tuberculosis in Côte d'IvoireTuberculosis (TB) is a bacterial illness spread through breathing contaminated air droplets from an infected individual. TB is also transferable by drinking unpasteurized milk containing Mycobacterium bovis, or Bovine Tuberculosis. The bacterium primarily affects the lungs, which is known as pulmonary TB. More than 90% of individuals with TB have a latent form and do not experience overwhelming symptoms. With tuberculosis being one of the leading causes of death in Côte d’Ivoire, the government is making numerous efforts to help those with the illness. The health agencies in Côte d’Ivoire, using assistance from the government and other countries, are mitigating the spread of TB through medicine, proper healthcare and bringing awareness to the communities. Here are five facts about the rising issue of tuberculosis in Côte d’Ivoire.

5 Facts About Tuberculosis in Côte d’Ivoire

  1. More than 8,000 people died from tuberculosis in Côte d’Ivoire in 2018. In addition, there were 36,000 reported cases of TB. While active efforts are being made to try and control the spread of TB, the citizens of Côte d’Ivoire struggle to afford treatment, healthcare and testing. With over 46% of the population living in poverty, it is difficult for most of them to find access to hospitals and testing centers. TB is highly endemic in Côte d’Ivoire, meaning it is extremely prevalent within many of the impoverished Ivorian communities. For every 100,000 citizens, 23 of them will die from tuberculosis. Among those 100,000 citizens, more than 148 of them will be diagnosed with a form of TB. It is increasingly important that a global effort is made to bring awareness to this illness and help the citizens of Côte d’Ivoire receive proper medical treatment. Thankfully, the transmission of TB has been on the decline within the past few years. In 2000, 367 people per 100,000 citizens of Côte d’Ivoire were diagnosed with TB. This contrasts 2018 in which less than half the number of citizens were diagnosed (only 142 per 100,000 individuals).
  2. There are multiple factors that lead to the spread of tuberculosis. TB can be spread through Côte d’Ivoire by living in poverty, existing in a post-war environment and having HIV/AIDS. Ivorian citizens living in impoverished circumstances suffer from malnutrition and weakened immune systems. This makes contracting TB far easier for those with an inferior healthcare system and little access to basic resources. Living in poverty also means less access to tests for TB, which makes it hard to know who is infected. The war-torn climate of the country weakens the healthcare system. This causes a wider outbreak of TB with fewer people being treated. Political unrest and violence also force citizens to escape to other parts of the country. The emigration of families moving from northern cities to rural settlements in the south of Côte d’Ivoire increases the spread of TB while limiting immediate access to healthcare. Abidjan is one major city that faces overwhelming cases of tuberculosis. HIV/AIDS renders immune systems weak and increases individuals’ susceptibility to TB. The comorbidity between HIV and TB in Côte d’Ivoire is extremely high. In 2018, more than 7,000 of the 36,000 citizens with TB were also treated for HIV/AIDS. The Ivorian Ministry of Health (MOH) works with organizations like Measure Evaluation to track the spread of diseases like HIV and TB and increase testing in high-risk areas. The efforts have so far been successful.
  3. There are currently four treatments for tuberculosis. As of 2020, there are four recognized medicinal treatments for TB: Isoniazid (INH), Rifampin (RMP), Pyrazinamide (PZA) and Ethambutol (EMB). These medicines must be taken for three to nine months as directed by a medical professional. This ensures that the bacterium is killed. Skipping a dose, because of inaccessibility to a prescription or otherwise, causes a tuberculosis infection to come back stronger. While most forms of TB are curable with medicine, Côte d’Ivoire is plagued with strains of drug-resistant tuberculosis. In 2018, there were more than 2,000 individuals with a drug-resistant type of tuberculosis (DR-TB). These individuals are harder to treat since any known medicine is ineffective against the strain of TB. Luckily, 82% of people who are treated for tuberculosis in Côte d’Ivoire recover successfully. With the help of well-trained medical professionals and funding from other countries, the government of Côte d’Ivoire can better treat and identify those with TB.
  4. Tuberculosis is primarily observed in young men. Men ages 20-40 years old experience TB more frequently than any other demographic. Most of these men are working-class and have little education. Because men are also frequently diagnosed with HIV/AIDS in Côte d’Ivoire, they are at a greater risk for contracting TB. As the rates of HIV/AIDS increase in the male population (a 3:1 sex ratio), the tuberculosis infection rates have also increased.
  5. World organizations and other countries have greatly aided in treating and ending the spread of tuberculosis in Côte d’Ivoire. With help from NGOs and world health outreach programs, TB in Côte d’Ivoire has decreased. In 2007, TB was the 7th leading cause of death, however, a decade later in 2017, TB has dropped to the 8th leading cause of death in Côte d’Ivoire.

