Poverty in LesothoIn the country of Lesotho, a mountainous region landlocked by South Africa, there are two playing fields, although neither one of them results in a fair chance of winning a life away from poverty’s grasp. Instead, the two fields paint similar pictures of poverty with contrasting colors. The first field, the lowlands, is statistically less impoverished than its towering companion, the highlands. Agricultural impacts are not the only factor impacting poverty. Here is some information about the impacts on poverty in Lesotho.

Agricultural Impact

According to UNICEF, 82% of children living in the highlands are multidimensionally poor compared to 53% of children living in the lowlands. This is due to the fact that the natural landscape of the lowlands is more suitable for agricultural endeavors as opposed to the rocky, mountainous terrain of the highlands. Since the majority of Basotho, the proper term for the country’s natives, grow their own food, a season of drought could greatly impact not only the current year’s harvest but future harvests as well because seeds would not reproduce for the Basotho to use the following year. Children lacking food and proper nutrition also increase student growth. In 2014, stunting impacted approximately 88,900 of 275,000 Basotho children. Stunting can result in a compromised immune system and poor cognitive performance which adds an unnecessary barrier to childhood education and future employability.

Educational Impact

One of the impacts on poverty in Lesotho including both the highlands and the lowlands is the absence of proper and consistent education. School is free for elementary-aged children. However, after these years, children have to purchase school uniforms to continue their education. This pulls many children out of the cinder-block classrooms and back into their homes. At home, they must often care for younger siblings or other abandoned children even though they have yet to reach puberty.

Allison Barnhill of Reclaimed Project, a nonprofit that partners alongside local churches to educate, equip and care for orphaned children, spoke with The Borgen Project saying, “Education is a huge part of it [poverty]. If you want to grow up and change the country, you have to be educated.” Reclaimed Project acknowledges this need by providing uniforms and school supplies to children in its program. These children also receive educational training outside of the classroom after each school day at one of Reclaimed Project’s orphan care centers. The care centers are located in two different highland villages and allow students to grow forward. Later in 2020, Reclaimed Project plans to open a skills training center to teach high schoolers and local Basotho basic computer, mechanic and sewing skills.

HIV/AIDS Impact

Another of the impacts on poverty in Lesotho is HIV/AIDS. It is easy to tell if a family does not have the means to purchase school uniforms. However, there is a type of poverty the Basotho people face that others cannot see. It is invisible and inescapable. HIV and AIDS fell upon the country of Lesotho in the 1990s, creating a wave of economic and social destruction. Currently, it affects 74% of children under the age of 2 with 23.2% of adults affected. Many victims of the disease are Basotho who once held steady jobs and now must succumb to treatment interventions.

Unfortunately, Basotho culture still highly stigmatizes this disease. Medical clinics, which predominantly serve people infected by HIV and AIDS, have specific days when people come to receive treatment. Therefore, if others witness a Basotho walking towards the clinic on this given day, they might assume that he or she has HIV or AIDS. This makes the unknown known and creates a social scar. To prevent this from happening, some Basotho willingly choose to avoid treatment and risk death to maintain their social standing. Overtime, refusing treatment can result in the inability to work, further lengthening the downward economic spiral of poverty.

Fortunately, with the passage of time comes the gradual reformation of these ideals. Within a five-year time span, the average percentage of full acceptance of Basotho living with HIV increased by 3.5%. This indicates that community acceptance is improving. However, HIV/AIDS treatment funding is limited and a burden on the government of Lesotho. In fact, the government funds less than half of Lesotho’s HIV/AIDS response. The majority of funding for HIV/AIDS reform comes from international resources. Therefore, the country relies heavily on the generosity of middle-income countries and nonprofits.

Future Impact

Speaking on the many dimensions of poverty, Barnhill stated that, “The issues are always compounding. If you’re living on the brink, it doesn’t take much to push you over the edge.” Fortunately, by 2030, the number of people living near the edge should reduce as the World Bank works with the Government of Lesotho to reduce extreme poverty. Even though poverty plagues the country of Lesotho, the country has come a long way from its roots. Lesotho continues to grow forward, creating branches of prosperity and leaves a budding of hope.

– Chatham Kennedy
Photo: Chatham Kennedy

Poverty in MalawiLocated in Africa’s Southern region, Malawi is a nation-state with a size comparable to that of the state of Pennsylvania and a population estimated to reach a little more than 20 million by July 2020. The country is primarily dependent on the agricultural sector which employs close to 80% of the population and remains predominantly rural. Poverty in Malawi is very high and it manifests itself in various indicators, such as in the economy, education and healthcare, rendering it one of Africa’s poorest nations. Here are six facts about poverty in Malawi.

