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A Possible Solution for Meningitis in the DRC

Meningitis in the drc
The Democratic Republic of the Congo (DRC) is one of the highest-risk countries for meningitis in the world. During the annual dry season from December to June, the disease claims thousands of lives and disables survivors with chronic illnesses.

Following decades of meningitis-related deaths and urgent calls for international support, the World Health Organization (WHO) launched the Defeating Meningitis by 2030: A Global Road Map. The 2030 roadmap lists three goals: eliminate bacterial meningitis epidemics, reduce cases of vaccine-preventable bacterial meningitis by 50% and deaths by 70% and improve aftercare.

In its new approach, WHO plans an aggressive intervention in the DRC and across the African continent. Experts from across the world have supported and contributed to the campaign through research and advocacy efforts. Yet, reaching the 2030 goal requires much more attention from organizations, funds and community advocacy.

Meningitis in the DRC

Meningitis has plagued the DRC for decades with an estimated 6,000 to 10,000 cases each year. It takes various forms, with some serogroups being more fatal or serious than others. The most recent success in meningitis research targeted meningitis A through the MenAfriVac conjugate vaccine. In the DRC and across the sub-Saharan region where meningitis is most prevalent, MenAfriVac significantly reduced cases of meningitis A. Still, many other common serogroups require attention.

Furthermore, meningitis does not always leave individuals unaffected. “Meningitis is the second cause of neurological conditions in Africa, after strokes,” said Dr. Andre Bita, Regional Control Officer for WHO Africa, in an interview with The Borgen Project. “In the world, it’s the fifth. With meningitis you can have epilepsy, blindness, and so many disorders.” The long-term effects of meningitis have caused medical debt, burdens on families and communities, and lifelong aftercare.

“It is very difficult for a country to have a vaccine stockpile,” continued Bita. In the DRC where diseases including COVID-19, Ebola and measles also run rampant, there is a “competing outbreak response” that often delays meningitis research or vaccinations. For instance, during the COVID-19 pandemic, meningitis control activities fell by 50% from 2019 to 2020.

WHO’s 2030 Plan

Still, the many variations of meningitis leave the DRC vulnerable. “Unfortunately,” Bita continued, “we have other epidemics due to other germs.” Where the MenAfriVac campaign focused on eliminating only meningitis A, WHO’s new vision “towards a world free of meningitis” is to completely defeat the disease and all of its variations by 2030.

The Defeating Meningitis by 2030 initiative outlines five interconnected pillars of meningitis treatment: prevention and epidemic control, diagnosis and treatment, meningitis surveillance, aftercare for meningitis survivors and advocacy and engagement. If WHO can meet these five goals, it will have a higher chance of reducing bacterial meningitis.

While the 2030 roadmap will particularly help sub-Saharan countries like the DRC, it also addresses meningitis in other regions. Bita helped conduct a risk assessment to determine a country’s risk for meningitis, discovering that “we now have 38 countries at high to medium risk, and we only have nine countries at low risk. That means, apart from the sub-Sahara, we have other countries such as Algeria with medium risk.” Therefore, to completely defeat meningitis by 2030, WHO will have to use a continental approach.

Spreading the Word

The 2030 roadmap has all the right goals in place. Experts in meningitis research and community advocates have created a medical and social approach to the problem. However, carrying out the plan will be no easy feat. To be successful, it will require more funds and community awareness from the DRC and the international community.

Bita stated that to carry out the 2030 plan, “we need to really involve all the beneficiaries, all the people who can support it, to make it possible.” It will require advocacy and engagement “at all stages” and resources that many countries do not have.

Through mobilizing provinces around the DRC, Bita hopes the 2030 plan will reach as many communities as possible. To do so, there needs to be more visibility on the 2030 plan, meningitis research, and community engagement at the local, national and international levels. If WHO’s regional plan for Africa receives full funding at its $1.5 billion estimate, the 2030 plan could save more than 140,000 lives.

– Anna Lee
Photo: Flickr

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Learn About Poverty in Chad

Poverty in Chad
Located in Central Africa, the country of Chad is the fifth largest landlocked state and has a poverty rate of 42%. With a total population of approximately 15.5 million, a lack of modern medicine, dramatic weather changes and poor education have riddled the country with deadly diseases and resulted in severe poverty in Chad.