One important organization is The Stop TB Partnership. By pairing government agencies with other foundations, research agencies and private sector resources, this organization aims to create a TB-free world. In 2014, various partners met with specialists from the Programme National de Lutte contre la Tuberculose to design a national committee tasked with controlling and treating tuberculosis in Côte d’Ivoire. The members of these groups were responsible for designing a plan for infection control, allocating monetary and human resources and outlining the structure of the new committee. Through this workshop, the anti-TB program in Côte d’Ivoire established clear strategies for tackling the problem of tuberculosis. Stop TB developed oversight committees, regulations for how resources are spent and a plan for reducing the spread of TB.

According to the United Nations, Côte d’Ivoire is on the way to reaching various Sustainable Development Goals (SDGs). The U.N. is actively helping Côte d’Ivoire eradicate illnesses like HIV, malaria and TB by the year 2030 through free doctor visits and accessible medicine.

It is crucial that the citizens of Côte d’Ivoire receive the proper treatment and financial assistance to help them overcome the tuberculosis endemic. It is imperative that those diagnosed with this illness are immediately identified and properly treated. With strategic planning, proper funding and extensive training for medical professionals, the infection rate of tuberculosis in Côte d’Ivoire is expected to decrease in the coming years.

– Danielle Kuzel
Photo: Flickr

Solving Poverty in Côte d'Ivoire
For years, people have known the Republic of Côte d’Ivoire as a bastion of religious and ethnic harmony with one of Africa’s most well-developed economies. However, an armed rebellion in 2002 split the nation in two. Even though renewed violence has intermittently interrupted peace deals, the country has slowly moved toward a political resolution. Côte d’Ivoire has seen its economy continue to flourish in recent years. The country has a population of nearly 24 million and remains the world’s largest exporter of cocoa beans, the primary force driving its economy. Though poverty in Côte d’Ivoire has improved, the country if far from resolving it. The poverty rate stands at 46.3%, and a quarter of the labor force remains unemployed. The biggest challenge for solving poverty in Côte d’Ivoire is how to translate a growing economy into social inclusion and a reduced poverty rate.

Background: Political Unrest

Côte d’Ivoire has a recent history of violent political unrest. In October 2018, conflicts over local elections resulted in the killing of 10 people. These tensions persist from conflicts in 2002 when incumbent President Laurent Gbagbo faced off with the Forces Nouvelles de Côte d’Ivoire. Conflicting ideals and values lead to a fully militant civil war from 2002 to 2004. The primary cause of the civil war was a feeling of discrimination among Muslim northerners by the politically dominant Christian southerners. 

Today, political unrest in Côte d’Ivoire is at an all-time high since the civil war as the 2020 presidential election has caused tensions to rise. There is significant uncertainty as to whether or not President Alassane Ouattara is going to run for reelection. Additionally, the International Criminal Court recently acquitted former president Gbagbo and is scheduled for release from prison. There is much speculation that Gbagbo will join the 2020 presidential race. As such, the current leading Party (Parti Démocratique de Côte d’Ivoire) and the opposition party (Front Populaire ivoirien) have established a new independent electoral commission in the hopes of easing tensions between supporters of the two sides. Despite this hopeful step, arrests of political opponents in May and clashes between law enforcement and demonstrators have heightened unrest.  

The Economy Now

Since 2011, the economy in Côte d’Ivoire has been among the fastest-growing in the world at 8% per year. Despite this, the country’s GDP growth has not increased. Instead, in recent years, Côte d’Ivoire’s GDP has declined by nearly 3%, from 10.1% in 2012 to 7.7% in 2017. Furthermore, Côte d’Ivoire ranks low in both the UNDP’s Human Development Index (170 out of 189 countries) and the human capital index score (0.35). Many poverty-related factors contribute to the low economic development rate.

The most significant challenges in solving poverty in Côte d’Ivoire are similar to those of many countries facing major poverty issues. One of the larger systemic problems perpetuating the country’s gender inequality is the secondary education completion rate, which is 42.7% for girls and 55.5% for boys. The low overall secondary education completion rate (35.5%) creates a challenge for future economic development. Also, the maternal mortality rate is high at 645 deaths per 100,000 live births, and there is a crisis of infant malnutrition. Finally, youth unemployment, which comprises people between the ages of 15 and 35, sits at 36% of the population. Poverty in Côte d’Ivoire is much deeper than economic growth, which does not directly translate to poverty reduction.   

Solving Poverty in Côte d’Ivoire

Despite the variety of issues outlined above, Côte d’Ivoire is working toward ending poverty in the country. In 2009, the country worked in conjunction with the IMF and World Bank to set initiatives for development. The four strategic outcomes outlined in the plan were: Reestablishing the Foundations of the Republic, Transforming Côte d’Ivoire into an Emerging Economy, Social Well-Being For All and Côte d’Ivoire is a Dynamic Actor on the Regional and International Scene. Through these initiatives, Côte d’Ivoire has a robust framework for progressing not just economically, but socially as well.  

Once political unrest subsides in Côte d’Ivoire, the nation can continue to enact initiatives to end poverty. The country’s continually growing economy is a positive first step in ultimately reducing poverty. Through continued work with the IMF and World Bank, Côte d’Ivoire has the potential to flourish economically and translate those results to its impoverished people.

– Max Lang
Photo: Flickr