HIV/AIDS in Africa
The HIV/AIDS epidemic remains a significant public health problem in southern Africa. In the last decade, infections have drastically dropped while awareness of HIV status and availability of treatment has increased. This progress aligns with the UNAIDS 90-90-90 goal. Meeting this goal means that at least 90% of people with HIV are aware of their status, 90% are receiving antiretroviral drug treatments and 90% are virally suppressed. Viral suppression means that the virus will not negatively affect a person and that that person will not be able to transmit it to another person. Some of the most HIV-afflicted countries in Africa have met and even exceeded the 90-90-90 goals. Eswatini has the highest HIV prevalence in the world today at 26.8%. It has reached 95% in all categories and is on its way to reducing new infections.

HIV/AIDS and Conflicts

Despite recent progress, international aid has been focusing on HIV/AIDS less and less, especially as the COVID-19 pandemic has become a more imminent global threat. Sub-Saharan Africa still has the highest rates of HIV/AIDS in the world. It is also one of the most conflict-ridden regions in the world.

HIV/AIDS has a history of destabilizing political and social institutions in countries and leaving them vulnerable to violent conflict. The International Crisis Group estimated that one in seven civil servants, including government employees, teachers and the armed forces in South Africa were HIV-positive in 1998.

How Does HIV/AIDS Affect Civil Servants in Africa?

  1. The disease affects the productivity of the military and its ability to respond to armed conflicts. In 2003, the Zimbabwe Human Development Report estimated that the Zimbabwe Defense Forces had an HIV prevalence rate of 55%. With such a high rate of illness, the military has high training and recruitment costs, as soldiers get sick and are unable to work. In addition to this, HIV can transmit through sexual contact. It disproportionately affects younger populations which typically make up the bulk of the armed forces.
  2. The HIV/AIDS epidemic breaks down political institutions by limiting their capacity to govern. According to former president Robert Mugabe in 2001, AIDS had a significant presence in his cabinet, killing three of his cabinet ministers in the span of a few years and infecting many more. The disease wipes out workers essential to the function of a state, like policymakers, police officers and judicial employees.
  3. HIV/AIDS threatens the quality and accessibility of education. A UNICEF report found that more than 30% of educators in Malawi were HIV positive. If children cannot receive a quality primary education, they are less likely to receive secondary education and start professional careers. Instead, crime may open up opportunities for security that education could not provide. With increased antiretroviral use and awareness of the disease, HIV rates and deaths among educators have likely dropped along with overall rates in the last decade.

Civil Servants

The impact of HIV/AIDS on civil servants in Africa has been immense. The disease affects vulnerable populations such as gay men, sex workers and young women disproportionately. However, it has also affected those who work as civil servants. Civil servants are integral to the functioning of governments. Without them, countries are vulnerable to conflict and violence. Furthermore, HIV/AIDS prolongs conflict in countries already experiencing it.

While there are many other causes of violent conflict, the breakdown of political and social institutions fueled by HIV/AIDS only exacerbates conflict. War can also be a vector for the further spread of the disease. According to UNHCR, both consensual and non-consensual sexual encounters happen more often during the conflict. Rape has been a weapon of war in conflicts in Rwanda, the Democratic Republic of Congo (DRC) and Liberia in recent years and has likely contributed to the spread of HIV.

Solutions

Combating HIV and AIDS is a very important step in stabilizing economic, political and social structures across Africa. USAID programs like PEPFAR have had a significant role in combating HIV and AIDS. PEPFAR has invested nearly $100 billion in the global AIDS response in various ways. Most notably, it has provided 18.96 million people with much-needed antiretroviral treatment.

PEPFAR also aids in prevention care. For example, it has supported more than 27 million voluntary medical male circumcisions as well as testing services for 63.4 million people. In 2012, there was a government campaign in Zimbabwe to promote circumcision, in which at least 10 members of parliament participated.

