Rethinking the "big three" of global health.

The aim of CSIS's Mission to Kenya was to identify models of successful global health programs to help inform the Obama Administration's policy on international development (i.e., how to spend Obama's $63 billion budget for global health). Thus, my posts on CSIS's blog focused on two of the most unique features of AMPATH's model.  My first post (from yesterday) focused on how AMPATH works within the existing framework of Kenya's government. My second post focuses on the interrelationship between health and socioeconomics. Again, you can read it in context by clicking here (note: they posted it as one long entry rather than the intended two separate posts).  Or you can just read it right here:

When most people think of "global health" they think of disease.  Specially, they think of the big three:  HIV/AIDS, malaria, and tuberculosis.  But the model AMPATH has developed to respond to the health crisis in Sub-Saharan Africa demonstrates a much different understanding of global health.  AMPATH makes it clear that health can not be viewed as a medical condition alone.  In fact, most determinants of health are socioeconomic, not medical.   For example, antiretrovirals (ARVs) are largely rendered ineffective if a patient is undernourished.  ARVs are free in Kenya.  But food is not.  So HIV+ patients can get the drugs they need to stay alive, but without food the so-called Lazarus Effect can not commence.  Which is why AMPATH not only prescribes ARVs to its HIV+ positive patients, it prescribes food to patients who are undernourished.  Through it's network of vegetable farms, AMPATH  now provides over 40,000 patients with food per month.  Of course, to simply provide medicine and food to a patient population would just create a model of dependency - a pandemic in and of itself.    Enter FPI - AMPATH's robust portfolio of income security programs.  These programs help ensure that AMPATH is providing a hand up to those in need, not just a hand out.  Everything from microfinance to agricultural training, a handicraft workshop to a juice factory, and business consulting to a seedling nursery are designed to provide AMPATH clients the help they need to become self-reliant citizens capable of building a better life for themselves, their families, and their communities.  At AMPATH, health lies at the intersection of medical care, food security, and income stability.  Perhaps those of us in global health need to rethink what we mean by the "big three."

Comments

[avin]

good post (or series of posts i should say).

i suppose it's part of overall efforts to promote nutrition, but does ampath work specifically on getting people access to clean water? isnt that an even less recognized global health issue than hunger? curious to hear your thoughts on orgs like charity:water and how/if they are helping/complimenting efforts.

[Chris Murphy]

thanks, avin. clean water is definitely a critical issue. we've got a team of engineers developing a plan to provide all our clinics, farms, and patients with clean water. the major issue with the existing water infrastructure is poor quality construction and little to no maintenance (apparently, there is no word in Kiswahili for maintenance). and for those fetching their water from nearby rivers, lakes, and ponds it's an issue of water treatment education and affordable in-home technologies (i.e., ceramic filters). i like that charity:water uses a range of solutions to provide clean water, including well rehabilitation. i'm not aware if they have a maintenance training program incorporated into their efforts, but it would be great if they do. seems to be one of the critical missing components to many clean water schemes.

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The aim of CSIS's Mission to Kenya was to identify models of successful global health programs to help inform the Obama Administration's policy on international development (i.e., how to spend Obama's $63 billion budget for global health). Thus, my posts on CSIS's blog focused on two of the most unique features of AMPATH's model. My first post (from yesterday) focused on how AMPATH works within the existing framework of Kenya's government. My second post focuses on the interrelationship between health and socioeconomics. Again, you can read it in context by clicking here (note: they posted it as one long entry...

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