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

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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

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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

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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
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Common Diseases in Tanzania

Gender 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

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Current Ugandan President, Yoweri Musevini, announced a new plan to reduce the number of people suffering from AIDS.

On June 6, 2017 in Kampa, Uganda, Musevini introduced the President Fast-Track Initiative on Ending AIDS as a public health threat in Uganda by 2030.

The President Fast-Track initiative has been dubbed “Kisanja hakno mchezo” (no playing games) highlighting the focus and devotion that President Musevini possesses for the program. It includes a five point plan for focused action against the spread of HIV and AIDS in the country.

President Musevini’s five point plan for the President Fast-Track Initiative:

  1. Accelerate steps to remove the propensity of new HIV infections (particularly among girls and young women and their partners.)
  2.  Eliminate the transmission of HIV from mother to child.
  3. Accelerate “Test and Treat” programs, bringing them up to 90-90-90 targets (obtaining a 90 percent for treatment, care and support by 2020).
  4.  Guarantee financial sustainability for HIV and AIDS programs.
  5.  Reinforce institutional effectiveness for a multi-sectoral response.

President Musevini took personal interest in the program and will receive reports in order to improve plans as they unfold. The Uganda AIDS Commission, along with leadership from President Musevini, will coordinate the initiative. UNAIDS, a leading UN agency in coordinating the HIV response, will have key leadership in the initiative.

Michel Sidibe, UNAIDS executive director, was in attendance during the announcement of the President Fast-Track Initiative: “For the millions of people who are not here today, they will be happy that their President is back in the driving seat of the HIV response, launching the first President Fast-Track Initiative. Once again, Uganda is leading Africa and the world to demonstrate that we can end the AIDS epidemic,” Sidibe said. “Under his leadership, Uganda is moving from breaking the conspiracy of silence to breaking the conspiracy of complacency.”

An estimated 1.5 million people suffered from HIV and 28,000 died from HIV and AIDS related illnesses in 2015. An estimated 40 percent of adults are still not on treatment due to mitigating factors, including access to medication, stigma and discrimination, an issue the President Fast-Track Initiative hopes to take care of.

Steps have already been put in place to reduce the HIV/AIDS epidemic in Uganda. According to UNAIDS reports, infections dropped to 83,000 in 2015, far lower than the 2009 estimated 130,000 people per year.

Drew Hazzard

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The Joint Programme Model was created by the U.N. to help in the fight towards ending the HIV/AIDS epidemic by the year 2030. To meet this goal, known as the “2030 Agenda for Sustainable Development,” it has been noted by the Global Review Panel that the program is in critical need for reform.

The Global Review Panel recently issued a report which identifies key changes that must be made within the Joint Programme Model to help combat the spread of HIV/AIDS around the world. Particularly, it focuses on ways to effectively assist persons who are already infected.

It is the panel’s belief that the creation of the Joint Programme Model has thus far been one of the most instrumental and practical ways to try and eliminate the disease. However, a few suggestions within the report include targeting ways to reduce HIV-related stigmas, reducing the number of deaths caused by HIV/AIDs to fewer than 500,000 and reducing infections caused by HIV to fewer than 500,000.

The report further elaborates on more detailed improvements that are critically necessary for the program’s overall success. Such improvements include making fast-track countries a priority in the allocation of financial resources, as well as maintaining a focus on the mobilization and allocation of funds. By doing so, governmental leaders can ensure that the program remains adequately financed for global ventures.

Additionally, a major concern among members of the panel rests on the need to hold individuals such as cosponsors and the Secretariat accountable for their actions with respect to the overall 2030 plan. Panel members further believe that a transparent public reporting system should be set in motion that “shows the impact of results for people living with and affected by HIV and captures the entirety of Joint Programme financing and performance.”

Awa Coll-Seck, co-chair of the review panel, has expressed her opinion in that all individuals and organizations involved in the 2030 plan to end HIV/AIDs should work together as a sort of think tank to efficiently reach resolutions in the fight towards ending the disease on a global level.

Lael Pierce

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The global AIDS epidemic continues to threaten women’s health. There has been significant worldwide progress in combating this outbreak, as evidenced by a U.N. report showing a 33 percent global reduction in newly diagnosed HIV infections from 2001 to 2012. However, development has been disproportionate for women, especially in regions such as sub-Saharan Africa.

As the Joint U.N. Programme on HIV and AIDS reports, adolescent girls accounted for 64 percent of new HIV infections among youth globally in 2013. In addition, sub-Saharan Africa houses 80 percent of young women with HIV worldwide. Those aged 15 to 24 are nearly twice as likely to contract AIDS compared to their male counterparts.

Such statistics have a number of causes. Women are more likely to be diagnosed with HIV if they have experienced physical or sexual abuse, especially through relationships that involve extramarital sex or little-to-no contraceptive use. Social norms, especially in sub-Saharan Africa, also impose barriers, as men have more dominance over women in relationships.

Lack of education, specifically sex education, also plays a role in women’s disproportionate diagnosis of HIV. A report by the U.N. demonstrated that out of 32 countries, “Women who had some level of secondary education were five times more likely than non-literate women to have knowledge of HIV.”

The probable leading cause of the AIDS epidemic affecting women comes from a lack of health services. Those who have insufficient access to HIV and reproductive health care treatments and support, are less likely to monitor their health and thereby reduce infection. This is the case in many African regions. Laws also introduce obstacles; for example, in 2014, nine countries reported regulations that inhibit girls from obtaining HIV-related services.

Executive Director of UNAIDS, Michel Sidibe, confirms: “This epidemic, unfortunately, remains an epidemic of women.” Fortunately, however, a number of organizations have made motions to counter the problem, beginning with UNAIDS itself. In 2015, it introduced a global initiative of reducing HIV infections to about half a million per year by 2020. This plan involves reducing new infections among women by a factor of 75 percent.

As the Human Rights Watch notes, such can be accomplished through legal reform, the implementation of health awareness programs, mandatory education measures and assistance from international NGOs. In order to combat the AIDS epidemic and its effect on women, serious action must continue worldwide.

Genevieve T. DeLorenzo

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