Archive for category: Global Health

Information and stories about global health.

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Polio Outbreak in Burundi

Polio Outbreak in BurundiHealth authorities declared a polio outbreak in Burundi after confirming three cases and finding the virus after wastewater surveillance in the country. After three decades of no documented cases, in the Isale district in western Burundi, a four-year-old boy and two children he was in contact with tested positive for poliovirus type 2. In places where poverty rates are high, polio tends to spread easily due to sanitary water scarcity and limited access to health care. Unfortunately, those with polio frequently find themselves in a vicious cycle of poverty with no social or financial support. With the most recent statistics showing Burundi having a poverty rate greater than 65%, the polio outbreak in Burundi presents major concerns.

Public Health Emergency

The polio outbreak in Burundi constitutes a national health emergency, as poliovirus is extremely contagious. Since its first detection, health authorities have also confirmed five environmental samples of poliovirus type 2 in the wastewater.

Dr. Matshidiso Moeti, the World Health Organization’s (WHO) Regional Director for Africa, praises Burundi health authorities’ fast virus detection in a WHO press release. “The detection of the circulating poliovirus type 2 shows the effectiveness of the country’s disease surveillance. Polio is highly infectious and timely action is critical in protecting children through effective vaccination,” said Dr. Moeti.

How It Started

Poliovirus is transmitted through contaminated water and food. The virus lives in a person’s throat and intestines and spreads through fecal contamination. Early detection of cases is imperative to prevent the viral disease from spreading, as it is extremely contagious.

There are three types of wild poliovirus (WPV): types 1, 2 and 3. The symptoms of poliovirus often look similar to the flu and usually, last two to five days, though symptoms can be worse. Paralysis is associated with the most severe cases.

According to the Global Polio Eradication Initiative (GPEI), and echoed in the WHO’s press release, the cases detected from the polio outbreak in Burundi are “circulating vaccine-derived poliovirus type 2 (cVDPV2).”

The GPEI explains cVDPVs as variants of the poliovirus that can occur as a result of low vaccination rates among children. GPEI informs that areas with poor sanitation and low immunization rates can develop cVDPVs.

According to GPEI, the prevention of cVDPVs outbreaks is possible through immunization campaigns and the immunization of all eligible children. Previous efficient vaccination campaigns have alleviated the outbreak. The GPEI states “the vaccine continues to be a safe, effective tool for outbreak response across the continent.”

Addressing the Outbreak

Since the Burundian government declared a state of public health emergency on March 17, they’re aiming to provide and administer vaccines to as many children under age seven as possible. The vaccine campaign is a necessary step in stopping the outbreak.

According to the CDC, the oral polio vaccine (OPV) and inactivated poliovirus vaccine (IPV) prevent poliovirus infections. OPV contains a weakened version of one of the three types of poliovirus: IPV protects against all three poliovirus types, and contains no live virus.

Both the WHO and GPEI are assisting the Burundi health authorities in contact tracing and risk assessment to prevent a further outbreak in Burundi and nearby nations. Early detection of the virus is essential in containing the illness before it can spread. Burundi health authorities’ quick detection of the outbreak allowed the WHO and GPEI to begin contact tracing and rolling out vaccines efficiently. This efficiency since its first detection means that Burundi, the WHO and GPEI are in a great position to address the outbreak before it worsens.

Curbing the outbreak of polio before it spreads could save the lives of countless people in the country. And with the help of vaccines and other organizations intent on mitigating polio’s effects, those experiencing poverty in Burundi can look to the future with hope.

– Maya Steele
Photo: Flickr

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Cholera Outbreak in Mozambique

cholera outbreak in MozambiqueOn Feb. 24, the World Health Organization (WHO) released a report documenting the current cholera outbreak in Mozambique. Since the first cholera case in this particular outbreak on Sept. 14, 2022, concerns have grown as the WHO fears the outbreak will worsen due to recent heavy rainfalls, which increase the risk of cholera. The number of cases started to pick up in December 2022. All provinces affected by the cholera outbreak in Mozambique are areas susceptible to flooding. As of Feb. 19, Mozambique records 5,237 possible cases of cholera and 37 deaths in six of 11 provinces.

Concerns Over the Situation

Mozambique is currently in its rainy season and the WHO’s report expresses concern over the possibility of heavy rainfalls only worsening the situation. The peak of the rainy season typically occurs in February, but the rainy season still continues through April.

Mozambique reports cholera cases during the rainy season (October through April) every year, but the WHO reports that the current cholera outbreak in Mozambique has impacted more geographical locations than in recent years. In the past few years, cholera impacted up to three provinces yearly; however, this season, the geographical locations impacted have doubled. The Niassa province is reporting its first cases in more than five years.

