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Sentebale: Addressing HIV in Southern Africa

HIV in southern AfricaIn 2006, the Duke of Sussex partnered with Prince Seeiso of Lesotho to form Sentebale, a charity focused on providing psychosocial support for children and young adults living with HIV in southern Africa. The charity partners with grassroots organizations in Botswana, Lesotho and Malawi and work to improve adherence to HIV medication programs.

HIV/AIDS: Sentebale

“We teach them that this human immunodeficiency virus doesn’t have to be a death sentence for anyone anymore, that the real enemy we are fighting is stigma and the antiquated attitudes that work against young people coming forward when wanting to take an HIV test,” said Prince Harry in a speech during a dinner for Sentebale in January 2020.

The name Sentebale was chosen by Prince Harry and Prince Seeiso. It means “forget me not” in Sesotho, which is Lesotho’s official language. Princess Diana, Prince Harry’s late mother, and Queen ‘Mamohato, Prince Seeiso’s late mother, were both previously involved in work with children who had been affected by HIV/AIDS. The mission of Sentebale is to become the leading organization for psychosocial support for young people and children with HIV in Southern Africa.

Let Youth Lead Program

In recent years, Sentebale has found that social accountability and peer-to-peer support were central tools to bolstering its mission. In March 2017,  Sentebale launched the Let Youth Lead program. The program’s objectives are to have all young people in southern Africa know their HIV status, provide and promote peer-to-peer support and help young people to advocate for themselves at the government level. Another goal of the program is to empower these advocates and young people with the tools to assist their peers and have their voices heard.

“I volunteered because I wanted to help people. I don’t see this as work, I just want to transform people’s lives,” said Pheto Kutmela, a Sentebale Let Youth Lead advocate. Kutmela has been volunteering in Ha Makunyapane, Thaba-Tseka district, where he lives.

These youth advocates have been able to facilitate community dialogues in 30 community councils, where they are able to discuss challenges they have been facing and suggest improvements for going forward. It can typically be difficult for young people to have their voices heard at the governmental level and this program helps create a platform for them to do so, by giving them the tools to engage with policy leaders and address education and health services.

Sentebale’s Impact

Sentebale has overseen some transformative improvements in the HIV/AIDS epidemic over the past several years. In Botswana, less than 500 children under the age of 14 were infected in 2018 and more than 95% of pregnant women living with HIV were receiving treatment.

Looking forward to 2021, Sentebale will continue to prioritize its commitment toward empowering youth who have been affected by HIV in southern Africa.

With staff now working from home and in-person programs suspended, Sentebale intends to adapt to the challenges that come with COVID-19 while still showing a commitment to improving the lives of young people affected by HIV in southern Africa.

– Katherine Musgrave
Photo: Flickr

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COVID-19 and HIV in the Philippines

HIV in the PhilippinesThe Philippines is designated as a quickly growing epicenter of the HIV epidemic. Before the COVID-19 outbreak, HIV in the Philippines was surging, largely due to their poor healthcare system. There is fear that the COVID-19 pandemic may exacerbate such difficulties due to restricted public transportation, the establishment of checkpoints and consequently, the inaccessibility of treatment.

While the COVID outbreak has many downsides, it may provide an opportunity to improve HIV services in the Philippines. Advocacy groups, community-based organizations and volunteers are now uniting to foster innovative solutions for the HIV epidemic.

The Philippines’ Department of Health Adopts Telemedicine

Travel and physical distancing restrictions have disrupted the supply and distribution of antiretroviral drugs; these drugs are essential for Filipino people living with HIV (PLHIV). Therefore, the Philippines’ Department of Health (DOH) recommends HIV facilities adopt an online courier service. This would ensure access to treatment while minimizing the risk of patient and staff exposure to COVID-19. This method allows PLHIV to choose their preferred medicine pick-up location and time through a mobile application.

The DOH’s plan for app-based medication distribution is key to enhancing the quality of HIV treatment and counseling. This app also improves HIV healthcare for the post-COVID world. However, this is not the only way Filipinos are improving HIV healthcare. Officials are working to give community-based organizations opportunities to participate in the DOH’s endeavors. These efforts are a favorable step towards the efficient mitigation of HIV in the Philippines.

