HIV/AIDS Prevention in Zambia

Antiretroviral therapy in Zambia has been one of the most effective HIV/AIDS prevention strategies in recent years. Thanks to the efforts of the CDC and the Zambian government, the spread of HIV/AIDS has decreased steadily by 13 percent since 2010.

HIV/AIDS Prevention in Zambia – Strategies

  • Education and Awareness: The effective response and resource allocation from the Zambian government through early HIV testing had a profound effect on the stigma surrounding the virus, encouraging more people to get tested. To that end, the government implemented the GIPA policy, emphasizing equality in medicine free from discrimination. In addition, the National Health Services Act is a government policy aimed at strengthening the structural power of Zambia’s medical field to increase its influence on rural communities. Aside from spearheading research, the act more clearly defines Zambia’s medical infrastructure with a power structure to allocate resources as effectively as possible. Integrating these government programs into the heart of Zambia’s most impoverished communities decreases the chances of an outbreak.
  • Antiretroviral Therapy: As mentioned above, the CDC is also active in Zambia, focusing on early antiretroviral therapy in highly affected areas like the Copperbelt and the western provinces. Within these parameters, 89 percent of those who began treatment immediately are less likely to spread the virus. Outreach programs to reach the more impoverished and marginalized groups have also been successful, with antiretroviral therapy increasing among children from 23 percent in 2009 to 79 percent as of 2019. The government has also promoted the use of Pre-Exposure Prophylaxis (PrEP), a daily course of antiretroviral drugs (ARVs) taken by HIV-negative people which reduces the risk of contracting the virus.
  • Preventing Mother-to-Child Transmission: Through the PMTCT (Prevention of Mother To Child Transmission) plan, Zambia has made great strides aimed at preventing the spread of the virus from mother to offspring by providing lifelong antiretroviral therapy in Zambia. According to the CDC, through early education and effective policy implementation, the health protection agency has prevented 98 percent of HIV-exposed babies from contracting the virus.

Final Thoughts

The lack of access to basic health care and a comprehensive understanding of how HIV spreads, especially in rural communities, produces a hostile environment where exposure risk increases. Furthermore, high poverty and unemployment levels create a shaky foundation where socio-economic growth is key to eliminating the HIV/AIDS epidemic in Zambia. However, increased government spending has sprouted new testing facilities in rural areas, providing quality service where “…the Government is scaling up social protection by increasing allocations to the Social Cash Transfer (SCT) and Food Security Pack (FSP) program[s] and other poverty mitigation measures.”

The key to a structural change in Zambia’s HIV epidemic lies partially in assisting Zambia’s fairly large impoverished community. In addition, antiretroviral therapy in Zambia continues to be a focal point of the government’s long-term plan to eliminate the virus with increased spending on antiretroviral therapy and sex education in a bid to secure more prosperous futures for its citizens.

Adam Townsend
Photo: Pixabay

Facts About Life Expectancy in Malawi

The landlocked country of Malawi has a life expectancy rate of 60.2 years for males and 64.3 years for females. While this is much lower than the global average of 69.8 years for males and 74.2 years for females, it represents an improvement from previous years. These eight facts about life expectancy in Malawi will help shed light on the reasons for the low rate as well as what the country has done, and can still do, to improve it:

