Archive for category: Global Health

Information and stories about global health.

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NCDs 101: How Do We Solve This Growing Problem?

ncd
The devastating effects of non-communicable diseases (NCDs) can be seen all around the globe. NCDs are responsible for the majority of deaths in developing countries, and they are not receiving the attention they need in order to be stopped.

NCDs are diseases that cannot be passed from person to person. Also known as chronic diseases, they last a long time and progress slowly. The four main types of NCDs are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. They can affect anyone of any age, gender, ethnicity, location or income.

However, the distribution of NCDs is not so equally spread. 80 percent of deaths caused by NCDs occur in low and middle-income countries, according to the World Health Organization (WHO).

As well as being concentrated in areas of poverty, NCDs have a large global impact. Sixty-eight percent of global deaths in 2012 were due to NCDs, and 42 percent were premature (before the age of 70) and avoidable, the WHO reports.

The combination of the prevalence of these diseases with the location (countries that are unable to help themselves), means that this problem is quickly growing out of control. Disease-specific solutions are being administered (vaccinations for AIDS, tuberculosis and malaria) in lieu of improving conditions so that NCDs are not even given a chance to affect a population.

Of course, vaccinations for communicable diseases are necessary as well, but they cannot be the sole solution in working toward better health. NCDs are proving to be more of a problem globally than other diseases, and, as such, the health conditions in suffering countries need our attention.

It is a fact that when measures are taken to prevent them, NCDs no longer majorly affect an area. This can be seen by the low numbers of deaths caused by NCDs in the U.S.–only 413 per 100,000 population in 2012 versus 967 per 100,000 in Mongolia, according to the WHO.

The difference between the U.S. and these affected countries is fewer risk factors. Tobacco use, unhealthy diet and physical inactivity are the top offenders, and lower-income countries lack the capacity to prevent and control these risks.

Although the UN has seen progress with its aid efforts, the focus on NCDs is lost. Goal six of the Millennium Development Goals (MDGs) lays out the initiative to combat HIV/AIDS, malaria and other diseases, but NCDs are not mentioned in the statistics.

For such a globally present cause of death, it would seem natural that NCDs would be a priority for 2015. However, that is simply not the case.

So, where do we go from here?

We know that if the major risk factors for NCDs were eliminated, around three-quarters of heart disease, stroke and type 2 diabetes would be prevented, as well as 40 percent of cancers, according to the WHO.

Health Affairs argues that Universal health coverage provides the opportunity for these diseases to be eradicated long-term. As far as combating NCDs, people in areas of extreme poverty need to be supplied with ways to obtain the necessary medicines without having to pay out-of-pocket.

More attention needs to be given to making accessible health care in developing countries a reality and taking care of those who are losing their lives due to preventable diseases.

In doing so, we must remember: we can conquer NCDs.

– Ashley Tressel

Sources: Health Affairs, UN, WHO, WHO 1, WHO 2, WHO 3, WHO 4
Photo: NotEnoughGood.com

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How a New Program Could Reconnect the Supply Chain

When Communication Really is Key; How a New Program Could Reconnect the Supply Chain and Keep Health Care Clinics Stocked
According to the World Health Organization (WHO), out of the close to the 1 million health centers in the developing world 40 percent of them are stocked out of essential supplies or medications.

In some countries, people walk three days to reach the nearest health clinic only to learn that they are out of stock of their medication. At the same time, health workers admit that they have life saving medications gathering dust and expiring on their shelves because their patients do not need them.

Reliefwatch is a platform for heath care organizations in the developing world to track the supplies in clinics and pharmacies. All clinics need to partake in Reliefwatch is a basic cellphone, which most clinic workers already own. The program involves no new hardware or installations and because all it requires is workers to punch in their inventory numbers into the cellphone, the training process is fast and simple.

Reliefwatch’s method is simple. An automatic call is sent to participating clinics whose staff enter their supply and medication inventories when prompted (Reliefwatch uses multilingual support systems). All the collected data is stored in their cloud system making it available in real-time anywhere in the world.

The information collected through Reliefwatch allows suppliers and NGOs to more accurately distribute medical supplies and medications. So instead of blindly shipping out supplies to clinics every three weeks, suppliers can effectively re-stock clinics based on their needs.

