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Poverty and Immunity: An Inextricable Correlation

Poverty and Immunity
Poverty emerges as a relentless enemy across nations, holding millions of lives at its mercy. While the implications of poverty on basic necessities have been studied, a consequence lies hidden within the fine lines of public health — the impact of poverty on the immune system. This article delves into the relationship between poverty and immunity in developing countries, exploring the lack of health measures, and how they intertwine to shape the vulnerability of populations. 

Poor Sanitation Leads to Poor Immunity

Two billion people across the world lack access to clean water and proper sanitation measures, while 10% of the world’s population does not have latrines or means of disposing of waste. The outright lack of sanitation in almost all cases results in pollution of water and food resources due to frequent open defecation and improper treatment. Then begins the vicious cycle of illness, as the constant presence of bacteria in communities can be fatal.

With the constant onslaught of diseases due to substandard sanitation, the bodies of impoverished people can grow weaker without nutrients to strengthen them. A study that Parasite Immunology published states that parasites known as helminths modify the immune system of the host, which results in a damaged immune response to vaccinations and other pathogens. 

Malnutrition and Immunity

Nourishing oneself is vital to provide nutrients to the body in order for several different organ and body functions to perform as normal. When a person does not ingest enough proper food, this can cause an entire host of issues for the body. 

Nutrients that the body needs in small amounts are known as micronutrients. They are small portions of vitamins and minerals that produce substances necessary for the development of the body. Deficiencies in these nutrients are common in low-income countries due to the lack of proper nutrition, which can have damaging effects. 

When there is a lack of nutrients in the body, infections that are contracted can prompt an immune reaction, showing another link between poverty and immunity. These infections can cause fever and bodily irregularities. Malnutrition is a major player in how severe an infection is — it is much more severe in those who have a lack of nutrients in their bodies to support the immune system’s counterattack. 

Limited Access to Health Care 

Without money, it is impossible to access health care across the world, especially as treatments evolve and become increasingly complicated. As a result, poor health restricts workers in developing nations from working properly — and this creates a merciless cycle, limiting one’s capacity to work to earn and to help themselves. Furthermore, several studies display that the wealthiest percentage of people are most often in good health because they are able to finance their health care while working. 

Another grave issue that lack of health care poses in developing nations is an absence of treatments for chronic and incurable diseases. Diseases such as HIV/AIDS are extremely common in poor nations, as they often spread unchecked without a timely preventative response. This results in unbridled death rates and a weakening population that cannot take care of themselves. 

With incurable diseases such as coronary heart disease and HIV/AIDS reigning at the top of prevalent diseases in developing countries, a lack of health care can cause the condition of populations to deteriorate. Both of these diseases gradually tear down the defenses of the immune system, and in the long term, carriers will be more susceptible to falling fatally ill from any disease in their path. 

Making a Change

Though the situation may seem bleak regarding the link between poverty and immunity, there are millions of people working to turn it around. Detailed below are three programs that aim to combat the lack of sanitation, widespread malnutrition and lack of health care that so many poverty-stricken people face. 

  • Sanitation: USAID uses the “Global Water Strategy” to reach people in need across all walks of life. The goal of this program is to increase access to sanitation measures and enhance the care of freshwater across the world. Thus far, the program has been able to provide 65 million people with sanitary drinking water, while 51 million people now have access to sanitation services for everyday excrement.
  • Malnutrition: In response to food insecurity crises across the world, USAID congregated to expend billions of dollars of aid to the countries that were most in need. This program, which was officially dubbed “Food for Peace,” provided millions of people who were severely affected by chronic and generational poverty with food during difficult times — whether they were climate-, conflict- or health-related.
  • Health Care: To combat diseases impairing the potential of impoverished populations, the Bridge of Life Foundation aims to build up global health care through programs that eradicate and treat chronic diseases. Since 2006, the organization has trained community health workers to treat their populations, distributed necessary equipment and improved treatment measures across 15 developing countries.

Looking Ahead 

With organizations such as USAID working to allocate funds and resources to populations in need of food and water and The Bridge of Life providing life-saving health care to struggling populations, the state of these populations will improve extraordinarily over time. By empowering communities and providing necessities, it is possible to break down health care disparities and ensure a thriving future for people in developing countries. 

– Divya Shankar
Photo: Pixabay

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“The Big Catch-up” to Immunity for Children

"The Big Catch-up" to Immunity for ChildrenCOVID-19 has impacted the world in several dire ways, but one that calls for immediate attention is the impact of immunization vaccinations. In light of this, “The Big Catch-Up” to immunity for children is making efforts through initiatives to inspire change.

