Professional Documents
Culture Documents
Achieving comprehensive childhood immunization: an analysis of obstacles and opportunities in The Gambia ................................................................................................. 13 Changing Childrens Chances: New Findings on Child Policy Worldwide ............................ 13 Urinary Tract Infection in Children: An Update...................................................................... 14
Malaria ..................................................................................................................... 14
Persistent detection of Plasmodium falciparum, P. malariae, P. ovale curtisi and P. ovale wallikeri after ACT treatment of asymptomatic Ghanaian school-children ........................... 14 Treatment practices in patients with suspected malaria in Provincial Hospital of Tete, Mozambique .......................................................................................................................... 14 Perception of malaria risk in a setting of reduced malaria transmission: a qualitative study in Zanzibar................................................................................................................................. 15 Performance of two rapid diagnostic tests for malaria diagnosis at the China-Myanmar border area ............................................................................................................................ 15 Pre-referral rectal artesunate treatment of childhood malaria in the community .................. 15
Tuberculosis ............................................................................................................. 16
A Media Guide on Reporting Tuberculosis Research and Related Issues in Uganda ......... 16 TBC: New Drug Against Multi-resistance.............................................................................. 16 Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosis: Workshop Summary ....................................................... 16 Corticosteroids for prevention of mortality in people with tuberculosis: a systematic review and meta-analysis ................................................................................................................. 17 A comprehensive assessment of housing conditions and other socioeconomic determinants of Tuberculosis among dwellers in urban slum communities in Uganda .............................. 17 Approval of a Tuberculosis Drug Based on a Paradoxical Surrogate Measure.................... 17 Integrating tuberculosis and HIV services in low- and middle-income countries: a systematic review .................................................................................................................................... 18 Aggressive Regimens for Multidrug-Resistant Tuberculosis Reduce Recurrence ............... 18 Abdominal Tuberculosis - A Review ..................................................................................... 18
Social Protection....................................................................................................... 23
Social Protection Systems in Latin America and the Caribbean........................................... 23 Transforming cash transfers: beneficiary and community perspectives on social protection programming ......................................................................................................................... 24 Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial ................................................................................... 24 Exploring the Role of Social Protection in Enhancing Food Security in Africa ..................... 25
Bolsa Famlia after Brasil Carinhoso: an Analysis of the Potential for Reducing Extreme Poverty .................................................................................................................................. 25
Human Resources.................................................................................................... 26
Developing a new mid-level health worker: lessons from South Africas experience with clinical associates.................................................................................................................. 26 Service delivery in Kenyan district hospitals -- what can we learn from literature on mid-level managers? ............................................................................................................................ 26 Health workforce remuneration: comparing wage levels, ranking, and dispersion of 16 occupational groups in 20 countries...................................................................................... 26
Education ................................................................................................................. 30
Limited potential of school textbooks to prevent tobacco use among students grade 1-9 across multiple developing countries: a content analysis study............................................ 30
Others ...................................................................................................................... 33
Africa Environment Outlook 3: Summary for Policy Makers ................................................. 33 UNEP Year Book: Emerging issues in our global environment ............................................ 33 Health risk assessment from the nuclear accident after the 2011 Great East Japan Earthquake and Tsunami ...................................................................................................... 33 Should trainee doctors use the developing world to gain clinical experience?..................... 34
TRAINING OPPORTUNITIES............................................ 36
Regional workshop: Monitoring and Evaluation of HIV/AIDS Programs ............................ 36 Impact Evaluation of HIV/AIDS and Health Programs .......................................................... 36
CONFERENCES................................................................ 37
COHRED Colloquium on boosting sustainable investments into research and innovation for health..................................................................................................................................... 37 th 6 MIM Pan-African Malaria Conference .............................................................................. 37 th 7 SAHARA Conference 2013 .............................................................................................. 37 rd 3 International Conference on Family Planning .................................................................. 38
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BOOKS
Evaluation of PEPFAR
Committee on the Outcome and Impact Evaluation of Global HIV/AIDS Programs; Board on Global Health; Board on Children, Youth, and Families; Institute of Medicine, 2013 677 pp. 9.7 MB:
http://download.nap.edu/cart/download.cgi?&record_id=18256&free=1
The U.S. government supports programs to combat global HIV/AIDS through an initiative that is known as the Presidents Emergency Plan for AIDS Relief (PEPFAR). This initiative focused on an emergency response to the HIV/AIDS pandemic to deliver lif esaving care and treatment in low- and middle-income countries (LMICs) with the highest burdens of disease. The overall aim of this evaluation is a forward-looking approach to track and anticipate the evolution of the U.S. response to global HIV to be positioned to inform the ability of the U.S. government to address key issues under consideration at the time of the report release. ***
Overwhelming evidence demonstrates the benefits of immunization as one of the most successful and cost-effective health interventions known. The Global Vaccine Action Plan (GVAP) is a framework approved by the World Health Assembly in May 2012 to achieve the Decade of Vaccines vision by delivering universal access to immunization. The mission outlined in the GVAP is straightforward: improve health by extending by 2020 and beyond the full benefits of immunization to all people, regardless of where they are born, who they are, or where they live. ***
ONLINE PUBLICATIONS
Global Health Who Should Pay for Global Health, and How Much?
