Gugu Xaba: making the most of a child’s first 1,000 days

Close-up of a newborn wrapped in a red blanket.

The first 1,000 days of life determine a child’s health and development, says Gugu Xaba. She leads our Window of Opportunity project to make sure kids get the best start. Photo: PATH.

Early in Gugu Xaba’s career, when she was still a community health nurse, she realized the difference she could make in the lives of her fellow South Africans. It was the early 1990s, and HIV was devastating people’s lives. Treatment was not yet available, and a solution seemed impossible.

Portrait of Gugu Xaba.

Gugu Xaba. Photo: PATH/Patrick McKern.

“I remember well the amount of counseling we had to do with people who were infected,” says Gugu, who now works with PATH’s program in South Africa. “The need to give hope when there was nothing.”

She knew she had succeeded when she saw a change in people’s eyes. “They came in with eyes that were despairing, but their eyes were calm when they left. They could see the reason to go on in life.”

A baby named Bokang

Eventually, the impossible became possible. Thanks to the efforts of the South African government and many organizations, including PATH, South Africans today are receiving treatment and living longer.

Gugu’s career took a turn, too. She earned a master’s degree in public health and worked at institutions including South Africa’s Department of Health, the Elizabeth Glaser Pediatric AIDS Foundation, and the US Centers for Disease Control. In 2012, she came to PATH to lead our Window of Opportunity project, which focuses on improving the health of children under the age of two.

These children often face dire health risks. South Africa has one of the highest rates of newborn mortality in the world—43,000 infants die every year. More than half of them are HIV-positive or exposed to HIV.

And 3.7 million children have been orphaned, including a little boy called Baby Bokang.

Watch this video to learn more about PATH’s Window of Opportunity project in South Africa.

Opening windows of opportunity

Both of Bokang’s parents were HIV-positive. Within a month of his birth, Bokang was abandoned by his mother, and his father died of HIV-related infections. He, too, is HIV-positive.

To help children like Bokang, the Window of Opportunity project is strengthening care over the course of the first 1,000 days of life—from a woman’s pregnancy to her child’s second birthday. Continue reading »

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Sophy Mabasa: a passionate advocate for the power of breast milk

Four adults and a toddler girl smile next to a decorated birthday cake.

Sophy Mabasa’s training in children’s nutrition took on new meaning for her when she had a family of her own. Photo: Sophy Mabasa

Sophy Mabasa

Sophy Mabasa. Photo: PATH/Patrick McKern.

There is school learning, and then there is learning from life. For PATH’s Sophy Mabasa, her degree in clinical nutrition came alive when she had her son, Rifumo.

“I used what I learned—getting regular antenatal care, exclusively breastfeeding Rifumo for six months, immunization—and it worked,” she says. “He was so healthy. It was amazing to see theory in practice.”

The steps Sophy took can be lifesaving, yet, as she knows too well, mothers and babies in South Africa, where she lives and works, miss out on them every day.

Dreaming big

“I grew up in Limpopo, which is one of the poorest provinces in South Africa,” says Sophy. “I was fortunate. I attended some of the best schools in the province, which helped me to dream big—to graduate from university and pursue a career that makes a difference in people’s lives.”

Sophy graduated as the top student in her program just after Nelson Mandela became president. The post-apartheid government was introducing new health programs for millions of underserved people. Sophy became an assistant director in nutrition for South Africa’s National Department of Health, an experience that deepened her commitment to advocating for breastfeeding.

“When I see children dying of malnutrition or HIV and I know that an intervention like breastfeeding can increase their chances of survival,” she says, “it really pushes me to do more.”

Sophy speaking to breakfast audience.

Sophy spoke at PATH’s Breakfast For Global Health event, telling an audience of PATH supporters in Bellevue, Washington, about her work as a specialist in maternal and child nutrition in South Africa. Photo: PATH.

Stop the transmission

South Africa has some of the highest rates of infant and maternal deaths in the world. HIV plays a big role—in some areas, one-third of pregnant women are HIV-positive. More than half of children who die have been exposed to HIV.

