Information and stories on health topics.

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Eli Lilly and Company’s Push Toward Accessible Insulin

Accessible Insulin
In 2022, Eli Lilly and Company became a corporate partner of the United Nations International Children’s Emergency Fund (UNICEF) with the aim of treating and preventing non-communicable diseases, such as diabetes, in young people globally. This four-year commitment aims to lower death rates and prevalence rates of ailments impacting children in low-and-middle-income countries. The pharmaceutical company has also acknowledged WHO’s Global Diabetes Compact, launched in 2021, and the WHO’s request for companies in the private sector to help further the goals of the compact. The compact’s key asks are to unite stakeholders, integrate better treatment and prevention worldwide (particularly in low-and-middle-income countries), innovate by “close[ing] priority research gaps,” track progress by setting targets, funding health care and educating about diabetes. With these goals in mind, Eli Lilly has made a push toward accessible insulin.

Eli Lilly and Company

Founded by Colonel Eli Lilly in 1876, Eli Lilly and Company has spent more than 145 years manufacturing medicines for the general public. The company has manufactured “commercial quantities of insulin” since the 1940s so that life-saving medicine for people with diabetes would become more widespread.

The company operates in close to 125 countries with 14 manufacturing sites worldwide. It offers products worldwide, with a presence in Africa, the Americas, Europe, the Middle East and various parts of Asia. While its headquarters are located in Indianapolis, it has subsidiaries in many countries, including Malaysia, Peru, Turkey, Austria and Israel.

Eli Lilly’s most notable product is its insulin. Humalog, also known as Insulin Lispro Injection, is a “fast-acting insulin” that the company sells. This insulin serves to control the high blood sugar levels of both children and adults. Eli Lilly also manufactures various cancer and immunology medicines, with more than 47 million people relying on its medication.

EVA Pharma Partnership

In December 2022, Eli Lilly partnered with EVA Pharma to manufacture and supply accessible insulin to low-and-middle-income countries. EVA Pharma products reach more than 40 countries and are made in facilities that are internationally known by organizations like the European Medicines Agency for “high-quality standards.”

Eli Lilly provided EVA Pharma with its API (active pharmaceutical ingredient) for insulin at a reduced price, alongside providing “pro-bono technical assistance.” The aim is for African-made insulin to be distributed within 18 months and for it to reach 1 million people by 2030, as part of the Lilly 30×30 initiative. The initiative pairs with external organizations like the Bill & Melinda Gates Foundation and aims to make quality health care more accessible for 30 million people in “limited-resource settings,” particularly in low-and-middle-income countries.

Price Cuts

In March 2023, Eli Lilly reduced the price of its insulin by 70%, dropping from $275 to a maximum of $35. Most notably, the company slashed the price of Humalog and its non-branded insulin. This occurred more than a year after China’s push for accessible insulin in 2021 when Eli Lilly reduced the price of insulin in China by 75%. During China’s push for more accessible insulin, Novo Nordisk and Sanofi cut their insulin prices by an average of 48%.

China’s VBP (volume-based procurement) goal in 2021 entailed providing consistent and lower pricing across the country for medication, particularly for medicine that had “outlived their exclusivity.” This centralized drug procurement program saved medical institutions ordering insulin an estimated 9 billion yuan. Another benefit of the program is the lowered price of insulin for patients with diabetes, thus making long-term use of this life-saving medication more affordable.

Impacts on Diabetic People in Developing Countries

A study by Anastasia A. Lam and others reports that, in 2019, 463 million people suffered from diabetes globally, and by 2045, this statistic could grow to 700 million. Furthermore, the study notes that 80% of those with diabetes live in low-and-middle-income countries. The International Diabetes Federation’s Diabetes Atlas projects a 129% increase in the prevalence of diabetes in Africa. This equates to 55 million people in one area of the world alone and showcases a dire need for accessible insulin.