Community-Based Organizations Revamping the Philippines’ HIV Healthcare Services

Network Plus Philippines, Pinoy Plus Advocacy Pilipinas, Red Whistle and TLF Share Collective are coordinating to implement a new guideline issued by the Philippines’ DOH. The guideline guarantees that PLHIV will receive their medicine through courier services, focusing on PLHIV in rural communities. Examples of contributions from community-based organizations are listed below:

  1. Red Whistle: Red Whistle mobilized 40 volunteers to collect antiretroviral refills from treatment facilities and deliver them across the country. It has worked with local authorities to avoid disclosure of confidential clientele information and partnered with MapBeks, an online mapping community, to create the #OplanARVayanihan: a map showing the nearest antiretroviral drug centers and delivery options.
  2. TLF Share Collective: TLF Share Collective has helped to deliver antiretroviral therapy to Filipinos. It has developed a tool to monitor medication delivery by community volunteers and created FAQ-cards for patients.
  3. Pinoy Plus Advocacy Pilipinas: PPAP has established a PLHIV Response Center where people with HIV can ask for information about accessible treatment hubs and advice on antiretroviral therapy.

International Assistance

In addition to the community-based organizations’ efforts to eliminate HIV in the Philippines, the international community has also provided guidance through programming and financing.

For example, UNAIDS has coordinated with The United Nations Development Programme to advise the Philippines’ Government on how to manage their HIV problem in the context of COVID. The UN’s creation of an analytical survey has revealed valuable information on the issues affecting PLHIV. These issues range from concerning factors like the feeble safeguarding of human rights to a lack of access to mental health and social protection services.

Similarly, USAID, The U.S. Agency for International Development, is collaborating with the Filipino government to assist them in establishing universal health care. Together, they are addressing legislative and institutional obstacles within their health financing system. The USAID’s services include prevention programming and case identification to strengthen epidemic control; funding streams from the Department of Health and local health budgets that align with UHC Law Provisions; and estimates for total future domestic investment requirements.

While COVID-19 presented a scope of challenges for HIV treatment and care services, it also propelled community-based organizations, the Filipino Government and international institutions to cooperate and execute innovative policies. The Philippines’ healthcare system will continue to combat HIV and become a robust system devoid of the defects that COVID-19 highlighted.

– Joy Arkeh
Photo: Flickr

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Paving the Way to Eliminate HIV in Sri Lanka

HIV in Sri Lanka
Human immunodeficiency virus (HIV) affects 38 million people globally. Spread via the exchange of bodily fluids, it attacks cells that can help fight other infections, making people more susceptible to other illnesses. While new cases have decreased by 23% since 2010, there is still much progress that needs to be made. Fortunately, innovative countries like Sri Lanka have established extensive programs to eliminate HIV.

HIV Around the World

On a global scale, HIV primarily affects people from more disadvantaged countries with low to middle incomes. As a result, HIV often goes hand-in-hand with other humanitarian issues. A majority of countries impacted by high HIV rates also struggle with food insecurity, economic disparities and other infectious disease issues.

While no cure exists for HIV, it is treatable with antiretroviral therapy (ART). By addressing HIV with medication, HIV-positive individuals can live abundant, healthy lives and have minimal risk of passing HIV to others around them. It is essential that more people are able to become aware of their diagnosis and combat it with ART to prevent spreading it further.

Sri Lanka’s Comprehensive Efforts

Recent efforts to reduce HIV have shown some progress, with 81% of HIV-positive individuals aware of their condition. However, there is still considerable progress to be made in providing access to testing and treatment. Fortunately, Sri Lanka, a south-Asian country with more than 21 million inhabitants, has made headway in preventing and treating HIV.

The Sri Lankan government has led efforts to combat and eliminate HIV by 2025. With an admirably low HIV-prevalence rate of 0.01%, it has enacted different social measures to meet this goal. These include educating Sri Lankans on HIV, testing at-risk individuals and providing quality treatment options to those who are HIV-positive.

Some of the government’s online efforts include launching the website Know4Sure.lk. This initiative trained caregivers from the private health sector on providing testing and treatment to those with HIV, in addition to providing a number of services for Sri Lankans. The website provides anonymous appointment scheduling and at-risk assessments, with paid advertisements and influencers encouraging HIV testing.

Furthermore, the program set up a peer network to call for more testing, treatment and social awareness of HIV. Mobilizers within this network encourage peers to get tested and communicate with others via a multimedia effort. Founded on the principle that “Your Life Matters,” this movement combats the transmission of HIV by instilling hope and optimism about one’s career and livelihood. HIV is preventable and treatable as long as Sri Lankans follow safe-sex practices, get tested regularly and take preventative measures.

