Archive for category: Disease

Information and news about disease category

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Progress in Zika Virus Treatment and Support in Latin America

Zika Virus TreatmentIn 2015-2016, Latin America faced a formidable challenge with the outbreak of the Zika virus. This mosquito-borne illness sent shockwaves through communities and health care systems. Originating in Brazil, the virus quickly spread across the region, prompting the World Health Organisation (WHO) to declare a Public Health Emergency of International Concern (PHEIC). The declaration lasted for nine months, during which concerted efforts were made to contain the spread of the virus and mitigate its impact, particularly on pregnant women and their unborn babies. According to the National Library of Medicine, the Zika virus epidemic affected more than 400,000 people in Latin America. There has since been significant progress in the treatment of the Zika virus. However, the disease’s lasting effects impact many communities in the region.

Pregnancy Complications

One of the most alarming aspects of the Zika virus was its association with severe congenital disabilities, most notably microcephaly, a condition characterized by an abnormally small head and an underdeveloped brain. Pregnant women infected with the virus faced heightened risks, as it could be transmitted from mother to fetus, leading to potentially devastating consequences for newborns. Centers for Disease Control and Prevention noted that the Zika virus affected 5% of babies whose mothers had contracted the virus while pregnant and that many babies did not receive the recommended care.

Government Responses

In response to the crisis, governments, health care organizations and international agencies mobilized resources and expertise to combat the outbreak. Public health campaigns were launched to raise awareness about the virus and educate communities about preventive measures, such as eliminating mosquito breeding sites and using insect repellent.

Americares, a nonprofit organization based in Stamford, has been supporting affected families by ensuring hospitals are equipped with the appropriate medication and skills to combat the disease. It has also distributed mosquito nets and repellent to many people in Latin America in an effort to prevent transmission. Its family care clinic in El Salvador treats 60,000 patients a year.

Vector control efforts played a crucial role in reducing mosquito populations and curbing transmission rates. WHO created a vector control framework for tackling the Zika outbreak. Interventions ranged from insecticide spraying to community-based initiatives aimed at removing standing water where mosquitoes breed. These efforts, combined with improved surveillance and monitoring systems, helped to identify and contain outbreaks more effectively.

Furthermore, research into the Zika virus accelerated rapidly, leading to a better understanding of its transmission dynamics, clinical manifestations and long-term consequences. This knowledge proved invaluable in guiding public health strategies and informing clinical care for affected individuals.

Present Day Struggles

Despite significant progress in Zika virus treatment, challenges remain, particularly in providing support to families affected by its complications. Children born with microcephaly and other Zika-related congenital disabilities require specialized care and services to address their complex medical and developmental needs. Additionally, families may face social stigma, economic hardship and emotional distress as they navigate the challenges of raising a child with disabilities. BMJ Global Health conducted a study that found that children who were moderately affected by Zika have an economic burden of more than $204 million over 10 years.

Efforts to support affected families have encompassed a range of interventions, including access to medical care, rehabilitation services, psychosocial support and financial assistance. Governments and nongovernmental organizations have implemented programs to provide comprehensive support to affected families, with a focus on promoting inclusion, empowerment and dignity. Children’s National created one of the first congenital Zika virus programs, which provides patients with accurate diagnoses and treatment plans.

Final Remark

While the Zika virus epidemic of 2015-2016 presented unprecedented challenges for Latin America, it also showcased the resilience, solidarity and collective action of communities and stakeholders in responding to public health crises. By building on the progress made and continuing to prioritize support for affected families, Latin America can work toward a future where the impact of Zika is minimized.

The fight against Zika is far from over. However, with continued commitment and collaboration, Latin America can overcome this challenge and build a more resilient and inclusive society for all.

– Lauren McKenna

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

Photo: Flickr

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The Cure Tuberculosis Project In The Kyrgyz Republic

The Success Of The Cure Tuberculosis Project In The Kyrgyz RepublicIn the Kyrgyz Republic, a landlocked country in Central Asia, health officials diagnose 1,400 people with drug-resistant Tuberculosis (TB) annually. It ranks among the nations with the highest rates of drug-resistant TB. This prevalence underscores a significant health challenge across the country. To address this, the Cure Tuberculosis Project has dedicated its efforts to lowering the rates of drug-resistant TB infections and enhancing the treatment for affected patients.

The Struggle with Drug-Resistant TB

TB ranks among the most lethal infections, causing 1.3 million deaths in 2022 alone. It disproportionately affects those in lower-income households, exacerbating the cycle of poverty. Infected individuals often face reduced earning capacity, leading to diminished access to health care and increasing health issues.