The public has progressively become more invested in the insulin industry. While Eli Lilly has been involved in initiatives for accessible insulin for a couple of years, for instance, its partnership with UNICEF since February 2022, the public continues to become more scrutinous toward the pharmaceutical industry.

As a result of this, accessible insulin has become important for companies like Eli Lilly to stay afloat. The more accessible insulin that comes from a particular company, the higher the chance of other companies following suit. When a global environment is bred for high-quality and affordable health care, companies and countries face pressure to provide just that through actions as large as China’s national insulin procurement program or as small as the average person’s critique. Eli Lilly’s recent actions demonstrate a push toward more accessible health care for diabetics and paint an optimistic outlook for the future of health care.

– Lachlan Griffiths
Photo: Flickr

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HIV/AIDS in the Philippines is continuing to spread

The Philippines is an archipelagic country located in Southeast Asia with a population of more than 100 million. According to data from the Philippine Department of Health (DOH), the Philippines has reversed the global trend of declining HIV cases, becoming the country with the fastest-growing rate of HIV in the world. From 2010 to 2021, the number of new HIV infections in the Philippines increased by 237%, while the rest of the world saw a decrease of at least 32%. In 2022, the Philippines recorded 14,970 new HIV cases, representing a 21% increase in the infection rate compared to the previous year. 

Reasons for the spread of HIV/AIDS in the Philippines

  1. Lack of HIV/AIDS knowledge and education: Many Filipinos lack access to information about HIV and birth control, and this prevents them from correctly avoiding HIV infection by practicing safe sex and properly using condoms. According to the World Health Organization (WHO), 35% of people in the Philippines infected with HIV are unaware of their infection. In addition, sexual intercourse is the main way of HIV transmission in the Philippines, with 93% of infections resulting from unsafe sex. On the other hand, the Philippines has the lowest recorded rate of condom use in Asia, with only 20% to 30% among high-risk groups such as sex workers. Moreover, the Government of the Philippines has issued laws requiring parental consent for young people to buy condoms, further hindering the protection of the young group at high risk of HIV. 
  2. Unsafe injection equipment: In recent years, the Philippines has experienced an increase in incidents of drug use. According to a study that the Joint United Nations Programme on HIV/AIDS (UNAIDS) conducted, the HIV infection rate among Filipinos who inject drugs is as high as 29%. This is mainly due to drug users sharing unclean injection equipment. The Dangerous Drugs Board in the Philippines identified the behaviors of individuals possessing and distributing medical devices as illegal, forcing many local public health organizations to discontinue providing safe syringes and needles for drug users. Unfortunately, the Dangerous Drug Act resulted in surges in many areas. In Cebu, for example, drug-related HIV infections jumped from less than 1% to 53% the year after the enactment of this regulation. 

On the Road

The Government of the Philippines has had mixed results in controlling HIV. On the positive side, in December 2022, the Philippine Department of Health launched the 7th AIDS Medium Term Plan (AMTP) to contribute to the global goal of ending AIDS as a public health threat by 2030. With the aim of reducing the inequalities that lead to the prevalence of HIV/AIDS in the Philippines by 2025, the strategy will take urgent actions to provide more basic HIV services to the public, including reproductive health services, free HIV testing, treatment centers and education campaigns about HIV. On the other hand, the Philippines government has received criticism for some policies and regulations that have hampered efforts to control the spread of the disease. 

Many international development agencies and NGOs actively participate in this fight. Among these organizations are the Joint United Nations Programme on HIV and AIDS (UNAIDS) and the United States Agency for International Development (USAID). These organizations continue to enhance the skills and knowledge of Filipino medical workers and improve treatment services to better serve people living with HIV. In December 2020, the United States pledged Php875 million within two years to aid HIV prevention and treatment. USAID will execute this program with the goal of assisting the Philippines government in achieving the UNAIDS 95-95-95 targets. These targets include ensuring that 95% of HIV patients are aware of their status, 95% of those individuals receive treatment and 95% of those receiving treatment attain viral suppression. Nevertheless, due to the impact of the COVID-19 pandemic, funding for the UNAIDS response has stalled, with an expected shortfall of $8 billion which could result in a serious impact on the Asia-Pacific region, especially the Philippines. 