Success and Global Impact

Sri Lanka’s commitment to eliminate HIV has already seen success. In 2018, the nation stopped vertical transmission – the transmission from mother to child – of the virus entirely. All pregnant women diagnosed with HIV are provided with ART treatment, assuring their health and the health of their unborn child. The elimination of vertical transmission is the culmination of the steadfast, multifaceted government effort to provide testing and treatment to all men and women.

HIV impacts people on a global scale. By establishing preventative measures and treatment programs, Sri Lanka has pushed back against HIV and taken significant steps to eliminate HIV by 2025. These efforts can be an example for other countries experiencing HIV outbreaks and setbacks. Hopefully, with more government efforts dedicated to fighting HIV, the virus will soon be eliminated worldwide.

– Eliza Cochran
Photo: Flickr

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Wealthy Philanthropist Donates Billions to Charities

Billions to Charities
It is no surprise that Forbes named Charles “Chuck” Feeney the James Bond of Philanthropy. After 38 years, Feeney achieved his lifetime goal: giving away all his $8 billion amassed wealth to charity and being alive to see its impact. When someone donates billions to charities, the impact should be substantial.

Charles “Chuck” Feeney

Chuck Feeney amassed his wealth from establishing a franchise of stores within thousands of airports known as the Duty-Free Shoppers Group. He also launched the General Atlantic, an American growth equity firm. Yet, the man, with this immense fortune lives in a rented San Francisco apartment. Moreover, he has even been found riding public transit. Feeney has credited his life philosophy to the Andrew Carnegie essay, “The Gospel of Wealth.” The essay declares that the millionaire’s sole duty is to give back to the poor. As Feeney donates billions to charities, he certainly obliges. Carnegie’s influence is extremely apparent within Feeney’s life. His coined phrase and mantra in life, “Giving While Living,” is essentially saying that you should give all you can to charity now rather than later. This, which closely resembles the messages behind The Gospel of Wealth.

Atlantic Philanthropies

In the early ’80s, the Duty -Free Shoppers franchise was at its peak. This is when Feeney decided to be the one who donates billions to charities. Without anyone’s knowledge, he secretly handed over all his shares and formed his new foundation, the Atlantic Philanthropies. Since 1982, the Atlantic Philanthropies has focused on issues of health, social and public policy throughout Australia, Bermuda, Ireland, South Africa, the U.S. and Vietnam. Within these countries, the foundation has addressed many important issues. Among them include facilitating the peace process in Northern Ireland, reducing the number of children without health insurance in the U.S., providing millions with HIV/AIDS medication in South Africa and helping modernize Vietnam’s health care system. While the foundation has officially dissolved recently, Feeney has one last message to relay: “To those wondering about Giving While Living: try it, you’ll like it.”

3 Countries Impacted

  1. South Africa: In the early years after Apartheid, Atlantic Philanthropies saw the opportunity to help advance South African society from its previous suppression. During the ’90s, the foundation assisted young black South African attorneys in getting their law degrees. In the 2000s, Atlantic made funds to advance nursing and health services. By the end of 2016, Atlantic Philanthropies had totaled $442 million in investments toward building democratic institutions and organizations. Overall, the foundation brought 2 million South Africans access to HIV medication. Also, it convinced the government to pledge $1 billion toward school improvements. Finally, it increased the number of nurses between 2005 and 2013 by 44%.
  2. Vietnam: The Atlantic Philanthropies have invested $381.5 million towards improving Vietnam’s public health system and renewing old libraries and universities. With Feeney’s contribution of billions to charities, Vietnam modernized its healthcare system, resulting in 9 million citizens receiving better and improved treatment. Further, the foundation focused on efforts that advocated for healthier behaviors. These included the widespread anti-smoking campaign and the passed mandate that forced motorcyclists to wear helmets. Also, in the education sector, Atlantic Philanthropies improved Vietnamese university libraries.
  3. Cuba: In the early 2000s, Cuba’s healthcare, although seen as one of the best worldwide, was suffering from a lack of resources. This, in turn, sparked the Atlantic’s activism. Overall, the foundation invested $66 million into organizations that work toward improving the care and treatment of Cubans. Moreover, these bodies spread knowledge about Cuba’s effective public health practices in nations with impoverished communities.

