Archive for category: Disease

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Mass Drug Administration Nears Lymphatic Filariasis Elimination

Lymphatic FilariasisPoverty and health are inextricably linked, with both negatively impacting each other. The main way they affect each other is through financial burdens, where people experiencing poverty are in a position where they can’t purchase the necessary things to support good health, such as quality food or health care. This is also impacted by people with low incomes often lacking the necessary guidance or information on the best practices that lead to a healthy life.

Poor health can also cause poverty in multiple ways. This happens mainly due to the direct costs of seeking health care and its associated costs, such as transportation to a hospital or medical professional. Furthermore, “the considerable loss of income associated with illness in developing countries” can greatly impact the sick individual and family members who may have to stop working or postpone their education to care for the ill relative. This is especially the case for those in extreme poverty (living below $1.90 a day), where people are often living hand-to-mouth with limited to no financial security if they can’t work.

Guyana and Lymphatic Filariasis

Guyana has around 800,000 people, with 90% living on 10% of the country’s total land area. Despite this, Guyana still has a relatively low population density. Due to recent discoveries of oil resources, Guyana’s gross domestic product (GDP) is growing quickly, with a growth rate of 42.3% from 2020 to 2023 but a GDP per capita of $18,199 in 2022.

However, the country still has a significant portion of its population living in poverty, with 48.4% living on less than $5.50 a day in 2019 and it’s estimated to be around 38% currently. Furthermore, in 2022, the Global Nutrition Report noted that 3.2% of the population lived on less than $1.90 daily and 4.7% on less than $3.20 daily. Guyana’s universal health care coverage is promising at 76% on the associated index in 2021, up from 65% in 2011. However, it hasn’t advanced in recent years.

One of the most impactful diseases in Guyana is Lymphatic Filariasis, which is endemic in the country, making it one of four countries in the Americas with such a status. However, the Pan American Health Organization considers lymphatic filariasis “potentially eradicable.” The efforts being made to eliminate lymphatic filariasis in Guyana support this claim. The disease can damage the lymphatic system, with symptoms often appearing later in life. These symptoms include lymphedema and hydrocele—swelling typically around the legs and groin—which can cause permanent disability or disfigurement, leading to social ostracism.

Globally, 120 million people are infected with lymphatic filariasis, with one-third suffering from disability or disfigurement as a result. Given the potential impact on daily life, such as restricted movement that can affect one’s job, particularly in agriculture (a significant industry in Guyana where 17% of workers are employed), the impact on those in poverty is substantial.

Guyana’s Mass Drug Administration Campaign

In Guyana’s efforts to eliminate lymphatic filariasis, the country has launched its third mass drug administration (MDA) campaign, targeting at-risk populations in two regions. The first round of MDA took place in 2019, treating 75.7% of the population, followed by the second round in 2021, which treated 72% of the population. The country is administering a drug regimen called IDA, which includes three separate drugs: Ivermectin, Diethylcarbamazine (DEC) and Albendazole.

In the current round of MDA, “700 trained volunteers and health workers are visiting schools and workplaces and will go door-to-door in regions three and four to administer pills” to bring closer the eradication of lymphatic filariasis in Guyana. With this aim in mind, they are stressing to people that participating in the MDA isn’t only for the health of the country but also the health of their community and families – a method supported by a study conducted on prior participation in MDA in Guyana.

Final Remark

The MDA campaign is bringing the elimination of lymphatic filariasis in Guyana closer. This, in turn, decreases the disease’s burden on those in poverty in the country, reducing the prevalence of the symptoms and, therefore, the impact it has on individuals’ abilities to work and those who would have had to care for those infected. The campaign will further benefit Guyana’s more remote communities, which may lack easy access to universal health care and social support, thereby increasing the impact of contracting lymphatic filariasis in these areas. By participating in the MDA campaigns, people in Guyana are more likely to avoid serious symptoms and maintain a normal life. This reduces the overall impact of lymphatic filariasis, particularly on those in poverty and helps break the cycle of poverty exacerbated by the disease.

– Archie Day

Archie is based in St Andrews, Scotland and focuses on Technology and Global Health for The Borgen Project.

