The third anniversary last week of the start of South Sudan's ongoing civil war served only to reinforce how intractable that conflict has become. A peace deal is in tatters, along with the country's economy. With the return of the dry season, the combatants appear to be preparing for another round of fighting. And the United Nations is now warning of possible genocide. Read more.
Concerns over disease outbreaks — and the threat they pose to international security — will for the first time feature prominently on the agenda of the upcoming Group of 20 summit. A coalition of development and relief agencies is using the opportunity to push global leaders for stronger commitments to improve health systems in some of the world’s poorest countries. Read more.
Uganda’s Ministry of Education is set to shutter the 63 schools run by Bridge International Academies, whose pioneering model for low-cost, private education has drawn significant attention — and investments — from major international players, including Bill Gates and Mark Zuckerberg.
Bridge has expanded quickly since opening its first schools in Uganda in February 2015, with more than 12,000 students currently enrolled in its academies across the East African country. According to ministry officials, though, it did so without meeting national standards. Bridge officials refute the allegations, and some education experts cast them as part of a broader international campaign to stop the development of affordable alternatives to underperforming public school systems. Read more.
There is a need “for self-initiated products that women, especially young women, can and will use consistently. Women need practical and discreet tools that they can use to protect themselves from HIV infection,” said Dr. Flavia Matovu, an epidemiologist and investigator with the Makerere University-Johns Hopkins University Research Collaboration, based in Uganda.
Now, researchers including Matovu hope they may have an option in the vaginal ring, a flexible piece of silicon laced with an antiretroviral medication. Women insert it near their cervix, where it can safely remain for about a month, slowing releasing the drug at the site of a potential infection. The method is being tested in two crucial “open label” extension studies, wherein all willing participants will receive the medicated ring, rather than a placebo.
It has been more than 6 months since the last diagnosis of Ebola in Guinea, Sierra Leone or Liberia. The three west African countries suffered nearly all of the more than 28,600 diagnosed cases and 11,300 deaths during the outbreak that began in December 2013 in a Guinean village.
Although the outbreak has ended, the scale of the epidemic collapsed these countries' health systems, while unleashing new medical crises. The capacity to treat even basic illnesses is now limited, while health needs of Ebola survivors stretch the services that do remain. With Ebola having killed health workers at a disproportionate rate, the years-long efforts to rebuild the health systems are only just beginning. Officials in all three settings acknowledge that the task ahead is immense.
The success of a promising HIV prevention intervention in sub-Saharan Africa — the region with the highest burden of HIV — will hinge more on the social than the scientific. Researchers and advocates will have to strike a balance in how they market and roll out pre-exposure prophylaxis (PrEP). They have to ensure that it reaches stigmatized populations with high HIV transmission rates, such as MSM and sex workers. But they must ensure it is not perceived as exclusively a treatment for marginalized groups, which will lower its appeal both within those communities but also to other people who could benefit from it. Read more.
In a sharp rebuke to the United Nations, Kenya has started the process of pulling its troops from the U.N. peacekeeping mission in South Sudan. To make matters worse, Kenya is simultaneously disengaging from peace efforts in South Sudan, where a 15-month-old agreement to bring together warring parties was already on the verge of collapse. The moves by Kenya, which has been a key regional force in pushing for South Sudanese stability, could cement its failure. Read more.
Global interest in the conflict in Darfur has faded, allowing the Sudanese government to effectively seal off the region to outsiders and take control of the narrative. The narrative it presents, though, is not terribly cohesive: In early September, for instance, Sudanese President Omar al-Bashir traveled to Darfur to declare that peace had officially returned, just weeks after African Union-backed peace talks fell apart in Addis Ababa, Ethiopia.
As international priorities have shifted, though, there appears to be little interest among global powers in challenging the government’s take, even as the reality that does emerge in the few unsanctioned dispatches from the region clearly undermines the official account. That includes a recent Amnesty International report documenting ongoing government-sanctioned violence across much of the region since the start of 2016. There is evidence those attacks may have included the use of chemical weapons against unarmed civilians. Read more.
Update: I was on World Politics Review's weekly podcast discussing the diminishing possibility of peace in Darfur.
The Ethiopian government’s recently imposed state of emergency, which followed months of clashes between political protesters and security forces, has imposed new curfews, limited the movement of civilians and diplomats and outlawed opposition media.
It has also largely silenced the extensive international aid community operating in the country from speaking about what effect the current political dynamic is having on their work. Read more.
For millions of patients, HIV has been transformed into a highly treatable, chronic condition thanks to the development and distribution of increasingly sophisticated combination therapies. These advances have come with another unanticipated outcome, though. Researchers and health workers now worry they may lose patients they have saved from AIDS-related illnesses to non-communicable diseases, including cardiovascular disease, cervical cancer, depression, and diabetes. Read more.
Because of reporting requirements that are too stringent and time consuming, some Global Fund principal recipients have had to overhaul their organizations and have had to reject potential sub-recipients who could not meet the reporting standards. Read more.
The international public health community that has watched itsfinancing dwindle, even as scientific advances make it increasingly possible to actually end some of the world’s worst diseases. That includes HIV, officially the deadliest epidemic in history. The decline in global health funding threatens not just to stymie scientific advances against diseases like HIV, but to actually reverse gains made in the past decade. Read more.
Despite the many challenges to developing health markets in low- and middle-income countries, there are programs — often efforts to treat specific illnesses — that have shown enormous success in meeting the needs of some health consumers. Now, to improve markets, innovators in some places are looking to layer additional services onto those systems — and they are pursuing partnerships with a variety of actors in order to do so. Read more.
An interview with Claire Reading, a British midwife who is on her second mission with Médecins Sans Frontières (MSF), serving as a midwife supervisor at a primary care health clinic in the remote South Sudanese town, Bentiu. Read more.
Ugandan police interrupted the Mr. and Miss Pride Uganda pageant at Kampala’s Venom nightclub on Thursday night, detaining several well-known LGBT activists for about three hours before releasing them without charge. Read more.
Update: Uganda's remaining Pride events were later postponed. I contributed to BuzzFeed's report on the evolving situation.