Information and news about disease category

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An Endemic Resolved: Trachoma in Mali

Trachoma in MaliLocated on the west coast, Mali is one of the largest countries on the continent of Africa. Mali faces extreme poverty, with numbers continuously rising since the COVID-19 pandemic. There are a variety of diseases in Mali that affect much of the population and can often be fatal.  Trachoma is a disease caused by a bacterial infection that affects the eyes and can eventually lead to blindness. When blindness occurs from trachoma, it is irreversible. According to data from 2022, 125 million people live in places with a trachoma endemic and are at severe risk of being exposed to the disease. Trachoma in Mali was a problem for a number of years. Women are twice as likely to suffer from blindness due to trachoma than men.

The disease spreads more in areas with poor sanitation and overpopulation. It is most commonly found in the larger areas of Africa, previously affecting Mali significantly. It is spread from person to person, originating from an infection in the eye. Trachoma in Mali has not been a quickly fixed battle. Data from the 1980s shows the former prevalence of the disease in the country and the dire need for a solution. 

The SAFE Strategy

Adopted by the WHO in 1993, the SAFE strategy helped supply countries with the resources needed to prevent the spread of trachoma. 

SAFE stands for surgery, antibiotics, facial cleanliness and environmental improvements. The strategy aimed to increase the number of surgical operations performed on those infected with trachoma as well as provide antibiotics to entire communities for the benefit of public health. Because of how easily trachoma can be spread, it was essential to promote facial cleanliness and understand that the infection rate is linked to overcrowded living conditions and unsanitary water. The SAFE strategy has been used in many different countries that suffer from a trachoma endemic, and Mali, among other countries, has finally overcome the public health problem. 

Trachoma in Mali

Political violence in Mali made it very difficult for the country to overcome this endemic problem. When the WHO created the SAFE strategy, the program slowly gained trust and developed a partnership with the Malian government. Diseases like trachoma affect the poorest communities and only lead countries to greater poverty rates. 

Trachoma is the first of the WHO’s neglected tropical diseases that Mali has eliminated, and Mali is the sixth country out of 29 in Africa that has successfully eliminated the disease. 

The WHO has several partners including The Carter Center and Sightsavers which all worked together to assist Mali in combating the disease. Through donations and medical training, trachoma is no longer a public health concern in Mali. It is important to note that several different organizations working alongside the WHO and the Malian government worked together to make this happen and improve the health and poverty rates of the people of Mali.

The World Health Organization recognized Mali for overcoming the trachoma endemic. Today, less than 5% of children suffer from inadequate access to antibiotics to treat trachoma, and the presence of trachoma in adults is nearly zero. On April 27, 2023, the World Health Organization announced that trachoma in Mali was no longer considered a public health problem.

– Alesandra Cowardin
Photo: Flickr

How Iraq Eliminated Trachoma

Trachoma in IraqRecently, the World Health Organization (WHO) declared that Iraq has successfully tackled trachoma as a public health issue. With this achievement, the country becomes the 17th to officially eradicate the disease. Here is what you need to know about how Iraq eliminated trachoma. 

What is Trachoma?

Trachoma, caused by the bacteria Chlamydia trachomatis, is a disease affecting the eyes. If left untreated, trachoma may cause irreversible blindness. Symptoms of the infection include inflammation of the eyelids, swollen lymph nodes and discharge from the eye. Nearly 2 million people have suffered visual impairment from the neglected tropical disease, and nearly 125 million live in areas where trachoma is endemic.

The disease is spread through direct or indirect contact with the eyes or nose of an infected person, with poor sanitation and hygiene serving as major risk factors for exacerbated transmission. Because of this, trachoma predominantly affects regions with little access to clean water and a higher population density. 

Iraq’s Efforts

In order to combat the spread of this disease, Iraq introduced a program to monitor trachoma among its population in 2012. The screening system was introduced in Iraq’s eye care facilities, as well as through in-school eye screening programs. 

The program involved thousands of eye care specialists and health care workers dedicated to combating trachoma as a public health issue. Through these measures, Iraq was able to successfully counter the unchecked spread of trachoma and treat patients in need of antibiotics. 