Daniel Yu, the founder of Reliefwatch, says his nonprofit has reduced stock-outs to 10 percent of current levels. Suppliers are more aware of which clinics need which drugs and facilities that have excess items can give them to clinics in need of them.

Reconnecting the supply-chain has a powerful effect. Suppliers can feel confident that their provisions are reaching places that need them, clinics and health care workers can adequately serve their patients and patients can depend on their medication being available when they need it.

– Brittney Dimond

 

Sources: Next City, Relief Watch
Photo: Flickr

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LIMBS International: Prosthetics for the Poor

prosthetics for the poorLIMBS International is a non-profit organization dedicated to creating affordable and durable prosthetics for the poor.

The demand for affordable prosthetics in the developing world is great and the supply is lacking. Prostheses that are affordable and sturdy enough are hard to come by.

Approximately 40 million people in the developing world are in need of prosthetics yet only five percent have any prosthetic options. Whether or not the five percent can afford the options is a whole other question.

LIMBS International works to reduce the number of amputees lacking prosthetics through innovative designs created with developing countries in mind. The organization is focused on finding cheaper and more efficient ways to produce practical prosthetics and has developed the first mass-produced, low-cost, multi-axis prosthetic knee.

The philosophy that LIMBS International uses is a holistic plan focused on education, community rehabilitation and technology development. The organization trains teachers to educate children on the needs of amputees in developing countries.

It also focuses on rebuilding the community through the Community Based Rehabilitation program to help address social, mental and emotional trauma that amputees have experienced. The technological development has an emphasis on creating low-cost, high-quality prosthetics.

Taking this further, the organization trains people to repair the prosthetic devices in their country of focus using material available in the region.

The prosthetic knee that LIMBS has built is manufactured in Bangladesh to be used in large-scale relief efforts by clinics and international organizations after natural disasters.

LIMBS International has launched a project called Project: Mobility to fit 250,000 amputees in the world with prostheses by 2024. The distribution of LIMBS International’s LIMBox to clinics that LIMBS partners with as well as to NGOs around the world will help reach that goal on time.

The organization is currently working in nine different countries: Bangladesh, Bolivia, Cambodia, Dominican Republic, El Salvador, Guatemala, India, Kenya and Mexico.

– Iona Brannon

Sources: LIMBS International
Photo: Wikipedia

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NeoVent Reaches Babies in the Developing World

Developing World's Babies Can Now Breathe Easier
In rural parts of the developing world, health care is iffy at best. If there is a healthcare facility, it often lacks trained employees and equipment. The equipment may even be outdated due to the expense to update it. And, too often, people traveling to a healthcare facility die in their travels.

This is the case seen in newborns when they are born in a rural village and must make the voyage to the nearest healthcare facility. It is very common for premature newborns to have difficulty breathing.

“Hospitals supply continuous positive airway pressure (CPAP) to keep the lungs ‘open’ as the baby breathes on its own. However, very premature babies who cannot breathe on their own require dual pressure treatment along with CPAP to provide both negative and positive pressure to the lungs at a normal breathing frequency.”

In first world countries, this is an easy fix because they are usually born at a hospital with the necessary equipment. However, this is not true in the rural parts of the developing world. Babies that need treatment for underdeveloped lungs do not have access to the dual pressure treatment system because the equipment is expensive, difficult to operate, or hard to upkeep.

According to the World Health Organization, the mortality rate of premature infants in underdeveloped countries can be up to eight times higher than in the U.S., due to lack of resources. But there is hope for the newborn babies of the developing world.

Stephen John and Joseph Barnett, two engineering students at Western Michigan University (WMU), invented the NeoVent. This device is an easy-to-operate dual-pressure system that is aimed at helping premature babies breathe.

“The NeoVent consists of an innovative oscillatory relief valve, and is driven by excess air generated by the CPAP machine. Air at a constant pressure is transported from the CPAP machines into the child’s airway via a tube. The tube is submerged into water to produce bubbles, which are caught in a small inverted bowl on the relief valve.”

