Archive for category: Disease

Information and news about disease category

, ,

Efforts for Improving Health Care in Nigeria

Health Care in NigeriaNigerians have faced a growing crisis in health care access in recent years. Nigeria has a population of more than 200 million people, marking it as one of the most populated countries in 2024. The country has a diverse group of people, cultures and languages. Although the country has a huge potential for widespread affluence due to its oil and natural resources, its systems are lacking in meeting the needs of all its citizens. For its health care system, as of 2023, Nigeria was ranked 157th out of 167 countries. Improvement within the system is essential for the well-being of the Nigerian people to be guaranteed.

Malaria

Malaria is a life-threatening disease found in primarily tropical countries and is transmitted to humans by mosquitoes. In 2021, approximately 619,000 people died from malaria, with more than half of all malaria deaths worldwide occurring in four African countries. Nigeria’s health indicators are some of the worst in Africa. Nigeria continues to undertake the highest level of malaria cases globally, which is the leading cause of child illness and death. Professor Olubenga A. Mokuolu oversees all malaria work in the country.

In an interview, he gave one reason for Nigeria’s high malaria burden: the country’s environmental management. “In terms of environmental management, Nigeria leaves a lot to be desired. The country has open refuse sites and blocked drainage systems and because people lack piped water, they store water at home in containers. These all provide ideal sites for mosquitoes to breed.” While the number of malaria cases has gone down in recent years, they are not at a level where people can fully be at ease.

Lack of Access

Health care access in Nigeria is very limited due to factors within the health system. The Nigerian primary health care (PHC) system is the lowest level and entry point for Nigerians to receive health care services such as visitations, preventative, curative and rehabilitative services. Although initially, the PHC system was seen as a guiding policy for further health improvements, there were many flaws with its enactment.

Vivien O. Abah, a Nigerian health care researcher, stated that “The PHC system was deployed to the grassroots, but geographical access did not translate to access to health care as the populations did not utilize the majority (80%) of these facilities.” Not only was the lack of geographical access difficult but the quality of care in these primary health facilities was proven difficult for some as well.

What Is Being Done

The Nigerian health care industry has faced serious setbacks in recent years due to a lack of funding, as well as the mismanagement of creating accessible quality care for the population. This does not mean that the country has given up, as there have been various measures taken into consideration to improve the system.

In 2018, the government approved the second National Strategic Health Development Plan (SHDP), which sought to ensure all Nigerians have access to health care in the country, with a focus on preventing the trend of citizens traveling abroad for medical care. The Former President of Nigeria, Muhammadu Buhari, said that the SHDP will be a transparent and accountable mechanism implemented to ensure the health of all citizens and to forbid corruption from affecting funding.

The government has also focused on individual epidemics and issues that have affected Nigerians, as its preventative measures for malaria have saved tens of thousands of lives, most of them children. The country’s health care system provides more than 25 million children aged less than 5 with preventive chemotherapy for malaria, which has considerably reduced the children’s mortality rates.

Improving Health

Improvement of the Nigerian health care system will be a long and arduous process. and its efficiency highly depends on whether or not the government prioritizes high-quality care and population outcomes. In the past, people have had tremendous trouble seeking high-quality care, with some having to leave the country to receive treatment.

Health care in Nigeria has undergone significant changes and is moving in the right direction, but there is still progress to be made. With a growing population in a country known for diseases and limited medical access, the health care system cannot currently guarantee treatment for all its citizens. 

– Oliver Martin

Oliver is based in Honolulu, HI, USA and focuses on Global Health for The Borgen Project.

Photo: Pixabay

, ,

Controlling Noncommunicable Diseases in Bangladesh

Noncommunicable Diseases in BangladeshNoncommunicable diseases (NCDs) are the leading cause of death in Bangladesh. In 2019, NCDs, including cancers, diabetes, cardiovascular and chronic respiratory diseases, accounted for 70% of mortality in the country. NCDs derive from genetic, environmental and behavioral factors, meaning a person’s lifestyle impacts their likelihood of diagnosis.

Air pollution in Bangladesh contributes to the rise of cardiovascular illnesses and chronic respiratory diseases, where heart disease, strokes and asthma impact individuals’ physical health. Unhealthy lifestyles, diet and physical inactivity are also causes of NCDs like cancer and diabetes. These ongoing causes and burdens have mobilized the government to work toward controlling NCDs in Bangladesh.

Health Discrimination

Health surveys from 2011 to 2018 have shown that socioeconomic disparities are connected to the prevalence of hypertension, diabetes and overweight and obesity. For example, those who work in manual labor in Bangladesh are more exposed to air pollution, increasing the incidence of hypertension and obesity. Conversely, economic growth has led to more processed, readily available and low-cost foods available to poor people. Unhealthy diets also contribute to high NCD prevalence in poorer communities in the country.