An Inspiring Message

Feeney’s extreme display of generosity via contributions of billions to various charities has inspired many notable philanthropists and entrepreneurs to do their part to help the less fortunate. An example of wealthy business moguls following in Feeney’s footsteps is the “Giving Pledge.” Warren Buffet and Bill Gates launched the Giving Pledge in 2010 as a campaign that seeks to persuade wealthy figures across the world to donate close to half of their wealth before they die.

– Maya Falach
Photo: Flickr

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Support the Keeping Girls in School Act

Support the Keeping Girls in School
Congresswoman Jeanne Shaheen first introduced the Keeping Girls in School Act. The bill claims to “support empowerment, economic security, and educational opportunities for adolescent girls around the world.” Specifically, the Committee on Foreign Affairs and the Committee on Foreign Relations will both work and engage in the implementation of providing opportunities for adolescent girls to obtain a secondary education. This is why support for the Keeping Girls in School Act is so crucial.

Assistance Needed

Congress will also need the assistance of the United States Agency for International Development (USAID) in managing and assisting international matters, such as providing global security for adolescent girls in vulnerable countries. Every five years, these federal committees will meet to monitor the progress of the bill and provide input on the upcoming protocols in improving the status of the situation.

As for quantitative costs, to support the Keeping Girls in School Act requires a large financial budget to be most effective in serving those countries at-risk. Cost estimates are about $340 billion, which is a substantial amount in providing lower-income countries access to secondary education, primarily for younger girls. However, with the economic benefits of this bill, it will prove to be a fulfilling investment.

The Problem At Hand

Every year, more than 130 million girls go unenrolled in school. The U.N. predicts that this rate will increase by up to 150 million girls by 2030. For example, in Yemen, 66% of women are illiterate. Meanwhile, in Burkina Faso, only 1% of girls complete secondary school.

One factor is how many girls enter into child marriages and are not able to obtain an education. In fact, in Ethiopia, 40% of girls are likely to marry under the age of 18. Similarly, in Bangladesh, at least 42% of girls marry younger than age 18 and 22% marry younger than age 15.

Many other external factors contribute to this global crisis. For example, girls with disabilities are less likely to enroll in school and only 1% of girls from the disabled community are literate.

Infections have also proven to hinder access to secondary education for girls under the age of 18. Especially through child marriage, girls are more susceptible to sexually transmitted diseases, such as AIDS. More than 380,000 girls, primarily from Africa, contract HIV or develop AIDS every year. In sub-Saharan Africa, at least 80% of HIV victims among adolescents are girls. A Harvard study noted that if an extra year of secondary education was available for adolescent girls, the risk of contracting HIV would decrease by 12%.

The Economic Benefits

Although it is a large investment, the benefits will far outweigh the costs. For example, if every girl attends school for 12 years, free of cost, estimates have determined that it will generate between $15 trillion to $30 trillion globally by 2030. Moreover, each year a girl attends school, the government saves approximately 5% of its educational budget. When girls have an educational background, they are more likely to obtain jobs and careers and thus, stimulate the economy.

What Now?

It is imperative to lobby support from local, congressional leaders to support the Keeping Girls in School Act, as it can help millions of girls obtain an education. Furthermore, the bill will substantially stimulate the economy in the future. A quick method to accumulate support is to email local representatives about endorsing the bill. With this template by The Borgen Project, emailing local congressional leaders will take less than one minute and benefit more than 130 million girls that do not have access to secondary education.

– Aishwarya Thiyagarajan
Photo: Wikimedia Commons

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Influenza in Sub-Saharan Africa

Influenza in sub-Saharan AfricaAfrica is known for being one of the world’s poorest continents. Poverty directly affects a person’s susceptibility to diseases like influenza. To combat this disease, the future of healthcare in Africa requires funding to improve accessibility in rural regions. Here’s what you need to know about influenza in sub-Saharan Africa.

Influenza in Sub-Saharan Africa

While sub-Saharan Africa only accounted for an estimated 7,000 influenza deaths in 2015, this remains the most common and deadly global disease. The mortality rate of influenza in sub-Saharan Africa affects children under the age of five and those over 75. Though the mortality rate seems low compared to the U.S., it does not take into account the presence of healthcare services in Africa versus the U.S. In contrast to Africa, the U.S. had 22,705 influenza deaths in 2015. While these statistics are higher, the U.S. also has more accessible healthcare.