These campaigns and USAID programs have had tangible results. In 2013, a study by the South African National Defense Forces showed an 8.5% HIV prevalence rate among its soldiers, much lower than the 19% prevalence in the general population. Given the successes in decreasing HIV/AIDS infections across Africa, perhaps economic, political and social stability is to follow.

– Emma Tkacz
Photo: Flickr

PSRD: Dedicated to Fighting Poverty Among the Specially Abled
Anyone, at any time and anywhere, can fall victim to poverty. However, some factors exist that put some individuals more at risk than others, and disabilities increase the likelihood of families living in poverty. In 2019, 25.9% of disabled people in the United States lived in poverty, more than double the rate for those without disabilities. The specially-abled face higher barriers when trying to find success in their lives and become financially stable. The connection between unemployment and disability remains serious: “half of all working age adults who experience at least one year of poverty have a disability.” In Pakistan, a country where the poverty rate is 5.4%, poverty amongst the specially-abled is significantly higher.

Physical Barriers and Poverty

  1. Health care: One reason for the physically challenged to fall into a state of poverty in Pakistan is the lack of adequate health care. Persons with disabilities are more likely to need extra resources and different types of treatment that are not easily accessible. Health care disparities arise due to societal stigma and a lack of policy changes to provide care that appropriately meets the needs of the specially-abled. There are relatively few advocates in Pakistan who are actively trying to open up more health care options for persons with disabilities. Such environments make it more difficult for poverty-stricken and physically challenged individuals in Pakistan to seek health care.
  2. Employment: The most significant cause of poverty among people with disabilities is the lack of employment opportunities they have. Pakistan ratified the Convention on the Rights of Persons with Disabilities in 2011. Pakistani law mandates 2% of hired employees in Pakistani institutions need to be specially-abled individuals, but this law is not always put into practice. For example, a study shows that government departments in Khyber Pakhtunkhwa, a province in Pakistan, are not meeting the 2% requirement.
  3. Education: Finally, a lack of education is a risk factor for poverty as it prohibits individuals from reaching a level of financial stability. It was found that, while education is accessible for many specially-abled children, rates of actual literacy remain low. More specifically, literacy rates for children with disabilities were much lower than those of their non-disabled peers. Regardless of socioeconomic status and family background, physically challenged students are not receiving the level of education necessary to reach the same standards of comprehension.

PSRD’s Solution

Evidently, many factors lead to the presence of poverty amongst the specially abled. The Pakistan Society for the Rehabilitation of the Differently Abled (PSRD) is a nonprofit organization working to bring specially-abled people out of poverty by focusing on health care, employment and education. Based in Lahore, Pakistan, the organization has worked with the population through the following programs:

  1. Vocational Rehabilitation Center: PSRD allows poverty-stricken and differently-abled individuals to maximize vocational skills. With an aim to eradicate the employment difficulties its students face, the center provides loans to jumpstart businesses. Those who receive help are better able to provide for themselves by becoming entrepreneurs and selling their own, handmade products. With their businesses, beneficiaries of the center are more capable of acquiring their own income and successfully support themselves.
  2. PSRD Hospital: In an effort to make health care more accessible for the specially abled, PSRD’s 100-bed orthopedic hospital is one of the largest in Pakistan. It provides specialized services for the needs of those facing physical barriers. The hospital does not refuse any patients and patients receive services at low or no cost depending on their situation.
  3. Orthotic and Prosthetic Center: With limited access to affordable resources, many physically challenged individuals are unable to obtain prosthetics and artificial limbs that ease their day-to-day lives and open up more employment options. PSRD creates customized prosthetics and approximately 3,900 patients have benefited from the center.
  4. PSRD High School: Education plays a large part in the road to employment and a successful future. By focusing on youth who are specially-abled, PSRD hopes to ignite the talent of all students so that they can lead better lives. The school also serves the needs of each of its students by providing therapy programs and making classes accessible for the most underprivileged children. The high school’s ultimate goal is to release the potential in each student and better “integrate” students into society.

