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Reporting from East Africa and Sudan

Gavin Yamey, the Senior Magazine Editor of PLoS Medicine, is currently on sabbatical from the journal after being awarded a “mini-fellowship” from the Kaiser Family Foundation to undertake a project as a reporter in East Africa and Sudan.

Shortly before he left, Gavin wrote the following blog outlining the project, the ideas, articles and interviews that led to the trip, and the key questions he will address in his reporting.

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Reporting from East Africa and Sudan

The Kaiser Family Foundation recently awarded me a “mini-fellowship” in global health reporting.  Sixteen journalists received this award, and their reporting will cover an enormously diverse range of topics, from Uganda’s use of DDT to control malaria to the role of needle exchange programs in the global fight against hepatitis C.

So what will I be doing with my fellowship?  I’m spending 6 weeks as a reporter in Uganda, southern Sudan, Kenya, and Tanzania, examining barriers and opportunities to scaling up low cost, low tech global health tools.  My particular focus will be on adult male circumcision for HIV prevention, insecticide-treated bed nets (ITNs) to prevent malaria, and cheap antimicrobial drugs for controlling neglected tropical diseases.

It was an interview that I did on National Public Radio in October 2007 that sparked the idea for this trip.  In August and September 2007, I contacted 30 people worldwide— clinicians, researchers, health reporters, health activists, development experts, members of communities living in poverty—and asked them to name the single intervention that they thought would do the most to improve the health of those living on less than $1 per day.  The responses, which I published as a debate article in PLoS Medicine, were striking in one particular way.  Almost all of the suggested interventions, such as ITNs, promoting breast feeding, and basic childhood vaccines, are low cost and low tech.  As the PLoS Medicine editors said in an accompanying editorial: “the global community easily has the financial and technical means to scale up all of these interventions immediately.”  I was invited to discuss my article in a live 15-minute interview with Ira Glass on NPR’s Science Friday on Talk of the Nation.  One of the most compelling questions that Ira asked me was: “If you could ask the respondents one follow up question, what would it be?”  I said that I would ask them about the barriers that are getting in the way of scaling up these crucial global health tools.

So in my trip to east Africa and southern Sudan, I will be exploring these barriers and how they can be overcome.  The successful mass scale up of cheap, basic global health tools would have a transformative effect on public health—particularly in low income countries that shoulder the world’s greatest burden of disease. In my reporting, I hope to address three provocative questions:

  • Why are these health tools not reaching all of the world’s poor?
  • What does science tell us about how we can overcome these barriers?
  • What can we learn from some of the implementation “success stories”?

I’ll be visiting clinics and hospitals, cities and remote rural villages, NGOs and ministries of health.  And I’ll be blogging from the field, whenever I can get Internet access, so I hope you’ll follow my progress.

Gavin Yamey

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