In addition, people with TB often spend more time indoors, heightening the risk of spreading the illness among both adults and children. This transmission within households can perpetuate a cycle of poverty across generations. Moreover, drug-resistant TB poses a growing global concern as certain treatments lose effectiveness. In 2022, about 410,000 individuals contracted drug-resistant TB, but only 43% received treatment, highlighting the urgent need for more effective interventions.

The Kyrgyz Republic faces a significant challenge with drug-resistant TB, with 29% of new drug-resistant TB cases compared to the global average of 3.3%, according to the World Health Organization (WHO). In addition, several factors contribute to this high incidence, including ineffective health care services, a shortage of medical resources and widespread difficulties in accessing medication for drug-resistant TB.

Addressing Drug-Resistant TB

The U.S. Agency for International Development (USAID) supported the Kyrgyz people by funding the Cure Tuberculosis Project from 2019 to 2024. This initiative aimed to assist the Kyrgyz government in identifying and treating individuals diagnosed with drug-resistant TB. Additionally, the project focused on ensuring rapid diagnosis for drug-resistant TB patients and facilitating their access to treatment, collaborating closely with the Ministry of Health of the Kyrgyz Republic. Moreover, the Cure Tuberculosis Project focused on four key areas for improvement:

  1. Develop more effective strategies to improve drug-resistant TB detection.
  2. Treat more patients with drug-resistant TB.
  3. Reduce the number of drug-resistant TB infections.
  4. Enhance government legislation concerning drug-resistant TB.

Impacts of the Cure Tuberculosis Project

The Cure Tuberculosis Project achieved success in all four targeted areas.

  1. Develop more effective strategies to improve drug-resistant TB detection: In Batken, Chui and Naryn Oblasts, 12 hospitals successfully screened all patients for drug-resistant TB, ensuring treatment for those diagnosed.
  2. Treat more patients with drug-resistant TB: The project equipped all hospitals and 91 health care services with online medical record management. Furthermore, more than 2,100 patients with drug-resistant TB benefited from mental health assistance and financial support.
  3. Reduce the number of drug-resistant TB infections: The project enhanced infection control in hospitals in Naryn, Batken and Talas, successfully reducing the average hospital stay for patients by 12%. It also sought to change the behaviors and perceptions of patients with drug-resistant TB and their families. This included producing 28 educational films that share patients’ experiences to raise awareness about the infection.
  4. Enhance government legislation concerning drug-resistant TB: The project collaborated with the Mandatory Health Insurance Fund to develop financial strategies to enhance drug-resistant TB treatment. Among these advancements is the facilitation of sputum sample transfers to hospitals for drug-resistant TB testing.

Looking Ahead

The Cure Tuberculosis Project has laid a strong foundation for ongoing efforts to fight drug-resistant TB in the Kyrgyz Republic. This marks a significant stride toward health security and poverty reduction. Furthermore, sustained collaboration and innovation could be essential in consolidating these gains and ensuring a healthier future for the Kyrgyz people.

– James McAlinden

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

Photo: Flickr

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Zambia’s Cholera Outbreak: The Battle for Public Health

Zambia’s Cholera OutbreakZambia’s recent cholera outbreak has been the catalyst for significant hardships for its population, with devastating consequences for public health. Since October 2023, there have been more than 10,887 cholera cases, with more than 432 reported deaths.

Cholera is a waterborne illness caused by the bacterium Vibrio cholerae, which produces a toxin in the small intestine, leading to loss of fluids and electrolytes. The bacterium manifests itself in contaminated water, which in turn affects underdeveloped countries lacking resources for proper water supplies and sewage disposal.

Densely populated areas such as Lusaka, with limited or no access to clean water and sanitation, are facing the worst consequences, with a devastating 4,443 cumulative cholera cases since October 2023.

Government Initiatives

In response to Zambia’s cholera outbreak, the Zambian government has taken decisive action through robust initiatives, including the Multi-sectoral Cholera Elimination Plan (MCEP) 2019-2025, with the aim to eliminate cholera by 2025. The MCEP has set six targets, including, but not limited to, improved surveillance of cases, reduction of the overall mortality rate of cholera by 90%, accelerated access to safe drinking water and conduction of oral cholera vaccination campaigns.

