[Funding of a free healthcare campaign in a rural district of Cameroon: optimizing the role of civil society in sub-Saharan Africa]. / Financement d'une campagne de soins gratuits par une association dans un district rural au Cameroun Nécessité d'optimiser le rôle de la société civile en Afrique subsaharienne.

Financial barriers represent a major obstacle to access to health care in sub-Saharan Africa and thus to the implementation of the Bamako Initiative. We describe an experience in which a civil society organization financed a free healthcare campaign in a rural health district in Cameroon. In all, 2,073 patients received free consultations, laboratory tests, and drugs. Adults older than 40 years accounted for 55.7% of all patients. The most frequent diseases were: osteoarticular conditions (24.1%), malaria (20.8%), and intestinal parasitosis (12.5%). In health systems financed mainly by cost recovery, some population needs remain uncovered by health services. There is a need to involve and reinforce the role of civil society in health system financing. It can help to pool more funds and improve the management of health resources to increase financial access to health care for poor people.

[Thirty years of tuberculosis control in Cameroon: alternating "vertical" and "horizontal" health care delivery systems]. / Trente ans de lutte antituberculeuse au Cameroun: une alternance entre systèmes d'offre de soins de santé "vertical" et "horizontal".

BACKGROUND: In sub-Saharan Africa, tuberculosis remains endemic despite reforms of health systems and the tuberculosis control organization carried out in the last decades. METHODS: We conducted a retrospective study of tuberculosis control in Cameroon from the period 2009 back to 1980. Data were collected from documents and activity reports of tuberculosis control, and interviews with managers of the National tuberculosis control program. FINDINGS: The history of tuberculosis control in Cameroon from 2009 back to 1980 can be divided into three main periods. The first period, from 1980 to 1994, corresponded to the implementation of the 'primary health care' policy. At that time, tuberculosis case management was delivered free of charge, but centralized in specialized services with a gradual and mild increase in new cases detected. The second period, from 1995 to 2000, was characterized by the implementation of the 'primary health care reorientation' policy that decentralized tuberculosis care to all health facilities, but introduced cost recovery --which came along with a dramatic drop in the number of tuberculosis cases detected. The National tuberculosis control program, established in 1996, entrusted health facilities--especially hospitals--with the responsibility of tuberculosis diagnosis and treatment, and referred to them as tuberculosis diagnosis and treatment centers. During the third period, from 2001 to 2009, owing to major support from global health initiatives, the number of tuberculosis diagnosis and treatment centers was increased (reaching 216 centers in 2009), with a significant increase of new cases detected that peaked in 2006, from where the situation started declining till 2009. CONCLUSION: Tuberculosis control indicators have never been optimal in Cameroon, despite the generally positive trend from 1980 to 2009. The strategy of tuberculosis diagnosis and treatment centers, which are essentially nested within hospitals, seems to have reached its intrinsic limitations. Better performance in tuberculosis control will henceforth require greater decentralization of tuberculosis detection and treatment to health centers. This careful decentralization will improve access for tuberculosis patients and lead to a comprehensive use of hospital technical expertise for tuberculosis care.

[The Emerging Voices for Global Health Initiative: an intensive capacity-building effort for young researchers from the South]. / L'expérience « Talents émergents en santé mondiale ¼ : une forme de renforcement intensif des capacités des jeunes chercheurs du Sud.

Researchers from developing countries, French-speaking nations in particular, are underrepresented in the international biomedical and health literature. Various initiatives seek to address this problem. This article presents the experience of the Emerging Voices for Global Health (EV4GH) program. This initiative provided 52 young researchers from developing countries with intensive skills and content training, with an assortment of complementary components: training in scientific writing and presenting skills, immersion in global health and health systems research, an innovative presentation of their work at the 52nd colloquium of the Institute of Tropical Medicine in Antwerp, and an active role in the first Global Symposium on Health Systems Research, supervised by a team of experienced researchers/coaches who supported them in the publication of a scientific essay. This approach targeting researchers in developing countries and combining the development of skills and knowledge through the publication process, merits reproduction and encouragement. Young researchers from developing countries should not miss out on the second version of this program in October 2012 in Beijing, China.