Mitigating the Spread

The elimination of trachoma was made possible through a number of approaches to improve public health. In order to properly address the spread of the disease, the WHO recommends a number of policies designed to reduce the spread and progression of trachoma. 

The SAFE strategy has shown to be very effective in combating trachoma and is encouraged in many countries facing issues of endemic trachoma. This strategy includes Surgery for those dealing with advanced stages of the disease, Antibiotics, Facial cleanliness and Environmental improvements — particularly improvements in sanitation. 

The Impacts

Trachoma significantly affects living conditions and economic activity in Iraq. The elimination of trachoma within the country has the potential to significantly affect the quality of life and poverty in Iraq’s most vulnerable regions.

Accessibility of treatment and prevention in Iraq has reduced the risk of contraction and progression of trachoma. Areas previously affected by the disease now have a far lower risk of visual impairment and blindness as a result of the infection. 

Trachoma’s global economic burden is estimated to be between $2 to 5 billion each year, centering around lost productivity as a result of vision loss. The elimination of trachoma provides a great deal of relief for regions most affected by the disease, including the potential for more economic stability. 

Conclusion

Iraq’s success in eradicating trachoma serves as yet another step towards the global eradication of the disease. After Iraq eliminated trachoma, it became the fifth country in the region to successfully tackle the disease. This achievement demonstrates the importance of comprehensive approaches to public health issues, as well as the potential for further disease prevention in Iraq and abroad. 

– Mary Burke
Photo: Flickr

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These Organizations Are Tackling Dengue in Singapore

Dengue in SingaporeSingapore typically faces a spike in dengue cases between May and October, as a result of the warm conditions that perpetuate the breeding of Aedes mosquitoes. Cases of the virus have risen in recent years, necessitating a response from the country’s government and efforts to mitigate its mosquito population. Several efforts are underway to help curb the spread of dengue in Singapore.

What is Dengue?

Dengue fever is characterized by symptoms such as headaches, nausea and vomiting, rashes and aching. The disease is spread through the bite of infected Aedes mosquitos. While it does not spread directly from person to person, a mosquito may become a carrier if it draws blood from a person infected with dengue.

The disease is best prevented by anti-mosquito measures, such as repellents and nets. However, Singapore is currently experimenting with new methods to help control the country’s mosquito population.

Wolbachia Mosquitoes/EHI

Recently, Singapore’s Environmental Health Institute has developed a program involving the release of lab-grown mosquitos infected with a bacteria called Wolbachia. These male mosquitoes can reproduce with females, but the eggs will not hatch. This strategy has been shown to suppress mosquito populations within a given area. As a result, the spread of dengue in Singapore should be mitigated.

Fogging/NEA

Another method that Singapore’s National Environmental Agency is deploying against mosquito populations is known as fogging. In this process, insecticide is released as a mist in an effort to control a large mosquito population in a dengue cluster. However, it is worth noting that this process does not eliminate the source of the population, and overuse may lead to insecticide-resistant mosquitoes.

Temasek Foundation

Along with these initiatives, several organizations are working alongside the government to help slow the spread of the virus. In 2022, the non-profit group Temasek Foundation partnered with the NEA to provide mosquito repellent to all students in Singapore. This effort was made to counter the spread of dengue through infected mosquitos. Overall, repellent was provided for more than 800,000 students.

Community Efforts

In order to combat the spread of dengue, several grassroots organizations have volunteered their efforts. These community-led efforts help to raise awareness about mosquito mitigation tactics, as well as inform the public on the symptoms and risks of dengue.

These community efforts included door-to-door visits in areas with a high dengue concentration. Volunteer groups from Singapore’s People’s Association, a government program with a large network of community-based organizations, contributed to this campaign.

Reduction in Dengue Cases

In 2023, cases of dengue in Singapore have dropped significantly. The WHO reports a 72% decrease in cases compared to this time last year. While there is still room for improvement, these numbers are a relatively good omen for the warmer season, taking into account last year’s outbreak. It appears as though the efforts of the NEA have not been in vain, and may have made a meaningful difference in the reduction of infected mosquito populations.

