Comments on: Combating HIV-AIDS, Malaria and Other Diseases Making the Millennium Development Goals Happen Tue, 25 Jan 2011 13:09:41 +0000 hourly 1 By: Amina Zuntuwa Amina Zuntuwa Mon, 06 Dec 2010 15:05:25 +0000 Malaria kills a child in the world every 30 seconds. The disease is a potent child killer especially when combine with poverty in which most of the developing world lives.

By: Daniela Brakewell Daniela Brakewell Mon, 04 Oct 2010 15:44:03 +0000 Revitalising Zambia’s Health Supply System

Over the past decade since the Millennium Development Goals were adopted, we have seen a significant scale-up of the supply of desperately needed commodities to fight HIV/AIDS, TB and Malaria.

This acceleration of supply has placed huge pressure on government health systems and has led to failures in the supply chain at the critical “last mile” of delivery into the hands of patients.

In 2004 the government of Zambia took the courageous decision to completely reform the operations of their Medical Stores (MSL) to ensure that the treatments being provided reached the people of Zambia at the right time and saved lives.
Crown Agents partnered with the Zambian government to transform MSL into an effective, efficient and demand-driven organisation.

MSL is now recognised as a model for medical stores operations in Sub-Saharan Africa. This model is now being replicated by the government of Botswana.

When former US president Bill Clinton toured MSL in 2007, he was very impressed with the national supply chain improvements made in Zambia through MSL. “What will keep people dying is the lack of infrastructure and the distribution network,” he said. “So this [MSL] is the sort of thing we need to do for the rest of Africa.”

One of the biggest signals of its success has been that virtually all development partners now route their commodities through MSL, creating a single consolidated logistics operation rather than parallel systems that tend to undermine government ownership and capacity development.

Improvements that have helped to create a first-class professional MSL have included:

• Financial Planning – introduction of annual business plans and operating budgets, improved financial management systems, and greater budgeting capacity;
• Human Resource Development – improved contracts for staff, regular appraisals, a training programme and a pension scheme;
• Operations Management – enhanced pharmaceutical standards and standard operating procedures, implementation of modern warehouse and distribution management information systems, new storage and handling equipment to streamline key activities, and a new fleet of vehicles with planned maintenance;
• Infrastructure – physical renovation of the warehouse, a new cold store, air conditioning throughout the facility, and overhaul of the telecommunications and IT infrastructure;
• Stock Availability – monthly detailed stock reports to the Ministry of Health which have contributed to better decision-making and cost savings, along with improved stock availability at all levels.

As a result, MSL’s performance metrics have improved dramatically since 2004, with 32% reduction in distribution costs, stock availability doubling, and 95% of all orders delivered on time (up from 50%) – a service more responsive to customers’ needs.

Distributing to the last mile

In order to drive the benefits even further towards the “last mile”, in 2009 we began a year-long distribution pilot sponsored by the World Bank. This increased the availability of drugs to 88% of public health centres in trial districts – nearly double the availability rates in control districts. The pilot was originally designed for anti-malarial drugs but was extended to all essential medicines. It ran for a year in 16 districts and proved so successful that the government of Zambia has decided to roll the pilot out to all 72 districts.

A second pilot recently began, working with the private sector to provide anti-malarial medicines and diagnostic tests through retail outlets and thereby contribute to improving access in rural areas. This pilot is already showing promising results, with improved availability and higher sales.

Working in partnership with the Zambian government, development partners and the private sector, we are getting life saving drugs out of warehouses and into the hands of Zambians when they are needed, thereby contributing to Zambia’s progress in achieving MDG 6 as well as the other health MDGs.

Providing a sustainable future

Through ongoing capacity building approaches we are working to ensure that change is sustainable, with the Zambian government gaining confidence and capacity to take complete ownership at the earliest opportunity.

We are now developing a work plan with the Zambian government that will further commercialise MSL, reducing its reliance on grants from the central government budget and thus releasing funds for other areas of development.

For more information, visit

By: Robin Smalley, Co-Founder and International Director, Robin Smalley, Co-Founder and International Director, Mon, 20 Sep 2010 13:58:09 +0000 mothers2mothers ( is an international organization headquartered in Cape Town, South Africa, that provides education and support for pregnant women and new mothers living with HIV/AIDS.