by Luis R. Carrasco, Richard Coker, Alex R. Cook PLoS Med 10(2): e1001392 (19 February 2013) 6 pp. 411 kB: http://www.plosmedicine.org/article/fetchObjectAttachment.action;jsessionid=37D 6DC594066963A2CD8E89C2D85DE37?uri=info%3Adoi%2F10.1371%2Fjournal.pmed. 1001392&representation=PDF Global health is a public good and ill-health in one part of the globe has consequences elsewhere: witness recent emerging infectious diseases. It follows that by contributing to global health, donor countries can benefit substantially: directly, in the form of a reduction in communicable disease emergence and transmission. Mirroring global carbon permit markets to mitigate climate change, the authors propose a cap-and-trade system consisting of a global cost-effectiveness criterion and a disability-adjusted life year (DALY) global credit market. ***
Towards Universal Health Coverage: concepts, lessons and public policy challenges
Background Document: WHO/World Bank Ministerial-level Meeting on Universal Health Coverage 18-19 February 2013, WHO headquarters, Geneva, Switzerland 4 pp. 147 kB: http://www.who.int/mediacentre/events/meetings/2013/uhc_who_worldbank_feb2 013_background_document.pdf Universal health coverage is about ensuring that all people have access to services that promote good health, prevent illness, offer treatment and rehabilitation. The services must be of good quality and effective, and people must not suffer financial hardship when paying for them. The meeting brought together ministers of finance and health from 27 countries with other high-level stakeholders. A series of roundtable discussions was held: to explore ways that countries are progressing towards universal health coverage; to share innovative solutions; and to identify actions the global community can take to support efforts. ***
has made a significant contribution to the fight against HIV/AIDS, TB and malaria. The results of the 5 Year Evaluation largely validate UNITAIDs business model, but they also point to a number of challenges ahead for the organisation. ***
Technical Support Needs of Indigenous Civil Society Principal Recipients of Global Fund Grants
International Council of AIDS Service Organizations (ICASO), 2012 36 pp. 431 kB: http://www.csathubs.org/download/?file=230 This report analyses the technical support needs of indigenous Civil Society Organizations (CSO) in building their capacity to be effective Principal Recipients (PRs). The intended audience of the report includes stakeholders involved in Global Fund processes, technical support providers, and other partners. Additionally, CSOs which are considering taking on the PR role may find the report useful. ***
Capacity Development Toolkit to Strengthen National Entities to Implement National Responses for HIV & AIDS, Tuberculosis and Malaria
United Nations Development Programme, Global Fund Partnership http://www.undp-globalfund-capacitydevelopment.org/home/cd-toolkit-forhivaids,-tb-malaria-responses.aspx This guide provides practical guidance on how to manage a capacity development pr ocess for national entities to implement national disease responses for HIV and AIDS, Tuberculosis and Malaria. It includes practical advice, tools, templates and process guidance for the five steps of the capacity development process. In addition, the toolkit has specific sections on transition planning and functional capacities.
serve countries in conducting their own midterm reviews, helping you to focus on the areas where action is most needed to reach your priority targets and elimination commitments by 2015. ***
Investing in Communities Achieves Results: Findings from an Evaluation of Community Responses to HIV and AIDS
by Rosala Rodriguez-Garca, Ren Bonnel, David Wilson et al. International Bank for Reconstruction and Development / The World Bank, 2013 143 pp. 2.1 MB: http://www.dfid.gov.uk/Documents/publications1/evaluation/Investi ng-communities-achieve-results.pdf While communities, in spite of their limited resources, have played a key role in the HIV/AIDS response, their contributions and innovative approaches to prevention, trea tment, care, and support have not always been the focus of systematic and rigorous evaluations. To address this deficit, a series of studies - including evaluations in Burkina Faso, India, Kenya, Lesotho, Nigeria, Senegal, South Africa, and Zimbabwe - were undertaken over a three-year period (early 2009 to early 2012), helping to build a robust pool of evidence on the effects of community-based activities and programs. ***
Global Policy Review of Antiretroviral Therapy Eligibility Criteria for Treatment and Prevention of HIV and Tuberculosis in Adults, Pregnant Women, and Serodiscordant Couples
by Somya Gupta, Reuben Granich, Amitabh B. Suthar et al. J Acquir Immune Defic Syndr, Vol. 62, Nr. 3, March 1, 2013 pp. e87e97 11 pp. 502 kB: http://pdfs.journals.lww.com/jaids/2013/03010/Global_Policy_Review_of_Antiretro viral_Therapy.20.pdf This article reviews the antiretroviral therapy (ART) initiation criteria from national treatHESP-News & Notes - 05/2013 - page 8
ment guidelines for 70 countries and determines the extent of consistency with the current World Health Organization (WHO) recommendations. The authors conclude that published guidelines from a significant number of countries are not following WHO recommendations. Although published guidelines may not reflect practice, it is important to adapt recommendations and services quickly to reflect the emerging science on the health and prevention benefits of earlier access to ART. ***
A longitudinal cohort study of heterosexual couples in Uganda has found more evidence of the efficacy of antiretroviral therapy (ART) in curbing HIV infection within the community. The study found 119 new HIV infections in 2334 couples over the course of the study, and 62 infections among the 254 couples that were initially or who became HIV serodiscordant. But it did not find a single example of transmission from a partner who was on antiretroviral therapy. ***
documents showed conclusively that maternal/infant ARV regimens during pregnancy and breastfeeding greatly reduce vertical transmission of HIV; and that exclusive and continued breastfeeding significantly improves overall HIV-free survival. Section 1: Introduction to current HIV and infant feeding policy Section 2: The global HIV pandemic and how it affects women and children Section 3: Interventions to maximise mother and child health and survival Section 4: Counselling HIV-positive mothers about how to feed their babies using current HIV and infant feeding recommendations Section 5: Chronology and evolution of HIV & IF policy Section 6: Glossary, definitions and further resources ***
Was higher viral load responsible for the African HIV epidemic?
by Gus Cairns NAM Publications, 12 February 2013 Read online at: http://mobile.aidsmap.com/Was-higher-viral-load-responsible-for-the-African-HIVepidemic/page/2568942 The HIV epidemic has carved contrasting trajectories around the world with subSaharan Africa (SSA) being most affected. Researchers from Cornell University in New York hypothesized that mean HIV-1 plasma RNA viral loads (VL) are higher in SSA than other areas, and that these elevated levels may contribute to the scale of epidemics in this region. ***
Access to HIV Prevention and Treatment for Men Who Have Sex with Men
Findings from the 2012 Global Mens Health and Rights Study (GMHR) by Sonya Arreola, Pato Hebert, Keletso Makofane et al. The Global Forum on MSM & HIV (MSMGF), December 2012 37 pp 1.3 MB: http://www.msmgf.org/files/msmgf//documents/GMHR_2012.pdf Data from the global survey revealed several barriers (factors associated with lower access) and facilitators (factors associated with higher access) that impact the ability of Men Who Have Sex with Men (MSM) to obtain condoms, lubricants, HIV testing, and HIV treatment. Homophobia, provider stigma, and negative consequences for being out as MSM were significantly associated with reduced access to services. Conversely, community engagement and comfort with health service provider were each significantly associated with increased access to services. ***
38 pp. 785 kB: http://www.demographic-research.org/volumes/vol28/13/28-13.pdf The emerging literature on HIV/AIDS and mental health in sub-Saharan Africa stresses that HIV-positive status is significantly related to mental illness. However, it has neglected an equally important concern in contexts where HIV is highly prevalent, namely, whether and how an HIV/AIDS epidemic affects the mental well-being of individuals in the general population, regardless of their HIV status. The authors conclude that mental health concerns in the context of an HIV/AIDS epidemic need to be addressed not only for HIV-infected individuals, but also for those who are not infected but are uncertain and fearful about being infected and about the ensuing life changes.
