2008 Lancet spotlights the planning process and expected impact of this meeting. The first meeting was convened in 2004 in Mexico City, and according to Lancet’s article:
“Ministers attending the [2004] summit committed to three key priorities: health-systems research, securing public confidence in research, and bridging the gap between knowledge and action.
These developments might have helped to stimulate the recent explosion of innovative new ideas and initiatives in global health. First, some innovative developing countries (IDCs) such as Brazil, China, India, and South Africa have become important producers of low-cost drugs and vaccines. Second, donors and developing countries have both begun, rightly, to embrace science and technology as key drivers of social and economic development. Read the rest of this entry »
This piece is cross-posted from the Uganda output-based aid (OBA) site which just got a major under-the-hood overhaul in its move to a blog format. The Uganda OBA project contracts private clinics to see qualified patients for complaints of suspected sexually transmitted infections (STIs). Patients who buy a subsidized voucher from local drug shops and pharmacies are entitled to seek care for themselves and their partner at any of the contracted clinics. Clinics are reimbursed on a negotiated fee-for-service schedule.
The following report (“VSHD, 2007, Assessment of OBA Clinic Utilization”) is an evaluation of the OBA program’s first year impact on utilization at participating clinics (July 2006 to June 2007). The study, led by Berkeley graduate students Richard Lowe and Ben Bellows, was undertaken June to August 2007 and required an extensive review of thousands of handwritten lab and outpatient entries at OBA facilities. Records were kept differently at many of the clinics and,at several clinics, data were simply not available. However, we have information from 7 of the 16 clinics and they indicate a strong patient uptake and program improvement in the first year of OBA. One of the more dramatic findings is that the total number of patient visits at contracted clinics increased 226% in the first year of OBA compared to the year before OBA.
It does not appear that patients who have attended OBA clinics simply substituted the OBA voucher for their own out-of-pocket spending. Taking all seven clinics together, the number of non-OBA patients seeking STI treatment actually increased in the first year of OBA. One likely reason is that social marketing stimulated greater demand for STI treatment beyond the voucher-using population.
Program adherence also appears to be improving over the first year of OBA as the number of fully paid claims increased from 30% of all submitted claims in July/August 2006 to 70% of all claims in June 2007. Although it should be stressed that claims quality varied significantly between providers.
There is some concern about the quality of lab testing at participating clinics. Lab technicians could benefit from better on-site follow-up and incentives for high quality diagnoses. However, the percent of positive gonorrhea tests more than doubled, indicating increased awareness of this infection in the community and at provider clinics.
The report paints a detailed picture of the participating clinics in their first year of OBA and it is hoped that findings can be used for program improvement as the expansion is planned.
Our many thanks go to both Microcare and MSI who graciously assisted with our many requests for supplemental data and assistance reaching clinic providers. Many thanks as well to the KfW Development Bank and the Bixby Program at UC Berkeley for funding the research.
After a holiday hiatus I should be back to blogging much more frequently. I did some desk clearing from emails that had gathered over the past month and naturally many of them were year end Top 10 lists. I thought it would be appropriate to capture some of these below. In addition to starting off with a couple of miscellaneous links, I included a section on business and global health. Once again I do this because I strongly believe it is important to understand the impact the business community/private sector is having on the issues we care about. In my opinion folks in the public health world are almost completely incognizant of what is happening with respect to this (and to be fair the opposite is also true). Enjoy the links below, I probably will have some more desk clearing to do as the week goes on. In particular the first link under the business and global health section below on Melinda Gates is quite interesting if you care to know more about her.
Miscellaneous Global Health Photo Contest, link
The Global Health Council’s Photography Contest is dedicated to drawing attention to health issues that have a global impact. Deadline is Feb 15, 2008.
What can $611 Billion buy? Try this - feeding the world’s poor for 7 years. Link
via Good Magazine.
Top 10 Lists *Top 20 Global Health Priorities, link
In one of the world’s largest public-health collaborations, 155 experts from 50 countries have a plan to tackle the world’s deadliest diseases. The result is a list, published in the journal Nature, of the top 20 research and policy priorities in chronic non-communicable diseases - which account for 60% of all deaths worldwide. It’s “a road-map” for action, says lead researcher Abdallah Daar at the McLaughlin-Rotman Centre for Global Health in Toronto.