Poor Health Conditions in Chad Lead to Disease

The most common types of disease and the primary causes of death include malaria, respiratory infections and HIV/AIDS. Malaria, usually spread through mosquito bites, is a potentially fatal disease and is quite common in the country of Chad. Due to poor sanitation, Chadians are more susceptible to malaria; the most recently estimated number of cases was 500,000 per year.

Along with malaria, lower respiratory diseases contribute to Chad’s high mortality rate – the most common and deadliest of those being meningitis. Lower respiratory tract infections occur in the lungs and can sometimes affect the brain and spinal cord. A lack of available vaccinations in the country has increased susceptibility to meningitis. Meningitis is most deadly in those under the age of 20, and with a countrywide median age of 16.6 years old, Chad has seen a rise in total meningitis cases and overall deaths.

As of 2015, there were an estimated 210,000 Chadians living with HIV. According to UNAIDS, there were 12,000 AIDS-related deaths just last year, along with 14,000 new cases. Those living with HIV/AIDS are at a higher risk of death with their compromised immune systems. They are unable to fight off diseases and, with the preexisting severe risk of malaria and meningitis, they are more susceptible to death.

Harsh Weather and its Role in Food Insecurity and Disease

Due to its geography, Chad is one of the countries most severely affected by environmental challenges. Approximately 40% of Chadians live at or below the poverty line, with the majority relying heavily on agricultural production and fishing. The drastic change in rain patterns and the consequent frequency of droughts have placed a significant strain on their food supply. Fishing in particular has been sparse. Lake Chad, the country’s largest lake, has diminished by 90% in the past 50 years. The rising temperatures in Chad have caused a decrease in both crop yields and good pasture conditions, placing more strain on those who depend on Lake Chad for food and the nutrients it adds to farming.

In addition to affecting poverty in Chad, intense weather patterns have also increased the number of infectious diseases. The infrastructure of the country has not been able to keep up with the rapidly growing population in urban areas. This results in poor sanitation. The sanitation services are overwhelmed during floods, which contaminates the water supply.

Lack of Education Affects Poverty in Chad

Despite the relatively large population, less than half of school-aged children attend school. With attendance rates so low, the literacy rates in individuals between the ages of 15 and 24 fall; currently, they only reach 31%. According to UNICEF, attendance rates are astonishingly low; 8% for children in upper secondary school and 13% for lower secondary school. With education rates so low, income inequality, infant and maternal deaths and stunting in children continue to rise; as a result, the overall economic growth of the country declines.

Enrollment is low in Chad due to the lack of resources in schools. With the country in severe poverty, schools remain under-resourced, both in access and infrastructure. Some schools have no classrooms and no teaching materials. Furthermore, students often outnumber teachers 100:1. As a result, the quality of learning decreases, as does the overall attendance rate.

As of now, only 27% of primary-school-age children complete their schooling. According to UNESCO, if adults in low-income countries completed their secondary education, the global poverty rate would reduce by half. Even learning basic reading skills could spare approximately 171 million people from living in extreme poverty. Educated individuals are more likely to develop important skills and abilities needed to help them overcome poverty. Education also decreases an individual’s risk of vulnerability to disease, natural disasters and conflict.

Poverty in Chad is widespread, and the rate of impoverished people will continue to grow if it is not addressed. Poor health conditions and a lack of education are just a few of the many problems people face; while the living conditions may seem dire in Chad, a gradual decrease in overall poverty rates proves that there is hope.

– Jacey Reece
Photo: Flickr

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Top 5 Causes of Child Mortality Globally

Child Mortality Globally
People have made significant progress in improving child survival rates globally. According to UNICEF, “one in 26 children died before reaching age five in 2018, compared to one in 11 in 1990.” However, far too many children who live in poor and vulnerable regions continue to die prematurely from preventable illnesses every day. Keep reading to learn the top five causes of child mortality globally.