Sexual & Reproductive Health Interventions to Reduce the Prevalence of Female Genital Mutilation / Cutting in African Countries
by Rigmor C. Berg and Eva Denison The International Initiative for Impact Evaluation (3ie), January 2013 155 pp. 1.7 MB:
http://www.3ieimpact.org/media/filer/2013/02/06/sr009_fgm_bergdenison.pdf
The authors aimed to review the empirical research on the effectiveness of interventions to reduce the prevalence of Female Genital Mutilation/Cutting (FGM/C) in African countries, and the empirical research on contextual factors that may help explain the effectiveness, or lack thereof, of such interventions. The findings show that much work remains to be conducted regarding the evaluation of FGM/C abandonment efforts. There is a need to conduct methodologically rigorous intervention evaluations. Such studies should address the local communities enforcement systems that support FGM/C and be based on a sound theory of behaviour change. ***
An all time low utilization of intrauterine contraceptive device as a birth spacing method - a qualitative descriptive study in district Rawalpindi, Pakistan
by Amna Khan and Babar Tasneem Shaikh Reproductive Health 2013, 10:10 (9 February 2013) 5 pp. 273 kB: http://www.reproductive-health-journal.com/content/pdf/1742-4755-10-10.pdf Pakistan has almost a stagnant contraceptive prevalence rate for more than a decade now, perhaps owing to the inadequate performance of the family planning programs. The provision and use of long term contraceptives such as IUCD has always been low (around 2%) and associated with numerous issues. The study revealed that the family planning clients are reluctant to use IUCDs because of a number of myths and misconceptions associated with the method. They also have reservations about the providers capability and quality of care at the facility. ***
Redeeming qualities: exploring factors that affect women's use of reproductive health vouchers in Cambodia
by Carinne D Brody, Julie Freccero, Claire D Brindis et al. BMC International Health and Human Rights 2013, 13:13 (26 February 2013) 21 pp. 166 kB: http://www.biomedcentral.com/content/pdf/1472-698X-13-13.pdf One approach to delivering healthcare in developing countries is through voucher programs, where vouchers are distributed to a specific population for free or subsidized health care. Recent evaluations suggest that vouchers have the potential to extend coverage of priority health services to the poor in developing countries. This study highlights the importance of tailoring voucher programs to specific community needs, a strategy that can lead to better program uptake.
Maternal & Child Health Misoprostol for postpartum hemorrhage prevention at home birth: an integrative review of global implementation experience to date
by Jeffrey Michael Smith, Rehana Gubin, Martine M Holston et al. BMC Pregnancy and Childbirth 2013, 13:44 (20 February 2013) 20 pp. 113 kB: http://www.biomedcentral.com/content/pdf/1471-2393-13-44.pdf Hemorrhage continues to be a leading cause of maternal death in developing countries. The 2012 World Health Organization guidelines for the prevention and management of postpartum hemorrhage (PPH) recommend oral administration of misoprostol by community health workers (CHWs). The authors conclude that community-based programs for prevention of PPH at home birth using misoprostol can achieve high distribution and use of the medication, using diverse program strategies. Coverage was greatest when misoprostol was distributed by community health agents at home visits. ***
Achieving comprehensive childhood immunization: an analysis of obstacles and opportunities in The Gambia
by Sarah Payne, John Townend, Momodou Jasseh et al. Health Policy Plan. (2013) - First published online: February 20, 2013 11 pp. 233 kB: http://heapol.oxfordjournals.org/content/early/2013/02/19/heapol. czt004.full.pdf+html This study assessed immunization coverage and the determinants of immunization in a semi-rural area in The Gambia. Despite high levels of coverage of many individual vaccines, delivery of vaccinations later in the schedule and achieving high coverage of full immunization remain challenges, even in a country with a committed childhood immunization programme, such as The Gambia. Our data indicate areas for targeted interventions by the national Expanded Programme of Immunization. ***
Malaria Persistent detection of Plasmodium falciparum, P. malariae, P. ovale curtisi and P. ovale wallikeri after ACT treatment of asymptomatic Ghanaian school-children
by Bismarck Dinkoa, Mary C. Oguikea, John A. Larbi et al. International Journal for Parasitology: Drugs and Drug Resistance, Vol. 3, December 2013, pp. 4550 6 pp. 328 kB:
http://pdn.sciencedirect.com/science?_ob=MiamiImageURL&_cid=280845&_us er=10&_pii=S221132071300002X&_check=y&_origin=article&_zone=toolbar&_coverDa te=2013--31&view=c&originContentFamily=serial&wchp=dGLzVltzSkzS&md5=e0bb942c33a751131c2211ab0eb243d7&pid=1-s2.0-S221132071300002X-main.pdf
This report raises two areas of concern for programmes seeking to eliminate malaria in sub-Saharan Africa. Firstly, co-infecting non-falciparum species were found by Polymerase Chain Reaction (PCR) to be common in asymptomatic individuals with patent P. falciparum parasitaemia, and the deployment of an artemisinin-combination therapy (ACT) thought efficacious against all three species failed to completely clear P. malariae and P. ovale spp. in approximately 10% of individuals over 3 weeks of follow-up. ***
Treatment practices in patients with suspected malaria in Provincial Hospital of Tete, Mozambique
by E. Bottieaua, P. Gilleta, A. De Weggheleirea et al. Trans R Soc Trop Med Hyg (2013) 107 (3): 176-182 (February 3, 2013) 7 pp. 180 kB: http://trstmh.oxfordjournals.org/content/107/3/176.full.pdf+html Nowadays, parasite-based diagnosis by microscopy or malaria rapid diagnostic tests (RDT) is universally promoted before malaria treatment. However, studies on adherence of primary caregivers to malaria test results have provided conflicting results. Adherence to malaria test results was good in this reference setting, but antibiotic prescription was relatively frequent in clinically stable non-malaria patients. Optimal management of parasite-negative patients must be further defined along with programmatic deployment of the parasite-based strategy. HESP-News & Notes - 05/2013 - page 14
Perception of malaria risk in a setting of reduced malaria transmission: a qualitative study in Zanzibar
by Julie A Bauch, Jessica J Gu, Mwinyi Msellem et al. Malaria Journal 2013, 12:75 (22 February 2013) 17 pp. 150 kB: http://www.malariajournal.com/content/pdf/1475-2875-12-75.pdf Malaria transmission has declined dramatically in Zanzibar in recent years. Continuing use of preventive measures such as long-lasting insecticidal-treated nets (LLINs), and use of malaria rapid diagnostic tests (RDTs) are essential to prevent malaria resurgence. This study employed qualitative methods to explore community perceptions of malaria risk and adherence to prevention measures in two districts in Zanzibar. ***
Performance of two rapid diagnostic tests for malaria diagnosis at the China-Myanmar border area
by Juan Yan, Nana Li, Xu Wei et al. Malaria Journal 2013, 12:73 (22 February 2013) 18 pp.814 kB: http://www.malariajournal.com/content/pdf/1475-2875-12-73.pdf Rapid diagnostic tests (RDTs) have become an essential tool in the contemporary malaria control and management programmes in the world. This study aims to evaluate the performance of two commonly used RDTs for malaria diagnosis in the China-Myanmar border area. The authors conclude that compared to Polymerase Chain Reaction (PCR), both microscopy and RDTs had lower sensitivities. RDTs had similar performance to microscopy for P. falciparum diagnosis, but performed worse for P. vivax d iagnosis. Other RDT products should be selected with higher sensitivity (and good specificity) for both P. falciparum and P. vivax diagnosis. ***
This manual has been developed to help health care practitioners in communities, normally referred to as Community Health Workers (CHWs), to understand how and when to provide rectal artesunate for children seriously ill with malaria, and to help them to refer patients to the nearest facility after this initial treatment.
