The United States is engaged in a historic debate over government's role in reforming health care. But on the continent of Africa, there is little debate that U.S. investment has reaped major rewards. Yet there, too, reforms are necessary.

By fighting measles, then AIDS and, more recently, malaria, the United States has partnered with African nations to help save millions of lives since the turn of this century. It's a remarkable achievement, and the American people have led; the American taxpayer should be proud.
So far things are going well in South Africa. My accommodations are nice and I am starting to become acclimated to the J'oburg suburb lifestyle. My work started here last Monday with a debriefing session with Stefan. We work out of a container that is on the property of a Catholic church. Each day there is a different task scheduled. On Tuesdays, we go to a little Protestant church in the informal settlement to meet with several of the women who are participants in a small savings and loan program called Village Savings Fund (VSF). Mostly all of the women have young children.

Engelina and Eva, two local women, lead these meetings and act as interpreters for Glenn and me. With such an attentive audience, it is the perfect venue to do health education. A retired health advisor, Mama Tandi, then discusses the current women's health topic. Last week, it was breast and cervical cancer. After the health talk, we begin the health screening. With the help of Engelina, Eva, and Mama Tandi, Glenn and I record height, weight, BP, and whether the children take breast milk, formula, or solid foods. We will continue to collect the data mostly to asses the health risks of obesity and hypertension.
Things are going well down here in the Southern Hemisphere. I've been here now for about 3 weeks and MAN has it flown by! Calandra Miller and I have both been comissioned to design and implement a needs assessment survey over the course of this summer. Project HOPE has about nine Village Savings Fund (VSF) groups set up and are being taught by 3 local volunteer workers (the majority of participants in these groups do not speak English, hence the need for these volunteers). The groups are comprised of about 20 women each, and the purpose is to educate these women on microeconomics. Ultimately, after undergoing the entire education course (which takes about 2 months of one day a week, weekly meetings), these women will have set up amongst themselves a system for both saving and loaning out money to group members. We're about halfway through the program with multiple groups right now, and Calandra and I have been going out with translators to survey these women on their progress. We are also obtaining a baseline survey for the orphans and other vulnerable children (OOVC) under the care of these VSF members with the same survey tool.

We can save a child for just $44
By William H. Frist

For the Journal-Constitution

Wednesday, May 27, 2009

Since swine flu grabbed the world's attention a month ago, 750,000 young children have died.

So you might wonder why nobody is talking about a pandemic of pneumonia or diarrhea -- the two biggest killers of these children.

One reason is that the word "pandemic" means worldwide epidemic.

In other words, there are more cases of a disease than normal, and they're occurring everywhere, even in the United States. Sadly, 25,000 children dying each day is "normal."

It's also widely unnoticed, because most of the young lives are lost in poor countries far away.

But most of these deaths are easily preventable. Why should we treat this as business as usual?

Through remarkably low-cost proven solutions and committed leadership, the United States can usher in an era where millions of mothers don't have to bury their babies within the first five years of life.

And we can accomplish the task with a smaller price tag than the well-spent money we've put toward the global fight against AIDS in the last several years.

What's grown to more than a $5 billion annual investment in the President's Emergency Plan for AIDS Relief has brought life-saving treatment for and prevention of HIV to millions.

It's also brought us goodwill and a safer and more secure planet.

For just a fraction of that money, Congress can follow President Obama's cue and prevent many more needless deaths of mothers and their children, and the incalculable suffering these bring.

I congratulate the president not only for pledging to continue his predecessor's initiatives to fight AIDS, malaria and tuberculosis, but for envisioning a new comprehensive global health strategy focused on the key interventions that will safeguard the health of mothers, newborns and children.

Now the dollars to do something about it must follow. U.S.-funded programs strengthen and expand the delivery of a package of basic child health interventions that cost about $44 per year per child.

These interventions, delivered by local health workers in clinics and in communities, include immunizations, breast-feeding and newborn care counseling, and treatment for childhood killers like pneumonia, diarrhea and malaria.

What a legacy for our 44th President to establish -- $44 to provide preventative and curative care to children in impoverished lands.

These affordable interventions work. If we double the $495 million the United States currently spends in this area, we could reach more than 22 million children with care and save more than a million lives each year.

Our leadership could encourage other G8 nations to make significant contributions of their own.

But our government must first commit the resources to make all of this happen.

Even as we grapple with a financial crisis and economic downturn, polling shows that the American people favor foreign aid that saves children's lives.

