By Ifeanyi Nsofor
ABUJA, Sep 13 2019 – Two African women were recently appointed to top global health positions: Winnie Byanyima as the Executive Director of UNAIDS and Dr. Matshidiso Moeti reappointed as the World Health Organization (WHO) Regional Director for Africa.
Already, Ms. Byanyima is focusing on human rights as a way to end the AIDS epidemic, and Dr. Moeti’s priorities include ensuring more Africans have universal health coverage, preventing and managing disease outbreaks and promoting good health.
In these powerful roles, they should also prioritize addressing issues uniquely affecting women — from HIV to childbirth to infectious diseases — because when women are healthy, the society progresses.
Further, the health of women is a measure of a society’s level of development. As a father to two daughters, I am rooting for Ms. Byanyima and Dr. Moeti to succeed and leave the world healthier than they met it. This is what they can do.
Too many women still die while trying to give life. Globally, an estimated 830 women die due to pregnancy or birth related complications daily. The burden is more in developing than developed countries – a ratio of 239 versus 12 per 100,000 live births respectively
Thirty-eight million people were living with HIV and 23 million had access to antiretroviral therapy according to UNAIDS 2018 global data , women are disproportionately affected by HIV. For instance, in sub-Saharan Africa, 80% of new infections among adolescents aged 15–19 years are in girls.
Globally, young women aged 15–24 years are twice as likely to be living with HIV than men. An additional crisis is how of the 1.3 million pregnant women who were living with HIV, only 82% received drugs that would prevent mother to child transmission of HIV. Thus, the cycle of having above 180,000 new HIV infections in children aged 0-14 years continues.
Ms. Byanyima’s major focus around HIV infections should be to ensure that women of reproductive age have access to the right information to prevent new HIV infections and not give birth to a HIV-infected baby.
There is a solution already — Prevention of Mother to Child Transmission of HIV (PMTCT) reduces this risk from 45% to 5%, it just needs to be applied more broadly. Further, there are lessons UNAIDS can learn and share from Cuba and Malaysia, countries that have eliminated mother to child transmission of HIV.
Too many women still die while trying to give life. Globally, an estimated 830 women die due to pregnancy or birth related complications daily. The burden is more in developing than developed countries – a ratio of 239 versus 12 per 100,000 live births respectively.
The Maternal Health task Force at the Chan Harvard School of Public Health reports a 2013 reviewwhich showed that 5% of pregnancy-related deaths globally and 25% of pregnancy-related deaths in sub-Saharan Africa are attributable to HIV and AIDS.
Research shows that use of community drug keepers can prevent excessive bleeding after birth, which is the commonest cause of birth-related deaths, by up to 83%, even with low skilled attendance at birth.
Consequently, community health workers should be used to improve maternal health because they live and work in communities and are trusted by the people. They can accompany pregnant women to health facilities for antenatal services/birth and provide other supports that would reduce the stress of pregnancy.
Despite the strategic position of community health workers in improving health, most of them are unpaid. Therefore, Ms. Byanyima and Dr. Moeti should ensure that community health workers, who are mostly women are henceforth paid for their services.
The important work they do across communities globally should no longer be considered as mere volunteerism and if it is paid, more people could undertake the job and save more lives at childbirth.
It is inevitable that infectious disease outbreaks will happen and that they will spread quickly. An infection which begins in a remote location can get to major capitals within 36 hours.
Sadly, there is no African country that is fully ready for epidemics, based on scoring on preventepdemics.org. Women are usually the caregivers when family members are sick and bear the brunt of infectious disease outbreaks.
Dr. Moeti should use her influence as the Head of WHO Africa Office to advocate to African leaders to ensure all countries on the continent conduct a joint external evaluation to document their levels of preparedness for epidemics and engage with legislatures to appropriate more funds to national public health institutes for epidemic preparedness.
WHO should work with national and sub-national ministries of health to educate communities about epidemics and their roles in detecting, preparing and responding to disease outbreaks.
Partnership between UNAIDS and WHO AFRO is imperative. Therefore, Ms. Byanyima and Dr. Moeti should work together to achieve these objectives. The global health community will continue to hold both accountable and demand for improved services for women.