– Mary Burke
Photo: Flickr

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5 Ways to Combat Communicable Diseases in Developing Countries

Communicable Diseases In Developing Countries
According to the World Health Organization (WHO), communicable diseases are those that are spread from person to person through “microorganisms such as bacteria, viruses, parasites and fungi.” These diseases, also known as infectious diseases, disproportionately impact developing countries. Based on 2001 data from the National Center for Biotechnology Information, 98.6% of the burden of infectious diseases arose in low and middle-income countries. Some of the most common communicable diseases burdening developing countries are tuberculosis, respiratory tract infections, malaria, HIV/AIDS and most recently, COVID-19.

Although the global burden of communicable diseases reduced by about 44% from 1990 to 2019, there is still a long way to go. Fortunately, there are numerous techniques to combat communicable diseases and alleviate the burden on underdeveloped nations across the globe. Here are five ways to combat communicable diseases in developing countries.

5 Ways to Combat Communicable Diseases in Developing Countries

  1. Promoting Hand-Washing: Although it seems simple, hand-washing is a highly effective way of hindering the spread of disease and is not always as commonly practiced as it may seem. About 2.3 billion people around the world do not have access to hand-washing facilities. This may be due to a lack of infrastructure or lack of access to clean, sanitized water sources. Hand-washing is one of the cheapest public health interventions available to solve this issue. In fact, WHO states that, with less than one dollar per year invested, “all households in the world’s 46 least developed countries could have hand-washing facilities by 2030.” This money could go toward building facilities in houses and hospitals or educating people on the importance of hand-washing.
  2. Improving Housing: Many people in developing countries have to live in unsafe conditions. As mentioned earlier, many households lack facilities with clean water, as well as other necessities like proper waste disposal and heating. These conditions create breeding grounds for bacteria and insects or rodents that carry diseases. Many people also must live in crowded houses due to their low income. Crowding makes it easier for respiratory illnesses like tuberculosis to spread. Addressing these issues could include creating temporary housing facilities for the homeless that are better regulated and sanitary. A more long-term solution would be building houses that are sustainable, affordable and safe. It is worth mentioning that the construction of new housing should involve the community at all stages and be adaptable to the local environment.
  3. Providing Vaccines: With the recent spread of COVID-19, the importance of vaccines is clearer than ever. According to the UN, only around 1% of people in low-income countries received one dose of the COVID-19 vaccine by 2022. This contrasts with the 60.18% of people in high-income countries that received at least one dose. Not only does vaccine inequity prevent developing countries from slowing the spread of communicable diseases, but it also affects countries economically. 2022 data from the United Nations Development Programme (UNDP) shows that Nigeria, Ethiopia, the Democratic Republic of Congo (DRC) and South Sudan lost 19.87 billion in GDP due to unequal access to vaccines. Without vaccination, lockdowns last longer, and people continue to get sick, forcing them to miss work. The European Investment Bank is working to establish local facilities for the development of vaccines. A new facility at the Institut Pasteur de Dakar in Senegal is an example of how developing countries can become more self-reliant in the production of vaccines.
  4. Access to Treatment: While preventing the spread of diseases is the first priority, there is also a need for better access to treatment once people contract the diseases. Health care often does not receive enough funding in developing countries which leads to more negative health outcomes. These areas face a lack of equipment, doctors and proper training. In addition, many people are unable to pay for treatment or live in remote areas. Christophe Paquet, Head of Health & Social Protection for the Agence Française de Développement (AFD), notes that the health care sector is “highly dependent on international aid.” The AFD is supporting health care programs in developing countries by renovating facilities, providing access to training for nurses and reducing costs incurred by procedures. For example, they currently cover 80% of the cost of a Cesarean section, a procedure that can save many women’s lives.
  5. Providing Education: In order for any intervention to be successful in the long run, it should be coupled with educational efforts. One contributor to the communicable disease burden in developing countries is a lack of understanding of how these diseases spread and how efforts can prevent them. Having accessible, easy-to-understand information about public health allows individuals to recognize signs of illness and take preventative measures. More general education may also promote longer lifespans and more positive outcomes. Reaching tertiary education, in particular, reduces infant mortality and improves child vaccination rates.

Looking Ahead

These are just a few methods that can help ease the burden of communicable diseases on low-income populations. The U.S. can do its part by providing aid and funding for health-related interventions, much like the AFD in France. Alongside aid, education should be at the center of all of these methods to empower countries to fight these diseases locally.