8 Facts About Life Expectancy in Malawi

  1. HIV/AIDS: As of 2017, an estimated 1 million people in Malawi were living with HIV/AIDS which places the country at 10th in the world in terms of the number of people living with HIV/AIDS. In addition, there were also 13,000 deaths from the virus in the same year. Still, the government has made major strides to curb the epidemic in the last 10 years. Part of its strategy includes providing free condoms as well as educating young people. As of 2018, 78 percent of all people living with HIV in Malawi are on medication. There was also a decline in the number of new infections from 55,000 in 2010 to 38,000 in 2018.
  2. Maternal Health: In 2015, maternal mortality stood at 634 deaths for every 100,000 live births. This is considerably higher than the global average of 216 deaths per 100,000 live births. However, it represents a significant improvement as the government along with support from USAID has been able to reduce maternal mortality by 53 percent between 1990 and 2013. Today, more expectant mothers in both rural and urban areas are now receiving prenatal care as well as skilled birth assistance.
  3. Child Health: Great improvements have also been made in terms of child health, as most children under 5 in both rural and urban areas are vaccinated. This has helped reduce deaths from communicable childhood diseases such as measles, tetanus and pneumonia. The Ministry of Health has also implemented strategies like deworming and has also distributed vitamin A supplements to deal with other major causes of childhood death.
  4. Fertility Rate: In the 1980s Malawian women had about seven children per woman. Today, that number is at 5.5 children per woman. The high fertility rate affects life expectancy in Malawi as it puts pressure on the government to provide adequate social amenities in order to improve people’s lives.
  5. Population Growth: According to a 2018 census, Malawi’s population is 17.6 million people. By 2020 this is projected to hit 20.2 million, before doubling by 2050. This rapid population growth puts a lot of pressure on the country’s land, water and forest resources and threatens life expectancy as most Malawians derive their income from agriculture. The Third Malawi Growth and Development Strategy (MGDS III) sets out a number of policies including promoting family planning and sexual and reproductive health rights as a means to slow population growth, and better managing migration and urbanization.
  6. Infectious Diseases: Malawians are at very high risk of contracting infectious diseases. Food and waterborne diseases include diarrheal diseases and typhoid fever. In order to deal with diarrheal deaths, Malawians are in need of nutritious food as well as an unpolluted environment. Other diseases include malaria, dengue fever and rabies from animal contact. The country has been dealing with malaria by subsidizing mosquito nets. Additionally, Malawi is one of the three African countries taking part in a malaria vaccine pilot. The pilot aims to reach 360,000 children each year across Kenya, Ghana and Malawi.
  7. Water and Sanitation: One in three Malawians do not have access to clean water while 9.6 million people do not have a decent toilet. This affects the life expectancy in Malawi as it leads to an increase in diarrheal diseases. With the support of UNICEF and organizations such as Water Aid, the government of Malawi has made significant progress in reducing the number of people who lack access to safe water. Additionally, the rate of open defecation has declined from 29 percent in 1990 to four percent in 2015.
  8. Education: Malawi introduced free primary education in 1994 which put a strain on the education system. This is because the infrastructure, number of teachers and number of teaching and learning materials were inadequate when compared to the number of students who enrolled. It resulted in poor performance by the students, especially in terms of literacy.  The government of Malawi has been making an effort to improve the education sector by allocating more than 20 percent of the national budget to education.  It has also partnered with bodies such as USAID and UNICEF to improve literacy levels as well as student enrollment and completion rates. An educated and skilled population will help increase Malawi’s economic growth. Educational reforms will help reduce the unemployment rate which is currently more than 20 percent.

Malawi is considered one of the poorest countries in the world, and a lot still needs to be done to improve the lives of its people. It is however clear that the government is working with the support of nonprofit organizations around the world to make life better for its people.

Sophia Wanyonyi
Photo: Flickr

Access to Medicine in Developing Countries
In the late 1990s, large pharmaceutical companies priced their HIV/AIDS medications at an exorbitant $15,000 a year, barring people from access to medicine in developing countries who suffered the most from the epidemic and raising public outcry across the world. Pharmaceutical companies defended their right to maintain these prices in the name of protecting their patent of these medical, life-saving drugs.

The good news is, leading pharmaceutical companies in recent years have turned their focus to helping the poor, in what they call “equitable pricing strategies.” This strategy targets middle-to-lower income countries. Large companies have priced HIV/AIDS medication for only $100 a year, a drastic decrease since the 1990s, and have made treatments for malaria, tuberculosis, hepatitis C and some cancers accessible in developing countries.

Impact of These Changes

Nearly 20 million Africans are on HIV/AIDS medication now, a statistic that stands in stark contrast to the thousands of people that died of HIV/AIDS each day in Africa 20 years ago due to the lack of access to medicine in developing countries.

The Access to Medicine Index ranks pharmaceutical companies on how accessible and affordable their medicine is. It ranked 20 of the world’s largest (research-based) pharmaceutical companies, indicating a healthy trend towards affordable medicine that can go to those most affected by common illnesses and diseases.

The Access to Medicine Foundation performs a deep analysis of these companies. For example, the foundation observes whether companies pay attention to the socioeconomic statuses of their customers in order to tailor the prices of their medicine effectively. The foundation has also remarked that large pharmaceutical companies have departed from previous policies and have granted licenses to generic drug companies who can produce a greater quantity of medicine at a lower price.

Cause of These Changes

Statistics show disparities between the health of high-income and low-income populations. In 2011, the life expectancy between high and low-income countries was as extreme as a 36-year gap. Given such a difference, it makes sense that pharmaceutical companies have specifically researched and developed cures for five main illnesses, including lower respiratory infections, diabetes, hepatitis, HIV/AIDS and malaria, that lead to premature deaths. It did this by improving access to medicine in developing countries.