*A Year of Worldchanging Ideas, link
Exec editor Alex Steffen of Worldchanging has compiled their best of list in several categories. The full list is below, I have selected a few that I liked: “Over the last year we ran more than 2,000 stories, including a number of pieces that I think are pretty much the best stuff we’ve ever done… here is my list of the top Worldchanging posts of 2007. It’s very subjective, though many of these stories have also been among our most popular (judged by visits) and provocative (judged by media coverage and blog links) posts.
*10 Highly Consequential Implications of Climate Change, link
A new report called The Age of Consequences, forecasts climate change in the coming century. It makes for fascinating if frightening reading. See table for impact on global health. via.
*Top 7 Social Entrepreneurship Blogs via Riches for Good
Finding and funding sustainable, scalable solutions to end global poverty
*Top 10 Wins For Women’s Health in 2007, link
Women’s health was a priority concern in 2007, as global donors, international agencies, and influential private foundations realized that investing in women’s health is investing in the world (hat tip - Pump Handle).
*The Independent announces its top 6 social entrepreneurs, link
Last year, The Independent – in collaboration with The Schwab Foundation for Social Entrepreneurship and the Boston Consulting Group – began a quest to find the UK’s most successful social entrepreneurs. (hat tip)
*10 Videos to change how you view the world (all TED videos), link
*10 top global health issues according to WHO, link (via)
*10 Universities With the Best Free Online Courses, link (via)
Business and Development/Global Health
*Who is Melinda Gates?, link
Interesting read: “Years before Melinda French met and married Bill Gates, she had a love affair - with an Apple computer…Of all the tricks that life can play, it’s hard to imagine any stranger than what befell Melinda French. Today she is married to the richest man in America - and giving billions of dollars away…”
*Global pharma firms take a tropical dose, link
Multinationals focus on diseases in developing countries as they lose protection by patents at home. The big multinational drug makers are increasingly focusing their research on diseases that no longer afflict their home countries. As many as nine companies are developing medicine for tuberculosis, which claims two million lives every year. At least seven are focusing on malaria, another killer.
*IFC betting 1 Billion on Africa’s private sector to improve health, link
The IFC plans to set up an equity investment fund, ultimately worth up to $500m, including money from other donors, to invest in small and medium-sized enterprises in the health-care industry. It also wants to create a $400m-500m debt vehicle that will fund local banks that lend to such entrepreneurs. See also - http://www.ifc.org/HealthinAfrica
*On Malaria: Charity vs. Capitalism in Africa, link
Africa’s best hope to fight malaria is the wide distribution of mosquito-repelling bed nets. But who best serves that need: the public sector or private interests?
*2 Young Hedge-Fund Veterans Stir Up the World of Philanthropy, link
As hedge-fund analysts, Holden Karnofsky and Elie Hassenfeld made six-figure incomes deciding which companies to invest in. Now they are doing the same thing with charities…Their efforts are shaking up the field of philanthropy.
*Oprah effect brings microlending to Main Street, link
Kiva hit the publicity jackpot in September when Oprah Winfrey featured the organization on her daytime television program, attracting a tidal wave of interest from Middle America. Demand was so high the day the episode aired, every loan on the site was fulfilled.
*Heinz Pledges to Provide Free Micronutrient Assistance to 10 Million Children by 2010, link
The H. J. Heinz Company is working to develop solutions to reduce global malnutrition, a commitment underscored in the Company’s 2007 CSR report. The report lays out the Company’s plans to provide free micronutrient assistance to 10 million children at risk of iron-deficiency anemia by 2010.
Jose from Little Devices That Could (LTDC) is going to be helping out with a fantastic looking course being offered by Harvard-MIT. The post below, with permission, is from LTDC. The course has some very bright minds involved. Could you imagine a collaborative course like this on every campus? I would bet there would be some great results. If you have any input or project ideas, send Jose an email (see his website below).
UPDATE: This course will be available via: 1. opencourseware
2. telecast (with hope of reaching overseas univs also)
3. open access to materials
4. potential roll out in other schools in 2009
From Little Devices that Could:
LTDC Goes to Graduate School: Harvard-MIT announce HST 939, Designing and Sustaining Technology Innovation for Global Health
Following a long history at MIT of incredible classes like D-Lab, Developmental Entrepreneurship and S-Lab from Sloan School of Management,the joint program in Health and Technology by Harvard and MIT have announced HST 939:Designing and Sustaining Technology Innovation for Global Health.
