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

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

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

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

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

Cancer Care in India
Cancer is an issue common across the world, without a cure no matter the financial circumstances of a country. The care that is available for treating cancer is expensive, limiting cancer care to individuals who are financially well-off. India is looking to establish universal health care insurance so that more people can access health care and organizations aim to extend the reach of cancer care in India.

India’s Poverty Epidemic

Poverty is one of India’s largest problems, with 256 million inhabitants living below the poverty line of $1.90 a day as of 2020. Poverty is a complicated issue, with many different causes and effects that intertwine. The economic causes of poverty in India include rising rates of unemployment, inadequate infrastructure, slow economic growth and development and resource deprivation. The social causes of poverty include caste system-based discrimination, societal inequality and corruption. Since Russia’s invasion of Ukraine in February 2022, inflation has increased worldwide, with especially high inflation rates in developing countries.

In countries already struggling with economic instability, like India, inflation hits hard. The cost of living goes up, but it does not always mean that salaries go up to support that. Several organizations aim to unravel the web of poverty by seeking to help the impoverished improve their quality of life.

Cancer and Poverty

Medical care is significantly expensive, even in developed countries. It is no different in India. Along with general inflation, India is also facing increasing medical inflation. In 2021, India noted “the highest medical inflation rate among the Asian countries,” at 14%. In April 2022, the price of medical treatment, including medicines and procedures, rose by 7.21%. These circumstances make it difficult for the impoverished to access health care services in India, let alone specialized cancer care. According to statistics from the National Cancer Registry Programme, about 1.4 million people in India had cancer in 2020.

Because of circumstances of poverty and the expensive nature of health care, among other reasons, the majority of Indian cancer patients often do not receive an official medical diagnosis until the cancer is in its later stages.

Fortunately, the Indian government has recognized this and is moving toward creating universal health care insurance, which would extend health care to more people from lower socioeconomic classes. In particular, this would cover chemotherapy and other cancer medications to improve cancer care in India.

In an article, Dr. Navneet Singh, an expert in “non-small cell lung cancer,” stressed the importance of patient advocacy in countries like India. This involves educating the public on cancer and treatment options. Singh said further that developed countries like the United States can aid India and other developing countries with similar issues “in the area of patient support groups and advocacy platforms.”

CAM Ensures Accessible Health Care

Organizations such as Charutar Arogya Mandal (CAM) aim to make health care accessible and affordable for the impoverished in India. In terms of cancer care, the organization runs a cancer center to provide treatment to impoverished cancer patients. The organization began in 1972 because of the dream of Dr. H.M Patel, a former minister of India. Patel looked to create an institution to “offer comprehensive and compassionate health care to everyone and anyone.” CAM takes special measures for those in less stable economic situations by providing free consultations and free treatment to women and children below the poverty line.

With commitments from the government and organizations, cancer care in India can include the impoverished.

– Kelsey Jensen
Photo: Flickr

Health Care in Mauritius
Mauritius, an African island nation in the Indian Ocean, had been an agrarian society with high unemployment rates and low per capita GDP for much of its history as an independent nation. However, in recent years, the country has shifted to having a diversified economy, high employment rates and higher life expectancy. Mauritius reached a per capita GDP of around $11,000 in 2018, and in 2020, achieved an all-time-high employment rate of 93.63%. In an April 2020 Poverty and Equity Brief, the World Bank highlights that Mauritius has eradicated extreme poverty. Along with these milestones, health care in Mauritius has also shown tremendous progress as the main cause of mortality shifted from infectious diseases to degenerative diseases, signaling the advancement of health care technology and policies.