6 Facts About Poverty in Malawi

  1. Throughout the past few decades, Malawi had made tangible progress in several areas of human development. For instance, primary education completion rates have increased by 17% between 2004 and 2013. Meanwhile, mortality rates for children under 5 decreased by approximately 48% between 2004 and 2015. Similarly, the country’s maternal health has improved as mothers are receiving necessary prenatal and birth care as well as increasingly using contraceptives.
  2. Despite the abovementioned improvements, Malawi continues to have high poverty rates, posing substantial challenges to human development and growth in the African nation’s quality of life. In 2017, its GDP per capita (PPP) amounted to only $1,200, leading it to rank among the poorest countries in the world.
  3. In 2016, Malawi’s poverty rate reached 51.5%. That number remained slightly unchanged at 52% in 2018, according to a 2018 integrated household report, which emerged as a result of a joined effort between the Malawian government and UNICEF. The report also highlights child poverty as a particularly problematic issue as more than two-thirds of children in rural areas in Malawi live in poverty.
  4. Higher poverty rates in a given society tend to go hand in hand with sizable challenges underpinning the state of the economy. Malawi’s dependence on agriculture implies that climate-related problems can be a serious threat to its national economic wellbeing. This was the case during the 2015 and 2016 drought, which negatively impacted the country’s economy. Alinafe Nhlane, a mother and farmer in Muona Village, exemplified another instance of Malawi’s economic volatility when she recounted that she had lost all of her crops as a result of the 2019 Cyclone Idai.
  5. In addition to the fact that an estimated 1 million Malawians are living with HIV/AIDS and that the degree of risk of infection with diseases such hepatitis A, typhoid fever and malaria is very high, the physician/population ratio in the country is quite low at 0.02 in 2016. In light of the recent COVID-19 global developments, the U.N. Resident Coordinator in Malawi, Maria Jose Torres, expressed her fears that the spread of the virus, even if minuscule, could be destructive to the country’s feeble healthcare system.
  6. On the other hand, it is notable that UNICEF along with U.K. Aid have worked to distribute hygiene and sanitation materials throughout Malawian districts to lead the fight against the virus. Ms. Nhlane also benefited from $33 she received from the World Food Program, aid which she will use to feed her family.

Malawi indeed continues to face paramount challenges that threaten the very livelihood and wellbeing of its citizens. Nonetheless, it has improved in many aspects including child health. For progress to spread and increase in scope and magnitude, however, it remains critical for the efforts addressing poverty in Malawi to carry on.

– Oumaima Jaayfer
Photo: Flickr

HIV in South Africa

With the end of apartheid, South Africa became the epi-center of the AIDS epidemic due to an influx of migrants. Despite the rapid rise of HIV infections and AIDS deaths in Africa in the 1980s, the response to HIV in South Africa was slow. This was a result of the narrative created about the disease in the Global North that connected the spread of the virus to the behaviors of injection drug users and gay men. Another factor was that the spread of the disease in Africa looked incredibly different as more than half of people living with HIV in sub-Saharan Africa are women.

When HIV and AIDS started having a widespread impact on South African society and communities, President Mbeki followed the arguments of Peter Duesberg, who stated that HIV could not be the cause of AIDS and was opposed to Western medical approaches to solving the epidemic. In 2003, the health minister, Tshabalala-Msimang advocated for nutritional solutions to alleviating HIV in South Africa and was notoriously known as “Dr. Beetroot”. Through Mbeki’s reasoning, continuous efforts from other countries to offer help for AIDS were declined and civil society groups raised grave concerns over the need for urgent action. One of the biggest groups to raise concerns and have the greatest impact in the region was the Treatment Action Campaign.

About the Treatment Action Campaign (TAC)

The Treatment Action Campaign (TAC) was founded in 1998 as a tripartite alliance between the AIDS Law Project and COSATU, a key organization that fought apartheid in the 1980s. TAC was formed as a response to HIV in South Africa due to the lack of urgency that the government and the medical industry had in responding to the virus.

The transformative and charismatic Zackie Achmat, a previous gay rights activist who was diagnosed in 1990, initially led the organization.

TAC was a human rights-based organization focused on fighting racial discrimination and economic exploitation. This group was not only technical, but also political in their arguments as they utilized justifications for actions through moral, scientific, and economic reasoning. The TAC also developed partnerships with activist groups such as the Gay Men’s Health Crisis (GMHC) and ACT UP, which have aided training “treatment literacy” and initiated a wider peer education network.

In addition, TAC formed partnerships between elites, academics, professionals, and press, but ultimately served to strengthen the effort for the poor to become advocates for themselves. Through the framework TAC developed and their understanding of the disease, TAC used their model for social mobilization, advocacy, legal action, and education. 

TAC’s First Action

TAC’s first action was to argue for the right to access medical resources – namely antiretrovirals (ARVs). TAC found inherent fault with the World Trade Organization’s 1995 TRIPS agreement, which legally protected intellectual property and patents.

 In 1998, TAC demanded that the South African government introduce the program “Prevent Mother-to-Child HIV Transmission” (PMTCT). The social movement around advocacy for PMTCT was predominantly made up of poor black women living with HIV in South Africa. The issue was framed as a moral issue: that the pharmaceutical company GlaxoSmithKline (GSK), the patent holder of AZT, was profiteering off the sale of the drug. TAC demanded a price reduction and in framing it as a moral issue with reference to the South African constitution, the organization succeeded in its demand for legal action.

