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Addressing Maternal Mortality: Global Efforts in DRC

Maternal Mortality in the DRCMaternal mortality remains high in the Democratic Republic of the Congo (DRC), at 620 per 100,000 live births in 2022, despite efforts to reduce the rate drastically. The DRC has the eighth-highest maternal mortality rate in the world and is not on track to reach its 2030 target according to USAID.

International Involvement: USAID

USAID is one of the biggest donors to the DRC in regard to its health sector. USAID has created a plan not only for the DRC but other nations impacted by high maternal mortality called the Preventing Child Deaths and Maternal Death Framework, taking place over a 7-year course between 2023-2030. The focus areas for USAID are ensuring that the quality of health care is improved through using a primary health care system, targeting the impoverished populations who do not have easy access to health care and ensuring that leaders within communities take accountability for health concerns.

International Involvement: UNICEF

UNICEF has been actively involved in some of the success associated with maternal mortality rates in the DRC for nearly 63 years. Between 2001 and 2018, maternal mortality fell by nearly 40%. UNICEF helps to tackle the issue before it becomes one such as preventing common diseases that mothers tend to face during pregnancy. UNICEF works closely with other international organizations such as Ending Preventable Maternal Mortality (EPMM) to ensure women are visited and checked up regularly during the period of conception and childbirth, those delivering children have the necessary skills to ensure a safe delivery for both the mother and the child and ensuring that postnatal care exists for the mother and the baby.

International Involvement: UNFPA

DRC’s health infrastructure has been damaged by conflict and poverty. The high rates of sexual violence against women also contribute to health complications during childbirth, which could lead to maternal death. As of 2018, 42,000 women were waiting for surgical care in regard to their genital fistulas, which are caused by sexual violence. With the recent internal and external conflicts happening especially in Eastern DRC, more women are in vulnerable positions than ever before.

The United Nations Population Fund, or UNFPA is a U.N. agency that aims to tackle reproductive and maternal health globally. UNFPA has worked in the DRC since 1978. In 2021, UNFPA was able to help provide almost 700 fistula repair surgeries for women. They have provided 6,800 life skill programs for girls and helped prevent 4,932 child, early and forced marriages. UNFPA has continuously supported Congolese women who suffer from different difficult situations that have contributed to maternal mortality.

Many international organizations and agencies have been working in the DRC to help out a vulnerable population who do not get protection from different forms of violence due to poverty and conflict. With continuous and hopefully increased support from other agencies, maternal mortality rates will decrease soon.

– Christelle Wealth-Mukendi
Photo: Flickr

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Strategies to Eradicate Tuberculosis

Strategies to Eradicate TuberculosisTuberculosis (TB) is an infectious disease that mainly affects an individual’s lungs and spreads when people with the infection cough or sneeze and release tiny droplets into the air. People in the surroundings inhale these droplets and they contract the same infection. Although the disease affects the lungs the most, in some rare cases the infection can affect the bones, glands or even the nervous system, causing severe symptoms that include fever, fatigue and a long-term cough that may be bloody. The World Health Organization (WHO) has implemented strategies to eradicate tuberculosis across the globe in order to reduce preventable deaths.

Being the world’s leading infectious disease, impacting a quarter of the population, TB claimed the lives of more than 1.6 million people in 2021, according to WHO. Even though TB is present in all countries and in all age groups, it is curable and preventable.

Understanding TB: Most Affected Countries and Why?

According to the Centers for Disease Control and Prevention (CDC), countries in sub-Saharan Africa, Eastern Europe and Asia are most susceptible to TB. There are many reasons why some countries have higher rated of TB infections than others:

  • Weak Health Systems: Low-income and middle-income countries have a lower standard of medical care due to a lack of funds, resources and availability of medical professionals, which leads to fewer clinics and hospitals where individuals can get tests or treatments for TB.
  • Poverty: Low funds in underdeveloped countries and an increased financial burden on individuals mean people often have to make the decision between buying food or life-saving medications. Additionally, due to a lack of sufficient funds, people tend to live together in cramped quarters, making it easier for the disease to spread to the residents.
  • Diseases: Pre-existing diseases such as HIV, diabetes, malnutrition and the frequent use of tobacco can make individuals more susceptible to TB, according to the WHO.

These factors combined make it extremely difficult to screen for TB in low-income countries and most people do not have access to medical facilities, and those who do, are unable to use them because they cannot afford to.

