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Leadership &Malaria in Pregnancy Bill Brieger | 26 Dec 2009 10:13 am

USAID – new director confirmed

The US Senate has given the development community a holiday gift. The indo-Asian News Service reports, “The Senate unanimously on Thursday confirmed the nomination of Shah, 36, and some three dozen other officials nominated by President Barack Obama before taking its Christmas break.”

Rajiv Shah has training in medicine and economics and has worked with the US Department of Agriculture. This gives him a broad development perspective and hopefully will ensure nutrition issues are not forgotten, “having championed Obama’s global food security initiative.”

Shah has also worked with the private and the NGO sectors, important partners in USAID’s work.

When Shah was nominated, President Obama said, “Rajiv brings fresh ideas and the dedication and impressive background necessary to help guide USAID as it works to achieve this important goal.”

There are those who are worried that fresh ideas alone may not be enough to guide an agency with such wide scope. remarked that, “Then there is the question of seasoning. While development junkies trade war stories of remote missions and malaria like currency, Shah has almost zero field experience. He may be the smartest guy in the room, but he doesn’t have that wellspring to draw on.”

During confirmation hearings Senator Richard G. Lugar posed a question about the future of the successful disease control programs initiated by the US Government in recent years. Shah explained that …

The welcome increase in funding for health assistance since 2000, particularly for combating HIV and malaria, has largely been targeted to African countries where disease and overall poor health conditions have had substantial socio-economic impact. That said, there are still tremendous unmet health and development needs in these countries. The Administration is committed to a broad Global Health Initiative that takes account of the range of health and development needs and, if confirmed, I look forward to working with Congress on this important issue.

The United Nations Foundations congratulated the President on Shah’s nomination and reiterated its own priorities which address both disease control and strengthening maternal and child health (MCH) services:

The United Nations Foundation is particularly focused on development goals related to global health, including our efforts to eradicate polio, reduce measles mortality, and eliminate malaria worldwide. In light of the unmet need in the world for maternal health and family planning, I hope that USAID’s new leadership will keep women’s health and international family planning a priority.

A good example of the nexus between malaria control and MCH is the challenge of preventing and treating malaria in pregnancy (MIP). Pregnant women bear a disproportionate burden of malaria that threatens their survival and that of the fetus and the newborn child.  Without strong a antenatal and reproductive health foundation, MIP control cannot reach those in need.

If Shah does have this bigger picture of malaria control in mind, we can hope for a broadening of malaria intervention into MCH programs that go beyond the limits of the 15 countries that constrained the potential impact of the President’s Malaria Initiative.

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