Furthermore, studies have shown that influenza affects many more people than accounted for. Research from the World Health Organization (WHO) shows 40% of antibodies for flu (B) were found in community members 40 years of age and older. This reveals that the virus continued to circulate with no monitoring processes. Importantly, this lack of surveillance contributes to countries’ and NGO partners’ ability to prepare for the next outbreak.

Higher rates of influenza in sub-Saharan Africa are typically found in low to middle-income regions with little resources and access to sanitation and healthcare. In particular, influenza puts nearly “two-thirds of the 34 million” persons infected with HIV at a higher risk for infection and mortality. Existing diseases such as HIV thus put a significant amount of the African population at risk for influenza.

Healthcare in Africa

Africa continues to possess one of the world’s worst healthcare infrastructures, despite funding from the U.S. In 2006, the U.S. gave R100 billion to the South African National Health Insurance (NHI). However, the U.S. provided $28.8 billion to those uninsured in the U.S. during that year, nearly twice the amount granted for all international health.

Rural regions in sub-Saharan Africa account for 60% the population, while urban areas contain 40%. Rural regions lack accessible healthcare compared to urban regions. Due to industrialization, urban areas have greater access to healthcare facilities and university hospitals.

Across many parts of Africa, the ratio of doctors to patients “is below 1/1000 population, with the ‘ratio of physicians per 1000 population essentially unchanged between 2004 (0.77) and 2011 (0.76).” Demand for physicians within these regions is increasing. However, although Africa is producing more physicians, many migrate to the U.S. This leaves rural regions of sub-Saharan Africa with few qualified healthcare providers.

Solutions and Aid

Awareness and aid are crucial to improving infrastructure and healthcare in Africa, so that it can respond to influenza outbreaks. The W.H.O. has created the Africa Flu Alliance, finding factors leading to the underfunding of healthcare to assess its overall impact. Similarly, the Africa Flu Alliance created a “strategic road map” of targets to control influenza in sub-Saharan Africa. It hopes to influence organizations, private funding and projects to support the organization’s initiatives.

Private sectors and nonprofits contribute to approximately half of Africa’s total healthcare funding and expenditures. Twenty-two organizations and nonprofits are working to combat the gap between health services in rural and urban areas. In addition, The African Network for Influenza Surveillance and Epidemiology (ANISE) was created in 2009, with a growing network alongside the CDC. Continual meetings from 2009 to 2012 allowed officials and representatives to discuss achievements and areas of improvement.

Reducing Aid Dependency: Can It Work?

Despite the reliance on Western assistance for years, President Trump’s foreign aid budget cuts could be incredibly harmful or begin for Africa. Given the situation, governments within Africa will need to strive for improvements in monetary policies, transparency and reduced corruption. To improve self-sufficiency, experts recommend regional integration, or “the process by which two or more nation-states agree to co-operate and work closely together to achieve peace, stability and wealth.” Initiatives like Africa’s Continental Free Trade Area (CFTA) will enable 54 countries to trade freely. This will improve Africa’s economic stability by an estimated 50% increase in trade.

The battle of influenza in sub-Saharan Africa correlates directly with the absence of monitoring for significant health concerns. Expanding upon the existing healthcare infrastructure can not only contain and treat disease but also help grow Africa’s economy. Surveillance will be key in this process, as statistics tell actors what they need to improve. But with the support NGOs, funding can help control influenza in sub-Saharan Africa.

– Allison Lloyd
Photo: Flickr

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7 Factors Affecting Poverty in Lesotho

Poverty in Lesotho
Lesotho is a small, mountainous nation surrounded entirely by South Africa. Since gaining independence from the United Kingdom in 1966, Lesotho has been plagued by political instability and slow economic development. A high prevalence of HIV further complicates efforts to end poverty in Lesotho. Despite an attempted military coup in 2014, conditions have been improving in the country in recent years. Here are 7 factors that affect poverty in Lesotho.