Looking Ahead

Efforts are underway in the Philippines to combat the alarming rise in HIV cases, with both government initiatives and support from international organizations. The launch of the 7th AIDS Medium Term Plan (AMTP) by the Philippine Department of Health demonstrates a commitment to reducing inequalities and providing crucial HIV services to the public. Additionally, international development agencies like UNAIDS and USAID are actively involved in enhancing medical workers’ skills, improving treatment services, and providing financial support. While challenges remain, these collaborative efforts offer hope for a future where the spread of HIV/AIDS is under control and the well-being of affected individuals is prioritized.

– Mingjun Hou
Photo: Unsplash

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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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Illegal Kidney Trade in Nepal: Disregard for Human Dignity

Illegal Kidney Trade in NepalNepal, a landlocked country in South Asia, shares borders with India to the south and China to the north. The majority of Nepalese, around 70%, depend on agriculture as their primary source of sustenance. However, Nepal is located in one of the world’s largest earthquake-prone areas, resulting in the destruction of countless homes and crop fields. Consequently, an increasing number of Nepalis are resorting to illegal kidney trade for sustenance.

According to a CNN report, Nepal witnesses up to 7,000 illegal kidney transplant cases each year. Many of the individuals involved in these transactions come from low-income backgrounds, driven by the need to repay debts or earn a livelihood. In the village of Hokse, commonly referred to as Nepal’s “Kidney Valley,” more than 300 residents have sold their kidneys for as little as $500 to $3,000.

Reasons Behind the Illegal Kidney Trade in Nepal

  1. Poverty: Nepal, one of the world’s poorest countries, faced numerous challenges in 2021. With a per capita GDP of only $1,208, the country heavily relies on donations from foreign countries to support its economic development. In fact, approximately one-third of Nepal’s population lives below the poverty line set by the World Bank at $2.15 a day. The average Nepalese worker earns less than $2 a day, driving many individuals to view selling their kidneys as a desperate means of survival.
  2. Medical resource scarcity: Compounding the issue is the scarcity of medical resources in Nepal. The country has one of the highest rates of kidney disease globally, affecting around 6% of adults with chronic kidney disease. The underfunding of Nepal’s health care system further exacerbates the overwhelming demand for kidney care. As a result, a thriving black market for organs has emerged, forcing many patients to turn to illegal kidney trade as their only option for treatment.
  3. Lack of basic medical knowledge: Furthermore, a lack of basic medical knowledge compounds the situation in Nepal. Organ brokers, who illicitly recruit individuals for organ sales, propagate the false notion that kidneys can regenerate and that the absence of one kidney will not impact overall health. These misleading statements manipulate and deceive uneducated Nepalis, leading them to consider selling their organs based on these unfounded claims

The Lifelong Harm

The kidneys play a vital role in filtering and detoxifying the body. The absence of one kidney can profoundly affect the body, as the remaining kidney must shoulder an increased workload. Consequently, individuals who sell their kidneys face the risk of life-threatening conditions such as renal failure. Furthermore, illegal kidney transplants lack the presence of qualified medical personnel and sterile equipment, resulting in potential infections, blood loss and other irreparable health complications.

Ongoing Efforts

The Indian government has introduced Bipanna Nagarik Kosh, a program aimed at providing financial aid to individuals suffering from serious illnesses, including cancer, kidney failure and other diseases. According to the Department of Health Services, the government has allocated over Rs2 billion for this initiative, with kidney diseases accounting for more than 52% of the expenditure. In January 2023, the Prime Minister of India announced plans to enhance the capacity of the National Human Organ Transplant Center (HOTC). Additionally, the Health Ministry has partnered with more than 50 NGO-operated hospitals, nursing homes and dialysis centers nationwide to offer free dialysis services and financial support for transplants and treatments for patients with kidney ailments.