The Importance of Vaccines

The development of vaccines is, what the president of Global Development at the Bill and Melinda Gates Foundation, Dr. Chris Elias, describes, as “a public health triumph.” Due to vaccines, the world has near eradicated once-fatal diseases such as poliovirus, measles, diphtheria and yellow fever. For instance, poliovirus in particular has seen a 99% decrease in cases since 1988, dropping from 350,000 a year to a record 30. The World Health Organization (WHO) has forecasted that by the year 2030, vaccines could save 50 million lives.

Beyond immunity and personal health, the importance of vaccines extends to communal and financial benefits. There is a domino effect when children who do not receive vaccines become ill. These children miss out on education, while the caregivers experience a loss of income and productivity as they stay home to provide care. A recent study that examined 94 low to middle-income countries reported a $20 return on every $1 “invested in immunization between 2021 and 2030,” according to the U.N. Foundation. That profit is the result of good health enhancing productivity, education and ability.

The Impact of COVID-19

Before COVID-19, the rate of children receiving immunization vaccinations across the globe was at 86%. According to the U.N. Foundation, this percentage dropped to 81% in 2021, representing approximately 67 million children in more than 100 countries with vulnerability to preventable fatal diseases, with reports of increasing outbreaks. In Africa alone, 8.4 million children go without essential vaccines in 2021.

The reasons for this setback all link to COVID-19. Overburdened health workers, decreased access to clinics, diverted resources, attention and supplies, reduced travel, school closures and increased vaccine misinformation all contributed to the lag in immunization vaccinations across the globe. Fortunately, several health organizations are banding together to catch up to the initial progress in immunity.

The Big Catch-Up Plan

Organizations including WHO, UNICEF and the Bill and Melinda Gates Foundation formed “The Big Catch-up,” in response to COVID-19’s impact on immunization vaccinations. Its mission is to, quite literally, catch up to the immunity progress made pre-pandemic and continue to push beyond that. In addition, there are efforts to introduce the HPV vaccine in low to middle-income countries where the risk is highest, according to the WHO.

The plan particularly focuses on providing vaccines to the 20 countries that saw the most decrease in immunity vaccines for children. These countries include Afghanistan, Angola, Brazil, Cameroon, Chad, DPRK, DRC, Ethiopia, India, Indonesia, Nigeria, Pakistan, Philippines, Somalia, Madagascar, Mexico, Mozambique, Myanmar, Tanzania and Vietnam.

“The Big Catch-up” aims to restore immunization levels by:

  • Improving health care workforce
  • Projecting accurate information and enhancing trust around vaccines
  • Strengthening health service delivery
  • Addressing obstacles and gaps to restoring immunization

“Catching up is a top priority. No child should die of a vaccine-preventable disease.” – WHO Director-General Dr. Tedros Adhanom Ghebreyesus.

Doing Important Work

“The Big Catch-up” to immunity for children is crucial to avoiding another pandemic – this time vaccine-preventable diseases that the world had almost eradicated completely. In fact, measles outbreaks are already being reported across the globe, and just a “small pocket…can be enough to fuel pandemics,” according to News Medical. Part of The Big Catch-up’s plan includes integrating immunization into primary health care, so the disruptions to vaccines experienced during the COVID-19 pandemic are never seen again.

“The longer we wait to reach and vaccinate these children, the more vulnerable they become and the greater the risk of more deadly disease outbreaks. Countries, global partners and local communities must come together to strengthen services, build trust and save lives,” said UNICEF Executive Director Catherine Russell.

– Jenny Boxall
Photo: Flickr

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How Somalia Has Converted its Polio Program to Fight COVID-19

Polio Program in SomaliaSomalia is one of the few countries remaining with a risk of poliovirus transmission. The polio program in Somalia was established as a way to eradicate the virus completely as part of the global immunization effort. However, with the arrival of SARS-CoV-2, the polio program in Somalia has been stifled. Somalia ranks 194 out of 195 on the Global Health Security Index. The international recommendation for healthcare workers is 25 per 100,000 people; however, Somalia only has two per 100,000 people. The country also has only 15 intensive care beds for a population of 15 million. It is considered to be among the least prepared countries in the world to detect and execute a quick response to COVID-19.

Effects of the Pandemic on the Polio Program in Somalia

Many of the workers that are part of the polio program in Somalia have suspended all door-to-door immunization due to the ongoing coronavirus pandemic. With travel kept to a minimum, polio samples cannot be flown abroad to external medical labs for testing. In addition to this, millions of polio vaccines will expire in a matter of months.

The global polio immunization program paused at the end of March 2020, leaving more than 20 million workers and medical practitioners without work. The World Health Organization (WHO) estimates that the number of unvaccinated children could reach 60 million by June in the Mediterranean region.

The Polio Program Fights COVID-19

Polio surveillance systems are developed disease surveillance systems. This network of disease surveillance has been able to track the poliovirus and deploy medical teams throughout the world. Now, the polio program in Somalia has shifted its efforts to combat the COVID-19 pandemic. The system’s infrastructure, its capacity and the experience of its medical staff make it prepared to deal with the novel coronavirus. As of July 2020, Somalia had approximately 3,000 confirmed cases of COVID-19 with 930 recovered cases and 90 deaths. The number of actual cases is likely significantly larger, but many cases go undetected due to a lack of testing.