Top 5 Causes of Child Mortality Globally

  1. Tuberculosis (TB) – Tuberculosis is currently one of the biggest causes of child mortality globally. A bacteria called mycobacterium causes TB. It mostly attacks the lungs but can affect other parts of the body as well. People can transmit the illness through the air when coughing, sneezing or talking. More than 600 children under the age of 15 die every day as a result of TB and around 80 percent of these deaths occur in children under the age of 5. Currently, only 96 percent of those children do not receive adequate treatment and as a result, die from the disease. UNICEF has created an agenda for action on childhood TB to help prevent children from dying on a global scale as part of the Sustainable Development Goals. To accomplish this objective, UNICEF needs funding support and investment from global and national decision-makers, governments and researchers.
  2. Measles – Measles is an infectious disease that a virus causes and people can contract it through the air, sneezes or coughs. It causes severe complications that can lead to death and is an extremely contagious disease killing children globally. It can last in the air up to two hours and if it affects one person, there is a 90 percent chance that those around them will contract it too. The measles caused 110,000 deaths among children globally in 2017 and most of these deaths were in children under the age of 5. From 2000 to 2017, people developed many preventative measures to stop measles and one of these measures was a vaccine. The vaccine was a major factor in reducing measles deaths among children. It prevented 21.1 million deaths between 2000 and 2017. To continue to prevent measles from taking more young lives, children should receive the vaccine routinely. In 2017, 85 percent of children around the world obtained the vaccine in one dosage. Two doses are ideal to protect children from contracting the disease. The World Health Organization played a huge role in distributing the vaccine. The WHO’s Assembly backed the Global Vaccine Action Plan by endorsing it in 2012. With this endorsement, WHO hopes to eradicate measles in five regions by 2020.
  3. HIV/AIDS – With a compromised immune system, AIDS can develop after contracting HIV. It can transmit to children from mothers through childbirth as well. HIV/AIDS greatly affects adolescent children, especially young women ages 15 to 19. Worldwide, two out of three adolescent girls of key populations have HIV. They are at the highest risk of contracting the disease and most likely do not have access to treatment. Without investment in HIV treatment and prevention programs, projections determine that 270,000 adolescents will contract HIV and 56,000 will die by 2030. Children are dying globally and reports in 2017 stated that the virus infected 430,000 children and killed 130,000 from complications. UNICEF plans to help stop the transmission of HIV from mother-to-child, close the HIV treatment gap and prevent the rise of HIV in adolescent children. UNICEF will do this by supporting governments and communities that fight to reduce inequities in HIV treatment. The organization also provides governments with technical assistance that strengthens their HIV services which include, treatment, prevention, programs and testing.
  4. Neonatal Deaths – Neonatal death refers to the death of a baby within the first 28 days of its life. It is a global phenomenon because children are at their most vulnerable during this time. Neonatal deaths account for 47 percent of deaths under the age of 5. Most neonatal deaths happen in the first day or week after birth. This averages out to about 1 million dying within the first day and close to a million dying within the first 6 days. Prevention of these deaths is important because there is an increasing rate of deaths under the age of 5. Although people cannot prevent most neonatal deaths, they can prevent some. Prevention methods include improving medical management by managing premature labor that can harm by the fetus and monitoring the heart rate of the fetus. Other preventative methods include neonatal intensive care referrals and monitoring possible respiratory complications during pregnancy.
  5. Meningitis – Meningitis is an infection of the membrane surrounding the brain and spinal cord. Viral infections can cause it, but other causes include bacterial, parasitic and fungal infections. Meningitis symptoms can also spread quite quickly. Fifteen percent of children who have developed meningitis become unconscious once the virus spreads. In newborns, the symptoms can be vomiting, rash, very high temperature or inactivity. Around 25 percent of newborns who have meningitis develop increased fluid around the brain that can last up to one or two days and can cause them to be near death within 24 hours. If left untreated 50 percent of patients suffering from meningitis die within 24 to 48 hours. Even with the right treatment, about 5 to 10 percent of patients still die, resulting in many children dying globally. Prevention of this disease begins with getting routinely vaccinated to lower the chances of contracting it. All young children must receive the vaccination in the hopes of preventing the disease from taking their lives.

There are many diseases that cause child mortality globally every day. The world needs to work together to end the epidemic of preventable diseases that are taking the lives of children everywhere. Investing in treatment for preventable diseases in countries that may not have access to it is the first step.

–  Jessica Jones
Photo: Flickr

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Tackling Meningitis in Africa with MenAfriVac

MenAfriVacOn Feb. 22, 2016, vaccine experts from all over the world convened in Ethiopia with leaders from the 26 African “meningitis belt” countries to celebrate the success achieved by MenAfriVac, a vaccine created for use in Africa.

