Life Expectancy in Timor-Leste
Timor-Leste, also known as East Timor, is a nation that occupies the eastern half of the island of Timor in Southeast Asia. With a population of 1.26 million people, Timor-Leste is one of the least populated countries in Asia. The Portuguese originally colonized the country in 1520. After declaring independence in 1975, Indonesia invaded the nation, which occupies the western half of the island. The Indonesian invasion brought violence, famine and disease to Timor-Leste, resulting in a large loss in population. After a majority of the Timorese population voted to become independent in 1999, Indonesia relinquished control and Timor-Leste moved under the supervision of the United Nations. The nation officially became independent in 2002, making it one of the newest nations in the world. These 10 facts about life expectancy in Timor-Leste outline the rapid improvement the country has made since Indonesian occupation and the issues it still needs to overcome.

10 Facts About Life Expectancy in Timor-Leste

  1. Life expectancy in Timor-Leste increased from 32.6 years in 1978 to 69.26 years in 2018, matching that of South Asia. The consistent improvement in life expectancy in the past decade is primarily due to the Ministry of Health’s public health interventions. Such interventions include the reconstruction of health facilities, expansion of community-based health programs and an increase in medical graduates in the workforce.
  2. Life expectancy in Timor-Leste increased despite a drop in GDP, which decreased from $6.67 billion in 2012 to $2.6 billion in 2018. However, Timor-Leste’s GDP rose by 2.8% from 2017 to 2018. Continued improvement in GDP and economic progress in the nation will only serve to increase life expectancy by providing more opportunities for employment, education and improved quality of life.
  3. Tuberculosis was the highest cause of death in 2014, causing 14.68% of deaths. In 2014, estimates determined that Timor-Leste had the highest prevalence of tuberculosis in Southeast Asia, and 46% of people with tuberculosis did not receive a diagnosis in 2017. Maluk Timor, an Australian and Timorese nonprofit committed to advancing primary health care, provides a service through which team members visit Timorese households to locate undiagnosed patients and raise awareness about the severity of tuberculosis in the community. The organization collaborates with the National TB Program and aims to eliminate suffering and deaths in Timor-Leste due to diseases that Australia, which is only one hour away, had already eliminated.
  4. Communicable diseases caused 60% of deaths in 2006 but decreased to causing 45.6% of deaths in 2016. While diseases such as tuberculosis and dengue fever remain a public health challenge, the incidence of malaria drastically declined from over 200,000 cases in 2006 to no cases in 2018 due to early diagnoses, quality surveillance, funding from The Global Fund to Fight AIDS, Tuberculosis and Malaria and support from the World Health Organization.
  5. The adult mortality rate decreased from 672.2 deaths per 1,000 people in 1977 to 168.9 deaths per 1,000 people in 2018. Additionally, the infant mortality rate decreased from 56.6 infant deaths per 1,000 live births in 2008 to 39.3 infant deaths per 1,000 live births in 2018. While public health interventions and disease prevention contributed to the decrease in the adult mortality rate, Timor-Leste needs to expand access to maternal health services in rural areas to continue to improve the infant mortality rate.
  6. Maternal mortality decreased from 796 deaths per 100,000 live births in 1998 to 142 deaths per 100,000 live births in 2017. The leading cause of the high maternal mortality rate is poor access to reproductive health services, as only 43% of women had access to prenatal care in 2006. While the Ministry of Health continues to expand access to maternal health care through mobile health clinics that reach over 400 rural villages, only 30% of Timorese women gave birth with a health attendant present in 2013. Even as access increases, challenges such as family planning services, immunization, treatment for pneumonia and vitamin A supplementation remain for mothers in rural communities.
  7. The violent crisis for independence in 1999 destroyed more than 80% of health facilities. Despite rehabilitation efforts to rebuild the health system, many facilities at the district level either have limited or no access to water. However, the number of physicians per 1,000 people improved from 0.1 in 2004 to 0.7 in 2017. The capacity of the health care system is also improving, as UNICEF supports the Ministry of Health in providing increased training for health care workers in maternal and newborn issues and in striving to improve evidence-based public health interventions.
  8. Timor-Leste has one of the highest malnutrition rates in the world. At least 50% of children suffered from malnutrition in 2013. Additionally, in 2018, 27% of the population experienced food deprivation. USAID activated both the Reinforce Basic Health Services Activity and Avansa Agrikultura Project from 2015-2020 to address the capacity of health workers to provide reproductive health care and the productivity of horticulture chains to stimulate economic growth in poor rural areas. Both projects aim to combat malnutrition by addressing prenatal health and encouraging a plant-based lifestyle that fuels the economy.
  9. Motherhood at young ages and education levels are key contributors to malnutrition, as 18% of women began bearing children by the age of 19 in 2017. Teenage girls are far more likely to experience malnourishment than older women in Timor-Leste, contributing to malnutrition in the child and therefore lowering life expectancy for both mother and child. As a result of malnutrition, 58% of children under 5 suffered from stunting in 2018. Additionally, findings determined that stunting levels depended on the wealth and education level of mothers. In fact, 63% of children whose mothers did not receive any formal education experienced stunting, while the number dropped to 53% in children whose mothers received a formal education.
  10. Education enrollment rates are increasing, as the net enrollment rate in secondary education increased from 40.5% in 2010 to 62.7% in 2018. Completion of secondary education links to higher life expectancy, especially in rural areas. Since 2010, Timor-Leste has increased spending on education. Additionally, local nonprofit Ba Futuru is working to train teachers to promote quality learning environments in high-need schools. After Ba Futuru worked with schools for nine months, students reported less physical punishment and an increase in innovative and engaging teaching methods in their classrooms. The organization serves over 10,000 students and provides scholarships for school supplies for hundreds of students. With more programs dedicated to increasing enrollment and the classroom environment, students are more likely to complete secondary education and increase both their quality of life and life expectancy.

