How does economic change affect AIDS?
<!-- -->Improving the health of people in extremely poor countries is tied to improving their economic well-being and, in turn, their environment. A team of Milwaukee researchers, including two faculty members from the University of Wisconsin–Milwaukee, is working to figure out the best ways to make that happen.Loren Galvao, a medical doctor and associate scientist in the University of Wisconsin–Milwaukee College of Nursing, is co-leader of a $2.53 million, five-year project that is studying the impact of economic change and food security on people’s vulnerability to HIV in the African country of Malawi. Patricia Stevens, UWM professor of nursing who had done extensive research on the impact of HIV/AIDS, is also part of the research team. The Malawi Pathways Project, funded through the National Institutes of Health (NIH), is a collaborative effort involving UWM’s College of Nursing and its Center for Cultural Diversity and Global Health), the Medical College of Wisconsin, CARE USA and CARE Malawi, the University of Pennsylvania, the London School of Economics and the University of Malwai. Lance S. Weinhardt, associate professor of psychiatry and behavioral medicine with the Center for AIDS Intervention Research at the Medical College of Wisconsin, is the project’s lead researcher.“International NGOs (nongovernmental organizations) have been doing a lot of integrated, multi-level interventions in the past decades in health, development, microfinance and diversified sustainable agriculture, says Galvao. In addition to her work with the College of Nursing, she is also associate director for community partnerships initiatives at the Center for Urban Population Health (CUPH). “However,” she adds, “there is a need to conduct rigorous scientific evaluations of these kinds of projects.” Especially with the global economic crisis, she says, it’s important that those working to improve public health in poor countries know what works. “We need to look at what organizations are doing to see if it is really effective – is it really improving the lives and health of people – and if it’s working, can it be duplicated in other regions of the world?” Malawi, in sub-Saharan Africa, has a high prevalence of HIV infection, poverty and malnutrition. Annual per capita income is $170, making it the seventh-poorest country in the world. Galvao, who has worked and conducted research in 18 countries in Africa, Asia and Latin America, sees the value of collaboration with many different organizations and countries on this long-term evaluation project. The Malawi Pathways team will be working with the local office of CARE, which has set up a long-term development program in Malawi. That program is training farmers to improve their food production, providing support for diversified agricultural practices, offering community-based microfinancing and helping villages develop strategies to strengthen local government. Through the CARE program, for example, local women can pool their money in a fund to make loans to other women. The women can then jump-start their own businesses with a loan of as little as $3. CARE’s experiences around the world have shown that providing poor women with opportunities to start or expand these small, often home-based, businesses, can lift people out of poverty and improve the family’s nutrition, education and housing, according to an article in CARE’s international magazine.“This is one of the first projects of this kind that NIH has funded on evaluating the health impact of integrated and multi-level interventions such as microfinance and diversified, sustainable agriculture,” says Galvao. “In the past decades, NIH has focused primarily on behavioral health research. So there is a need to study broader structural interventions that may also have an impact on health and HIV.Since the research project started in April 2008, Galvao has traveled to Malawi twice with project director Weinhardt to meet with government and local officials, the local CARE office, the field research team and the people in areas that CARE Malawi serves. One of the goals of the College of Nursing and its Center for Cultural Diversity and Global Health’s involvement in the project is to attract more students to this vital area of international health work, says Anne Banda, center director. The college offered a UWinteriM course for nursing students in Malawi a year ago, and researchers Lucy Mkandawire-Vahlmu, Stevens and Galvao are also studying violence in the lives of HIV-infected women in Malawi through another project that received a UWM RGI (Research Growth Initiative) grant. “I love working in global health research, and I hope our involvement in projects like these will help generate additional global health research projects and attract more nursing and public health students to this field,” says Galvao.