– Yesenia Aguilera
Photo: Flickr

Diseases impacting Kosovo put strain on country’s medical care

Diseases impacting Kosovo Kosovo, the second youngest country in the world, is one of many nations struggling with an increase in non-communicable diseases. Treating and preventing the diseases impacting Kosovo is more difficult than in other European nations because of Kosovo’s status as the second poorest European country, alongside having a significant percentage of its population (40%) that is under 25 years old.

Causes of Disease

In 2017, 21.6% of adults in Kosovo reported having a chronic non-communicable disease, with cardiovascular disease being the most common cause of mortality and morbidity. Respiratory and malignant diseases, along with diabetes, are also common.

There are a number of causes that can be attributed to the rise in non-communicable diseases. A 2022 Frontiers article found that there are high levels of smoking, physical inactivity and obesity in Kosovo. Additionally, poor nutrition is a widespread issue in the nation, with 85% of adults not getting the recommended amount of fruits and vegetables in their diets.

According to a 2021 UNICEF report, 23% of people living in Kosovo are in poverty. Individuals who are living below the poverty line are more likely to suffer from chronic diseases. For example, adults living in poverty who suffer from type 2 diabetes are twice as likely to face diabetes-related mortality compared to those who earn the highest income, according to Diabetes Care.

Treatment Challenges

The level of concern for the overall health of the Kosovo population is low because of the predominantly young population, according to a 2023 article in the International Journal of Environmental Research and Public Health. However, because of noticeable changes in lifestyle trends and environmental factors, the nation could face difficulties in both detecting and treating non-communicable diseases in the future.

Because Kosovo became a country just 15 years ago, the nation’s health care system is still underdeveloped and inadequately funded. As a result, it is challenging to provide enough medical supplies and treatment for the population. Supply chain faults have caused shortages in medical supplies and a low supply of well-trained medical staff — Kosovo only has 1.44 physicians per 1,000 residents (compared to 3.4 per 1,000 residents across the European Union as a whole) — has presented challenges in the ability to provide treatment against diseases impacting Kosovo, according to the same article.

Treatment Improvements

Initiatives like Project HOPE have worked alongside Kosovo’s Ministry of Health to help combat these challenges. According to its website, Project HOPE has donated much-needed items, such as consumer disposable products, medical equipment and pharmaceutical drugs, to clinics and hospitals in the country.

Additionally, Project HOPE trains medical staff to better treat and detect non-communicable diseases. The organization has donated more than $60 million since 2010 to improve the medical industry in Kosovo.

The Kosovo government has also initiated plans to improve the health of low-income families. In 2019, it drafted Kosovo’s Social Assistance Program (SAS) which aims to reduce poverty and eliminate the cost of health insurance premiums and services for families relying on SAS.

Looking Ahead

The increasing emergence of non-communicable diseases impacting Kosovo is putting a strain on the newly founded nation. Despite the challenges, the country is making progress with the help of donations and programs like Project HOPE to equip the health care system with the required tools and skills to maintain a healthy population.

– Tristan Weisenbach
Photo: Flickr

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Schistosomiasis Treatment Bringing Hope for the Future

Schistosomiasis Treatment
Schistosomiasis is a chronic parasitic disease that is particularly threatening to young children. Infection occurs when people come in contact with water infested with parasitic larvae that penetrate the skin. Once inside the body, the larvae develop into adult worms that nest in human blood vessels. The female parasites lay eggs, some of which become trapped in human tissues, causing inflammation and damage to vital organs. Others exit the body in feces and urine. Symptoms of schistosomiasis include diarrhea and abdominal pain. In children, it can result in anemia, stunted growth and reduced cognitive development. Luckily, child-safe schistosomiasis treatment is emerging to help eliminate the disease.

About Schistosomiasis

Alarmingly, the disease can spread through water sources contaminated with infected human excrement, leading to ongoing cycles of infection. Currently, the drug praziquantel is the only available treatment. The World Health Organization (WHO) recommends large-scale administration of praziquantel to both treat the disease and prevent its spread. According to a study published in 2021, periodic administration of praziquantel to school-aged children between 5 years and 14 years old has reduced schistosomiasis prevalence among this group by about 60% over the past two decades.