These 10 facts about life expectancy in Timor-Leste indicate an optimistic trend. Although malnutrition, disease and adequate access to health care remain prevalent issues in Timor-Leste, the nation’s life expectancy has rapidly increased since Indonesian occupation and has steadily improved its education and health care systems since its founding in 2002. To continue to improve life expectancy, Timor-Leste should continue to focus its efforts on improving public health access and community awareness in poor rural areas, and particularly to emphasize maternal health services to reduce both maternal and infant mortality rates. Despite being one of the newest nations in the world, Timor-Leste shows promise and progress.

Melina Stavropoulos
Photo: Flickr

Tuberculosis in DjiboutiTuberculosis (TB) is an infection caused by Mycobacterium tuberculosis. In addition to airborne spread, TB can be transmitted through unpasteurized milk contaminated with Mycobacterium bovis. This infection attacks the respiratory system, but in extreme cases, it can impact the central nervous system, bones, joints, lymphatic system and urogenital area. It’s a disease that is endemic in Djibouti, a country in eastern Africa. 

Infection Rates and Spending Levels

From 2000 to 2018, there were two peak levels of tuberculosis in Djibouti — one in 2001, and the other in 2010. In these years, Djibouti hit 716 cases of TB per 100,000 people and 621 cases per 100,000 people, respectively. As of 2018, TB rates were the lowest they had been in since 2000, at only 260 cases per 100,000 people. That being said, TB has remained the number four cause of death in Djibouti since 2007.

Despite the fact that deaths have increased, health data analyzers seem optimistic that the incidence of TB will decline as more funding goes toward health in Djibouti. In 2016, only $66 was spent per person on health. By 2050, experts predict that spending will rise to $87 per person. This increase will largely come from expanded development assistance and a rise in government spending on health — predicted to jump from $35 per person in 2016 to $48 in 2050. With more money being put into the health of citizens, it will be easier to get and keep people healthy. If someone does contract TB, there will be more money allotted for their treatment. Increased health funding will also allow for more community outreach and education around the spread and treatment of TB. If someone contracts TB and cannot get to a medical facility, they will at least have tools to keep themselves healthy and ensure that their case doesn’t spread. 

Refugees and Tuberculosis in Djibouti

Refugees account for nearly 3% of Djibouti’s population. Most refugees come from neighboring countries raging with war. Djibouti’s refugee camps are small, cramped and perfect breeding grounds for TB. While things may seem bleak, there is hope. The government in Djibouti is working with multiple NGOs to bring awareness and treatment to TB in refugee camps. UNDP has partnered with UNHCR and the Global Fund to address tuberculosis in Djibouti. So far, they have provided treatment for 850,000 TB patients, as well as 19,139 patients with drug-resistant TB. The work of NGOs has allowed families to stay with the sick during treatment, without fear of contracting the infection.

The goal of this partnership is to end TB in Djibouti by 2030 — an ambitious goal, but one that is potentially attainable as support and funding help to educate, treat and provide support for the people who need it. While treatment is important, however, these NGOs have also shown that community outreach programs aimed at teaching people how to avoid TB are just as vital in stopping the spread of the disease.