Heavy rainfalls and flooding increase the risk of cholera because flooding can lead to inadequate access to clean water and sewage treatments, causing bacteria to spread.

Another concern is that one of Mozambique’s neighboring countries, Malawi, is grappling with the most fatal outbreak ever experienced. Even with the outbreak in Malawi, there continues to be a lot of movement across the borders of the two countries.

Cholera and How it Spreads

Cholera is an infectious disease caused by ingesting food or water infected by the bacteria Vibrio cholerae. After exposure to contaminated food or water, cholera incubates between 12 hours and five days. The most common symptoms include diarrhea, dehydration and vomiting.

According to the WHO, the bacteria remains in a person’s feces for one to 10 days. The stool produced by sick individuals can affect others if not disposed of properly. Others can ingest the bacteria if the patient or caretaker does not thoroughly wash their hands. Both children and adults can get cholera. Though it is a preventable disease, it can be fatal if untreated.

Response to the Outbreak

The government and the WHO are working together to address the cholera outbreak in Mozambique efficiently. When the outbreak first began, a national cholera task force formed. The WHO and national cholera task force are combining forces to create preventive and remedial responses, such as handing out brochures in local languages to residences and placing educational posters all over towns and treatment centers in affected districts. If communities do not understand the risks associated with treating patients and ingesting unsanitary food or water, the spread of the disease will only continue. Education and communication of potential contamination are necessary to control an outbreak.

The response also included distributing rapid test kits in areas most impacted. National Rapid Response Teams (RRT) are overseeing the investigation of cases in affected provinces. The teams aim to record data and track family members or friends of patients who are exposed or vulnerable to exposure.

The International Coordinating Group (ICG) on Vaccine Provision responded to a request for 700,000 doses of Oral Cholera Vaccine (OCV) to address the cholera outbreak in Mozambique. Health workers began administering the oral vaccines on February 27, 2023.

Mozambique’s government along with support from the WHO and other global communities is working toward administering vaccines, treatment and contamination protocols while also educating locals on how the disease spreads. A critical preventative measure that the WHO mentions in its report is the establishment of lasting infrastructure for safe drinking water. It is not likely that rainy seasons will cease in Mozambique and neighboring nations, but ensuring sanitary water for citizens can prevent further outbreaks.

– Maya Steele
Photo: Flickr

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Ban of Toxic Skin-Lightening Cosmetics Gets Global Push

Toxic Skin-lightening Cosmetics
The fact that mercury is a common ingredient in skin-lightening cosmetics poses serious human health concerns. Furthermore, many cultures continue to use toxic cosmetics to lighten skin by suppressing melanin production. Luckily, global humanitarian organizations are now collaborating with several countries to ban toxic skin-lightening cosmetics.

The Harm of Toxic Skin-Lightening Cosmetics

Women and men both use skin-lightening cosmetics to lighten their skin, fade blemishes and freckles and treat acne. However, people who use these products do not realize the damage they can cause because they contain mercury. Toxic skin-lightening cosmetics can cause skin rashes, scarring and digestive, neurological and immune system damage.

Not only are those who use mercury-laden products at risk, but the toxic skin-lightening cosmetics harm children through breastfeeding and other family members when users wash off the products. The washed-off products contaminate the family’s food chain. Moreover, these washed-off products can travel far without breaking down, contaminating both soil and water.

Global Demand for Skin Lightening

The skin-lightening cosmetics industry is slated to grow to $11.8 billion by 2026. High demand stems from a growing South Asian middle class and changing demographics in the Caribbean and Africa. Although the United States Food and Drug Administration (FDA) bans cosmetics with mercury, it recently found mercury in numerous products that did not indicate its presence on their labels.

The Minamata Convention on Mercury

As more becomes known about the harm of toxic skin-lightening cosmetics, countries and global organizations are mounting campaigns to reduce or eliminate their use. Gabon, Jamaica and Sri Lanka are collaborating as part of a $14 million comprehensive strategy to prohibit mercury from skin-lightening cosmetics and promote the beauty of all skin tones. Their Minamata Convention on Mercury strives to severely limit mercury in cosmetics.  This group set a limit of 1 mg/kg of mercury in cosmetics; however, tests have proved it is difficult to get compliance. In 2018, tests showed that 10% of 300 tested cosmetics in 22 countries exceeded the limit and worse yet, some exceeded the limit by 100 times.

Still, the Mimamata collaboration continues to work towards its goal. The Conference of the Parties to the Minamata Convention on Mercury (COP-5) will have its fifth summit in Geneva, Switzerland during the fall of 2023.

