Sunday, May 10, 2009

Happy Mothers day and Reflection


We wish you a very happy, wonderful, and happy mothers day.

Appropriately Mr. Nicholas Kristof from the NYT has given us a gift of reporting on a condition that effects both mothers and children, yet remains largely under funded with few direct advocates. Mr. Kristof reports that childhood pneumonia is an illness that is easy to treat, yet more than two million children die each year in developing countries. Thanks again to the herculean advocacy efforts of Lance Laifer the world is becoming better acquainted with a condition that Mr. Kristof states will kill almost twenty children in the five minutes it will take to read his column or my blog.

Though we are reminded that part of the challenge of advocating for childhood pneumonia is typically the condition can be a secondary infection caused by a primary underlying condition such as upper respiratory disease, HIV, malaria and malnutrition. Actually many scientists and health officials will argue that malnutrition or under nutrition and health illiteracy by parents are the biggest root causes of disease.

This highlights the challenge of advocating for a disease versus channeling the energy and funding dollars to strengthen health systems and increase health literacy to improve primary health care services and tackle root causes of disease. Otherwise, if we target a specific disease, yet do not thoughtfully look to apply needed attention to strengthen the health delivery system, we may get a disproportionate investment in treating one disease versus improving overall health services for mothers and children.

For example I’ve worked with local health workers in Tanzania to help develop primary prevention programs to eradicate rheumatic heart disease (RHD) over the last 5 years. RHD is thought to be an entirely treatable and preventable condition (it was a leading primary and secondary cause of cardiovascular death in the US prior to the discovery of penicillin), yet we have millions of children and adults in the developing world suffering from this disease. However, my colleagues and I have learned that the root cause and treatment for RHD goes beyond screening for streptococcus A and handing out penicillin. The inability to eradicate RHD in the developing world also has also been effected by traditional focusing on disease specific programs versus strategic strengthening of systems to detect and prevent diseases among infants and children.

Lance and Bill; We know your reporting and advocacy work are making an amazing difference for mothers and children the world over. The world needs more people like you bringing attention to these conditions. Lets hope that the tremendous advocacy and resulting funding dollars are spent wisely to also focus on root causes of disease and strengthening primary care and prevention services. Otherwise, the world will continue to follow the treatment of one disease at a time strategy versus creating a system that promotes wellness and health for an entire community and village.

Happy Mothers Day to all!