Voice of America, June 2014
At the second anniversary of USAID's Child Survival Call to Action, USAID...
In August I attended the International Congress of Pediatrics, which was hosted in Melbourne, Australia. The Congress is a global meeting place of physicians, researchers, nurses and health care workers in the field of pediatrics and civil society partners. A key thematic area of the conference was addressing pneumonia and diarrhoeal disease – the two leading killers of children under five across the globe. Given the extensive experience of PATH Cambodia in terms of addressing childhood pneumonia and diarrhoea, we felt that engagement in this Congress would be critical.
With the support of the Advocacy and Public Policy (APP) team at PATH we developed a poster for presentation at the Congress. The poster, entitled Tackling Pneumonia and Diarrhoea Through Policy Integration and Community-Level Implementation, highlighted the integrated approach that Cambodia has adopted in terms of preventing and treating pneumonia and diarrhoea.
Since 1998, the Ministry of Health Cambodia (MoH) has integrated both diseases into one National Acute Respiratory Infection and Control of Diarrhoeal Disease Program (ARI/CDD Program) and made it a top priority in terms of addressing childhood morbidity and mortality. In collaboration with the Cambodia MoH, PATH implemented the Enhanced Diarrheal Disease (EDD) Initiative from June 2011 to August 2012. The programme, piloted in one district, consisted of a two-pronged approach to build the political will to strengthen policies related to diarrhoea and pneumonia, and then to implement a new integrated package of services within communities.
The Cambodian MoH was encouraged by the launch of the Global Action Plan for Pneumonia and Diarrhoea (GAPPD) by WHO and UNICEF in April 2013, which provides the global normative guidance supporting the integration of pneumonia and diarrhoea and calls on countries to adopt this approach. Cambodia is integrating the policies and programmes for pneumonia and diarrhoea and the results are being felt – Cambodia is on track to reach Millennium Development Goal 4 on reducing the levels of childhood morbidity and mortality and the efforts to address the leading killers of children under 5 has played a significant role in this success.
Partners at the Conference were highly interested in the integrated approach that has been adopted in Cambodia. Many participants came to ask how this had been rolled out, and what the results have been, and how this is working from an operational level. So many participants wanted to know how this could be replicated in their own countries and what the key lessons learned have been. I feel proud of what we have been able to achieve in Cambodia and excited that we can share the lessons learned and provide a model that could be used in other countries. I believe this model can be replicated and have a major impact of addressing these two diseases; strong political commitment, advocacy to create an enabling environment for policy integration and programme implementation, with a strong focus on community involvement and ownership, are some of the essential ingredients to making this a success!
For more information
- Fact sheet: Combining forces in Cambodia to overcome childhood diarrhea and pneumonia
- Case study: Tackling pneumonia and diarrheal disease through program and policy coordination: A case study of PATH's integrated approach in Cambodia
- Photo gallery: Cambodia 2011
I won't lie to you. When I told our graphic designer about our idea, he was skeptical (maybe even a little freaked out). A calendar of toilets?! I'll admit, it's just not the first thing that comes to your mind for a product typically dominated by scenic vistas and inspirational quotes, and it's enough to make any serious visual artist raise an eyebrow.
So how did I convince our graphic designer that this wasn't a crappy idea? He knows (as you probably do, if you're reading this) that diarrhea kills more than 2,000 children/day and that a lack of sanitation is a major contributor to this tragic statistic. Sure, but that still doesn't mean that people will want photographed commodes in their cubes.
So I talked about one of core values here at DefeatDD: to break the taboo around poo, especially with a spirit of celebration for the simple solutions that save lives - like toilets. We've said it before, and we'll say it again: If we can't talk about diarrhea, we can't defeat it!
I told him about our successful Poo Haiku Contests, and how we learned that creativity and humor inspires and empowers people to raise their voices for change, which is so important for an uncomfortable, giggle-inducing topic such as diarrhea. Toilets aren't only foundational for health and well-being; they are somehow inherently amusing and funny, too.