5 Facts About Health Care in Mauritius

  1. Free Public Health Care. Public health care in Mauritius is free for its residents. In 2017, public health institutions provided for around 73% of the health requirements of the population while private institutions addressed 27% of these needs. The number of physicians per 1,000 people has also increased from 1.2 in 2010 to 2.5 in 2018. Additionally, as of 2021, Mauritius’ health care infrastructure consists of “five major regional public hospitals, four specialized public hospitals, two public district hospitals, two cardiac centers, 19 private clinics and hospitals and 30 medical laboratories.”
  2. The Health Care System Shifts to Develop High-Value Activities. Mauritius is promoting an increase in medical tourism, seeking to reign in more profit for its health industry. In fact, “in 2017, Mauritius attracted more than 11,500 foreign patients for treatment” in cosmetic surgery, orthopedics, fertility treatment and other specialized areas. As more investment pours into the sector, advancements in infrastructure can potentially attract more foreign patients.
  3. Health Care is One of the Government’s Main Priorities. Health care in Mauritius is Prime Minister Pravind Kumar Jugnauth’s main priority as he looks to improve the health care system by further addressing non-communicable diseases. Mauritius’ minister of finance, Renganaden Padayachy, whose role is to manage economic activities, is also prioritizing health care in Mauritius by expanding the public health care budget. In 2019-2020, 9.5% of the total budget went to the public health sector, marking a 7.4% increase from the previous year.
  4. Government Commitment in Addressing Health Care Challenges. One of the main challenges health care in Mauritius faces is ineffective distribution and mix of human resources in terms of numbers and skillsets of health workers. In response, the government recruited 538 medical and non-medical personnel in 2020 to receive training on primary health care services, such as immunization programs. Another challenge is Mauritius’ reliance on a paper-based administration form that proved to be inefficient. In January 2021, Mauritius launched an e-health project “to modernize the actual health care system and to make a transition to a technologically-based medical service.”
  5. Advancements in Medical Equipment. Mauritius is promoting the development of high-tech medical tools in the industry. In 2020, Mauritius imported around $30.5 million worth of medical equipment and exported $32 million of medical equipment. In 2021, Mauritius had six medical device manufacturers providing job opportunities to about 600 people.

Looking Ahead

At the onset of the pandemic, the World Health Organization (WHO) placed Mauritius among the African nations at significant “risk of a public health disaster” due to its dense population, a high proportion of elderly citizens and high rate of chronic illnesses. However, Mauritius’ progress and commitment to protecting the health and wellness of its citizens proved to be key in combating COVID-19 as Mauritius emerged as one of the few coronavirus-free places on Earth. Mauritius avoided WHO’s prediction by immediately implementing public health safety measures such as lockdowns, mass testing and contact tracing.

With continued progress in the health care arena, Mauritius stands as a beacon of hope and inspiration to post-colonial countries that progress is possible.

– Samyukta Gaddam
Photo: Wikimedia Commons

Health Care in South Africa
With the ongoing ramifications of the pandemic that began in 2020, the world recognizes how much life has become integrated with digital technology. Some regions, like South Africa, have turned that growing dependency to their advantage. South Africa carries a large population, more than 30 million of whom live in poverty, according to a study finished in 2015. However, with technologies more readily available, health care in South Africa is changing for the better.

Digitization has impacted business, trade, learning, recreation and a whole slew of social aspects. In many ways, bringing a community up-to-date with 21st-century technology correlates with benefits. According to the World Bank, which actively promotes affordable broadband Internet access, the web is a tool that can help in “the delivery of essential services such as education and health care, offers increased opportunities for women’s empowerment and environmental sustainability and contributes to enhanced government transparency and accountability.”

A Continent’s Digital Coming-of-Age

Unfortunately, not every country in the world enjoys easy wi-fi access. According to statistics from 2017, a mere 22% of the whole African continent had access to the internet. Global organizations have implemented various programs over the years to offer more stable and effective wi-fi to Africa. The African Union, partnering with the World Bank Group, hopes to grant access to everyone on the continent by 2030.

Over the past two years, South Africa showed determination (and profits) in building up its digital proficiency. In 2020, South Africa witnessed an influx in online presence due to the COVID-19 pandemic. As a response, in April 2020, the Independent Communications Authority of South Africa gave 4G and 5G frequencies to operators to meet the increased demands.

In 2021, the e-commerce market in South Africa increased, garnering a total of $5 billion, and putting the nation’s e-commerce income above that of Iraq. Furthermore, South Africa sported a robust 68.2% of its population as internet users at the onset of 2022, having increased somewhat from a year prior. Digital updates and more wi-fi usage are even multiplying real health benefits.

Health Care in South Africa

South Africa takes the lead when it comes to the region’s medical advancements. It has the best hospitals in the southern part of the continent, yet there are still many barriers within the health care system.

According to 2019 statistics from the World Bank, there are 0.8 physicians for every 1,000 people in South Africa. In rural areas, access to health care remains inadequate. Lured by the appeal of private practice, many physicians abandon public practice. The public system relies on government subsidies and suffers from underfunding and a shortage of resources. Meanwhile, a stronger although more selective group of private physicians cater to middle- and upper-class people and are able to acquire better supplies. About 80% of doctors operate in this private sector, which means they only offer care to approximately 20% of the country’s populace.