FDA Involvement

The U.S. Food and Drugs Association (FDA) has also taken part in global health and access to medicine crisis in developing countries. The FDA awarded $50,000 to four companies and $25,000 to two companies during its National Capital Consortium for Pediatric Device Innovation. These six companies received awards for their innovative solutions for childcare, ranging from devices that diagnose spinal deformities to technology that cleans central-line associated bloodstream infections. Developing and investing in these technologies could have huge impacts on access to medicine in developing countries where child mortality still poses a serious threat.

Growth for Big Pharma

There are also economic reasons for these changes in the pharmaceutical industry. Research has shown that improving public health boosts the economy. Even incremental improvements in life expectancy can increase yearly economic growth rates by nearly 0.5 percent. As populations become healthier, it increases the demand for medicine. Consequently, pharmaceutical companies have witnessed growing revenues from emerging markets in developing countries. In fact, two large pharmaceutical international companies, AstraZeneca and Sanofi, receive a third of their revenues from developing markets. In short, improving access to medicine in developing countries means future profits for pharmaceutical companies.

The Upshot of These Changes to Access of Medicine in Developing Countries

Despite all the progress that pharmaceutical companies have made, there is still a persistent problem they will only invest and research in drugs that they think will make a profit. Drug prices are often high because of rebates, the cost of taking on risks for development and research of life-saving drugs and fees for intermediary pricing companies. In order to change these persistent industry practices, public pressure seems to play the strongest role, especially in America.

The continued change will come from the convincing of top leadership in pharmaceutical companies to focus on helping the world’s poor and sick, especially in developing countries. For example, under the direction of former Chief Executive, Andrew Witty, for GSK, a British-based pharmaceutical company which has always ranked first on the Access to Medicine Index, has pledged to do as much as he could for the poor in Africa and Asia. It is up to large pharmaceutical companies to set the tone in this new era of providing access to medicine in still developing countries.

–  Luke Kwong
Photo: Pixabay

10 Facts About Life Expectancy in Mali
In 2020, the country of Mali will celebrate its 60th anniversary of independence from French colonial rule. However, since 1960, Mali has had a tumultuous history filled with numerous civil wars, coups and failed revolutions. Despite these setbacks, Mali is making strides to improve the quality of life for its citizens. Here are 10 facts about life expectancy in Mali.

10 Facts About Life Expectancy in Mali

  1. According to the CIA World Factbook, the life expectancy of a citizen of Mali is 60.8 years on average or 58.6 years for males and 63 years for females. This puts Mali at a rank of 206 out of 223 countries for life expectancy. These 10 facts about life expectancy in Mali will explain why.
  2. Mali reported 43 births per 1,000 people in 2018, the third-largest figure in the world. Many expect the country’s population to double by 2035. This has led to overcrowding in the capital city of Bamako. In response, the World Bank has begun to invest in the infrastructure of Malian cities via performance-based grants for communities.
  3. Despite this massive population growth, Mali suffers from extreme infant and child mortality, which adversely affects life expectancy in Mali. In 2015, 114 out of 1,000 Malian children died by the age of 5. Recently, organizations like WHO and UNICEF have begun to sponsor community case management initiatives that focus on improving health conditions in impoverished areas. Areas where these initiatives occurred, such as Bamako’s Yirimadio district, have been able to reduce child mortality rates to up to 28 deaths per 1,000, about a quarter of the national rate.
  4. In Mali, the maternal mortality rate is very high. The U.N. estimates that there are 630 maternal deaths per 100,000 live births. This is partly because only one in four births in Mali have someone with proper birthing training, but deep-rooted societal attitudes that restrict women’s rights may also be a cause. According to the Center for Reproductive Rights, an organization fighting against maternal mortality in Mali, child marriage and female genital mutilation are both common in Mali, which both cause higher risks to the mother during birth. The organization has called upon the Malian government to “meet its national and international commitments and take the necessary steps to reduce maternal mortality.”
  5. The leading cause of death in Mali is malaria, which accounts for 24 percent of deaths in the country. To address this, the Malian government has partnered with global organizations such as the CDC to distribute anti-malarial medications during the country’s late autumn rainy season, in which most cases of malaria appear. This partnership was established in 1995 as part of the CDC’s global initiative to stop diseases in other countries before they can reach the U.S.
  6. Illnesses that often stem from a lack of access to clean water, such as meningitis and diarrheal diseases, cause a significant number of deaths in Mali. Twenty-three percent of the population of Mali overall and 35.9 percent of the rural population lacks access to clean drinking water, and 78.5 percent of rural Malians lack access to proper sanitation. This leads to the spread of the diseases mentioned above. An organization called Charity Water has invested over $9 million to give rural Malians access to clean water and sanitation by building wells and pipe systems, allowing Malians to tap into the country’s rich aquifers for clean drinking water.
  7. Malnutrition causes 5 percent of deaths in Mali. According to the World Food Program, 44.9 percent of the country live in poverty, which is a significant cause of food insecurity. To combat this, programs like the World Food Program have been working on distributing nutritious meals to Malian families, as well as setting up long-term programs to create infrastructures such as roads and dams.
  8. HIV and AIDS cause 3 percent of deaths in Mali. Although HIV infections in the country have risen by 11 percent since 2010, deaths from the disease have gone down by 11 percent in the same period. Efforts by the CDC and other organizations have focused on treating HIV to prevent victims of the disease from going on to develop AIDS, as well as improving blood safety measures.
  9. Mali suffers from a significant shortage of physicians, with 0.14 physicians and 0.1 hospital beds per 1,000 people, compared to 2.59 physicians and 2.9 beds in the U.S. Despite that, the country has recently taken significant steps forward on providing universal health coverage via a $120 million initiative from the government, which will focus on training more doctors, broadening access to contraceptives and improving care for the elderly.
  10. Eighty percent of Mali relies on agriculture for a living. Although Malian farmers have been fighting soil degradation and lack of access to modern equipment, initiatives like Feed the Future have been working to improve conditions for Malian farmers. As a result, Mali poured $47.34 million into its agriculture industry in 2017.