World Health Organization and the Biodiversity Research Institute Leadership

The World Health Organization and the Biodiversity Research Institute are now collaborating with the governments of Gabon, Jamaica and Sri Lanka. They are leading the effort for the Global Environment Facility (GEF)-funded, United Nations Environment Program (UNEP)-led campaign “Eliminating Mercury Skin-Lightening Products.” This project hopes to eliminate skin-lightening cosmetics that include mercury by:

  • Assisting governments by creating new laws and regulations as well as strengthening those that already exist all in accordance with the Minamata Convention.
  • Improving national capabilities for evaluating and tracking skin-lightening goods.
  • Increasing awareness of the problem in the project nations as well as on a global scale.
  • Enlisting participants in the supply chain in an attempt to prevent the manufacture, sale and distribution of skin-lightening goods.

Moving Forward

The collaboration between Gabon, Jamaica and Sri Lanka and global partners in the “Eliminating Mercury  Skin-Lightening Products” campaign is significant and the fifth Minamata Convention should synergize global efforts to raise awareness of the harmful effects of skin-lightening cosmetics.

– Lauryn Defreitas
Photo: Flickr

Cholera Outbreaks in Lebanon

Cholera Outbreaks in Lebanon
As of November 4, 2022, Lebanon has reported 18 deaths and more than 400 others infected with the notoriously contagious digestive disease, cholera. The World Health Organization (WHO) has classified the disease as a global threat to “public health.” Because the disease is so virulent, it has the ability to affect hundreds of people at once if spread through sewer and water systems within a community.

Current State of Lebanon

Since July 2021, the economic crisis in Lebanon seems to be one of the worst in the world since the 1800s. Banks are beginning to freeze withdrawals. As hospitals and pharmacies began to run out of medication and services to provide patients, the health of not only the people but also the economy began to take a dark turn. As of 2020, approximately 1.7 million refugees could be residing in Lebanon in extremely close-contact, low-budget camps. Furthermore, as of late 2019, “approximately three-quarters of Lebanon’s population” lived below the poverty line.

What is Cholera?

Cholera is a disease that spreads through the ingestion of food or water contaminated with the bacterium. The disease causes infected persons to experience a harsh acute diarrheal infection, eventually leading to severe dehydration. It can kill in hours if left untreated. The World Health Organization has reported that cholera transmission is “closely linked to inadequate access to clean water and sanitation facilities.” Commonly referred to as a “disease of poverty,” cholera outbreaks typically affect the world’s poorest people due to a lack of public sewage systems. As a result, human waste can mix with water that people use for drinking and cooking.

Cholera Outbreaks in Lebanon

After almost 30 years without a single case, cholera has re-appeared in Lebanon following a recent outbreak in Syria. Syria has recently reported more than 20,000 suspected cases and 75 deaths. There has been a high influx of Syrian refugees traveling to Lebanon. Consequently, the transition of the disease most likely occurred because of high population densities within the refugee camps. Reporter Daniel Stewart writes that the increase in cholera outbreaks is “mainly due to increased flooding, drought, conflict, migration and other factors affecting access to clean water.”

A Disease Linked to Poverty

In his research published in the National Library of Medicine, Arturo Talavera wrote that cholera outbreaks are key indicators of social development within a region. Cholera outbreaks remain a serious challenge in countries where people do not have assured access to safe drinking water and adequate sanitation. Talavera explained that cholera outbreaks affect low-income countries more than middle or high-income countries. Economic development is an important factor in determining how deadly an outbreak may be.

Solutions to the Cholera Outbreaks in Lebanon

Thankfully, France is delivering vaccines to Beirut. However, the World Health Organization warns that if not curved soon, the disease may begin to spread more rapidly. French Ambassador Anne Grillo explains that the recent cholera outbreaks in Lebanon are “a new and worrying illustration of the critical decline in public provision of access to water and sanitary services.”

The key to stopping cholera outbreaks is to provide communities with water security. Furthermore, vaccines can drastically curve the contraction of the disease. As more than 13,000 doses have already arrived in Lebanon with more to come, hopefully, Lebanon will be able to halt the spread of the disease with the help of foreign aid.

– Opal Vitharana 
Photo: Flickr

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Tackling HIV/AIDS in Barbados

tackling-hiv-aids-in-barbadosHIV/AIDS rates in the Caribbean are the highest in the world after Sub-Saharan Africa. With the prevalence rate within the region being 1.6% in 2005, the National Strategic Plan of Barbados marked HIV/AIDS as one of the nation’s biggest threats. Its small size and population mean that Barbados, and the Caribbean as a whole, tend to be overlooked in discussions of HIV/AIDS. Despite this Barbados has since, with foreign help, embarked on a mission to reduce the transmission of HIV/AIDS within the nation.