Depending on one’s income, the fees and health care coverage vary. However, some 3,500 health institutions offer cost-free care for expectant mothers and children younger than 6. Alternative or traditional medicine is widely practiced with more than 90% of rural South Africans utilizing these services to some extent.

South Africa’s government aims to develop a national health insurance program in order to improve national health, offer more affordable health care and eliminate inequalities regarding patient treatment.

Digitizing the Health Care System

Some of the steps taken to improve health care in South Africa have less to do directly with policy and more to do with integrating up-to-date technology. Both are necessary, but new technologies will particularly focus on streamlining the health care process.

Pharmacies seek to incorporate e-commerce models. Luis Monzon, of IT News Africa, said that “These systems of quick and convenient dispensation of medicines are a boon for individuals who require chronic medicines but struggle with travel.” Thus, digitization in this sector helps those least able to help themselves.

“We’re seeing a range of innovations in areas such as medical practice management, patient health care records, telehealth and remote health care, as well as low cost but high functioning medical devices,” says Sheraan Amod, CEO of RecoMed, a South African online marketplace specializing in health care. “The future looks incredibly bright for African healthtech innovation,” Amod said to IT  News Africa.

Telehealth provider Udok, which emerged in 2018, aims to “facilitate the delivery of online doctor consultations” by “providing remote consultations directly to patients and via pharmacy clinics.” The Udok platform allows health care practitioners to consult via videoconferencing while recording a patient’s medical information in order to diagnose a patient remotely in real-time. Udok has partnered with one of South Africa’s major pharmacies, Clicks, and will be available in about 200 Clicks pharmacies across the country. Udok-based virtual consultations are also cost-effective, which increases the accessibility of health care services.

Looking Ahead

In a country where differing medical protocols and lack of physician availability upset the system, the digital era, which is steadily on the rise in South Africa, offers increased access to necessary medicines, information on symptoms and other perks. Platforms like Udok help transform the health care landscape for the better. With the prioritization of policies on the one hand and digital transformation on the other, the bright future for health care in South Africa appears to be quickly approaching.

– John Tuttle
Photo: Flickr

Everything to Know About Poverty in Lebanon
It has been almost three years since Lebanon, previously labeled as the “Switzerland of the Middle East,” began to slowly drown in poverty. As the ESCWA report stated, 82% of the Lebanese and non-Lebanese population lives in multidimensional poverty while 40% of them live in extreme multidimensional poverty. Those numbers result from an unprecedented economic crisis that started in October 2019 and kept on worsening with the COVID-19 outbreak, the Beirut Port explosion, the ongoing corruption and the war in Ukraine. Here is everything to know about poverty in Lebanon.

Health Care

One of the most important and dangerous symptoms of the poverty increase in Lebanon is the degradation of the health care system. The Lebanese lira has lost more than 90% of its value since 2019, making it impossible for many health care professionals (nurses and doctors) to live decently with their salaries, thus leading them to leave the country for better opportunities abroad. In addition to that, the country imports many medical care products and medicines, leading to a huge increase in their prices, making them unaffordable for many. Lebanon has the means to produce its drugs, an action that the actual government is encouraging while it still needs time before being fully implemented.

Public Utilities and Food Security

Another dimension to know about poverty in Lebanon is the lack of public utilities available to the people. The most famous, touching a majority of people, is the lack of electricity the state provides, forcing the Lebanese people to reach out to owners of private generators to have a few hours of electricity a day. However, this alternative has a considerable cost to Lebanese households. The fuel that powers the generators comes from abroad, requiring payments in USD and making it impossible for many to subscribe to this service amidst the severe economic crisis the country is going through.

A more recent issue Lebanon must face as a result of the War in Ukraine is the wheat crisis and with it a risk of shortage in bread production. The country imports more than 60% of its wheat from Ukraine. The urgency of this new issue also depends on the government’s capacity to secure enough quantities before any increase in the price of wheat.

Education

The numerous challenges Lebanon has faced over the past three years have also had their effect on education. According to UNICEF, 260,000 Lebanese children risk interrupting their education. Whether it is the COVID-19 pandemic that forced the students to stop their studies because of the lack of means to pursue them online, the destruction of some schools in Beirut after the port explosion and the economic crisis forcing some schools and universities to increase their tuitions making them unaffordable for many.

Efforts to Help Lebanon

A year ago, the World Bank approved a $246 million project to provide 147,000 households with basic needs as well as cash transfers. More recently, the International Monetary Fund (IMF) reached an agreement of $3 billion with the Lebanese government to help Lebanon get out of the crisis. On another note, local NGOs are playing an important role in helping people in need. Private actors are also taking initiatives to benefit from this situation, by enhancing made in Lebanon products, thus relying less on imports.