“Most South Africans, including myself, know someone who has lost a baby,” says Sophy. “Many know a woman who died in childbirth. Yet almost all of these deaths are preventable.”

Through her work at PATH, Sophy encourages women to practice what she did with Rifumo: exclusively breastfeed for six months to give infants the nutrients and immune support found only in breast milk. “Even if the mother is HIV-positive,” she explains, “breastfeeding actually reduces the risk of HIV transmission.”

Sophy is also helping to guide the implementation of human milk banks, which collect donor breast milk for vulnerable babies who otherwise wouldn’t have access to it.

Best for babies

There’s a story that Sophy shares that exemplifies the challenges she sees in South Africa and the potential. It’s the story of a baby named Sipho, whose mother was HIV-positive.

“Like many women in South Africa, Sipho’s mom didn’t attend the clinic regularly when she was pregnant. She had anemia, which wasn’t diagnosed until too late. As a result, she bled too much when she was giving birth to Sipho, and she died.

“Sipho was not only an orphan, he was premature, and he had been exposed to HIV. He desperately needed breast milk.”

Fortunately for Sipho, he was in a hospital with a human milk bank. But very few hospitals in South Africa can afford the high-tech pasteurizers that ensure donated milk is free of HIV and other pathogens.

Affordable and safe

Inspired by survivors like Sipho, PATH collaborated with the University of Washington and the Human Milk Banking Association of South Africa to develop an innovative, low-cost pasteurization monitoring system that uses a mobile phone application.

The app guides health workers through the process of heating donated milk over a burner and monitors the temperature to make sure the milk is heated just right—so no bacteria or viruses are left and no nutrients are destroyed. The system, called FoneAstra, was launched in four hospitals in South Africa and will soon be expanded to more.

“Sipho is HIV-free and doing well. He just started grade 1,” says Sophy. “He has been given the chance to achieve his potential and that is what we want for all of South Africa’s children.”


A prototype of the FoneAstra device for monitoring the temperature of breast milk using a smartphone. Photo: PATH/Steffanie Chritz.

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How 4 mothers are making life better for children

Because PATH focuses on saving lives and improving health, especially among women and children, we meet many remarkable mothers in the course of our work. No matter their location or circumstances, they share one trait: they are all working to provide a healthy life for the children in their communities.

To celebrate Mother’s Day in the United States, we honor four of these women, and their tenacious and loving dedication to making life better for children.

Savita Rai: adapting tradition to give babies a better chance

Woman in a yellow and pink sari holding a toddler kneels in a dirt yard, before a clothesline.

Savita Rai and her grandson, Aakash. Photo: PATH/Gabe Bienczycki.

In the Indian village of Amkoil, mothers-in-law like Savita Rai make the decisions in the house, such as whether a daughter-in-law will give birth in a health center and how she will care for her baby. When her daughter-in-law was pregnant, Savita attended a mother’s group where PATH-mentored teachers provided lifesaving information on childbirth and care. When the time came, she adapted her practices and made sure her grandson was born in a health center. “I’ve learned how to take care of the mother and child,” she says. “Now I’m not so worried about my daughters-in-law or my grandchildren.”

Jane Wamalwa: teaching others about deadly diarrhea

Woman in a blue t-shirt looks directly at the camera. Trees in the background.

Jane Wamalwa, who lost three children to diarrhea, helps other mothers understand how to help keep their children safe. Photo: PATH/Gabe Bienczycki.

Jane Wamalwa lost three young children to an illness that is both deadly and easily preventable: diarrheal disease. Jane, and other women in her rural Kenya community, knew little about what caused the illness and less about how to stop it. Selected by village leaders and trained by PATH, Jane is now a community health worker taking the fight against diarrhea door to door in her community. Her deeply personal understanding of the disease’s consequences makes her a powerful ambassador for the tools and techniques that can save children’s lives. Continue reading »

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10 years of inspiring stories, and breakfast

Guest contributor Karina Collins is senior events coordinator at PATH.