We think it’s a remarkable time for mothers around the world. Just over a week ago, mothers2mothers joined Johnson & Johnson as they announced a new five-year global commitment to improving maternal and child health. Last week I was in Geneva, meeting with the WHO about mothers2mothers’ effective, sustainable program. This week, we head to New York for the MDG Summit … and I’ll be bringing along Babalwa Mbono, junior trainer for mothers2mothers and a former client, to tell her inspiring story (

mothers2mothers is working hard to show mothers that HIV is not a death sentence, and no baby has to be born with HIV/AIDS. We employ HIV-positive mothers who have been through our program, and they go on to mentor other mothers, empowering them to access life-saving treatments for their babies and for themselves. I feel lucky to be a part of this growing movement that is so integral to the Millennium Development Goals.

Millennium development goals is a state of where aech and everybody gets a sound mind to contribute his or her quota in the socio _economic development in a community, country and the world as a whole of which every normal being appreciate for unique development , How ever the major obstacles to this is lack of quality Health.
Realizing this the United Nation and it Agencies , WHO.,UNDP, UNICEF., etc have instituted a primary Health care policy PHC, this move was party necessitated by the shift in emphasis in medical practices.
With the aim of preventing diseases , since prevention is better than cure with creative approaches to preventive measures which is understandable .though diseases are not only the pains or suffering one experiences , but sometimes expensive to cure , therefore all effort must be geared towards it’s preventions where endemic diseases are controlled before the they turned epidemics , for instance HIV/AIDS becomes epidemic in many part of the world where people consider sex as a game to release tension , cholera occurs where sanitation is poor ,there is communicable diseases such as measles , tuberculoses all needs proper sanitation and required an involvement of communities in health delivery programmed Mother and child clinics must be provided to for health child becomes healthy adult and these clinics must have well trained nurses to give free advice on good nutrition , family planning , good food provide , good health and immunization ensures resistance against diseases.
In most rural communities in Africa and in Ghana to be precise , mental disorder and HIV/AIDS, Epilepsy and other communicable diseases such as tuberculosis measles and leprosy diseases . other disease such as malaria and cholera are attributed to some spiritual force due to lack of knowledge about their causes and such reason , the victims of such diseases are isolated and left in their own fate .
As contributing to substain the MDG,Globsek a maiden NGO hasit upon itself taking educate the masses on the cause of this diseases.
HIV/AIDS Globsek drew the attentions of the masses especially the rural dwellers to the fact that HIV/AIDS is a universal disease which any and everybody at any time can be victimized if preventive measures are not well taken
Globek observe that the few rural dwellers who had a little
Knowledge about the disease assumed it is acquired only through sexual intercourse, which is not the case.
We made them aware that the disease can be acquired through direct contact from fresh sharp cut like blades which have cut or parsed an infected person.
We also educate them to reisist from unprotected sex and encourage them to use condoms if necessary.
Globsek also most of victims of such disease are isolated from friends , family due to misconception, that the disease is communicable .
How ever friends and relatives are also advice to keep constant contacts with the victims as their relationship was before the disease was contacted.
Cholera . it occurs where sanitation is poor improper storage of food exposure of food to flies and drinking of contaminated water are the main cause of this diseases , therefore we advice them to keep their environment clean with proper disposal of refuse .
The masses regular cleaning and drainage of stagnant waters, use of insecticide or pesticide sprays.
Globsek also found very expedient to educate the rural dwellers on the need to control communicable disease by vaccinating the children under two years against tuberculosis, polio diphtheria and not forgetting their domestic animals against rabbis.
Mental- illness/insanity; I s one of the diseases that many people especially Africa and Ghana , for that matter consider as a disease caused by spiritual forces , that is the victim is a witch or wizard and been punished by his own sins that is superstitious belief.
For that matter, they are dejected by their relatives or the society , for this reason a workshop was organized by Globsek and the main motive of this workshop was to educate the people to desist from the notion and erase that erroneous impression and embrace them and seek medical attention. Since some of these diseases are as a result of stress, poverty, accident etc.
The relatives are advice to seek for essential drugs for their drugs for their patient in order to cured and put into apprentice or vocational training to earn their living to benefit the nation and the world as large