I've witnessed how powerful our contributions can be.

Every year I go to Africa, where I've seen expanded access to health care save lives and spread peace and goodwill.

In Sudan, men from different sides of the conflict showed up at a school where I performed surgery.

In Nairobi, I met a mother who named her young daughter America because U.S.-funded HIV treatments gave the girl a future.

Just think what wiping out millions of child deaths could mean to parents and societies around the world.

Let's lend the name of America to a new legacy that redefines normal for child mortality worldwide.

Former GOP Senate Majority Leader William H. Frist, a physician, is the chairman of Save the Children's Survive to 5 campaign.

Getting Healthy: Looking Beyond Health Care

Friday, May 15, 2009 -- PODCAST -- SEE WEBSITE


Where we live, learn, work and play can have an enormous influence on our health and well being.

Yet millions of working men and women and their families face almost insurmountable barriers to better health on a daily basis.

Many of these hurdles can't be cleared simply by choosing a healthy path. For example, many inner city and rural families have virtually no access to healthful foods. Many neighborhoods are unsafe for walking, let alone exercise. Children who do not receive high-quality services and education run a higher risk of becoming less healthy adults.

How much of Americans' overall health is related to these non-health care factors? Which factors are most important for good health? What policy changes could provide more opportunities for people to make healthy choices? The Robert Wood Johnson Foundation's Commission to Build a Healthier America recently offered a series of recommendations for policymakers and the public laying out a roadmap for building healthier communities.

To discuss these recommendations and questions, the Alliance for Health Reform and the Robert Wood Johnson Foundation sponsored a May 15 briefing. An expert panel drawn from members and staff from the commission included: former Senator Bill Frist of Vanderbilt University, a member of the commission; Paula Braveman of the University of California at San Francisco, principal researcher for the commission's work; and David Williams of the Harvard School of Public Health and staff director of the commission. Moderating were Robin Mockenhaupt of the Robert Wood Johnson Foundation and Ed Howard of the Alliance.



To address global poverty, first fight for global health

The Charlotte Observer
By William H. Frist
Special to The Observer

U.S. initiatives are building water and sanitation systems to help children in Mozambique. FILE PHOTO

Here's the fundamental truth: Developing countries will not grow out of poverty if their citizens are sick. As a physician, I've listened to people in the clinic beds of some of the world's poorest communities. They cannot think about lifting themselves out of poverty and contributing to the economic growth of their countries as they face daunting health risks.

U.S. support for global health – especially through the innovative use of development assistance – will continue to deliver life-saving returns. Recognizing that the interconnected world demands an integrated approach to global health, President Obama unveiled a bold initiative last week to invest $63 billion over six years in a comprehensive global health strategy. This smart use of resources improves the health of the world's poorest and strengthens the global economic climate for us all.

Healthy workforce is neededEconomists would argue that one of the surest ways out of poverty is for people to increase their incomes to take care of themselves and their families. For incomes to rise, developing economies must work to generate growth opportunities through trade and commerce, reliable infrastructure, and sound policies that create and sustain jobs for the poor.


When the poor are stricken by disease and weak health, they are unable to take advantage of these opportunities. Rather than climbing out of poverty, they fall deeper into it. It's clear that economic development and human development are intertwined. Growth needs a healthy workforce. The productivity and development of communities – and their ability to participate in the global economy – rely on the physical well-being of citizens to innovate, build, harvest, and work. Sustaining such productivity requires children to learn in school, not fall behind because they are too sick to concentrate. By building healthier, hopeful, and productive communities, we build safer and more secure societies that can alleviate global poverty and contribute to global prosperity. When communities are productive and thriving they don't become breeding grounds for dangerous extremism.

We need to rethink America's global health diplomacy within this context. It is more than doctor-patient relationships or medicines to relieve immediate symptoms. To date, Congress authorized billions to combat global HIV/AIDS, tuberculosis, and malaria to demonstrate America's commitment to this issue. These are important steps, but we must not overlook other factors that directly affect global health. Roads, for example, are essential not only to transport crops to market to generate livelihoods for farmers but also to provide them access to health clinics. Reliable water and sanitation systems are vital community services, but also reduce deadly water-borne diseases.

Development assistance through the federal government's Millennium Challenge Corporation takes a holistic approach to global health, laying the groundwork for poverty reduction and economic development. MCC awards assistance to countries already committed to practicing sound policies that invest in human development. The policy factors MCC uses to determine with whom to partner include a country's immunization rates, total public expenditure on health and commitment to combating corruption, which siphons resources away from healthcare.