As these 10 facts about life expectancy in Mali show, life expectancy in Mali is significantly lower than in other parts of the world, but the country is making strides forward to combat illness and poverty. With help from the global community, Mali is moving forwards towards a brighter future.

– Kelton Holsen
Photo: Flickr


The UN’s 2016 High-Panel report on global access to medicine opens with an inspiring message: “Never in the past has our knowledge of science been so profound and the possibilities to treat all manner of diseases so great.” It is hard to debate that recent advancements in targeted cancer therapy and HIV drug development indicate a bright future for the Rx world. The potential for positive change may go unrealized, however, if access to medicine remains limited. To serve the 3.5 billion people without basic medical services, along with the 100 million who find themselves in extreme poverty because of high medical costs, governments and organizations have to confront the complex economic forces undermining global access to medicine. This article will discuss two such forces and consider how international actors have responded.

Too Big to Heal?

Economic orthodoxy holds that the equilibrium of a product’s supply and demand will determine its price, but medication prices do not adhere to this rule. This is because firms in the pharmaceutical industry possess the key to market distortion. Monopoly power or the ability for firms with outsized market shares to raise prices without experiencing a corresponding drop in sales. Pharmaceutical companies tend to obtain monopoly power for several reasons, such as:

  1. High entry costs, especially those associated with research and development. This excludes smaller, potentially disruptive firms from the market.
  2. The continuation of company consolidation. In the past 20 years, a group of 60 different pharmaceutical companies shrank to a mere 10.
  3. Large profits. Profits are huge, with the 10 highest-earning companies netting a 20 percent profit margin on average. This allows these companies to fortify their already-large market share. Most importantly, once a company patents a drug, it holds exclusive title to the production and distribution of that drug for 20-25 years.

During that period, no lower-priced, generic substitutes can enter the market. Equipped with this uncontested control, these companies can charge high prices for their products, as those who need them will have no other choice but to bear the cost. Yet some, especially individuals in poorer countries dealing with diseases like Hepatitis C and cancer, simply cannot afford these costs.

There are many individuals and corporations who are attempting to solve this problem, however. For example, GlaxoSmithKline (GSK), a pharmaceutical company based in London, England, is trying to put an end to exorbitant prices for prescription drugs in low-income countries. In March 2016, it announced that it would not seek patent protection for its drugs in 50 of the world’s poorest countries. By doing this, the company opened the path for smaller companies to bring lower-priced, generic versions of their drugs to the market. So far, the approach has been effective, earning GSK the top spot in the 2018 Access to Medicine Index. The positive publicity it receives from the ranking will hopefully motivate other companies to follow suit.