7 Factors Affecting Poverty in Lesotho

  1. Agriculture: Sixty-six percent of Lesotho’s population lives in rural areas where the economy is largely based on small scale agriculture. Many of these people engage in subsistence farming, meaning they rely on a good harvest to be able to feed their families. The success of each harvest makes a huge impact on the lives of millions in Lesotho. A drought from 2015 to 2016 crippled poverty reduction efforts for the next few years, proving the delicacy of this system.
  2. Gender: Households run by women have a poverty rate of 55.2%, compared to 46.3% for households run by men. This is because women are typically denied the same opportunities as men in Lesotho’s highly patriarchal society.
  3. Urbanization: Poverty in Lesotho is more prevalent in rural areas than in urban areas. Urban areas have a 28.5% poverty rate while rural areas face a 60.7% poverty rate. Despite Lesotho’s economic development in recent years, most improvements have been made in urban areas while rural areas have been left behind.
  4. Education: Achieving a college education is extremely rare in Lesotho – only 4.4% of people live in households with someone who has gone to a college or university. Those that do receive higher education have a low poverty rate of 8.7%.
  5. Government programs: Over the past 20 years, the government in Lesotho has been working with international organizations to expand protections for the poor and increase economic opportunity. As a result, the national poverty rate decreased from 56.6% to 49.7% from 2002 to 2017.
  6. HIV: Poverty and HIV are clearly connected in Lesotho. Almost 24% of adults are living with HIV and treatment is essential to stopping the spread and helping these people live normal lives. Lack of resources and awareness means that on average only 57% of people with HIV are currently getting help. This directly impacts their quality of life and makes it harder to land above the poverty line.
  7. NGOs: Though poverty in Lesotho is an important issue for the country’s government, NGOs are stepping in to fill gaps. Many international nonprofit groups such as Caritas Lesotho operate in the country. Caritas Lesotho is a group which seeks to help individuals escape poverty by teaching them technical skills. They focus on vulnerable children and teach them a trade such as farming or woodworking. Groups like Caritas Lesotho are slowly helping to improve the economic situation in the country.

Examining the causes of poverty in a country is essential in deciding how best to address the issue. It is clear that poverty in Lesotho will continue to be an issue for many years. However, the country is on the right track and will improve as education and economic opportunity increase.

– Jack McMahon
Photo: Flickr

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Tackling Tuberculosis in Botswana

Tuberculosis in BotswanaBotswana is a southern African country with just over 2 million residents living inside its borders. Every Batswana lives with the threat of tuberculosis, an infectious disease that remains one of the top 10 causes of death on the African continent. Tuberculosis has a 50% global death rate for all confirmed cases. Investing in tuberculosis treatments and prevention programs is essential. Botswana has one of the highest tuberculosis infection rates in the world with an estimated 300 confirmed cases per 100,000 people, according to the CDC. Preventative and community-based treatment shows promise in combating tuberculosis in Botswana.

Treating Tuberculosis in Botswana

Tuberculosis treatment cures patients by eliminating the presence of infectious bacteria in the lungs. The first phase of treatment lasts two months. It requires at least four separate drugs to eliminate the majority of the bacteria. Health workers administer a second, shorter phase of treatment to minimize the possibility of remaining bacteria in the lungs.

Early identification of tuberculosis is a crucial step in the treatment process and significantly reduces the risk of patient death, according to the Ministry of Health. Preventative treatment methods are vital because they inhibit the development of tuberculosis infection. They also reduce the risk of patient death significantly.

Health workers detect tuberculosis with a bacteriological examination in a medical laboratory. The U.S. National Institutes of Health estimate that a single treatment costs $258 in countries like Botswana.

Involving the Community

Botswana’s Ministry of Health established the National Tuberculosis Programme (BNTP) in 1975 to fight tuberculosis transmission. The BNTP is currently carrying out this mission through a community-based care approach that goes beyond the hospital setting. Although 85% of Batswana live within three miles of a health facility, it is increasingly difficult for patients to travel for daily tuberculosis treatment. This is due to the lack of transportation options in much of the country.

Involving the community requires the training and ongoing coordination of volunteers in communities throughout the country to provide tuberculosis treatment support. Community-based care also improves treatment adherence and outcome through affordable and feasible treatment.

The implementation of strategies such as community care combats tuberculosis. For example, it mobilizes members of the community to provide treatment for tuberculosis patients. The participation of community members also provides an unintended but helpful consequence. For example, community participation helps to reduce the stigmas surrounding the disease and reveals the alarming prevalence of tuberculosis in Botswana.

A Second Threat

In addition to the tuberculosis disease, the HIV epidemic in Africa has had a major impact on the Botswana population, with 20.3% of adults currently living with the virus. Patients with HIV are at high risk to develop tuberculosis due to a significant decrease in body cell immunity.