Hence, having presented everything to know about poverty in Lebanon, shows clearly that the country is not in its best phase. However, hope is always there with small steps taken towards a better future and especially with a young generation who is learning from the mistakes of the older. Helping Lebanon is therefore helping a country full of potential and showing once again that it will rise despite all.

Youssef Yazbek
Photo: Flickr

Global Opioid Crisis
Political pundits and policymakers have acknowledged the severity of the U.S. opioid crisis. However, there is also a drug that is quietly wreaking havoc on developing nations. Many have touted tramadol as a safer alternative to other opioids. However, it has instead fostered addiction in the poorest nations and bankrolled terrorists. Authorities fear that the drug’s growing popularity may even destabilize entire regions, causing the global opioid crisis.

Is Tramadol Safe?

At first glance, it is not clear how tramadol is fueling the global opioid crisisIn 2021, the National Institute of Health (NIH) released a study declaring that tramadol has “a low potential for abuse” and has a significantly lower rate of nonmedical use than comparator opioids.

In addition, the World Health Organization (WHO) Expert Committee on Drug Dependence has reviewed the drug several times. It recommended against regulation in its most recent report. The main reasons are its concerns that regulation may hinder access to the drug in developing nations.

However, a closer look at the drug and its effect on the developing world demonstrates clearly how tramadol is fueling the global opioid crisisTramadol is an opioid that medical professionals use to treat moderate to severe pain. It may cause nausea, dizziness, constipation, headaches, respiratory depression and even death.

Tramadol and the Global Opioid Crisis

Despite its presentation as a safe alternative to opioids such as Vicodin, there are plentiful examples of how tramadol is fueling the global opioid crisis:

  1. The illicit market for tramadol is booming. Grünenthal, a German company, originally manufactured the drug for medicinal purposes. However, inadequate access to medicine in the developing world allowed the illicit market to blossom. Lower prices and immediate access to illicit painkillers relieved the shortcomings of poor health care structures, as UNODC reported. Most of these drugs are coming from India. Pill factories have been meeting the demand for tramadol pills by shipping them across the planet in illegal amounts. The demand for these drugs and the absence of regulation keep such illicit trade profitable. U.S. law enforcement has estimated that its seizures of tramadol tablets leaving India in the 2017-2018 period exceeded 1 billion.
  2. Tramadol addiction is rampant in West Africa. According to the UNODC report, “opioids and their nonmedical use have reached an alarming state in West Africa.” The report collected data from Ghana, Burkina Faso, Benin, Niger and Togo. Tramadol seized in West Africa in 2017 accounted for 77% of the tramadol seized globally. It also acknowledged that non-medical use of tramadol is ubiquitous in Niger, where it is the narcotic people are most familiar with. The number of narcotics seized in Nigeria nearly doubled from 53 to 92 tons between 2016 to 2017. The report showed that overall, tramadol is the most popular opioid as it accounts for 91% of all pharmaceutical opioids seized in West Africa in 2017.
  3. The UNODC report on tramadol in West Africa highlighted one of the most sinister aspects of how tramadol is fueling the global opioid crisis. The report stated that “it cannot be denied…that there may be a link between tramadol trafficking and terrorist groups.” The report cited examples of Al Qaeda prompting its followers to trade tramadol to finance its terrorist operations as well as Boko Haram fighters depending on the drug before attacks. The statistics support these claims. According to CSIS, law enforcement intercepted $75 million worth of tramadol heading to the Islamic State group from India in 2017. Authorities also confiscated another 600,000 tablets bound for Boko Haram and found 3 million in a truck in Niger. In May 2017, authorities seized 37 million pills in Italy. Isis had bought them and intended to sell them for profit.

Tramadol Trouble Shooting

Despite the growing problem, many have paid attention. For instance, UNODC met in July 2019 to discuss its West Africa report. Representatives from West Africa, India, the European Union (EU), Interpol and WHO were a few of the guests that attended the meeting to discuss how tramadol is fueling the global opioid crisis.

Not only are organizations, nations and individuals paying attention, but they are also actively strategizing to mitigate the crisis. The meeting highlighted the need for international cooperation and increased law enforcement. Lastly, there was great emphasis on the need for uniform regulation of the pharmaceuticals, in hopes that cooperation would crush the illicit market while meeting demand.

– Richard Vieira
Photo: Unsplash