Which intervention would do the most to improve the health of the extreme poor?

October 22, 2007

This week PLoS Medicine publishes a special collection of articles that aim to highlight the profound influence of poverty upon health, as part of the Council of Science Editors' Global Theme Issue on Poverty and Human Development (http://www.councilscienceeditors.org/globalthemeissue.cfm):

Please mention PLoS Medicine in your report and use the links below to take your readers straight to the online articles:

Which intervention would do the most to improve the health of the extreme poor?

For PLoS Medicine's special issue on poverty and health, the journal asked thirty commentators, including some of the world's most respected global health experts, to name the one intervention that would improve the health of those living on less than $1 a day.

The collected responses--from health researchers and activists, journalists, academics, and communities living in poverty--highlight effective, low tech, and remarkably cheap ways to make a profound difference to the lives of the poorest people on the planet.

Paul Farmer (Partners in Health and Harvard University) chose training of village health workers as the most effective intervention. "If we train village health workers, and make sure they're compensated," he said, "then the resources intended for the world's poorest--from vaccines, to bed nets, to prenatal care, and to care for chronic diseases like AIDS and tuberculosis--would reach the intended beneficiaries."

Other commentators, including Mushtaque Chowdhury (Bangladesh Rural Advancement Committee, Dhaka, Bangladesh) and Murugi Murekio (a health reporter in Ethiopia) stressed the crucial role of hunger alleviation. In Ethiopia, said Murekio, "antiretrovirals are free, but mostly women can barely afford a meal a day and so this diminishes their capacity to live healthily with HIV."

Jeffrey Sachs (Director of the United Nations Millennium Project) focused his response on prevention and treatment of malaria: "In tropical Africa, a mass distribution of free long-lasting insecticide-treated bed nets to fight malaria accompanied by free access to artemisinin-based combination anti-malaria medicines." But he added that he has "spent years objecting to posing the question this way, since at low cost we could achieve major health advances through more comprehensive approaches."

Many of the responses note the importance of the rich world fulfilling its obligations to the global poor, while other commentators highlighted the empowerment of women ("There's a saying that when you educate a woman you have educated a whole village," said reporter Rosebell Kagumire in Uganda), promotion of breastfeeding, provision of clean water, and childhood vaccination. Members of poor rural communities in Ayacucho, Peru, talked about the importance of housing, food, family, and social interactions--a view of health promotion that goes far beyond a strictly biomedical approach.

In a related Editorial, the PLoS Medicine editors argue that the global community "easily has the financial and technical means to scale up all of these interventions immediately--it has more than enough resources, for example, to distribute insecticide-treated bed nets and artemisinin-based combination therapy for malaria, train community health workers, promote breastfeeding, and vaccinate all children."

Citation: Yamey G on Behalf of the Interviewees (2007) Which single intervention would do the most to improve the health of those living on less than $ per day? PLoS Med 4( 0): e303.

PLEASE ADD THE LINK TO THE PUBLISHED ARTICLE IN ONLINE VERSIONS OF YOUR REPORT: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040303

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-10-yamey.pdf

Related PLoS Medicine Editorial:

Citation: The PLoS Medicine Editors (2007) Thirty ways to improve the health of the world's poorest people. PLoS Med 4( 0): e310.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040310

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-10-editorial.pdf

The PLoS Medicine editors


Executive Director of UNAIDS discusses links between AIDS and poverty

Peter Piot (Executive Director of UNAIDS, Geneva, Switzerland) and colleagues at UNAIDS explore the "downstream" effects of AIDS on poverty, and the "upstream" effects of poverty upon the risk of acquiring HIV.

Citation: Piot P, Greener R, Russell S (2007) Squaring the circle: AIDS, poverty, and human development. PLoS Med 4( 0): e314.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040314

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-10-piot.pdf

Sarah Russell
Joint United Nations Programme on HIV/AIDS
Geneva 27, CH 1211

How can we improve the health of those living in urban slums?

The defining physical and legal characteristics of slums profoundly affect the health of these communities and may also serve as potential targets for immediate intervention, argue Alon Unger (University of California, Los Angeles, USA) and Lee Riley (University of California, Berkeley, USA)

Citation: Unger A, Riley LW, et al. (2007) Slum health: From understanding to action. PLoS Med 4( 0): e295.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040295

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-10-unger.pdf

Alon Unger
University of California-Los Angeles
Departments of Medicine and Pediatrics
10833 Le Conte Avenue
12-335 MDCC, Mailcode 175217
Los Angeles, California 90095
United States of America
+1 415-238-6233

Can the international framework of children's rights be used to improve child survival rates?

David Gordon (University of Bristol, UK) and colleagues in the United Kingdom explain how the international framework of human rights can be better used to help reduce child poverty and improve child survival rates.

Citation: Pemberton S, Gordon D, Nandy S, Pantazis C, Townsend P (2007) Child rights and child poverty: Can the international framework of children's rights be used to improve child survival rates? PLoS Med 4(0): e307.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040307

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-10-gordon.pdf

Dave Gordon
University of Bristol
Townsend Centre for International Poverty Research
8 Priory Road
Bristol, BS8 1TZ
United Kingdom
+44-117-954 6761
+44-117-954 6756 (fax)

Using information technologies to conduct clinical trials in low income settings

Eva Harris (University of California, Berkeley, USA) and colleagues in the United States and Nicaragua report their experience of integrating information technologies in clinical and epidemiological studies of dengue infection in Nicaragua.

Citation: Avilés W, Ortega O, Kuan G, Coloma J, Harris E (2007) Integration of information technologies in clinical studies in Nicaragua. PLoS Med 4( 0): e291.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040291

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-10-harris.pdf

Eva Harris
University of California, Berkeley
Division of Infectious Diseases, School of Public Health
140 Warren Hall
Berkeley, CA 94720-7360
United States of America
+1 510) 642-4845
+1 510 642-6350 (fax)

Improving access to health care in the world's poorest countries

Brigit Obrist (Swiss Tropical Institute) and colleagues in Tanzania and Switzerland present a framework for analysis and action to explore and improve access to health care in resource-poor countries, especially in Africa.

Citation: Obrist B, Iteba N, Lengeler C, Makemba A, Mshana C, et al. (2007) Access to health care in contexts of livelihood insecurity: A framework for analysis and action. PLoS Med 4( 0): e308.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040308

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-04-10-obrist.pdf

Brigit Obrist
Swiss Tropical Institute
Department of Public Health and Epidemiology
Socinstrasse 57
Basel, Basel 4002
+41 61 2848163
About PLoS Medicine

PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http://www.plosmedicine.org

About the Public Library of Science

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