The prevalence of HIV contributes to the high rates of the disease. The level of HIV co-infection with tuberculosis in Botswana is approximately 61%. African Comprehensive HIV/AIDS Partnerships (ACHAP), a nonprofit health development organization, provides TB/HIV care and prevention programs in 16 of the 17 districts across the country in its effort to eradicate the disease.

Fighting Tuberculosis on a Global Scale

The World Health Organization (WHO) hopes to significantly reduce the global percentage of tuberculosis death and incident rates through The End TB Strategy adopted in 2014. The effort focuses on preventative treatment, poverty alleviation and research to tackle tuberculosis in Botswana, aiming to reduce the infection rate by 90% in 2035. The WHO plans to reduce the economic burden of tuberculosis and increase access to health care services. In addition, it plans to combat other health risks associated with poverty. Low-income populations are at greater risk for tuberculosis transmission for several reasons including:

  • Poor ventilation
  • Undernutrition
  • Inadequate working conditions
  • Indoor air pollution
  • Lack of sanitation

The WHO emphasizes the significance of global support in its report on The End TB Strategy stating that, “Global coordination is…essential for mobilizing resources for tuberculosis care and prevention from diverse multilateral, bilateral and domestic sources.”

– Madeline Zuzevich
Photo: Flickr

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The Key to HIV Prevention in Sub-Saharan Africa

HIV prevention in AfricaHuman Immunodeficiency Virus (HIV) is known to have impacted the world for approximately 40 years. Considering the fact that the virus was equally as aggressive as it was untreatable, first world countries like the United States and France were more able to provide for their citizens. Doctors could properly and continually perform research in order to educate citizens on the virus. Additionally, they could hastily link HIV prevention and methods of protection and treatment. Unfortunately, in sub-Saharan African countries, accomplishing the same feats proves more difficult. Therefore, 66% of newly diagnosed HIV cases worldwide come from sub-Saharan African countries.

HIV/AIDS’s Effect on Africa

Eswatini, Lesotho, Mozambique, parts of South Africa, regions in Zambia, Namibia, Southern Malawi and Kenya are the countries in Africa whose populations have the highest rates of being infected or affected by HIV. In Kenya, only about 30% of sexually active individuals practice safe sex methods. Additionally, only 47.5% of adolescent women could properly identify methods that would prevent them from contracting HIV sexually. With that said, women are at an extremely high risk of contracting HIV in sub-Saharan Africa.

An Increased HIV/AIDS Risk Factor for Women

One of the main factors contributing to women being at a higher risk of contracting HIV in sub-Saharan Africa is that the rate of school attendance is extremely low for girls in sub-Saharan Africa. Girls are more likely to be exposed to social and economic scenarios that could potentially threaten their survival and put them at an increased risk of contracting HIV. Therefore, it is important to increase both the school attendance rate for girls and the amount of sex education offered at school. This would include information on HIV and STI prevention.

Sex Education’s Impact on Adolescent Health and Choices

UNAIDS analyzed a series of studies in order to determine whether or not sex education makes a significant impact on school-aged children’s sexually based decisions. Out of a total of 53 studies, 22 studies showed that, after sex education was implemented, three things changed– individuals waited a longer amount of time to initially have sex, the number of sexual partners per person decreased and the number of unplanned pregnancies and STI diagnoses decreased. Additionally, 27 studies showed that HIV/AIDS rates, alongside overall sexual health, did not improve or worsen the amount of sexual activity, pregnancies or STI rates.

Overall, the results of these studies support the claim that implementing sex education in schools’ curricula is an efficient way to reduce practices that could result in the spread and contraction of HIV/AIDS and other STIs in school-aged children.

Africa’s Implementation of Sexual Education

South Africa has taken the initiative to create and implement a plan for discussing HIV prevention in the school setting. The priorities of this plan include generating attention toward HIV/AIDS for both students and teachers, including information on HIV/AIDS in the school’s curriculum and creating models that display the effects of HIV/AIDS on the school district. This initiative also ensures the protection of students’ and teachers’ constitutional rights and confidentiality about HIV/AIDS status.

Due to these precautions, HIV-positive individuals will not be discriminated against. In order to ensure that the students are learning the best methods of HIV-AIDS prevention, the curriculum will remain up-to-date and teachers will be trained accordingly.