People with physical disabilities are far more likely to face poverty than their non-physically disabled counterparts. With health care disabilities, limited employment options and lower high education rates, poverty may be inevitable for many specially-abled individuals. Organizations such as PSRD in Pakistan are working to empower differently-abled persons and provide them with the resources needed to persevere through their challenges and reach their goals. PSRD works to dismantle poverty amongst the specially-abled in Pakistan.

– Mariam Kazmi
Photo: Unsplash

Oral hygienePeople are often taught to brush and floss their teeth twice a day to prevent cavities or other oral diseases. Some estimates suggest that roughly 60-90% of children around the world and 100% of adults have cavities or another type of dental carie. These seemingly high rates of poor oral hygiene are present almost everywhere. The lack of market infrastructure and limited transportation can make acquiring seemingly simple items such as toothbrushes and toothpaste difficult or impossible in many countries. However, Sweet Bites, the first chewing gum made entirely of xylitol, was created for the sole purpose of providing an easy and affordable way for children and adults to protect their smiles from the debilitating problems associated with tooth decay.

Effects of Poor Oral Hygiene

The term “oral hygiene” can often be misleading. Oral hygiene is not limited to mouth diseases but can negatively affect people’s overall well-being. Potential short-term effects include a buildup of dental plaque, bad breath, breakouts and skin infections. Meanwhile, potential long-term effects include a risk of serious oral inflammation and a depressed immune system as well as tooth decay, cavities, gum disease and tooth loss.

The Science Behind Xylitol

Xylitol is a sugar alcohol that can be harvested from plants and is known to reduce plaque. This would also subsequently decrease the probability of tooth decay. Sweet Bites claims that “chewing xylitol-sweetened gum for five minutes after every meal can protect a person’s mouth from tooth decay, caries and all of the consequences that follow, including increased risk for cardiovascular disease.”

Five students from the University of Pennsylvania are the visionaries behind Sweet Bites. Although the health benefits of xylitol are not a new discovery, the young entrepreneurs’ three-pronged plan to help those suffering from tooth decay is admirable.

Sweet Bites Changes Lives

Sweet Bites’ mission is to “Fight Tooth Decay. Educate Children. Empower Students.” The entrepreneurs’ plan to address oral hygiene by selling their pure xylitol gum in stores throughout India’s most impoverished areas. The organization also has representatives traveling to schools, businesses and community events to educate the people of India on the importance of oral hygiene. This includes “health messaging on the wrapper, so each piece reinforces important behaviors, like brushing twice a day.” Lastly, Sweet Bites provides part-time work to local students. This ensures the chewing gum remains distributed by members of the community who understand the magnitude of the issue.

Currently, Sweet Bites is running various funding campaigns and applying for grants to bring their life-saving gum to the people of India at an affordable price. The Sweet Bites health initiative remains limited to India. However, the company’s CEOs are working to secure factory space so that their product can reach people around the world.

Sweet Bites’ Legacy

Sweet Bites has not just created a product but has also created a lifestyle. The company provides people with a product that will keep consumers happy and healthy. The product also teaches people about good oral hygiene habits and their effect on overall well-being. With several major global issues, it is often difficult to recognize seemingly minor issues that can spiral out of control when left unaddressed. Nevertheless, Sweet Bites creates a way to help those in need, which is truly the definition of giving back.

– Sara Jordan Ruttert
Photo: Flickr

Health Care in SwedenSweden has the highest income tax rate in the world. More than 57% is annually deducted from people’s incomes. However, Sweden placed seventh out of 156 countries in the World Happiness Report 2019, and its healthcare system is one of the best in the world.

In 1995, Sweden joined the European Union and its population recently reached over 10 million people. Healthcare is financed through taxes and most health fees are very low. Sweden operates on the principle that those who need medical care most urgently are treated first. Higher education is also free, not only to Swedes, but also to those who reside in the rest of the European Union, the European Economic Area, and Switzerland. Like healthcare, it is largely financed by tax revenue. Here are 10 facts about healthcare in Sweden.