The Fight Against TB

There have been many strategies to eradicate TB in LMCs and one of the most recent and most impactful has been the WHO’s End TB Strategy “to reduce TB incidence by 50% and mortality by 75% by 2025,” according to The Lancet Global Health. Through a multi-step initiative, WHO aims to eradicate TB by 2035.

  • Vaccination at Birth: The first step toward ending TB is through immunizing children against the disease from birth. In 2018, after extensive research WHO established a new criterion for vaccination against TB which stated, “For infants, a vaccine should be either better than BCG or at least 80% effective in preventing TB.”
  • Vaccination for Children and Teens: As part of a trial, routine vaccination was implemented for children who were 9 years old, and a one-time vaccination was implemented for children more than 10 years old. This trial lasted five years and the results revealed that both routine vaccination and a one-time vaccination were effective against the disease, but the routine vaccinations had a higher success rate.
  • Vaccination for Adults: A newly-developed vaccine known medically as the M72/AS01 vaccine has been 49.7% efficient in preventing the progression of TB.

Looking Ahead

In the fight against tuberculosis, significant strides have been made through initiatives like the WHO’s End TB Strategy. Vaccination efforts targeting children and teens have proven effective, while a newly-developed vaccine for adults shows promise in preventing the progression of TB. These advancements offer hope in reducing the incidence and mortality rates of this infectious disease, bringing us closer to a world free from the burden of tuberculosis.

– Vahisté Sinor
Photo: Flickr

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Improving Health Care in Guinea-Bissau

Health care in Guinea-Bissau
Like most countries across West Africa, Guinea-Bissau’s health care struggles have threatened the well-being of the country’s people. Several organizations are working to improve health care in Guinea-Bissau.

Health Care in Numbers

According to the World Bank, Guinea-Bissau spent 8.35% of its GDP on health care in 2019, an increase from 7% in 2017. The 2019 GDP expenditure rate was significantly higher than many other comparable African countries. For instance, the West African country of Nigeria spent only 3% of its GDP on health in 2019. World Bank data also shows that the country had 0.2 physicians per 1,000 people in 2020 and one hospital bed per 1,000 people in 2009. As a result of limited access to trained health care professionals and proper health care, life expectancy in Guinea-Bissau equaled 60.2 years compared to the global average of 73. However, life expectancy in Guinea-Bissau has improved by 9.93 years from an average of 50.3 years in 2000.

Water-Borne Illnesses in Guinea Bissau

Similar to many West African countries, the people of Guinea-Bissau suffer from inadequate access to clean water. According to UNICEF, 50% of hand pumps across the nation are dysfunctional. According to the Multiple Indicator Cluster Survey in Guinea-Bissau 2014, “75[%] of the country’s total population have access to improved drinking water source.” This forces a significant proportion of the population to use contaminated water for everyday uses such as drinking and cooking.

Guinea-Bissau has suffered frequent cholera outbreaks. As a result of the frequent consumption of contaminated water, cholera spreads quickly across areas with poorly maintained sewage and water systems. The cholera outbreak that occurred between 2005 and 2006 saw a total of 25,111 overall cases and 399 fatalities. Despite cholera being most prevalent in urban areas, particularly in the capital Bissau, most fatalities occur in rural areas. This is because of the lack of medical facilities located outside the cities. During the 2008 cholera outbreak, the World Health Organization reported that the “overall case-fatality rate stands at 1.9% and decreases below 1% for hospitalized cases” but “reaches 9% in remote areas.”

Maternal and Child Health in Guinea-Bissau

Guinea-Bissau struggles with providing adequate maternal and child health care. The World Bank says, in 2017, the maternal mortality rate stood at 667 maternal deaths per 100,000 births. However, this is an improvement from 1,210 in 2000. Maternal mortality in Guinea-Bissau is higher than its regional average — a consequence of underfunding and understaffing in the area of maternal health care in the country.

According to the Global Nutrition Report, “Guinea-Bissau has made some progress toward achieving the target for stunting, but 27.7% of children under 5 years of age are still affected, which is lower than the average for the Africa region (30.7%).”

Solutions

Although Guinea-Bissau’s health care struggles have eased, charitable organizations are attempting to make further improvements.

In 2019, focusing on improving children’s health care in Guinea Bissau, UNICEF supported deworming and vitamin A implementation into the care routines carried out by community health workers. UNICEF has also made strides in combating acute malnutrition by supporting screening and treatment processes aiding children suffering from severe cases of acute malnutrition. These treatment centers have been set up in 78 health care facilities nationwide. 