Key Tool to Success

A key tool for TAC’s success was its use of legal resources and advocacy. Not only did TAC make legal demands of the South African government, but they collaborated with progressive lawyers, scientists, and researchers to develop plans and alternative policy proposals. The organization went beyond simply advocating for the poor. They also based policy on the entitlement of rights to the individual. TAC has taken successful mitigation measures on five occasions; in 2001-02, for a national program for PMTCT; in 2004, for implementation of ARV roll-out; and in 2006-07, for access to ARVs for prisoners in Westville and KwaZulu Natal province, for ongoing litigation to challenge the profiteering of pharmaceutical companies and for denouncing alternative treatment to defend the Medicines Act. These cases were supported by not only the efforts of lawyers but the actions of TAC which involved marches, media campaigns, legal education, and social mobilization.

These actions were not possible only as a result of the advocacy and partnerships formed by the TAC, but also the structures in which the group functioned. Article 27 of the South African constitution, which took effect in 1997, includes the right to access medical services, reproductive health care, and emergency medical treatment. Through these efforts, TAC has helped advocate for an improved response to HIV in South Africa, a process that must continue to further combat the spread of the virus.

Danielle Barnes
Photo: Flickr

Uganda has been noted as an African country that is on the rise out of poverty. This is partly due to foreign assistance coming from countries like the United States. The United States Agency for International Development (USAID) has carried out work in Uganda excelling improvements in economy, health care, education, and the state of democracy.

Economic Growth

USAID has been engaged in Uganda’s efforts to reduce poverty and hunger. Among many other goals, Uganda and USAID are working with public and private sectors to promote investment, agriculture production, food security and efficient energy usage. US based programs like Development Credit Authority, Feed the Future Youth Leadership for Agriculture and Global Development Alliances, have assisted in Uganda’s success of lowering the poverty rate. By connecting Ugandans with businesses to market their products, USAID is helping to improve household incomes as well as stabilize the country’s gross domestic product. Investments in the future are also being made by training youths for the job market and connecting farmers, refugees, and workers with agricultural resources and trade opportunities.

State of Democracy

USAID works with the Ugandan government to bring up issues regarding transparency, human rights, and justice for citizens. USAID’s democracy program in Uganda particularly focuses on women and youths as a voice to be heard. The USAID’s overall objective of promoting civil society encompasses the opportunity for citizens to part-take in the governing process while leaders are working for the people. Improving the democracy of Uganda will help build a strong and independent country, which in turn will partake in flourishing the entire region.

Education and Training

With a high number of vulnerable children, USAID is working with the Ugandan government to implement plans providing education for young children, while focusing on teaching languages and educating on health, HIV/AIDS and violence. USAID is also striving to develop the future workforce with the Better Outcomes for Children and Youth activities, which helps youths cultivate the skills needed for success, both in work and in life. There is also new training available for teachers, with improved computer technology.

Health and HIV

USAID’s effort in addressing health care issues in Uganda includes eliminating HIV/AIDS through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), reducing tuberculosis infection rates, and eradicating malaria under the U.S. President’s Malaria Initiative (PMI). Other health care programs include child and maternal health, family health, and disease prevention, as well as educating young women on sexual violence and HIV/AID protection. Since many diseases are spread through poor sanitation, USAID’s work in Uganda also focuses on improving water sanitation and hygiene practices.

Humanitarian Transitions

Through USAID, the U.S. is helping Uganda with emergency food supplies, health care assistance, and conflict resolution in democracy to improve the country’s status and enhance people’s quality of life. The continuing basis of humanitarian aid effort has made the U.S. the “largest single honor of humanitarian assistance in Uganda,” according to Anne Ackermann, a photojournalist with USAID.

USAID’s continuing work in Uganda, along with the positive outcomes seen by the country so far, underscores the effectiveness of overseas involvement and the power of foreign aid in general. Foreign aid will always have an important role in country development and growth.

– Hung Le

Photo: Flickr

Why HIV and AIDS in Russia is Steadily IncreasingHIV and AIDS have increased in Russia throughout the years. In fact, Russia’s failure to implement government policy, education and resources has allowed HIV/AIDs rates to increase at an unknown rate. These rates allow poverty and infection to course throughout the country. According to estimates from the World Bank, more than 10 percent of the total population will have HIV/AIDs by 2020. Also, as many as 21,000 people per month could die from infection of HIV and AIDS  in Russia. Experts anticipate that these values will continue to increase by 10 to 15 percent each year.

Efforts

The Russian government has made minimal efforts toward eradicating this epidemic. Numbers show that HIV and AIDS in Russia primarily occur among certain groups of people. In 2016, individuals who inject drugs accounted for the largest number of confirmed cases at 48.8 percent.