Young girl holding a cotton ball over an injection site on her upper arm.

Oceane, whose story we told at the 2011 Breakfast for Global Health, received a vaccine that will protect her against a devastating infection of the brain, meningitis A. Photo: PATH/Gabe Bienczycki.

This year, we celebrate the tenth anniversary of the Breakfast for Global Health, PATH’s annual fundraising event. Since the first Breakfast, the event has grown from a group of 100 supporters gathered in our conference room to an event with more than 1,000 attendees in two locations. This week, for the first time we’re having Breakfast in the city of Bellevue, on the east side of the Puget Sound region, as well as in our headquarters city of Seattle.

Graphic with text reading, "Breakfast for Global Health 2014 lead sponsors." Logo of McKinstry appears beneath the heading "visionary." Logos of Amazon, JP Morgan Chase, and Microsoft appear below the heading "partners."

Illustration: PATH/Shawn Kavon.

In ten years, we’ve told touching stories to thousands of people and raised millions of dollars to catalyze PATH projects. And even though the event has grown and changed, our purpose has always been the same: to come together and share our common belief that innovation can change the world and that there is a role for each of us in this work.

Behind the scenes at Breakfast

I start planning each Breakfast eight months in advance, and by the time you sign in for the event, I’ve seen your name on hundreds of spreadsheets and could probably tell you your email address off the top of my head. (Don’t worry. I won’t, because that would be weird.) I’ve made sure our featured speaker has arrived safely from another corner of the world. I’ve fact checked, proofread, ironed, folded, printed, and arranged hundreds of details all so you can experience and support PATH. Continue reading »

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JE vaccine: the affordable answer to Asia’s “brain fever”

A schoolgirl sits in a white plastic chair as a health worker administers vaccine in the girl's arm.

Photo: PATH/Aaron Joel Santos.

Each year, more than 2 million children die from just four illnesses: malaria, pneumonia, diarrhea caused by rotavirus, and Japanese encephalitis. To mark World Immunization Week, we’re profiling vaccine projects in our extensive portfolio that aim to protect children from these illnesses. Today, we look at vaccine against Japanese encephalitis, the first vaccine manufactured in China to receive World Health Organization prequalification.

Graphic with text reading, "International Immunization Week 2014. Four vaccines, millions saved: malaria, pneumonia, rotavirus, Japanese encephalitis."

Illustration: PATH/Shawn Kavon.

The challenge

Often called “brain fever,” Japanese encephalitis (JE) begins like the flu but quickly progresses to a brain infection that kills nearly one in three people with the virus. Among its survivors, up to half suffer permanent neurological damage, such as paralysis, recurrent seizures, or the inability to speak.

The disease mainly strikes children in poor, rural communities in Southeast Asia and the Western Pacific, where four billion people live at risk of JE. Up to 70,000 cases are reported annually. The fate of those who become infected is a guessing game—there is no treatment for JE. The only viable solution is prevention through vaccination.

The vaccine

In October 2013, the World Health Organization (WHO) gave its critical stamp of approval to an affordable JE vaccine to protect children from the virus. Through an innovative partnership with China’s Chengdu Institute of Biological Products (CDIPB), PATH helped to scale up the vaccine—which had been used successfully to protect more than 200 million of China’s children—and prepare it for WHO approval so that it could reach the roughly two dozen countries at risk of JE. Continue reading »

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Rotavirus: preventing killer diarrhea

A crying baby in its mother's arms is given a dose of oral vaccine.

After her children struggled with diarrheal disease, Teresa was determined to get one-month-old Vusi vaccinated as soon as she heard about the availability of rotavirus vaccine. Photo: PATH/Gareth Bentley.

Each year, more than 2 million children die from just four illnesses: malaria, pneumonia, diarrhea caused by rotavirus, and Japanese encephalitis. To mark World Immunization Week, we’re profiling vaccine projects in our extensive portfolio that aim to protect children from these illnesses. Today, we take a look at a vaccine to protect children from the most common cause of deadly diarrhea.