Tuberculosis A Media Guide on Reporting Tuberculosis Research and Related Issues in Uganda
by Milly Nattimba, Joseph Kawuma, Francis Adatu Panos Eastern Africa, June 2012 23 pp. 883 kB: http://www.panosea.org/Panosea/doc_92 This guide is designed to support the media in their role of social mobilisation, policy advocacy, awareness creation, and community engagement for tuberculosis (TB) management and control. It provides information on key and current TB research and related issues in Uganda, as well as guidance on the role the media can play in sharing and engaging voices of the public on these issues. ***
Developing and Strengthening the Global Supply Chain for Second-Line Drugs for Multidrug-Resistant Tuberculosis: Workshop Summary
by Anna Nicholson, Rebecca A. English, Rita S. Guenther et al. Board on Health Sciences Policy; Institute of Medicine, 2013 170 pp. 1.7 MB:
http://download.nap.edu/cart/download.cgi?&record_id=13524&free=1
To effectively treat patients diagnosed with drug-resistant (DR) tuberculosis (TB) and protect the population from further transmission of this infectious disease, an uninterrupted supply of quality-assured (QA), second-line anti-TB drugs (SLDs) is necessary. This public workshop explored innovative solutions to the problem of how to get the right SLDs for MDR TB to people who critically need them. More specifically, the workshop examined current problems and potential opportunities for coordinated international efforts to ensure that a reliable and affordable supply of high-quality SLDs is available. ***
Corticosteroids for prevention of mortality in people with tuberculosis: a systematic review and meta-analysis
by Julia A Critchley, Fiona Young, Lois Orton et al. The Lancet Infectious Diseases, Vol. 13, Issue 3, pp. 223-237, March 2013 15 pp. 324 kB:
http://download.thelancet.com/pdfs/journals/laninf/PIIS1473309912703213.pdf
The effects of corticosteroids are systemic, but their benefits in tuberculosis are thought to be organ specific, with clinicians using them routinely to treat some forms of tuberc ulosis (such as meningitis), but not others. The authors conclude that steroids could be effective in reducing mortality for all forms of tuberculosis, including pulmonary tuberculosis. However, further evidence is needed since few recent trials have assessed the effectiveness of corticosteroids in patients with pulmonary tuberculosis. ***
A comprehensive assessment of housing conditions and other socioeconomic determinants of Tuberculosis among dwellers in urban slum communities in Uganda
by Nikki Jeffery, Morris Lab, Ekwaro Obuku et al. Target Tuberculosis (Target TB) and International Medical Foundation (IMF), October 2011 95 pp. 2.4 MB: http://www.panosea.org/docs/pub/TB%20NA%20Research%20Report%20final% 20Dec%202011.pdf The study revealed that awareness of Tuberculosis (TB) was high but comprehension of cause, transmission, and prevention was low. Stigma at personal and community level was evident with majority perceiving their communities to reject TB patients. Although most residents were within reasonable reach to a health unit, significant barriers to health care were identified including: the lack of services, drugs or health care workers in facilities; transport costs and user fees. ***
On December 31, 2012, the US Food and Drug Administration (FDA) announced its approval of a new drug to treat multidrug-resistant tuberculosis (MDR-TB). The agency granted bedaquiline (Sirturo) fast-track approval, assessing its efficacy by a surrogate measure rather than an actual clinical outcome. When, as with bedaquiline, favourable findings on a surrogate measure run counter to data on clearly important clinical ou tcomes such as disease progression and death, the agency should withhold its decision until more evidence is available to resolve the conflicting signals, rather than being HESP-News & Notes - 05/2013 - page 17
obliged to make an approval decision prematurely based on what may turn out to be inadequate information. ***
Integrating tuberculosis and HIV services in low- and middle-income countries: a systematic review
by Helena Legido-Quigley, Catherine M. Montgomery, Palwasha Khan et al. Tropical Medicine and International Health - Vol. 18, No. 2, pp. 199-211; February 2013 13 pp. 147 kB: http://onlinelibrary.wiley.com/doi/10.1111/tmi.12029/pdf Given the imperative to scale up integrated tuberculosis (TB) and HIV services in settings where both are of major public health importance, the authors aimed to synthesise knowledge concerning implementation of TB/HIV service integration. They conclude that, while scaling up integrated services, robust comparisons of the impacts of different models are needed using standardised outcome measures. ***
Other Infectious Diseases Economic and Disease Burden of Dengue in Southeast Asia
by Donald S. Shepard, Eduardo A. Undurraga, Yara A. Halasa PLoS Negl Trop Dis 7(2): e2055 (21 February 2013) 12 pp. 596 kB:
http://www.plosntds.org/article/fetchObjectAttachment.action;jsessionid=505AFBF37520E326 E62C218958A86FB2?uri=info%3Adoi%2F10.1371%2Fjournal.pntd.0002055&representation=PDF
The authors estimated the economic and disease burden of dengue in 12 countries in SEA: Bhutan, Brunei, Cambodia, East-Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Viet Nam. They conclude that dengue poses a substantial economic and disease burden in SEA with a disability-adjusted life years (DALY) burden of 372 per million inhabitants in the region. This burden is higher than that of 17 other conditions, including Japanese encephalitis, upper respiratory infections, and hepatitis B. ***
Non-communicable Diseases Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020
World Health Organization, Revised Draft, 11 February 2013 47 pp. 546 kB: http://www.who.int/nmh/events/2013/revised_draft_ncd_action_plan.pdf Four categories of disease cardiovascular diseases, cancer, chronic respiratory diseases and diabetes make the largest contribution to morbidity and mortality due to noncommunicable diseases and are the main focus of the draft action plan. These four noncommunicable diseases can be largely prevented or controlled by means of effective interventions that tackle shared risk factors, namely: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol as well as through early detection and treatment. These major noncommunicable diseases and their risk factors are considered together in the draft action plan in order to emphasize shared aetiological factors and common approaches to prevention. ***