R&D Incentives

While the economics of monopoly power generates the problem of overpricing, the incentives of research and development make it such that many medicines needed in low-income countries go underproduced. As mentioned above, patents spell large rewards, but it costs $800 million on average for a company to obtain one and to bring a drug to the market. This pressures companies to develop the drugs that are most likely to produce a substantial financial return. Additionally, as the UN High-Panel notes in its report, this means that widespread, treatable diseases can oftentimes go unaddressed. For example, antimicrobial-resistant viruses and parasites threaten to kill as many as 10 million people annually by 2050, yet drug companies worldwide have developed virtually no new antibiotics in the past 25 years. In the absence of this innovation, however, public-private R&D partnerships have proven to be a successful substitute. The Global Fund is an example as it has saved 27 million people that malaria, HIV/AIDS and tuberculosis threatened by raising money from both public and private sources and collaborating with domestic task forces and commissions.

A Reconceptualization

Economic barriers to improve global access to medicine remain, but more and more people are starting to conceptualize the problem as an ethical one rather than an economic one. However, ensuring access to health care and maintaining market efficiency are not mutually exclusive. For example, cost-efficient drug production techniques are necessary to disseminate medicines at reduced prices. But other times “policy incoherencies,” as the UN High-Panel report calls them, force decision-makers to choose between the promotion of economic innovation and the provision of public health. Thanks to leading companies like GlaxoSmithKline and compassionate organizations like the Global Fund, the international community is starting to opt for the latter.

James Delegal
Photo: Flickr

Fight Disease in the DRC
With 80 million hectares of arable land and over 1,100 precious metals and minerals, the Democratic Republic of the Congo has quickly established itself as a large exporter in the lucrative diamond industry. Despite this, the DRC ranks 176th out of 189 nations on the UN’s Human Development Index and over 60 percent of the 77 million DRC residents live on less than $2 a day. Internal and external war, coupled with political inefficacy and economic exploitation, has hindered the country’s ability to combat poverty and improve health outcomes. Listed below are some of the most deadly diseases that are currently affecting individuals in the DRC and the different strategies that governments and NGOs have taken to fight disease in the DRC.

3 Deadly Diseases Currently Affecting Individuals in the DRC

  1. Malaria

The DRC has the second-highest number of malaria cases in the world, reporting 15.3 million of the WHO-estimated 219 million malaria cases in 2017. Of the more than 400 Congolese children that die every day, almost half of them die due to malaria, with 19 percent of fatalities under 5 years attributed to the disease. However, some are making to reduce malaria’s negative impact.  For example, the distribution of nearly 40 million insecticide-treated mosquito nets, or ITNs, has helped lower the incidence rate by 40 percent since 2010, with a 34 percent decrease in the mortality rate for children under 5. The DRC government procured and distributed the nets with international partners such as the Department for International Development, Global Fund and World Bank. In addition, the President’s Malaria Initiative, a program implemented in 2005 by President Bush and carried out by USAID, has distributed more than 17 million nets. UNICEF has also been a major contributor in the efforts to fight malaria and recently distributed 3 million ITNs in the DRC’s Kasaï Province. However, the country requires more work, as malaria remains its most frequent cause of death.

  1. HIV/AIDS

Among its efforts to fight disease in the DRC, the country has made significant progress recently in its fight against HIV/AIDS. As a cause of death, it has decreased significantly since 2007, and since 2010, there are 39 percent fewer total HIV infections.

This particular case illuminates the potential positive impact of American foreign aid. The DRC Ministry of Health started a partnership with the CDC in 2002, combining efforts to fight HIV/AIDS. PEPFAR, signed into U.S. law in 2003 to combat AIDS worldwide, has invested over $512 million since 2004, which has helped to fund antiretroviral treatment for 159,776 people. In 2017, it funded the provision of HIV testing services for 1.2 million people.

The country is also addressing mother-to-child transmissions. In the DRC, approximately 15 to 20 percent of mothers with HIV pass the virus onto their child. The strategy to end mother-to-child transmissions involves expanding coverage for HIV-positive pregnant women, diagnosing infants with HIV earlier and preventing new infections via antiretroviral drug treatment. UNAID, The Global Fund and the DRC Ministry of Health have undertaken significant work to accomplish these objectives and their efforts have resulted in the coverage of 70 percent of HIV-positive pregnant women.  However, much work remains to cover the remaining 30 percent of pregnant HIV-positive women.