Photo: Wikimedia Commons

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Diseases Impacting Tanzania

Diseases Impacting TanzaniaTanzania has, in the last 10 years, seen a consistent reduction in its poverty rates after it decreased from 34.4% to 26.4% between 2007 and 2018, this mostly being in more rural areas of the country. Disease in Tanzania is becoming a lesser problem for citizens: the combined efforts between the World Health Organization (WHO) and the Ministry of Health in monitoring outbreaks and surveillance of diseases have resulted in improved responses to disease and treating the infected.

The decrease in poverty has also meant that increased funding can go into health care facilities, for example, the 2.22 trillion Tanzanian Shillings (Tsh) allocated to health care in Tanzania in 2017-2018, an increase of 34% from that in 2016-2017.  However, communicable diseases in Tanzania remain a threat to public well-being, and without a fast diagnosis and access to correct treatment, they can often be fatal. Here is information about three diseases impacting Tanzania.

Malaria

Malaria, a disease carried by mosquitoes, is one of the most common communicable diseases in Tanzania. In 2022, there were an estimated 7,960,000 confirmed cases of malaria in the United Republic of Tanzania, making Tanzania the country with the sixth highest number of cases. In response to this, the World Health Organization (WHO) began offering training for district vector surveillance (and control) officers (DVSOs), who collect samples of vectors from around Tanzania that can be analyzed.

This training then saw the certification of 56 new DVSOs, who now play a vital role in malaria prevention and elimination as mosquitos and other disease vectors often tend to behave based on human interaction, and the study of how they behave would help in creating new strategies that align with recent changes in vector behavior. With access to the correct resources, malaria is incredibly preventable. For example, the use of mosquito nets in sleeping areas helps to keep mosquitoes from biting citizens, and even just wearing protective clothing can minimize the spread of malaria in Tanzania.

HIV and AIDs

In 2021, the United Nations states began to work towards the 95-95-95 targets for HIV/AIDS, which aim to ensure at least 95% with HIV know their status, 95% of those with HIV are undergoing treatment and 95% of those undergoing treatment are virally suppressed. In Tanzania, as of 2019, there were 1.7 million people who had confirmed cases of HIV, and in line with the 95-95-95 goals, 83% of those suffering from HIV knew that they had it, and of these, 92% were virally suppressed and receiving treatment.

The National AIDS Control Programme in Tanzania has worked to ensure that condoms are readily available to the Tanzanian population, to prevent the spread of HIV and age-appropriate messages to educate about HIV prevention and myths young people may encounter surrounding it are distributed, in hopes of minimizing the disease and its impact in Tanzania.

Tuberculosis (TB)

Estimates currently indicate that there are around 208 cases of TB for every 100,000 people in Tanzania, and the country is currently on a watchlist for its high TB burden rates, according to the WHO’s Country Outlook. Because of the high rates of HIV and AIDs in Tanzania, this immediately puts anyone impacted at higher risk of contracting TB, due to the compromise in their immune system. In 2021, The Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC), Directorate of Preventive Services through the National TB and Leprosy Programme (NTLP) launched a StopTB Partnership that works to end TB in Tanzania by 2030.

So far, it has been working on raising awareness about TB, by holding workshops to educate local journalists about TB and calling for increased funding towards TB diagnosis and treatment in Tanzania. It has also enforced a framework which ensures that treatment in the form of antibiotics is free to all TB patients through public and private health care systems and that TB notifications are mandatory, according to its 2023 report. This increased access to treatment for Tanzanian citizens could hopefully lower infection rates and decrease its impact in Tanzania.

Looking Ahead

While these diseases impacting Tanzania still have a large impact on the population of the country, the work of these organizations has significantly decreased its impact and improved the lives of many. With continued funding and work from these organizations, Tanzania will likely be able to meet health targets, such as those set by the Global Technical Strategy for Malaria, and move towards eliminating these diseases impacting Tanzania in the future.