Understanding the Problem

HIV/AIDS transmission in Barbados saw a significant uptake in the early 2000s. This upward trend was mirrored across most of the Caribbean region. The Barbadian government identified that disfranchised groups were overrepresented in statistics regarding HIV/AIDS transmission.

A range of factors led to the higher than global average rate of HIV/AIDS in the nation. One of the largest factors contributing to the relatively high rate of HIV/AIDS in Barbados was the low rate of condom usage among the nation’s youth. In 2006, only 21% of Barbadians between the ages of 15 to 24 reported using a condom in their most recent instance of sexual intercourse.

Men who have sex with men, sex workers and other venerable groups also accounted for a disproportionate share of those infected with and dying from HIV/AIDS. These vulnerable and at-risk groups later became the focus of transmission reduction and treatment efforts.

Most recently the COVID-19 pandemic distracted from efforts to combat HIV/AIDS in the country. Initiatives such as the Man Aware event, which seeks to raise awareness of HIV/AIDS among Barbadian men, were canceled. The risk of spreading COVID-19 meant such face-to-face events could not be held.

Calls to Action

Various national and international actors have had a hand in combating HIV/AIDS transmission and AIDS-related deaths within Barbados. The World Bank provided one avenue of initial support. The World Bank’s Adaptable Program Loan, known as APL, provided the nation with additional health care funding. The main purpose of this program’s adoption in Barbados was to combat HIV/AIDS transmission and quell deaths from HIV/AIDS, according to The World Bank. One way Barbados achieved this was by providing free antiretroviral to HIV-positive citizens.

The U.S. Emergency Plan for AIDS Relief (PEPFAR), created in 2003, partnered with the Barbadian government, among other developing nations, to combat HIV/AIDS transmission. The U.S. organization contributed over $80 billion to this global project so far. PEPFAR also oversaw the wide-scale adoption of pre-exposure prophylaxis (PrEP) HIV prevention treatment in the nation. The Barbadian Ministry of Health and Wellness worked closely with PEPFAR to adapt HIV/AIDS treatment services to each vulnerable group.

As well as partnering with American-led organizations, Barbados also partnered with the governments of other Caribbean nations under the Pan-Caribbean Partnership Against HIV/AIDS (PANCAP). This regional collaborative effort sort to connect HIV/AIDS funding, on the governmental and intergovernmental level, to local services. This aided research within research facilities and supported the functioning of further treatment centers. Barbados, along with its partners in the PANCAP has seen the most progress in combating HIV/AIDS in the Caribbean region.

Progress

The action taken to combat HIV/AIDS in Barbados by both internal and external actors have brought about significant progress in the fight against the disease. Through these various initiatives, Barbados embarked upon a U.N. set a target of having at least 90% of HIV-positive citizens know their status and receive treatment by the year 2020. As of 2020, Barbados has reached 89% of HIV-positive citizens knowing their status, according to the U.S. Embassy in Barbados, the Eastern Caribbean and the OECS.

This promotion and uptake of testing began saving lives immediately upon its adoption as a major priority by the Barbadian government. Between 2001 and 2006 the number of AIDS-related deaths in Barbados plummeted by 72%. Within the same time period, new AIDS diagnoses fell by 46%, according to The World Bank.

The education which accompanied testing and treatment has helped quell much of the further spread of HIV/AIDS in Barbados. The education of Barbadian youth resulted in 72% of young people aged 15 to 24 stating they used a condom during their most recent sexual encounter in 2014. This rose significantly from the 21% reported in 2006, The World Bank reports.

Centers for Disease Control and Prevention (CDC), has continued much of the positive work pioneered by the Barbadian government, U.N. and previous U.S. interventions. The CDC established its regional office in the Caribbean region in 2002. The CDC has paid particular attention to ensuring testing and treatment for men who have sex with men, one of the most vulnerable portions of Barbadian society. Today the CDC continues to work with its ministries to improve the quality of testing and treatment services. CDC funding also continues to create great outreach for HIV/AIDS prevention and treatment efforts.

These progressive strides made within Barbados over the last two decades to tackle HIV/AIDS have been a result of the collaboration between numerous stakeholders. Although it still needs more progress, Barbados has come a long way in combating the disease over the last 20 years.

–Bryce Mathurin Lindsay
Photo: Flickr

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US Aid to Help Pay Ukraine’s Health Care Workers

Help Pay Ukraine’s Health Care WorkersOn July 12, 2022, the U.S. and World Bank announced the provision of $1.7 billion in aid to help pay Ukraine’s health care workers and supply “other essential services.”