Comprehensive cervical cancer prevention and control: A healthier future for girls and women
World Health Organization (WHO), Department of Management of Noncommunicable Diseases (NMH/MND), February 2013 12 pp. 929 kB:
http://apps.who.int/iris/bitstream/10665/78128/1/WHO_IVB_13.02_eng.pdf
This WHO Guidance Note, that is part of the overall guidance WHO is issuing on Womens cancers, is aimed at senior policy makers and programme managers. It gives a broad vision of what a comprehensive approach to cervical cancer prevention and control means. It is not new guidance but summarizes existing WHO publications. In particular, it outlines the complementary strategies for comprehensive cervical cancer prevention and control, and highlights the need for collaboration across programmes, organizations, and partners. ***
The Burden of Non-Communicable Disease in Transition Communities in an Asian Megacity: Baseline Findings from a Cohort Study in Karachi, Pakistan
by Faisal S. Khan, Ismat Lotia-Farrukh, Aamir J. Khan et al. PLoS ONE 8(2): e56008 (13 February 2013) 9 pp. 177 kB: http://www.plosone.org/article/fetchObjectAttachment.action?uri=info%3Adoi%2F 10.1371%2Fjournal.pone.0056008&representation=PDF The present study was designed as a unique Framingham-like Pakistan cohort with the objective of measuring the prevalence and risk factors for hypertension, obesity, diab etes, coronary artery disease and hepatitis B and C infection in a multi-ethnic, middle to low income population of Karachi, Pakistan. The findings highlight the need to monitor risk factors and disease trends through longitudinal research in high-burden transition communities in the context of rapid urbanization and changing lifestyles. They also demonstrate the urgency of public health intervention programs tailored for these transition communities. ***
This paper discusses the potential consequences for Africas human and economic resources of the double disease burden facing the continent. The level of response by African governments and health systems to the rising non-communicable disease (NCD) epidemic and the extent of research and funding towards NCDs in Africa are also discussed. Furthermore, recommendations are made on ways in which to stem the tide of NCDs. ***
Food & Nutrition Toolkit on How to protect and Promote the Nutrition of Mothers and Children in Latin America and the Caribbean
by Marie Chantal Messier, Christine Macdonald, Susan Shulman et al. The World Bank - Human Development - Health, Nutrition & Population, January 2013 Access the toolkit at:
http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/LACEXT/EXTLACREGTOPHEANUT POP/EXTLACREGTOPNUT/0,,contentMDK:23342299~pagePK:34004173~piPK:34003707~theSit ePK:4160378,00.html
The aim of this toolkit is to inform changes in countries policies and practices and to guide their attempts to deal with persistently high prevalence rates of malnutrition among their poorest, least educated, and indigenous populations. In a single-source compilation, it offers clear guidance on cost-efficient interventions to assist countries in safeguarding the nutritional status of mothers and children during times of stability, crisis, and emergency. ***
Superfood for Babies: How overcoming barriers to breastfeeding will save childrens lives
by Frances Mason, Kathryn Rawe, Simon Wright et al. The Save the Children Fund, February 2013 75 pp. 2.9 MB: http://www.savethechildren.org.uk/sites/default/files/images/Superf ood_for_Babies_UK_version.pdf Superfood for Babies is a global call to action to rediscover the importance of breastfeeding and to support mothers to breastfeed their babies especially in the poorest communities in the poorest countries. The report puts forward a series of recommend ations to governments, international institutions and multinational companies to ensure that every infant is given the life-saving protection that breastfeeding can offer. ***
Estimating the relative contribution of parasitic infections and nutrition for anaemia among school-aged children in Kenya: a subnational geostatistical analysis
by Rachel L Pullan, Carol Gitonga, Charles Mwandawiro et al. BMJ Open 2013;3:e001936, (22 February 2013) 11 pp. 554 kB: http://bmjopen.bmj.com/content/3/2/e001936.full.pdf+html The study intended to quantify geographical variation in the relative contribution of parasitic infections, socioeconomic factors and malnutrition in the aetiology of anaemia among schoolchildren across Kenya, thereby providing a rational basis for the targeting of an integrated school health package. The observed geographical heterogeneity in the burden of anaemia attributable to different aetiological factors has important implications for the rational targeting of anti-anaemia interventions that can be included in an inteHESP-News & Notes - 05/2013 - page 22
Essential Medicines Nitrogen-14 Nuclear Quadrupole Resonance Spectroscopy: A Promising Analytical Methodology for Medicines Authentication and Counterfeit Antimalarial Analysis
by Jamie Barras, Darragh Murnane, Kaspar Althoefer et al. Anal. Chem., Publication Date (Web): February 5, 2013 8 pp. 345 kB: http://pubs.acs.org/doi/pdfplus/10.1021/ac303267v In the developing world, drug counterfeiters produce and sell antimalarial drugs that come in the same packaging as and look like drugs made by pharmaceutical companies. But these fake pills may contain too low a dose of the active compounds or lack them completely. A spectroscopic technique can spot counterfeit drugs with improper amounts of active ingredient even when the pills are still in their packaging. A selling point for the method is that the radio waves can penetrate paper and cardboard, so an inspector or doctor wouldnt have to break open a drugs packaging to analyze it. ***
Understanding public drug procurement in India: a comparative qualitative study of five Indian states
by Prabal Vikram Singh, Anand Tatambhotla, Rohini Kalvakuntla et al. BMJ Open 2013;3:e001987 12 pp. 607 kB: http://bmjopen.bmj.com/content/3/2/e001987.full.pdf+html The authors highlight critical success factors that significantly influence the outcome of any procurement model. The analysis indicated that autonomous procurement organisations were more efficient in relation to payments to suppliers, had relatively lower drug procurement prices and managed their inventory more scientifically. In a way, this study raises more questions and seeks the need for further research in this arena to aid policy makers.