As this tube fills bubbles, a positive pressure is applied to the infant’s lungs, bringing in air. And as the bubbles disperse, a negative pressure is applied to the infant’s lungs, pulling air out of the lungs. This is seen as a breathing motion on the infant’s chest.

By keeping the developing world in mind, John and Barnett have priced the machine at a mere $25. The engineering students plan to implement the NeoVent in limited resource facilities in Nepal, Kenya and Uganda.

John and Barnett received $3,500 as U.S. winners of the 2015 James Dyson Award. The students plan to use this money to start clinical trials and manufacture a second round of production level devices.

The NeoVent also won the Lemelson-MIT undergraduate “Cure It” competition and the Brian Thomas Entrepreneurial competition at Western Michigan University. In addition to these awards, NeoVent is also the recipient of a VentureWell E-teams grants and a research grant from WMU’s honors college.

NeoVent maybe not look like the expensive technology in state of the art hospitals, but it functions just the same. By creating an effective and affordable device, John and Barnett will be saving many premature infants’ lives in the developing world.

– Kerri Szulak

Sources: Machine Design, WMU News
Photo: Flickr

PATH’s 30 Key Global Health Innovations

The 30 Innovations PATH Chose to Save Lives
PATH, the Program for Appropriate Technology in Health, headquartered in Seattle, WA, is an international nonprofit organization and leader of global health innovation. For 40 years, PATH has improved health and saved lives.

PATH recently released the Innovation Count Down 2030 report, which identifies 30 key global health innovations. With support from the Norwegian Agency for Development Cooperation, the Bill & Melinda Gates Foundation, and the U.S. Agency for International Development, PATH assembled a group of experts and innovators from around the world “to identify, evaluate, and showcase health technologies and interventions with great promise to accelerate progress toward solving the world’s most urgent health issues,” according to the report.

The report features innovations that could hasten the pace of progress towards the health targets in the proposed United Nations Sustainable Development Goals (SDGs).

Those targets include reducing the global maternal mortality ratio to less than 70 per 100,000 live births and ending preventable deaths of newborns and children under five years old; ending the epidemics of AIDS, tuberculosis, malaria, and other diseases; reducing by one-third premature mortality from noncommunicable diseases; and ensuring universal access to sexual and reproductive health care services.

The global health innovations listed below, are presented in four categories that align with the SDGs proposed health targets. To read the summary of each goal, visit path.org and click the IC2030 report.

Innovations for maternal, newborn and child health:

  1. New formulations of oxytocin
  2. Uterine balloon tamponade
  3. Handheld device to measure blood pressure
  4. Simple, safe device for assisted delivery
  5. Chlorhexidine for umbilical cord care
  6. Kangaroo mother care
  7. New neonatal resuscitators
  8. New treatment for severe diarrhea
  9. Rice fortification
  10. New tools for small scale water treatment
  11. Portable pulse oximeters to measure oxygen
  12. Better respiratory rate monitors

Innovations for combating infectious diseases:

  1. Protective malaria vaccine candidates
  2. Malaria transmission-blocking vaccine
  3. Potent, single-dose antimalarial drug
  4. Expanded use of rapid malaria tests
  5. Broadly neutralizing antibodies in HIV vaccines
  6. Long-acting injectable antiretrovirals
  7. Oral pre-exposure prophylaxis
  8. Novel multidrug treatment regimen for TB
  9. New vaccines to prevent TB
  10. Nucleic acid amplification tests

Innovations for reproductive health:

  1. Expanded access to implants and intrauterine devices
  2. Injectable contraceptives

Innovations addressing non-communicable diseases:

  1. One-year contraceptive vaginal ring
  2. Polypill
  3. Broader use of HPV vaccine
  4. Task-shifting for diabetes care
  5. mHealth innovations
  6. Portable, affordable screening for eye problems

“On the eve of launching the SDGs, the global community now knows what we can accomplish by coming together around a common set of goals and throwing our collective weight behind health solutions with the most potential for impact,” the report states. “As world leaders consider how to finance and scale up those solutions, we know that coordinated investment and financing will be essential in our efforts to reach the 2030 health targets—and to ensure we can financially sustain those gains into the future.”