However, until recently, there has been no safe and effective treatment for preschool-aged children. Furthermore, continued reliance on a single drug could cause parasites to develop drug resistance. Fortunately, a new pediatric medication, arpraziquantel, has been formulated to treat and prevent schistosomiasis in 3-month- to 6-year-old children. Here is why it is promising for mitigating the disease’s spread among this vulnerable group and achieving the World Health Assembly goal of eliminating schistosomiasis as a public health concern by 2030.

Vulnerability

Globally, an estimated 240 million people suffer from schistosomiasis, most of them living in tropical and subtropical regions. Because the disease spreads through contaminated water, feces and urine, it poses a great risk to communities that lack access to safe water and basic sanitation services. Furthermore, people whose occupations involve contact with water, including fishermen and irrigation workers, are highly vulnerable to the disease, as are women and girls, who risk contracting female genital schistosomiasis while collecting water or carrying out domestic chores. Overall, more than 700 million people live in at-risk areas where transmission is moderate-to-high. Schistosomiasis is especially prevalent in Africa, which is home to an estimated 90% or more of those in need of treatment.

Current Prevention and Treatment

Praziquantel is administered in 500-600 mg oral tablets. It is low-cost and, in large doses, has proven effective in protecting against adult parasites. However, it is less effective against larvae and juvenile parasites, requiring repeated doses to provide protection. In addition to heightening the possibility of drug resistance, this increases expense, the risk of reinfection and the likelihood of continued transmission in low-income countries where medication supplies and people’s access to them are lacking.

In addition to partnering with the pharmaceutical company Merck to supply more than 1.4 billion praziquantel doses to those in need, WHO has therefore emphasized further measures for controlling the spread of the disease. These include improving sanitation and water supplies, controlling the snail populations in which parasites reside, educating endemic communities and administering “large-scale treatment using the pediatric praziquantel formulation.”

A Child-Safe Treatment Brings Hope for the Future

In November 2021, the Pediatric Praziquantel Consortium, an EU-funded international partnership, successfully completed clinical trials on arpraziquantel, a new child-safe, oral treatment for schistosomiasis. According to the Merck-led consortium, clinical trials on infected Kenyan children showed that a single dose of arpraziquantel had a cure rate of about 90%. The medication is a praziquantel derivative, yet, in comparison to the large 500-600 mg tablets, it comes in small 150 mg doses that are safe and effective for preschool-aged children. The tablets are orally-dissolvable to prevent choking and flavored to appeal to children. Additionally, the drug can withstand hot environments, making it suitable for tropical and sub-tropical climates.

The Future Ahead

In 2022, the European Medicines Agency accepted arpraziquantel for review. Pending approval, Merck, working in partnership with stakeholders including WHO and UNICEF, hopes to begin distributing the medication in sub-Saharan Africa in 2024. The ultimate goal is to ensure sustainable, affordable access to medication for all 50 million preschool-aged children in need. Coupled with ongoing efforts to develop other new single-dose treatments, arpraziquantel brings hope that a schistosomiasis-free future is within sight.

– Isla Wright
Photo: Flickr

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How Epilepsy Care is Managed in Africa

Epilepsy in AfricaEpilepsy is one of the most widespread neurological disorders in the world, with about 50 million people living with it. More than 75% of people living with the disease are located in less developed countries, where there is difficulty receiving advanced medical treatments. Of that 75%, around 25 million people have epilepsy in Africa, forcing a great burden on people’s daily lives.

Common signs of an epilepsy episode may include seizures, unconsciousness, distress in movements and other psychological illnesses such as anxiety and depression. Premature death is three times more prevalent in epilepsy patients than in those without the disease, the highest rates being in rural areas. Not only is there a significant gap in treatment, but the rise of stigma and discrimination within African communities has prevented people from seeking care for epilepsy in Africa. 

Fortunately, health care systems in African regions have begun to take action by incorporating facilities and therapies tailored to treat epilepsy for patients, especially for rural populations. On the other hand, due to embedded cultural and traditional values in African societies, there are still lingering struggles to understand what epilepsy is, its diagnosis and cures. 