Social Protection Social Protection Systems in Latin America and the Caribbean
Economic Commission for Latin America and the Caribbean (ECLAC) and Deutsche Gesellschaft fr Internationale Zusammenarbeit (GIZ), 2013 http://dds.cepal.org/socialprotection/social-protection-systems/ This site presents a series of national case studies which characterize two major components of social protection systems - non-contributory (traditionally known as social assistance, which can include both universal and targeted measures) and contributory HESP-News & Notes - 05/2013 - page 23
social protection (or social security). The case studies also discuss employment policies as well as social sectors such as education, health and housing, as their compr ehension is needed to understand the challenges for peoples access to those sectors in each country. ***
Transforming cash transfers: beneficiary and community perspectives on social protection programming
by Fiona Samuels, Nicola Jones, Paola Pereznieto et al. Overseas Development Institute (ODI), 21 December 2012 Cash transfers are predictable payments made directly to poor people. There is growing evidence that cash transfers have a range of positive effects, however the evidence varies it is strong, for example, on reducing poverty and hunger, and helping people to access health and education services. But it is weaker on more transformational effects; there is strong logic but little evidence of the effects of cash transfers on citizens voice, empowerment, gender equality, social cohesion and state-building. The following six country reports are the first of several sets of outputs from the research project: Transforming cash transfers: beneficiary and community perspectives on the Senior Citizen Grant (SCG) in Uganda Transforming cash transfers: beneficiary and community perspectives on the Palestinian national cash transfer programme - Part 1: the case of the Gaza Strip Transforming cash transfers: beneficiary and community perspectives on the Palestinian national cash transfer programme - Part 2: the case of the West Bank Transforming cash transfers: beneficiary and community perspectives on the basic social subsidy programme in Mozambique Transforming cash transfers: beneficiary and community perspectives on the cash transfer for orphans and vulnerable children programme in Kenya Transforming cash transfers: beneficiary and community perspectives on the social welfare fund in Yemen ***
Effects of unconditional and conditional cash transfers on child health and development in Zimbabwe: a cluster-randomised trial
by Laura Robertson, Phyllis Mushati, Jeffrey W Eaton et al. The Lancet, Early Online Publication, 26 February 2013 10 pp. 464 kB: http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673612621680.pdf Cash-transfer programmes can improve the wellbeing of vulnerable children, but few studies have rigorously assessed their effectiveness in sub-Saharan Africa. The authors conclude that their study results support strategies to integrate cash transfers into social welfare programming in sub-Saharan Africa, but further evidence is needed for the comparative effectiveness of unconditional cash transfers (UCTs) and conditional cash transfers (CCTs) programmes in this region. ***
Bolsa Famlia after Brasil Carinhoso: an Analysis of the Potential for Reducing Extreme Poverty
by Rafael Guerreiro Osrio and Pedro H. G. Ferreira de Souza The International Policy Centre for Inclusive Growth, March 2013 9 pp. 749 kB: http://www.ipc-undp.org/pub/IPCPolicyResearchBrief41.pdf The paper explains the changes in the design of the Bolsa Famlia Programme from 2003 to 2012. It focuses on the introduction of Brasil Carinhoso, an unconditional cash transfer aimed at eliminating extreme poverty in families with children aged less than 15 who are beneficiaries of Bolsa Familia. To achieve this, the extreme poor families r eceive an income transfers that is equal to the gap between the self-reported monthly family per capita income and the extreme poverty line. The authors suggest that given the small number of families without children aged 0-15 who are still in extreme poverty, the government could in fact extend the Brasil Carinhoso benefit to all families living in poverty. This change was actually announced by the Government of Brazil on the 19th February.. 2013
Water, Sanitation & Hygiene Handbook on Climate Change and Disaster Resilient Water, Sanitation and Hygiene Practices
by Kazi Shahidur Rahman, Arif Abdullah Khan, Hasina Akter Mita et al. WaterAid in Bangladesh, December 2012 68 pp. 2.8 MB: http://www.preventionweb.net/files/31324_31324climatechangean ddisasterresili.pdf Safe water, sanitation and hygiene are primarily public health concern. These are essential for healthy life and sustainable livelihood. This handbook focuses on safe water supply, sanitation and hygiene practice and considers specifically the rural context of Bangladesh. It discusses existing national policy structures and institutional system for HESP-News & Notes - 05/2013 - page 25
ensuring safe water, sanitation and hygiene practice as well the strategies to cope with the climate change and disaster induced uncertainties.
Human Resources Developing a new mid-level health worker: lessons from South Africas experience with clinical associates
by Jane Doherty, Daphney Conco, Ian Couper et al. Glob Health Action 2013, 6: 19282 10 pp. 128 kB: http://www.globalhealthaction.net/index.php/gha/article/viewFile/19282/pdf_1 Mid-level medical workers play an important role in health systems and hold great potential for addressing the human resource shortage, especially in low- and middleincome countries. South Africa began the production of its first mid-level medical workers known as clinical associates in small numbers in 2008. To sustain and expand on early achievements, clinical associates must be produced in greater numbers and the required funding, training capacity, public sector posts, and supervision must be made available. Retaining the new cadre will depend on the public system becoming an employer of choice. ***
Service delivery in Kenyan district hospitals -- what can we learn from literature on mid-level managers?