Moreover, NCD services are costly and access to proper care is far less attainable for people experiencing poverty. These chronic conditions require long-term care and jeopardize patients’ financial stability with medical expenditures. In 2021, the country allocated 2.36% of its gross domestic product to health expenditure. Out-of-pocket spending accounts for a 68.5% share of health expenditure. Dependence on out-of-pocket spending causes financial distress, especially among vulnerable families.

The Plan

Bangladesh’s Multisectoral Action Plan for the Prevention and Control of NCDs 2018-2025 commits to address these diseases and improve the health care system. The operation plan’s success requires four courses of action that are conducive to controlling noncommunicable diseases in Bangladesh.

  • Action area 1: Advocacy, leadership and partnerships.
  • Action area 2: Promotion and risk reduction.
  • Action area 3: Health systems strengthening for early detection and management of NCDs and their risk factors.
  • Action Area 4: Surveillance, monitoring and research.

Successes since 2018

Through partnerships, the country has made significant progress in creating a strong foundation for NCD prevention and control. The collaboration between 30 ministries and agencies was one notable success. In the 2022 first National NCDs Conference in Bangladesh, national and international stakeholders assembled to discuss NCD prevention and control strategies and established the Dhaka Declaration, 32 steps to combat NCDs. This declaration furthered the Multisectoral plan’s goal of controlling tobacco, alcohol and indoor air pollution and promoting physical activity and healthy diets.

NCD Corners in health complexes have also been developed across the country, increasing access to care. These corners facilitate early detection and management of common NCDs, even in rural areas. By October 2022, 6,231 patients were treated for high blood pressure and 1,386 for diabetes through these corners. The National Heart Foundation Bangladesh has also reported an increase in hypertension control across the country’s administrative districts. For instance, in Kualara, from May 2022 to October 2022, the number of patients with controlled hypertension rose by 15%, from 55%,  with the assistance of NCD corners. These corners are located in community health centers and primary health care facilities, providing easy access for all population groups.

Furthermore, progress has been made in developing policies to control shared risk factors of NCDs. To promote healthy diets, the country has imposed taxation on domestically produced sugar-sweetened beverages. First, there is a 15% value-added tax and then a 25% supplementary duty for carbonated drinks and 35% for energy drinks. Taxes on unhealthy items help reduce consumption and the prevalence of obesity and other NCDs can decrease.

Ongoing Efforts

There is still more to be done. Taxation is effective in controlling Bangladesh’s tobacco problem. In the fiscal years 2024 and 2025, the government strives for a 66% increase in the tax rate on cigarettes and tobacco products. This change factors in indoor pollution control as tobacco smoke inside homes exposes nonsmokers to smoking and poor air quality.

The plan further addresses health financing and expenditure. In the fiscal year 2024, the country increased its federal budget allocation for health by 9%. However, this improvement had little effect on the country’s health care quality. Bangladesh’s Multisectoral plan proposes financial risk protection through:

  • Accessing NCD services without upfront costs.
  • Integrating essential services at district and lower levels, including an annual NCD voucher system with minimal costs.
  • Adjusting the fee structure if other strategies cannot be implemented.

By prioritizing these strategies, Bangladesh can look toward a healthier future for all its citizens, ensuring equitable access to quality health care.

Conclusion

Noncommunicable diseases continue to impact mortality and quality of life in Bangladesh. However, Bangladesh’s Multisectoral plan has successfully coordinated efforts across various sectors to control NCDs. Collaboration, policies, regulations and initiatives for enhancing accessibility remain conducive to these goals.

– Caroline Albright

Caroline is based in Milton, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Pexels

, ,

ARIDA: Tackling Childhood Pneumonia

ARIDAThe World Health Organization (WHO) identifies pneumonia as the leading cause of mortality among children under five, attributing more than 700,000 child deaths to the disease in 2019. Consistently, UNICEF estimates that pneumonia annually claims the lives of 800,000 children under five worldwide, marking it as the top cause of child morbidity from infectious diseases globally. Pneumonia can be contracted through various agents, including viruses, bacteria or fungi. It affects the lungs, specifically the alveoli—small sacs where air exchange occurs. Normally, these sacs expand with air when inhaling. In cases of pneumonia, the alveoli fill with fluid or pus, making breathing painful and limiting the ability to take deep breaths.