Barriers to Health Care 

Around 80% of people with epilepsy in Africa are not able to obtain medicines to treat and manage seizure episodes. Rural communities in African countries are often confronted with a lack of awareness and comprehension when it comes to diagnostic treatments for epilepsy, which can often lead to misdiagnosis. Additionally, because health care institutions are uncommon in low-income areas, people have to travel a long way in hopes of accessing medical attention. Due to the unstable infrastructure in the health care systems, finding professionals like epileptologists and neurologists specializing in epilepsy care is rare. 

Receiving treatment is also a major financial burden for many Africans, as the cost of health insurance ranges from $10 up to $50 per month. Medication and MRI scans which serve for assessing and treating epilepsy patients can cost between $50 to $1000.

Fighting Stigma and Discrimination

People with epilepsy living in poverty are usually the ones that receive the most backlash and face discrimination due to societal myths about the condition. Many people have perceived epilepsy as a contagious disease leading to them avoiding assisting someone during an epileptic episode. Along with this, discrimination has led to difficulty finding jobs and isolation from the rest of the community.

Education and legislation play a vital role in diminishing the stigma toward people with epilepsy. This is important because it can offer factual proof that calls for better assistance and treatment for epilepsy. Moreover, those who have seizure episodes in the work environment often face employment termination and are not able to continue work because of the stigmatization. Only a small portion of African countries have implemented legislation to safeguard individuals with epilepsy, but these protections have not always been in full enforcement.

Rehabilitation centers and health programs 

On a positive note, there have been ongoing developments in the health sector that help to dismantle stigma and enable treatment access for people in need. Many African regions have been incorporating “Mobile Health Clinics (MHCs)” to help people in remote communities where there are no health institutions. This innovation paves the way for the right specialists and health care providers, who work with different therapies, to improve the livelihood of people living with epilepsy. Speech, physical and cognitive therapies are crucial to managing epilepsy in patients to relieve psychological stressors. 

Other health programs have implemented reliable tests to distinguish and improve particular diagnoses of the disorder. The focal point for these programs is to work with communities in more impoverished areas while empowering women, the elderly and children. Additionally, this has offered a safe and unprejudiced environment for people with epilepsy, since they can speak through their condition without the feeling of judgment and dehumanization.  

Future Prospects

Efforts toward advancing and prioritizing care for epilepsy in Africa have been on the rise, with a focus on offering rehabilitation and therapy services. Research organizations, like CURE Epilepsy, have been working with local organizations in various countries to continue with the efforts and support to better the livelihood of many African individuals living with epilepsy. 

– Alessandra Amati
Photo: Flickr

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Diseases Impacting India

Diseases Impacting IndiaIn 2023, India became the most populous nation in the world, with the fifth-largest GDP and one of the fastest-growing economies in the world to boot. However, on the other side of this economic prosperity is the growing income inequality within the population. While 64 new Indian billionaires emerged between 2020 and 2022, India also continues to house the most number of people living in poverty, with almost 230 million people living below the poverty line. Many Indians living in chronic poverty are vulnerable to a wide range of diseases impacting India, especially because the cost of health care is practically prohibitive for the Indian poor.

Waterborne Diseases

A significant amount of surface water in India is polluted and unsafe to use. Unfortunately, the unclean water serves as a breeding ground for several waterborne diseases. Approximately 70% of surface water in India is dangerous to drink, including major river channels. Every year, waterborne diseases incur up to $600 million in economic costs in India.

Between 2011 and 2020, India recorded a total of 565 cholera outbreaks, with contaminated water and poor sanitation representing the chief causative factors. The poor hygiene and water conditions of India are also directly related to one of the leading causes of child mortality in the country, which is diarrhea. Around 13% of all deaths of children under the age of 5 are due to diarrheal diseases, making it the third biggest cause of death for children in the aforementioned age group.

Several years earlier in 2014, the government of India recognized the severity of India’s water conditions and launched the Namami Gange project. With a total budget of more than $4 billion, Namami Gange focused on constructing sewage treatment facilities and river-front development in the River Ganges. In 2022, the United Nations (U.N.) recognized the project as one of the Top 10 World Restoration Flagships for restoring over 900 miles of river length so far.

