Inflammation and stories on healthcare

malaria
Malaria kills over a million people each year, taking child and adult victims. Although nets and insecticides have become common defenses against the mosquitoes spreading this disease, scientists have been working to develop a more aggressive technique in the fight against malaria.

Through research by a group at Imperial College London, scientists are exploring an approach that involves injecting male mosquitoes with a gene that will cause their offspring to most often turn out to be male. The method involves injecting the males with a homing endonuclease called I-PpoI, which will attach itself to a part of the X chromosome. When the males make sperm, the gene destroys part of the chromosome, making it more likely for the parents to produce male offspring. Data from their trials suggests 95 percent of the offspring were fertile males who were able to pass on this gene to their offspring, which, in turn, passed it on to their offspring.

Because they do not bite humans, one immediate advantage to this method is that males don’t transmit the disease. If successful, the hope is that this technique will eventually result in a severe drop in the mosquito population, and perhaps in the future it will result in their complete annihilation. In 2008, a group worked to fight the disease with a similar idea, and while their efforts yielded sterile mosquitoes, the inability to pass on the injecting gene proved unhelpful in the larger battle to eradicate malaria. Although the notion of toying with the sexes of mosquitoes in order to combat malaria was considered about 50 years ago by evolutionary biologist Bill Hamilton, the technology to do so has not been available until very recently.

In an interview with The Guardian, a lecturer at the London School of Hygiene and Tropical Medicine expressed concern with the mating patterns of mosquitoes. He said while there was no concrete evidence to prove they would not, he wondered how often the wild females would mate with the transgenic males instead of the wild males. Overall, however, he noted that the proposed project possessed much promise.

Director of GeneWatch UK Dr. Helen Williams relayed her concern to The Guardian in a different respect. Williams said that before implementing this technique as the main method against malaria-causing mosquitoes, scientists will need to consider the environmental impacts of their decision. While this technology provides a great potential for the disappearance of malaria, analyzing how other factors of the environment will be affected should also be of chief concern.

— Jordyn Horowitz

Sources: World Health Organization, NetsForLife, The Guardian, PLOS Genetics
Photo: Blogspot

MedShare International
Established in 1998 with a mission of “bridging the gap between surplus and need,” MedShare International is an innovative nonprofit that brings medical equipment and supplies to the developing nations where they are needed the most. More than 2 million tons of medical waste are generated by hospitals in the U.S. every year. At the same time, 10 million young children in developing nations die every year simply because they lack access to proper medical care.

MedShare takes the steps necessary for eliminating that gap by collecting those supplies and delivering them to the developing world. To date, they have delivered in excess of $100 million in medical supplies to over 95 developing countries, making them one of the biggest nonprofit investors in health care in poor communities.

How does it work? Imagine you go to the hospital and need surgery. Your surgeon may not necessarily need all of the tools he is supplied for your operation, especially if there are no complications. However, FDA regulations prevent the doctor from using any of those supplies on another patient, even if they are still sterile and in their original packaging. MedShare collects these medical products and sorts, ships and distributes them. The best part? Medical centers in the developing nations MedShare serves can request certain supplies, allowing MedShare to customize shipments to fit those centers’ specific needs.

Making a concerted effort to attend to the medical needs of the poor is one of the most important steps to eliminating poverty. Illness prevents individuals from escaping poverty by precluding them from seeking or keeping employment, attending to the needs of themselves and their families and accessing other resources.

MedShare recognizes the link between poverty and health care and has been working for over 15 years to reduce the prevalence of the former by providing the tools necessary for the latter. Many medical centers in the developing world possess both the staff and the technical knowledge necessary to adequately treat illness, but lack the proper infrastructure or supplies. The equipment that MedShare provides has saved thousands of lives, and as an added effect, has also kept millions of tons of waste from being unnecessarily dumped into American landfills. One would be hard pressed to find a nonprofit that does more for the environment domestically and for health care abroad. MedShare is a true leader in both of these realms.

— Elise L. Riley

Sources: Health Poverty Action, MedShare
Photo: Good Health Blog

keralan province
In the thicketed tropical jungle of southern India is a burgeoning industry of female nurses. The Keralan province has garnered a reputation for the nursing programs that help create careers for the local women. According to the Indian Planning Commission, Keralan poverty rates are the second lowest in the entire country, and the statistics for infant mortality are among the lowest as well.