The tuberculosis crisis in Djibouti has been a lasting one. Thanks to recent investments by the government, new technologies to combat TB and organizations helping contain the refugee TB crisis, there is hope for the future of this country and its citizens.

Maya Buebel
Photo: Flickr

tuberculosis in KiribatiKiribati is one of the world’s smallest countries, located in the middle of the Pacific Ocean. The 30 plus islands that together form Kiribati may be small and house a population of a little more than 100,000 people, but Kiribati is modernizing every day. The country only became fully independent in 1979 after a history of colonialism, and it joined the U.N. in 1999. Today, one of the biggest threats it faces is tuberculosis (TB). Of all the neighboring pacific island countries, Kiribati has the highest incidence of tuberculosis with a report of 349 incidents per 100,000 in 2018. While tuberculosis is endemic in Kiribati, the situation is far from hopeless. New scientific approaches to diagnosing and treating tuberculosis are making it possible to eradicate the disease in the future.

Tuberculosis and Overcrowding

Tuberculosis is directly related to overcrowding. While there are 33 total islands of Kiribati, only 20 of these islands are inhabited. Moreover, almost all of these islands are very sparsely inhabited, with around 64,000 inhabitants living on the main atoll, Tarawa. Though the nation does not boast a large overall population, the population density of the country is one of the highest in the world. Tarawa has a population density on par with major cities, like Tokyo and Hong Kong. This high population density means that most households in Kiribati are vastly overcrowded, creating a greater likelihood of spreading tuberculosis. Oftentimes, the housing lacks proper construction or proper ventilation, which also impacts the spread of TB. On average, households in Tarawa have between eight and nine people in them.

Tuberculosis and Diabetes

Tuberculosis and diabetes are often co-morbid illnesses causing major concern in Kiribati, which has one of the top 10 highest rates of diabetes in the world. In Kiribati, between one fourth and one-third of adults have diabetes, so the likelihood of having tuberculosis and diabetes is quite high. In fact, one-third of citizens with tuberculosis are also diagnosed with diabetes. This is so prevalent because diabetes can impact the treatment of tuberculosis. As a result, most of the citizens with both diabetes and TB have the infectious form of TB. This means that they pose a greater risk of spreading the illness to other members of the community.

New Methods for Catching and Eliminating TB

While tuberculosis is a serious concern to citizens of Kiribati, there are groundbreaking efforts to speedily diagnose and treat tuberculosis. Addressing TB is one of the country’s top priorities. In conjunction with organizations like the Global Fund to Fight Aids, Tuberculosis and Malaria, Kiribati has managed to acquire modern diagnostic tools like portable X-ray machines. In recent years, another strategy that targets specific “hotspot” areas has proved incredibly useful in diagnosing TB in the early stages. This process focuses on areas known to have the greatest likelihood of TB by using patterns from past years to locate the most at-risk communities. After locating these communities, citizens of the area participate in screening for TB. In 2019, during a hotspot case study, healthcare workers screened 3,891 people for tuberculosis in less than two weeks. Over the course of the 11 days, they diagnosed seven new cases.

A More Positive Future

In the past few years, the general fear of tuberculosis in Kiribati has greatly diminished. With the new systems in place to screen, diagnose and treat TB, citizens have become more aware of how to prevent the spread of disease. The new systems also allow more citizens who may be living in poverty or isolated areas to access treatment. Healthcare workers go directly into the villages within each hotspot, allowing citizens to easily walk to clinics for screening. At these clinics, they receive prevention tips, pamphlets and a better understanding of how to care for themselves and those around them.

Despite overcrowding and comorbidity with diabetes, the future of tuberculosis in Kiribati is looking up. With only 323 cases in 2018 after 745 new cases in 2007, the numbers are slowly decreasing. With increased awareness and prevention tactics, along with modern technology and hotspot screening, it is hoped that this trend will continue.

– Lucia Kenig-Ziesler
Photo: Flickr

tuberculosis in Eastern Europe
One of the oldest diseases, tuberculosis is still prevalent in hundreds of countries and nearly every continent. Although many countries have been able to reduce their number of cases through medical intervention and policies, Eastern Europe remains affected by the disease. Despite the rising cases of tuberculosis in Eastern Europe, European and other governments are coming up with new solutions to better treat individuals with TB and potentially eradicate the disease. Here are five facts about tuberculosis in Eastern Europe.