The class will focus on exploring new ways and avenues of answering global health’s most vexing problems at the intersection of business, public health, and disruptive technologies. Hands on participation in real life projects with international community and corporate partners will allow students to experience global health development 2.0 from the start.
The class is the brainchild of HST affiliate Jeff Blander, a social entrepreneur and global health expert, who teamed up with Utkan Demirci, a scientist and inventor at Harvard with a shared focus on global health technologies. They’ve asked Yours Truly to participate in the design and instruction of the technology and bottom-up innovation aspects of the class, and I’ve heartedly agreed.
If my posts have been infrequent lately, I apologize, but the there has been a lot of work to set up some exciting projects which I will be sharing with you shortly. We are continuing to receive a lot of interest from corporate and foundation sponsors about their own projects and the door is open for continuing collaboration. One of the most exciting aspects of the course is its commitment to cross-institutional collaboration. The current partners include companies, NGOs, and other academic institutions beyond Harvard and MIT. So get ready, in a few months, we’ll be highlighting the next little devices that could—and the business report cards that go along with them! Everything starts in Spring 2008, but you can submit your projects now!
The Uganda Ministry of Health has its work cut out this month. From the front page of the December 5th Daily Monitor:
AS the country grapples with the deadly Ebola outbreak in western Uganda, medics are struggling to contain a rising spate of meningitis and bubonic plague in West Nile [district], cholera in Hoima and Buliisa [districts], and yellow fever in the northern district of Kitgum.
Depending on the source, 19 to 21 deaths, including two doctors, have been attributed to the latest Ebola outbreak. No news yet on results from the two suspected cases in Mbarara and not much new found on HealthMap. Otherwise, life continues as normal here. At the University chapel across the road from our place, there’s a wedding on the lawn. Great weather for a wedding today. The academic term ends this week. Mbarara University students are in exams.
Last Friday the Ugandan dailies the New Vision and Monitor both reported 16 deaths and 51 cases of Ebola in the western Uganda district of Bundibugyo bordering Congo. The mountainous area is also experiencing an influx of Congolese refugees from recent fighting in the eastern states of Congo. As of Monday morning there are 18 confirmed deaths and 58 cases.
Over the weekend, the Sunday Vision updated the story suggesting that the outbreak may have originated from social contacts during a goat roast in August. The Sunday Vision published a Reuters story reporting that CDC tests concluded the outbreak is due to a previously unknown strain which appears to have a lower case fatality rate.
This is only the second confirmed outbreak of Ebola in Uganda. The first killed more than 200 between August 2000 and January 2001 in the north of the country. According to doctors at the hospital in the town where we live, there were several local cases then when an infected soldier returned home to Mbarara town. The hospital here has an isolation unit from that time, I’m told.
It’s an interesting opportunity to see when web-based early reporting sites first noticed the outbreak. HealthMap picked up stories from November 29th forward. HealthMap sources include Google News and other less visible sites such as ProMED Mail at the International Society for Infectious Diseases. A Technorati search turned up blogposts reporting after the reports hit the news wire. No site that I’ve found has anything prior to November 14th (The Monitor, Uganda) which if offline reports of early cases in September are true, would indicate a great deal of needed improvement in early online detection. In comparison, the three Marburg cases from Kamwenge district in early August were quickly reported and quarantined.
Tomorrow is World AIDS Day and instead of “barraging you with [another set of] statistics, gruesome photos, or heart-wrenching stories” (quote credit to Mr. Casnocaha), I want to alert you to something we prefer here - solutions, problem solving, technology, and creative thinking. Piya Sorcar, a doctoral student in Stanford’s Learning, Sciences & Technology Design program has used her considerable skills to figure out how to reach the minds of children in devleoping countries when it comes to HIV/AIDS education.
Incorporating a variety of techniques from several disciplines Piya has generated an animation based educational technique and curriculum, the first of its kind in this area. The first results from this groundbreaking technique are in and they have been outstanding. The indefatigable Sorcar has plans to disseminate the educational curriculum free to schools and other organizations. She also has plans to launch the animation on social networking sites such as Orkut (very popular in some developing countries) and Facebook.
This educational technique and curriculum has taken over 2 years to develop and as far as we know no one else is using this animation based method. This work is truly inspirational, overcomes various methodological barriers and just as importantly political barriers (especailly in countries where sex education is banned). The early results indicate tremendous success. I highly encourage you to read the full story below and visit the website where the animation can be viewed: http://www.interactiveteachingaids.org/
We previously covered Piya Sorcar’s work in a post last year and it has been the most read post on this blog with over 1700 visits. You can view that here for further background information.