Finally, I talked about you, our fellow advocates and partners. I assured him that the same people who flooded the social media space with inspiring pooetry will surely do toilets justice with photography, proudly hang a calendar of places we "go" in their offices spaces, and use the opportunity to spark conversation and education in the year ahead.
I think I've convinced him for the time being, but the rest depends on you. We can't wait to see your creative ideas to help celebrate and advocate for the global right of a place to go. Thanks for joining the movement!
For more information:
-- Visit our contest page for details, submit photos, and spread the word!
-- Get inspired by the early submissions!Read more
Quest-driven, yet reticent, Vidya Sagar Uprety, Senior Program Officer, (Clinical Trials) of a rotavirus Phase III efficacy study, was always the school topper. From the calm and peaceful environs of the hill state of Uttarakhand, to the hustle bustle of the Indian capital, Delhi, Vidya accepts that the city has offered him great opportunities. In his day-to-day work, he still relies on skills that he once learned as a keen adventure enthusiast. He also firmly believes that a lot of hard work goes into resolving challenges.
Pur How did you choose clinical research as your career goal?
I graduated from Kumoun University, Nainital in 1999 and came to Delhi to pursue higher studies in computers. While in Delhi, I learnt about a postgraduate course in clinical research, which I was told by my friends was a career oriented course and had a good future. I completed my studies from the Institute of Clinical Research in New Delhi and today I am happy to have taken this decision.
What do you find most exciting in your job profile in PATH?
Everything about clinical trials and the drug development process is exciting, because this is directly related to saving lives. You feel very proud and satisfied when the drug or vaccine that you have been working on is approved and available to help people. My job profile at PATH is special to me as I am involved in clinical operations for a large multi-centre community-based rotavirus Phase III efficacy study. It is a huge responsibility to oversee, manage, guide and assist sites involved in this trial and ensure that the highest international standards are followed and that they are in compliance with regulatory requirements and guidelines.
My responsibilities include project planning, development of study operational documents, investigator site identification and selection and helping sites prepare for the trial. This also includes site management, oversight of the contract research organization, conflict management and so on. The most exciting part of my profile is identification and selection of good and potential investigator sites and ensuring they follow international standards during the trial.
Do you face any challenges? If yes, what do you think is the best way to tackle them?
As a person, I have a simple rule for challenges. I often step back and take time to personally engage with conflicting issues or personalities.
You have been an adventure enthusiast – can you tell us something about that?
Yes, Uttarakhand is an adventure sport’s haunt. I have been actively interested in parasailing, rock climbing, paragliding, snow skiing and river rafting since I was 16. I have been hurt during these endeavors, but I have learned a lot. In parasailing I learned to how to control, without even the basic protective gear! All this taught me to focus and follow instructions!
What are your future plans?
I want to stay in the clinical research industry. In the course of my career, I have seen the complete development of a drug and I was very proud to be associated with something as exciting as this.Read more
One of the job perks at PATH is working with lots of smart people all relentlessly tackling a health and scientific challenge. Our vaccine development program is one such team of scientists, doctors, and other experts focused on accelerating progress on new vaccines for infants and children in low-income countries. We buttonholed Alan Fix, senior medical officer based in our Washington DC office, to find out about his work.
What does it mean to be medical officer?
The most important part of my job is ensuring that our clinical trials protect the safety of the volunteers and meet international standards for vaccine trials. Because safety needs to be built into the trial design, I help with setting up our trials and helping the clinical trial sites prepare. The additional important role in participating in, if not leading, development of the trials is helping to assure sound and relevant scientific approaches. I also support the sites throughout the trials and help with reviewing the results and distilling what we learn from the research.
How did you find your way to this work?
My training is in Pediatrics and Preventive Medicine, so working to develop and increase global access to effective pediatric vaccines has obvious appeal.. From the moment I started working in public health in the developing world, I have found it stimulating and invigorating. And at PATH, we’re focused on the children who are most vulnerable. For these children, vaccines offer perhaps one of their best hopes for a healthy shot at life. The exciting part of the work is that we are making rapid progress on vaccine candidates that could have substantial public health impact.
Can you say more about how you work with our trial partners?