According to the World Health Organization and the United Nations Children’s Fund (UNICEF) Joint Monitoring Programme for Water Supply and Sanitation, 39% of Zambia’s population does not have access to basic drinking water services. In comparison, 69% do not have access to basic sanitation services. The MCEP has estimated that in order to reach its targets, Zambia will need to provide basic water supply to 660,000, basic sanitation to 1.16 million and basic hygiene services to 1.46 million people yearly. In order to do so, the MCEP has set a budget for $99,345,493 over seven years, with $67,877,076 dedicated directly to water supply, sanitation and hygiene.

NGOs and International Aid Efforts

In addition to government initiatives, nongovernmental organizations (NGOs) and international aid agencies have played a crucial role in addressing Zambia’s cholera outbreak. For example, Oxfam and the Keepers Zambia Foundation (KZF) are working together to train volunteers to be health promoters. Volunteers help people who fall ill with cholera get oral rehydration therapy, refer patients to the hospital and encourage people to practice good hygiene. Furthermore, Oxfam is working with KZF to provide oral rehydration salts and chlorine to treat unsafe water, as well as providing equipment such as soap and clean buckets to prevent the further spread of cholera.

Another example of international aid efforts comes from WaterAid. The organization calls on global governments and stakeholders to invest funds in sustainable water resources, sanitation and hygiene services to support Zambia both immediately and in the future. Moreover, WaterAid Zambia is working with local Zambian communities to fight against waterborne diseases such as cholera. This includes education on basic hygiene practices and promotion of community-led sanitation initiatives. These are sustainable, long-term changes that address the root causes of the cholera outbreak in order to prevent any possible future outbreaks.

Innovations in Cholera Prevention

There are currently three WHO pre-qualified oral cholera vaccines: Dukoral, Shanchol and Euvichol. All of these vaccines require two doses for full protection. Dukoral requires a buffer solution of 150ml of clean water and protects for two years. Shanchol and Euvichol, however, do not require a buffer solution and protect from cholera for three years.

The latter two are currently available for mass vaccination campaigns in areas with an outbreak through the Global Oral Cholera Vaccine (OCV) stockpile, supported by Gavi, the Vaccine Alliance. Currently, a mix of live, killed and conjugated vaccines are in development with the hopes of long-term protection and easy administration.

Conclusion

Zambia’s cholera outbreak has underscored the critical need for comprehensive public health interventions to address waterborne diseases effectively. While significant progress has been and continues to be made through government initiatives, NGO efforts and international aid efforts, challenges such as limited supplies and heightened demand persist. However, with sustained commitment, investment and community engagement, Zambia can work towards a future where the impact of cholera outbreaks is minimized and public health resilience is strengthened.

– Emily Weir
Photo: Flickr

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Tuberculosis in Kenya

Kenya Battles TuberculosisKenya continues to battle against major communicable diseases, including tuberculosis (TB). With more than 120,000 affected patients each year, the African Institute for Development Policy (AFIDEP) documents the disproportionate rising cases among men from low and middle-income countries such as Kenya. ADIDEP cites how inequalities toward men seeking health, have exasperated due to factors such as poverty, poor environment, housing, food security, lack of education and financial hardship. 

The World Health Organisation (WHO) recognizes common symptoms of TB include prologued cough with blood, chest pain, weakness, fatigue, weight loss, fever and night sweats. In recognition of the 32% undiagnosed and untreated TB patients in Kenya reported in 2023, the Ministry of Health launched the 2023/24 – 2027/28 National Strategic Plan (NSP) for TB, Leprosy and Lung Health. This program aims to put an end to the devastating impact of TB on Kenya’s communities.

Diagnosis and Treatment

Doctors treat tuberculosis with antibiotics. In Kenya, the primary antibiotics improving TB patients’ health are isoniazid, rifampin, pyrazinamide, ethambutol and streptomycin. Patients must take these medications daily for four to six months. WHO advises anyone experiencing symptoms of TB to seek medical attention immediately.

Ministry of Health Support to End Tuberculosis

During its launch, Mary Muthoni, the Principal Secretary for Public Health and Professional Standards, emphasized the 2023/24-2027/28 National Strategic Plan’s commitment to a people-centered approach in addressing tuberculosis in Kenya. In her February 2024 speech to the National Assembly Committee on Delegated Legislation, Mary announced the start of a community-centered Universal Health Coverage (UHC) initiative, to deploy 100,000 Community Health Promoters. This initiative aims to enhance household screenings proactively and strengthen the government’s battle against TB. Furthermore, the program seeks to eliminate TB, leprosy and other lung complications by 2030.