Lasly, there is much more to say about Piya’s work which we will save for another post. I have placed some links about World AIDS Day below this entry and as a side note - even rock group Queen is getting into the action with their first new recording in a decade to mark the event.
Enjoy!:
Doctoral student creates groundbreaking animation to teach HIV/AIDS prevention in developing countries
To combat the stigma associated with discussing HIV/AIDS and sexual practices in India and other developing countries, doctoral student Piya Sorcar has developed a groundbreaking animation-based curriculum to teach HIV/AIDS awareness and prevention in a culturally sensitive manner to young adults around the world.
Sorcar’s project, Interactive Teaching AIDS, is already being used in several countries…The animation emphasizes the biology of HIV/AIDS, presenting a storyline with a dialogue between a curious student and a friendly yet authoritative cartoon “doctor” on the biological facts about HIV,its spread, and its prevention.
“What’s groundbreaking is that she’s shown that we can inform people about AIDS while respecting the culture,” said Communications Prof. Clifford Nass, an advisor to Sorcar’s Ph.D. project. “That’s an enormous accomplishment.”
“The result was Interactive Teaching AIDS, an animation-based tutorial featuring a friendly cartoon doctor and patient who guide participants through the biological aspects of AIDS transmission. The tutorial is available online and on a CD.”
RESULTS
A recent study of the application in India by Sorcar with 423 students in private schools and colleges in North India, showed significant gains in learning and retention levels after interacting with the 20-minute animated tutorial. Prior to testing, only 65% knew that HIV was not spread through coughing; after the tutorial, this percentage increased to 94%. Students stated that they were comfortable learning from the tool, and more than 90% said they learned more about HIV/AIDS through the animated tutorial than any other communication method such as television or school. One month after initial exposure to the tutorial, students were rapidly seeking and educating others about HIV/AIDS prevention through their networks, with nearly 90% sharing information they learned from the tutorial with someone else.
Just heard this website described in detail by the site’s developer on the BBC Outlook program. I can’t find the podcast yet but great little word games that bring ad revenue dollars to the UNFPA.
One of the Millennium Villages is just down the road from Mbarara. I have known this, kind of, since my first visit to western Uganda in 2005. But this past Sunday several of us, led by a friend working for the UN in Mbarara, drove the hour or so up a tortured dirt road into the highlands of Isingiro district where residents with assistance from various local and regional governments and international funding, are working to improve their way of life.
The drive through hilly farm country was striking - deep green banana farms planted to the base of lighter green grass hills; wattle and cement homesteads dotting the red dirt roadside. Near the Millennium Villages pilot, the road rose quickly, I had to shift into low gear and creep up to the ridge road that took us to Ruhiima. The air was cool along the ridge road and the views of distant gray storm clouds, green valley farms, and everywhere cultivated land was impressive. Small farms of banana, cabbage, potatoes, beans, and other produce were planted on the hillsides. Homes were often located on hilltops, requiring someone to do a lot of climbing when fetching water. Well kept, graded dirt roads connected villages and farms.
We visited a tree nursery, an improved water spring, a recently constructed health clinic, a telecommunications center, and a renovated primary school. The core ‘village’, referred to as MV1 by the UN staff, has about 5000 residents and a prospective cohort of 300 volunteer households enrolled in rather intense observation. The intervention area surrounding MV1 is called, well, MV2 with roughly 45,000 residents and subject to less frequent research efforts.
We were clearly on the visiting dignitaries loop but it was great to finally see the place. I was struck by what I heard about the community involvement in each of the projects - the Millennium Village felt like the Peace Corps on a serious funding kick. The requirement for some level of community contribution, the community members’ planning meetings, and the focus on incremental but important improvements to the agricultural economy were familiar in tenor (though far larger in scale and scope) to what Peace Corps volunteers have attempted with neighbors and friends in many places (check out the PC Partnerships grant program). There have been multi-year integrated rural projects coordinated by Peace Corps volunteers in the past with mixed results.
The project is premised on making large-scale changes in social behavior. The primary school, for instance, has a new feeding program. In the first year, the MVP procures beans and rice with an agreement from parents and perhaps other residents (in our quick visit it wasn’t clear who was involved) that in each succeeding year, local farmers will contribute increasing percentages of food until they shoulder the full responsibility by the end of the program’s fifth year. The assumption that the local residents would take on greater involvement over time was built into every improvement we visited. This can be a weak assumption largely conditional on a culture of effective leadership.