Thousands of frontline workers for the polio program in Somalia started curbing the spread of the coronavirus. These workers form rapid response teams trained to detect COVID-19 cases as well as to educate and raise awareness about the ongoing pandemic in Somalia. WHO’s national staff and local community healthcare workers have joined theses polio response teams, utilizing their resources and skills to tackle the virus.

WHO Support

These teams have traveled to remote areas in Somalia, providing critical information regarding physical distancing, hand-washing, detection of symptoms and prevention. With WHO’s aid, the program has acquired testing kits and equipment to evaluate potential cases of the virus. The surveillance teams have adopted the same procedures that they used for the polio program in Somalia for COVID-19. After collecting potential COVID-19 samples from suspected cases, the rapid response teams transport the samples to external laboratories for testing. Outside humanitarian agencies use the same protocols and operations that they used for the poliovirus.

Furthermore, the response teams continue polio immunization simultaneously with the COVID-19 response. It is essential for the polio program to continue immunization, as Somalia experienced a polio outbreak earlier this year.

How Other Countries Have Adapted

Other countries in the same region have realized the practicality of the polio network. They have accordingly redeployed their own immunization programs to fight COVID-19. For example, South Sudan has converted approximately 80% of its polio workforce to track coronavirus cases in the country. It has trained polio contact tracers to evaluate people for symptoms of COVID-19. Mali has also been engaging its own polio program in response to the ongoing pandemic.

Even though polio and COVID-19 do not have much in common, the polio program is an important tool to fight the pandemic. The Bill and Melinda Gates Foundation, in partnership with the WHO, has been working to equip these polio networks to help countries deal with the pandemic. The suddenness of the pandemic has left no time for countries such as Somalia to prepare. As such, the global polio immunization campaign is a valuable resource for this unprecedented emergency.

– Abbas Raza
Photo: Flickr

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Immunization in Pakistan Resumes During COVID-19

immunization in pakistanDuring the COVID-19 pandemic, 63 polio cases were reported in Pakistan. Four months after the COVID-19 outbreak occurred in Pakistan, more than 50 million children did not receive a polio vaccination, as immunization in Pakistan was delayed. At the end of July 2020, Pakistan was able to complete a round of vaccinations to cover 780,000 children.

Vaccinations and COVID-19

On April 1, 2020, Pakistan went into a nationwide lockdown for a month due to COVID-19. During the lockdown, immunization in Pakistan reduced by more than 50%. This reduction occurred mainly in impoverished regions and areas that were far from service delivery.

Healthcare workers’ contracting COVID-19 led to a halt in immunization services in some areas. More than 150 Expanded Programme on Immunization healthcare workers contracted COVID-19. Additionally, shortages of personal protective equipment (PPE) further reduced immunization, as healthcare workers were concerned about the risk of transmission while providing immunizations without proper PPE.

Transportation Interruptions Delay Immunization

Many immunizations in Pakistan were not delivered due to flight disruptions from COVID-19. Reduced immunization in Pakistan can lead to new outbreaks of other preventable diseases, like measles. The Khyber Pakhtunkhwa Province, an area with a large refugee population and limited healthcare access, has already seen an increase in measles cases.

The lack of public transportation available during the pandemic also made it difficult for many to travel to receive immunizations. People who are at high risk of contracting COVID-19 were often afraid to go out in public and get immunized.

New mothers in particular were not willing to risk the travel to hospitals to get their children vaccinated. One new mother expressed her concern that the absence of vaccinations could lead to contracting preventable diseases, but she was also worried about the coronavirus. Furthermore, multiple private and public hospitals were overwhelmed with COVID-19 and did not allow babies and mothers to receive their immunizations.

WHO’s Restrictions Led to Vaccination Difficulties

After the World Health Organization advised countries to postpone their immunization campaigns, Pakistan halted its door-to-door polio immunization program. The postponement of mass vaccination programs may lead to 117 million children worldwide not receiving a measles vaccine. Countries that have low immunization rates are at the highest risk. Pakistan’s routine vaccination campaign for tuberculosis, for example, reached only 66% of its slated coverage this year, compared to 88% in 2019.

In Karachi, the Health Education and Literacy Programme (HELP) works to support maternal and child health and maximize vaccination coverage. Founder of HELP, Dr. D. S. Akram, said that the delay in immunization could lead to hundreds of thousands of young Pakistanis missing their tuberculosis and polio vaccines. On average, 12,000 to 15,000 children are born in Pakistan every day. Since polio is still endemic in Pakistan, the suspension of the door-to-door polio immunization program may lead to more outbreaks in the future.