Ukraine’s Health Care Workers

Despite the ongoing Russian offensive, many Ukrainian health care workers have opted to remain in the country, performing their duties under extreme strain and hardship. These individuals are key to Ukraine’s continued resistance, providing essential medical services for soldiers and civilians alike. Ukraine’s minister of health, Viktor Liashko, expressed that “the overwhelming burden of war” has made it more difficult to pay health care workers, emphasizing the urgency of continued financial support.

Importance of Humanitarian Assistance

The latest aid package brings the total U.S. budgetary assistance to Ukraine, via USAID, to $4 billion as of July 2022. Ukraine has used this aid to maintain essential social services, such as ensuring schools and medical facilities receive gas and electricity, providing basic humanitarian supplies and supporting civil servants. USAID Director Samantha Power expects that Ukraine’s dependence on foreign aid will continue as the Russian offensive continues targeting Ukraine’s public services.

The importance of supporting Ukraine’s hospitals cannot be overstated. Russia’s offensive strategically targets health care institutions alongside other public works. Ukraine noted 269 attacks on Ukraine’s public health institutions as of June 2, 2022. Russia’s strategy has decimated vital supply lines and infrastructure. The recent U.S. aid to help pay Ukraine’s health care workers is a step in the right direction, however, continued international support for Ukraine’s humanitarian services remains essential.

Additional International Support for Ukraine

The U.S. has sent the most aid to Ukraine since the start of the war, however, many other countries have also stepped up to support Ukraine’s humanitarian and military needs in this time of crisis. As of July 4, 2022, the U.K. had committed about $3.5 billion and the European Union had pledged nearly $1.5 billion to the cause. The IMF and World Bank have also sent multiple aid packages worth several billion U.S. dollars since the conflict began. The private sector is also a valuable source of aid for Ukraine, with major corporations such as IKEA, Adidas and Google pledging millions of dollars worth of assistance.

Fund-tracking platforms such as Devex estimate that there are a total of about $100 billion in aid commitments to Ukraine as of July 2022. Unfortunately, only about $8.5 billion will be allocated toward humanitarian aid, with the remaining funds being tied up in military packages or loans that cannot be allocated toward emergency services.

The $1.7 billion in U.S.-World Bank aid to help pay Ukraine’s health care workers and sustain essential services will bolster Ukraine’s health system and public institutions. As Russia’s offensive grows more protracted, the continuance of such humanitarian assistance is crucial.

– Mollie Lund
Photo: Flickr

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Why Middle-Income Countries Lag Behind

Middle-Income Countries
In 2019, the United States donated $8.1 billion in official development assistance (ODA) to the global health sector, according to the Organization of Economic Co-operation and Development (OECD). This kind of government aid, alongside other contributions, explicitly aims to promote economic development and welfare in developing nations as the OECD has defined. The Development Assistance Committee (DAC) of the OECD, an international forum of some of the largest providers of aid, including the United States, adopted ODA as the “gold standard” of foreign aid in 1969 and continued to be the primary source of financial assistance for development in other nations. Foreign support for health often prioritizes low-income countries over middle-income countries (MICs). According to a policy report, the national average income level for nations fails to reveal poverty and inequality. Millions of people living in poverty in MICs end up behind as donors focus on the poorest countries.

Who are the Middle-Income Countries

According to the World Bank, MICs are home to around 75% of the global population and 62% of the world’s poor. Middle-income countries also have two categories: lower-middle-income and upper-middle-income economies. Finally, the gross national income (GNI) per capita for MICs ranges between $4,046 and $12,535. Middle-income countries are diverse in terms of region, size, population and income level. Countries considered MICs could be nations with small populations such as Belize to larger countries such as China and India. Since the category of MIC expands to a multitude of different nations, there are a variety of other challenges. For those in the lower-middle-income category, one of the most significant issues may be providing citizens with essentials, such as water and electricity. The most critical challenges could potentially be corruption and governance for upper-middle-income nations.

How Health Donors Target Poverty

Duke University’s Center for Policy Impact in Global Health “analyzed donors’ allocation policies to determine if they reflect subnational poverty trends.” In addition, researchers aimed to identify ways funders can adapt their policies to ensure that no one ends up behind.

The researchers found four key features of the allocation policies including an overreliance on national poverty indicators, focus on critical and vulnerable populations, future subnational targeting and health system strengthening.

Health aid funders relied on national-level economic indicators for a country’s aid eligibility. There was also a high correlation to most health donors prioritizing epidemic control over poverty elimination, especially for organizations that target specific diseases. Through targeting diseases, health aid funders define populations by their epidemiological risk profile rather than making an explicit link to subnational poverty that may be causing a higher exposure to the diseases. Many donors also direct their funds to two different pathways of either “a ‘health systems strengthening (HSS) window or a cross-cutting HSS approach.” Organizations including the Global Fund to Fight AIDS, the World Bank’s International Development Association (IDA) and the United States Agency for International Development (USAID) use HSS to reach people considered the poorest. Unfortunately, the organizations do not often track poverty-specific metrics linked to their HSS portfolios even while trying to reduce poverty.