Overall, there is still a lot of necessary work to undergo in the fight against HIV/AIDS in the DRC and around the world.  In total, UNAIDS estimated that HIV/AIDS was the cause of 17,000 deaths in the DRC in 2018.  While this is a decrease from previous years, it shows that the DRC still has a long way to go in order to fully control the spread of the disease.  Additionally, there must be more global funding. The U.N. announced on July 2019 that annual global funding for fighting HIV/AIDS decreased in 2018 by almost $1 billion.

  1. Ebola

Since 2018, the DRC has undergone one of the world’s largest Ebola outbreaks. On July 17, 2019, WHO declared the outbreak an international health emergency. Since August 2018, more than 2,500 cases have occurred, with over 1,800 deaths.

However, the country is making efforts to prevent the transmission and spread of Ebola in the DRC.  Recently, more than 110,000 Congolese received an experimental Ebola vaccine from Merck & Co. The vaccine is called rVSV-ZEBOV, and studies have shown the vaccine to have a 97.5 percent efficacy rate.  This vaccine provides hope that people will be able to control Ebola breakouts in the near future.

While there have been attempts to fight disease in the DRC in recent years, such as malaria, HIV/AIDS and Ebola, each disease remains a major issue. In the coming years, the country must continue its efforts.

– Drew Mekhail
Photo: Flickr

Venezuela's Failing Economy
People know Venezuela as one of the most diverse environments in the world because of its natural features, landscape and wide range of wildlife. Venezuela has massive oil reserves and ranks in the top list among countries such as Saudia Arabia, Canada and Iran, making it the most urban country in Latin America. However, in only approximately six years, the country has seen a drastic economic decline. Venezuela’s failing economy has placed the country in headlines across the world. This article will highlight a few casualties resulting from Venezuela’s financial crisis, as well as evaluating its causes.

The Impacts of Venezuela’s Economic Crisis

The extended effects of Venezuela’s economic crisis are hitting those who choose to remain in the country the hardest. Venezuela’s failing economy has led to a severe shortage and rationing of resources, including food, water and electricity. Despite the country being oil-rich, many Venezuelan’s are questioning why they are struggling. “It’s so unfair; we are such a rich country. It’s not fair that this is happening,” Jakeline Moncada told the Washington Post.

Many turn to natural water reserves despite safety concerns as these reserves often come from sewage drains leading to the spread of preventable diseases. Meanwhile, frequent power outages have caused water sanitation facilities to cease proper function. Physicians have noticed an increase in illness that commonly results from contaminated water and food, such as amoebiasis.

Estimates determine that more than 60,000 Venezuelans who started treatment for HIV now lack access to antiretroviral medications as a result of Venezuela’s failing economy. Many Venezuelan’s that could afford medical services before, now experience challenges attempting to access medical and health services. As a result, those dependent on medications must make costly trips to neighboring countries or hope to find donated medicines from organizations outside of the government.

As Venezuela’s economy has drastically decreased, a survey that the country’s top universities conducted estimated that more than two-thirds of the population lives below the poverty line. As the country experiences hyperinflation of 1.7 million percent, many families cannot afford to feed themselves more than one meal a day. Various organizations have ceased publishing the statistics of the country after specific data showed significant negative changes. For example, The Health Ministry stopped reporting data in 2017 after reports indicated a high rise in infant mortality rates. After the inflation rates suddenly rose, Venezuela’s central Bank discontinued publishing its figures in 2016. In this instance, Venezuelan organizations stopped sharing information once the statistics showed unfavorable characteristics.

Accessibility

Venezuela’s failing economy has led to difficulty accessing resources like medicare, and as a result, nearly 10 percent of the Venezuelan population is emigrating to other countries. Although Venezuelans are having a few problems getting out of the country, there has been a more significant challenge getting resources in. The military has restricted many resources from passing through its borders or at least the areas where they have the right to. The Pemón community, which borders along Brazil, has spoken in support of permitting assistance through its territory. This region, known as La Gran Sabana, also contains the only paved crossing between the two countries.

When Nicolás Maduro became president in 2015, many nations did not consider him the country’s leader but rather Juan Guaidó, the Venezuelan opposition leader. As a result, Maduro severed the remaining diplomatic relations between Venezuela and the U.S. as well as ceasing the accessibility of aid into Venezuela. Maduro has resisted outside assistance, describing the efforts as the United States desiring to meddle in Latin American affairs. However, many believe that the sudden decline results from mismanagement of funds and corruption.

Venezuela has several countries willing to provide support as it endures this period of financial difficulty. It will only receive this aid if its government allows, though, as it regulates the resources that pass through its border. Once nations can establish a common interest and agree on how to address the issue, Venezuela’s reconciliation can begin.