Despite these efforts, Nepal’s National Human Rights Commissioner has raised concerns about the lack of attention from the Nepalese government and international humanitarian agencies regarding this issue. This negligence continues to expose numerous innocent Nepalis to the perils of the illegal kidney trade, making them vulnerable victims.

Looking Ahead

The illegal kidney trade in Nepal is an ongoing issue. However, there is a glimmer of hope as dedicated efforts seek to address this pressing issue. These initiatives, backed by substantial funding, demonstrate a commitment to improving the lives of those affected. The hope is to create a safe and prosperous society where the people of Nepal never have to consider trading organs for survival.

– Mingjun Hou
Photo: Pixabay

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Being Poor in Cuba

Being Poor in CubaDuring Fidel Castro’s leadership, which lasted from 1959 through 2008, citizens experienced the reality of being poor in Cuba. Despite improved health care and education in the country, as shown by the United Nations Educational Scientific and Cultural Organization’s (UNESCO) recognition of near-universal nationwide literacy, the Cuban economy and people still suffered under Castro’s rule. Meanwhile, the U.S. imposed an embargo on Cuba in 1962, following Castro’s ascension to power and this presented further hardships for Cuban exporters.

The embargo served to prevent the spread of communist ideology by isolating Cuba and restricting communication with the outside world. In an April 1960 memo, U.S. Deputy Assistant Secretary Lester D. Mallory wrote, “Every possible means should be undertaken promptly to weaken the economic life of Cuba.” The embargo is still active in 2023, with many pressuring President Biden to put an end to the repressive blockade in order to improve the quality of life for those living the reality of being poor in Cuba.

3 Facts About Being Poor in Cuba

  1. Food Scarcity. During the COVID-19 pandemic, Cuba faced a food crisis, particularly due to a combination of diminished food imports and tightened U.S. sanctions. Meanwhile, with an inflation rate of 42% in 2023, Cubans are struggling to put food on their tables. The current food shortage and scarcity issues mean that Cubans have few affordable food options. Even the most basic food items like eggs, milk, bread and toilet paper are becoming increasingly hard to find in local supermarkets.
  2. Employment Problems. For a country with a struggling economy, Cuba has a notably low unemployment rate compared to countries with a similar economic standing. Cuba has no minimum national wage, and in 2022, a report by the Cuban Observatory for Human Rights (OCDH) revealed that more than 72% of Cubans are living below the poverty line. In the same report, 30% of Cubans surveyed claimed to have full-time work, leaving the remaining 70% in precarious and unstable working conditions and heavily reliant on a small proportion of the population for financial support. With such a high number of Cubans working full-time and living in poverty, there is significant pressure on the employed to find additional ways to make ends meet.
  3. Health and Education. Even with the harsh reality of poverty in Cuba, Cubans enjoy free access to health and education. Because primary-level education is compulsory for all Cuban children, the country has a near-nationwide literacy rate. Moreover, preventative care stands as the priority of the Cuban health care system. Cuba also comes in first place in the world’s leaderboard for the number of doctors per 1,000 people at 8.4 in 2018, giving the country an exceptional reputation for an abundance of medical personnel.

CARE’s Work in Cuba

As a British charity operating internationally, CARE works to solve global poverty and eradicate all problems of inequality with a particular focus on women and girls. In 1959, CARE began working in Cuba to provide food security for those with little to no means. In 2019, CARE began making efforts to enable Cuban farmers to develop climate resiliency in the face of changing weather patterns as a means of strengthening food security. CARE also ran programs to improve quality of life, ensure access to clean water and implement sustainable agricultural methods in vulnerable communities. In terms of upholding the right to food, nutrition and water, CARE has run nine programs in Cuba. In 2022, programs of this nature benefited more than 5,500 people.

