The President’s Emergency Plan for AIDS Relief (PEPFAR) was created in 2003 as a cornerstone of the global HIV/AIDS response. In the 14 years since its inception, PEPFAR has helped 13 million people receive counseling and antiretroviral therapy.

PEPFAR has gone through multiple iterations and been managed by three U.S. presidents. The program is currently managed by the Trump administration, which, on December 1, launched the PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control.

PEPFAR’s accelerated strategy includes putting a focus on 13 countries with an exceptional HIV/AIDS burden. The countries, Kenya, Zambia, Côte d’Ivoire, the United Republic of Tanzania, Uganda, Zimbabwe, Malawi, Lesotho, Botswana, Namibia, Swaziland, Haiti and Rwanda, will be receiving widespread and much-needed antiretroviral therapy coverage. The strategy also includes a strong focus on young girls and women with HIV and AIDS.

The ultimate goal of PEPFAR’s accelerated strategy is to gain control of the epidemic in these 13 countries by the year 2020. Though the prospective outcome is bright, this change could bring about more issues than anticipated.

In May, President Trump announced his plan to restructure the federal budget. Approximately 19 percent of the HIV/AIDS global care and prevention budget is proposed to be cut in 2018. Prior to PEPFAR’s accelerated strategy, the program was providing assistance to 50 countries around the world. The plan is to continue providing assistance to those countries while also providing extra provisions to the 13 focus countries.

While it is important, of course, to increase assistance where the burden is heavier, it is also important that other vulnerable communities aren’t left behind. With a lowered budget and the focus of PEPFAR being shifted, worldwide HIV/AIDS prevention and recovery programs are at risk.

Important programs like safe needle exchange, counseling for sex workers and homosexual men and care for children living with HIV and AIDS could potentially lose funding. Without these and other programs, there’s a high chance that infection rates will increase rather than decrease.

The general notion of the focus shift is a positive one. By gaining epidemic control in the focus countries, PEPFAR would be creating a roadmap for further epidemic control and prevention in other countries.

However, in order to gain epidemic control, infection rates need to be lower. Before making an attempt at an AIDS-free generation, PEPFAR needs to focus on providing prevention as well as treatment to all affected communities.

– Anna Sheps

Photo: Flickr

With a new campaign called My Health, My Right, UNAIDS will celebrate World AIDS Day on December 1, 2017. The campaign aims to bring awareness to the universal right to health, and also to shed light on the hardships people face globally in obtaining these rights.

My Health, My Right is meant to remind people that a human’s right to health is not only about accessing the necessary services and medicines, but also about quality living and working conditions that are sanitary and safe with access to basic needs. When these rights are not being met, preventative measures against disease decrease and illnesses increase, including HIV. This campaign allows for open conversation to begin regarding thoughts and concerns about rights to health, the importance of health equality and justice for people worldwide.

The campaign will occur mostly on twitter, with downloadable posters available to hang throughout communities and informational brochures equipped with messages about the rights to proper health care. The right to health for all people is crucial in the U.N.’s Sustainable Development Goals, as one of the goals includes ending the AIDS epidemic by the year 2030.

As of August 2017, 36.7 million people are living with HIV/AIDS throughout the world. 30 percent of these people don’t know the status of their disease. The majority of those infected with AIDS live in low- and middle-income countries; 25.5 million of these people live in sub-Saharan Africa. Although there has been significant progress in ending the AIDS epidemic, experts say it is not being done fast enough to meet the global targets.

World AIDS Day aims to pay respects to those who have died from an AIDS-related illness. The day was originally founded in 1988, as the first ever global health day. A day to recognize the virus is extremely important for the eradication of the disease, as many of those infected do not know how to protect themselves and the others around them. It also helps demolish the discrimination and stigma associated with people living with the condition. AIDS has not disappeared, and there is a crucial need for funds, resources, increased awareness and improved education regarding the disease.