Once Pakistan started to come out of its lockdown in May 2020, clinics began to reopen in an effort to continue vaccination campaigns. Pakistan faced two obstacles in attempting to increase routine vaccinations: both opening hospitals and ensuring that parents felt safe to bring their children there. Hospitals had to ensure not only that there were enough vaccinations in supply but also that parents would be willing to get their children immunized.

In Pakistan, children who belong to poor households are affected by vaccination coverage the most. The reduction of immunization in Pakistan has occurred mainly in slum areas, where it is difficult to deliver healthcare products. Despite the delay in immunization caused by COVID-19, Pakistan continues to adapt in its efforts to return to routine vaccination.

– Ann Ciancia
Photo: Flickr

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4 Facts about Measles in the Central African Republic

Measles in the Central African Republic
Measles is a viral infection spread through airborne respiratory droplets from an infected individual. Measles can cause typical flu-like symptoms and a skin rash, and, under certain circumstances, it can lead to death. While the illness is virtually obsolete in more developed countries, other countries, such as the Central African Republic, struggle with keeping it at bay. Here are four important facts you should know about measles in the Central African Republic.

4 Facts About Measles in the Central African Republic

  1. Measles primarily affects children. The viral infection is especially taxing on those with weakened immune systems. Thus, children, especially those who are malnourished or HIV-positive, are more likely to become infected and die from the measles. In 2017, only 49% of Central African children under five years of age received vaccinations against measles. In the resurgence of measles in 2019, 90% of cases in the Central African Republic affected children aged 10 or younger. Although a safe vaccine is available, many Central African families have been displaced, live in rural areas or do not have access to a nearby healthcare center. With the help of foreign aid, the government can initiate more vaccinations and widespread awareness – two critical components in combating measles.
  2. The fight against measles in the Central African Republic is ongoing. For more than 40 years, Central African citizens have struggled with measles. The epidemic is a health crisis and is at the top of the country’s political priorities. In 2014, with the help of the Red Cross and the United Nations, the government of the Central African Republic rolled out a vaccination campaign. It aimed to provide free measles vaccines for more than 115,000 children. However, in January 2019, a resurgence of the measles appeared in the Central African Republic. Since then, the citizens have been fighting widespread outbreaks of the disease. From January 2019 to February 2020, there were more than 7,000 new cases of the measles and 83 deaths.
  3. Vaccines are hard to distribute in the Central African Republic’s war-torn political climate. As of 2017, nearly 900,000 Central Africans had fled violence and unrest. More than half of these displaced people were children. Children and adults are more likely to contract measles and die if they are subjected to overcrowding, malnutrition, immunosuppression or poor healthcare systems. The political turmoil throughout the country can cause these factors to become more prevalent and inhibit effective immunizations. Furthermore, the looting and closing of healthcare facilities across the country has stifled the progress made by previous vaccination campaigns.
  4. The government is working with other international organizations to eradicate measles in the Central African Republic. As a response to the recent outbreaks, the Ministry of Health partnered with the World Health Organization to develop specialized courses of action and vaccination campaigns. They have increased epidemiological tracing, communication about the disease’s risks and vaccination and medicine availability. Additionally, the Center for Emergency Operations in Public Health has aided government officials in devising plans for dealing with outbreaks. Another important international program is Gavi, an alliance that promotes free access to vaccinations all over the globe. Gavi has helped the Central African Republic fund measles treatment and follow-up vaccines by donating more than $1 million to the cause. Similarly, USAID has helped in the fight against measles by making financial donations that fund testing and vaccinations.

Although the prevalence of measles in the Central African Republic is serious, the government and other organizations are committed to fighting it. Moving forward, continued efforts are needed to reduce the prevalence of measles in the nation.

– Danielle Kuzel
Photo: Flickr

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10 Facts About Life Expectancy in Togo

10 Facts About Life Expectancy in Togo
Although global aid has decreased, Togo has managed to increase its health expenditure as a share of GDP to 6.6 percent in 2016, a jump of about 8 percent from the previous year where this amount was actually negative. Due to the scarcity of hospitals and health centers, Togo’s 2018 population of approximately 8.2 million faces numerous obstacles from birth onwards in the battle to survive. Of every 1,000 Togolese infants, 49 will die before they are 1 year old and approximately 69.8 before they reach the age of 5. In addition to infant deaths, the maternal mortality ratio is 396 per 100,000 live births as of 2017. Overall life expectancy in Togo is 69 for females and 63 for males, the 178th worst globally. These 10 facts about life expectancy in Togo demonstrate the changes over time. 