Typical Barriers to Treating Pneumonia

Pneumonia is often misdiagnosed as a disease like malaria or tuberculosis, complicating early detection efforts. The WHO reports that in remote areas with limited health facilities, health workers rely on manual counts of respiratory rates (RR) to diagnose pneumonia. However, manually counting a child’s breaths is challenging and subjective, with variations in what different health workers consider a single breath. This inconsistency makes it difficult to obtain an accurate RR, hindering effective diagnosis.

ARIDA

In 2014, UNICEF launched the Acute Respiratory Infection Diagnostic Aid (ARIDA) program to develop technology that would enable health workers to diagnose pneumonia more accurately. This initiative introduced two new devices: the Philips ChARM, which stands for Children’s Automatic Respiratory Monitor and the Masimo Rad G, both designed to improve the assessment of respiratory rates in children.

The Philips ChARM, priced at $44 per unit, automatically counts a child’s respiratory rate when strapped around the torso, designed for use while the child lies horizontally. The Masimo Rad G, costing $250 per unit, uses a clip-like monitor attached to the child’s finger to calculate respiratory rate and simultaneously measure blood oxygen levels. Using devices to calculate respiratory rates has enabled health workers to adhere more closely to WHO guidelines for diagnosing pneumonia quickly and accurately. More than one million children gained access to life-saving antibiotic treatments due to the ARIDA devices and an additional 300,000 received enhanced care services.

The Future of ARIDA

The trials of the ARIDA devices took place in Bolivia, Nepal and Ethiopia from 2017 to 2019, significantly advancing Ethiopia’s health goals for women and children. These ongoing efforts are part of a broader commitment to the Global Action Plan for Pneumonia and Diarrhoea, aiming to eliminate all treatable pneumonia and diarrhea-related deaths by 2025. The plan includes expanding the range of ARIDA products available for government purchase. However, the scaling of ARIDA products faces challenges such as unit costs, though countries may offset these costs through funding from UNICEF’s development partners. This initiative also supports the United Nations (U.N.) goal to end preventable deaths of newborns and children under five by 2030.

Looking Ahead

The ARIDA initiative has made significant strides in diagnosing and treating pneumonia, particularly in remote areas. Trials in Bolivia, Nepal and Ethiopia have already enabled more than a million children to access life-saving treatments. Despite cost challenges, the expansion of ARIDA products aligns with global health goals, aiming to reduce child mortality rates and improve health care outcomes by 2030.

– Naomi Finapiri

Naomi is based in London, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

, ,

Fighting the New Spike Of Malaria in the Philippines

Malaria in the PhilippinesThe Philippines is familiar with the problem of malaria. In 1970, the country’s malaria morbidity rate per 100,000 people was nearly 80%. The mosquitoes that transmit the parasitic disease extend all across the nation. With the devastation that the Philippines faced, its government became very committed to limiting and reducing the damage caused by the disease.

Success in Malaria Reduction

One of the many ways the Philippines fought malaria was through an increase in surveillance systems, working toward finding specific malaria outbreaks to target with boosted treatments. The government’s actions were extremely successful. In 2005, the Philippines achieved a reduction rate of 92% in cases and a decrease in the malaria mortality rate by 98%. Additionally, around 60.9% of the country’s provinces were officially declared malaria-free in 2018.

Leveraging Digital Technology

By employing new digital technology, specifically its Online Malaria Information System, the Philippines is able to catalog, process and distribute information on malaria outbreaks. This allows for speedy treatment and prediction of future outbreaks by monitoring reports made by locals. This system is available to everyone on Android, so it is very accessible to the Filipino people.

Current Challenges and Advanced Strategies

Due to significant humanitarian aid and government infrastructure expansion, the Philippines experienced a general decline in malaria cases. However, in 2023, the country saw a sharp increase in cases, about 6,248, nearly doubling from the previous year, which was 3,245. Many health professionals attribute this rise to the relaxation of restrictions in the post-COVID-19 world. Nonetheless, new health centers are now focused on eliminating and preventing the spread of malaria.

Filipino health centers collect data on patients and the environment to monitor potential malaria outbreaks. Quick identification leads to quick treatment and with sufficient treatment, the Philippines aims to be entirely malaria-free by 2030. The approach is more complex than merely distributing surveys or looking for common symptoms.

The health centers are exploring advanced diagnostic and geographical mapping tools, improved surveillance technology and the identification of less common and often overlooked symptoms of malaria. With better diagnostic tools, medical professionals can assess patients more quickly and determine which strain of malaria is affecting them, enabling faster and more effective treatment.