Tuberculosis (TB)

In 2021, India alone accounted for 28% of all TB cases worldwide, and roughly 500,000 Indians died from TB. Moreover, the global rise of drug-resistant tuberculosis is heavily affecting India as well, with 23% of new cases in India having resistance to some kind of drugs.

Indian Prime Minister Narendra Modi recently announced his goal to eliminate TB in India by 2025. In addition to this goal, USAID has been providing TB-related aid to India since 1998 and assigned a total budget of $15 million on addressing TB in India in 2022.

Noncommunicable Diseases Impacting India

Between 1990 and 2016, the proportion of NCD-related deaths drastically increased from 37.9% to 61.8%. Cardiovascular diseases have become the most common and deadly NCD in India, along with chronic obstructive pulmonary diseases (COPD), cancer and diabetes.

Long-term day-to-day habits and routines of individuals can cause various NCDs. Smoking, drinking, unhealthy diet and high blood pressure are some of the most common risk factors for NCDs, and many Indians are prone to them. For instance, India is the third biggest producer of tobacco in the world, and the nation itself consumes nearly half of the tobacco production.

NCDs are also closely associated with poverty in India. More than 35% of all Indians do not have any form of health insurance coverage and people usually pay their medical expenses out-of-pocket. A staggering amount of 55 million Indians fell into poverty because of medical expenses in a single year.

In an effort to combat the impact of NCDs on Indians in poverty, the Indian government launched the Ayushman Bharat program back in 2018, a nationwide health protection scheme that aims to provide public health insurance to low-income Indians for free. In 2020, the program received an estimated $1 billion in funding.

The Good News

While India faces pressing issues that demand intervention aimed at ensuring the protection of its citizens from diseases impacting India, ongoing efforts present a reason to hope for a better future. The Indian government is making progress in mitigating major health hazards in the country, while also improving the accessibility of health care for individuals living in poverty.

– Junoh Seo
Photo: Unsplash

Diseases Impacting South Africa

Diseases Impacting South AfricaAccording to the World Bank, in South Africa, based on the upper-middle-income country poverty line, the poverty rate stood at about 63% in 2022. High poverty rates lead to poor living conditions and a lack of access to quality health care services and treatments. This results in a high burden of disease. Among the most common diseases impacting South Africa are SARS-CoV-2, HIV/AIDS and tuberculosis.

Diseases Impacting South Africa

  1. SARS-CoV-2. As of April 20, 2023, South Africa has noted more than 4 million cases of COVID-19 and 102,595 COVID-19 related deaths. The country reported its first confirmed case in March 2020, and since then, SARS-CoV-2 has become one of the main diseases impacting South Africa. Considering the nation’s fragile health care system, in 2020, the World Health Organization made a commitment to strengthening South Africa’s pandemic response by educating more than 1,200 medical workers on infection prevention and control and training more than 1,400 people on case investigation and contact tracing. The WHO also helped to boost vaccination efforts. To date, health workers have administered more than 38 million COVID-19 vaccine doses. Researchers from Wits University and other partners ramped up COVID-19 testing efforts in South Africa by repurposing the Cepheid GeneXpert machine in May 2020, originally designed to test for tuberculosis (TB). This system allowed for testing faster and more extensively.
  2. HIV/AIDS. South Africa has the highest burden of HIV globally as it accounts for 20% of all cases, according to a UNAIDS publication from 2018. Poverty has significant links to HIV and South Africa is a country with many impoverished individuals. According to UNAIDS data from 2021, more than 7.5 million adults and children in South Africa have HIV infections. But, as of 2021, more than 5.5 million individuals in South Africa are on antiretroviral treatment, equating to almost 70% of all infected individuals. PEPFAR (President’s Emergency Plan for AIDS Relief) is a U.S. initiative that aims to fight HIV/AIDS. PEPFAR began efforts to address HIV/AIDS in South Africa in 2004. PEPFAR efforts center around “27 high-burden districts throughout South Africa” and the South African government is partnering with PEPFAR to supply antiretroviral treatment to more than 4 million citizens.
  3. Tuberculosis. Commonly known as TB, this is a disease of poverty, which is why it is prevalent in South Africa. Tuberculosis is transmitted by airborne droplets, which makes it easily transmissible. Poor living conditions in crowded areas with little ventilation contribute to the spread of TB. A lack of education on this topic also increases the risk of a TB infection. In 2018, TB stood as the number one leading cause of death in the nation out of all diseases impacting South Africa. In 2021, for every 100,000 people in South Africa, 513 people had TB infections, according to the World Bank. PEPFAR also works in South Africa to reduce the transmission of TB.