Further, in 2015, government reports determined that more than 38 percent of newly diagnosed cases occurred in women. These numbers pushed experts to believe that heterosexual transmission would significantly impact the heterosexual population. In fact, in 2017, researchers found that heterosexual transmission occurred in 48.7 percent of the Russian population.

Additionally, sex work is one of the leading causes of HIV and AIDS in Russia. People’s stigmas with this specific group of people inevitably cause an increased risk for those who utilize this service. Sex workers are often unable to access health care resources to decrease the likelihood of spread, thus making it challenging to eradicate HIV and AIDS in Russia.

Barriers

The marginalization of certain groups of people has led to a reduction in the treatment and prevention of HIV and AIDS in Russia. One study showed those who are living with HIV/AIDS and are injecting drugs are unlikely to seek treatment. Only 10 percent of that specific group has sought treatment. Some experts assume that the inaccessibility of information and denial of treatment or prevention services are the primary reasons for this low percentage.

Also, women who are sex workers are particularly vulnerable. Studies have shown the unwillingness to seek treatment due to negative opinions regarding the occupation of these women.

Another obstacle is funding for HIV and AIDS education, which is very minimal if it exists at all. Financial support for HIV/AIDS programs in Russia remains a significant barrier to treatment and prevention. Dedicated support for HIV and AIDS in Russia has decreased and no programs to educate and prevent the disease have replaced it.

Solutions

In 2013, the Aids Healthcare Foundation in Russia registered with the Russian Federation to ensure the implementation of programs to contribute support financially, provide education about HIV and treat those living with HIV. Russia made further efforts in 2017; the Russian Federation committed to a 90-90-90 target by 2020. This goal aimed to diagnose, update treatment status and suppress the viral loads of 90 percent of people living with HIV.

In 2018, the Russian Federation released a progress update, showing substantial improvements from 2017. Overall, 81 percent of people living with HIV received confirmed diagnoses, 45 percent of people who knew of the diagnosis received treatment and 75 percent of people who obtained treatment experienced viral suppression.

At the 28th meeting of the Health Council of the Commonwealth of Independent States, Ms. Veronika Skvortsova, the Russian Minister of Health stated that “We have to provide every person living with HIV with quick access to the correct treatment. The Ministry of Health plans to increase the coverage of people living with HIV who know their status on antiretroviral therapy to 75 percent by 2019, and by 2020 the figure should reach 90 percent.”

Rates of HIV and AIDS in Russia continues to raise concerns across the country. Without Russian government implementation of policy toward a movement of eradication, estimates suggest that the numbers will continue to rise.

Tiffany Hill
Photo: Wikimedia

HIV/AIDS Stigma in Mexico
As of 2018, approximately 230,000 people in Mexico were living with HIV. About 75 percent of people with HIV in Mexico were aware of their status and about 70 percent were accessing antiretroviral therapy (ART). While ART does not cure HIV, it is a combination of drugs that is able to suppress the virus and significantly reduce transmission rates. HIV is highly prevalent in certain populations in Mexico including sex workers (specifically in the Tijuana red light zone), prisoners, gay men and the transgender community. As a result, there is a significant HIV/AIDS stigma in Mexico.

Since 2003, The Universal Access to ART Program has guaranteed access to ART in Mexico through the national health system. Additionally, this policy ensures the availability of HIV tests for individuals without social security. These governmental actions are significant steps towards reducing HIV prevalence, but 30 percent of individuals living with HIV in Mexico are still not accessing treatment. This is in part due to stigma and fear surrounding the social implications of receiving testing or treatment.

Implications of the Stigma Surrounding HIV

The social stigma around HIV and discrimination based on sexual orientation in Mexico is one of the issues that discourage many people from getting tested. Tradition and religion, especially in rural and poorer areas, are major obstacles to destigmatizing HIV. At the root of this issue are the “machismo” culture and anti-gay beliefs.

As a result of this stigma, people have associated getting tested for HIV with being gay or promiscuous. Consequently, many people are unaware of their HIV status and are not receiving treatment out of fear of discrimination. About 20 percent of patients who are undergoing treatment for HIV do not keep up with their treatment plans or their follow-ups which is also in part due to stigma and discrimination.

Mexico should prioritize the addressing of HIV/AIDS stigma. There is no point in putting resources into treatments and facilities without first ensuring that people obtaining testing or complying with their treatment plans. The quality of the treatment and health care is crucial but will not matter without patient cooperation.

Recent Progress

UNAIDS set forth the 90-90-90 goal for HIV treatment in 2015. This target mobilized efforts globally to test 90 percent of people living with HIV, to provide 90 percent of those people with HIV treatment, and to achieve viral suppression for 90 percent of those by 2020. Mexico has made significant progress towards this goal but has yet to achieve it.

Recent policies have addressed the HIV/AIDS stigma in Mexico, such as the code of conduct from the ministry of health, which includes training to prevent discriminatory behavior and promote respect and patient confidentiality for HIV cases. This code of conduct aims to reduce stigma and discrimination based on gender and sexual orientation in health centers throughout Mexico.