 10 Facts About Healthcare in Sweden

  1. Sweden has a decentralized universal healthcare system for everyone. The Ministry of Health and Social Affairs dictates health policy and budgets, but the 21 regional councils finance health expenditures through tax funding; an additional 290 municipalities take care of individuals who are disabled or elderly. To service 10.23 million people, Sweden has 70 regionally-owned public hospitals, seven university hospitals, and six private hospitals.

  2. Most medical fees are capped and have a high-cost ceiling. According to the Swedish law, hospitalization fees are not allowed to surpass 100 kr (Swedish Krona), which is equivalent to $10.88, a day and, in most regions, the charge for ambulance or helicopter service is capped at 1,100 kr ($120). Prescription drugs have a fee cap and patients never pay more than 2,350 kr ($255) in a one-year period. In the course of one year, the maximum out-of-pocket cost is 1,150 kr ($125) for all medical consultations. If the person exceeds the cap, all other consultations will be free. Additionally, medical services are free for all people under the age of 18.

  3. The cost for medical consultations not only has a price cap, but is generally low. The average cost of a primary care visit is 150 kr-300 kr ($16-$33) and the cost of a specialist consultation, including mental health services, ranges from 200 kr-400 kr ($22-$42). The cost of hospitalization, including pharmaceuticals, does not exceed 100 kr ($11) per day and people under the age of 20 are exempt from all co-payments. Healthcare services, such as immunizations, cancer screenings, and maternity care, are also free and have no co-payments.

  4. All dental care for people under the age of 23 is free. When a person turns 23, they no longer qualify for free dental health care in Sweden and must pay out of pocket. However, the government pays them annual subsidies, or an allowance, of 600 kr ($65) to pay for dental expenses. In Sweden, the cost of a tooth extraction is 950 kr ($103) and the cleaning and root filling for a single root canal costs 3,150 kr ($342). If dental care costs total anywhere between 3,000 kr-15,000 kr ($326-$1,632), the patient is reimbursed 50% of the cost. If it exceeds 15,000 kr, 85% of the cost is reimbursed.

  5. To battle its large medical waiting lists, Sweden has implemented a 0-30-90-90 rule. The wait-time guarantee, or the 0-30-90-90 rule, ensures that there will be zero delays, meaning patients will receive immediate access to health care advice and a seven-day waiting period to see a general practitioner. The rule also guarantees that a patient will not wait more than 90 days to see a specialist and will receive surgical treatment, like cataract removal or hip-replacement surgery, a maximum of 90 days after diagnosis. Sweden’s government also committed 500 kr million ($55 million) to significantly decrease wait time for all cancer treatments. In 2016, Sweden developed a plan to further improve its health services by 2025 through the adoption of e-health.

  6. In 2010, Sweden made private healthcare insurance available. The use of private health insurance has been increasing due to the low number of hospitals, long waiting times to receive healthcare, and Sweden’s priority treatment of emergency cases first. In Sweden, one in 10 people do not rely on Sweden’s universal healthcare but instead purchase private health insurance. While the costs for private plans vary, one can expect to pay 4,000 kr ($435) annually for one person, on average.

  7. Sweden’s life expectancy is 82.40 years old. This surpasses the life expectancies in Germany, the UK, and the United States. Maternal healthcare in Sweden is particularly strong because both parents are entitled to a 480-day leave at 80% salary and their job is guaranteed when they come back. Sweden also has one of the lowest maternal and child mortality rates in the world. Four in 100,000 women die during childbirth and there are 2.6 deaths per 1,000 live births. There are 5.4 physicians per 1,000 people, which is twice as great as in the U.S and the U.K, and 100% of births are assisted by medical personnel.

  8. The leading causes of death are Ischemic heart disease, Alzheimer’s disease, stroke, lung cancer, chronic obstructive pulmonary disease and colorectal cancer. While the biggest risk factors that drive most deaths are tobacco, dietary risks, high blood pressure and high body-mass index, only 20.6% of the Swedish population is obese and 85% of Swedes do not smoke. The Healthcare Access and Quality Index (HAQ Index) also estimates that, in 2016, the rate of amenable mortality, or people with potentially preventable diseases, were saved at a rate of 95.5% in Sweden. The HAQ Index estimates how well healthcare in Sweden functions; the index shows that it is one of the best in the world.