Concerning water accessibility, in 2022, the United Nations Development Programme (UNDP) commissioned a new borehole in the southern province of Guinea-Bissau providing clean water for approximately 3,000 people in the region. Providing communities with safe drinking water helps limit the spread of waterborne diseases, such as cholera, which is prevalent in the country.

Looking Ahead

While Guinea-Bissau has significant health care challenges, with the help of charitable organizations addressing children’s health care needs and improving access to clean water, the intensity of Guinea-Bissau’s health care struggles can lessen.

– Freddie Trevanion
Photo: Flickr

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Saving Afghanistan’s Health Care System

Afghanistan’s Failing Health Care System
Despite the constitutional promise from the state to provide health care to its citizens, Afghanistan remains unable to fulfill its pledge, leaving millions of its citizens struggling with poverty and poor health. Extreme poverty and falling income rates further stress the failing health care system. The UNDP reported in September 2021 that 97% of the population faced a risk of falling into poverty by the middle of 2022. Thankfully, despite the poor state of Afghanistan’s health care system, the medical community is receiving international financial and medical aid from organizations, including the United Nations and Doctors Without Borders.

Afghanistan’s Health Care System

The Afghan government implemented a new constitution in 2004, with Article 52 stating, “The state shall provide free preventative health care and treatment of diseases as well as medical facilities to all citizens in accordance with the provisions of the law.” With the assistance of international and domestic donors, Afghanistan created a health care system intending to take the burden of medical care and costs off its citizens regardless of financial status. The progress made over 17 years led to health improvements nationwide and costs minimizing exponentially.

Before the Taliban assumed full control of Afghanistan in 2021, the Afghan government passed countless measures to expand the country’s health care system. Slowly but surely, Afghanistan had begun broadening how much the government’s health care system could do for its people and expanding operations into the rural regions. Under the health care system, Afghanistan had more than 3,000 state-run hospitals and clinics, meaning each district and region at least had access to some form of health care.

Since the Taliban took control of Afghanistan, donors paused or fully stopped their funding of the Afghan health care system. Afghanistan’s failing health care system must deal with and navigate the resurgence of rising poverty rates in conjunction with devastating issues, such as increasing malnutrition, rising maternal mortality rates and the continued spread of polio.

The Shortcomings of Afghanistan’s Health Care System

After the Taliban assumed power in 2021, all previous improvements made by the health care system fell apart. Less than 10 years after the constitutional commitments to improve health, Afghanistan’s maternal mortality rate reduced to around 300 maternal deaths per 100,000 births. However, by the end of 2021, mere months after the system’s collapse, the maternal mortality rate rose to around 630 deaths per 100,000 births.

What remains of Afghanistan’s failing health care system is minimal and centralized in the largest cities as the country could not keep the rural hospitals and clinics open when international donors pulled their funding.

In 2020, 47% of Afghanistan’s population lived in poverty, but by 2021, 97% became susceptible to falling into conditions of poverty by mid-2022. The pulling of financial assistance from all international partners and allies sent Afghanistan into a humanitarian crisis with soaring poverty rates and limited access to basic resources. These inadequacies contribute to worsening health as lacking food causes malnutrition and poor access to water and sanitation causes illnesses including diarrhea, dysentery and typhoid. To make matters worse, the inflated prices of goods in the country, especially medical resources, deter people from seeking medical assistance as they cannot afford these costs.

Organizations Improving Afghan Health Care

Afghanistan’s failing health care system has garnered international attention. As the underfunded health care system faces daily struggles, international organizations are trying to bring relief to Afghans without bringing power to the Taliban. The greatest source of income for Afghanistan’s health care system is the United Nations. In September 2022, the U.N. promised its first batch of emergency funds for Afghanistan. The U.N. released $45 million to various non-government organizations (NGOs) that will bring immediate and long-term assistance to Afghans in need of health care.

Doctors Without Borders brings medical personnel and resources to hospitals throughout Afghanistan and even opened new trauma centers to help Afghans needing immediate assistance. The work of Doctors Without Borders brings help to the regions most impacted by a lack of water and sanitation access, where the risk of waterborne diseases and other illnesses is high.

The NGOs supporting Afghanistan are easing the economic and poverty challenges that Afghans face daily while supporting Afghanistan’s collapsing health care system. The health care system is finding support from international organizations as the health of citizens and the humanitarian crisis worsen. Afghanistan’s citizenry will find relief through international assistance.