by Jacinta Nzinga, Lairumbi Mbaabu and Mike English Human Resources for Health 2013, 11:10 (26 February 2013) 20 pp. 1.0 MB: http://www.human-resources-health.com/content/pdf/1478-4491-11-10.pdf The authors examined literature on the roles of mid-level managers to help us understand how they might influence service delivery quality in Kenyan hospitals. In the Kenyan hospital settings, these are roles that head of departments who are also clinical or nursing service providers might play. This review highlights the possible significance of mid-level managers in achieving delivery of high-quality services in Kenyan public hospitals and strongly suggests that approaches to strengthen this level of management will be valuable. ***
Health workforce remuneration: comparing wage levels, ranking, and dispersion of 16 occupational groups in 20 countries
by Kea Tijdens, Daniel H de Vries and Stephanie Steinmetz Human Resources for Health 2013, 11:11 (28 February 2013) 27 pp. 212 kB: http://www.human-resources-health.com/content/pdf/1478-4491-11-11.pdf This article breaks new ground by investigating for the first time the wage levels, ranking, and dispersion of occupational groups in the HRH workforce across countries. The explorative findings illustrate that the assumption of similarity in cross-country wage HESP-News & Notes - 05/2013 - page 26
ranking holds, but that wage dispersion and wage levels are not similar. These findings might contribute to the policies for health workforce composition and the planning of healthcare provisions.
Health Systems & Research Preparatory Phase for submitting ideas on Research Networks for Health Innovation in Sub-Saharan Africa
Call for proposals of the German Federal Ministry of Education and Research (BMBF)
http://www.internationales-buero.de/african-health-networks/index.php
The BMBF is preparing a new initiative for advancing health research networks in and with Sub-Saharan Africa. The initiative aims at providing sustainable support for NorthSouth and South-South cooperation in health research and its links to medical education and training as well as to health services delivery. Please find at the above URL the call text for the preparatory measures, the guidelines for applicants, templates for calculating the budget of the preparatory measures and for the letters of intent and detailed information about the implementation phase in German and in English. The call text, the guidelines and the information about the implementation phase will be available also in French and Portuguese, soon. ***
Over the last ten years, Rwandas health system development has led to the most dramatic improvements of health in history. Rwanda is the only country in sub-Saharan Africa on track to meet most of the Millennium Development Goals. But there is disagreement about the reasons for the success. Some have claimed that Rwandas progress largely reflects high spending on health care, much of it financed by foreign aid. Substantial credit for Rwandas progress is due to the central government, including the Ministry of Health. Rwandas progress has not been uniform, however, and many challenges lie ahead. ***
This paper presents various scenarios on the African continent to illustrate why the conHESP-News & Notes - 05/2013 - page 27
tinent has little to show in terms of health outcomes, despite millions of dollars being poured into African healthcare systems. The paper further highlights the importance of improving certain aspects of these systems, such as resource management, combating corruption and the performance of health workers and facilities. Good governance in these areas has the potential to lead to functioning, effective and efficient healthcare systems.
Information & Communication Technology For the Sake of Inquiry and Knowledge - The Inevitability of Open Access
by Ann J. Wolpert N Engl J Med 2013; 368:785-787; February 28, 2013 3 pp. 467 kB: http://www.nejm.org/doi/pdf/10.1056/NEJMp1211410 It is difficult to have a measured conversation about open access - the term widely used to refer to unrestricted online access to articles published in scholarly journals. People who believe that free and unrestricted access to peer-reviewed journal articles will undermine the viability of scholarly journal publishing disagree sharply with those who believe that only open access can expedite research advances and ensure the availability of that same scholarly literature. Arguments for and against open access tend to focus on implementation details, ignoring the powerful motivations underlying the phenomenon. Related Articles: Open but Not Free - Publishing in the 21st Century http://www.nejm.org/doi/pdf/10.1056/NEJMp1211259 Creative Commons and the Openness of Open Access http://www.nejm.org/doi/pdf/10.1056/NEJMp1300040 The Downside of Open-Access Publishing http://www.nejm.org/doi/pdf/10.1056/NEJMp1214750 ***
Mobile Village Health Teams (VHTs) Support System Improving motivation and community health
Malaria Consortium, 2013 2 pp. 111 kB: http://www.malariaconsortium.org/media-library/mediafiles/201212180256-inscale---technology-arm.pdf The use of mobile phones is intended to increase the status of the Mobile Village Health Teams (VHTs) in their communities and allow frequent feedback and support from the VHT supervisors based on submitted data. This will provide the desired performance based feedback and promote connectedness to the health system. It will increase the frequency and quality of contact between supervisor and VHT through the establishment of closed user groups as a result of which VHTs will be able to make unlimited, free calls to each other and their supervisors. ***
Sustainable Financing for Mobile Health (mHealth): Options and opportunities for mHealth financial models in low and middle-income countries
by Tore Godal, Erick Gaju, Lisa Felton et al. mHealth Alliance and Vital Wave Consulting, February 2013 43 pp. 852 kB: http://www.mhealthalliance.org/images/content/sustainable_financ ing_for_mhealth_report.pdf While there is no longer doubt that mHealth is a viable strategy and tool for improving access, coverage and quality of care, as well as generating cost savings, the question of financial sustainability and ultimately Who pays for mHealth, and at which stage is the investment most needed and appropriate? poses persistent challenges and barriers to scale and investment. ***
Education Limited potential of school textbooks to prevent tobacco use among students grade 1-9 across multiple developing countries: a content analysis study
by Junko Saito, Daisuke Nonaka, Tetsuya Mizoue et al. BMJ Open 2013;3:e002340 7 pp. 183 kB: http://bmjopen.bmj.com/content/3/2/e002340.full.pdf+html Content analysis was used to evaluate if the textbooks incorporated the following five core components recommended by the WHO: (1) consequences of tobacco use; (2) s ocial norms; (3) reasons to use tobacco; (4) social influences and (5) resistance and life skills. A rather limited number of school textbooks in developing countries contained descriptions of prevention of tobacco use, but they did not fully cover the core components for tobacco use prevention. The chance of tobacco prevention education should be seized by improving the content of school textbooks.