Due to a focus on elements that poverty or national-level economic indicators cause, donors often overlook the poor in middle-income countries.

The Importance of Donors

To ensure impoverished people can benefit from health aid, eliminating poverty should be a central goal for donors. They should use geospatial data sources and methods, consult the citizens living in poverty and use other indicators and factors to assess poverty. This would ensure that donors deliver the best aid to the community. However, donors should also acknowledge that poverty is a “complex, multidimensional and context-dependent social phenomenon that cannot be captured by monetary indicators alone.” Donors have to realize that the value for money approach may not align with the idea of ensuring that no one ends up behind.

Donors should also work alongside domestic policymakers to achieve long-term sustainability for a clear action plan for vulnerable groups. The donors have to define who will receive the program, how these people will access the program and what benchmarks will determine progress. The donors should also ensure that the community involves itself in a meaningful way to create change. In addition, medical interventions including vaccines should have mechanisms in place to set reasonable prices.

The United Nations Conference on Trade and Development (UNCTAD)

Middle-income countries have garnered the attention of the United Nations Conference on Trade and Development (UNCTAD). As U.N. General Assembly President Volkan Bozkir said that “The international community must urgently address the structural obstacles holding back progress…” Specifically, when middle-income countries experience exclusion from relief initiatives, they cannot respond effectively to the COVID-19 pandemic and the other social and economic effects. UNCTAD Acting Secretary-General Isabelle Durant said, “If the international community fails to support middle-income countries, the debt crisis will threaten global efforts to tackle poverty, inequality and climate change for years to come.” To help, UNCTAD developed the Productive Capacities Index (PCI) that would measure “how far productive capacities and benchmark their achievements.” This will help nations to formulate and implement better policies and benchmarks in terms of development and country-specific conditions.

Hope exists that the correct aid will uplift the community and implement sustainable solutions to today’s health issues ranging from parasites to chronic and infectious diseases. Middle-income countries will continue to grow their health infrastructure to give their citizens the best future possible.

– Gaby Mendoza
Photo: Flickr

Programs Addressing HIV/AIDS in Mexico

HIV/AIDS in Mexico
To better understand the HIV/AIDS crisis in Mexico, looking at the numbers alone is only half the equation. In 2020, UNAIDS reported 340,000 people living with HIV, a 55% increase from 2018’s report of 230,000. The stigma surrounding positive HIV status plays a significant role in discouraging HIV testing and treatment. However, several programs in Mexico aim to make treatment more accessible and address the underlying issues relating to HIV/AIDS in Mexico.

HIV/AIDS in Mexico

HIV prevalence in Mexico is notably high among gay men, prisoners, transgender people and sex workers. Men who have sex with men (MSM) account for the highest number of infected people, with approximately 1.2 million men affected in this category. Despite this fact, only about 40% of these individuals go for HIV testing and know their HIV/AIDS status. Homophobia and a machismo culture mean that “sex between men is highly stigmatized.” Therefore, individuals within this category are hesitant to access HIV testing. Regular HIV testing is significantly higher in the transgender and sex workers communities at 62% and 66% respectively. The stigma surrounding HIV leaves many unaware of their status and exposed to potential transmission.

“PrEParing” for a Better Future

The fight against HIV/AIDS in Mexico starts with the United Nations PrEP program. On September 13, 2018, the U.N. launched its pilot PrEP program with the goal of targeting high-risk HIV-negative individuals. PrEP or (pre-exposure prophylaxis), is a preventive treatment for HIV-negative people who have an increased likelihood of coming into contact with the virus, such as sex workers and individuals whose partners have HIV.

The program received $26 million in HIV treatment funding to assist “7,500 at-risk people in Mexico, Brazil and Peru” until 2020. In Mexico, the PrEP program was open to assist up to 3,000 people with free treatments across four Mexican cities including Puerto Vallarta, Mexico City, Merida and Guadalajara. Additionally, patients received STD testing, counseling and condoms free of charge.

In a 2018 press release, Dr. Ariel Campos of Jalisco’s State Council for AIDS Prevention (COESIDA) said that in Puerto Vallarta, 300 people would receive a one-month supply of Truvada through the program. After the first month, the plan was to re-test patients for HIV and other STDs and then put them on a “three-month schedule” of Truvada. Studies show that PrEP is 99% successful at preventing HIV infection “when taken as prescribed.”