Looking Ahead

Due to its complicated history and ongoing political difficulties, a large fraction of the Cuban population lives below the poverty line. Also, the U.S. embargo currently makes it challenging for U.S.-based charities to provide aid to Cuba. This leaves the responsibility of providing aid to Cuba to countries and organizations outside the U.S. Despite these struggles, Cuba’s health and education services help to raise the quality of life in the nation.

– Genevieve Lewis
Photo: Flickr

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Non-Communicable Diseases in Small Island Developing States

Small Island Developing StatesAccording to the IFRC, “Non-communicable diseases are diseases that are not spread through infection or through other people but are typically caused by unhealthy behaviors. [NCDs] are the leading cause of death worldwide and present a huge threat to health and development, particularly in low- and middle-income countries.” Non-communicable diseases in Small Island Developing States (SIDS) are responsible for the premature deaths of more than half of the population. But, most NCDs are preventable, “with poor health largely driven by five main modifiable risk factors: tobacco use, unhealthy diets, physical inactivity, alcohol use and air pollution,” the NCD Alliance says.

NCDs in SIDS

Due to their size, location and susceptibility to extreme weather events, Small Island Developing States, commonly referred to as SIDS, are a collection of 52 islands and coastal countries that face similar development difficulties. World Health Organization (WHO) data shows that SIDS has the highest number of non-communicable diseases and “mental health risks” in the world.

At the 1992 United Nations Conference on Environment and Development, the U.N. acknowledged SIDS as a “special case for both their environment and development.” These states grapple with several interrelated issues, for example, the COVID-19 pandemic and additional factors such as unemployment and poverty. A U.N. assessment in 2018 calculated the multi-dimensional poverty rate across 16 SIDS and came to an average rate of 47.5%. Conditions of poverty contribute to the rise of non-communicable diseases and mental health issues.

The five core types of non-communicable diseases (NCDs) are “cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma), diabetes and mental health,” according to the Healthy Caribbean Coalition. NCDs already disproportionately affect developing countries, which account for close to 75% of NCD deaths, equating to 28 million people.

Action to Address NCDs

In January 2023, WHO, the Pan American Health Organization (PAHO) and the Government of Barbados hosted a “SIDS High-level Technical Meeting on NCDs and Mental Health” that lasted two days. The conference’s primary focus is to promote domestic action and global cooperation to address NCDs and mental health in SIDS.

About 80% of NCDs are preventable, according to the NCD Alliance. Founded in 2009 and based in Switzerland, the NCD Alliance’s goal is to “unite civil society and drive action on non-communicable disease (NCD) prevention and care, leaving no one behind,” bringing together 300 members across 81 nations. By 2025, the NCD Alliance aims to reduce premature deaths caused by NCDs by 25%. By 2030, it aims to reduce this rate by 33% and advance “mental health and well-being.” Through advocacy efforts, NCD education initiatives for health care professionals, accountability, monitoring and more, the NCD Alliance promotes health and saves lives.

The NCDA 2021-2026 Strategy bases its efforts on four goals: advocacy and accountability, capacity development, knowledge and partnerships. The phase sets out both short- and long-term strategic goals to “support civil society in driving progress on NCD prevention, care and financing,” the NCD Alliance website says.

NCD Alliance Prioritizes SIDS

The Alliance collaborates with regional organizations, such as the Caribbean Public Health Agency (CARPHA) and the Pacific Community (SPC), to support efforts to prevent and control non-communicable diseases in Small Island Developing States.

In addition, the NCD Alliance works with SIDS to address the social determinants of health that contribute to the burden of NCDs, such as poverty, food insecurity and lack of access to health care. The Alliance advocates for policies that promote healthy lifestyles, such as tobacco control measures, healthy food options and physical activity promotion.