– Clara Mulvihill
Photo: Flickr

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6 Facts About Health Care in the Central African Republic

Health Care in the Central African Republic
The Central African Republic (CAR) is a sub-Saharan nation comprising a population of approximately 5.5 million. Its capital is Bangui. Similar to many regions of Africa, the country has poor health care with limited access to clean water and sanitary spaces. Health care in the Central African Republic is in an extremely poor state with the country having a life expectancy of just 55 in 2020. Here are six facts about health and health care in the Central African Republic. 

1. Diseases

Common diseases in Africa such as malaria, yellow fever and diarrheal-related diseases exist in CAR. Tropical diseases spread easily through the country with insufficient medical resources. The National Library of Medicine shows that malaria accounts for 40% of all illnesses in the country.

Yellow fever is also prominent in the country, as with much of north and central Africa. Although some action has occurred in the roll-outs of vaccines, with a 2021 UNICEF statistic illustrating that 41% of the population is vaccinated, the country is still far from reaching the 80% threshold which indicates a country’s immunity.

Diarrheal-related illnesses are similarly frequent, particularly in children. Although organizations such as WaterAid have taken action in the construction of clean water pumps, water insecurity provides a constant risk for the country’s majority. A statistic from the National Library of Medicine shows an average of seven episodes per child per year.

2. Children’s Health Care

Life is especially tough for children living in the Central African Republic. Conflict within the region has left many children homeless and without an education. A 2021 UNICEF statistic illustrates that 370,000 children are internally displaced across the country as a result of widespread violence. Civil unrest in the country has forced children to join armed groups or flee their homes. To aid children’s well-being, UNICEF is introducing community-based interventions to support children’s mental health.

3. Malnutrition

UNICEF also helps children formerly a part of armed groups through programs that reunite them with their families. Malnutrition is also very common among children due to a low intake of healthy food. A statistic from UNICEF predicts that a minimum of 24,000 children under the age of 5 will suffer from acute malnutrition. The Central African Republic has one of the least funded childcare health care programs in the world and continues to struggle with this issue.

4. Access to Sanitation and Clean Water

Similarly to much of Africa, access to clean water remains a serious problem in the present day. Despite charitable efforts to introduce water pumps and sanitary spaces, much of the country, especially rural communities, go without the human right of access to clean water.

A statistic from the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) shows that only 37% of Central Africans have access to clean water. As a result, the majority of its population have exposure to dirty and germ-infected water for their everyday needs including drinking, washing and cooking. As a result of this frequent intake of dirty water, the country suffers from a high rate of water-borne diseases such as typhoid disease and diarrhea.

5. COVID-19

COVID-19 had severe impacts on underdeveloped countries. With a lack of medical knowledge, the virus spread rapidly across CAR with 15,367 cases reported to the World Health Organization (WHO).

As a result of the lockdown and school closures, COVID-19 also increased the frequency of gender-based and child abuse. This has resulted in many people suffering mental health issues and requiring psychosocial help.

6. Hospitals

A key reason for the country’s failing health care system is the extreme lack of hospitals and medical facilities. There is one major hospital located in the capital Bangui and a few more around the country. However, these hospitals are low-staffed and poorly equipped to deal with the high number of patients requiring medical attention. Health care in the Central African Republic lacks so much funding that humanitarian organizations provide 70% of health services within the country. 

Solutions

Although the current health care system is failing, with help from charities, hope exists for significantly better health care in the Central African Republic. UNICEF has put projects in place for 2023 to improve the quality of health in the country through a humanitarian approach. UNICEF’s programs prioritize children’s protection and set out to provide 140,000 with psychosocial care. In regard to combatting malnutrition, UNICEF plans to provide 60,000 children with medical treatment for this preventable condition.

In response to the low accessibility of drinking water, Concern Worldwide is conducting a project which plans to construct five water well boreholes in Mobaye town to provide people with safe and germ-free drinking water. Combined with the restoration of five damaged water wells, this project will increase the number of people who have access to clean water in Mobaye town by 50%.

Despite the challenges that the health care system is facing in CAR, several organizations are making a difference regarding its population’s health. Through their continued work, hopefully, health and health care will continue to improve in the Central African Republic.