Kimberly Debnam
Photo: Flickr

 

HIV/AIDS in Botswana

Botswana is a landlocked country in Southern Africa that is bordered by South Africa, Zimbabwe and Namibia. It has a relatively stable economy, boasting the fifth highest GDP per capita in Africa. However, in 2019, Botswana had the third-highest rate of HIV/AIDS in the world with 21.9 percent of the population living HIV positive. This article will discuss the efforts that the government of Botswana and other global companies and organizations have made to help bring this epidemic to a halt.

“Masa” Program

HIV/AIDS rates have been steadily declining every year in Botswana since 2000, when the HIV/AIDS epidemic reached its peak in the country with 26.3 percent of people testing positive. In 2001, Festus Mogae, the President of Botswana at the time, pledged to devote significant resources towards stopping the spread of the virus. In 2002, through a partnership with the Botswana government, the American pharmaceutical company Merck & Co offered to donate antiretroviral therapy drugs (ART) free of charge to individuals in communities throughout the country. By 2013, the program, called “Masa,” had reached more than 220,000 individuals.The Masa program also helped fund infrastructure development and health care professional training. In addition, new treatment centers and resource centers were constructed to help treat patients and contributed to the decline in HIV/AIDS rates.

UNDP Efforts

In 2010, the United Nations Development Programme (UNDP) entered into a cost-sharing agreement with the government of Botswana. The agreement called for increased funding to help improve the capacity and effectiveness of HIV/AIDS treatment in the country. So far, the agreement has helped to improve Botswana’s institutional capacity to fight HIV/AIDS. In addition to these efforts, in 2010, the UNDP, in conjunction with the Unified Budget Results and Accountability Framework (UBRAF) helped fund additional HIV/AIDS prevention efforts. These efforts included a commitment to reduce the stigma of using HIV/AIDS-related services. This program has been successfully implemented in various communities across the country.

“90-90-90” Targets

In 2011, UNAIDS set what they dubbed “90-90-90” targets for the year 2020. The goal is to diagnose 90 percent of individuals with AIDS, have 90 percent of diagnosed individuals on antiretroviral therapy (ART) and ensure that 90 percent of individuals with AIDS achieve viral suppression. Botswana has already achieved these targets, as have other countries including Cambodia and Denmark. This is a testament to the commitment made by the Botswana government to fight HIV/AIDS.

New Health Strategies

In 2017, of the estimated 380,000 people diagnosed with HIV/AIDS in Botswana, almost 320,000 had access to treatment. However, in June 2019, President Mokgweetsi Masisi announced a renewed commitment to fighting HIV/AIDS in Botswana. This renewed focus includes two new five-year health strategies — the Third National Strategic Framework for HIV/AIDS and the Multi-Sectoral Strategy for the Prevention of Non-Communicable Diseases — to help further tackle the problem of HIV/AIDS in Botswana. These health strategies are set to be reevaluated in 2023.

– Hayley Jellison
Photo: Flickr

Affordable Medicine in Developing Countries
In 1997, thousands of people in low-income, developing countries died every day from treatable diseases because they could not pay the high price pharmaceuticals charged for medicine. Today in these same regions, millions are receiving treatment and mortality rates have dropped dramatically as drugmakers around the world are providing affordable medicine in developing countries.

Pharmaceuticals in the Past

In 1997, AIDS was killing thousands of Africans each day. In the same year, people with AIDS in the U.S. were enjoying greater life expectancy and quality of life, with AIDS-related deaths dropping by 42 percent thanks to the use of anti-HIV drugs.  With a $12,000 per patient per year price tag and strict patent laws forbidding the purchase of generic types, these life-saving drugs were inaccessible to millions of AIDS victims in developing countries. Unwilling to lower their prices, the pharmaceutical industry looked on while thousands of people died with treatment just beyond their reach.

Refusing to sit by as its people died every day while a treatment existed, South Africa legalized the suspension of drug patents in 1998, making it possible for South Africans to purchase generic anti-HIV drugs at affordable prices. Thirty-nine top pharmaceutical companies promptly engaged South Africa in a lawsuit, attempting to keep them from accessing HIV drugs at a reduced cost for fear that other countries would follow and the industry would miss out on profits.

The pharmaceuticals soon dropped the lawsuit when the international community received word that drug companies were keeping poor and dying people required medicines. However, drug prices remained inaccessibly high.