Overall, the NCD Alliance plays an important role in advocating for the prevention and control of non-communicable diseases in Small Island Developing States and supporting efforts to address the social determinants of health that contribute to these diseases.

– Lauryn Defreitas
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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Mitigating Bird Flu Outbreaks in the Americas

Bird Flu Outbreaks
In light of recent outbreaks of avian influenza, or bird flu, in the Americas, the Pan American Health Organization (PAHO) held a meeting in Rio de Janeiro on March 16, 2023. Organized by PAHO’s Health Emergency Department and the Pan American Center for Foot and Mouth Disease (PANAFTOSA), the meeting gathered health experts from the Americas. They discussed strategies for halting the spread of the disease, which poses great health and economic risks to those dependent upon poultry.

Bird Flu

Bird flu occurs due to a virus of the Orthomyxoviridae family. Although the disease mainly spreads among birds, it can be transmitted to humans through contact with infected animals or contaminated feces. According to PAHO, risk factors include “handling infected poultry carcasses, and preparing poultry for consumption, especially in domestic settings.” Depending upon the severity of the infection, bird flu’s effects on humans can range from mild or asymptomatic to lethal.

Re-emergence

In the recent past, several strains of the virus have spread across the globe. In the last decade alone, Southeast Asia and West Africa saw the disease spread widely, resulting in substantial losses of livestock and income. With more recent outbreaks of a highly pathogenic A(H5) variant in 10 countries of the Americas, PAHO circulated an epidemiological alert on 11 January. By March, the disease had spread to 14 countries across the region, with the first human case reported in Ecuador.

Bird Flu and Poverty

Bird flu can have a detrimental impact on those living in poverty. A research study funded by the U.K. Department for International Development, which explored the relationship between poultry and poverty in Vietnam, found that “poultry is in fact very much a livestock asset of the poor.” In Vietnam, as in other countries, much of the rural population depends upon poultry for sustenance and income. According to the study, poultry is both “an important source of protein” and “an investment” that “yields extremely high returns.”

Bird flu can therefore be devastating for small-scale poultry farmers. They face, not only a higher risk of infection and transmission but also lack the resources needed to prevent and treat infections among their livestock. A report by the World Bank shows that the spread of bird flu could disproportionately impact low- and middle-income countries. The report estimates that if 12% of domestic birds died from bird flu worldwide, low- and middle-income countries would see a GDP reduction of 0.4%, even though global GDP would shrink by just 0.1%. The spread of bird flu would particularly affect Latin America and the Caribbean, causing a cumulative GDP reduction of 0.7%.

Solutions

With attendees from Argentina, Brazil, Canada, Chile, Colombia, Ecuador, Guatemala, Mexico and the United States, the PAHO-hosted meeting in Rio de Janeiro provided an opportunity to collaborate to protect the region’s most vulnerable. Dr. Manuel Sánchez Vázquez, a Veterinary Epidemiology Advisor at PANAFTOSA, said, “it is crucial that public and animal health sectors carry out joint risk analyses to establish mitigation strategies.” There were several recommendations for reducing the risk of regional bird flu transmission. These included increasing monitoring and surveillance; enforcing proper hygiene standards; and creating “national technical commissions for information exchange and analysis between ministries of health, agriculture and environment.”

PAHO regularly organizes such meetings to strategize plans for responding to zoonotic diseases. The Ministerial Level Inter-American Meeting on Health and Agriculture, for instance, provides an ongoing regional forum to discuss threats such as the bird flu and collaborate in prevention and response planning.

The WHO’s Global Influenza Surveillance and Response System (GISRS) also supports global influenza surveillance and mitigation. With institutions in 125 WHO member states, GISRS provides guidelines, alerts and monitoring mechanisms to ensure a high level of global readiness to respond to threats of influenza.