– Freddie Trevanion
Photo: Flickr

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RSV in Developing Countries and the Need for a Vaccine

RSV in Developing CountriesAs of 2022, pandemics such as COVID-19 and tuberculosis are still rampant around the world. But there is another respiratory virus called the respiratory syncytial virus (RSV) that poses a risk, especially for those living in low-income countries and young children.

RSV in Developing Countries

RSV is a contagious virus that affects the lungs and breathing passages. The reason why RSV is not as well known is because its symptoms are the same as a cold. These include cough, a runny nose and fever. RSV can infect people of any age, but elderly people and children ages 2 and under are at the most risk of catching the virus. And much like the flu and COVID-19, it spreads when an infected person coughs or sneezes when around others and touches surfaces and objects.

People infected with RSV may even develop severe infections such as pneumonia or bronchiolitis which is the inflammation of the small airways in the lungs. Despite the danger, however, RSV is preventable. People can protect themselves from infections by simply washing their hands with soap and hot water for 20 seconds, covering coughs and sneezes, wiping surfaces that have been frequently touched and maintaining distance.

With these simple prevention methods, one might be asking just why is RSV so dangerous. While cases of RSV can be mild and clear on their own, a person can be infected multiple times in their lifetime. Furthermore, for those with severe symptoms who lack access to health care services, the outcomes can be devastating.

The Importance of Medical Care

“A seasonal virus that emerges during the winter months” causes RSV. Infants are more at risk for catching RSV since they do not have immunity compared to adults. Not only that, but in recent months the virus has been surging and that is ironically due to the prevention protocols against the COVID-19 pandemic.

Prevention methods such as social distancing, hand washing and mask-wearing during the COVID-19 pandemic helped to limit the spread of RSV. As a result, there have been no RSV infections over the past few years. That also means that there are two to three-year-olds who have no immunity to RSV. 

The situation is most worrisome when it comes to tackling RSV in developing countries. Many kids in low-income countries may also live in remote areas without access to medical assistance. “More than 95% of RSV deaths occur in low-income countries,” according to Bill and Melinda Gates Foundation. Unfortunately, a percentage of those who do survive may suffer from long-term health issues such as lung damage.

The Future

Currently, there is no known drug or vaccine for RSV. However, a vaccine to prevent RSV is in development by Pfizer who announced at the end of 2022 that its vaccine “showed an efficacy of 82% against hospitalization among infants under 90 days old and 69% among those younger than six months.”

The only challenge left is facilitating vaccine access to low-income countries. On that note, the Bill and Melinda Gates Foundation announced a grant to support the development of affordable multidose vials for delivery. The foundation is “optimistic that this vaccine could be available to low-income countries at an affordable price by 2024.”

– Aaron Luangkahm
Photo: Flickr

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Miracle Gel Could Save Millions Of Lives In Nepal

Miracle Gel
Since 2022, USAID and partners have been working to prevent infant mortality in developing countries. Chlorhexidine, a chemical element that comes in gel and liquid form, could be a potential solution to infant mortality. Typically used to disinfect human skin and sterilize surgical instruments in hospitals, the substance can also help protect the umbilical stumps of newborns to prevent deadly infections. USAID’s Chlorhexidine “Navi” Care Program applies this technique in rural Nepal. Furthermore, the miracle gel has decreased newborn deaths by 24% and newborn infections by 68% in Nepal.

Susceptibility to Infant Mortality in Nepal

Rural and low-income communities in Nepal are susceptible to high rates of infant mortality and infections that arise from traditional home birthing practices. Mothers sometimes cut umbilical cords with unsanitized house tools and treat the stump with turmeric as an antiseptic. However, these methods can be harmful as evidenced by a neonatal mortality rate of 23 per 1,000 live births in 2020. Furthermore, about 70% of infant mortality cases in Nepal tend to occur within the first year of the infant’s life.

USAID’s “Navi” Care Program

The Navi Care Program began in October 2011. With a budget of $3.9 million, the program was able to expand from 49 operating districts to cover all 75 districts in Nepal by 2014, according to USAID. The Navi Care Program helps in training nurses and healthcare practitioners to use chlorhexidine gel. The program also works to spread awareness about the miracle gel and supports the Ministry of Health and Population in Nepal to integrate it into the newborn and maternal healthcare systems.

Raising Awareness Through SBCC

As remarkable as the miracle gel is in terms of reducing infant mortality, not enough people in Nepal know about the solution and how they can access it. A social behavior change campaign (SBCC) started in 2015 works to ensure that locals learn about chlorhexidine. The campaign spreads information about the usefulness and affordability of the miracle gel through local and national radio and broadcast television.