The geographical mapping tools allow people to monitor the spread of outbreaks, see where the infected mosquitoes are moving and act proactively against the disease. As the World Health Organization (WHO) advises, surveillance is one of the best ways to prevent and combat malaria, so the Philippines is looking to improve its preexisting system to fight this current wave of malaria.

Conclusion

Malaria is one of the most notorious and dangerous diseases and humanity has been fighting it for decades. The Philippines, in particular, has a long and difficult history with malaria but has developed effective systems to combat it. The Filipinos’ active efforts to reduce malaria in their country offer hope for a malaria-free world, evidenced by the 72 provinces that are now officially malaria-free.

Another promising development in the fight against recent malaria outbreaks is the emergence of new vaccines that provide immunity against various strains of the life-threatening disease. With a vaccine in the works and new health centers being established, the Philippines is optimistic about seeing a reduction in malaria cases soon.

– Paige Tamasi

Paige is based in Los Gatos, CA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

, , , , ,

Strengthening Health Care Centers in Saint Lucia

Strengthening Health Care Centers in Saint LuciaLocated in the Caribbean, Saint Lucia is a small island nation with a population of just under 200,000. Like many Small Island Developing States (SIDS), it faces challenges such as limited technology and overwhelmed health care services, making its population vulnerable to poor health. Noncommunicable diseases (NCDs) like hypertension and diabetes reportedly account for approximately 82% of the country’s deaths.

Causes of Vulnerability

SIDS are particularly vulnerable to NCDs. According to a 2023 World Health Organization report, of 15 countries experiencing a 30% higher mortality rate from NCDs, eight are SIDS. This heightened vulnerability stems from several factors, including governance issues, educational gaps and economic inequality. Their isolated locations restrict trade and access to resources, while small populations limit their ability to develop extensive health care facilities and secure sufficient funding. The high cost of medical technology further strains their GDPs.

SIDS faces frequent natural disasters like hurricanes and cyclones, which annually cost 1% to 8% of their GDP, leading to infrastructure damage that requires ongoing reinvestment and rebuilding of national services. Additionally, these nations often suffer from brain drain, as many skilled professionals emigrate in search of better opportunities, further depleting the health care workforce.

Strengthening Health Care Centers in Saint Lucia

With funding from the World Bank, the Ministry of Health, Wellness and Elderly Affairs in Saint Lucia has implemented a Performance-Based Financing mechanism for health care centers. This scheme distributes funding to wellness services across the island, aiming to improve access to primary-level health care for patients and reward centers for their treatment provision. By allocating funds based on data-driven performance metrics, the ministry makes strategic investments to maximize effectiveness.

Long-term investment in health care services enhances their efficiency and resilience in recovering from unprecedented events and shocks. Recent years have highlighted the importance of such resilience, with many countries struggling to handle crises like the COVID-19 pandemic. This resilience is especially critical for SIDS, given their increased vulnerability to natural disasters like hurricanes. These meteorological events strain the economy and necessitate frequent strengthening of infrastructure.

A recent World Bank report found that individuals suffering from non-communicable diseases spend about 36% of their income on health care annually, a figure that rises to nearly 50% among those experiencing higher levels of poverty. Improved health services allow individuals to consult local providers instead of resorting to more expensive hospital care. Strengthening health care centers in Saint Lucia boosts economic conditions on both national and individual levels.

Looking Ahead

Saint Lucia, like many SIDS, faces significant challenges in managing NCDs due to its limited health care resources and economic constraints. The government, with World Bank support, has introduced a Performance-Based Financing mechanism to improve primary health care access and efficiency. Strengthening these services can potentially reduce health care costs for individuals and enhance the island’s overall economic resilience. This approach aims to mitigate the impact of natural disasters and health crises on the nation’s vulnerable population.

– Aimee Masters

Aimee is based in London, UK and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

, ,

Lassa Fever in Nigeria

Lassa Fever in Nigeria Lassa fever, a viral hemorrhagic illness, was first identified in the town of Lassa in northeastern Nigeria. The primary reservoir of this virus is the multimammate rat, a common sight across West Africa. Human infection typically occurs through exposure to food or household items contaminated with the urine or feces of infected rats. The symptoms of Lassa fever can range from mild to severe, including fever, headache, sore throat and muscle aches. In severe cases, the disease can progress to hemorrhaging, organ failure and even death. Each year, Lassa fever affects between 100,000 to 300,000 people in West Africa, with an estimated 5,000 deaths.

Socioeconomic Impact

The disease’s prevalence is particularly pronounced in Nigeria and has become a significant public health concern. The country’s endemic status is exacerbated by socioeconomic conditions, including widespread poverty. In regions where Lassa fever is rampant, many households lack the means to maintain proper sanitation and secure food storage, creating ideal conditions for rodent infestations. In addition, limited access to health care services and inadequate infrastructure hinder timely diagnosis and treatment, compounding the disease’s impact.