Finally, a turning point came in 2001 when Indian drug-maker Cipla shocked the international pharmaceutical industry by announcing its plan to sell anti-HIV drugs directly to poor nations and to Doctors Without Borders for only $350 per patient per year (less than $1 a day). Cipla’s offer exposed the huge markups pharmaceutical companies were profiting from, prompting several major drug-makers to lower their prices and make drugs more accessible to developing countries.

Pharmaceuticals Today

Today, the pharmaceutical industry’s attitude and approach toward providing affordable medicine in developing countries have greatly shifted. The Access to Medicine Foundation shares that nearly all major drug companies have goals for addressing access to medicine now, while many have pioneered innovative ways to reduce costs and create medicines and vaccines for low- and middle-income countries (LMICs). In the past 10 years, drug makers have doubled the number of medicines they are developing for LMICs.

Nine companies that own patents for HIV/AIDS treatment now use their IP rights flexibly to allow LMICs to import and purchase generic supplies. As a result, over 14 million Africans are now on HIV drugs, and AIDS-related deaths dropped drastically by nearly 40 percent over the past 10 years.

Seven drug companies have made efforts to include the poorest populations in their customer base, focusing on products for diabetes, heart disease and other NCDs which are a rising problem in the developing world. In 2017, the leading drug maker, Pfizer, partnered with Cipla to sell chemotherapy drugs to African countries at prices just above their own manufacturing cost, selling some pills for as little as 50 cents.

Several leading pharmaceuticals now partner with generics to produce affordable drugs for Africa, Asia and Latin America, and a fair price strategy now covers 49 percent of products. Thanks to the improvements in the pharmaceutical industry, hundreds of thousands of people now have access to affordable medicine in developing countries.

– Sarah Musick
Photo: Wikimedia Commons

 

Cure for HIV
HIV/AIDS affects nearly 37 million individuals around the world every day, with close to 5,000 new infections daily. The virus’ reach extends around the world, affecting individuals in all six habitable continents. However, new research from the University of Nebraska Medical Center indicates that there may now be a cure for HIV. The journal, Nature Communications, published this research on July 2, 2019, and it has major implications; such a cure could bring relief to countless millions of individuals who currently suffer from the virus.

Treatment Development

Using mice as test subjects, researchers utilized a “long-acting, slow-effective release” antiretroviral (referred to as LASER ART) therapeutic strategy in conjunction with gene-editing (done with a tool called CRISPR-Cas9) to remove the HIV DNA from the mice’s cells. The HIV virus replicates by inserting its genome directly into the host cell’s genome. The LASER ART treatment stopped the HIV virus from replicating, while the gene-editing removed the HIV DNA from the infected genomes. Together, the two therapies completely removed HIV in roughly one-third of the mice tested. While that number may seem low, researchers say that there is potential that the treatment could be 100 percent effective on mice within two to three years. These results are a promising step towards a human cure for HIV.

HIV/AIDS Reduction & Potential Roadblocks

HIV affects millions of individuals every day around the world. Over 70 percent of affected individuals reside in Sub-Saharan Africa. Many of these individuals do not have the financial means to purchase HIV/AIDS treatments; given this, it is of the utmost importance to have a cheap, efficient, alternative solution to cure HIV/AIDS.

While the issue of HIV/AIDS is very prevalent in a number of countries, many positive steps have moved towards the reduction of disease prevalence in recent years. Such positive steps have included preventative measures such as educating individuals about HIV transmission as well as on the benefits of using condoms during sexual intercourse. There has also been work done to help increase the availability of health services that can give individuals a proper HIV diagnosis (roughly 50 percent of individuals with HIV do not know that they have the virus). The push for a cure, however, has proved difficult, and while this latest innovation brings great promise, there are some potential roadblocks to implementation. Assuming that humans can use the treatment, researchers must still access whether it will work for those in rural areas where the disease is often most prevalent. Finding an effective treatment is only one part of the problem. There is still a lack of trained individuals and sufficient infrastructure to help administer the treatments currently available and a cure for HIV will not solve that part of the problem.

Potential Impact on Global Poverty

If development goes smoothly, this new treatment has incredible potential to solve one of the biggest problems currently plaguing both the developed and developing world. While the treatment requires a lot of testing and work, researchers have taken an important step towards curing a disease that many previously believed to be incurable. In time, HIV may no longer be a lifelong burden, but rather something that someone can eradicate with two simple injections.

– Kiran Matthias
Photo: Flickr