American Journal of Tropical Medicine and Hygiene
June 2015; 92 (6)
http://www.ajtmh.org/content/current

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The Post-2015 Development Agenda: Keeping Our Focus on the Worst Off
Daniel Sharp and Joseph Millum*
Author Affiliations
Clinical Center Department of Bioethics, National Institutes of Health, Bethesda, Maryland; Fogarty International Center, National Institutes of Health, Bethesda, Maryland
Abstract
Non-communicable diseases now account for the majority of the global burden of disease and an international campaign has emerged to raise their priority on the post-2015 development agenda. We argue, to the contrary, that there remain strong reasons to prioritize maternal and child health. Policy-makers ought to assign highest priority to the health conditions that afflict the worst off. In virtue of how little healthy life they have had, children who die young are among the globally worst off. Moreover, many interventions to deal with the conditions that cause mortality in the young are low-cost and provide great benefits to their recipients. Consistent with the original Millennium Development Goals, the international community should continue to prioritize reductions in communicable diseases, neonatal conditions, and maternal health despite the shifts in the global burden of disease.

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Needs, Acceptability, and Value of Humanitarian Medical Assistance in Remote Peruvian Amazon Riverine Communities
Juan F. Sanchez, Eric S. Halsey, Angela M. Bayer, Martin Beltran, Hugo R. Razuri, Daniel E. Velasquez, Vitaliano A. Cama, Paul C. F. Graf, Antonio M. Quispe, Ryan C. Maves, Joel M. Montgomery, John W. Sanders and Andres G. Lescano*
Author Affiliations
U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru; David Geffen School of Medicine, University of California, Los Angeles, California; Universidad Peruana Cayetano Heredia, School of Public Health and Management, Lima, Peru; Alto Amazonas Health Network, Peruvian Ministry of Health, Yurimaguas, Peru; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Naval Medical Center, San Diego, California
Abstract.
Much debate exists regarding the need, acceptability, and value of humanitarian medical assistance. We conducted a cross-sectional study on 457 children under 5 years from four remote riverine communities in the Peruvian Amazon and collected anthropometric measures, blood samples (1–4 years), and stool samples. Focus groups and key informant interviews assessed perspectives regarding medical aid delivered by foreigners. The prevalence of stunting, anemia, and intestinal parasites was 20%, 37%, and 62%, respectively. Infection with multiple parasites, usually geohelminths, was detected in 41% of children. The prevalence of intestinal parasites both individual and polyparasitism increased with age. Participants from smaller communities less exposed to foreigners expressed lack of trust and fear of them. However, participants from all communities were positive about foreigners visiting to provide health support. Prevalent health needs such as parasitic infections and anemia may be addressed by short-term medical interventions. There is a perceived openness to and acceptability of medical assistance delivered by foreign personnel.