– Chloe Turner

Photo: Flickr

Life Expectancy in AfricaLife expectancy is one of the methods used to measure health in various countries. Countries with low life expectancies usually have problems maintaining health and longevity, while countries with higher life expectancies generally have better healthcare and longevity. Africa is a continent that has long had a very low life expectancy; however, in recent years the life expectancy in Africa has fortunately been on the rise.

Since 2000, the average life expectancy in African countries has increased from 20 percent to 42 percent. That is the biggest increase in  life expectancy recorded in that time frame in all regions around the world. One of the biggest life expectancy increases has occurred in Malawi. Malawi’s life expectancy in 2000 was 44.1 years. In 2014, it was reported that the new life expectancy in Malawi was 62.7 years – a 42.2 percent increase.

Health and welfare improvements are one of the main reasons why life expectancy in Africa has been on the rise. One of the biggest health issues that Africa has been plagued with is the HIV/AIDS epidemic. HIV/AIDS has tragically claimed many lives in Africa, which is a large reason why life expectancy was so low. Treating these diseases was difficult at height of the epidemic, so many Africans unfortunately died. Because HIV/AIDS has been such a huge issue, there has been a lot of research done to help alleviate the problem. Improvements in medication and treatment have helped Africans and others around the world combat the AIDS epidemic. Not only is there now medicine available to help suppress the disease, but this medicine has become much more affordable for all people, including those in developing countries.

Although an epidemic, HIV/AIDS was not the only problem that African countries suffered from. Malaria was also an issue that affected life expectancy in Africa. However, strides have since been made to alleviate that issue as well. The World Health Organization (WHO) in Africa has reported that the rate of malaria has decreased by 66 percent since the year 2000. More importantly, malaria in African children under the age of five has decreased by 71 percent. This is important because more children are surviving in Africa. Prior to these improvements, HIV/AIDS and malaria have claimed many lives of children under the age of five. Since healthcare – and access to it – has increased in Africa, more children are surviving past age five. Once these kids clear the first five years of their lives, it is much more likely that they will grow up to reach the age of 60.

Life expectancy in Africa has increased and things are only looking to get better. Not only has the life expectancy dramatically increased, it is beginning to look like malaria may be eliminated by 2020 and HIV/AIDS by 2030. This will surely serve to further increase the life expectancy of African countries, as well as elsewhere around the world.

Daniel Borjas

Photo: Flickr

Eliminate AIDSThailand has recently launched a new national strategy, with the goal of eliminating AIDS as a public health threat by 2030. The plan, devised by the Ministry of Public Health, aims to use rigorous strategy of detecting, treating and suppressing the AIDS virus within the infected population.

The first step of the plan aims to meet the global 90-90-90 goal by 2020, where the first 90 percent of people who have AIDS are informed of their infection. This 90 percent of infected people should then have access to, and begin, treatment. Then, 90 percent of people who have received treatment are fully virally suppressed. This breakdown provides realistic goals for the plan’s execution.

This plan is targeted to the key demographics among which the HIV rate is the highest. Thailand’s government is committing full efforts to providing the citizens with prevention and outreach programs in highly infectious areas to help inform and protect the uninfected populations.

One of the further goals of this plan is to eventually include hepatitis C, tuberculosis and other infectious diseases as serious public health issues to be resolved within Thailand. The U.N. Programme on HIV/AIDS (UNAIDS) firmly believes in Thailand’s plan, as its pilot tests have resulted in an excellent effective rate. Because of this, UNAIDS would like to implement the plan in more nations dealing with similar situations.

The initial segment of the plan – encompassing 2015 to 2019 – is dedicated to the testing of new measures as well as setting up new two-way coordination frameworks for the execution of the rest of the plan. This segment includes a majority of pilot testing, where the results of the data collected would help to produce the next plan segment.

While Thailand is pioneering new widespread measures to eliminate AIDS, their groundbreaking work will be a stepping stone to the elimination of AIDS in the nation. With massive organizations, such as UNAIDS, working alongside them to study and develop solutions, there is a lot of promise in the eventual elimination of the global AIDS issue.