SELF MEDICATION. Many people take drugs without the consulting a physician or doctor for necessary advice ,which subsequently causes unnecessary anxieties, by doing so they prevent the early diagnoses on serious disorders, they inflect upon themselves unpleasant complication which may result from over dose and unwanted drugs at a point in time that is failure to take precautionary measures from appropriate quarters, one can not used pain killing compound to fight against typhoid fever and this is dangerous habits . In any case we in the front line must be assisted and in order to train and straightening in our campaign against that in other that one need to contact a doctor first. Putting a square peg into round bottom hole.
We need to get a van with a educational films to the rural areas where access to television and the radio-active appliance are not common
SEXUAL ABUSE.. In commemoration of International Human right Day,GLOBSEK assemble boys and girls of their school going age and address them on sexual abuse at Christian Institute Of Accountancy and technical(CIAT) auditorium at Bomson a sub of kumasi Ghana the topic was Violence Against Girls child Abuse , this is one commitment to fight for schools, devoid of sexual abuse in Ghana because this denies girls from their right to education and dignities and it also affect the ability of a nation to attain the millenniums Development Goals on education agenda , thousand of girls could not write their final examination due to premature pregnancy perpetrators from the communities so consider these issues.
The impunity and seaming inaction of the education authorities to sanction private and public school perpetrators who expose their student to sexual abuse or condone in sexual practice and probably sentence them or any one who impregnate a student should be dealt with accordingly . if possible U.N should make a law that functional and sustained relationship between the police and students as means of strengthening reportage of sexual abuse cases in school . Not at all, we urge the UN to facilitate the process of developing of code of conducts for private and public schools authorities to comport themselves . This will go on a long way to curb gender disparities
The physical handicap such as blind, deaf and other disables people , there must be an unbreakable laws laid down for their authorities to go through accordingly.
Same problem are facing the vulnerable and orphans in the children home , they are sometimes deprive them from their right to fundamental human right and lure to sexual abuse
If all said is accomplished, we will achieved MDG.

By: Joshua Nthakomwa Joshua Nthakomwa Fri, 03 Sep 2010 12:53:06 +0000 In my opinion, with regard to HIV/AIDS, and particualry commenting on the Malawi behavioral pattern and the approach vis-a-vis HIV/AIDS, it boils down to a matter of appealing to the will of the people involved in such behavior.

I was in a recent discussion with an officer from our National Aids Commission (NAC), who told me that out of 3 people reached on HIV/AIDS, 5 more are getting infected – an appalling statistic. NAC has done what it can to reach out effectively. Not many people in Malawi today can say that they do not know the dangers of HIV/AIDS and how it can kill them, their families and leave their children destitute. Many simply don’t care. They still want to do what they’re doing because according to many male friends of mine, “how can a man be without a concubine.” To many, It’s an issue of self-esteem, but it also is a kind of value without which a man doesn’t have a story to talk and boast about. That’s what I have concluded as I interacted with business persons in my consultancy walk.

It’s unfortunate that the worst case scenarios – again in my opinion – are those with knowledge (high learning), money and success. The more money they get, the more they want to get involved with women. Because of the prevalence of incidences at this high level of knowledge, I believe that persons lower down in terms of status in society figure out that if they are doing it, why can’t we?

Therefore, my conclusion is that while information sharing on topics such as HIV/AIDS is very strategic to combating HIV/AIDS, it is not exhaustive on its own because that still doesn’t appeal to the will of many people. It’s different from Malaria in that people don’t derive pleasure from being bitten from mosquitos that leads to Malaria, whereas people derive pleasure from sex which leads to HIV/AIDS. There is need to come up with a strategic concept that will appeal to the emotion of the person; that will want him/her to will behavioral change. Furthermore, there is need for persons with high status in society to become role models to those who look up to them.

By: SY SY Fri, 03 Sep 2010 11:23:36 +0000 Ma Suggestion: La pulvérisation intradomiciliaire (PID) est une méthode de lutte anti vectorielle qui a donné des des résultats interessant dans la réduction de la transmission du paludisme dans les pays sub sahariens où elle a été appliquée par exemple le Sénégal. Elle est pour les programmes de lutte contre le paludisme de ces pays un palier majeur dans la phase de pré élimination du paludisme. Je suggére que les villages sélectionnés dans le cadre du pojet des OMD puissent faire l’objet de la PID là évidemment les conditions de faisabilité sont requises.