We aim to share scientific and operational experience to move the work forward in a collaborative way. We work together on problem solving, for example how to adapt to meet shifting regulatory requirements or how to ensure the appropriate resources at the trial site that will meet the needs of the participants. Safety is the number one concern in any clinical trial, especially so in settings where children may have underlying health challenges such as undernutrition or exposure to pathogens in unsafe drinking water, compounded by limited access to care. We have to be ready to provide care if a child becomes ill during the study even if that illness is unrelated to the vaccine candidate.
That is why I am so impressed with our partners. For example, we are working with The Mahatma Gandhi Institute of Medical Sciences in Sewagram, India. This is a facility that is deeply committed to the community around it and is well structured to meet that commitment. They have attracted dedicated staff and students and they are tireless in their efforts to meet the community’s needs. It is inspiring to see the good they are doing and to be a part of that.Read more
Recently, my husband and I did a rare thing and attended a major league baseball game. We made ourselves comfortable in the outfield bleachers just fair of the foul pole, ready for a few lazy hours in the sun rooting on the Seattle Mariners. Then, in the third inning… CRACK… we heard the sound of bat on ball and, shockingly, saw the ball bulleting straight for us. It seared into the crowd and ricocheted into the seat next to us. My husband reacted quickly, dove into the bleachers, and grabbed it, beating out several other lunging fans. And with that, we were suddenly members of an elite group of fans that had beaten the odds and snagged a homerun ball.
Wondering what odds we had actually beaten, I did some research. In truth, the question has many answers depending on seat location, game attendance, stadium dimensions, etc. But, whichever way the data are cut, most calculations have the probability of catching a homer at less than one percent. Dare I say, that’s a ballpark figure.
Here in the United States, children dream of someday catching a ‘long ball’ and go to games with mitts in hand, hoping to beat the odds. But in less developed countries where poverty and disease are pervasive, children often dream of beating the odds in a far different way—making it past their fifth birthdays. For these children one of the most powerful health tools that can help make that dream a reality, vaccines, can be as elusive as catching a homer.
In baseball, choosing a seat in homerun territory has significant bearing on a person’s chances of catching one, but improving the odds beyond that is largely out of anyone’s control. In global health, being born in an impoverished country has considerable bearing on a child’s chances of making it to adulthood, but improving that child’s odds of survival is well within our power. Expanding access to vaccines in these regions can give children the tools they need to come from behind and win the faceoff with disease.
The good news is that a reversal of odds is in the process of playing out against many diseases, including two of the world’s top child killers—pneumonia and diarrhea. Thanks to assistance from groups like the GAVI Alliance, children in low-resource countries are gaining access to vaccines at an unprecedented rate and a chance at survival that they would not have had otherwise.
In the case of pneumococcal disease—the most common cause of severe childhood pneumonia—only one percent of the world’s infants had access to pneumococcal vaccines a decade ago, and only in the industrialized world.Today, 33 percent of the world’s infants have access to these lifesaving tools, including infants from 27 low-income countries and counting. Pneumococcal vaccine rollout in the developing world has occurred in record time and could avert over half a million child deaths by 2015 and up to 1.5 million such deaths by 2020.
Global rollout efforts for vaccines against rotavirus, the leading cause of deadly diarrhea in children, are also making history, having succeeded in introducing rotavirus vaccine in the United States and a GAVI-eligible country in 2006—the same year. If rotavirus vaccine rollout in GAVI-eligible countries continues as planned, at least 30 of the world’s poorest countries will have access by 2015 and more than 2.4 million young lives could be saved by 2030.
Part of the thrill of going to a baseball game is in the slim chance that a homerun could single us out in the crowd, but slim chances hold no thrill in the game of disease prevention. We may have had luck on our side at that Mariner’s game, but thousands of others at the game did not. Ensuring that access to a shot in the arm in the developing world ceases to be as elusive as catching a shot out of the park requires vigilant, continued investment and action from the global health community. Ultimately, universal vaccine access holds the promise that will give child survival odds we can live with. Everyone going home with a ‘shot’ would ruin the fun in baseball, but it would change the game in global health.
-- Lauren Newhouse, Communications Officer for the Vaccine Development program at PATHRead more