Rebekah

Photo: Flickr

AIDS Prevention in AfricaDespite its relatively low prevalence in the U.S., AIDS continues to be a seemingly uncontrollable global epidemic. But nowhere else on earth suffers as much from this tragic disease as Sub-Saharan Africa, where 69 percent of all those infected reside. Although poor sanitation, lack of preventative treatments and education are doubtlessly responsible, the inaccessibility of healthcare technologies also substantially inhibit AIDS prevention in Africa.

Many people in developing countries lack access to even the most basic of healthcare technologies. Access to these innovations are hindered by a variety of complex obstacles. Sometimes the treatments exist, although it is often impossible for the average person to afford them. Other times, however, the healthcare infrastructures are so poor that they are unable to support the life-saving technologies that wealthier countries can enjoy. The festering epidemic has caused the U.S. to make AIDS prevention in Africa a priority for U.S. foreign policy. This led to the creation of the President’s Emergency Plan for AIDS Relief (PEPFAR).

Since its inception in 2003, PEPFAR has received strong bipartisan support for its leadership in the containment of the HIV/AIDS crisis. It currently provides 11.5 million patients with antiretroviral treatment. This number is up from the mere 50,000 individuals receiving treatment before PEPFAR was established.

These numbers confirm the success of the program’s strategy. Through a new partnership with the financial leader Mastercard, however, PEPFAR plans on elevating its approach to AIDS prevention. The private-public partnership will introduce digital technologies and data analytics to improve access prevention and treatment plans. Research conducted by PEPFAR shows that the greatest cost in HIV/AIDS treatment is in treatment delivery rather than the cost of drugs. Through its partnership with Mastercard, the organization hopes to improve efficiency of its efforts.

Mastercard has a history of developing digital solutions for impoverished regions through its Foundation Fund for Rural Prosperity (FRP). Since its formation in 2015, FRP has financed 19 projects across Sub-Saharan Africa that widen the economic inclusion of poor people living in rural areas. This unique charitable expertise makes Mastercard the perfect partner for PEPFAR in the endeavor to promote AIDS prevention in Africa.

Bringing healthcare technology to rural, impoverished communities may be the single most powerful step toward combating deadly diseases. Healthcare in developing countries is impeded by many obstacles such as a lack of formal training, research tools and funding. As a result, medical technology is only as useful as those implementing it are resourceful. With the partnership of two global leaders in health and innovation, PEPFAR and Mastercard promise to bring AIDS containment to regions that are suffering most.

Micaela Fischer

Photo: Flickr

Zambia's AIDS Response Fast-TrackHIV/AIDS affects millions of people in Africa. Zambia and other countries in Africa are greatly impacted by HIV/AIDS daily. Even though Western countries are working to improve the HIV/AIDS rate in Africa, countries in Africa are working even harder to help their people. Zambia’s AIDS Response Fast-Track Strategy recently launched with important goals for 2017-2021.

Zambia’s AIDS Response Fast-Track Strategy sets out a plan to achieve the global Fast-Track prevention and 90-90-90 targets, where 90 percent of people living with HIV will know their HIV status. The strategy also aims to ensure that 90 percent of people who know they are HIV positive are accessing treatment and 90 percent of people on treatment have decreased their viral loads.

The strategy establishes clear approaches to increase the HIV response for everyone, set yearly targets at the national and state level and estimate costs and resources required. Zambia’s AIDS Response Fast-Track Strategy will provide more facility-based and community-led programs. The strategy will increase HIV testing and help counsel districts that have high HIV rates. The Fast-Track Strategy will also target key populations and partner with other healthcare services regarding HIV testing.

HIV treatment and care services will be guaranteed through the strategy. The most important goal of the strategy is to eliminate all new HIV infections among children. A significant impact has been made in the past few years on new HIV infections. New HIV infections have decreased from 69,000 in 2005 to 59,000 in 2016. The rate of women receiving medicines to prevent mother-to-child transmission has increased to 87 percent.