A study in 2016 that examined the prevalence of HIV among men who have sex with men (MSM) in Tijuana, Mexico concluded that there is an urgent need for new testing methods. These interventions include non-stigmatizing, confidential testing for younger and less educated MSM, as well as timely referral to HIV treatment. Confidential HIV testing will not necessarily reduce stigma, but it has the potential to increase the number of people who are willing to obtain testing and have access to ARTs. In addition to these testing methods, Mexico could implement community-based HIV awareness programs that educate and destigmatize HIV to target HIV/AIDS stigma in Mexico and encourage testing.

Overall, Mexico has made significant progress to decrease the prevalence of HIV/AIDS in Mexico. The country has been making great strides to overcome various obstacles, including socioeconomic inequality and HIV/AIDS stigma in order to increase the number of people receiving testing and treatment.

– Maia Cullen
Photo: Pixabay

Health Care Progress
The Democratic Republic of the Congo (DRC) has faced various issues surrounding health care in the past several decades and some have amounted to significant setbacks for the nation. However, the country has seen health care progress in the DRC in recent years and international organizations are looking forward to the future.

Improving Vaccines for Citizens

International partners have been able to pair with the government in the DRC to initiate this health care progress, and the country has been polio-free for four years as a result. The lack of infrastructure and geographical size of the DRC makes it particularly difficult to reach milestones in health care progress. The United States Agency for International Development has been a vital component of health care progress in the DRC serving over 12 million people spanning a multitude of different provinces. The organization has additionally remained committed to providing HIV/AIDS support in 21 concentrated zones. These focused zones are crucial for health care progress in this region.

In addition to the international organizations doing their part to help health care progress in the DRC, the country’s Ministry of Health has been working diligently in recent years to improve vaccines and their means of storage. Keeping vaccines in the appropriate cooling storage containers and fridges has proved especially difficult due to the DRC’s tropical climate. In a 2018 plan, the Ministry of Health aimed to provide immunizations to almost 220,000 children and improve vaccine storage conditions. Partnerships with outside organizations have helped to deliver 5,000 solar-powered fridges specifically intended for vaccine storage and they will distribute more later on.

Progress in Hospital Conditions

One of the first dependable and reliably functional hospitals opened in Kavumu through an initiative called First Light. This hospital garnered a brand new electronic medical records system to make keeping track of patient history astronomically easier than before. The hospital staff received tablets to mobilize the system and expedite the process of patient diagnosis and care. With this technology, the hospital is able to treat nearly three times more patients than it was able to without these resources – originally, doctors were only able to see approximately six or seven patients per week.

The hospital also implemented a motorcycle ambulance program so patients no longer have to walk or have others carry them to emergency care in order to tackle the issue of having no ambulance access in the city. This program utilizes motorcycle sidecars specifically to transport patients, which was a successful method that people originally used in South Africa.

The Future of Health Care in the DRC

The World Health Organization (WHO) has continuously been an important player in the health care progress of the DRC. It has partnered with non-governmental organizations to deliver medicines and various other resources to hospitals and clinics in areas where people have limited health care access. In the interest of continuing the progression of the country and establishing a functional health care system, WHO also remains dedicated to analyzing and quantifying statistics within the country that gives organizations clues on what they need to do next. These statistics are able to pinpoint issues in specific areas, therefore making it easier for government and international organizations to act, provide aid and implement programs for improvement. The continuation of this data collection will hopefully allow for more health care progress in the future.

There is still a lot to do in the DRC when it comes to health care. There are organizations and efforts dedicated to treating all of the diseases and epidemics that threaten the country’s current health care progress like malaria, cholera, tuberculosis, HIV/AIDS and more. Some organizations involved in the nation even specifically focus on the care of mothers and children or improving sanitation conditions.

It will be small, incremental changes over time that will lead to continued health care progress within the region. The country cannot fix everything at once, but the collective efforts and partnerships of international organizations and governmental entities have already dragged the country out of its most difficult struggles with health care and access to health resources. The continuation of these practices will ensure the building and sustainment of a functional and reliable health care system, therefore alleviating the worries of so many citizens within the DRC.

For now, health care progress in the DRC is on track and only time will tell how these small initiatives eventually reform and reshape the country’s health care system entirely.

Hannah Easley
Photo: Flickr

CDC Intervention in Haiti
Haiti is the poorest country in the western hemisphere with a UNDP national poverty index ranking of 68th. The country is also home to one of the world’s most populated cities without a centralized sewage system –  Port-Au-Prince. Although the developing country is vibrant, Haiti is still struggling. Since the initial destruction that the 7.0 magnitude earthquake in 2010 brought, cholera and HIV have ravaged the nation. However, as a direct result of the CDC intervention in Haiti, the nation has not fallen. The CDC has provided financial and technical assistance to the Government of Haiti (GOH) since 2002. In the 2010 earthquake’s aftermath, the CDC refocused on both immediate health necessities and public health systems within days of the U.N.’s arrival. CDC intervention in Haiti assisted the GOH in developing disease surveillance systems and establishing a competent public health force aimed to aid Haiti in developing a proper disease outbreak response.