Protecting Prisoners

The Mexican Movement for Positive Citizenship (MMPC) helps combat HIV/AIDS in Mexico by helping those “invisible to society.” Many living with HIV in Mexico’s prisons often lack basic medical treatment, including prisoners in the advanced stages of the AIDS illness. People living with HIV in prison have personally affected each woman working with the MMPC.

For 30 years, Georgina Gutiérrez, a human rights activist and representative for the MMPC, has worked with Mexicans living with HIV. Her partner faced eight years of imprisonment in the Santa Martha Acatitla Penitentiary where the reality of the prison system opened her eyes. MMPC is one of 30 UNAIDS initiatives encouraging community-based HIV work. MMPC “received an award of $5,000” to carry out its work. To date, the MMPC has helped 180 HIV-positive prisoners at the Santa Martha Acatitla Penitentiary, providing both COVID-19 PPE and HIV/AIDS training. An additional 1,000 prisoners and staff have “benefited from the project.”

The efforts in the fight against HIV/AIDS in Mexico continues to grow with help from everyday citizens, commitments from organizations and advancements in medicine. If support continues to grow, the stigma behind HIV/AIDS in Mexico will soon be a thing of the past and Mexico will have its HIV/AIDS crisis well under control.

– Sal Huizar
Photo: Flickr

Maternal Mortality in South Sudan

Maternal Mortality in South SudanOne of the happiest moments in a mother’s life is taken away from her in South Sudan. With 789 deaths amongst 100,000 births, South Sudan’s maternal mortality rate ranks as one of the highest in the world. The probability of death when giving birth is higher when a woman is in poverty. Also, with little access to professional assistance and resources, death becomes far more likely. 

In turn, when maternal mortality occurs, the risk for child mortality increases. Orphaned children are more likely to become subject to child labor. They also tend to have limited access to high-quality education and encounter more obstacles that prevent them from reaching their highest potential. Maternal mortality in South Sudan is an urgent issue not only because mothers die, but also because maternal mortality leads to the ongoing suffering of the children left without moms.

Causes of Maternal Mortality in South Sudan

First, studies have shown that many women do not receive professional assistance when giving birth. In Juba, the capital of South Sudan, only a quarter of the women go to a hospital during the time of labor. That low figure partially stems from a lack of South Sudanese trained in maternal, newborn and child health (MNCH). With only one physician per 65,574 people and one midwife per 39,088 people, the country has a severe lack of professionals at hand. For this reason, mothers are forced to request assistance from non-certified individuals.

Poverty is a significant cause of maternal mortality risk factors. According to the World Health Organization (WHO), 4.8 million people in South Sudan, mothers included, suffer from food insecurity. Additionally, only 7% of the population has access to sanitation resources, which further prevents safe births. Poverty also influences South Sudan’s high illiteracy rate of 88% among women. In turn, that high illiteracy rate limits awareness of healthy birth practices.

Finally, communicable and chronic non-communicable diseases contribute to maternal and child mortality. Tuberculosis, a risk factor of maternal mortality, is high at 146 cases per 100,000 people in South Sudan.  Second, HIV/AIDS is at epidemic levels in South Sudan. Finally, diabetes and cardiovascular diseases are on the rise and elevate maternal mortality risk factors.

 A Focus on Increasing Trained Labor and Delivery Staff

Several initiatives have been launched to reduce maternal mortality rates in South Sudan. One significant example is the Global Health Innovation Laboratory’s Maternal, Newborn, and Child Survival (MNCS) program. Launched in 2010, MNCS has worked to increase training for MNCH professionals throughout South Sudan. Importantly, MNCS trainees learn how to identify and prevent major threats that women face during labor. In its first two years, MCNS trained 732 healthcare workers who are now providing assistance in labor and delivery patients in South Sudan.

Also, in 2012, the Ministry of Health in South Sudan, the United Nations Population Fund (UNPFA) and local nonprofits collaboratively launched the Strengthening Midwifery Service to train midwives and nurses. Additionally, three years later, the Ministry of Health also began partnering with the Canadian Association of Midwives and UNPFA to foster professional mentorships between midwives in Canada and South Sudan so they can exchange expertise with each other.

On the Path to Save South Sudanese Women and Children

Maternal mortality in South Sudan has been an urgent issue since the beginning of the South Sudanese Civil War. It puts both the mother and child at risk of death and may permanently jeopardize the future of a baby. Fortunately, the South Sudanese government and international organizations are working to improve that dire situation. With more professional help available to mothers, slowly, South Sudan is saving its women and children.