5 Facts About Tuberculosis in Eastern Europe

  1. Most of Europe’s tuberculosis cases are in Eastern Europe. According to the World Health Organization (WHO), Europe has the lowest incidence of tuberculosis in the world. However, the cases that do exist concentrate in Eastern Europe. The WHO found that 18 countries in Eastern Europe bear 85% of the tuberculosis burden for the continent. Over the past decade, cases of tuberculosis have halved throughout Europe. Despite this decrease, however, the number of cases in Eastern Europe is almost eight times higher than that of Central and Western Europe.
  2. Eastern Europe has the highest rates of drug-resistant tuberculosis. Multidrug-Resistant Tuberculosis (MDR tuberculosis) is currently the most prevalent form of TB in Eastern Europe. MDR tuberculosis occurs when the bacteria that causes tuberculosis becomes resistant to at least isoniazid and rifampin, the two most common drugs doctors use to treat tuberculosis patients. Typically, this resistance occurs when patients do not finish their antibiotics or when tuberculosis infects a person more than once. In all of Europe, 99% of MDR tuberculosis cases occur in Eastern Europe. As a result, scientists need to develop new antibiotics or treatments for patients in that region.
  3. Tuberculosis outbreaks are more common in poorer regions. In general, researchers tend to find tuberculosis in poorer and developing countries. Similarly, the levels of TB in Eastern Europe could connect to the overall poverty rates in the region. The poverty rates in Central and Western European countries such as the Czech Republic are as low as 10%. However, in Eastern European countries, such as Romania, the poverty rates are as high as 25%. In poorer countries, access to medical treatment and preventative care decreases. Thus, in Eastern Europe, a common struggle for individuals with tuberculosis is finding health care that is effective and affordable.
  4. Problems with tuberculosis are worsening due to COVID-19. The COVID-19 pandemic has led countries to implement social distancing and stay-at-home policies. As a result, the circumstances for individuals with tuberculosis in Eastern Europe may worsen. A recent modeling study looked at the rate of incidence of tuberculosis and the tuberculosis mortality rate during the lockdown. The study predicted that both the number of cases and the number of deaths will rise as people remain in close quarters. For example, imagine the lockdown in a high-risk country such as Ukraine lasting for 3 months with a 10 month recovery period. The rate of incidence would increase by 10.7% and the mortality rate would increase by 16%. One reason for this increase is the lack of medical care available during the pandemic. As more supplies and medical officials go towards fighting COVID-19, other diseases such as tuberculosis could go unchecked during the lockdown.
  5. Better diagnostic services are currently in progress. This year, in 2020, the European Lab Initiative (ELI) on tuberculosis, HIV and Viral Hepatitis, a regional center that has dedicated itself to the treatment of those three diseases, released its goals for 2020 and 2021. These goals, which include improved drug treatments and better tracking algorithms, hope to allow doctors in Eastern Europe to diagnose patients with tuberculosis faster. By diagnosing people earlier, the transmission of tuberculosis will slow, and those who test positive for tuberculosis will have a higher chance of recovery.

Although the rates of TB continue to drop in Western and Central Europe, wealth inequality and the COVID-19 pandemic are keeping the number of cases up in Eastern Europe. However, if progress on better diagnostic services continues, the occurrence of tuberculosis there will decrease.

– Sarah Licht 
Photo: Flickr

8 Facts About Tuberculosis in Russia With COVID-19 emerging as a global pandemic, attention has centered on alleviating its effects. However, this has posed challenges to combating other respiratory illnesses, like tuberculosis, due to the lack of control efforts. Russia has been particularly hit by this, where it has a higher sensitivity to respiratory issues. To better understand this and the solutions that might be used to fight both COVID-19 and tuberculosis, here are eight facts about tuberculosis in Russia.