Facilitating Gender Responsive Policies

The Division of National Tuberculosis, Leprosy, and Lung Disease Program (DNTLD-P) has collaborated with the LIGHT consortium since 2020 to enhance the Kenyan government’s efforts in addressing gender discrimination among TB patients. This partnership aims to fill gaps identified in Kenya’s previous NSP for 2019-2023, which lacked initiatives targeting gender-specific barriers to TB care and treatment.

The government has evaluated gender-equality approaches to ensure TB patients in Kenya receive fair treatment, regardless of gender. LIGHT, a global health research program, focuses on supporting TB treatment policies and practices in Kenya, Malawi, Nigeria and Uganda, with an emphasis on gender inclusivity. Its research demonstrates that improved access to TB care for men has decreased TB-related deaths, curbed transmission within communities and reduced the financial strain of TB treatment in Kenya. In response to LIGHT’s policy enhancement efforts, the NSP for 2023/24–2027/28 outlines specific initiatives aimed at assisting male TB patients in Kenya through the following targeted implementations:

  • Addressing socio-cultural barriers that prevent men, women and children from accessing healthcare
  • Creating awareness of TB and reducing stigma
  • Engaging strategically with a range of key stakeholders to ensure research is informed

 A Healthier Kenya

Initiatives like the NSP for TB and the LIGHT consortium’s efforts illuminate the path toward ending tuberculosis by fostering inclusivity and community support. These strategies are poised to transform health and tuberculosis care in Kenya and signal a promising future where access to treatment transcends gender barriers, enabling a united fight against this persistent disease.

– Kasia Flisiuk

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

Photo: Flickr

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Preventing Chronic Obstructive Pulmonary Disease in Nigeria

Chronic Obstructive Pulmonary DiseaseChronic obstructive pulmonary disease or COPD, ranks as the third leading cause of death worldwide, trailing only behind heart disease and strokes. The condition impedes breathing by damaging the airways and/or lungs. It may cause chronic coughing, mucus and wheezing and permanently disable the affected individual. In affluent countries, one can easily avoid it by self-care, especially by avoiding smoking.

On the other hand, in developing countries, air pollution and the living environment are much more significant factors. Interestingly, estimates suggest that 50% of COPD cases in Sub-Saharan Africa occur in individuals who have never smoked and it often remains undiagnosed. It is a silent killer of so much of the population simply because they are impoverished.

Chronic Obstructive Pulmonary Disease in Nigeria

The lifestyle of the people in Nigeria likely causes chronic obstructive pulmonary disease in the country. Whether or not people smoke tobacco, most African kitchens suffer from poor ventilation due to biomass smoke. Biomass fuel includes anything from a living thing, mostly wood or animal waste. Fires, often fueled by more biomass or kerosene, are also constant for heating or light. Although women are less likely to smoke than men, they have the same amount of COPD cases because they spend far more time inside the house.

COPD prevalence in Nigeria is attributable to factors beyond solely toxic air. Malnourishment at birth is a high-risk factor, potentially leading to weaker or misshapen lungs. Unborn and newborn infants, sharing environmental exposures with their mothers, may also encounter lung defects. Moreover, in economically disadvantaged African communities, high rates of HIV and tuberculosis persist. These diseases, if causing lung damage, contribute to the risk factors for COPD.

Prevention

COPD remains incurable, with survival strategies centered around removing oneself from potential dangers, such as tobacco use, engaging in regular exercise and maintaining optimal lung health. Ideally, addressing this concealed epidemic involves preventive measures to stop it before it begins.

However, the World Health Organization has implemented multiple steps to protect Africans from chronic obstructive pulmonary disease. The first is the WHO Framework Convention on Tobacco Control, approved by 180 countries, including Nigeria, which aims to help protect people from tobacco smoke. The second is the Global Alliance against Chronic Respiratory Diseases (GARD), a network aimed solely at eliminating respiratory illnesses like COPD and asthma in low- and medium-income countries.

Various other proposals have been suggested to prevent illnesses caused by indoor air pollution. One approach involves the construction of homes equipped with chimneys or flues, allowing smoke to exit the living spaces efficiently. Creating infrastructure to provide homes with electricity or gas for cooking could eliminate the use of biomass fuel and its associated smoke.

Enhancing housing conditions goes beyond improving living standards; it has the potential to not only create better living environments but also to save lives.

– Varsha Pai
Photo: Pixabay

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Chagas Disease: Unveiling the Silent Struggle

Chagas DiseaseChagas Disease (CD) is a tropical disease caused by the parasite Trypanosoma cruzi. In 2022, The Bolivian Chagas Network reported that approximately 7 million people are infected with CD and 25 million are at risk of infection. More than one million of these cases stemmed from Bolivia, the country that retained the highest rate of CD in the world.