10 Facts About Life Expectancy in Togo

  1. Crime: In Togo, the homicide rate was nine cases per 100,000 people in 2015. Compared to the United States, it has 4.1 more cases per 100,000 people. Violent crimes, theft and pick-pocketing are common in marketplaces or along the beach of Lome. There is an abundance of scam artists that fake online friendships to steal or stage accidents to jack cars and there has even been a threat of kidnapping recently. The ECOWAS Regional Action Plan renewed for 2016-2020 to address crime and drug trafficking in West Africa.

  2. Sanitation: Most drinking water sources in the urban parts of Togo have improved with only 8.6 percent of urban populations not having access to reliably safe drinking water. In rural areas, however, 55.8 percent of the water sources have remained unimproved. Sanitation facility access has not improved much, either, with 75.3 percent of urban Togo and 97.1 percent of rural Togo having unimproved sanitation facilities. Public toilets are often unavailable as well, and when they are available, they generally range from sit-down and squat toilets to holes in the ground.

  3. Disease: As of 2017, Togo’s most prevalent diseases are malaria, neonatal disorders, HIV/AIDS, lower respiratory infection, ischemic heart disease, diarrheal diseases and tuberculosis. HIV/AIDS afflicted approximately 110,000 Togolese or 2.3 percent as of 2017, ranking the country 22nd worst globally. An estimated 4,700 deaths were from HIV/AIDS in 2017, the 43rd worst ranking in the world. It is also common for infants to suffer from diarrhea, one of the main contributors to the infant mortality rate in Togo.

  4. Malnutrition: Malnutrition rates exceed 10 percent in three out of five regions in Togo, with 16 percent of children under 5 underweight. Many parents have been relying on feeding their children a simple paste that is filled with vitamins and minerals, called Plumpy’Nut, and has improved the situation of many Togolese children. An agricultural improvement is the development of a drought-resistant, high-yield rice, Nerica, specifically for Africa. For Western Africa, rice is a staple, but to meet nutritional demand, the region needs to import 3.5 million tons of rice per year, which costs nearly $1 billion.

  5. Overcrowding: The best example of Togo’s overcrowding problem is its 12 prisons. Though there is a set capacity for these prisons, they end up holding more than twice their capacity. As a result of these cramped conditions, hygiene, food and medical care are poor, and disease and death run rampant. Prisoners reportedly sleep like “sardines in a tin,” and even sleep in shifts, with some waiting for their turn against a wall.

  6. Immunization: Immunization coverage among Togolese children is severely incomplete. A study found that 36.2 percent of children did not receive all vaccines that the Expanded Program on Immunization (EPI) recommends. Togo has a multi-year plan (2016-2020), a national system to monitor adverse events following immunization, and a standing technical advisory group on immunization.

  7. Maternal/Neonatal/Child Health: Only 61.4 percent of Togolese births have skilled health personnel in attendance, and as a result, the maternal mortality rate in Togo is 396 deaths/100,000 live births as of 2017. Mothers already have to travel long distances to reach health facilities, and when said places do not have the necessary expertise or medication, they become discouraged from attending any appointments before birth. When these women do not attend regular checkups, health professionals cannot detect problems early on or provide mothers with rudimentary health care.

  8. Health Systems: Togo only has 746 health centers, which is approximately 11 health centers per 100,000 people, and only six regional hospitals, which is 0.09 per 100,000 people. There are only 0.05 physicians per 1,000 people as of 2015. This scarcity of health facilities results in overcrowding of existing ones and it stretches health professionals thin. With so few people operating each facility, Togo cannot meet average health standards and thus cannot help people efficiently. Life expectancy could improve in this respect by creating more health centers.

  9. Substance Abuse: Togo is a transit point of Nigerian heroin and cocaine traffickers. There were 2,000 drug users in 2001 (12 deaths), 3,000 in 2006 (68 deaths) and 3,575 in 2007 (100 deaths). Togolese drug use has only increased over time, stretching to 5.5 percent of students. The students consider drugs to be fortifying and have developed a dependency on drugs just for studying.

  10. Road Safety: People do not stress road safety in Togo. Many Togolese drivers do not obey traffic laws mostly due to traffic signals not functioning properly, and a lack of reinforcement. Sometimes they run red lights and stop signs or drive in the wrong direction on one-way streets. Not only do these driving standards threaten pedestrians and drivers alike, but they also set the stage for fake accidents.

These 10 facts about life expectancy in Togo show that even the smallest of changes could evolve into much more for the Togolese. The ECOWAS is working diligently to improve the lives of those in West Africa by limiting crime and drug trafficking and abuse. Togolese life expectancy has even increased because of other countries’ efforts.

– Nyssa Jordan
Photo: Flickr

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Madagascar’s measles outbreak prompts aid

Madagascar Measles Outbreak

Between September 2018 and April 2019, Madagascar‘s measles outbreak has killed over 1,200 people. According to the World Health Organization, measles is a highly contagious viral disease that remains a significant cause of death among young children globally, despite the availability of vaccines.  Organizations are currently coming together to aid Madagascar against the outbreak and educate the public about the importance of vaccinations in protecting children from harm.