Graphic with text reading, "International Immunization Week 2014. Four vaccines, millions saved: malaria, pneumonia, rotavirus, Japanese encephalitis."

Illustration: PATH/Shawn Kavon.

The challenge

Rotavirus is as common as it is deadly. Nearly every child, rich or poor, is at risk of rotavirus infection, the most common cause of severe, dehydrating diarrhea. But 95 percent of rotavirus-related deaths in young children happen in low-income countries in Africa and Asia, where access to lifesaving care can be limited or unavailable. Vaccination is the best way to prevent rotavirus, which is highly contagious and resistant to traditional diarrhea prevention strategies like hand-washing and ensuring a clean water supply.

The vaccines

ROTAVAC® is a new vaccine awaiting licensure in India that could transform the fight against rotavirus. At a cost of just $1 per dose, ROTAVAC will protect children at a fraction of the price of currently available rotavirus vaccines. PATH was part of a cross-sector partnership led by the government of India that developed the vaccine, providing technical support on pivotal clinical trials and manufacturing issues. PATH also is working with manufacturers in China, India, and the United States to advance other promising rotavirus vaccine candidates, some of which are now in clinical trials. Continue reading »

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Pneumonia: smart vaccines to fight the number one child killer

Two young children, one with her arm around the other.

Pneumonia kills more young children than any other disease—about 1 million every year. Photo: PATH/Mike Wang.

Guest contributor Laura Anderson is an editor at PATH.

Each year, more than 2 million children die from just four illnesses: malaria, pneumonia, diarrhea caused by rotavirus, and Japanese encephalitis. To mark World Immunization Week, we’re profiling vaccine projects in our extensive portfolio that aim to protect children from these illnesses. Today, we look at the need for a new kind of vaccine against pneumonia. 

Graphic with text reading, "International Immunization Week 2014. Four vaccines, millions saved: malaria, pneumonia, rotavirus, Japanese encephalitis."

Illustration: PATH/Shawn Kavon.

The challenge

Pneumonia kills more children worldwide than any other disease. Last year, it took the lives of more than a million children—3,000 every day—primarily in the world’s poorest countries.

Poor access to sanitation and safe drinking water, a lack of health care, and inadequate diagnostic tools all contribute to pneumonia’s toll. Often, parents don’t recognize children’s symptoms in time, and when they do, lifesaving care may be miles—or even days—from their homes.

Meeting these challenges requires a combination of approaches. For more than ten years, vaccines have been a particularly powerful ally. Last year, immunization against the leading cause of pneumonia, the pneumococcus bacterium, saved thousands of lives in more than 100 countries. Yet existing vaccines are complicated to manufacture, too expensive for many low-resource countries, and don’t offer complete protection against disease. To beat pneumonia, we need to keep improving our tools. Continue reading »

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Malaria: is vaccine against a parasite possible?

Five smiling mothers hold their young children on their laps while health workers look on.

These children in Tanzania are among more than 15,000 African children participating in a phase 3 trial of RTS,S, the most clinically advanced malaria vaccine candidate. Photo: PATH/David Poland.

Each year, more than 2 million children die from just four illnesses: malaria, pneumonia, diarrhea caused by rotavirus, and Japanese encephalitis. To mark World Immunization Week, we’re profiling vaccine projects in our extensive portfolio that aim to protect children from these illnesses. Today, World Malaria Day, we look at progress toward a vaccine that promises to be the first to provide humans with protection from a parasite.

Graphic with text reading, "World Immunization Week 2014. Four vaccines, millions saved: malaria, pneumonia, rotavirus, Japanese encephalitis."

Illustration: PATH/Shawn Kavon.

The challenge

How do you stop a complex and adaptable killer that has survived for millennia?

Malaria is responsible for the deaths of more than 600,000 people each year, mostly children in sub-Saharan Africa. And every year, it sickens some 200 million others. While drugs and insecticides save millions of lives, the mosquito-borne malaria parasite is developing resistance to both. A safe, effective, and affordable malaria vaccine could close the gap in interventions.