8 Facts About Tuberculosis in Russia

  1. Tuberculosis (TB) is endemic, or regularly found, in Russia. In fact, Russia has the world’s 11th highest burden of TB. Compounding its status as a major public health problem is a rising incidence of multidrug-resistant TB (MDR-TB). This means that TB does not respond to many of the antibiotics that are most commonly used to treat the disease. Russia has the third highest number of MDR-TB in the world.
  2. The severity of Russia’s TB epidemic stems from historical, social and economic factors. When the Soviet Union collapsed, health infrastructure and the economy declined dramatically. Poverty and crime rates increased, leading to higher incarceration rates. As TB is airborne, it spreads best in cramped and crowded conditions, just like those in prisons. These factors contributed to the rapid spread of both TB and MDR-TB. The Fall of the Iron Curtain also led to unstable living conditions, increased mass migration and exacerbated the TB epidemic with a 7.5 percent annual increase in new cases from 1991 to 1999.
  3. There is a close synergy between the TB and HIV/AIDS epidemics in Russia. The TB notification rate of individuals living with HIV infection is approximately 1,700 per 100,000 HIV-infected. Because HIV attacks the immune system, HIV infection leaves patients more vulnerable to infection with all sorts of pathogens, including TB.
  4. In the early to mid-2000s, the Russian government increased its budget allocation for tuberculosis control. Russia also received a $150 million World Bank loan, two thirds of which was designated for tuberculosis. Additionally, it received a $91 million grant from the Global Fund To Fight AIDS, Tuberculosis and Malaria.
  5. In recent years, there have been some improvements in TB infection rates in Russia. Cases of TB in Russia decreased by 9.4 percent to a rate of 48.3 per 100,000 people in 2017. In the same vein, Russia has recently experienced a steady decline in TB morbidity and mortality. Since 2012, morbidity or disability due to TB has decreased by more than 30 percent, and mortality has decreased by more than 48 percent.
  6. The COVID-19 pandemic is interfering with TB diagnosis, prevention, treatment and control efforts worldwide. It is grimly clear that Russia will not be exempt. A recent report based on analyses of several countries, including neighboring Ukraine, predicts an additional 6.3 million cases of tuberculosis by 2025 as a result of COVID-19’s disruption of TB control efforts. Progress in the fight against TB could be set back by five to eight years. Russia is facing its TB epidemic in a world where TB kills 1.5 million people a year, more than any other infectious disease. Five years ago, world leaders pledged to end the TB epidemic by 2030. In addition, in 2018, they pledged to double TB funding by 2022. However, the COVID-19 pandemic’s diversion of attention, funding, and resources makes the realization of these TB goals unlikely.
  7. Partners in Health, a nongovernmental organization, treats TB and uses a comprehensive model of ambulatory care. They treat every patient free of charge and provide care as it is most convenient to patients, bringing medication to each patient individually twice a day. Their close relationship with patients in this community based model gives their patients up to a 90 percent cure rate. Particularly, Partners in Health established The Sputnik Initiative, where it provided social and clinical support for poor MDR-TB patients in Tomsk, Russia. This initiative allowed Partners in Health to treat 70 percent of its total 129 participants who would otherwise not receive adequate medical care.
  8. Partners in Health has success in curbing TB by integrating TB treatment with the provision of other medical care. They have established TB clinics within HIV treatment centers, which is strategic as the HIV and TB co-infection rate among the patients they treat is five percent. Additionally, they have incorporated mental health and drug addiction services into their TB treatment program in Russia. A similar integrative model could conceivably be deployed for COVID-19 once a treatment becomes available.

Tuberculosis and COVID-19 pandemics present unique challenges both individually and as they co-occur. However, existing community based treatment models for tuberculosis in Russia may contain useful lessons as we learn to treat COVID-19.

– Isabelle Breier

Photo: Flickr

Leading Diseases in Sri Lanka
A 6-year-old boy cried from pain from a small room in an overcrowded ward. The small child had a fever and rash and pointed to the different parts of his body that hurt. Hannah Mendelsohn, a medical volunteer from Haifa, Israel, tried to distract the boy with games of tic-tac-toe and peekaboo.

The child displayed classic symptoms of dengue fever. Doctors diagnosed him with the virus at Karapitiya Teaching Hospital in Galle, Sri Lanka during the summer of 2015. “[The boy] had luckily gotten to the hospital when he was still in an earlier stage of the disease,” Mendelsohn told The Borgen Project. “There were a few times I heard doctors tell patients with dengue that there were no options for life-saving care.”

While non-communicable diseases are the main causes of death in Sri Lanka, many still consider certain infectious diseases, including dengue fever, threats to public health. Here are five leading diseases in Sri Lanka.