Lassa Fever and Global Poverty

The disease’s transmission is closely tied to environmental and socioeconomic factors. In addition, the changing climate is exacerbating the situation. Hotter and drier conditions drive rodents into human habitats for food and water, increasing the risk of transmission. As these environmental changes unfold, the interplay between Lassa fever and global poverty becomes starkly evident. Poverty-stricken communities, often lacking adequate housing and sanitation, are more susceptible to rodent infestations, thereby heightening their risk of contracting the virus.

The health infrastructure in impoverished regions is typically under-resourced, making early diagnosis and effective treatment more challenging. Health care costs and limited access to medical facilities mean that many affected individuals cannot afford or access timely medical care, leading to higher mortality rates. The burden of Lassa fever in Nigeria thus reflects the broader issue of global poverty, where infectious diseases disproportionately impact vulnerable populations.

Public Health Response

Health authorities and strategic planners in Nigeria have implemented a multifaceted public health response to Lassa fever, involving immediate medical interventions and long-term strategies to reduce transmission. In fact, the country hosted the first Lassa fever treatment trials in 40 years. These trials mark a critical step forward in finding effective treatments for this devastating disease. The initiative is a collaborative effort involving local health authorities, international organizations and pharmaceutical companies, highlighting the global recognition of the need to combat Lassa fever.

Strengthening Health Infrastructure

The World Health Organization (WHO) has played a pivotal role in supporting Nigeria’s response to Lassa fever outbreaks. The WHO is strengthening disease surveillance, enhancing diagnostic capacities and training health care workers as part of its comprehensive strategy. These efforts ensure that health care workers detect and manage cases of Lassa fever in Nigeria promptly, thereby reducing the potential for widespread outbreaks. Furthermore, the WHO emphasizes the importance of community engagement and education to raise awareness about preventive measures, such as proper food storage and hygiene practices to limit rodent exposure.

Economic Considerations

The economic burden of Lassa fever in Nigeria extends beyond the immediate health impacts. Outbreaks can disrupt local economies, as affected individuals cannot work and health care costs soar. This further entrenches poverty, making it harder for communities to recover and prevent future outbreaks. International support, such as funding for research and health care infrastructure improvements, is vital in breaking this cycle. The global community’s investment in combating Lassa fever in Nigeria underscores the interconnectedness of health and poverty and the need for a coordinated, sustained response to address both issues simultaneously.

Looking Ahead

Efforts to combat Lassa fever in Nigeria involve significant collaboration among local health authorities, international organizations and pharmaceutical companies. These initiatives focus on strengthening disease surveillance, improving diagnostic capabilities and educating communities about preventive measures, with hopes of alleviating Lassa fever.

– Maya DaSilva

Maya is based in Seattle, WA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

, ,

Efforts and Successes in Combating Disease in Sri Lanka

Disease in Sri LankaSri Lanka, the neighboring island nation to India in South Asia, is a developing country making many efforts to increase its standard of living. One of these central efforts is the fight against disease and illness, which Sri Lanka has reduced with great success. Malaria, Leprosy and noncommunicable diseases (NCDs) have been reduced or eliminated from the country.

The Efforts

Disease in Sri Lanka comes in two forms: communicable diseases and NCDs. Considering the side of communicable diseases, Sri Lanka has taken great strides to reduce two of the most prevalent diseases within the nation: Malaria and Leprosy.

The Anti-Malaria Campaign (AMC) has taken on malaria and its prevalence within the region in full force. This initiative, supported by country collaborations, technical leadership and financial investments from the World Health Organization (WHO) and the Global Health Fund, has supplemented a national budget dedicated to the fight against malaria.

Leprosy shares a similar story. Successful campaigns and efforts against the disease caused Sri Lanka to experience a considerable decline in the prevalence of leprosy in the years following 1983, with the introduction of multidrug therapy (MDT) by the WHO.

However, communicable diseases in Sri Lanka were only responsible for 14,265 deaths in the year 2019. In contrast, NCDs such as heart disease and diabetes were responsible for the deaths of 96,072 people in the same year.

Public Health in Sri Lanka

Public health in Sri Lanka relies not only on funding from the WHO and the Global Health Fund but also on grassroots efforts to educate the public about the dangers of a sedentary lifestyle. Managing NCDs requires a preventive care approach, leading to a reorganization of the country’s health care system through the globally funded Primary Health care System Strengthening Project (PSSP). This project aims to support the government in enhancing the utilization and quality of health care, with a primary focus on the detection and prevention of NCDs.