The Impact of Chagas Disease

There is no vaccine against CD, but if detected in the initial acute phase it can be treated.

The disease mostly spreads as a result of vector-borne transmission. These blood-sucking bugs, called triatomine, bite an infected animal or person and pass the parasites on to humans via feces. These bugs also tend to bite people’s faces, and are therefore referred to as “Kissing Bugs.”

CD can also be transmitted via blood and organ donation as also congenital transmission, from a pregnant woman to her baby. Contraction of CD in the initial phase presents as mild flu-like symptoms and in the later stages can lead to cardiac, digestive and neurological alterations. It has been detected in 21 countries in Latin America and is endemic to this region. In November 2023, The Global Health Innovative Technology Fund reported, that in comparison to all other parasitic diseases in the Americas, CD carried the largest burden of disability-adjusted life years.

The Bolivian Chagas Platform

In 2009, The Bolivian Chagas Platform was formed in a bid to control CD. It consisted of both local and international forces with a strong emphasis placed on promoting trans-nationality to allow research to be shared. Groups involved in The Bolivian Chagas Platform included ISGlobal, CEADES, AECID and the Bolivian National Chagas Program.

Originally piloted in three of Bolivia’s most affected regions, Cochabamba, Tarija and Chuquisaca, a specific strategy was implemented in seven centers to begin with. The four focus areas were: providing care, training health personnel, performing research and engaging with the community.

Due to the success of the pilot program, the operation was scaled up and extended to a further 52 centers.

The results of the Platform have been positive and have improved the care for CD at both national and international levels.

Detecting Chagas Disease

The existence of the Bolivian Chagas Platform centers has facilitated the screening of more patients, resulting in the detection of a greater number of CD cases. CD is often referred to as a “silent disease” as infected patients present either with no symptoms at all or with ambiguous symptoms resulting in misdiagnosis. If treatment is not given quickly, the damage becomes irreversible, and the patient cannot be cured. Therefore, timely detection of CD to ensure early treatment is crucial to save a person’s life. Furthermore, early detection of the CD helps in its control because transmission is prevented.

Increasing Research and Resources Available

ISGlobal reports that, at present, there are two drugs available for treating CD, nifurtimox and benznidazole. Research studies on this disease have been scarce due to limited resources and funding. As a result, the majority of people infected with CD do not have access to treatment.

The Bolivian Chagas Network reported that of the 57,871 people who tested positive for CD, 32.1% were able to be treated as a result of this platform. Furthermore, 67% of health care workers were given CD training, more resources were provided and detailed research was undertaken.

Whilst the two drugs used to treat CD are highly effective, they were developed over 50 years ago, therefore greater updated research is imperative.

Minimizing the Stigma and Promoting Awareness

Despite 10,000 people dying from Chagas Disease every year, it remains largely unheard of by the general public.

The UN has reported the negative consequences of the stigma associated with CD. Largely people view CD as confined to rural and poorer areas, but this is not the case. ISGlobal reported that in Spain, only an estimated 30% of people with CD are diagnosed and treated.

– Heidi Helen Horgan
Photo: Flickr

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The Bolivian Chagas Platform

The Bolivian Chagas PlatformChagas disease, a parasitic disease commonly found in Latin America, has become a global public health concern. Affecting more than six million people annually, Chagas is one of 17 illnesses acknowledged as neglected tropical diseases. Also known as American trypanosomiasis, Chagas is primarily transmitted to humans through the feces of triatomine bugs, also known as “kissing bugs,” when they bite and feed on blood. The disease can also be transmitted through blood transfusions, organ transplantation, contaminated, uncooked food and from mother to child during pregnancy.

Chagas claims more than 12,000 lives each year and is the leading cause of heart disease in the Americas. However, the disease is treatable. While most Chagas patients are infected as children, symptoms often only manifest in adulthood, by which time it is often too late. The majority of cases occur in poor communities in Central and South America, where 99% remain ultimately untreated due to inadequate global Chagas surveillance. Today, Bolivia has the highest worldwide prevalence of Chagas disease.

Bolivia’s Efforts at Disease Control

Although the Bolivian Ministry of Health declared the prevention and treatment of Chagas to be of national interest, lack of resources, management, implementation and regulation of solutions prevented the introduction of treatment until the early 2000s.