Recent Outbreak

Madagascar is facing the largest measles outbreak in its history, and only 58 percent of people on the island have been vaccinated against the disease. Dr. Dossou Vincent Sodjinou, a WHO epidemiologist in Madagascar, expressed concern about the expansion of the outbreak and the lack of vaccination.

“The epidemic unfortunately continues to expand in size, though at a slower pace than a month ago,” said Dr. Sodjinou. “Some cases of resistance to vaccinations exist because of the influence of religion or of traditional health practitioners but they are isolated ones.”

Measles is one of the leading causes of death for children, and WHO reports that 450 die each day worldwide due to the illness.

According to the Centers for Disease Control and Prevention, the symptoms of measles generally appear seven to 14 days after a person is infected. Measles begins with a fever, a cough, runny nose, a sore throat and red eyes. After a few days of symptoms, tiny white spots, medically known as Koplik’s spots, begin to appear inside the mouth.

The outbreak is complicated by the fact that nearly 50 percent of children in Madagascar are malnourished, which increases the likelihood of severe cases. Those whose immune systems have been weakened by HIV/AIDS or other diseases are also at risk.

Weak Healthcare and Shortage of Vaccines

According to United Nations Children’s Fund, once a child is infected, there is no specific treatment for measles, so vaccination is a life-saving tool for children.

“The Madagascar measles outbreak is a particularly precarious situation because many of the districts have weak health infrastructure and systems to begin with, which is now exacerbated with a shortage of vaccines,” said Michael L. Rich, a Harvard Medical School assistant professor and the chief clinical advisor at PIVOT, an organization partnering with the Madagascar Ministry of Health. “Without a reliable supply of vaccines, strong supply chains or facilities adequately staffed with trained personnel, an end to Madagascar’s ongoing measles crisis is difficult to foresee.”

Doing More to contain the outbreak

The United Nations Children’s Fund is issuing an urgent appeal to governments, health care providers, and parents to do more to contain Madagascar’s measles outbreak. Efforts against the outbreak include educating the public about the safety of vaccines, vaccinating all children between the ages of 6 months and 5 years, training and equipping health workers, and strengthening immunization programs.

PIVOT, an organization dedicated to providing healthcare to impoverished communities, aims to help Madagascar become a symbol of healthcare transformation. In the wake of the outbreak, PIVOT is aiding public systems and pushing for an era of medicine guided by the needs of the poor.

While organizations successfully fight measles in Madagascar, there is also hope around the world. Under the Global Vaccine Action Plan, the elimination of measles is a target in five WHO regions by 2020. WHO, as the lead agency responsible for achieving this goal, is giving children around the world hope for a healthier future.

– Carolina Chaves
Photo: Flickr

 

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Kenya Eliminates Maternal and Neonatal Tetanus

Maternal and Neonatal Tetanus
The silent killer, otherwise known as maternal and neonatal tetanus, is a life-threatening bacterial infection in newborns and their mothers that is associated with nonsterile delivery and cord-care practices. Although it is vaccine-preventable, when tetanus develops, mortality rates are extremely high. This is especially true when the appropriate medical care is not available, which is often the case in low-income counties. In 1999, there were 57 countries where tetanus posed a considerable risk for women giving birth. Today, that number has dropped significantly, but maternal and neonatal tetanus remains a public health threat in 13 countries: Afghanistan, Angola, Central African Republic, the Democratic Republic of the Congo, Guinea, Mali, Nigeria, Pakistan, Papua New Guinea, Somalia, South Sudan, Sudan and Yemen.

Kenya has put in great effort to eliminate maternal and neonatal tetanus where it once was a common problem. The commitment the country made has drawn global attention and is inspiring other countries to do the same.

Kenya’s Initiative

As of 2018, Kenya has been removed from the list of countries that sees maternal and neonatal tetanus as a public health threat by attaining elimination status. Elimination is only attained when there is a reduction of neonatal tetanus incidences to below one case per 1,000 live births per year. Kenya’s progress towards achieving this important public health milestone began in 2001, proving that this process takes time. A pre-validation assessment took place in Kenya in September 201 by the Ministry of Health with the support of the World Health Organization (WHO) and UNICEF. A WHO-led validation process took place in 2018 to confirm the elimination of the disease.

Eliminating maternal and neonatal tetanus takes a lot of planning, and Kenya has set a great example. In 2002, Kenya introduced a five-dose tetanus toxoid vaccination schedule and in 2003, the country began to implement immunization campaigns in high-risk areas. Kenya also focused on providing free maternity services to increase skilled birth attendants. Over time, they began including tetanus toxoid vaccines into the routine antenatal care packages. Today, Kenya is still working on strengthening health facilities and resources and plans to provide free medical care to children under five years of age.