Harm Reduction & Drug Use Impact of a stepwise introduction of smoke-free legislation on the rate of preterm births: analysis of routinely collected birth data
by Bianca Cox, Evelyne Martens, Benoit Nemery et al. BMJ 2013;346:f441 (Published 14 February 2013) 8 pp. 274 kB: http://www.bmj.com/highwire/filestream/631122/field_highwire_ar ticle_pdf/0/bmj.f441.full.pdf It is well known that smoking during pregnancy can stunt the growth of unborn babies and shorten gestation while second-hand smoke exposure can also affect births. But little was known about the impact of smoking bans on pre-term birth rates. This study shows a consistent pattern of reduction in the risk of preterm delivery with successive population interventions to restrict smoking. This finding is not definitive but it supports the notion that smoking bans have public health benefits from early life. ***
Mortality Attributable to Smoking Among HIV-1Infected Individuals: A Nationwide, Population-Based Cohort Study
by Marie Helleberg, Shoaib Afzal, Gitte Kronborg et al. Clin Infect Dis. (2013) 56 (5): 727-734 8 pp. 164 kB: http://cid.oxfordjournals.org/content/56/5/727.full.pdf In a setting where HIV care is well organized and antiretroviral therapy is free of charge (Denmark), HIV infected smokers lose more life-years to smoking than to HIV. The excess mortality of smokers is tripled and the population-attributable risk of death associHESP-News & Notes - 05/2013 - page 30
ated with smoking is doubled among HIV patients compared to the background population. ***
Exploring knowledge, attitudes, and practices related to alcohol in Mongolia: a national population-based survey
by Alessandro R Demaio, Otgontuya Dugee, Maximillian de Courten et al. BMC Public Health 2013, 13:178 (27 February 2013) 16 pp. 152 kB: http://www.biomedcentral.com/content/pdf/1471-2458-13-178.pdf Focusing on Non-Communicable Diseases and their risk factors, this publication explores the alcohol-related findings of a national Knowledge, Attitudes and Practices survey. The research suggests that Mongolia faces an epidemiological challenge in addressing the burden of alcohol use and related problems. The findings suggest a focus and context for public health measures addressing alcohol-related harm in Mongolia.
The World Federation of Public Health Associations executed a qualiquantitative survey to explore the opinion of public health professionals worldwide and their experience concerning the implementation and achievement of the Millennium Development Goals (MDGs) with a focus on sub-Saharan Africa. The respondents main activities focused on MDGs 4, 5, and 6. Their answers do not differ significantly between respondents position, WHO regions, and country's Gross National Income. ***
Health risk assessment from the nuclear accident after the 2011 Great East Japan Earthquake and Tsunami
by Makoto Akashi, Billy Amzal, Lynn Anspaugh et al. HESP-News & Notes - 05/2013 - page 33
A comprehensive assessment by international experts on the health risks associated with the Fukushima Daiichi nuclear power plant (NPP) disaster in Japan has concluded that, for the general population inside and outside of Japan, the predicted risks are low and no observable increases in cancer rates above baseline rates are anticipated. ***
Should trainee doctors use the developing world to gain clinical experience?
The annual Varsity Medical Debate - London, Friday 20th January, 2012 by Barnabas J Gilbert, Calum Miller, Fenella Corrick et al. Philosophy, Ethics, and Humanities in Medicine 2013, 8:1 (21 February 2013) 8 pp. 115 kB: http://www.peh-med.com/content/pdf/1747-5341-8-1.pdf The 2012 Varsity Medical Debate between Oxford University and Cambridge University provided a stage for representatives from these institutions to debate the motion "This house believes that trainee doctors should be able to use the developing world to gain clinical experience." This article brings together many of the arguments put forward du ring the debate, centring around three major points of contention.
ELECTRONIC RESOURCES
The Internet Resources Digest
compiled by Irina Ibraghimova HealthConnect International, January 2013 10 pp. 861 kB: http://www.healthconnect-intl.org/files/ir-bulletin/IRD_Jan13.pdf This issue is devoted to internet resources on evidence-based practice and policy in health care and social work in low- and middle-income countries. Although there is still some resistance to the evidence-based medicine movement, evidence-based health care has now become widely accepted and adopted. Wherever health care is provided and used, it is essential to know which interventions work, which do not work, and which are likely to be harmful. ***
Bulletin of the World Health Organization - Vol. 91, Nr. 3, March 2013
http://www.who.int/bulletin/volumes/91/3/en/index.html This issue includes articles on the following topics: A global elimination target for congenital syphilis? HESP-News & Notes - 05/2013 - page 34
Losing limbs and lives to landmines Rapid roll out of new tuberculosis test in South Africa Interview: Brazil and the yellow fever vaccine Tracking the effects of new vaccines Making medicines affordable in China Impact of WHO HIV/tuberculosis treatment guidelines in Cambodia ***
HIFA-Watch
Health Care Information for All (HIFA) by 2015 http://www.hifa2015.org/hifa2015-and-human-rights/hifa-watch/ Governments have a legal obligation, under international human rights law, to ensure progressively that all citizens and health professionals have access to the healthcare knowledge they need to protect their health and the health of others. HIFA-Watch will provide examples worldwide of positive and negative actions taken by governments that either promote or withhold the availability of essential healthcare knowledge for citizens and health professionals.
TRAINING OPPORTUNITIES
Regional workshop: Monitoring and Evaluation of HIV/AIDS Programs
6 - 17 May, 2013, Addis Ababa, Ethiopia This two-week course is offered in collaboration with Addis Continental Institute of Public Health and will provide intensive, hands-on training in the fundamental concepts and tools for monitoring and evaluation of HIV/AIDS programs. The course is aimed at mid-level health and population officers, program managers and other professionals involved with the implementation of HIV/AIDS programs in this r egion. For more information see: http://e2.ma/click/8he9g/kfcngl/0vnvsb or contact measure_training@unc.edu ***
Applications must be submitted to University of Pretoria by April 10, 2013. For more information, access the workshop brochure and application materials go to: http://e2.ma/click/s94bh/kfcngl/g0dfub
CONFERENCES
COHRED Colloquium on boosting sustainable investments into research and innovation for health
27 to 28 March 2013 - The International Conference Centre of Geneva, Switzerland The Council on Health Research for Development (COHRED) in collaboration with the Lancet Commission on Investing in Health will jointly host the third COHRED Colloquium. This edition of the Colloquium will focus on the investments that are required in research and innovation for health in order to meet the needs of low- and middle-income countries (LMICs). For more information on the third COHRED Colloquium, go to: http://www.cohred.org/colloquium2013/ mailto:colloquium@cohred.org ***
CARTOON
versions that are yours forever. There wont be any limitations that trial versions usually have, either. You can visit the website to get information about giveaways for that particular week or subscribe to their newsletter. Users can make sure they are downloading something worthwhile, because there are detailed software reviews for every title they have nominated. If you find software that seems interesting, make sure you act fast, because it is only available for 24 hours. ***