Through the commitment of the government and organizations, the prevalence of diseases impacting South Africa can reduce and the well-being of South Africans can improve.

– Anna Konovalenko
Photo: Flickr

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Non-Communicable Diseases in Small Island Developing States

Small Island Developing StatesAccording to the IFRC, “Non-communicable diseases are diseases that are not spread through infection or through other people but are typically caused by unhealthy behaviors. [NCDs] are the leading cause of death worldwide and present a huge threat to health and development, particularly in low- and middle-income countries.” Non-communicable diseases in Small Island Developing States (SIDS) are responsible for the premature deaths of more than half of the population. But, most NCDs are preventable, “with poor health largely driven by five main modifiable risk factors: tobacco use, unhealthy diets, physical inactivity, alcohol use and air pollution,” the NCD Alliance says.

NCDs in SIDS

Due to their size, location and susceptibility to extreme weather events, Small Island Developing States, commonly referred to as SIDS, are a collection of 52 islands and coastal countries that face similar development difficulties. World Health Organization (WHO) data shows that SIDS has the highest number of non-communicable diseases and “mental health risks” in the world.

At the 1992 United Nations Conference on Environment and Development, the U.N. acknowledged SIDS as a “special case for both their environment and development.” These states grapple with several interrelated issues, for example, the COVID-19 pandemic and additional factors such as unemployment and poverty. A U.N. assessment in 2018 calculated the multi-dimensional poverty rate across 16 SIDS and came to an average rate of 47.5%. Conditions of poverty contribute to the rise of non-communicable diseases and mental health issues.

The five core types of non-communicable diseases (NCDs) are “cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma), diabetes and mental health,” according to the Healthy Caribbean Coalition. NCDs already disproportionately affect developing countries, which account for close to 75% of NCD deaths, equating to 28 million people.

Action to Address NCDs

In January 2023, WHO, the Pan American Health Organization (PAHO) and the Government of Barbados hosted a “SIDS High-level Technical Meeting on NCDs and Mental Health” that lasted two days. The conference’s primary focus is to promote domestic action and global cooperation to address NCDs and mental health in SIDS.

About 80% of NCDs are preventable, according to the NCD Alliance. Founded in 2009 and based in Switzerland, the NCD Alliance’s goal is to “unite civil society and drive action on non-communicable disease (NCD) prevention and care, leaving no one behind,” bringing together 300 members across 81 nations. By 2025, the NCD Alliance aims to reduce premature deaths caused by NCDs by 25%. By 2030, it aims to reduce this rate by 33% and advance “mental health and well-being.” Through advocacy efforts, NCD education initiatives for health care professionals, accountability, monitoring and more, the NCD Alliance promotes health and saves lives.

The NCDA 2021-2026 Strategy bases its efforts on four goals: advocacy and accountability, capacity development, knowledge and partnerships. The phase sets out both short- and long-term strategic goals to “support civil society in driving progress on NCD prevention, care and financing,” the NCD Alliance website says.

NCD Alliance Prioritizes SIDS

The Alliance collaborates with regional organizations, such as the Caribbean Public Health Agency (CARPHA) and the Pacific Community (SPC), to support efforts to prevent and control non-communicable diseases in Small Island Developing States.

In addition, the NCD Alliance works with SIDS to address the social determinants of health that contribute to the burden of NCDs, such as poverty, food insecurity and lack of access to health care. The Alliance advocates for policies that promote healthy lifestyles, such as tobacco control measures, healthy food options and physical activity promotion.

Overall, the NCD Alliance plays an important role in advocating for the prevention and control of non-communicable diseases in Small Island Developing States and supporting efforts to address the social determinants of health that contribute to these diseases.

– Lauryn Defreitas
Photo: Flickr