Part of the success is the educational training given to young women and girls to provide a sense of independence as well as financial stability. In speaking with a head nurse at a Keralan province hospital, she said that it is more common for someone to come in with car accident wounds than for people to arrive with tropical infections. She continued to say that though the cases did occur, they were still pretty rare. As medical advancements and accessibility increase, over time, the infant mortality rate has decreased and overall life expectancy has increased as well.

The hospital is near a nursing school, and after their shifts, the nurses in training gather in the dusty courtyard. These young nurses, most just around 20 years old, are the future of the Kerala economy. With the in-demand knowledge, young women in the nursing sector are becoming migrants in the Gulf region and Western nations. Contributing to the decrease of Keralan poverty, these immigrants often send back money to help the relatives that remain in Kerala.

The education of the nurses empowers them to be financially independent. The job opportunities for women in nursing are helping to decrease the margin of the gender gap in India. Additionally, women are more able to stand up to the existing patriarchy. They have the liberty to move to other Indian states or immigrate, if they choose.

Expanding the opportunities for women, as well as extending health care to the rural Keralan province, has helped changed the socioeconomic landscape of the state. With the movement of nurses to other states, the knowledge from these colleges goes with them. Proving that knowledge is power, the health care industry has been revitalized by this new generation of promising young nurses, and in turn gives hope for the ability of future generations of women to expand on these opportunities.

— Kristin Ronzi

Sources: The New Indian Express, InfoChange
Photo: The Hindu

doctors of the world
Doctors of the World is an organization dedicated to helping vulnerable groups of people by providing them basic health care. This organization was first founded in 1980 by 15 doctors who believed in bringing relief to the poorest population in the world. The first doctors were sent to unstable areas like El Salvador and Afghanistan during wartime. Doctors of the World, also called Médecin du Monde (MdM,) settled its headquarters in Paris in 1980.

There are several important fields that MdM are working on. First of all, MdM takes care of women and children living in developing countries that lack basic health facilities. Second, MdM delivers health care to people who are infected with infectious diseases like HIV/AIDs, malaria and tuberculosis. Third, MdM also takes care of the immigrants, who are new to an environment and left their country’s health care systems behind. Last but not least, MdM are dedicated to helping people suffering from local conflicts and war. During the times of conflicts and war, people leave their heath resources behind and are vulnerable to diseases.

MdM is actively involved in Africa, Asia, the Middle East, Latin American and New York State. For example, its involvement in Rockaways, N.Y. has become a great relief to the local population. In Rockaways, 21 percent of the residents lack health insurance and 20 percent of them live below the poverty line. Since Hurricane Sandy came to Rockaways, MdM has tried its best to provide basic health care. MdM brings volunteer doctors to local families to provide primary treatment and prescribe further care if needed.

MdM also applies innovative ways to help unprivileged people. In North America, Doctors of the World Canada launched its first mobile clinic, which will provide health care services in several districts. In addition to volunteer doctors, the team also includes a driver, nurses and other volunteers. Using mobilized clinics makes it more convenient to provide basic health care to marginalized people.

MdM consider “access to health care a fundamental right of all human beings.” Today, its global network provides basic care for over 1.6 million in 79 countries all over the world.

— Jing Xu

Sources: Doctors of the World, CNW
Photo: DOW Frontline Diaries

The British Department of Development announced on June 24 that is it set to donate £39 million to help support the elimination of trachoma. The funding is designed to support implementation of the Surgery, Antibiotics, Facial Cleanliness and Environmental Improvements (SAFE) strategy, which has seen considerable success in helping to eliminate the disease.

Trachoma is an infectious disease of the eye caused by the bacterium Chlamydia trachomatis. The disease has a variety of clinical manifestations, but the most common one is an acute infection that results in mild itching, irritation and inflammation. Repeated infections and inflammation can cause visual impairment, scarring and, eventually, blindness. As is typical with such diseases, children are especially susceptible to contracting it. Trachoma is responsible for 3 percent of global blindness, with 230 million people at risk of contracting the disease, and 70 percent of those who are affected are women

The £39 million will be implemented by a consortium of International Coalition for Trachoma Control (ICTC) members and will be managed by SightSavers. The ICTC was established in 2004 with two main goals: contribute to the global effort to eliminate blinding trachoma and to advocate for and implement the SAFE strategy. The ICTC consists of a wide variety of organizations committed to trachoma control and is endorsed by the Wold Health Organization (WHO.) One of those organization is SightSavers. Their work has already spread to 37 different countries, helped over 120 million people and it currently has over 200 active projects.