The vaccine was developed specifically for Africa and targets meningococcal A meningitis, a bacterial infection of the thin lining surrounding the brain and spinal cord. Meningitis is a highly-feared disease due to its capacity to kill its host within hours. Survivors often experience permanent hearing loss, paralysis or even mental retardation.

“We have achieved something truly historic with MenAfriVac®—creating an affordable, effective, tailor-made vaccine for Africa,” said Steve Davis, president and CEO of PATH, a nonprofit global health organization.

According to PATH, more than 90 percent of meningitis epidemics in Africa attacked mostly infants, children and young adults. To zero in on this specific cause of meningitis, PATH partnered with the Meningitis Vaccine Project and the World Health Organization (WHO).

In the five years that MenAfriVac has been in effect, 235 million children and adults have been vaccinated. From 250,000 cases during an epidemic from 1996 to 1997, to only 80 confirmed cases in 2015, the vaccine has effectively protected millions of people.

However, a resurgence is possible within 15 years if an immunization program is not implemented permanently. Several countries applied for funding to begin implementing MenAfriVac into their national childhood immunization programs. Gavi, a global health partnership that focuses on vaccines, has spent $367 million campaigning and stockpiling the vaccine since 2008 to support these countries.

“Meningitis A was a scourge across Africa’s meningitis belt for generations but today we can be proud that a safe, effective meningitis vaccine is protecting hundreds of millions of people from death and disability,” said Dr. Seth Berkley, Gavi CEO. “But we must not be complacent. It is critical that at-risk countries begin introducing this vaccine into their routine schedules and ensuring every child is reached and protected.”

This achievement could not have been possible without the vital partnerships that contributed to the development of the vaccine. U.S. agencies financially supported MenAfriVac, provided technical expertise and participated in clinical studies of the vaccine.

Continued partnerships could lead to solutions for other diseases around the world and have a positive impact on global health.

– Emily Ednoff

Sources: Gavi, PATH
Photo: Flickr

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Meningitis A Vaccine in Africa Almost Eradicates the Disease

meningitis_A_vaccineA new report published in Clinical Infectious Diseases suggests that meningitis A is nearly eliminated in Africa.

We can thank a vaccine developed only five years ago. It was produced to help curb meningitis A, a strain that only impacts Africa.

The need to create the vaccine became apparent in 1996 when more than 250,000 people became infected with the disease and 25,000 people died.

While meningitis can be fatal, prevention is possible. Brown University estimates that a simple vaccination can prevent up to 70 percent of meningitis bacteria strains.

However, for those living in impoverished conditions, accessing life-saving medications may not always be possible. In 2010, the United Nations reported that approximately 28 million people in sub-Saharan Africa lived on less than $1.25 per day.

The meningitis epidemic prompted action from African health ministers. Answering that call was the Serum Institute of India, which produced a low-cost vaccine that only costs 50 cents a dose.

The vaccine was made possible in large part to the generosity of the Bill and Melinda Gates Foundation that provided $70 million to initiate its development.meningitis_A_vaccine

“The disease is highly feared on the continent; it can kill or cause severe brain damage within hours,” the World Health Organization (WHO) said.

“But just 5 years after an affordable meningitis A vaccine was introduced, its use has led to the control and near elimination of the deadly meningitis A disease in the African ‘meningitis belt’ stretching across the continent from Senegal to Ethiopia.”

The success of the vaccine is incredible. In 2013, WHO revealed that there were only four laboratory-confirmed cases across the 26 countries in Africa’s “meningitis belt.”

“We have nearly eliminated meningitis A epidemics from Africa, but the fact is the job is not yet done,” said Dr. Jean-Marie Okwo-Bele, WHO’s director of Immunization, Vaccines and Biologicals. “Our dramatic gains against meningitis A through mass vaccination campaign will be jeopardized unless countries maintain a high level of protection by incorporating the meningitis A vaccine into their routine childhood immunization schedules.”

The vaccine does more than prevent the deadly meningitis A strain. A WHO study suggests “90 percent of people who received the vaccine still have the antibodies 5 years later.” Additionally, an added benefit is a protective boost against tetanus.

According to the WHO, more than 237 million people across 16 countries have been treated. However, 10 additional countries still need to implement the vaccination.

– Alyson Atondo

Sources: UN 1, Columbia University, University of Minnesota Twin Cities, UN 2
Photo: Flickr, Pixabay