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GHD Is Not An AFZ. HTH You Understand What They Mean!

Leif Parsons for NPR

One thing we've learned here at Goats and Soda is that the world of global health and development is swimming in abbreviations/initialisms. We try not to use them in the blog because let's face it, dear readers, if you saw a story about NGOs (nongovernmental organizations) trying to improve BHS (basic health services), you'd probably click over to a video of RCC (really cute cats).

Global health and development abbreviations do have their defenders. They are a convenient shorthand for people who work in the field.

Although not everyone is a fan.

"I can't stand acronyms in general," says William Savedoff, a senior fellow at the Center for Global Development (CGD). When a report comes with a one-to-two-page list of all the abbreviations a reader will encounter, he says, well maybe that's just a few abbreviations too many.

Abbreviations and acronyms can also dehumanize. Health gurus worked hard to come up with a phrase to describe people who have AIDS. The phrase "people living with HIV/AIDS" was used to get away from the stigma of calling them AIDS victims, says Savedoff. Then the phrase was turned into PLWHA. "It seems so impersonal," he says.

Yet behind every acronym and abbreviation there is a story. So we thought, maybe it'd be enlightening to dive into a soup of those that float about the world of GHD (oh, sorry, global health and development). Because once you understand what the abbreviations mean, you do understand a bit more about the issues of the day.

Here's a sampling. Please, people of the GHD world, share with us your favorites (and unfavorites).

BRT: Bus rapid transit. In developing countries (as well as the rest of the world), the goal of BRT is to build urban bus systems that get people to stop driving cars. The result is less congestion and less pollution. But BRT doesn't just mean putting a bunch of buses on the street. BRT aims to keep buses moving quickly and efficiently. To speed up the process, passengers pay their fare before boarding. Boarding platforms rise up to meet the bus so passengers don't have to climb up stairs. And the city streets will be reallocated so the BRT buses have their own lanes and maybe even their own traffic lights. BRT started in Brazil in the 1970s and has spread to some 200 cities, carrying 33 million people a day. Daily ridership and kilometers of routes are tallied by country at brtdata.org

COD Aid: That's "cash on delivery" aid, in which the funds are handed over if a country can present independently verified proof of progress in achieving a goal — say, reduced infant mortality. The recipient country has the flexibility to figure out the best way to meet the goal. The concept was developed by CGD (the Center for Global Development, in case you're not remembering what the abbreviation stands for) and is often used in the health sector — paying TB patients to stick with a drug program, for example, or paying parents to take their children to the doctor for checkups.

ITN: It stands for "insecticide-treated net," which can ward off malaria-bearing mosquitoes. A better version of an ITN is an LLIN (long-lasting insecticide-treated net), which some companies have developed. According to the CDC (sorry — that's the Centers for Disease Control and Prevention), these nets can "maintain effective levels of insecticide for at least 2 years, even after repeated washing."

LICs, LMICs, UMICs and HICs: These are the four World Bank categories for countries based on gross national income per person: $1,045 or less for low-income countries (LICs); more than $1,045 and less than $12,736 for the middle, with $4,125 the dividing point between lower-middle (LMICs) and upper-middle (UMICs); and $12,736 or more for HICs.

MDR-TB: Multidrug-resistant tuberculosis is caused when patients don't adhere to the strict six-month drug regimen normally used to treat the disease. In covering MDR-TB for our blog, reporter Jason Beaubien wrote: "It's one of the most difficult diseases in the world to cure." The antibiotics prescribed for MDR-TB can bring on nausea, headaches and exhaustion and can destroy the patient's hearing. Even more difficult to fight is XDR-TB, extensively drug resistant tuberculosis.

NCDs: Noncommunicable diseases, like diabetes and heart disease. These two diseases are on the rise worldwide — and in the developing world. That's partly because communicable diseases are declining there so people are living longer, partly because people are becoming more Westernized, which means they're less physically active and their diets are changing for the worse.

PEPFAR: The President's Emergency Plan for AIDS Relief was initially a five-year, $15 billion effort by the U.S. to save the lives of HIV/AIDS patients, especially in Africa and the Caribbean. President Bush called for action in 2003; the PEPFAR name was created in 2004. PEPFAR was reauthorized in 2008. In fiscal year 2015, PEPFAR's accomplishments included antiretroviral (aka ARV) drugs for 9.5 million men, women and children and HIV testing and counseling for 68.2 million.

PPFP: Postpartum family planning. The goal is to help women who have had a child and wish to prevent unintended pregnancies in the year ahead or delay having more children. In some countries, PPFP counseling sessions are integrated into postpartum care, with the husband in attendance.

PMTCT: Prevention of mother-to-child transmission of HIV. Mother-to-child transmission is responsible for more than 90 percent of infections among infants and young children. The risk of transmission during pregnancy is 20 to 45 percent, but with antiretroviral drugs the rate of transmission can be cut to less than 2 percent.

VMMC: Voluntary male medical circumcision. It's a term used in the effort to prevent HIV transmission. The risk of female-to-male sexual transmission is reduced by about 60 percent when men undergo VCCM. WHO (that's the World Health Organization) recommends the procedure as a way of reducing HIV infections. A current goal is to hit 80 percent coverage among men in 14 sub-Saharan countries, which could potentially prevent 3.4 million HIV infections. A report issued by WHO this year cites a "remarkable expansion" to nearly 9.1 million VCCMs in these "priority countries."

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Corrected: January 11, 2016 at 10:00 PM MST
An earlier version of this post contained an incorrect abbreviation for voluntary male medical circumcision. It's VMMC, not VCCM. Additionally, a previous version of this story and correction incorrectly referred to acronyms when it should have said abbreviations. (An acronym is a pronounceable word, not just a combination of letters.)
Marc Silver
Marc Silver, who edits NPR's global health blog, has been a reporter and editor for the Baltimore Jewish Times, U.S. News & World Report and National Geographic. He is the author of Breast Cancer Husband: How to Help Your Wife (and Yourself) During Diagnosis, Treatment and Beyond and co-author, with his daughter, Maya Silver, of My Parent Has Cancer and It Really Sucks: Real-Life Advice From Real-Life Teens. The NPR story he co-wrote with Rebecca Davis and Viola Kosome -- 'No Sex For Fish' — won a Sigma Delta Chi award for online reporting from the Society of Professional Journalists.