In 2009, in conjunction with the CEADES Foundation and the Barcelona Institute for Global Health (ISGlobal), Bolivia established the Platform for the Integral Care of Patients with Chagas Disease. The platform aimed to provide comprehensive care for individuals with chronic infection. It was based on four pillars:

  1. providing care
  2. training health personnel
  3. performing research
  4. engaging with the community

The Bolivian Chagas Platform developed a two-stage plan aimed at addressing the situation. First, the platform implemented a top-down test program to introduce a health care plan using protocols to work closely with local health authorities in seven local centers. From 2009 to 2014, the program was recognized as a successful approach for effectively handling Chagas disease in three of Bolivia’s most affected cities.

In the second phase of the Bolivian Chagas platform, starting in 2015, the model was expanded to 52 primary health care centers. This expansion was achieved through a decentralized and horizontally scaled-up approach. At the end of the second phase in 2018, more than 181,000 people at risk for Chagas received testing, resulting in a 32% increase in diagnoses and considerably improved patient care. Additionally, 67% of health care workers in the intervention area received training specific to the Chagas Platform guidelines. Chagas screening has now been implemented for regulatory health care visits.

Current Situation and the Way Forward

Although Bolivia ranks as the leading country in the global prevalence of Chagas, it fell from first to fourth position in terms of the number of people infected by the disease as of 2015, after the program’s first stage. The global impact of Chagas disease has demonstrated a consistent decrease in the number of cases.

While most are still concentrated in Latin America, the rising numbers in North America and Europe underscore the need to screen high-risk populations and increase awareness of this overlooked tropical disease. Chagas persists today as an endemic disease in 21 countries. With adequate resources, quality of diagnosis, proper treatment and primary health care integration, the effects of the Bolivian Chagas Platform can ensure long-term success.

– Bella Simokaitis
Photo: Flickr

Harvard and Roche Discover Antibiotic for Drug-Resistant Disease

Drug-Resistant DiseaseAs the new year arrived, so did an antibiotic: Zosurabalpin. Founded by Roche, tested by Havard, praised by scientists broadly, the antibiotic has the potential to provide relief against one of the World Health Organization’s (WHO) critical priority pathogens. Diseases caused by such pathogens infect over one million people annually, North Africa clocking close to 90% resistance rates. Zosurabalpin is only in early testing stages, but the novel antibiotic is already demonstrating the potential to provide significant aid in North Africa by fighting drug-resistant disease on the global stage.

Northern Africa

North Africa has the lowest rates of poverty across Africa, achieving, in 2019, the Sustainable Development Goal (SDG) of 3% in poverty. Post-COVID, during the years 2021-2023, the region has maintained a steady GDP growth at close to 4.0%, 4.5% and 4.2% respectively. However, these figures mask the continued struggle against poverty that North Africa endures.

Of the seven North African countries, Sudan has the highest poverty rates with an estimated 35% living in conditions of extreme poverty. That figure is projected to rise as we head towards 2025, and more than half of the 42 million people living in Sudan are in need of humanitarian assistance.

Algeria, Libya, Egypt, Tunisia and Morocco account for close to half of North Africa’s population but only 25% of the region’s GDP. In addition, dwindling economies and lack of job opportunities continue to remain areas of concern. The prospect of extreme poverty threatens to rear its head, going by current data.

Health Care in North Africa

The geography of North Africa significantly influences its health care infrastructure, or lack thereof. Being the least connected to other regions of the continent makes it difficult for North Africa to collaborate and benefit from any progressive medical approaches that have served other regions well.

Of the North African countries, Egypt possesses an advanced ability to manufacture vaccines and other pharmaceuticals. The $450 million World Bank investment into providing ambitious health reforms and services for all in Morocco is a significant step toward enhancing health care initiatives in the North African region.

The Pitfalls of Health Care in North Africa

Despite concerted efforts, what persists throughout hospitals in North Africa is suboptimal antibiotic stewardship and sparse surveillance data. These factors make critical priority WHO diseases such as Carbapenem-resistant Acinetobacter baumannii (CRAB) become a major concern.

CRAB diseases are up to 90% resistant to treatment in North Africa. Besides manifesting as pneumonia and killing hundreds of thousands across Africa each year, CRAB diseases mainly attack the respiratory system, and respiratory infections constitute close to 10% of all deaths in North Africa.

Zosurabalpin and Its Potential

The novel antibiotic, Zosurabalpin, offers some hope against these worrying numbers. Founded by Swiss pharma company, Roche, this new antibiotic hopes to shift medical discourse globally and have an immense impact in North Africa.

In early trials it has shown to be an effective treatment against the very diseases that have high rates of mortality in North Africa, namely, the highly resistant strains of CRAB manifesting as pneumonia and sepsis.