The Successes

Since the turn of the century, Sri Lanka has made excellent progress in reducing the prevalence of malaria—the total number of cases in Sri Lanka was reduced by 78%, from 22.9 million to 5 million. The budget from the Global Health Fund and the WHO supplemented the efforts to successfully eradicate malaria as a common disease in Sri Lanka.

Leprosy has also wavered greatly in recent years. Assisted by the creation of MDT by the WHO, the country achieved a WHO elimination goal of leprosy cases, yielding less than one for every 10,000 people in the population by the turn of the 21st Century. The formative research provided by outside organizations, along with the campaign’s efforts to increase social awareness about the disease and its communicability, successfully reduced the rate of Leprosy.

NCDs are also being addressed, however, in a drastically different manner than that of communicable diseases. The people in Sri Lanka have been informed of the dangers of communicable diseases yet are ill-informed of the dangers of a sedentary lifestyle and how being proactive is healthy for the body. This is being curbed through efforts established by the PSSP and its association with Primary Medical Care Institutions (PMCI).

Primary Medical Care Institutions

According to the World Bank, curative primary health care services in Sri Lanka are delivered mainly through PMCI. This includes district-level hospitals and Primary Medical Care Units situated around the nation. In March 2022, about 350 of the 1,030 PMCI in Sri Lanka were strengthened under the PSSP initiative. However, by the end of the project in 2023, this number reached a minimum of 550.

The lack of information regarding the dangers of a sedentary lifestyle is slowly being overturned through an increasingly active information campaign. Alongside this are initiatives to raise awareness of the importance of daily exercise and how a proper diet is beneficial to overall health. These efforts by the PSSP are effectively paving a path toward a healthier nation.

Final Remark

Sri Lanka has yet to eradicate diseases completely. Even with the successful efforts to combat malaria and leprosy, there is still a great risk of their return. Diseases are always on the cusp of coming back. However, with the continued dedication of organizations around the world and commitment from the leadership of Sri Lanka, it will always be at the forefront.

– Luke Scroggins

Luke is based in Dallas, TX, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

, ,

Fighting Diseases in Palestine

Diseases in PalestinePalestine includes two non-contiguous territories located in the Middle East: the Gaza Strip and the West Bank. The West Bank is home to 3.2 million people and Gaza to 2.1 million. Since Oct. 7, 2023, continuous warfare between Israel and the resistance of Palestine has resulted in a severe health crisis, highlighted by a rapid spread of infectious diseases and the collapse of essential health care services.

Political and economic instability–worsened by the blockade and fighting– has left the health care infrastructure in shambles, severely impacting the well-being of Palestinians. Both chronic and transferable illnesses, coupled with a rapid decline in mental health, have steadily worsened. However, international and local nongovernmental organizations (NGOs) are working to combat the dire situation.

Crumbling Health Care System

The health care system in Palestine, particularly in Gaza, is on the brink of collapse. The conflict has led to severe shortages of medicines, fuel and medical supplies, making it nearly impossible for hospitals and clinics to function effectively. According to reports, there are around 350,000 patients in Gaza suffering from chronic conditions such as cancer and diabetes, alongside 50,000 pregnant women who are struggling to access necessary care​​.

The World Health Organization (WHO) has reported that nearly two-thirds of health clinics in Gaza are nonfunctional. Furthermore, the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East has indicated that fewer than half of its health centers can offer primary care to patients​​. This has left a sizable portion of the population without access to basic medical services, exacerbating the health crisis.

Sanitation and Water Crisis

The water and sanitation situation in Palestine is extremely dire. There is only one shower for 4,500 people and one toilet for more than 200 people. This has led to a significant increase in the spread of infectious diseases in Palestine. The situation is a result of the ongoing conflict, which has forced many Palestinians to seek refuge in overcrowded shelters or relocate to the south, where unsanitary conditions prevail.

Contaminated water supply and poor hygiene are leading to outbreaks of illnesses such as diarrhea, respiratory infections and chickenpox. Up to 70 people are crammed into single rooms, creating an environment ripe for disease transmission​​. Respiratory diseases in Palestine are particularly rampant, with more than 150,000 cases of upper respiratory infections reported, alongside numerous cases of meningitis, skin rashes, lice and chickenpox. The risk of cholera and other epidemics looms large as the health and sanitation infrastructure continues to deteriorate​​.

Efforts to Combat Disease

Despite the overwhelming challenges, various efforts and initiatives are underway to alleviate the health crisis in Palestine. NGOs are spearheading humanitarian aid to mitigate the ongoing situation.