– Kelsey Parrotte

Sources: IC2030 Report, PATH
Photo: Flickr

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UNAIDS Wants Trade Agreements to Uphold Commitments

UNAIDS Wants Trade Agreements to Uphold Commitments to Public HealthWith the celebration of reaching 15 million people with HIV treatments and committing to end the AIDS epidemic, UNAIDS reminds countries that new trade agreements should not limit access to medicine.

At the 2011 Political Declaration on HIV/AIDS, governments reconfirmed their commitment to the use of existing flexibilities under the Trade-Related Aspects of Intellectual Property Rights (TRIPS). Specifically, governments reiterated their commitment to promoting access and trade of medicines and to ensure that intellectual property rights provisions in trade agreements do not undermine existing flexibilities.

TRIPS had to be reestablished with governments because as explained by UNAIDS Executive Director, Michel Sidibé, “We are entering a crucial phase of the AIDS response which will decide whether we end the epidemic as a public health threat by 2030. Anything that undermines that response must be avoided.”

Trade negotiators from 12 countries are working to conclude the Trans-Pacific Partnership Agreement (TPP). Under this text, there are reportedly provisions that go beyond what is required under the TRIPS Agreement.

With these “TRIPS-plus” provisions, generic competition could become more difficult. This would lead to higher drug prices. “Generic competition in the pharmaceutical industry, as well as the use of intellectual property flexibilities, have helped make prices for life-saving drugs much more affordable and enabled the unprecedented scale up of HIV treatment programmes.”

To achieve the elimination of AIDS by 2030, treatment drugs should not become more expensive. Instead, testing and medications should become more abundant and affordable to individuals.

The Fast Track Initiative not only wants to treat individuals who are infected with the virus but prevent the further spread of infection. With the combination of treatment and spreading awareness, this is how AIDS will be eliminated.

With this initiative, 28 million HIV infections will be avoided between 2015 and 2030. Twenty-one million AIDS-related deaths with be avoided during that same time period. A main point in this initiative is that the billions of dollars spent on HIV treatment will be made available to be spent on other areas of health care.

Early testing and treatment of HIV will save a generation that may not even be aware that they are infected. With many African countries being plagued by the spread of HIV, informing people about treatment and options is one of the best ways to end AIDS.

If the global Aids response is to attain the 90-90-90 treatment target by 2020 — 90 percent of people living with HIV knowing their status, 90 percent of people who know their status on treatment, and 90 percent attaining viral suppression — HIV treatment must be accessible and scale up must be financially sustainable.

– Kerri Szulak

Sources: UNAIDS 1, UNAIDS 2
Photo: Flickr

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UN 15-Year Executive Summary on AIDS: Hopes and Lessons

UN 15-Year Executive Summary on AIDS: Hopes and Lessons
Over the past 15 years, many lessons have been learned, and much hope has been gained toward the future of eradicating HIV. The U.N. Executive Summary on Aids, published this last month, highlights many hopes and lessons learned over that time period.

U.N. Secretary General Ban Ki-Moon writes in the introduction, “The AIDS response has been like no other. From the start it has put the focus on people and put their needs first. It has been a turning point for the recognition of health as a human right.”

The HIV response has been one of the greatest unifying factors in the modern world. Hundreds of countries have put aside their differences, be it social, political or economic, to combat the spread of AIDS. In 2001, $4.9 billion was invested in combattng HIV, today that number is over $32 billion.

With experience comes the opportunity to learn and share. Here are a few of lessons from the past 15 years:

Global access to antiretroviral treatment is key

As more and more people have received access to HIV testing, those who are infected are more likely to receive the proper treatment—helping them live better lives and preventing the virus from spreading to others. In 2001, one million people worldwide were on HIV antiretroviral therapy.

In 2014, that number had grown to over 15 million. The goal is to give medical access to all infected individuals by 2030.

The impact generated by people receiving treatment is the bar by which success is measured. This is because of the direct correlation between HIV treatment and death from AIDS. The summary states, “Treatment access has resulted in AIDS-related deaths declining by more than 42% between 2004 and 2014.