– Freyja Stone

Freyja is based in Manchester, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Pharma Giants against Poverty: Merck’s Plan to Eradicate Bilharzia

BilharziaSchistosomiasis, also known as Bilharzia, is a tropical disease caused by parasitic flatworms that claims 200,000 to 300,000 lives a year. Its prevalence in sub-Saharan Africa is significant, second only to malaria. Contracting schistosomiasis is serious and symptoms can be lethal. It can eventually cause stunted growth, learning disorders and anemia. The task of eliminating the disease is considerable, but one that Merck believes it can accomplish.

Answer to the Problem

Merck’s plan to eradicate Bilharzia is one of education, innovation and practicality. The water-borne parasite that causes the disease is far more widespread in poorer communities with a lack of access to clean water. This indicates that the ultimate cause of the disease is rooted in poverty. In 2007, Merck allied with the World Health Organization (WHO) to eradicate schistosomiasis, pledging to wipe out the disease by 2030.

The Merck Praziquantel Donation Program is an initiative developed by Merck to tackle the disease. It focuses on the distribution of praziquantel, the tablet used to treat the disease, with enormous success rates. The program primarily focuses on preventing and treating the disease in school-age children in poorer communities. Additionally, the program emphasizes the role of education in preventing schistosomiasis.

Is It Working?

In short: yes! Merck has donated more than 1.5 billion tablets of praziquantel to the WHO. Additionally, more than 800,000 people have been treated as a result of Merck’s plan to eradicate Bilharzia. Countries are targeted individually to increase efficiency and maximize the number of people who can benefit from the program.

In Rwanda, a further 8 million tablets have been supplied in support of its plan to eliminate schistosomiasis and “Neglected Tropical Diseases.” Merck has also pledged money to the Deworming Innovation Fund, which looks to wipe out schistosomiasis and intestinal worms in Zimbabwe, Kenya, Rwanda and Ethiopia, furthering its campaign against tropical diseases.

The Bilharzia Storytelling Lab

After previous sessions in Rwanda and Kenya, in 2024, the Bilharzia Storytelling Lab (sponsored by Merck) took place in Ethiopia, a competition that asks candidates to formulate storytelling-oriented answers to facing schistosomiasis. The winning solution is decided by a panel of judges and granted more than $10,000 to facilitate the implementation of the solution throughout the country. Focusing on the educational dimensions of tackling Bilharzia, the workshop this year was held in Addis Ababa. The initiative has so far helped treat more than 800,000 people. Individual communities that are most in need of education and treatment for the disease have benefitted from the initiative. 

The groups most at risk are still largely unaware of the disease. Most at risk include school-age children and women, highlighting how necessary the money invested by Merck truly is. As is the case in many developing areas, women are still largely tasked with domestic duties that require access to clean water. This is not realistic for many women in sub-Saharan Africa, meaning many women have no choice but to expose themselves unknowingly to schistosomiasis in order to carry out tasks expected of them. Because of the Praziquantel Donation Program and Bilharzia Storytelling Lab, Merck’s plan to eradicate Bilharzia stands a chance of meeting the 2030 goal set out in 2007.

Final Remark

The financial capability of pharmaceutical giants can evidently be utilized for change. When corporations decide to use their wealth to benefit the international community, millions benefit. The benefits help those who are suffering needlessly from curable diseases to spend their time furthering their families and businesses. Once healthy, they can become assets in their communities and consequently improve the country’s prospects in the future. Merck has demonstrated this beautifully. It has returned futures to countless school children, allowing them to contribute to society rather than sentencing them with disease.

– Molly Ralph

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

Photo: Flickr

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The Gavi Group: Working Toward Immunization in Haiti

The Gavi Group: Working Towards Immunization in HaitiHaiti, with a population of more than 11 million, faces dire challenges, as UNICEF’s 2023 annual report indicates that 90% of its residents live in poverty. This economic hardship severely limits access to health care, evidenced by Haiti’s low rankings—163rd out of 191 countries on the Human Development Index and similarly on the Gender Inequality Index. Despite these obstacles, Haiti is determined to enhance vaccination services, expand coverage and combat vaccine-preventable diseases. The country and organizations like the Gavi Group have made notable progress in its immunization efforts, navigating through the COVID-19 pandemic and increasing violence through strategic health interventions and effective partnerships.

