Marie is struggling today in the oppressive Haitian sun.

It's not that it's hotter than usual today, it's always hot here, but as the baby grows in Marie's womb, he takes the last of the nutrients out of Marie's already depleted body and today she feels it more than ever. She thinks of her other six children and remembers how hard their births were as she cried out on the dirt floor of her mud hut with only her sister to help her. She sees the faces of her two little ones that she laid to rest in that same dirt the year before.

(The Hill, May 28, 2013)

By Rep. Barbara Lee and Bill Frist

A Democratic Congresswoman and a former Republican Senator aren’t afforded many opportunities to work together. Especially at a time of fiscal crisis when every dollar is scrutinized and fought over, partisanship pushes us into opposite corners. But we agree on a program that truly has bipartisan support, saves millions of lives a year, and contributes directly to stability, security and economic growth worldwide.

Ten years ago this May, when the AIDS pandemic was at its worst, ravaging many African countries and a sure death sentence for millions, our country responded in an unprecedented way. We both, along with the late Republican Congressman Henry Hyde and the late Democratic Congressman Tom Lantos, worked with the Congressional Black Caucus and a bipartisan group of legislators to address this enormous problem. Soon after, in 2003, then-President George W. Bush instated PEPFAR, the President’s Emergency Plan for AIDS Relief, pledging $15 billion over five years to combat the spread of HIV, prevent further infections and improve access to care for millions of people across the globe.  Each year since then, Congress, with bipartisan support, has stood behind the program, providing critical funding to enable PEPFAR to truly help change the trajectory of the AIDS epidemic.

Now, a decade later, PEPFAR’s success isn’t just measured in dollars spent, but in lives saved and communities improved. The Institute of Medicine called the program “transformational” in global health.

PEPFAR has directly supported life-saving antiretroviral treatment for nearly 5.1 million men, women and children around the world, and is helping prevent hundreds of thousands of mother-to-child transmissions, an essential step toward achieving an AIDS-free generation. Engaging women is crucial to the broader goal; about half of the people living with HIV worldwide are women, and their empowerment is critical to beating this disease. PEPFAR supported HIV testing and counseling for more than 11 million pregnant women in 2012 alone.

Because of PEPFAR, we’re not just working toward an AIDS-free generation, we’re achieving an AIDS-free generation.

All around the world, PEPFAR is caring both for the health of the individual and the health of communities. The medications and programs supported by PEPFAR are so effective that people living with HIV/AIDS are doing just that — living. Infected individuals can care for their families and hold jobs. Communities enjoy economic stability. The United States earns a positive reputation.

But we are at a tipping point to truly realize this vision. If we back away now, the gains we’ve made will evaporate; the success we’ve had will disappear. Support of PEPFAR now is as important as it was 10 years ago.

HIV is a virus, not an ideology. Democrats and Republicans should be proud of PEPFAR’s legacy and continue to support it moving forward, providing the program with the robust funding it still needs to help achieve an AIDS-free generation.

Lee serves on the House Committee on the Budget and the House Appropriations subcommittee on State, Foreign Operations, and Related Programs, and is founding co-chair of the Congressional HIV/AIDS Caucus and represents the United States on the United Nations’ Global Commission on HIV and the Law. Frist is adjunct professor of surgery at Vanderbilt and Meharry medical schools and former majority leader of the U.S. Senate.

(The Hill, May 22, 2013)

By Senator William H. Frist, M.D.

On June 8, the United Kingdom, under the leadership of Prime Minister David Cameron, will host “Nutrition for Growth,” a high-level meeting where donor governments, including our own, will pledge funding and other commitments to address undernutrition and its devastating impact on the long-term health and productivity of millions of people in developing countries.

Sitting side by side with donors and foundations will be representatives of developing country governments, the private sector and civil society organizations, demonstrating the truly complex and multi-stakeholder nature of nutrition.

Malnutrition is one of the world’s most serious, yet least-addressed, development challenges. It contributes to almost 2.5 million young child deaths annually. Malnutrition is a serious drain on economic productivity, costing countries as much as 11 percent of GDP.