The WHO also works to ensure that the most vulnerable are protected in times of need. It has secured 10% of the global supply of pandemic flu vaccines for low- and middle-income countries. It is negotiating with manufacturers to secure 20% of the global supply of vaccines for other types of pandemics.

Bird flu is a virus that can be lethal to humans and animals alike. While the threat of bird flu is real, there are proactive measures and cooperative efforts that can be taken to mitigate its effects. With the right strategies in place, more lives and livelihoods can be saved from this potentially deadly virus.

– Siddhant Bhatnagar
Photo: Flickr

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Efforts to Address HIV/AIDS in Ghana

HIV/AIDS in GhanaThe Ghana AIDS Commission reports that 346,120 people are living with HIV/AIDS in Ghana. The HIV prevalence rate stood at 1.7% among people aged 15-49 in 2021, the World Bank says, marking a steady decrease since 2000. However, infections among females are almost double the rate of infections among males. Organizations are committed to reducing the number of people infected with HIV/AIDS in Ghana.

HIV/AIDS and Poverty

HIV and poverty have a two-way connection. Conditions of poverty increase the risk of contracting HIV and HIV contributes to the condition of living in poverty. According to the International Labour Office, “Poverty also drives girls and women to exchange sex for food and to resort to sex work for survival when they are excluded from formal sector employment and all other work options are too low-paying to cover their basic needs.”

HIV/AIDS can also push people into poverty due to the expense of medical care/treatment. “HIV/AIDS causes impoverishment when working-age adults in poor households become ill and need treatment and care because income is lost when the earners are no longer able to work,” the ILO explains. Losses of human capital and reductions in the labor force also slow a country’s economic growth.

The far-reaching impacts of HIV/AIDS show that the epidemic stands as a significant obstacle to poverty reduction and progress toward the 17 Sustainable Development Goals, particularly in the poorest countries.

Ghana’s Progress

In 2020, UNAIDS announced a new set of targets for countries to strive toward in the fight against HIV/AIDS. The goals, with a target date of 2025, aim for “95% of all people living with HIV to know their HIV status, 95% of all people with diagnosed HIV infection to receive sustained antiretroviral therapy and 95% of all people receiving antiretroviral therapy to have viral suppression.”

According to the Ghana Aids Commission, currently, 71% of individuals living with HIV are aware of their status, 99% of HIV-positive individuals are on sustained antiretroviral treatment and 79% of those individuals have achieved viral suppression. With just two years to go, significant action is necessary to ensure that Ghana meets these goals.

A Differentiated Service Delivery (DSD) Approach

According to the World Health Organization, Ghana is working toward these UNAIDS goals with the use of a Differentiated Service Delivery (DSD) approach. This person-centered approach adapts health services for people with HIV/AIDS so that service delivery is improved and the health care system does not become overburdened.

For example, a “multi-month dispensing approach” can allow virally suppressed patients to receive their medications for multiple months at a time. This lowers the workload of health workers as patients need to visit less frequently and also saves patients from making multiple trips to the clinic.

The implementation of the DSD approach has seen positive results. For example, Kpone Polyclinic in Ghana has increased its success rate of providing ART from 85% to 99% in just one year as of March 2023.

PEPFAR’s Efforts

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has worked in Ghana for 20 years. Over the last 14 years, PEPFAR has invested $140 million in efforts to address HIV/AIDS in Ghana. PEPFAR Ghana supports community organizations in dissolving stigmas surrounding the disease, encouraging people to undergo HIV testing and for infected individuals to begin a treatment program promptly.

Looking Forward

Ghana aims to achieve universal health care. Its vision for 2030 is for all of the country’s people to have “timely access to high-quality health services irrespective of their ability to pay at the point of use.” Although conditions in Ghana are improving, large gaps are still present in the control of HIV/AIDS in Ghana. With the continued assistance from supporting countries and ongoing work in Ghana, incidents of HIV/AIDS in Ghana can reduce along with poverty.

– Leah Smith
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