The Gavi Group

The Gavi Group, a vaccine alliance, aims to save lives and protect people’s health by increasing equitable and sustainable use of vaccines. This organization has successfully vaccinated approximately 1 billion children in 78 lower-income countries, preventing more than 17.3 million future deaths. Gavi collaborates extensively with various organizations, including UNICEF, advocating for increased support in providing essential vaccinations to low-income areas. In 2022, Gavi partnered with 19 manufacturers that supply prequalified vaccines supported by the alliance.

Zero-Dose Children

The zero-dose children program is one of its main programs, it targets children who have not received any routine vaccines. The Gavi Group defines zero-dose children as those who lack the first dose of the diphtheria-tetanus-pertussis (DTP1) vaccine. Children younger than seven require five doses of DTP1. Due to its high poverty rate, Haiti has many communities that lack access to these essential vaccinations.

Improving Vaccination Rates in Haiti

According to the Gavi group, Haiti has 64,706 children who have not received any routine vaccines. The coverage rate for the DTP vaccine in Haiti rose to 75% in 2022. There has been a consistent increase in the number of children receiving the DTP1, DTP2 and DTP3 vaccines. This progress enables children in low-income communities to grow up without the threat of these diseases. Children are fundamental to the future of our society and need protection. Enhancing vaccination rates in developing countries can potentially improve the future of health care in these areas.

Looking Ahead

Despite facing severe economic hardships, Haiti has made significant strides in improving its immunization rates. Through strategic health interventions and effective partnerships, the country increased its coverage rate for the DTP vaccine to 75% in 2022. The Gavi Group’s efforts have been instrumental in vaccinating thousands of zero-dose children, ensuring they are protected from preventable diseases. These advancements highlight the importance of continued support and collaboration to enhance health care outcomes in Haiti.

– Tess Curran

Tess is based in Boston, MA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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The Fight Against Sleeping Sickness in the DRC

Sleeping Sickness in the DRCThe Democratic Republic of Congo (DRC), the largest country in sub-Saharan Africa, ranks among the five poorest nations worldwide. Approximately one in six individuals live in extreme poverty, a condition largely stemming from the DRC’s long history of conflict, political upheaval and authoritarian rule. This tumultuous history has left the economy in turmoil and unpredictability. The lack of political and social stability makes managing international aid and establishing a proper health care system difficult, resulting in an extremely high disease burden.

Neglected Tropical Diseases

Neglected tropical diseases (NTDs) are bacterial and parasitic diseases that thrive in tropical environments, currently affecting more than one billion individuals worldwide, especially those in low-income countries and marginalized populations. Despite their devastating impact on health, the pharmaceutical industry pays relatively little attention to NTDs due to financial disincentives to research and develop new treatments for impoverished populations. Individuals affected by NTDs often face stigma within their communities, which further hinders their access to necessary care.

DNDi’s Focus On Sleeping Sickness

The Drugs for Neglected Diseases Initiative (DNDi) is a nonprofit research and development organization focusing on the lack of awareness surrounding NTDs and is actively working to develop new treatments for sleeping sickness. Currently, about 65 million individuals in the rural areas of sub-Saharan Africa are at risk of contracting sleeping sickness. Specifically, in the last five years, the DRC has reported 61% of all cases, highlighting a staggering need for concern and action.

Sleeping sickness, transmitted through tsetse fly bites, initially causes symptoms like fever, chills and headaches in infected individuals. These symptoms quickly progress to attack the central nervous system, leading to sleep disruptions, severe neuropsychiatric disorders, convulsions and potentially a coma. Without treatment, sleeping sickness usually proves fatal rapidly.

Complicating its treatment, the initial symptoms of sleeping sickness closely resemble those of malaria, another prevalent disease in the DRC. This similarity often leads to misdiagnosis and mistreatment, with the correct diagnosis frequently coming too late. Historically, the only available treatment was melarsoprol, an arsenic derivative that carried a fatality rate of 10-50%. Additionally, factors like massive population displacement, violence and persistent poverty in the DRC exacerbate this and other epidemics, hindering effective treatment efforts.

