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(page 2 of 3)

Mobilizing political leadership

Virtually all of the successful cases show the importance of visible, high-level commitment to a health initiative. In Thailand, for instance, the government showed strong leadership and vision in its early efforts to curb a growing HIV epidemic, making a bold commitment that led to one of the very few successes in HIV prevention on a national scale.

Individual champions are also key to rallying resources and international resolve. The near-eradication of guinea worm from Africa and Asia is due in large measure to the personal involvement and advocacy of U.S. President Jimmy Carter and former African heads of state General Toumani Toure and General Yakubu Gowon. These leaders visited endemic countries, mobilized the commitment of political and public health communities, and raised both awareness and financial resources. The guinea worm campaign also benefited from the participation of a wide range of partners, including UN agencies like UNICEF and the World Health Organization (WHO), private companies and foundations, NGOs, more than 14 donor countries, and the governments of 20 countries in Asia and Africa.

Making Technological Innovation Work

Many health improvements turn on the development of a new technology—a drug, vaccine, or pesticide—that is appropriate to the conditions of the developing world. New technology often permits an existing program to work

Many health improvements turn on the development of a new technology

more effectively, or achieve rapid health gains. The Latin American initiative to eliminate Chagas disease—a parasitic ailment that produces severe and sometimes fatal heart problems—gained great momentum in the 1980s, for example, with the development of a synthetic pesticide that was both more effective and more acceptable to the population than the earlier one.

For the technology to take hold, however, there must also be a concerted and large-scale effort to make it available at an affordable cost. Often this happens through a “public-private partnership” in which the private sector either donates the product or provides it at concessionary prices and the public sector (both national governments and donor agencies) take responsibility for distribution. These deals may be brokered or facilitated by international NGOs, such as The Carter Center.

Getting Expert Consensus

New strategies to fight disease are often based on expert agreement about what will work best, supported by solid evidence. For example, the World Bank and the WHO helped China revamp its fight against tuberculosis, the leading cause of death of Chinese adults. They recommended the introduction of DOTS (directly observed treatment, short-course) strategy, which is a way to package a variety of elements of successful TB control. At the heart of the approach is a system in which patients are watched by health workers as they take their medicine—a requirement to ensure that the full course of treatment is taken, and the risk of drug-resistance is minimized.

Subsequently, in 1991, China launched the world’s largest DOTS program, which resulted in a 37 percent decline in the disease’s prevalence. In Morocco, the government joined forces with the WHO and an international group of partners to launch a comprehensive strategy to both prevent and treat the blinding parasitic disease of trachoma in that country. The program included providing low-cost surgery, antibiotics, and a better water supply. Both the campaigns in China and Morocco proved the importance of having agreement among health experts. 1 | 2 | 3 | NEXT PAGE

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