Monitoring and Evaluating

In 2017, the Navi Care Program prevented nearly 9,600 newborn deaths in Nepal. With the help of the JSI Research & Training Institute, the USAID Navi Care Program has set up mechanisms to document and monitor the impact of the program. Chlorhexidine reports have been integrated into the pre-existing government health management information system (HMIS) and logistics management information system (LMIS). In addition, JSI wanted to monitor the process of program implementation. It uses a comprehensive mechanical system to gather external research and surveys from local women. JSI conducted telephone calls and in-person visits to meet healthcare professionals, pregnant women in their last leg of pregnancy and women with infants under the age of six months. Through this, they have been able to gather feedback and identify gaps in the implementation of the Navi Care Program in Nepal.

The Navi Care Program and miracle gel have become increasingly successful in Nepal and can save millions of lives in other countries too. The discovery and implementation of medical solutions can have a revolutionary impact on all communities, especially those that are susceptible to illnesses and infant mortality.

– Samyudha Rajesh
Photo: Flickr

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Life Expectancy in Africa on the Rise

Life Expectancy in Africa
Life expectancy in Africa is rising, increasing to 56 years from 46 in 2000, thanks to expanding healthcare access. Other parts of the world have not observed this tremendous growth rate of 10 years and show a valiant effort to address the issue of essential health care in African countries.

Reshaping Health Care Infrastructure

To tackle the issue of life expectancy in Africa, governments must revamp the framework of their existing healthcare infrastructures. Essential medications, equipment, facilities and technology for communication and information are the significant elements when redesigning a country’s current healthcare infrastructure.

Some countries, such as Ethiopia, utilize infrastructure roadmaps, which help establish a clear plan to improve public health. In Sierra Leone, strategic plans help the government identify what equipment is necessary to combat public health issues effectively. The Central African Republic has worked to maintain existing infrastructure.

From a technological standpoint, the World Health Organization’s AFRO (WHO AFRO) sector assisted African countries based on their healthcare infrastructure status. Modifying and verifying data in the Integrated African Health Observatory is a priority for less established countries, including Burundi and Nigeria, allowing WHO AFRO to determine what aspects of the health care system require improvement. Updated information and technology included new systems to certify causes of death and disease rates.

Affordable and Accessible Health Care

Life expectancy in Africa has a direct connection to access to health care services. Since 2000, there has been a 22% increase in the number of people able to receive necessary health care treatment. In 2019, healthcare coverage in Africa rose to 46%, contrasted with only 24% in 2000. Those living in higher-income countries typically have a more advanced healthcare system than those in lower-income countries.

The ultimate goal is to prevent households from spending excessive money on health care. Many families must spend more than 10% of their income on health-care-related treatments, increasing poverty rates. Ghana and Mauritius utilized medicine pricing strategies and pharmaceutical policies to work towards affordable health care.

These numbers show governments must reform public health spending. Affordable and accessible health care would allow the people of Africa to receive help for treatable diseases as well as offer services to prevent people from contracting diseases in the first place.

Treating Disease with Vaccines and Medications

To continue the current inclination of life expectancy in Africa, public health efforts must focus on those under the age of 5 and above 60. According to Give Well, the top causes of death in those under the age of five are malaria, respiratory infections, diarrhea, perinatal conditions, measles and HIV/AIDS. Those above the age of 60 also risk mortality from ailments similar to those responsible for high death rates among those under five. The leading causes of death among those between 5 and 60 are HIV/AIDS, tuberculosis and maternal mortality.

Nigeria, a country with one of the weakest public health infrastructures, has created a National Drug Policy and implemented vaccination policies for all citizens. The organization of treatment guides and essential medication lists will strengthen the process of treating patients for curable and vaccine-preventable diseases. Many countries have worked to complete this goal, with Sierra Leone finalizing and validating these guidelines.

The mobilization of vaccines and vaccine campaigns has shown some success with meningitis type A breakouts. WHO anticipated stopping all meningitis outbreaks by 2030 with a vaccine named MenAfriVac.

No new meningitis type A cases occurred as of 2017; the form of the disease was responsible for 90% of cases and deaths prior to 2010. The coronavirus pandemic has significantly disrupted these efforts, but the results have shown that life expectancy in Africa can continue to increase by focusing on improving health care.