Comprehensive Sexuality Education

Eleven sub-Saharan countries have introduced various courses into their schools’ curricula to educate them on sex education in varying degrees. Rwanda and Zambia adhere to what the United Nations has deemed necessary for students to learn through sex education. These classes fall under the category of “Comprehensive Sexuality Education” (CSE). These classes discuss healthy relationships between genders and how to decrease sexual violence; in addition to sex education in a way that is appropriate for younger children and adolescents. The main objectives of CSE are to teach children:

  • to acknowledge their “health, well-being and dignity”
  • to create considerate relationships, both sexually and socially
  • to analyze their choices and consider how the potential consequences will affect themselves and others
  • how to comprehend and protect their rights throughout their lives
There has recently been evidence of CSE being used at an increased rate in certain areas of Africa. Burundi, Senegal, Nigeria, Mozambique and Zambia have all ensured that their teachers and educators receive the proper education and training on CSE. Zambia’s program has been especially praiseworthy because the costs of instruction for sexual and reproductive health are included in the budget for education.

Various projects and initiatives throughout the world have provided crucial information pinpointing which countries need HIV prevention through sexual education implementation. The collaboration between many organizations has allowed third world countries to access resources that would be more difficult to achieve independently. Fortunately, the difficult challenges that impoverished countries have faced to prevent the spread of HIV in sub-Saharan Africa are becoming more attainable.

– Amanda Kuras
Photo: Wikimedia Commons

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Mass Incarcerations in Colombia: 4 Things to Know

mass incarcerations in Colombia
Colombia is a country in South America with a population of nearly 50 million as of 2018. It is the second largest country located in South America, with the 38th largest economy in the world. The Colombian Justice System is structured similarly to that of the United States, where defendants have the right to a fair and speedy trial and are sentenced by judges.

Colombian prisons have a problem with mass incarceration. They have an overall capacity of 80,928 people; however, their actual capacity is at 112,864 people as of May 2020. The majority of people are incarcerated for non-violent crimes, such as drug-related offenses. Mass incarcerations in Colombia are also an issue because they lead to other health issues, such as the transmission of HIV and tuberculosis. Here are four more important things to know about mass incarcerations in Colombia.

Mass Incarcerations in Colombia: 4 Things to Know

  1. Capacity Rates: There are 132 prisons in Colombia with a total maximum capacity of just over 80,000 people. Despite this capacity, Colombian prisons have an occupancy level of 139.5%, or just over 112,000 people. Women make up approximately 6.9% of this number, or about 7,700 women. There are no children actively incarcerated in Colombian prisons. The country’s congress has regularly fought against the release of prisoners, instead choosing to keep the prisons full.
  2. Effects of COVID-19: Prison riots are becoming increasingly common in Latin America with the spread of the coronavirus. Mass incarcerations in Colombia have created panic amongst the prisoners, who have demanded more attention to their conditions. The Colombian Minister of Justice, Margarita Cabello, has not outwardly acknowledged the prison riots as demands for better care against COVID-19. Instead, she has stated that the riots were an attempt to thwart security and escape from prison. Furthermore, because of the scarcity in the number of doctors, many prisoners have contracted and/or died from COVID-19. In one particular prison in central Colombia, over 30% of staffers and prisoners have become infected with the virus.
  3. Infectious Diseases: Beside COVID-19, mass incarcerations in Colombia have allowed for the spread of other infectious diseases, such as HIV and tuberculosis. Colombian prisons have designated cell blocks for those who contract HIV, as it is common for prisoners to engage in sexual relationships with guards. Healthcare facilities are not readily available in prisons, and condoms are in scarce supply. Active cases of tuberculosis (TB) also correlate with mass incarcerations in Colombia. Approximately 1,000 prisoners per 100,000 were found to have active cases of TB with little to no access to affordable care.
  4. Possible Solutions: Local citizens Mario Salazar and Tatiana Arango created the Salazar Arango Foundation for Colombian prisoners. Salazar conceived the idea after being imprisoned in 2012 on fraud charges and seeking ways to make serving his sentence more tolerable. The Salazar and Arango Foundation provides workshops for prisoners in the city of La Picota and puts on plays for fellow inmates. Prisoners have found the organization to be impactful to their self-esteem and their push for lower sentences.

Mass incarcerations have had major impacts on the Colombian prison system. Issues such as food shortages and violence have given way to poverty-like conditions with little action. Despite these conditions, organizations such as the Salazar Arango Foundation look to make mass incarcerations in Colombia more tolerable for those behind bars. Hopefully, with time, mass incarcerations in Colombia can eventually be eliminated.

– Alondra Belford
Photo: Unsplash

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