WHO is improving health conditions by coordinating with local and international partners to enhance aid delivery and establish more supply routes. More than a dozen high-risk operations have been conducted to provide supplies to hospitals in Gaza. WHO helped establish two kitchens at Al-Shifa Hospital, which serve 1,200 meals a day. Its distribution of medical supplies currently supports treatment for 1,250 children with severe malnutrition.

The United Nations Children’s Fund (UNICEF) also plays a pivotal role in saving lives. In addition to first aid, it provides 600,000 vaccinations and nutritional supplements to children and expecting mothers. It also provides safe drinking water for 1.3 million people to curb infectious diseases.

While efforts to provide relief are ongoing, the situation remains precarious. However, the resilience and determination of health care workers combined with international support allow for much optimism. Sustained efforts and global solidarity offer hope in paving the way for a healthier future in Palestine.

– Asiya Siddiqui

Asiya is based in Fremont, CA, USA and focuses on Global Health and Good News for The Borgen Project.

Photo: Flickr

, ,

The New Innovative Meningitis Vaccine in Nigeria

The New Innovative Meningitis Vaccine in NigeriaNigeria has the highest meningitis death rate among African countries. The most severe outbreaks typically occur in March and April, when intensified heat and airborne dirt contribute to the disease’s spread. To combat this, Nigeria has introduced an innovative meningitis vaccine to the public in a historic move. This vaccine promises to be more effective in eliminating meningitis and has the potential to significantly improve the lives of many Nigerians.

This achievement in Nigeria aligns with the World Health Organization’s (WHO) “Defeating Meningitis by 2030: A Global Road Map.” This strategy aims to eradicate meningitis outbreaks, reduce the mortality rate from the disease and improve the well-being of those recovering from meningitis.

Meningitis

Meningitis, a fatal illness, causes swelling of the membranes around the spine and brain. Various viruses, parasites and microbes can cause this disease. Bacterial meningitis, the most severe form, can be fatal within 24 hours of infection. It currently poses a significant threat to global health. Approximately one in six individuals who contract bacterial meningitis die and one in five survivors sustain a permanent disability after treatment.

Meningitis Challenge in Nigeria

Sub-Saharan Africa is described as the African Meningitis Belt, as this area is most prone to meningitis. Approximately 30,000 diagnoses are documented in the region annually.

Nigeria, located in the African Meningitis Belt, is highly susceptible to meningitis. Reports indicate that between Oct. 1, 2023 and March 11, 2024, there were 1,742 suspected meningitis cases in Nigeria, resulting in 153 deaths and 101 confirmed cases of the disease.

Introduction of the Men5CV Vaccine

Nigeria has become the first country to implement the Men5CV vaccine to combat meningitis, effectively protecting against the five meningococcal bacteria types—A, C, W, Y and X. This vaccine is a significant improvement over its predecessor, which only offered protection against strain A.

The WHO is assisting Nigeria with the rollout of the Men5CV vaccine for meningitis, including training health providers. The organization anticipates that this vaccine will significantly reduce the rate of meningitis diagnoses and support efforts to eventually eliminate the disease, especially in countries within the African Meningitis Belt. Projections suggest extensive advertising campaigns for the Men5CV vaccine throughout the African Meningitis Belt by 2025.

The Men5CV vaccine could help Nigerians avoid falling into poverty. Treating meningitis can cost a family three to four months of income, potentially pushing them into poverty due to the financial burden. Additionally, long-term effects of meningitis, such as deafness, can make it challenging to secure employment. Therefore, the Men5CV vaccine might reduce the economic impact of treating meningitis.

Optimism For The Future

In response to Nigeria’s significant progress, world leaders will convene at a global conference in Paris in April 2024. They celebrated Nigeria’s advancements and discussed future challenges. The conference will also provide an opportunity for other world leaders to commit to accelerating efforts to eradicate meningitis as a global issue by 2030.

The introduction of the Men5CV vaccine in Nigeria marks a pivotal advance toward eradicating meningitis globally. Dr. Nanthalile Mugala, PATH’s Chief of Africa Region, stated, “The introduction of MenFive [the “Men5CV vaccine”] in Nigeria heralds a transformative era in the fight against meningococcal meningitis in Africa. Building on the legacy of previous vaccination efforts, this milestone reflects over a decade of unwavering, innovative partnerships. The promise of MenFive [the “Men5CV vaccine”] lies not just in its immediate impact but in the countless lives it stands to protect in the years to come, moving us closer to a future free from the threat of this disease.”

– James McAlinden

James is based in Rosehearty, Scotland and focuses on Global Health for The Borgen Project.

