A really impressive little story today, about how the Madagascan government and its people have 'got it right' in terms of improving public health. For a start, the island nation has the lowest rate of HIV infection in sub-Saharan Africa, due in large part to early and significant investment in sex education, condom promotion, HIV testing and targeting of high-risk groups. But it doesn't stop there. The government and its partners have also rolled out comprehensive programmes in malaria, childhood vaccination, nutrition and other services. The result? Child deaths have dropped by around 40% in recent years. It shows what can be done with leadership and commitment, and appropriate and timely external support in the right places. It makes me wonder why I don't hear more about Madagascan healthcare professionals sharing their knowledge with their African neighbours - let's hope that is happening, even if it's done quietly. Meanwhile, if the Madagascans sustain their own efforts, I have no doubt that health indicators will improve further and the country will be recognised as a model for others.
Monday, December 17, 2007
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There have been impressive improvements in health care in Madagascar which have led to impressive results. The worrying sentence in the report is that Madagascar "also has a high rate of sexually transmitted diseases, a sign of vulnerability to AIDS."
One estimate suggests that 30% of the population is infected with syphilis. The mismatch between HIV and STD infection is puzzling: could it be down to geography rather than preventation? Time will tell. As Madagascar become more affluent and attracts more migrant workers fron RSA, its health care system will be severely tested. Let's hope it is up to it.
Thanks Harry - interestingly, the disparity is the same in the UK (less so in the US), where there are now high rates of STIs such as chlamydia, gonorrhea and HPV, but HIV infection rates remain fairly low and largely confined to high-risk groups. This is common in many countries - and in many countries has been a stepping stone to the virus entering and then gaining a foothold in the general population. The UK public cannot afford to be complacent - not least since I don't think UK efforts to improve HIV awareness are nearly as impressive as Madagascar's, or at least they seem to resonate less... E
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