– Mariam Kazmi
Photo: Flickr

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Global Hepatitis Elimination by 2030

Global hepatitis eliminationHepatitis-related illnesses kill someone every 30 seconds. While many strains have treatments, the disease is incredibly prevalent. About 354 million people have hepatitis B or C and around 80% are unable to receive the appropriate care. The illness appears all over the world, as 116 million have it in the Western Pacific Region, 81 million in Africa, 60 million in the Eastern Mediterranean Region, 18 million in South-East Asia, 14 million in Europe and 5 million in the Americas. Global hepatitis elimination is possible with additional steps and education. However, as of right now, hepatitis is clearly very significant across the globe.

What is Hepatitis?

Hepatitis is inflammation of the liver often from infection or liver damage. While acute hepatitis often does not have symptoms, some symptoms can occur including:

  • Muscle and joint pain
  • High temperature
  • Fatigue
  • Loss of appetite
  • Dark urine
  • Pale, grey fecal matter
  • Itchy skin
  • Jaundice

Types of Hepatitis

There are five prominent types of hepatitis:

  1. Hepatitis A: Caused by the hepatitis A virus, people usually catch it when consuming food or drink contaminated with the fecal matter of an affected person. It is more common in places with poor sanitation and typically passes within a few months but could potentially be life-threatening. While there is no specific treatment, professionals recommend vaccination if a person is at “high risk of infection” or traveling to an area where it is more prevalent.
  2. Hepatitis B: Caused by the hepatitis B virus, hepatitis B spreads through “the blood of an infected person.” Hepatitis B is very common globally and typically spreads from an “infected pregnant woman to her babies or [through] child-to-child contact.” Sometimes it spreads through injecting drugs or unprotected sex but that is fairly rare. This strain is significant in southeast Asia and sub-Saharan Africa. Most adults who get it recover in a couple of months, however, children often develop a long-term infection that can lead to cirrhosis and liver cancer. A vaccine exists for hepatitis B.
  3. Hepatitis C: The hepatitis C virus causes this strain and is fairly common globally. Typically, the virus spreads through blood-to-blood contact with an infected person, so sharing needles is significant. Since many do not have symptoms, most people may not know they are sick without testing. One in four people is able to fight off the infection, however, it will stay in others for years. Chronic hepatitis C could cause cirrhosis and liver failure.
  4. Hepatitis D: Caused by the hepatitis D virus, this strain only affects those with hepatitis B. Spread through blood-to-blood or sexual contact, it is prevalent in Europe, the Middle East, Africa and South America.
  5. Hepatitis E: Caused by the hepatitis E virus, people usually catch it by eating raw or undercooked pork, venison, shellfish or offal. Typically, it is a “mild and short-term infection that does not require any treatment,” but people with a weakened immune system may be more at risk.

Other forms include alcoholic hepatitis, which occurs when a person drinks large amounts of alcohol. There is also autoimmune hepatitis, which is rare and occurs when “the immune system attacks and damages the liver.” A medication to reduce inflammation is available. Global hepatitis elimination needs to focus on all strains but especially B and C.

Methods of Reduction

By 2030, diagnostic tests, awareness campaigns, testing and vaccines could prevent 4.5 million deaths in low and middle-income countries. Currently, only 42% of children receive the birth dose of the hepatitis B vaccine. Nevertheless, global hepatitis elimination is very possible. A daily medication taken for 8-12 weeks cures most with hepatitis C and medications for hepatitis B are available. Both hepatitis A and B are preventable with safe and effective vaccines. Vaccinating more children would significantly reduce cases and be a major step towards global hepatitis elimination.

Additionally, since hepatitis A and E both spread mostly in areas with poor sanitation, improvements in sanitation could drastically reduce infections. Testing is another important step as many do not know they have it. In 2019, the World Health Organization (WHO) “estimated that only 10% of people with hepatitis B and 21% of people with hepatitis C worldwide knew they were infected. Of these, 22% and 62% had received treatment, respectively.”

Goals for 2030

The World Health Assembly called for the near or total elimination of viral hepatitis by 2030. This would entail:

  • A 90% reduction in new cases of hepatitis B and C
  • A 65% reduction in deaths
  • Treatment for 80% who have the illness

The Global Immunization Strategic Framework has laid out how to achieve global hepatitis elimination. Goals include strengthening vaccination services, helping improve access to testing and improving the response to outbreaks. Safe vaccines for hepatitis A and B already exist, so improving access to them is important. However, the World Health Organization (WHO) has estimated that only 10% of people with hepatitis B and 21% with hepatitis C know they are sick. That means that improvements in both testing and education are vital first steps before improving vaccination rates. Therefore, global hepatitis elimination is possible with increased testing and vaccination rates.

– Alex Alfano
Photo: Flickr