Since its announcement on January 3, 2024, Zosurabalpin has gained mass support from the global scientific community, and Harvard has become involved in the testing stages too.

Zosurabalpin in 2024

Due to the lengthy period and the many stages of antibiotic testing, it is a given that the rolling out of the novel antibiotic is a multi-year goal.

However, the medical properties of Zosurabalpin cannot be ignored. Not only could the antibiotic bring with it a fresh approach to hospital protocol, but also a relief to drug-resistant disease in North Africa. Both bring hope for the future of mortality rates on the African continent to be one of steady decline.

– Joseph Wray
Photo: Flickr

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USAID Fights Infectious Diseases in Nepal

infectious diseases in NepalNepal is the latest country to receive support from the U.S. as part of efforts to improve the health care technical capacities of 50 countries worldwide by 2025. The December 11, 2023, agreement concerns the control of infectious diseases in the Himalayan nation. A transdisciplinary method to achieve this goal has been created. After experiencing the pandemic and infectious diseases exclusive to the region, people in Nepal can approach their health care in 2024 with reassurance due to the new U.S. measure. 

Infectious Diseases in Nepal in 2023

COVID-19 has infected more than one million Nepalis as of 2023. And though the rate of cases has steadily subsided since September 2023, the one million figure maintains that COVID-19 has impacted over 30% of the population in Nepal. As September brought about the decline of COVID-19 in Nepal, it witnessed an increase in the rates of dengue – the infectious disease spread by mosquitoes that results in headache, fever, rashes and nausea. The tropical disease, most effective in the summer months, had alarmingly high rates in as early as April 2023. As of October 2023, there had been more than a quarter of a million reported cases of dengue, with close to 1,500 associated deaths.

Facing Diseases

In 2019, Nepal’s health infrastructure found itself unprepared to confront the severity of challenges posed by COVID-19 and other infectious diseases. Recognizing the urgent need for support, the U.K. helped thousands by establishing critical response units between 2019 and 2021. The U.S. also stepped in with a significant contribution during the pandemic years, providing a total of $50.9 million in aid. While helping the battle against COVID-19, the support offered by the U.K. and the U.S. apply only a temporary band-aid to a weak infrastructure for health in Nepal.

Nepalese Health Care System

Beneath the band-aid is Nepal’s continued struggle to adapt to the shift from a centralized health care system to a federalized model. The change, which was initiated in 2015, continues to highlight widespread confusion in Nepalese society regarding health care. Additionally, there are issues of poor coordination and, most importantly, a shortage of skilled health care staff in Nepal.

Nepal has only 0.67 doctors for every 1000 inhabitants, a figure that falls significantly below the standards recommended by the World Health Organization (WHO). The shortage of skilled workers is exacerbated by the fact that access to healthcare for over 35% of households in Nepal requires a journey of more than 30 minutes. Furthermore, the nation grapples with disparities in access to health care based on rural-urban, male-female and racial divisions.

USAID: Nepal

To address Nepal’s inadequate health infrastructure, myriad inequalities and the 15% figure used to symbolize the amount of Nepalis living in poverty, the U.S. has provided nearly $650 million in assistance to the country. This foreign aid has economic benefits for the U.S., as the nation has become a top trade partner with Nepal.

The Global Health Security Program

December 11, 2023, saw a consolidation of the relationship between the U.S. and Nepal, thanks to the collaboration between USAID and the Nepalese government launching a new global health security program. With support from WHO and the Food and Agriculture Organization (FAO), the merger emphasizes the importance of recognizing the interdependence of ecosystems before attempting to tackle zoonotic infectious diseases in Nepal.

The U.S. has pledged close to $7 million over the next three years to boost the health care system in Nepal. This support aims to reduce infectious diseases in the nation and improve emergency response management, enhance biosafety and facilitate upgrades to national laboratory systems both directly and indirectly. The involvement of the U.S. is expected to enhance Nepal’s ability to combat serious pandemic threats and mitigate infectious diseases exclusive to the region. This effort will allow countless Nepalis to approach 2024 with a newfound assurance in their nation’s health care system.

– Joseph Wray
Photo: Flickr

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Stroke in Low- and Middle-Income Countries

Stroke in Low- and Middle-Income CountriesThe World Stroke Organization reported in 2022 that more than 85% of stroke-related deaths worldwide occur in low- and middle-income countries. Strokes also happen at a lower average age in these countries than in high-income countries, often during peak working years. Strokes can cause death and disability and create an economic burden in low- and middle-income countries. The occurrence of strokes in impoverished people in developing countries can severely impact them and worsen their lack of essential resources. A stroke is an abrupt death of brain cells caused by a shortage of blood flow and oxygen to the brain. Key factors contribute to the burden of stroke in low- and middle-income countries, and global organizations implement strategies to improve outcomes. 