Close to 200 million children throughout the world are chronically malnourished and suffer from serious, often irreversible cognitive damage. Physically, undernourished children are stunted—smaller in stature than their well-nourished peers, more susceptible to illness throughout life, including noncommunicable diseases such as heart disease, cancer and obesity.

The case for greater leadership and investments in global nutrition is clear. The Copenhagen Consensus, an expert panel of economists that includes several Nobel laureates, concluded that fighting malnutrition in young children should be the top priority investment for policymakers. In the group’s report, they stated that every $1 invested in nutrition generates as much as $138 in better health and increased productivity. Similar studies have found that undernutrition causes between $20 billion and $30 billion in additional health costs every year to treat the long-term consequences of early childhood malnutrition.

While the problem is complex, the solutions don’t need to be. Cost-effective, evidence-based solutions exist. What we need are the resources and the political commitment to scale up proven nutrition solutions.  Political commitment in the form of presidential leadership and bipartisan congressional support works. We have seen it in the Global Fund, the President’s Malaria Initiative, the Millennium Challenge Corporation and the President’s Emergency Plan for AIDS Relief (PEPFAR).

We can do it again — this time to scale up and align nutrition investments. To follow the proven PEPFAR model, we should target resources to benefit the most vulnerable; align resources across all agencies and programs; focus on countries where we have committed partners and country-led strategies; and coordinate efforts internationally.

UNICEF reports that 1 in 4 children under the age of five is stunted and 80 percent of those children live in just 14 countries. The Lancet’s series on maternal and child health and nutrition highlights the 1,000 days from the beginning of pregnancy to a child’s second birthday as the critical window of opportunity for human health and development.

Like PEPFAR, we can target our interventions to benefit those most vulnerable to undernutrition, namely pregnant women and young children. We have commitments from more than 30 countries, which as part of the Scaling Up Nutrition (SUN) movement — a partnership of donors, developing countries, nongovernmental organizations and the private sector — have identified undernutrition as a severe impediment to economic development. A number of those countries have developed national nutrition plans that offer donors an opportunity to build upon and strengthen the country-led aspect of the investments.

We can begin by working with those committed country partners through bilateral and multilateral channels and offer our government’s technical expertise and best practices to galvanize a concrete investment strategy that includes innovative public and private partnerships and financing mechanisms.

There is an emerging international coordination effort for nutrition: the Nutrition for Growth event in London, last year’s G8 commitment to the New Alliance for Food Security and Nutrition, the UK-led Hunger Summit of 2012 and the growing Scaling Up Nutrition movement. These efforts will help the United States to share with other donors the cost of alleviating this global problem.

This is a critical moment for the U.S. to lead on global nutrition. The June 8 summit in London is the perfect opportunity for the Obama administration to announce a bold global nutrition strategy that outlines a multifaceted and multi-year approach to better coordinate and integrate nutrition resources across sectors and agencies, with clearly defined goals and targets, and with the dedicated resources necessary to achieve the strategy’s stated goals. Bipartisan leaders in Congress must step forward and commit to working with the president to make global nutrition a top priority of U.S. development assistance.

The moment for turning the corner on global nutrition is here, and it is time for our elected leaders to demonstrate anew how American leadership is the driving force for building a healthier, safer and more prosperous world.

William H. Frist, M.D. is a nationally acclaimed heart transplant surgeon, former U.S. Senate majority leader, the chairman of Hope Through Healing Hands and Tennessee SCORE, professor of surgery and author of six books. Learn more about his work at BillFrist.com.

It is with great pleasure that today we announce Global Health Service Corps (GHSC) is changing its name to Seed Global Health. As many of you know, we have been considering a name change over this past year to better capture the full scope and mission of our work and to better distinguish our cause. We believe this new name better represents our efforts to cultivate stronger, sustainable health systems through training new generations of physicians and nurses in countries where they are needed most.

Originally published in Roll Call.

A decade ago, as I was beginning my time as Senate majority leader, bipartisan consensus in Washington helped launch a new era of progress in global health just when it was sorely needed. Twenty years had passed since I first saw AIDS patients in Boston, though at the time we didn’t even have a name for this savage disease. Advances in treatment and technology were helping control HIV in the United States, but AIDS was decimating communities worldwide. There were tens of millions of infections, yet only 400,000 people in low- and middle-income countries had access to lifesaving antiretroviral therapy, meaning only a tiny fraction were able to escape death.