Public Health Security

According to a WHO survey in 2021, 90% of the 36 responding countries disclosed one or more coronavirus-related events that halted healthcare services. These services included immunizations for other diseases and nutritional programs.

The coronavirus pandemic and the responses of African countries are an example of the relationship between healthcare investment and public health security. When African countries do not have the resources needed to combat threats to public health, the people of those countries can not focus on improving the economy.

As of July 2022, 282 million people in Africa received their first round of COVID-19 vaccinations, an increase of 10% since January 2022. This news reflects a continent dedicated to securing the public health, another factor helping to increase life expectancy in Africa.

– Mikada Green
Photo: Flickr

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New Insights into Oceania’s Health Challenges

Oceania's Health ChallengesRecent genetic studies of Pacific Islanders are revealing new insights into Oceania’s health challenges. In turn, these insights may drive sustainable solutions that improve community health and save lives.

Convenience-food diets, obesity, lack of resources and the health challenges that result from these conditions are escalating in many island nations in the Pacific. Worse, the resulting non-communicable diseases (NCDs) are leading to an increase in preventable deaths. Activists from many nations are working to better protect many Pacific Island populations from Oceania’s health challenges.

Oceania

Oceania is a group of countries and territories that share a border with the Pacific Ocean. These 14 countries and territories are diverse culturally, economically, geographically and demographically. Oceania includes the large and wealthy countries of Australia and New Zealand and smaller and less affluent countries including Figi, Tonga and Palau.

Vulnerability

Indigenous people in Oceania are more genetically prone to gut issues and certain NCDs that evolved during colonization. While traditionally, Oceania diets were low-energy-density, the introduction of processed foods and more modern snacks brought obesity and linking issues. Before colonization, there was little to no obesity in the Pacific Islands. According to a 2019 study published in Frontiers in Immunology, “During the period of nutritional transition, the people came to consume energy-dense foods imported from Australia and New Zealand.”

The study reports that certain health conditions disproportionately affect specific indigenous populations including the Polynesians in Hawaii, the Maoris in New Zealand, and the Aboriginal and Torres Straits Islanders in Australia compared to non-indigenous people in the same places.  Mortality rates, NCDs and fertility decline are all issues that disproportionately affect these populations. Studying Pacific Islanders’ health data more closely, as this study did, may lead to sustainable solutions.

Environmental factors such as urbanization, sanitation and pathogen exposure also have the potential to increase disease susceptibility. Genetic vulnerability in the form of microbiome genetic mutations and immune function justifies population-specific medical studies and consideration in regards to nutrition. Accessibility and food insecurity have also driven people to foods that are low in nutrition.

Solutions

There are several specific solutions to combat the sharp rise in NCDs in the Pacific Islands. One strategy is better health monitoring. Current medical data surrounding nutrition is almost nonexistent and therefore Pacific Islander nutrition lacks proper evaluation. Increasing data and enhancing research in this area can better inform people about their eating habits.

The George Institute for Global Health, Fiji National University, Sydney University and Deakin University have created the Global Alliance for Chronic Diseases project. This effort hopes to collect data on preventable deaths and possible food policy initiatives for the future. The researchers already found that decreasing salt intake by one gram a day for a year would prevent heart attacks and strokes and save 131 lives a year.

A second strategy is creating a sustainable interest and consumer demand for fresh and healthy foods.  Since COVID-19, Fiji’s Ministry of Agriculture has distributed seeds for people to grow their own food at home. Additional countries could benefit from a program like this as well.

Other strategies include projects and policies that focus on building a stronger market for healthy foods. Finally, the study suggests applying a gender lens to improve Oceania’s health challenges.  While more women are joining the workforce, they continue to play the primary role in caring for and feeding their families.  They do not have the time to prepare complicated meals so they are turning to convenience foods.

World Bank Showcases Oceania Women Leaders

The 2019 genetic study, others like it and the projects mentioned above are setting a trend of focus on the nutritional health of Pacific Islanders. Sustainable change and progress are occurring throughout Oceania. This progress prompted the World Bank to showcase some inspiring women who are starting to implement solutions to Oceania’s health challenges. In Samoa, Lenara Tupa’i-Fui is the assistant CEO of Health Information Technology and Communications at the Somoa Ministry of Health. She is helping lead the Samoan eHealth system that will better track medical records and provide accessible health monitoring and data. As program director of the Partnership of Human Development in Timor-Leste, Armandian Gusmão Amaral advocates for better health care, especially for women and children. She also focuses on mentoring women to pursue careers in the medical profession.