Fast-Track Cities was launched on World AIDS Day in 2014 in Paris. Over 70 cities with high HIV rates have signed the Paris Declaration on Fast-Track Cities Ending AIDS, including Zambia’s capital Lusaka. The strategy was created by a team led by the National HIV/AIDS/STI/TB Council and UNAIDS. The International Association of Providers of AIDS Care (IAPAC), the United Nations Human Settlements Program (UN-HABITAT), UNAIDS and the City of Paris are supporting Fast-Track Cities. By participating in this initiative, Zambia can bolster its own Fast-Track Strategy and bring better care and prevention to its people sooner.

Treasure Shepard

Photo: Flickr

Africa has had a long history with AIDS and has struggled to find solutions to keep AIDS-related deaths low. However, in the past few years AIDS rates in Africa have decreased, and it is no longer the leading cause of death.

This achievement is mostly due to better diagnosis and treatment, along with more information and better education on the condition. Additionally, other preventive strategies, such as self-testing, have become more prevalent. In fact, 40 countries have already added HIV/AIDS self-testing to their national policies, with 48 more developing similar policies, almost double the amount in 2015.

With these strategies being implemented, the number of HIV/AIDS-related deaths in Africa have decreased by 24 percent over the last five years. In 2015, there were a reported 5.2 million deaths caused by group 1 conditions, which includes AIDS, with AIDS reportedly causing approximately 760,000 deaths in 2015, a decrease from 1 million in 2010 and 1.5 million in 2005.

With AIDS no longer the leading cause of death, lower respiratory tract infections have taken the lead. Yet AIDS is not the only disease that has decreased; malaria has also seen a decrease in deaths, reporting a drop of 60 percent in the last 15 years, accounting for about 6 million people saved from the disease.

With expanded education regarding AIDS prevention, treatment, and self-testing, Africa is on its way to fulfilling the U.N.’s goal of eradicating AIDS on the continent by 2030. Additionally, with funding from donor countries and supplying clinics with the proper drugs, AIDS in Africa will continue to see a drop in deaths over the next few years, meaning the continent can focus on other leading causes of death.

Amira Wynn

Photo: Flickr

Common Diseases in Sudan
Sudan is an East African country that has been embroiled in civil wars for several decades, leading to its split with South Sudan in 2011. The long period of instability in the country has contributed to conditions that encourage the spread of communicable diseases, which are some of the most common diseases in Sudan.

 

Most Common Diseases in Sudan

 