An estimated 1.2 million [1.0 million–1.5 million] people died of AIDS-related causes globally in 2014, but in the absence of antiretroviral therapy, AIDS-related deaths would have risen to 2.0 million by 2014.”

Transmission prevention among children

Infants born with HIV has been a focus strategy in AIDS globally. Millions of children were becoming orphans due to infected parents dying from AIDS. In 2009 14.4 million children were orphaned due to AIDS, over the last 6 years that number dropped to 13.3 million.

Another major concern was the transfer of HIV from pregnant mothers to children. In 2001, 580,000 children were infected with HIV. Today that number has been reduced by a little over 50 percent. The strategy educates and recognizes that childbirth is not the only means of infection, but even breastfeeding can lead to HIV infection.

The prevention strategy aggressively targets pregnant women who are infected with HIV. By providing testing, education and treatment, the transmission has been successfully halted and is now being reversed. The goal is to reduce the number to less than 50,000 HIV infections among children by 2030.

Safe Sex and HIV awareness

The youth are the leaders of tomorrow. Educating and preparing them to lead the world tomorrow is one of the keys in fighting HIV and AIDS. When HIV first became widely known in the 1980’s and 1990’s, many misunderstandings prevailed. The disease was thought to be only spread by homosexuals and many did not understand how it was contracted.

As time has gone by, campaigns to spread HIV awareness have led to young people understanding the two best methods of preventing HIV transmission—reducing the number of sexual partners and using condoms.

In 2001, awareness among youth worldwide about HIV was at 25 percent, with most being in developed nations. Today, that number is close to 35 percent. The goal is to raise awareness over 90 percent by the year 2030. The goal of reducing multiple sexual partners has been modest at the most, but still progressive.

Globally, condom use has increased, but levels are still too infrequent among youth in Central and Western Africa (large HIV-populated regions). Sub-Saharan Africa is a huge target population and conservative efforts have been made to allow access to contraceptives such as condoms.

Financing and Aid will allow us to reach the U.N. goals

Over the past 15 years, the fight has moved from millions of dollars to billions being spent annually. This has allowed the resources needed to be allocated appropriately.

The world has learned from HIV that political commitment for public health investments can continuously be created and when adequate levels of spending on health is allowed, it leads to unprecedented levels of success.

At this point in time, the United States cannot waiver in its support of programs funding HIV and AIDS prevention. Hard lessons learned have helped us unite and combat one of the deadliest outbreaks in world history. The road ahead is still going to be hard, but it is not out of reach.

– Adnan Khalid

Sources: UNAIDS, World Bank
Photo: UN AIDS

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Improving Global Surgery Addresses Development Needs


According to the World Health Organization, 5.8 million people die each year as a result of injuries. This is 32 percent more than the number of fatalities that result from malaria, tuberculosis and HIV/AIDs combined.

The most common life-threatening issues include road traffic, homicide and suicide. The World Health Organization also states that “injuries are a leading killer of youth.” Unfortunately, less attention has been directed toward surgical services in the developing world. A study in the Lancet Global Health Journal analyzed the factors that have contributed to this unmet need.

Key factors include:

  • Lack of leadership in the global surgery community
  • Disagreement on how to address the problem
  • Lack of effective efforts to take advantage of political actions
  • Minimal data on effects of surgical diseases

Despite these difficulties, there are networks committed to advancing the priority of global surgery. One promising solution is to link these efforts with other global health goals.

Basic surgical care could avert 1.5 million deaths per year. A few surgical diseases include blindness, fractures and appendicitis. While we may place less of an emphasis on these health issues, in comparison to HIV/AIDS for example, they still place significant burdens on the quality and productivity of life in developing communities.

It is important for the above factors to be addressed with existing organizations that have the structure and ability to bring attention to this goal. With adequate healthcare, communities in developing countries are more likely to develop in a sustainable and equitable manner.

– Iliana Lang

Sources: World Health Organization, The Lancet
Photo: Unsplash

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Debates Over Deworming

Deworming
Although multiple studies have found that worm infections in developing countries should be treated with deworming pills, there is some debate within health organizations as to who qualifies for treatment. Currently there are 280 million children that are being treated for worms worldwide, but some experts believe that this is excessive.

