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Wednesday, October 21, 2015

Rwanda Minister of Health wins $100,000 Roux Prize

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Dr. Agnes Binagwaho, a trained pediatrician and Minister of Health of Rwanda has won the Roux Prize, for turning evidence into health impact, rebuilding her country's war-torn health system and creating initiatives to improve indoor air quality and combat neonatal deaths.

She is the second winner of the Roux Prize, worth a US$100,000 which is given by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and is named for founding board member David Roux and his wife, Barbara.

It was launched in November 2013 and it is the world’s largest award for evidence-based public health achievement. She will be presented with the Roux Prize at a ceremony in Washington, DC, today on October 21.

Dr. Binagwaho has been using Global Burden of Disease (GBD) data and evidence from the Ministry’s own data-gathering efforts to ensure the country’s limited resources are saving the most lives and reducing suffering.

Dr. Binagwaho was working as a pediatrician in France when the Rwandan genocide occurred in 1994. When she returned to her country in 1996, most of the health system infrastructure had been destroyed and many health workers had been killed or fled the country.

“There was no trust in the health system, no medications, and no tools to provide health care,” said Dr. Binagwaho. “I remember coming back with kilos of meds in my bag, just to be able to provide care.”

Dr. Binagwaho’s work was part of a wider effort led by the government of Rwanda to rebuild the country from the ground up and ensure that even the poorest citizens could receive health care.

After directly caring for patients as a physician, Dr. Binagwaho served as Executive Secretary of the National AIDS Control Commission and Permanent Secretary of the Ministry of Health. In 2011, she was appointed Minister of Health.

Dr. Binagwaho has been an active user of GBD data since 2012 and eventually joined the GBD enterprise as part of the international collaborative network, which now totals more than 1,400 contributors from 115 countries. GBD is a systematic, scientific effort to quantify the comparative magnitude of health loss due to diseases, injuries, and risk factors. Along with Dr. Bingawaho, more than 20 Rwandans now collaborate on the GBD study.

“The Global Burden of Disease, by creating and generating data, helps us understand where we need to invest the next dollar, the next effort, the next education initiative,” said Dr. Binagwaho.

Dr. Binagwaho has overseen a remarkable improvement in the health of Rwandans. GBD data revealed that between 1990 and 2013, Rwandan life expectancy increased by about 15 years for both men and women, one of the strongest increases of any country in the world.

Healthy life expectancy has also risen dramatically, by roughly 12 years for both sexes since 1990. Much of this improvement can be mapped directly to policies and investments that Dr. Binagwaho has instituted.

For example, after looking at GBD estimates and finding that household air pollution was the leading risk factor for premature death and disability in the country, Rwanda started a program to distribute 1 million clean cookstoves to the most vulnerable households. 

On a recent fact-finding trip, IHME interviewed families who have received these cookstoves and found that not only is the air they breathe much cleaner, but they are also spending less money on cooking fuel, allowing them to devote more of their household budget to healthier foods.

Dr. Binagwaho and her staff also analyzed GBD data to see where and how they could improve the country’s health and found a large percentage of Rwandans were dying during the first months of their lives. 

They decided to embark on a campaign to decrease neonatal deaths. After investing money in education, equipment, and training in neonatology at hospitals throughout the country, the neonatal mortality rate has started to decrease.

“Whether you are in the capital of Kigali or out in a rural hospital, health policy decisions are being made based on data in Rwanda,” said Tom Achoki, IHME Director of African Initiatives. “The Honorable Minister has made it a priority not only to educate the Ministry in how to produce and analyze quality data, but how to use data to effectively and efficiently overcome Rwanda’s health challenges.”

“In the course of her work leading Rwanda’s health policy and planning, Honorable Minister Binagwaho has come to embody what Dave and Barbara Roux had in mind when they conceptualized the Roux Prize: using rigorously derived evidence to improve health in her community,” said Dr. Christopher Murray, Director of IHME and co-founder of GBD. “Dr. Binagwaho is not just using disease burden data to improve health – she and her staff at the Ministry of Health are committed to making the Global Burden of Disease study stronger and more useful by vetting its results and addressing data gaps.”

Now an ongoing enterprise with annual updates, GBD is an international, collaborative effort with more than 1,400 researchers in 120 countries, led by IHME. Results are regularly published in peer-reviewed journals for more than 300 diseases, injuries, and risk factors, by age, gender, and country. Results from the latest updates through 2013 are available in a series of online data visualization tools at http://www.healthdata.org/gbd/data-visualizations.

The Roux Prize is intended for anyone who has applied health data and evidence in innovative ways to improve population health. Nominees may come from anywhere in the world and could include, but are not limited to, staff in government agencies, researchers at academic institutions, volunteers in charitable organizations, or health providers working in the community.

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