The biggest concern regarding trachoma is that as a result of blindness, those who contract the disease are unable to work. As a result of this, the inability to work traps those who catch the disease in a cycle of poverty. As the International Development Minister Lynn Featherstone explains, “Stopping trachoma before it gets hold [sic] can make a significant difference to people’s lives, especially women. Up to 90 percent of blind people cannot work, making their poverty worse and leading to greater financial insecurity and lower standards of living.” Hopefully this donation can help those in need and turn the tides on this entirely preventable disease.

Andre Gobbo

Sources: SightSavers, International Coalition for Trachoma Control, Department for International Development
Photo: Medical Ecology

Universal_Healthcare
Universal health care has recently become a hot-button issue in the United States. However, the idea has also been popularized in developing nations, namely: India.

India’s current health care system struggles to provide for many in need of medical attention. Dr. Paras Pokharel, Professor JN Pande and Professor LM Nath outline the major challenges in a presentation at the University of Pittsburgh. According to the educators, the enormous population of India creates a strain. With 1.24 billion citizens and counting, “India is the second most populous country in the world” and health care systems are “over-burdened by increasing population.”

Additionally, India is confronting the “twin epidemic” of both infectious diseases and chronic degenerative illnesses. These ever-growing problems, in conjunction with the poor economic and educational status of a large segment of India’s population, create a strain on the existing health care system.

According to The National Bureau of Asian Research, there are two major health care providers in India. The National Rural Health Mission (NRHM) is “the central government’s attempt to improve delivery of services in public facilities,” while the Rashtriya Swasthya Bima Yojana (RSBY) is “a health insurance program led by the Ministry of Labor and Employment.”

In short, the RSBY provides coverage of expenses for impoverished Indians, while the NRHM attempts to improve existing health care services. The Bureau says that it is still “not clear whether this program improves population health.”

Researchers from the World Health Organization (WHO) have examined the possibility of universal health care for India, as they claim, “those accessing health care in the public sector generally receive poor quality services.” Additionally, The National Bureau of Asian Research states that in the private sector “there are a large number of health workers who have only a high school education or do not have a medical degree.”

The WHO examined the Indian city of Chandigarh. Chandigarh has an array of both public and private health care services to serve a population of over 1 million citizens. Following data collection, the WHO formulated a package of health care services, complying with the guidelines of the Indian Public Health Standards (IPHS).

One of the most important aspects of the study was, of course, the final cost. The WHO says that by using generic drugs each household in India would have to pay INR 6852 (USD $152) annually in order to sustain universal health care. This would make the amount of the GDP going toward health care rise from 1 percent to 3.8 percent.

According to both The Wall Street Journal(WSJ) and The National Bureau of Asian Research, the Indian government must aim to reduce out-of-pocket costs for Indians, which can be as high as 70 percent of the bill, and provide access to free medication. Additionally, the WSJ reports that the number of doctors in India is far too low to serve the country. Providing students with the opportunity to be trained in the medical field is essential. In order to do so, doctors suggest increasing the number of seats in medical schools.

The possibility of universal health care in India exists, but requires a comprehensive overhaul of the economic and educational systems that currently exist.

— Bridget Tobin

Sources: University of Pittsburgh, NBR, WHO, Wall Street Journal
Photo: Time

Life expectancy has risen in the past two decades by over nine years. Both wealthy and impoverished nations have managed to raise their citizens’ lifespans. In the wealthier countries, less people are dying from heart diseases by the age of 60. According to the U.N.’s World Health Organization annual statistics, six countries’ babies are healthier, with less dying before the age of 5, explained Margaret Chan, World Health Organization chief, in a statement.

The six poorest countries managed to raise life expectancy by over 10 years between 1990 and 2012. Liberia’s lifespans increased the most by 20 years (42 to 62).

The next few countries that were able to significantly raise their lifespans are Ethiopia (from 45 to 64 years), Maldives (58 to 77), Cambodia (54 to 72), East Timor (50 to 66) and Rwanda (48 to 65).

According to the WHO, a girl who was born in 2012 will most likely live to be approximately 73-years old and a boy up to 68-years old.

More people are starting to live longer because of an increase in food supplies, better nutrition, improvements in medical supplies and technology (immunizations and antibiotics), improved sanitation and hygiene and safer water supplies.

Although the life spans in Africa are the lowest, they have still made a significant increase by about 10 percent . Malaria deaths have decreased by 30 percent and HIV infections have also decreased by 74 percent.