  9. Sweden’s health expenditure represents a little over 11% of its GDP, most of which is funded by municipal and regional taxes. Additionally, in Sweden, all higher education is free, including medical schools. There are no tuition fees and a physician can expect to have an average monthly salary of 77,900 kr ($8,500).

  10. In Sweden, 1 in 5 people is 65 or older, but the birth rate and population size are still growing. Because Sweden has one of the best social welfare and healthcare systems in the world, people live longer and therefore 20% of the population does not generate income or pay taxes from their salary. This dynamic stagnates social welfare benefits and slows down the economy. Increasing immigration and a rise in births are the two solutions to ensure that the younger generations will receive the same benefits. Swedish-born women have an average of 1.7 children and foreign-born women have an average of 2.1 children. In 1990, Sweden broke the 2.1 children fertility rate but quickly dropped below 2.0 in 2010. Since 2010, Sweden has seen an increase of 100,000-150,000 immigrants and has seen 45,000 citizens emigrate.

In 2018, Sweden reached its record highest GDP (PPP) per capita of almost $50,000. Despite having the highest taxes in the world, the living conditions and healthcare in Sweden are some of the best. With time, its population will continue to grow and the healthcare system will continue to advance.

Anna Sharudenko
Photo: Flickr

Oral Health and Poverty
Dental health is a topic that people often forget in discussions of global poverty as other health issues can overshadow it. However, oral health and poverty have a link. Maintaining proper dental health is essential for individuals to stay healthy and out of poverty. Listed below are four ways in which improving individuals’ oral health can help fight global poverty.

4 Connections Between Oral Health and Poverty

  1. There is a close link between poor oral health and malnutrition. This is largely because people who have inadequate nutrition may also have weaker teeth, which are then more prone to decay. The pain of tooth decay and inadequate chewing is often enough to keep many individuals from consuming an adequate amount of food. Individuals who have fewer than three functional molars have even more difficulty consuming food. These individuals have shown a 40 percent reduction in masticatory performance or the ability to chew.
  2. People with chronic dental pain struggle with productivity. As most anyone who has had a toothache can attest to, dental pain can affect one’s ability to focus. In addition to this, the FDI World Dental Federation claims that people miss millions of work or school days each year due to oral afflictions. Untreated dental pain prevents people from being able to learn and earn successfully. This is another way that oral health and poverty connect.
  3. Uncontrolled oral bacteria can cause larger health issues. Without regular oral hygiene measures like brushing and flossing, the mouth, and especially the gums, can build up bacteria that does not just cause tooth decay but is also harmful to the rest of the body. This bacteria can cause endocarditis and pneumonia, as well as pregnancy complications. In short, good oral hygiene can prevent other health conditions from occurring.
  4. Focusing on oral health requires habits that benefit overall wellness. The primary example of this is the reduction of tobacco use. Smoking and chewing tobacco have a number of negative side effects, including crippling tooth decay, gum disease and cancer. In addition to this, most experts estimate that smoking kills more than 8 million individuals annually across the globe. There are also economic consequences to smoking, as evidenced by the staggering economic damage that people can incur as a result of smoking. One can calculate the economic damage by adding up both medical costs and the loss of productivity that smoking causes. The World Bank estimates that this figure is more than $1.4 trillion annually. Everything said, maintaining good oral health can help individuals stay healthy and productive.

Efforts by NGOs to Improve Oral Health

Fortunately, many groups have already begun to respond to this pressing issue. Dental care-centered mission trips and humanitarian outreach programs have long been in effect. Now, other larger organizations are increasingly involving themselves in oral health. For example, the organization Shoulder to Shoulder conducted a 17-year-long effort to craft an oral health program that produced many benefits for the people of Honduras. The program helped many individuals improve their dental health and people considered it to be a great success. UNICEF implemented a similar program that focused on tooth-brushing in the Philippines. This program reached countless schoolchildren in the country.