The vaccine

A vaccine that protects people from a human parasite has never been developed before, and until recently, many people thought it was impossible. But PATH, through our Malaria Vaccine Initiative, is working with many partners to accomplish an important goal of the malaria community: develop a first-generation vaccine that cuts the number of episodes of malaria in young children by about half, with protection lasting for more than one year. Continue reading »

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Our goal: defeat malaria forever

Woman holding toddler in her mud-brick home, standing in front of a bednet hung above a mattress.

Sharon Atieno shares a mosquito net with her husband and two-year-old son, Ronald. Photo: PATH/Eric Becker.

Guest contributors Dr. Carlos C. (Kent) Campbell and Bindiya Patel wrote this post to commemorate World Malaria Day. Kent is leader of our Malaria Control Program. Bindiya is a strategy officer at PATH.

Portraits of Kent Campbell and Bindiya Patel

Kent Campbell and Bindiya Patel. Photo: PATH.

Ending malaria is a priority at PATH, and we are proud to be a key contributor to an emerging global campaign that is intensifying the control of malaria illnesses and deaths around the world.

PATH’s portfolio of malaria programs has grown exponentially since our first malaria projects were launched in the 1990s. The span of our program experience, expertise, and available technologies has expanded to meet the rising opportunity to stop transmission of malaria infections altogether.

PATH now employs 115 staff across a diverse portfolio of malaria projects, working with 29 countries and a combined annual budget of $79 million. We take a multipronged approach in fighting the disease through optimizing the use of current strategies and technologies, developing the next generation of tools, and working with countries to demonstrate how to rapidly bring down childhood and maternal deaths from malaria—with the ultimate goal of eliminating the disease community by community.

We can’t stop at malaria control

Not only is PATH’s goal to intensify the development of strategies and tools to reduce the burden of malaria and build toward the eventual elimination of the disease, our experiences over the years have shown us that this must be the long-term goal of all malaria programs, partners, and endemic countries.

Defeating  malaria—and forever ending the well-documented risk of resurgence—is the only long-term goal. Some may argue that sustained control of the spread of malaria is more feasible or cheaper, but simply put, malaria control is not and cannot be an endpoint. Rather, it is part of the natural evolution of malaria programs as they move from an initial phase of scaling up efforts to achieving significant reductions in malaria illnesses and deaths and eventually clearing malaria infections in all people. Continue reading »

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10 reasons vaccines are the best protector of human life

Schoolgirl with a broad smile recieves a shot in her upper arm as her schoolmates watch.

Every year, vaccines save the lives of between 2 and 3 million children. Photo: PATH/Aaron Joel Santos.

Immunization is one of the most powerful health interventions ever introduced. Every year, the World Health Organization estimates, vaccines save between two and three million children from killers such as polio, measles, pneumonia, and rotavirus diarrhea.

To mark World Immunization Week, which begins tomorrow, over the next week we’re reporting on the lifesaving potential of vaccines against four illnesses that kill more than 2 million young children a year: malaria, pneumonia, rotavirus, and Japanese encephalitis. Today, Dr. John Boslego, director of our Vaccine Development Program, gets us started with his list of the top 10 ways vaccines make a difference for children and for global health. His post originally appeared on our sister blog, DefeatDD.

Graphic with text, "World Immunization Week 2014, four vaccines, millions saved, malaria, pneumonia, rotavirus, Japanese encephalitis."

Illustration: PATH/Shawn Kavon.

No. 10: Vaccines lower the risk of getting other diseases.

Portrait of John Boslego.

Dr. John Boslego. Photo: PATH.

Contracting some diseases can make getting other ones easier. For example, being sick with influenza can make you more vulnerable to pneumonia caused by other organisms. The best way to avoid coinfections is to prevent the initial infection through vaccination.

No. 9: They keep people healthier longer.

Some vaccines protect people for a limited time and require booster doses; others protect for a lifetime. Either way, vaccinated people are much safer from many serious diseases than people who haven’t been vaccinated, both in the short and long term. Continue reading »

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