Helping across the worldThese policies support results-oriented health programs, like building clinics, delivering immunizations, fighting HIV/AIDS, and expanding prevention initiatives. For instance, in Indonesia more than three million children under the age of one received measles and DPT3 vaccines. More than 3,463 participants attended awareness and prevention sessions in Cape Verde on HIV/AIDS and other sexually transmitted diseases. MCC partners are building roads to connect communities and health clinics. Mozambique is constructing water and sanitation systems. And, coordination between PEPFAR and MCC is strengthening health systems in Lesotho. By deepening support for effective development assistance, like MCC grants, Congress stands in solidarity with the world's poor and invests in their health and productivity.


Eradicating global poverty starts with the health of the world's poor. It starts with empowering them physically to contribute to the vitality of their countries. This benefits them as much as the rest of us, who want healthy partners with which to trade and do business. This makes as much good sense for the world's poor as for our collective international economic growth.

Republican former Sen. Bill Frist, M.D., is the former U.S. Senate Majority leader and a member of the Millennium Challenge Corporation's Board of Directors.

Leading U.S. and Russian Experts Hold Dialogue: Agree to Work toward Future Joint Initiatives in Global Health

Led by Fmr. Senate Majority Leader Frist and Russian Duma Committee on Health Protection Vice-Chair Gerasimenko

May 13 2009


Leading US and Russian Experts hold dialogue led by Fmr. Sen. Maj Leader Frist and Russian Duma Committee on Health Protection Vice-Chair Gerasimenko:


Agree to work toward Future Joint Initiatives in Global Heath


WASHINGTON, May 13, 2009 - The Center for Strategic & International Studies (CSIS) Russia-Eurasia Program and the CSIS Center on Global Health Policy yesterday (Tuesday, May 12) hosted a panel of twelve leading Russian and American experts in global health policy to examine their respective nations' experiences in infectious disease surveillance, health systems reform, chronic disease, and global health partnership and leadership.


Co-chaired by Senator William Frist, former Majority Leader of the U.S. Senate and CSIS Trustee, and Dr. Nikolai Gerasimenko, First Vice Chair of the Russian Duma's Committee on Health Protection, the panel discussion entitled, "U.S.-Russian Collaboration for Global Health," weighed new ideas for future Russian-U.S. joint initiatives.


During their talks, the joint Russian-U.S. panel identified four key areas which hold considerable promise for future collaboration, including:


1. Measures to lower health risks associated with tobacco and alcohol use, especially among young people, including public education strategies and coordinated international efforts.

2. Continuing dialogue on enhanced surveillance systems and improvements in data use to facilitate the improved management of infectious and chronic disease.

3. An annual U.S.-Russia forum on reform of national health systems, with a special focus on financing, cost controls, and evaluation mechanisms. This forum would have the flexibility to broaden participation to other interested countries.

4. Expansion of existing successful research, institutional twinning and professional exchange programs to include an increased focus on emerging issues such as challenges in health care reform.


The panel's discussions underlined a strongly shared interest between the two nations in developing Russian-U.S. partnerships in the health sector. Such partnerships underscored a confidence among the group that cooperation in the global health sector can enhance the promising strategic reengagement currently under way between Russia and the United States. Moreover, the panel agreed that joint cooperation in this arena can demonstrate tangible value to the American and Russian public.


The panel discussions revealed that both official and non-governmental entities have essential contributions to make to this effort. Russia and the United States are each in the midst of historic efforts to reform their national health systems, bring about greater efficiencies in complex federal forms of government, and create healthier and safer populations.


Each nation also exercises important leadership on critical global health issues, including surveillance systems crucial to detecting and responding to newly emerging threats.


During the Cold War, Russia and the United jointly pioneered new vaccine technologies for use in global small pox and polio campaigns, and over the decades Russia and the United States have developed extensive legislative, scientific and research exchanges. These efforts have provided important foundations for current and future collaborations, the panel agreed.


For more information about the panel's discussions, please contact, CSIS Vice-President for External Relations, H. Andrew Schwartz by emailing [email protected] or calling (202) 775-3242.





The Center for Strategic and International Studies (CSIS) is a bipartisan, non-profit organization that seeks to advance global security and prosperity by providing strategic insights and practical policy solutions to decision-makers.



H. Andrew Schwartz




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