Global Health Initiative Document Mentions a Non Communicable Disease, But Barely









There have been several significant developments within the past few weeks concering the President's Global Health Initiative (GHI), a planned $63 billion six-year effort to tackle some of the globe's most persistent health problems.  Originally announced by President Obama in May 2009, the GHI is intended to "shape a new, comprehensive global health strategy," in all of the U.S. Government's global health efforts, and especially in a first group of eight "GHI Plus" countries. However, as many observers have noted, despite this laudable goal, the GHI is not actually comprehensive in that it generally does not deal with the global epidemic of non communicable diseases.

Within the past month, the Administration announced a new Executive Director for the GHI, Lois Quam.  In addition, the Administration created and debuted a new website devoted to the initiative.  And on the website, the Administration provided the very first details about how the initiative would be rolling out in one of the GHI Plus countries: Kenya.

Not unexpectedly, the Kenya strategy is primarily about infectious diseases, including HIV and neglected tropical diseases.  There is a strong focus on maternal, newborn and child health, as well.  These are important emphases that reflect major needs in Kenya, given the runaway prevalence of HIV, the observed prevalence of diseases like Leishmaniasis and Chagas, as well as the dramatic and negative statistics on maternal mortality

However, the same document also offers a window on how existing global health programming could also include, at little marginal cost, screening for conditions that can precede a non communicable disease.  In this case, buried deep in the first appendix for the Kenya strategy, is the following reference under the section on Antenatal Care: "improve screening for and management of cervical cancer (consider HPV vaccine)."  This cryptic line refers to the possibility of preventing the vast majority of cervical cancer by screening for the presence of the Human Papillovirus, and preventing infection from it by inoculating women with the HPV vaccine.  This simple and inexpensive procedure, common in the United States, could save as many as 1,600 deaths annually in Kenya.

But why stop with cervical cancer?  There are numerous other infections that could be screened for in women and children which can lead to fatal non communicable diseases: Epstein-Barr virus (which can lead to Burkett's Lymphoma) and Streptococcus (which can become chronic rheumatic heart failure) are just two additional examples, both of which afflict many Kenyans unnecessarily.

The bottom line is that with a little bit of prevention, and a modicum of creativity, the U.S. Government could transform its Global Health Initiative and its other global health programs into a much more comprehensive strategy. Is our government up to the challenge?  Maybe we'll find out at the UN High Level Session on Non Communicable Diseases, which will be held in New York, over September 19-20.

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