  1. Yellow Fever – Yellow fever is a common virus found in tropical areas of South America and Africa. Transmitted to an individual through the bite of an infected mosquito, yellow fever ranks as one of the most common diseases in Sudan. Symptoms include influenza-like symptoms such as a fever, chills, severe headache, back pain, general body aches, nausea, vomiting, fatigue and weakness, according to the Centers for Disease Control and Prevention (CDC). Severe cases can lead to internal bleeding and failure of major organs. Sudan is listed as one of the thirty countries in Africa with a high risk of yellow fever.
  2. Rift Valley Fever – From 2007 to 2010, a major outbreak of Rift Valley fever, a mosquito-borne viral disease, was recorded in Sudan. Standing water from unusual flooding allowed for infected mosquito eggs to lie dormant. Infected mosquitos also feed on livestock, which can pass the disease to humans through infected blood and meat. The Rift Valley fever outbreak devastated Sudanese agricultural communities, leading to an almost 100 percent mortality rate among young animals and high pregnancy failures among child-bearing livestock. According to the CDC, nearly 75,000 people were infected with the disease over the course of three years. Symptoms include fever and liver irregularities, but severe cases can cause hemorrhagic fever, encephalitis or ocular disease.
  3. Guinea Worm Disease – One of the most geographically specific and common diseases in Sudan is Guinea worm disease. The infection, caused by the parasite Dracunculus medinensis, the Guinea worm, is spread by drinking water containing worm larvae. Guinea worm disease highly affects poor communities in Sudan that have little access to clean drinking water. Once ingested, over the course of a year, larvae grow into full-size adults within a human’s digestive tract. Within 24 to 72 hours after reaching full-size, the infected person develops blisters on their hands or feet, out of which the worm eventually emerges. Based on research by the CDC, there is applicable treatment of Guinea worm disease and no vaccine for prevention.
  4. Meningococcal Meningitis – Meningococcal meningitis is a bacterial disease that causes an inflammation of the lining of the brain and spinal cord. It is a respiratory disease transmitted from person to person by close and prolonged contact resulting from crowded living conditions. Sudan lies in the region of sub-Saharan Africa referred to as the “Meningitis Belt,” where the highest rate of meningococcal meningitis occurs throughout the continent. Symptoms can include a stiff neck, high fever, headaches and vomiting. The CIA World Factbook listed Sudan as a country at very high risk of infection.
  5. Malaria – Transmitted to humans through the bite of the female Anopheles mosquito, malaria ranks as one of the most common diseases in Sudan. With cases recorded in all regions of Sudan, the risk of contracting the disease is extremely high. According to the CDC, symptoms of malaria include fever, chills and flu-like illness. Severe cases can end in death. In 2015, a confirmed 586,827 cases of the disease were treated. However, the World Health Organization (WHO) estimates that, including unreported cases, there were 1,400,000 total. Estimated deaths total around 3,500.
  6. HIV/AIDS – Based on research conducted by the CDC, human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) affect an estimated 35 million people worldwide, with more than two-thirds of those living in sub-Saharan Africa. In 2015, 25 percent of adults in Sudan were living with HIV/AIDS, according to the CIA World Factbook. HIV/AIDS is most often spread through unprotected intercourse but can be contracted by blood-to-blood contact with an infected person. Symptoms are often flu-like and can progress to severe cases that can be fatal. HIV/AIDS ranks as an extremely common disease in Sudan today.

Despite the country’s high risk of contracting an infectious disease, work is being done to combat issues related to health and sanitation. The World Health Organization, in coordination with the Sudanese Ministry of Health, is taking action, such as expanding cholera emergency responses to lower future risk and training health workers in disease detection.

Riley Bunch

Photo: Flickr

US Budget Cuts Could Weaken Global Fight Against AIDS
The President’s Emergency Plan for AIDS Relief (PEPFAR) has been the largest national effort by any country to combat a single disease and has resulted in 11.5 million people put on antiretroviral treatment. PEPFAR has received wide bipartisan support since its inception in 2003, but the Trump administration has proposed a 17 percent cut to the program as part of the 2018 budget proposal. Experts are now warning that these cuts to PEPFAR and other global health programs could inflame the AIDS epidemic.

Laurie Garrett, a senior fellow for Global Health at the Council on Foreign Relations fears the worst. “Without a revolutionary breakthrough in either vaccines or the entire model of HIV control, a massive second global wave of AIDS will come, perhaps within the next 10 years.” These predictions come as the U.S. shows a greater reluctance to commit funds to fighting HIV/AIDS.

With the wide distribution of antiretroviral drugs, deaths from AIDS have been halved over the past decade, but new infections haven’t slowed down. Two million people are infected with HIV annually, and these new infections are showing greater resistance to traditional treatments. Despite the need for further research, global funds for research and development have been declining. The Trump administration has proposed a 20 percent budget cut to the National Institutes of Health, America’s leading funder of HIV research.

Though the proposed budget would uproot U.S. efforts in the global fight against AIDS, political analysts have predicted that Congress will fight to reduce these cuts. PEPFAR has bipartisan support and the Republican majority considers it a party accomplishment due to its enactment by President George W. Bush. The National Institutes of Health have also recently gained bipartisan support with both Republicans and Democrats supporting greater funding.

Although the Trump administration’s cuts will likely be reduced by Congress, advocates worry that the proposed cuts will keep these programs from operating at their current levels. “I have no doubt Congress will succeed in restoring some level of funding,” says Scott Morris, director of the U.S. Development Policy Initiative at the Center for Global Development. “But it strikes me as an insurmountable lift to get back to the level of funding these programs currently enjoy.”