This past decade, Haiti has not seen much progress due to reform efforts growing stagnant. Subsequently, the changes the country has seen thus far have turned out to be unsustainable and/or have been ill-fitted solutions to Haiti’s unique predicament. Fortunately, CDC intervention in Haiti has been critical to the continued survival of many, and the number of people saved will hopefully continue to grow.

Haiti’s Cholera Epidemic and the CDC

The GOH and the CDC have also been collaborating to devise a longterm plan to eliminate cholera. CDC intervention in Haiti has increased patient case surveillance, laboratory capacity, oral cholera vaccine (OCV) administration and clean water and sanitation access in efforts to curb cholera’s spread

One of these efforts includes the Haitian Ministry of Health (MOH) building the National Cholera Surveillance System (NCSS) in conjunction with the CDC support. The platform is a rapid identifier of concentrated outbreaks, providing critical guidance to further prevent future outbreaks. Thanks to these efforts, along with others, incidence rates dropped from 112 cases per every 100,000 in 2017 to 25.5 cases for every 100,000 in 2018.

The CDC’s “Foot-Soldiers” in the Battle Against Cholera

Through the design of training programs, protocols and supplemental assistance, the CDC has created an entirely new workforce titled TEPACs or officially the Techniciens en Eau Potable et Assainissement pour les Communes. Having been key in Haiti’s disease prevention, these “foot-soldiers” ensure the safety of water sources, improve sanitation standards and routinely assess communal water systems and sources for free chlorine. They also performed Haiti’s first inventory of those sources; inventory of resources provide valuable information to donation/volunteering groups. Alongside the efforts of the CDC, TEPACs has launched the WASH initiative – coordinated work in the area of water, sanitation and hygiene – in a supplemental effort to eradicate cholera from Haiti.

CDC Impact On the AIDS Crisis

It is estimated that 150,000 people living in Haiti have HIV/AIDS. CDC intervention in Haiti is achieving more control over the AIDS epidemic. Outlining the concern of the epidemic and the impact of CDC support, 98 percent of all pregnant women and 100 percent of TB patients that CDC clinics saw received tests for HIV. Further, all TB patients that tested positive for HIV also received antiretroviral therapy (ART) in 2018. 

The CDC and the President’s Emergency Plan For AIDS Relief (PEPFAR) have sought to better medical treatment, fortify health care systems, improve laboratory information networks and cover medical fees. The development of information-sharing systems to track data of HIV patients has saved countless lives.

CDC Provides Household Water Treatment and Storage

The CDC also implemented household water treatment and storage (HWTS) to support adequate sanitary conditions for Haitians. HWTS has the potential to provide safe drinking water in primarily rural households. CDC intervention in Haiti has offered HWTS product certification developmental protocols and a national strategy for HWTS programs and product evaluation. The Direction Nationale de l’Eau Potable et de l’Assainissement (DINEPA) intends these programs to support disease prevention and treatment in Haiti.

A Solution to the Underlying Sanitation Problem

While recovery has been slow, CDC intervention in Haiti has been an immensely influential factor in public health. One aspect of public sanitation the CDC does not have a direct influence on is the waste that litters Haiti.

Today, the capital, Port-Au-Prince, is still without central sewage. With every rainfall, a potentially lethal flood of human fecal matter, urine and other harmful substances accompany the water. 

The country is in dire need of infrastructure reforms specifically for the needs of Haiti and its people. The CDC has dedicated itself to controlling and minimizing epidemics, but it has yet to address flooding latrines and a lack of proper sewage disposal systems despite their inflammatory influence on disease.

Flaure Dubois has a potential solution to Haiti’s flood problem. Dubois proposes the Haitian government hire those working to clean latrines, called Bayakous, to create jobs for Haitian citizens. Officializing the Bayakou occupation would bring a wage increase and higher public esteem. If the GOH and the CDC work in conjunction with Bayakous to educate citizens about the dangers of raw sewage, people might be more willing to pay for Bayakou services. Further, it would encourage the sewage shipment to treatment plants, rather than it going into canals. A larger influx of latrine waste enables Haiti’s one functional plant to operate at peak performance and support economic growth in the sanitation sector.

Government-funded Bayakous provide a basis to expand Haiti’s waste-management industry, eventually increasing aptitudes for efficient waste treatment/disposal methods. Expansion of this industry could result in a higher degree of sanitation and a lower rate of disease transmission.

The GOH or the CDC’s involvement in waste management would lead to superior safety and higher circulation of information for Haitian citizens and workers in the sanitation industry. Employing Bayakous has the potential to sponsor the country’s most important pillar in ensuring safe water sources and sanitation. By offering better equipment, methods and working conditions CDC intervention in Haiti can support sustaining health improvements. Haiti needs a sustainable solution to the root of its sanitation problem before it can begin to have lasting-recovery.

