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The Latest News from the World of Public Health Profiles by Mike Field UGANDANosa Orobaton In Africa, where the full force of the AIDS epidemic has hit hardest, governments and service providers have come to recognize the need for urgent, coordinated action through a broad spectrum of entities. Nosa Orobaton, MPH ’90, DrPH ’95, is a leading advocate for this new approach. He believes that in order for the fight against AIDS to succeed, it will need to enlist clinics and schools, governments and private employers, UN agencies and NGOs, foreign aid providers and for-profit specialists—many of which have worked in isolation from one another in the past—in a common effort to reverse rising rates of infection and death. Nosa Orobaton (right) and Karungari Kiragu-Gikonyo, PhD ’91, discuss a proposed research study of health workers affected by HIV/AIDS in Zambia. “In Zambia I had a staff of 32 physicians, pediatricians, obstetricians, public health specialists, and others who provided technical assistance to the Ministry of Health and the Central Board of Health,” Orobaton says. Charged with expanding the delivery of quality HIV/AIDS services at the community level while increasing the organizational effectiveness of key Zambian institutions responsible for fighting the epidemic, Orobaton led the John Snow effort in expanding the role of the for-profit private sector in the fight against AIDS. “We have had great success in expanding and promoting the concept of HIV prevention and management in the workplace,” Orobaton says with some satisfaction. “We helped start a new NGO that is doing incredible work with the corporate sector, helping companies such as Citibank, Zambia Breweries, Coca-Cola, and others develop HIV/AIDS services for their personnel. Shortly before I left, a number of private companies began discussing funding an insurance company to pay for the antiretroviral drugs used in controlling AIDS.” Moving the fight against AIDS into the workplace is in part a matter of necessity. Orobaton notes that the most recent government survey in Zambia found HIV infection rates ranging from 8 percent to a high of 22 percent by province. “Every family is affected and HIV pervades virtually every aspect of the health system,” he says. “There is a shortage of workers to operate the health centers. Even our own staff is affected; several precious health workers have either died or are chronically ill.” In the rural areas, farms go untended as the disease devastates entire communities. Only through intense and coordinated cooperation, he believes, will nations like Zambia begin to stem the tide of devastation. Recently, USAID helped create the Zambia Integrated Health Project, coordinating the efforts of four entities, including John Snow, Inc., and the Johns Hopkins Center for Communication Programs. Orobaton calls the result “a first-class program” that is able to effectively build upon the expertise of each of its entities. “We had to devise ways of strategizing cooperatively, to make the whole greater than the sum of its parts. This is the future of fighting AIDS in Africa.” |