Looking Ahead

Advocating for better data tracking and health communication, increasing the understanding of and demand for healthy foods and applying a gender lens to improving eating habits are all steps that are helping the vulnerable in Oceania take action on their health.

– Karen Krosky
Photo: Flickr

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Screening for Sickle Cell Disease in Zambia

Sickle Cell Disease in Zambia
Sickle cell disease is most common globally in sub-Saharan Africa. Up to 45% of sub-Saharan Africans are carriers of the disorder. Sickle cell disease appears to have evolved as an adaptation against malaria, which is why it would be so prevalent in these African countries. For example, Zambia is one of the 20 countries in the world with the highest malaria incidence and mortality. About 2% of the world’s sickle cell disease cases occur in Zambia, and about 5% of cases in eastern and southern Africa occur in the country.

Alarmingly, after significant progress in controlling the disease in the 2010s, sickle cell in Zambia started to escalate in 2020. In fact, during the first half of 2020, sickle cell cases, test positivity and mortality increased from 30% to 50% between 2018 and 2019. That is why as of 2021, the Zambian Ministry of Health recognizes sickle cell disease as a public health crisis. Specifically, 20% to 25% of the Zambian population is a carrier and 1% to 2% of children born in Zambia have the disease. That is why early screening programs are so important in fighting sickle cell disease in Zambia.

Sickle Cell Disease

Sickle cell disease is actually a group of conditions that cause misshapen red blood cells called “sickle cells.” Most red blood cells look like discs, but sickle cell patients have red blood cells that look like sickles or crescents. Sickle cells tend to stick together and obstruct the movement of blood, which makes sickle cell patients more vulnerable to infection. Also, sickle cells are more easily breakable than non-diseased red blood cells. This can lead to patients not having enough blood cells, a condition known as anemia.

Patients with sickle cell disease experience pain when the blood cells clog blood vessels. This pain may last a short time or for hours. Also, their anemia makes them often feel tired. Although it is not clearcut what triggers a sickle cell crisis, being overly cold or overly stressed seems to provoke incidents. Finally, other illnesses and dehydration trigger sickle cell crises.

Treatment for Sickle Cell Disease

Luckily, there are drugs that treat sickle cell disease. To prevent pulmonary infections, to which sickle cell disease patients are more prone, health professionals commonly prescribe penicillin. They also suggest that all sickle cell patients stay fully vaccinated. To prevent anemia, patients take folic acid to help the body manufacture new red blood cells. Additionally, medical professionals frequently prescribe the medication hydroxyurea to decrease the stickiness of red cells and adverse effects of the disease. If an infection or anemia still occurs, patients may need hospitalization. There, they receive more intensive medicine, including blood transfusions. Bone marrow transplants can cure sickle cell disease by replacing the diseased blood with healthy blood from a donor. However, not everyone is a candidate for a bone marrow transplant, and the procedure has a lot of risks.

Newborn diagnosis, careful monitoring and access to care results in survival to adulthood in 96% of cases of sickle cell disease. That is why all 50 states and the District of Columbia in the United States mandate sickle cell screening. European countries also have robust screening programs. However, in Africa, where newborn screening is sparse, up to 80% of children born with the disease die before they turn 5 years old. Zambia is working assiduously to improve its sickle cell screening and launched its newborn screening program in April 2021.

Zambia Launches Screening Program

Zambia’s Sickle Cell Disease (SCD) Newborn Screening (NBS) program focuses on early therapeutic intervention and builds on the country’s framework for early vaccination and HIV screening. The program hopes to annually screen 10,000 newborns and develop an electronic database of patient demographics, medical history and laboratory records. Initially, the program will screen at three sites in northwest Zambia.  The screening program involves taking a blood test sample from infants at different hospitals and sending the sample to its Tropical Diseases Research Center.

Additionally, through the Consortium of Newborn Screening in Africa (CONSA), scientists can use newborn screening data on the disease in the future so they can map out the disease in Zambia and across Africa to inform treatment and prevention. Dr. Jonas Kamina Chanda, the Zambian minister of health, claims that the new screening “marks an important milestone in the health sector, as well as those living or caring for someone with sickle cell disease.” Hopefully, Zambia will serve as a model for other African countries that do not currently screen to offer such a critical service to their citizens as well.

– Mikaela Marinis
Photo: Pixnio