Photo: Flickr

, ,

4 Aspects of Global Poverty That Lead to Cholera Outbreaks

Cholera OutbreaksCholera is an acute diarrhoeal disease causing severe diarrhea and dehydration and it can be fatal if left unchecked. With the onset of 2024, the persistence of cholera has become evident. In January alone, across 17 countries in four regions – Africa, the Eastern Mediterranean, the Americas and South-East Asia – 40,900 cases and 775 deaths were reported. Here are five aspects of global poverty that contribute to cholera outbreaks:

Lack of Access to Sanitation and Clean Water

While there have been efforts to address inadequate sanitation through Water, Sanitation and Hygiene (WASH) interventions in the past, there are still challenges. On a positive note, previous studies have indicated that initiatives like extensive media outreach, engagement of community health workers and the provision of essential items such as water purification tablets, soap and oral rehydration solutions have demonstrated efficacy in encouraging behavioral shifts aimed at preventing cholera.

However, the effectiveness of WASH interventions varies across different regions and contexts, especially regarding recontamination. Despite efforts to disinfect water storage containers, a significant percentage of containers are becoming recontaminated at the household level. The distribution of household disinfection kits as an alternative presents the potential to diminish social stigma and empower households to uphold hygiene practices. Yet, additional evaluation is required to confirm their efficacy. Additionally, more research is needed to evaluate the effectiveness of WASH interventions during cholera outbreaks and inform international policy and practice.

Unplanned Urbanization

Unplanned or unmanaged urbanization often refers to the rapid and unplanned growth of urban areas without adequate planning, infrastructure and governance. In the context of public health, the consequences of unplanned urbanization are profound, particularly concerning the spread and impact of infectious diseases like cholera.

It is important to note that cholera outbreaks primarily impact impoverished communities characterized by low socioeconomic status. Particularly vulnerable are individuals living in densely populated regions with restricted access to safe water and sanitation facilities – the overcrowding in these regions is exacerbated by unplanned urbanization.

Therefore, the lack of urban planning often results in disparities in access to health care services, exacerbating the burden of disease on already marginalized populations. Reducing unplanned mass urbanization would require a multifaceted approach that addresses both the underlying drivers of urbanization – including weak governance, unaffordable housing and a lack of investment in infrastructure – and the consequences of rapid and disorderly urban growth.

Food Insecurity

Currently, a negative correlation exists between national food security levels and annual incidences of cholera. In a cross-sectional survey investigating the relationship between food insecurity and cholera in rural Haitian households, it was found that moderate and severe household hunger were significantly associated with a history of cholera. Certain high-risk behaviors were identified as potential mediators of the association between food insecurity and cholera.

These behaviors include the consumption of food and beverages prepared outside the home, the use of antacids and the consumption of leftover non-reheated food items. Household food insecurity was positively associated with these high-risk behaviors, indicating a potential pathway through which food insecurity may increase the risk of cholera transmission.

Interventions targeting food insecurity may help reduce the prevalence of high-risk behaviors and subsequently lower the incidence of cholera in vulnerable populations. Future longitudinal and qualitative research can be done to investigate the relationship between food insecurity, high-risk behaviors and cholera risk further. By addressing and understanding underlying socioeconomic determinants such as food insecurity, public health initiatives can disrupt the transmission dynamics of cholera outbreaks and alleviate the burden of this preventable disease in resource-constrained settings.

Vaccine Shortages

More recently, there was a significant scarcity of Oral Cholera Vaccines (OCV) globally from January 2023 to January 2024, impacting the ongoing cholera response efforts. Within this timeframe, 14 countries urgently requested 76 million doses of OCV, yet only 38 million doses were accessible. The depletion of the OCV stockpile was exacerbated by Shantha Biotechnics’s exit from the market in 2023. 

This left the stockpile solely reliant on EuBiologics, a South Korean company, which faced challenges in meeting the unpredictable demand and low pricing associated with vaccine production. However, EuBiologics aimed to produce 35 million doses of the current vaccine and potentially 15 million more if the World Health Organization (WHO) prequalifies its new vaccine.

Despite the temporary shortage, there are prospects for increasing vaccine production in the coming years, with other manufacturers expected to enter the market. However, achieving the Global Task Force on Cholera Control’s target of reducing cases by 90% by 2030 requires sustained efforts, including long-term preventive vaccination programs and the previously mentioned improvements in WASH infrastructure.

Overall, the devastating impact of cholera outbreaks underscores the urgent need for collective action to address the underlying vulnerabilities and ensure access to essential health care services for affected populations.

– Avery Fuller
Photo: Flickr