The involvement of schools is another factor that helped Kenya eliminate maternal and neonatal tetanus. Aliaphonse’s Katuit primary school is a prime example of the success seen from the campaign. Ann Talam, one of Katuit primary school’s teachers, explained in an interview with UNICEF that the campaign not only reaches members of the student body but also their sisters or relatives who may not attend school. Education ensures that all girls, even those from poverty-filled communities, are immunized.

Kenya’s Impact

Reducing deaths from neonatal tetanus is one of the simplest and most cost-effective ways to reduce the neonatal mortality rate. As of 2012, Kenya’s immunization coverage for newborns protected against tetanus reached 73 percent — and it continues to rise. WHO estimates a 94 percent reduction in neonatal deaths from 1988, when an estimated 787,000 newborn babies died of tetanus within their first month of life.

As Kenya eliminates maternal and neonatal tetanus, it has inspired the country to combat other diseases as well. They plan to identify the unreached and design an innovative approach to reach these populations with immunizations. On February 22, 2019, WHO representative, Dr. Rudi Eggers, addressed the recent measles outbreak in the country, attributing it to lapses in the routine immunization system since the previous measles and rubella outbreak in 2016.

“There is an urgent need for all stakeholders to come together and work to increase immunization coverage and address inequities,” Eggers said.

The Kenya campaign also aims to vaccinate nearly 14 million children between the ages of nine months and 14 years — nearly 40 percent of the population — for other common viruses.

Since Kenya’s elimination of maternal and neonatal tetanus, more than 153 million women around the world have been immunized with two or more doses of vaccines fighting against tetanus. The Eliminate Project, funded by the Kiwanis Children’s Fund, plans to learn from Kenya’s success and use it to inspire other countries to follow their lead. In 2018, The Eliminate Project raised a total of $502.282.72 to save and protect mothers and their babies worldwide.

Along with planning and taking initiative, Kenya recommends planning outreach activities for remote places, promoting delivery in health facilities and strengthening knowledge of health workers on the immunization schedule. Kenya sets an example of how small changes can overcome the silent killer of maternal and neonatal tetanus.

– Grace Arnold
Photo: Flickr

 

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Increasing Access to Vaccines in Egypt

Vaccines in Egypt
For the past 20 years, the Centers for Disease Control and Prevention (CDC) of the United States has assisted the Egyptian government by providing aid to fight vaccine-preventable diseases. Efforts such as strengthening immunization services, responding to public health emergencies and conducting surveillance studies and surveys have contributed to the reduction of these fatal diseases. The CDC has provided financial support for diseases that can be prevented by vaccines in Egypt through the World Health Organization (WHO), which focuses on polio, measles and rubella elimination.

Impeding Access to Vaccines

In 2006, vaccinations in Egypt eradicated wild poliovirus transmissions. The government continues to monitor the environment for wild polioviruses in a program involving the CDC and other organizations. However, despite the efforts of these organizations, many of those living in poverty in Egypt still do not have access to the vaccination. This presents a problem in the eradication of vaccine-preventable diseases since disease such as the wild poliovirus could return.

According to WHO, full immunization coverage for the poorest to the wealthiest populations showed national levels in Egypt to be under 20 percent. Studies show that the high rates of unemployment and low literacy rates contribute to the increase in the population living in poverty. This results in many individuals being unaware of the healthcare and medical aid they are entitled to and leads to the low proportions of immunization within the population.

Many children are also part of the child labor industry. Working interferes with their school attendance and education, resulting in low literacy rates, which perpetuate the ongoing poverty cycle. Without awareness of health and safety maintenance, those who live under the poverty line may not have the necessary knowledge to access vaccinations in Egypt.

Improvements Made in Vaccinations

The Expanded Program of Immunization (EPI) in Egypt focuses on saving lives by controlling vaccine-preventable diseases such as measles, diphtheria, tetanus, polio and whooping cough through constant surveillance and an increase in vaccine coverage. Despite the extreme decline of cases of vaccine-preventable diseases in the past decades, outbreaks of measles in 2013 and 2014 suggests that full immunization coverage is not yet supported for all populations of Egypt.

However, despite 60 percent of the population living under the poverty line and a large number of people not receiving immunizations, resources and efforts towards improving access to vaccinations in Egypt have increased. WHO claims that only 24 cases of measles, 5.9 cases of mumps and 34 cases of rubella were reported in 2017. A drastic decrease compared to decades of consistent outbreaks in the thousands. Part of the progress could be a result of the fact that 94 percent of children aged 12-23 had received measles vaccinations in 2017. Furthermore, in 2008-2009, there was a significant increase in vaccines in Egypt for measles, mumps and rubella, with 95 percent of children having been vaccinated, an increase of 53 percent from 2007.

