Zika across the Americas, Ebola’s long goodbye, antiretroviral treatment stockouts in Uganda . . . We’re reading about realities on the ground

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NewWWRWHO Director General briefs Executive Board on Zika – “Questions abound. We need to get some answers quickly,” World Health Organization Director General Margaret Chan told the agency’s executive board in Geneva today. Actually, in the view of some experts acquainted with patterns of global pandemics, the answers on the Zika outbreak that will be provided by an emergency committee convened by Chan today are already running late. Her announcement today follows a spread of the virus across the Americas in 24 countries since Brazil reported its first case last May, and the emerging possibility in the time since that the virus is linked to a sudden and steep rise in babies born with microcephaly as well as to the paralyzing Guillain-Barré syndrome. The emergency committee, which will meet Monday, will decide if the outbreak is a public health emergency of international concern.

The Emerging Zika Pandemic – This JAMA opinion piece published Wednesday outlines the reasons the WHO action announced today is important, including the U.S. Centers for Disease Control and Prevention’s first travel alert for pregnant women, the urgent needs the continuing spread indicates for vector control, public health information, and research and development, all, as it points out, as “the 2016 Oympics in Rio De Janeiro loom.” Published before today’s announcement, it also questions why, in light of the lessons Chan has said the agency she leads learned following its delayed response to Ebola, WHO didn’t act sooner this time. The lead author, Dr. Daniel Lucey, who has responded to disease outbreaks around the world in the course of his career, and most recently during the Ebola crisis, has seen first-hand the difference timely steps can make, and the impacts of delay.

This country doesn’t want women to get pregnant until 2018 – As questions about both the results and responses to the spread of Zika virus await answers, this report on El Salvador’s recommendation that women there postpone pregnancies for the next couple of years provides a look at reality on the ground in a region with persisting unmet needs for family planning, where abortion is illegal under all circumstances, and where a woman can face arrest for miscarrying.

Shaken by Ebola setback, Sierra Leone probes health system readiness – From a young woman’s blood test taken by a nurse without protective clothing, to her precipitous discharge from care, to her traditional burial, the story of Sierra Leone’s first Ebola casualty following the November declaration that the outbreak was over, “sounds like it was plucked straight from the earliest days of Sierra Leone’s 2014 Ebola outbreak,” this Reuters report notes. Only it happened earlier this month, even as the World Health Organization expressed confidence in the strengthened systems and population of experts the Ebola crisis in West Africa left in its wake. This report takes a hard look at reasons, in the responses as well as the toll of the outbreak, why continuing to grapple with the disease, care for its survivors and respond to what the WHO calls expected “flare-ups,” will be an ongoing struggle.

Redemption in LIberia: a hospital’s painful recovery from Ebola – This report from Liberia, also from Reuters, shows the difficulties facing a hospital hobbled by the toll of Ebola as the emergency recedes, leaving long-term needs.

“It Hurts” — When Uganda Runs Short of HIV Drugs and Uganda: Limited Budget for ARVs Hinders HIV Fight – These articles, looking at shortages of the most effective tools against illness, deaths and spread of HIV show the ongoing denials of reality and human rights that have made a country once hailed for the apparent success of its AIDS response now a noted failure.

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