All of the above reasons demonstrate why improving oral health is crucial for fighting poverty. All said, there is a lot of good work that NGOs are currently doing to help promote oral health education and practices. Oral health is essential to ensure individuals’ overall health as well as their financial security. It is important that the connection between oral health and poverty remains at the forefront of discussions surrounding global health care going forward.

– Molly Power
Photo: Flickr

Dental Care in the Philippines

Dental care in the Philippines is crucial as statistics show that at least 80 percent of Filipinos suffer from dental problems. The current dental system has not been effective in reducing the number of people suffering from tooth decay or cavities. Today, the country is shifting towards adopting prevention methods. Here are three examples of how the Philippines is preventing tooth decay.

Education Programs

Statistics show that 95 percent of 12-year-olds suffer from tooth decay or cavities. Poor oral hygiene is the main reason for children with oral health problems. Building healthy habits is the key to preventing oral disease. To promote prevention measures, the Philippines is integrating oral health as part of the education curriculum in public schools.

The country’s Department of Education released the program, Fit for School as a way to address tooth decay in school-aged children. Every day, students go out to the school courtyard to brush their teeth with fluoride toothpaste. Fit for School not only promotes healthy habits, but it also provides the students with access to clean water and appropriate washing facilities. Today, the Fit for School Approach has become the Essential Health Care Program, which targets about 2 million children in 40 provinces in the Philippines.

Tax on Sugar

Sugar is one of the many causes of oral health issues in the Philippines. There is an abundance of sweet treats and sugary drinks throughout the country. Coca-Cola alone is predicted to spend $5.5 to $12 billion in marketing in Asian and African countries. Obesity and diabetes are diseases have links to high sugar diets. Now, tooth decay is also associated with sugar.

To make matters worse, foods high in fat and sugar are more accessible than a toothbrush. Filipinos living in poverty-stricken regions are the most vulnerable to make poor dietary choices and suffer from oral health issues. Several countries, like Mexico, have seen a drop in sugar consumption after implementing a tax on sugary drinks.

In 2018, the Philippines implemented a sugar tax. The tax raises the cost of sugary drinks by 13 percent. As a result, the Philippines expects to lower soda sales as well as a drop in the number of people suffering from tooth decay. The money collected from the sugar tax will be used to fund health care initiatives and infrastructure.

International Impact

From the United States to Australia, foreigners are flocking to the Philippines for dental care. The affordability of treatments has made dental care in the Philippines one of the most popular dental tourism destinations in the world. Dental tourism refers to the practice of traveling to another country to undergo dental treatment such as implants or teeth whitening.

Due to its popularity, dental tourism is fostering economic growth for the Philippines. However, it has not improved access to oral care for Filipinos. A 2016 report found that Filipinos rarely visit the dentist office and over 7 percent had never been. The report also found that 98 percent of Filipinos experience tooth decay.

Some argue that dental tourism has made dental care even more limited to Filipinos. The price of visiting the dentist is low for foreigners but very costly for Filipinos. Additionally, dentist offices are prone to schedule prioritize foreign patients rather than local ones. However, foreign travelers are also bringing free dental care to the Philippines. For instance, access to quality dental care is limited in Cebu and other underserved regions in the Philippines.

Aid for Dental Care

The University of the Pacific (UOP) is one of many organizations working to increase the accessibility of dental care. Each summer, UOP sends a group of dental students to Canjula Elementary School in Cebu to provide the students with free dental care. Students unable to afford yearly trips to the dentist for cleanings, fillings or extractions now have access to get the care they need. In addition to treatment, UOP also provides oral health information sessions to promote the building of good hygiene habits.

As a whole, dental care in the Philippines has been improving with time. While it is a common critique that treatment is valued over prevention, there have been efforts aiming towards children. Additionally, tourism and higher institutions are working to increase access to dental care in the Phillippines.

– Paola Nuñez
Photo: Flickr