The Future of Disease Control

The Ministry of Health and Population (MoHP) works to promote the funding of the Haemophilus influenza vaccine as a part of the PENTA vaccine, a type of vaccine designed to protect the receiver from multiple diseases. The PENTA vaccine will help fight bacterial pneumonia, a communicable disease that contributes to high mortality rates. With WHO supporting the MoHP, the push for programs that fight viral hepatitis is stronger as more resources are being devoted to procuring equipment, allocating funding and the constant surveillance of vaccine-preventable disease outbreaks.

Efforts to control vaccine-preventable diseases are allocating funding to provide coverage for those who may not be able to afford it. Now, increased focus on spreading awareness to the population about the importance and availability of vaccines in Egypt is needed in order to increase coverage and finally eradicate some of the vaccine-preventable diseases in the country.

– Aria Ma
Photo: Flickr

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Immunization Programs Bring Benefits to Africa

immunizations africa
Globally, more than 2 million children are saved every year by immunizations. In Africa, the success of programs for immunization plays a significant role in world health. Immunization programs bring benefits to Africa and other countries around the world by reducing, containing and eliminating life-threatening diseases.

Successful Immunization Program

The Expanded Programme on Immunization (EPI) is responsible for most of the vaccinations in Africa. EPI focuses its attention on immunizing children against six life-threatening diseases: diphtheria, pertussis, tetanus, tuberculosis, polio and measles.

EPI has been acknowledged for maintaining control over many infectious diseases, showing significant progress since its initiation in 1974. For instance, EPI is credited for being on the forefront of eradicating smallpox. The eradication of the polio-virus is currently underway. This disease was responsible for infecting and killing millions of children previous to EPI. After the launch of EPI, enormous reductions of paralysis caused by polio was observed due to polio immunization.

Eradication and Vaccination

In 2017, the required three doses of the polio vaccine were successfully distributed to 85 percent of newborns around the world. With the exception of Afghanistan, Nigeria and Pakistan, polio has been eradicated in almost every country, according to The World Health Organization.

Measles vaccinations have been a huge success as well. In 2015, about 85 percent of children around the world, including Africa, have been immunized with the measles vaccine. In 2017, 167 countries had received two doses of the measles vaccine. Since 2000, more than 20 million lives worldwide have been saved through measles immunization.

MenAfriVac, the first vaccine created specifically for Africa, is a vaccine for adults and children (9 months to 29 years old) that protects them from group A Meningitis. More than 270 million people have been immunized, and cases due to the type A bacterium have declined 99 percent in areas that obtained full vaccinations. It is predicted that more than 400 million people will be vaccinated with MenAfriVac in fewer than two years. This can prevent over 150,000 deaths.

Immunization programs are making huge changes for better healthcare. Immunization coverage in Africa has advanced since the start of EPI, which has helped increase the needed dosages of DPT3 (a vaccine that shields diphtheria, pertussis and tetanus) for children. In 2017, DPT3 had reached as high as 90 percent in 123 countries.

The Economic Impact of Vaccinations

Vaccines also have a strong economic impact on people. “A healthy child is more likely to go to school and become a more productive member of society in later life while their families can avoid the often crippling healthcare costs that diseases can bring” explained Dr. Seth Berkley, CEO of a vaccine alliance (GAVI). “[…] this is enough to save millions of people from the misery of extreme poverty. [..] we now need to redouble our efforts to ensure every child, no matter where they’re born has access to lifesaving vaccines.”

Not only are families saved undo economic hardship thanks to vaccines but also governments save money through ensuring a healthier population. On average, $16 is saved for every $1 that is spent on vaccinations. This can be due to the money that would be lost from missing work, healthcare costs and lower productivity due to illness.

Other Immunization Programs

There are many other programs like EPI that are aiming to make a difference such as The Global Immunization Vision and Strategy (GIVS), The Sustainable Development Goals (SDGs), and The Global Vaccine Action Plan (GVAP). Programs such as these are continuing to help Africa in powerful ways.

Although these developments have been successful, 1 in 5 children still will not get the vaccines needed to prevent life-threatening diseases. Immunization coverage in Africa is still below the goal of 90 percent, leaving many people without vaccines.

The need for extending immunization to everyone is extremely high, and a plan is currently in place through The Global Vaccine Action Plan (GVAP) to continue to achieve the goal. GVAP has set six principles to elaborate on the plan in order for it to be achieved by 2020, saving millions of lives. These principles include partnership, country ownership, equity, integration, sustainability and innovation.

Hope

To help GVAP achieve their goals, each region has developed their own plan in order to ensure that every child will be immunized and protected from deadly viruses. If this plan works out, all communities will have access to life-saving vaccines.

Vaccinations meet the needs to care for weaker societies by enabling good public health, which helps in reducing poverty. Immunization programs bring benefits to Africa as well as saving millions of people in need of vaccines. Challenges are still faced but hope continues.

– Kathleen Smith

Photo: Flickr