Carson Hughes
Photo: Flickr

Common Diseases in TanzaniaGender inequality, limited access to safe water, lack of sanitation, poor hygiene and a recent drop in immunization are major issues Tanzanian citizens face in urban and rural areas of the country. These factors have contributed to the rampant spread of three common diseases in Tanzania: HIV and AIDS, cholera and malaria.

The most common disease affecting the Tanzanian populace is HIV and AIDS. HIV is a virus that attacks the immune system, the body’s natural defense against disease. The immune system is destroyed when left untreated and the person cannot recover from infections, big or small. At this stage, the person has AIDS.

According to the World Factbook, in 2015, almost 1.4 million people in Tanzania were living with AIDS. This is the most recent estimate. Also reported by the same source, Tanzania ranks sixth in comparison to the rest of the world with the number of its citizens living with the disease.

HIV is the main source of adult mortality in the country. The World Factbook states that in 2015 an estimated 35,700 Tanzanian adults died from the disease, placing the country in fourth place in comparison to the rest of the world.

According to the charity organization, AVERT, the populations most affected by HIV in Tanzania are people who inject drugs, men who have sex with men, mobile populations and sex workers. Of all HIV infections, 80 percent of them result from heterosexual sex. Tanzanian women are infected more than men due to having older partners, getting married earlier and neglecting negotiating skills for safer sex due to gender inequality.

The second of the most common diseases in Tanzania population is cholera. Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe diarrhea and dehydration. Cholera kills infected persons within hours when left untreated.

According to the World Health Organization (WHO), by April 20, 2016 there was a total of 24,108 cases of cholera in Tanzania, including 378 deaths. The majority of the cases were reported from 23 regions in mainland Tanzania (20,961 cases, including 329 deaths). Neighboring Zanzibar islands reported 3,057 cases of the disease, including 51 deaths.

The disease spread quickly due to conducive conditions such as limited access to safe water in poor households, sanitary problems and poor hygiene found in both mainland Tanzania and Zanzibar. In addition, the nation’s water supply institutions lacked the capacity to disinfect water and conduct regular water quality monitoring and assessments.

Recently, there has been a decline in the number of newly reported cases of cholera. However, the conditions that helped the disease to persist still have not changed, so risk for more infections remains high.

The final common disease affecting the Tanzanian population is malaria. Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. Mild symptoms include fever, headache and chills. Severe symptoms include anemia, difficulty breathing due to fluid-filled lungs and cerebral malaria in children. In adults, organ failure is also frequent.

The World Factbook reports malaria is a leading killer of children under five in Tanzania. According to the Malaria Spot website, Tanzania has the third-largest population at risk of malaria in Africa. Over 90 percent of the population live in areas where there is malaria. Each year, 10 to 12 million people contract malaria and 80,000 die from the disease, most of them children. There is no vaccine for malaria. This fact contributes to why the disease continues to be a threat for Tanzanians.

Common diseases in Tanzania are prevalent because the geographical and economic conditions of the country favor their spread. While HIV and AIDS, cholera and malaria have been a threat to the population there has been positive strides. The Center for Disease Control (CDC) has been working with the government of the United Republic of Tanzania and more than 60 partner organizations since 2001 to address HIV, malaria, and other health threats by helping support service delivery and strengthen health systems and infrastructure. The CDC partnership has seen success, including:

  • 637,875 people are currently receiving HIV treatment
  • 74,430 pregnant women have received medication to reduce transmission to their babies through PEPFAR (The United States President’s Emergency Plan for AIDS Relief) since 2010
  • 1,155,833 men have been circumcised to prevent new HIV infections since 2010
  • New malaria infections have decreased from 18 percent to 10 percent in children 6-59 months in 2011-2012

With continued aid and improvement in living conditions for the Tanzanian people, common diseases in Tanzania will no longer remain common.

Jeanine Thomas

Photo: Flickr