A great contribution to the increasing lifespans is the larger income Africans are making, which has increased by 30 percent.

One of the poorest countries in the world, Mozambique, has made huge improvement due to the discoveries of coal and gas.

Today, this is proof that people are able to make a change in others’ lives — the ones who need it the most. Although the poorest countries still have the shortest lifespans, they have definitely increased. Over the next few decades, one could expect even more growth.

 —  Priscilla Rodarte

Sources: ENCA, SF Gate, Geography, The Independent

healthcare
The well-being of global citizens relies heavily on the health of their health care systems. However, the type of medical attention you will receive when you go to the doctor, or even the likelihood you will attempt to seek care, varies vastly depending on where you live. Indicators like average life expectancy, infant mortality and obesity prevalence highlight the success of the health care systems. With this wealth of information, we can assess why certain nations’ health care systems are in better condition than others.

1. France

France had the best health system in the world in 2000, according to the World Health Organization’s (WHO) most recent assessment of world’s health systems. So what makes France’s method so successful? First, statistics on doctors and life expectancy are often on France’s side. France has less doctors per capita than second place Italy at 3.07 per 1,000 people, but more annual doctor visits than most of the top 10. It also has 3.43 hospital beds per 1,000 people, which is rivaled only by Japan and Italy of those in the top 10. Life expectancy is 81.66 and infant mortality rate is 3.31 of every 1,000 live births.

It falls on the government to negotiate doctor and hospital fees in an effort to keep costs low. In addition, a national insurance program flips 70 percent of the bill for everyone. The other 30 percent is picked up by private insurance. This means that out of pocket spending on health care is only $307 per capita.

2. The United States

The United States has one of the biggest economies in the world, yet it ranks 36 this year on the success of its health care system. Perhaps this is because the United States, while a wealthy nation, has an infant mortality rate of 6.17 per 1,000 births and a life expectancy of 79.56, neither of which are something to cheer over compared to other industrial nations where the average is higher. In addition, obesity prevalence has reached 36.5 percent, about three times as high as France. This signals that while the United States has the capability to provide good health care, it is falling far behind its peers. That being said, the United States is often considered the leader in medical research and cancer treatment.

In this country, insurance is provided mostly by for-profit private insurance groups, with some exceptions. Those over 65 years old qualify for Medicare and the disabled or low-income population qualifies for Medicaid, which are sponsored by the federal government and paid for by taxes. The number of uninsured is dropping, and in 2014, only about 15.6 percent of the population goes without insurance. However, citizens still pay a whopping $987 per capita out of pocket for health care. Changes will occur over the next few years with the implementation of the Affordable Care Act, but it is still early to assess how recent patterns will change the ranking of the health care system.

3. Pakistan

Pakistan ranked 122 according to the WHO in 2000 and continues to struggle with health care and disease today. The average life expectancy is 67.05 in 2014, below that of Syria and Iran. In addition, infant mortality is a frightening 57.48 of every 1,000 births. Pakistan has only .6 hospital beds and .8 doctors per 1,000 people. All this indicates that the health care system in Pakistan is struggling, leaving its citizens in serious trouble.

There is much to learn from the health care systems of other nations, but changes can be made at different levels for different countries. For countries like the United States where some tweaking to the costs and the insurance sector would vastly increase the overall health of the citizens and the system, taking notes on France’s system would be beneficial. Changes would allow more people to get coverage for less money from the federal budget. But for places like Pakistan where the system is in shambles, a functioning health care system must be in place first. Overall, different nations stand in different positions, but health care systems across the world could use a restructuring.

– Caitlin Thompson 

Sources: CIA(1), CIA(2), Commonwealth Fund, Gallup Poll, NPR, The Patient Factor, PBS, WHO(1), WHO(2), World Bank(1), World Bank(2)
Photo: Telegraph

cancer

A new report, published in part by the American Cancer Society, has revealed that certain types of cancers are strongly associated with living in poverty while others are associated with being wealthy.

The study included information from over 3 million cancer diagnoses, using poverty rates as the indicator of socioeconomic status (SES) in an effort to identify any links between the two factors. Each diagnosis was organized by type of cancer and by the poverty level of the area the patient lived in. Out of 46 cancer sites tested, 38 of them showed a significant relationship with poverty, whether that meant being more likely or less likely to have that type of cancer as a result of low SES. The cancers most strongly associated with high levels of poverty were found to be those of the larynx, cervix and Kaposi sarcoma, which affects connective tissues.