Hypertension in Low- and Middle-Income Countries

Low- and middle-income countries have a high incidence of hypertension, or high blood pressure, which leads to stroke. The poorest people in developing countries often experience hypertension. The link between poverty and hypertension is counter to the common assumption that people in poverty have low body weight and high physical activity levels. Still, other environmental and lifestyle factors can cause hypertension in poor populations. Hypertension damages blood vessels and can cause them to leak or clog, increasing the chances of a stroke. High blood pressure in developing countries is linked to various factors, including environmental conditions and diets high in salt and low in fruits and vegetables. 

There is less awareness and treatment of hypertension in low- and middle-income countries compared with high-income countries. Research published in 2019 by Pascal Geldsetzer and others showed that 26% of people with hypertension in 44 low- and middle-income countries had never received a blood pressure check. Furthermore, merely one in 10 of the hypertension cases had attained control. People in poverty with hypertension often cannot access quality treatment and heavily depend on good health to support themselves financially. 

Air Pollution and Stroke

Air pollution is a significant contributor to stroke and causes 21% of worldwide stroke deaths, according to a report from Dean Schraufnagel and others in 2019. The World Health Organization (WHO) reported in 2016 that more than 85% of air pollution-caused deaths occur in low- and middle-income countries. Lower-income groups in developing countries often work outdoors and endure more air pollution exposure, creating a relationship between poverty and air pollution. Jun Rentschler and Nadezea Leonova reported research in 2023 showing that more than 700 million people living on less than $2 per day experience unsafe levels of air pollution exposure. Air quality standards are typically less strict in developing countries than in high-income countries. The sources of air pollution include older models of machines and cars, city transportation systems, industrialization and the clearing and burning of land for farming. 

Both short-term and long-term exposure to air pollution increases the risk of stroke. Over the long term, tiny pieces of air pollutants affect internal organ function, leading to increased blood clot formation and a potential stroke. 

Health Care Access and Stroke Outcomes

Health care access affects the outcomes of stroke in low- and middle-income countries. A research study by Peter Langhorne and others published in 2018 showed that people in low- and middle-income countries had reduced access to evaluation and treatment when experiencing a stroke. Poverty is also linked to decreased access to quality care for strokes and other cardiovascular events. 

According to a study by Mohammad Rabhar and others published in 2022, access to health care contributes to the lower average age of stroke in low- and middle-income countries. Health care facilities in these countries do not always start preventative stroke measures, such as treating hypertension and measuring blood lipids. Developing countries often lack the imaging capabilities necessary to diagnose stroke effectively. Improving access to health care before, during and after stroke is a potential strategy to reduce stroke incidence and death in low- and middle-income countries. 

The Fight To Improve Stroke Outcomes in Low- and Middle-Income Countries

With an increased understanding of stroke in developing countries, organizations are acting to reduce the burden. In 2017, the International Society of Hypertension began a global campaign to screen people for hypertension. Over two years, the effort resulted in the blood pressure evaluations of 4.2 million people. 

There are also regional groups fighting stroke, including the Middle East and North Africa Stroke Organization, the African Stroke Organization, the European Stroke Organization and the Asia Pacific Stroke Organization. In 2022, the American Heart Association recognized the Middle East and North Africa Stroke Organization for its efforts to educate citizens and health care professionals about stroke and its advocacy for stroke health services. 

The World Stroke Organization—Lancet Neurology Commission Stroke Collaboration Group published a multi-pronged practical strategy for improving worldwide stroke outcomes in October 2023. The commission outlines a path to improve stroke outcomes in developing countries, including increasing surveillance, and access to preventative health care, acute stroke care and rehabilitation therapies. To encourage research on global stroke prevention and treatment, the World Stroke Organization announced funding for four pilot research projects in 2024, prioritizing projects focused on stroke in low- and middle-income countries. 

Looking Ahead 

Stroke in low- and middle-income countries is a complex and multifaceted issue. People in poverty can experience increased exposure to the risk factors of stroke and have fewer resources to cope with stroke. International organizations continue researching and implementing practical strategies to reduce stroke in impacted countries. Improvements in the prevention and treatment of stroke can potentially improve citizens’ quality of life and economic contributions.

– Kelly Carroll
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