By: Cooper Chibomba Cooper Chibomba Wed, 01 Sep 2010 08:19:12 +0000 Improving Food Security to Combating HIV and Malaria in Zambia
In order to reduce he incidence of HIV and Malaria, improving the food security and livelihoods resilience of PLWHA and their families is crucial in attaining the MDG on HIV and malaria. Its will compliment the current efforts at mitigating the effects of HIV and AIDS on the vulnerable households. By mitigating the socio-economic impact of HIV and AIDS through the provision of sustainable socio-economic empowerment and livelihoods activities for PLWHA, OVC and care givers and the scaling up of nutritional support and food security to all infected and affected persons, the Millennium Development Goals 1 and 6 which aim to reduce poverty and hunger by half by 2015 and stem the spread of HIV, malaria and other diseases by 2015 respectively can be attained.

HIV rates vary considerably among and within provinces ranging from 8% in Northern Province to 21% in Lusaka Province and 18% in the Central Province. The epidemic prevalence dynamics differ between rural areas and urban areas with 22.5% prevalence in urban areas and 8.4% in rural areas. Findings from the Zambia HIV Epidemic, Response and Policy Synthesis Report of 2009 also indicate that nearly 80% of HIV transmission in Zambia is through heterosexual contact exacerbated by the high risk sexual practices, gender inequality, and high levels of poverty, stigma and discriminatory practices. It is clear that where poverty is high, food insecurity is high. There is a strong bias towards food than health care among households faced with both.

In order to increase the momentum of civil society organizations contributions to attaining the MDGS, the following issues need to be addressed:
Firstly, food and nutrition security packages for the PLWHA are currently based on the provider mode where external assistance is mobilised and distributed with minimum participation of the affected households and communities in decision making. Households are not aware of crop varieties and quantities to grow to address the annual food deficit of five months between August and January. Government departments and NGOs are distributing generic input packages consisting of maize seeds and fertilizer to all farmers iregardless of the PLWHA needs and priorities as well as recommended WHO nutrition standards. The current household food basket consists mainly of cereals such as maize, sorghum and millet, produced through dryland cultivation and vegetables from home gardens. Where food production levels are high communities are lacking the knowledge and skills to prepare, process and preserve some of the food to cover for the deficit periods.Thus platforms for knowledge sharing at village, ward and district level on food processsing and preservation must increase the level of awareness for PLWHAs and their families on best practices on food and nutrition security at the household level.

Secondly, conventional agricultural production systems have failed to meet the food and nutrition requirements of PLWHA and their families in the Central Province of Zambia. There is a limited choice of input packages from support agencies including the private sector for PLWHA and their families to chose from. The uptake of sustainable farming methods such as conservation farming is still low but there is a high opportunity to scale up current low external input agricultural production efforts being promoted by the Ministry of Agriculture and Cooperative.

Extension support to PLWHA has not in any way been differentiated with the support and delivery model for those living without HIV and AIDS. The Community Based Extension System offers the potential to reach many more people within the limited financial resources available to the Zambian government, to respond to widespread needs as in the situation of HIV and AIDS, and to significantly improve people’s quality of life. In addition, they allow communities to influence services to meet their own, locally specific needs, and to monitor the performance of delivery agents.

Responses to food and nutrition insecurity have been guided by the priorities and objectives of the implementing agents and Donors with minimum consultation processes taking place at the community level to determine their needs and priorities. There are different and sometimes conflicting approaches by stakeholders and these tend to confuse the beneficiary communities. Building the capacity of the support organisations will increase their ability to interact and interface with communities through participatory planning and implementation processes.

In Conclusion, combating HIV will require not only how Civil society organisations and government respond to the epidemic but what bottlenecks are identified and planned for. While HIV infection may appear to be reducing, the upsets caused by acute food shortages have the abiity to reverse all the progress attained. By combining a human rights based approach to HIV prevention building on strengthening household food security of poor households, who usually are the majority infected, Malaria and HIV AIDS resources will be put to full use.