– Hana Burson
Photo: Pixabay

10 Biggest Problems in the World 
There is no better time to focus on the biggest problems in the world. The everlasting tightened world economy, war threats and lingering diseases all ubiquitously affect human lives in every corner of the world. The United Nations (U.N.) has compiled a list of the current 10 biggest problems in the world.

 10 Biggest Problems in the World

  1. Peace and Security: Civil conflicts in Syria, Libya and Yemen, Russian aggression over Ukraine and its neighbors and tensions in the South China Sea are some global peace and security threats that are in existence today. These threats cost many lives due to terrorist acts and population displacement. The U.N. has 16 peacekeeping operations currently underway with nine in Africa, three in the Middle East, two in Europe and one in the Americas. With a peacekeeping budget of approximately $8.2 million, it keeps over 125,000 military personnel, police and civilians grounded and armed. The U.N. has made some progress with success stories coming from Burundi and Sierra Leone. U.N. forces eliminated more than 42,000 weapons and 1.2 million rounds of ammunition. It also demilitarized 75,000 fighters, including children, in Sierra Leone.
  2. AIDS: Among these 10 biggest problems in the world, AIDS is still a global health issue with 37.9 million people living with HIV. HIV newly infected around 1.7 million people and 770,000 people died of AIDS-related illnesses in 2018. Many global initiatives have emerged to lower the number of HIV cases including the GMT Initiative and TREAT Asia. The Foundation for AIDS Research, amfAR, lowers the number of AIDS cases with its GMT Initiative by supporting HIV organizations in developing countries to provide better education about HIV, expand prevention services and advocate for more HIV treatment and prevention funding. The TREAT Asia initiative links a network of clinics, hospitals and research institutions to perform research on HIV and AIDS treatments within the Asia-Pacific region. Many people (23.3 million) living with HIV in 2018 were undergoing antiretroviral therapy. New HIV infections have fallen by 16 percent since 2010 and AIDS-related deaths have fallen by 55 percent since the peak in 2004.
  3. Children in Poverty: Children around the world regularly do not have a fair chance for health, education and protection due to armed conflicts, violence and poverty. Millions of young children in 2019 did not have basic health care and proper nutrition resulting in stunted growth. The Millennium Development Goals have been in place for the past 15 years to help address the above issues affecting children. The Bill & Melinda Gates Foundation has been working with governments, the U.N., other NGOs and the private sector to broaden the impact on addressing child poverty with a particular focus on child malnutrition.
  4. Climate and Agriculture: The United Nations Intergovernmental Panel on Climate Change’s Fifth Assessment Report stated that human activities cause climate change and that the impacts are adverse. Climate change ties to world poverty by negatively impacting agriculture with increasing energy use, decreasing food production and increasing food prices. Many say that more water is necessary to grow crops due to high temperatures and drought, downpour rain in other areas causes sea level rises and that people require more lands with favorable climates. Russia, Ukraine and Kazakhstan had low yield on their crops in the summer of 2010 due to excessive heat that led to very high food prices, starvation, malnutrition and poverty. Some agricultural areas around the world have made improvements to their agricultural practices such as scaling sowing time, using different cultivation techniques and testing different cultivars.
  5. Democracy: Countries around the world often experience democracy deficit, weak institutions and poor governance. The U.N. is working to bring democracy to countries around the world by working with each country’s government to promote fair and exemplary governing practices, facilitate transparency and accountability and advise on new constitutions. The United Nations Democracy Fund (UNDEF) is funding projects that promote human rights, civil society and democratic inclusion. UNDEF is funding projects to include youths in elections in Cote d’Ivoire, promote gender equality in Palestine and support citizens in elections in Brazil.
  6. Poverty: The United Nations poverty facts and figures show that approximately 8 percent of the world’s workforce and their families live off of less than $1.90 daily. High poverty rates exist in small and deserted regions with armed conflicts, and approximately 55 percent of the world’s population has no social protection such as cash or food benefits. The condition of those living in poverty is improving following the U.N.’s 2030 Agenda for Sustainable Development. In fact, the percentage of the world’s population living off of $1.90 or less per day in 2015 is down to 10 percent from 16 percent in 2010.
  7. Hunger: Statistics have identified that 821 million people around the world suffered undernourishment in 2017, 149 million children had stunted growth and 49 million children under 5 years old experienced wasting due to malnourishment. The World Food Programme, U.N. Food and Agriculture Organization, World Bank and the International Fund for Agricultural Development are working together toward the Sustainable Development Goal to end hunger, maintain food security, improve nutrition and promote excellent agricultural practices. The World Bank Group is working with partners to promote farming practices, improve land use, grow high-yield and nutritious crops and instruct on storage and chain supply to prevent food loss.
  8. Gender Equality: Women in more than 60 countries cannot get citizenship. Sixty percent of people lacking basic literacy skills are women and one-third of women experience sexual violence, according to U.N. Women. The United Population Fund supports the protection of women’s rights through the law. They helped fight for women’s access to reproductive health care in Ecuador and Guatemala. The United Population Fund also helps to build shelters for trafficked women in Moldova and girls fleeing mutilation in Tanzania.
  9. Health: Half of the 7.3 billion people worldwide do not have access to adequate health services, according to the world health statistics of 2019. The World Health Organization (WHO) is leading the efforts in addressing world health issues which include malaria, women’s health and tuberculosis. For the Ebola virus outbreak in West Africa in 2014, WHO deployed experts, medical equipment and medical teams to set up and run mobile laboratories and treatment clinics.
  10. Water: In 2019, 2.2 billion people did not have access to safe drinking water and 297,000 children under 5 years old died from diarrheal diseases. Eighty percent of wastewater went back into the ecosystem without prior treatment in 2017. The U.N. is promoting agreements among countries to ensure better usage of water. The 2015 Addis Ababa Action Agenda includes policies and measures that incorporate finance, technology, innovation, trade, debt and data to support the achievement of the Sustainable Development Goals including water sanitation and water usage.