Conversely, wealthier patients are most significantly associated with melanoma and thyroid cancers. Why might certain cancers disproportionately affect the poor?

There are obvious ways in which poverty could impact health — the impoverished are more likely to lack access to health care and are less likely to have stable food security. However, there also appear to be impacts that are less noticeable and require more examination, as this study has revealed. The answer may lie in “behavioral risk factors” that occur more often in communities with high levels of poverty, such as “tobacco, alcohol and intravenous drug use, sexual transmission and poor diet.”

For the types of cancers that affect wealthier communities more often, the study finds these cancers are the ones most likely to be over-diagnosed. It seems that lacking access to adequate health care and certain behavioral factors together predispose those in poverty to have different kinds of cancers. What is most unfortunate is that the cancers associated with low levels of poverty, the study found, tend to be the most lethal.

A relationship does exist between SES and cancer, and this study is one of the first to use poverty levels to find this link. In one of the first studies ever done on the subject, published in the same journal as this newest report and using a different measure of SES, researchers said, “It is increasingly apparent that a substantial proportion of the disparities in cancer defined by race and ethnicity can be attributed to socioeconomic status.”

Unfortunately, this relationship is often hard to define and there are not extensive amounts of literature on the topic. However, interest in finding the links between cancer and poverty is growing, and the results of this report reaffirm the importance of taking SES into account. Hopefully more researchers will make similar efforts to examine the details of the relationship between poverty and health, including the unfortunate link between poverty and lethal types of cancer.

-Emily Jablonski 

Sources: Medscape, Wiley
Sources: OnlyMyHealth

hiv research
Since the first diagnosis back in 1981, the world’s approach to HIV and HIV research has changed drastically. Receiving a diagnosis of the disease that 33.4 million people are currently living with means something very different than what it did 33 years ago.

In 1981, when 26 homosexual men presented with unexplainable tumors and other strange symptoms, researchers and doctors worldwide were at a loss for what to do. As they later identified the disease as HIV, or human immunodeficiency virus, it dawned on them that they were dealing with a virus they were wholly unprepared to tackle.

In its early years, the life expectancy that came with an HIV diagnosis was heartbreakingly short and the answers for how to cure the virus were few and far between. According to Dr. Woodrow Myers, a public health official from Indiana, the life expectancy of someone who had HIV in 1987 was 18 months.

Actually diagnosing people who had HIV was an obstacle initially, seeing as it was a minimally understood virus, especially in areas of the world with a lack of information. Progress began when researchers developed a blood test that could be used to identify those who had contracted the virus, allowing researchers to start focusing on improving the lives of those with HIV.

As researchers gained more of a grasp on the virus, they developed the drug AZT, which was approved by the Food and Drug Administration in 1987 and was distributed to patients in the U.S. Unfortunately, AZT came with its own nasty cocktail of side effects, some of them life threatening, thus ruling it out as a viable solution.

Soon after, things improved when researchers developed a treatment that had multiple drugs in one pill and had some success in saving lives. These treatments were being administered up to 20 times a day, resulting in more unpleasant side effects; also not an ideal solution.

Fast-forward two decades and research has uncovered treatments that have made an HIV diagnosis less of a death sentence. Myers reports that the life expectancy with an HIV diagnosis is now 22 years, putting it along the lines of chronic diseases like diabetes and heart disease.

Though there is still no cure for HIV, the treatments are more manageable with a greater variety of options. Some treatments require only five pills a day and often have minor side effects, making managing the virus less intensive.

Justin Goforth, a 47-year-old who has been living with HIV for over 20 years, believes that in today’s world, an HIV diagnosis should not be restrictive in how you live your life, explaining “You can go to your doctor two, three times a year, get some tests done and make sure everything’s on track, and then just live the rest of your life as you would.”

This is not to say, however, that HIV should be less of a priority. Two million people died of HIV in 2008, with 2.7 million new diagnoses, and many more lives have been lost since then. Impoverished areas like Sub-Saharan Africa and Southeast Asia suffer greatly because they lack the education and resources to prevent and treat HIV, leading to often uncontrollable proliferation of the virus.

The progress shines through, however, as the number of people in poor countries receiving resources to treat people with HIV having increased 10-fold since 2002, and the standards of living have improved. As sexual education, treatment research and resource distribution improve, an HIV diagnosis becomes more and more manageable.

– Maggie Wagner

Sources: AIDS.gov, CNN, Oprah, The Herald News
Photo: Red Hot