By: Ndegwa Jack Ndegwa Jack Mon, 30 Aug 2010 10:37:00 +0000 Health care is a basic human right and good health and a reasonable longer life span is the most prized of human conditions. In Africa, the strive to provide better health care especially for HIV/AIDS, TB and Malaria face several challenges. First, HIV/AIDS, TB and Malaria services are offered through health institutions (public or private) and if the overall health system and health strategies; financing, management, reforms, Planning, evaluating programmes are ‘wanting’; these three areas will adversely be affected. In addressing challenges that may hider achieving MDG 6 therefore, we may need also to focus on boarder issues affecting health care delivery and systems in Africa.

First, the national health policies and priorities for investment in health affect the range of services provided and where they are provided. Most sub-saharan African countries though have good national health policies have a limited budget allocation to health priorities, not because this cannot be propped up, but due to wrong priorities, poor governance and lack of strong or due to limited commitment by political leaders to see a health care system that meet the needs of the public especially the poor. This can further be examined by reviewing the budgeting processes and allocations on health ministries in some low resourced governments in relation to other ministries like – defense. The need to prioritize country-owned and initiated efforts to develop and implement effective and sustainable health strategies that deliver improved health services and health outcomes in Africa is real.

Second, where the basic health care is not completely free of charge, poor people are likely to deny themselves treatments because of costs. Health financing for the poor and social justice and equity are prerequisite for the achievement to maintenance of health. Health access need to be re-looked as a human right issue in Africa, where the rich have access, the poor aren’t. Mere existence of health services is no guarantee that everyone will be able to use them or benefit from them. Poor people in Africa are the ones are the ones who most need adequate health care and they are the people whose requirements for health remain most systematically unmet.

Third, economic recession and economic pressure forces (global) have had an effect of cutting of health budgets by governments, donors, INGOs and multi-lateral institutions with an impact on the health of the poor people. These have reduced health budgets especially in poor countries. The impact of debts (external) and SAPs on already inadequate health services also need to be monitored. The main issue is the state funding larger scale health programmes (health care Financing); where few government have invested limited time and resources including Human resource to draw out homemade models that would work effectively for Africa even in dealing with HIV, TB and malaria. This lead to the issue of Health workforce in Africa which is very clear; Africa is grossly understaffed with health workers.
Lastly, there is need to engage in government sponsored initiatives (Researches) on a larger scale and at a higher level on cost affective, wide ranging health care delivery systems and health financing etc To accelerate the progress towards developing effective strategies, systems, laws and policies, and incentivizes for quality and universal access to health
In conclusion, it is important to remember that in dealing with the MDG 6 in Africa, health cannot be considered in isolation from the acute social-economic, political and even cultural problems facing many poor resourced African countries.

Thank You,
Jack Ndegwa
VSO Nepal

By: Malcolm Trevena Malcolm Trevena Tue, 24 Aug 2010 20:38:31 +0000 In regards to malaria.

The organization I work for (Meaningful Volunteer – is about to launch a program in the small rural community of Buyaya in Eastern Uganda. We have a (very) modest budget of about $1,500 for initial net purchase. We will then distribute these in the areas.

We are set to launch in early 2011.

Our programs are designed to bring volunteers from all over the world to help us with distribution.

The challenges in fighting malaria and the solutions we have come up with include.

* Logistics
Giving one net to one family and training them in its use easy. Giving out thousands of nets to thousands of families and training is a lot harder.

Our project (“The Malaria Operation”) gets around the logistical problems by the use of an online database. We record such things as a photo of the household, number of sleeping sites, and so on.

One very critical piece of information we record is the GPS location of the house. This allows us to easily find the household visit during critical times (such as the onset of the rainy season), as well as allowing for a very easy hand-over when volunteers come and go: No one person is critical to the project.

* Illiteracy
From a census we conducted in area (, the rates of illiteracy are huge. As a result, our community outreach revolved around highly visual and interactive games that teaches people on the basics of mosquitoes.

* Process. Process. Process.
Our process covers every step from initial volunteer training, through to organizing a community meetings, running community meetings, the actual net distribution, and follow up visits.

This makes our project easily expandable and scalable. We will expend this project to other areas of Uganda as well as Ghana (in 2012).

Thanks for your time
Malcolm Trevena

By: Improve links with HIV services to deliver all the health MDGs | Aids Alliance Blog Improve links with HIV services to deliver all the health MDGs | Aids Alliance Blog Tue, 24 Aug 2010 16:00:47 +0000 [...] First published at Making the Development Goals Happen [...]