Global Health Articles from The Lancet

A few articles to consider:

A commentary on the Gates Foundation's priorities for Global Health. The authors argue that the funds are too heavily weighted on new technologies that will take decades to produce, whereas "two-thirds of global child deaths could be prevented if existing interventions were fully implemented..." Currently over 10 million children die each year. The vast majority of these are preventible. The authors also take issue with the 'poor correlation between fudning and childhood diesease burden." Again, where the Gates Foundation has a strong focus on select diseases (malaria, TB, HIV) the majority of child deaths are due to different diseases: pneumonia, diarrhea, malnutrition. The Lancet Editorial has words of both praise and admonition. An original paper looks at how the Gates Foundation is spending its money, and who it is giving its money to, concluding: "The findings of this report raise several questions
about the foundation’s global health grant-making programme, which needs further research and assessment."


In 2004 the WHO published a handbook on Home-Management of Malaria.
"Home management of malaria is the presumptive treatment of febrile children with prepackaged antimalarial drugs that have been distributed to households by members of the community; diagnostic tests are not used." Rural areas have been targets of this intervention due to higher incidence of malaria and poorer access to health services. An original article in The Lancet looked at home management in urban Uganda. The authors concluded:
"Although home management of malaria led to prompt treatment of fever, there was little eff ect on clinical outcomes. The substantial over-treatment suggests that artemether-lumefantrine provided in the home might not be appropriate for large urban areas or settings with fairly low malaria transmission." However, a commentary disagreed.

Finally, a letter from the Director-General of WHO, Margaret Chan, argues the case for "Primary health care as a route to health security."