World leaders united to tackle AIDS and other scourges through an innovative financing tool — the Global Fund to Fight AIDS, Tuberculosis and Malaria. President George W. Bush and Congress made a founding pledge of $300 million to the international initiative. Bush, with bipartisan support from both chambers of Congress, also established the President’s Emergency Plan for AIDS Relief, the largest program ever to combat a single disease. President Barack Obama has similarly embraced this program and America’s role in eradicating this disease.

U.S. leadership at the Global Fund, and bilateral health programs such as PEPFAR and the President’s Malaria Initiative, signaled a renewed commitment to a core facet of our country’s greatness: compassion for those most in need. Understanding that improving global health is good for national security, economically prudent and — most importantly — the right thing to do, the U.S. taxpayers made an unprecedented investment in the world’s future.

That investment is paying off.

As we mark the 10th anniversary of PEPFAR this year, the number of people on lifesaving treatment has increased more than twentyfold. HIV infection rates are down. The number of malaria cases has plummeted by more than 50 percent. Tuberculosis mortality rates are falling steadily. The Global Fund alone saves an estimated 100,000 lives each and every month, working in more than 150 countries. These health gains were once unimaginable.

A new chapter in global health begins this month as visionary leader Dr. Mark Dybul takes the helm as executive director of the Global Fund. With so much gridlock in Washington, Dybul’s appointment is a reminder of what we can accomplish by reaching across party lines.

Dybul, who began as a physician treating AIDS patients in the early years of the pandemic, helped transform the fight against the disease as the architect and leader of PEPFAR. Now at the Global Fund, he will lead the charge to defeat AIDS, malaria and tuberculosis. Armed with scientific expertise and dedicated to a mission that goes beyond political ideology, there may be no one better suited for the job.

Today there is real hope in this fight — but it’s far from over. We have the science to help people with HIV live healthy lives, but millions still lack access to the treatment they need. We can detect and treat TB, but drug-resistant strains represent a growing threat, and disease respects no borders. And malaria still takes countless lives each year, though it can be stopped with basic, incredibly cheap prevention.

The next two weeks I found myself much better able to engage in the hospital system. Now I had learned the names of Benson, Mugo, Humphries all clinical officer or medical officer interns. It became my pleasure on night and weekend call to lead them through surgical triage or procedures. On subsequent calls I was able to help one of the medical officer interns through two chest tube placements. These patients had spontaneous pneumothoraces, but were not in extremis, thus I could take my time and coach the intern through the procedure. By the second placement, Mugo was able to anesthetize the patient appropriately, make the incision, and perform this life saving procedure. He remained a bit tentative, but I had seen vast improvement by this second time. These guys and gals are the front line of the Kenyan medical system, and are seeing patients in isolated places with no surgeons, or even residency trained physicians available. Teaching Mugo to place a chest tube well could benefit multiple Kenyan patients in the future.

FGHL Blog: Jason Axt - Extreme Medical Issues in the Field

Warning: This post contains graphic medical images.

Feb 28 2013

Warning: This post contains graphic medical images.

This week started with an orientation to the hospital. I learned where the theatres were, where the clinic patients were and the location of the wards. Patients were housed in common sleeping rooms with 4 – 20 patients per ward, with men and women housed separately. I was introduced to Dr. Irungu, the Kenyan consultant whose service I would join.
Spoiled. That’s the only way to describe how I feel heading back to the states. I feel that I had the opportunity to practice medicine the way my 6-year-old-self imagined it while in Guyana and I couldn’t be more thankful for the experience.
January 13

I can’t believe my time here in Haiti is over—but it is. I’m
writing this from my guesthouse in Port-au-Prince, in preparation for
my flight home tomorrow.

I would like to thank Senator Frist for forming the Frist Global
Health Leadership Program, and for allowing me to have come to Haiti
to work at HIC. I’d also like to thank the many people at Vanderbilt,
Dartmouth, and HIC who helped me make the needed connections and
organize the details of my trip. Last but not least, I’d like to give
a special shout-out to my boyfriend, for supporting and encouraging me
to leave him—and the U.S.—for three months and go work in Haiti.
Thank you.

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