In 2009, Obama convened senior politicians in the Oval Office to discuss one magazine article: why were there Medicare costs of $15,000 per person per year in the Texan town of McAllen, when a neighbouring town had costs of $7,500 per person per year? Especially when the hospitals in McAllen were performing worse than its neighbour.

“He came into the meeting with that article having affected his thinking dramatically. He, in effect, took that article and put it in front of a big group of senators and said, ‘This is what we’ve got to fix,’” recalls one of the senators. more…

It has been a winter of discontent regarding the status of women in India, sparked by national outrage following the gruesome gang rape of a young trainee physiotherapist in Delhi. The spontaneous public protests have highlighted the need for reform to promote a gender-equitable society. Today, as we observe International Women’s Day, we also need to critically examine how the health system has responded to the needs of women in India. more…

Bridget Ugorji is a midwife at Hadejia General Hospital in Jigawa Northern Nigeria. On International Women’s Day, she shares her experiences of how the life saving skills training she received from Partnership for Transforming Health Systems is helping save the lives of women and newborns.

I am privileged to see a life join this earth every other day, although my heart breaks to watch mothers go through such agonising pain. I believe no woman should die while giving birth and this has been my driving motivation to save the lives of women and newborns in Hadejia community in Jigawa state, Northern Nigeria. more…

Vienna—Efforts to rid the world of dangerous medicines have been given a boost by the United Nations Office of Drugs and Crime. Delegates of UN member states, police, manufacturers, academics, and pressure groups gathered recently at UNODC headquarters in Vienna to discuss the present and future criminalisation of “fraudulent” medicines, which increasingly threaten the international supply chain and have led to recorded fatalities. The choice of meeting room—belonging to the International Atomic Energy Agency, where previously nuclear weapons reductions talks were held—added solemnity, perhaps unintentionally. more…

My recent visit to the Buruli ulcer ward run by Médecins Sans Frontières in Akonolinga Hospital, Cameroon, was both inspiring and disturbing. The care provided was state of the art, but the visit led me to imagine an ideal world in which we could close these wards and change the face of this disease dramatically. So why would a doctor want to shut down hospital wards?

Buruli ulcer is an infection acquired mainly in rural, remote, and tropical parts of west and central Africa, most commonly in areas with limited access to healthcare. It affects mainly children and causes necrotising, progressive, lesions usually on the limbs, but occasionally affecting the face or trunk. Untreated they can progress to cause significant tissue destruction and may result in permanent deformity and disability, or even limb amputation. The frustrating thing to all involved is that the mode of transmission remains unclear—it is hard to prevent something when you don’t know how you get it in the first place. Although it is estimated to be the third most common mycobacterial infection worldwide it remains significantly under researched. more…

This is an update of an earlier blog (15 November 2012 – here), which described what is happening around the global framework on non-communicable diseases, and how NCDs link into discussions on the successors to the Millennium Development Goals (due to expire in 2015) and the proposed new set of Sustainable Development Goals (as proposed at the Rio+20 conference in 2012). The full inclusion of NCDs within these processes will drive progress for decades to come. Recent developments merit an update of the blog – and I have, of course, included links wherever possible. As before, I have made every effort in this blog to be accurate and up to date as of mid-February 2013. For earlier information, see the website of C3 Collaborating for Health here. more…

A day in the life of a Chilean family doctor

She wipes her eyes with the backs of her hands. A thin circle of white skin against the dark tan of her left ring finger is the only visible sign of her recent loss. She sits in the ‘sala de espera’. Esperar, in Spanish, means ‘to wait’, but also ‘to hope’. She sits in the room of hope. A room where thirty other souls hope, and (this being a Catholic country) pray, that their lives may become a little better after the meeting with the medico. more…

Emma Bell, Susan Bewley, Silvia Petretti, Lynda Shentall, and Alice Welbourn.

Intimate Partner Violence (IPV) [1], increases the vulnerability of women and girls to acquiring HIV. Research from Asia, Africa, Latin America, and now the UK shows that gender based violence, of which IPV is one part, is also experienced by women with HIV—often precipitated or exacerbated by discovery of their HIV status. Indeed, even the seemingly benign offer of testing for HIV in pregnancy is, itself, potentially dangerous. Pregnancy alone is an established risk factor for partner violence and femicide and there are many international reports of women being beaten or raped by their partners upon an HIV diagnosis. They may be thrown out of their homes, lose custody of their children, have their confidentiality violated and have nowhere to turn for support. Such violence, be it psychological, physical, sexual, financial, or legal is devastating. But additional institutional violence from healthcare settings also happens. more…

There is a sense that if you are not working at something that helps counter climate change (or climate disruption, as it should be called) then you are wasting your time. You are Nero, and Rome is burning. Those of us who work on non communicable disease (NCD) are “lucky” in that most of what needs to be done fits with reducing the harm from climate change. The time has come for the “NCD agenda” to be integrated with the broader “sustainability agenda,” and this was the focus of a joint meeting this week between the London School of Hygiene and Tropical Medicine and the Lancet. more…

A mosquito buzzed idly against the window inside the coach. Was it carrying the dengue virus we wondered? And if it was, what is the chance of dying from dengue haemorrhagic fever?

Such questions run through your mind when you are in a country where the disease is endemic, and as the WHO has recently flagged up, this now exceeds a hundred countries. As the incidence of disease has increased steadily so has concern about its toll on health and economies. Being reminded of this was a good reality check for conference participants as we bussed up to a small community in the Saraburi province, around 150km north of Bangkok to see “community self reliance” in action. more…