These 10 biggest problems in the world may bring uncertainty and worry, however, many organizations are planning and implementing initiatives to solve these issues. People can provide support to these organizations either financially or through direct involvement to aid in eliminating these challenges.

Hung Minh Le
Photo: Pixabay

 

 

HIV in the United Arab Emirates
HIV infection is a critical global health threat and a prevailing issue in the Middle East, which had the second fastest-growing HIV epidemic in 2016. Although some identify the HIV/AIDS situation in the United Arab Emirates (UAE) as low-prevalence, there are some substantial concerns that people should not neglect. The recent shift in attitude towards HIV in the UAE contributes to addressing the existing concerns and issues.

HIV Data

The UAE ranks as number one in the world for the lowest prevalence of HIV (per percentage of the adult population). However, it is crucial to keep several factors in mind; the country only includes the local population in the available data as anyone who applies for a residence/work permit in the UAE must take a medical examination identifying HIV-negative results. In addition, the UAE may deport those already living in the UAE who test HIV-positive.

The first cases of HIV in the UAE emerged in reports in the 1980s and reached a cumulative total of 780 cases among UAE national citizens by the end of 2012. According to the World Health Organization, the number of new HIV cases per year increased from 25 in 2010 to 49 in 2016, which, despite the increase, remains significantly low. Due to the lack of available recent data on HIV seroprevalence in the UAE, increases in the number of cases are neither precise or updated. Indeed, the reported number of cases only represent the people who had officially registered themselves during screenings of blood donations, premarital testing, pregnancies and patients with tuberculosis. Accordingly, the available data may underrepresent or exclude groups with the highest risk exposure including people who have sexual relations and those who inject drugs.

Current Issues

HIV/ AIDS remains a sensitive and taboo topic in the UAE due to the lack of knowledge and awareness regarding the issue as well as strong beliefs that people can only transmit HIV through religiously forbidden sexual relations. Indeed, a study from 2016 identified 48 percent of students as having low knowledge on the topic and misconceptions, contributing to the stigmatization and discrimination of people living with HIV.  

As Human Rights Watch reported, prisoners with HIV in the UAE suffer segregation and isolation from others in the prison, thus facing systemic stigma and discrimination. Moreover, non-national detainees with HIV encounter considerable risks while in Emirati prisons, as reports determined that the prisons denied some lifesaving HIV treatments. Indeed, prison authorities have sometimes delayed or interrupted critical medical treatment for several months, thus increasing the feasibility of health deterioration for non-nationals. Moreover, Human Rights Watch emphasizes the obligation the UAE has to provide appropriate health care to all prisoners without discriminating against non-nationals and reiterates that denying or interrupting medical treatment is a violation of the right to health and possibly the right to life.

Response and Progress

The UAE is shifting its approach regarding the topic of HIV/AIDS and making efforts to strengthen its fight against the virus. The UAE’s National Aids Programme is increasing its transparency and working with the United Nations on reports shedding light on the prevalence of HIV in the UAE. Furthermore, the UAE has aligned its national agenda to the 2030 Sustainable Development Goals (SDG), as both a member of the United Nations and a major international donor. UAE’s Vision 2021 strengthens the importance of improving its health care system and preventing diseases. An essential health-related target in the SDG agenda involves ending the epidemics of AIDS and communicable diseases (Target 3.3), which the UAE specifically addresses in its 2021 national agenda targets.

Dismantling the barrier of HIV/AIDS as a taboo topic in the United Arab Emirates is, nevertheless, crucial for the country to achieve its upcoming targets and reinforce its aspirations for the future. Despite the prevailing issues regarding HIV in the United Arab Emirates, the seven Emirates have demonstrated some progress and willingness to improve the situation by working with international institutions such as the United Nations.

Andrea Duleux
Photo: Flickr