Recognizing these ongoing challenges, the DNDi acknowledges the critical importance of early diagnosis to prevent the progression of symptoms to the neurological stage. DNDi is urgently investing in the research and development of safe and effective treatments for sleeping sickness.

DNDi Receives Impactful Grant

The DNDi received a $12 million grant from the Bill and Melinda Gates Foundation to accelerate the development of an innovative new drug for sleeping sickness. DNDi has already revolutionized treatment with Fexinidazole, a new single-pill, single-dose medication. Along with a new rapid diagnostic test, this grant has significantly advanced the sustainable elimination of the disease. The funding will continue until the end of 2027 to support the delivery of this new cure to various rural areas in the DRC. The World Health Organization (WHO) and DNDi are optimistic about reaching and sustaining zero cases of sleeping sickness in the DRC by 2030.

Optimistic Future Ahead

Health professionals have screened more than 2 million individuals for sleeping sickness, including 749 patients from the DRC, where the new innovative drug, Fexinidazole, has proven effective and safe for adults and children. This advancement and continued treatment efforts offer hope for the DRC’s future in combating disease burden and poverty.

– Kewe Chen

Kewe is based in Memphis, TN, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Poverty and Dengue Outbreaks in Timor-Leste

Dengue Outbreaks and Poverty in Timor-LesteTimor-Leste, also known as East Timor, is a country in Asia situated on the eastern half of the island of Timor. As one of the lowest-income nations in the world, it has a GDP per capita of $3,900. The nation’s low income leads to numerous poverty-related challenges, including health issues. Dengue fever, in particular, poses a significant health problem in the country. Dengue outbreaks occur annually in Timor-Leste, peaking during the hot and rainy season from Dec. to April. In Jan. 2022, Timor-Leste experienced a severe dengue outbreak, with nearly 900 cases recorded in Dili, the nation’s capital, compared to about 100 cases the previous year. From 2018 to 2022, Timor-Leste reported an incidence rate of 330 dengue cases per 100,000 people.

Dengue

Dengue, a disease prevalent in tropical and subtropical areas, spreads mainly through Aedes mosquitoes. Common symptoms include fever, aches, rashes and nausea. While not always fatal, dengue can lead to death in severe cases. Currently, no specific treatment exists for the illness; the primary advice for those affected is to rest and drink plenty of fluids.

Dengue Impacts the Impoverished

Due to Timor-Leste’s low income and high poverty rate, dengue outbreaks hit especially hard. About 42% of the nation’s population lives below the poverty line and these individuals suffer more from the outbreaks than those who are not impoverished. Environmental factors often place people in poverty at higher risk. Many are displaced by natural disasters like flooding, which forces them to seek new housing and living spaces, increasing their risk of dengue transmission. Additionally, these disaster sites often lead to increased mosquito populations due to standing water, further elevating the risk of infection. Accessing health care is also challenging for many impoverished people, exacerbated by Timor-Leste’s weak health care system. Poor education and high poverty rates hinder the development of a robust health care industry, allowing illnesses to spread more widely.

Actions Being Taken

The World Health Organization (WHO) is actively combating dengue in Timor-Leste through multiple initiatives. WHO is supporting the government in strengthening its health care system and has trained many workers to provide necessary care. It has also developed national dengue control guidelines for managing future outbreaks and launched a nationwide campaign to educate the public on dengue prevention and home treatment methods. Additionally, WHO has organized cleaning efforts to maintain clean water and environments, reducing contamination risks. The organization also employs fumigation to eliminate mosquitoes from residential areas. The Timor-Leste Red Cross has also contributed, seeking assistance from the International Red Cross. From Feb. to Aug. 2022, these combined efforts successfully reduced the spread of dengue and minimized its impact.

Looking Ahead

Timor-Leste faces significant challenges due to its low income and recurring dengue outbreaks. The WHO and the Timor-Leste Red Cross have implemented various measures to combat the spread of dengue, including health care worker training, public education campaigns and environmental cleaning efforts. Despite these ongoing efforts, the country continues to struggle with the impacts of poverty and a fragile health care system, necessitating ongoing support and resources to effectively manage and reduce dengue cases.

– Tyra Brantly

Tyra is based in Los Angeles, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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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

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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

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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

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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