From where I stood in the village, the development efforts looked like what we would expect from any good government investing in the common weal. [Also brought to mind this JAMA article ("Informing Resource-Poor Populations...") on the health effects of simply educating villagers about existing government programs.] The inevitable question followed - how long will it all continue after external funding ended? The answer passed by then in the form of a flatbed truck heavily loaded with green bananas. There is a good deal of local commercial agriculture. “Matooke” banana are cultivated everywhere and sold to middle-men who truck the green fruit to urban centers (Kampala for the most part) in drier eastern Uganda where less bountiful rains inhibit matooke production. You can see where a broad-spectrum but geographically focused investment in the inputs of development has the potential to strengthen long-term economic links like the matooke trade and dairy production far beyond the borders of the Millennium Village.
There were a couple of other threads that came to mind during the visit.
1. Vertical versus horizontal programs. For a great discussion on this in the context of global health, see the CGD blog (”Should All Vertical Programs Just Lie Down?“). Standing at the improved water source with locals proudly telling us the water was now clean while children harvested huge cabbages on the drainage slopes downstream, it was clear what it means to have functional water systems, a school with a teacher and involved parents, and a newly hired doctor at a renovated health clinic all at once.
2. Policy makers have been drawn to ‘clusters-as-catalysts’ in other settings including ‘village-based’ counterinsurgency strategies. Bad metaphor for the MV effort… but does this cluster strategy work in security or development?
BBC reports that “a study published in the Public Library of Science journal by researchers from the Harvard School of Public Health suggests the policy has saved Brazil around $1bn between 2001 and 2005.” The article itself is available freely online as a part of the open access policy of PLoS.
From the Harvard School of Public Health press release:
The results showed that, although costs for Brazil’s locally produced generic antiretroviral drugs (ARVs) increased from 2001 to 2005, the country still saved approximately $1 billion in that time period through controversial price negotiations with multinational pharmaceutical companies for patented ARVs. Since 2001, Brazil has been able to obtain lower prices for patented ARVs by threatening to produce AIDS drugs locally. Though these negotiations initially prompted major declines in AIDS drug spending, HAART costs in Brazil more than doubled from 2004 to 2005. The steep increase reflects the fact that more people living with HIV/AIDS began treatment and are living longer. The increase also reflects the challenges associated with providing complex, costly second- and third-line treatments as people develop resistance to first-line drugs, live longer and require more complex treatment regimens.
Figure 6 from the article - Impact of Alternative Price and Quantity Scenarios on Total ARV Costs, 2001–2005 - shows how the increase in spending is primarily related to increases in quantities rather than costs (Figure 6.A). This figure also shows how much would have been spent if there were no price changes (6.B) and the theoretical minimum that could have been spent by buying the lowest-priced generics on the market (6.C).
Beyond Good Intentions:
What Really Works In International Aid?
“The Beyond Good Intentions film will document effective examples of international aid and inspirational humanitarians who are making the world a better place through their work. This is a rough cut trailer for the documentary film that is taking us around the world to ten different countries over the course of a year including Colombia, Peru, Argentina, India, Cambodia, Laos, Indonesia, Madagascar, Mozambique, and South Africa.” See trailer below, actual story profiles begin at the 3:15 minute mark (via Change the World blog):
AIDG is a wonderful organization and they are having an event tomorrow in NYC. Please pass this onto your networks:
“The Appropriate Infrastructure Development Group (AIDG) helps individuals and communities get affordable and environmentally sound access to electricity, sanitation and clean water. Through a combination of business incubation, education, and outreach, we help people get technology that will better their health and improve their lives.”
As BBC reports, the World Toilet Summit 2007, which was scheduled to be inaugurated by former Indian President A.P.J. Abdul Kalam, is being convened in New Delhi from 31-Oct until 3-Nov. The summit has been organized by NGO Sulabh International Social Service Organisation and is supported by various Indian ministries along with UN Habitat New Delhi. Fourty countries are reported to be participating in this meeting which in recent years took place in Russia, Northern Ireland, and China . For reference, UNICEF provides a mid-term assessment regarding the Millennium Development Goal drinking water and sanitation target.
). This is for all you grad and former grad students out there. Thanks to Ben for sending this along from Chris Blattman’s 
As 