When people are infected by worms, they suffer multiple ailments, primarily internal bleeding, which can lead to a loss of iron and anemia. Worms also cause diarrhea and malabsorption of nutrients. Compounding the problem, people also suffer a loss of appetite, which means they ingest less food overall. People most at risk are children and women of childbearing age.

Deworming people, especially children of a young age, has shown to be an effective measure to ensure that they stay in school for longer periods of time. A study conducted in Kenya after a deworming program showed that school absenteeism decreased by 25 percent. Even improved attendance in schools in which no children were treated within a three kilometer radius was remarked.

However, diagnosis is relatively expensive in developing countries because it involves a lab analysis of fecal matter, costing four to ten times the price of treatment. Some experts therefore recommend that mass deworming programs be carried out where a large number have been found to be infected.

This is currently the World Health Organization’s policy. Some scientists have challenged this practice, claiming that the available evidence is not enough to assure the safety or necessity of mass treatments. They believe that a lack of teachers, rather than absent children, are the cause of most problems in education in developing countries.

The deworming medication itself is extremely cheap, at just 30 to 40 cents per child. Many studies have suggested that this is a cost effective way of getting kids to go to school. These children also performed better at academic tests eight year later and at cognitive tests ten years later. In the southern United States, a deworming campaign in the early 1900’s had the same effects.

– Radhika Singh

Sources: The Conversation, Harvard University, Voxeu, WHO
Photo: Answers

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USAID: Interview with International Development Worker

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Since 2009, USAID’s budget has gone down by about 16 percent. The United States’ foreign aid organization is already underfunded, making up less than one percent of the federal budget. Yet, USAID has 1,920 projects across almost every continent in the world.

With so little funding, it is impressive how much the organization can accomplish. Given the funding cuts, I talked to an active international development specialist and visiting professor at Colorado College.

Dr. Joseph Derdzinski had much experience with law and security forces in foreign countries during his time in the U.S. Air Force. Since then, he has conducted research on the democratic consolidation processes of post-authoritarian states as well as serving on election observation missions in Afghanistan and Egypt.

Q: Why do you think that USAID’s funding has gone down so significantly since 2009?

A: USAID was a main focal point of building infrastructure in Iraq and Afghanistan, so USAID funding was contingent on Afghanistan and Iraq. The reduction in USAID’s funding and budget is largely due to a reduction of foreign military personnel as well as development agencies from Afghanistan and Iraq.

Q: Why is the organization so underfunded?

A: It would make sense to fund more fully the agency, but there’s very little will from taxpayers or incentive for elected officials to increase USAID’s funding. In the annual federal budget, foreign aid doesn’t get the same level of attention as other budget items or priorities. This is due in part to the low level of understanding of how little funding foreign aid programs actually receive.

During or in the immediate wake of a war, foreign development funding is easier to justify, but it’s harder for a lawmaker to make a case for aid once the war is over. Moreover, everything to do with the war in Iraq, including development projects, was never part of the annual budgets. They were a supplement to the annual budget.

Q: Can you give me an example of how foreign aid helps the United States?

A: What’s happening in Greece in terms of migrations of people into Greece is a good example. The great majority who aren’t from Syria are fleeing authoritarian regimes and economic woes. And that’s the same as what’s happening at the U.S. border. Migrants to the US are fleeing social unrest and oppressive regimes.

And so, if the goal is to keep people in their home countries, one potential impact of international development is to allow people the option to remain in their home countries.

Q: Would you say that the budget cuts make working in international development difficult?

A: Yes, now more than ever it is more challenging to work in international development.

Conclusion: USAID is an important and undervalued organization in the United States. While at first glance, the work that USAID is doing may appear to primarily benefit the countries that are receiving assistance, it is in fact work that is beneficial to the United States as a whole. International development creates jobs for Americans, protects national security, and as Dr. Derdzinski described, can assist with the United States’ immigration dilemma.

With all of these factors kept in mind, foreign development assistance should no longer be something that is difficult for lawmakers to justify, but rather should be an integral part of policymaking.

– Clare Holtzman

Sources: Colorado College, Foreign Policy, USAID 1, USAID 2
Photo: United States Air Force Academy