5 Leading Diseases in Sri Lanka

  1. Dengue Fever: Dengue is a mosquito-borne virus that is endemic to Sri Lanka. A person can contract dengue any time of year. However, the risk elevates during the monsoon season. This is the time of year when dengue-bearing mosquitos are most common, and severe storms often inhibit travel for care. The year 2019 saw double the cases when compared to the previous year with over 99,000 reported cases and 90 deaths. The World Health Organization (WHO) is currently working with Sri Lanka’s Ministry of Health, Nutrition and Indigenous Medicine to control the spread of dengue fever by enhancing dengue surveillance and training health care workers dengue case management and prevention. Among the suggested prevention strategies, WHO advises keeping neighborhoods clean and using mosquito netting and repellents to prevent bites.
  2. Acute Lower Respiratory Infections: Acute lower respiratory infections (ALRI) are leading causes of childhood mortality and morbidity in Sri Lanka; they are responsible for 9 percent of deaths of children under age 5. Poor access to health care, food shortages, lack of safe water and poor sanitation elevate the risk and disease burden. Fortunately, the political prioritization of public health has led to increased administration of vaccinations. This has reduced the impact of contracted ALRI. In 2014, Sri Lanka’s government enacted a national immunization policy which guarantees every citizen the right to vaccination. A separate line in the national budget aims to ensure the continuous availability of immunizations.
  3. Typhoid Fever: Typhoid is a bacterial infection that has a high mortality rate when a person does not receive treatment. Between 2005 and 2015, Sri Lank had 12,823 confirmed cases of typhoid fever. The risk of typhoid is related to overcrowding, food shortages and poor water quality. Sri Lanka’s prevention strategy has largely focused on disease surveillance and health education. Every medical practitioner has to notify the government of any typhoid fever diagnosis. Health education has involved the promotion of proper sanitation and immunization campaigns.
  4. Meningitis: Meningitis, a bacterial disease, was the 20th leading cause of premature death in Sri Lanka in 2010. Malnutrition, poor access to health care and poor sanitation are risk factors for infection and disease severity. Since 1990, the annual number of deaths due to meningitis in Sri Lanka has decreased. It was formerly the 16th leading cause of premature death. Experts largely attribute this to the growing accessibility of the Haemophilus Influenzae B vaccine.
  5. Tuberculosis: Tuberculosis was the 21st leading cause of premature death in Sri Lanka in 2010. The estimated number of cases has progressively increased from 10,535 in 1990 to 11,676 in 2007. The National Strategic Plan for Tuberculosis Control 2015-2020 states that Sri Lanka has successfully maintained a high treatment rate for tuberculosis. Because tuberculosis transmits from person-to-person, a high treatment rate reduces the risk of transmitting further infections. Additionally, Sri Lanka has received funding from the Global Fund for AIDS, Tuberculosis and Malaria. The funds are for raising awareness and increasing access to medication.

Non-communicable diseases currently represent a larger health burden. However, the continued incidence of infectious diseases ­­in Sri Lanka highlights the burden of poverty. For many of these five leading diseases in Sri Lanka, vaccinations are widely available and accessible in developed countries. Yet, reports of cases and fatalities in Sri Lanka still occur.

Still, for infectious diseases where vaccines remain elusive, poverty is a prominent risk factor for infection and severity of illness. Poverty affects the ability to receive adequate nutrition, sanitary housing, health care and more.

“Around the clock, patients died from diseases that are definitely preventable,” Mendelsohn said. “Coming from a developed country where medical care is among the best in the world, it was hard for me to accept that, just a continent away, people were still dying of infectious diseases to which the cures had already been found.”

– Kayleigh Rubin
Photo: Pixabay

Global Health News
The start of 2020 is the time to look back and see global health news for 2019. From new drug recommendations and global vaccination efforts to ongoing diseases and funding to eliminate them, health agencies and national governments are working tirelessly to keep everything in place. They are making sure the general public, especially those in affected countries, get the right information and the best resources to address these health issues. They are gathering enough funding to implement different health programs for treatment and prevention. Finally, they are continually conducting research to find new treatments to make the world a healthier place.

Global Health News Updates for 2019

  1. Tafenoquine use for malaria is under new guidance: According to the World Health Organization (WHO), there were about 219 million malaria cases around the world in 2017. People can use Arakoda (tafenoquine 300 mg) and Krintafel (tafenoquine 150 mg) to treat malaria. The government of Kenya joined Ghana and Malawi to test the malaria vaccine for children. Results of clinical trials show that vaccinated children do not contract malaria as often as unvaccinated children.
  2. Poliovirus outbreaks increase sharply: Poliovirus (cVDVP) outbreaks have increased worldwide. Twenty-nine outbreaks occurred in 15 countries within a one-and-a-half-year period (2018-2019). The 29 outbreaks also tripled the number of outbreaks in the year prior (2017-2018) among six different countries. The Center for Disease Control (CDC) has send staff to the affected areas to provide treatment and prevention efforts.
  3. Measles numbers increased: Measles cases have increased tremendously in the last three years. In 2018, there were approximately 10 million measles cases with 140,000 deaths. The number of deaths has increased from 90,000 in 2016. People are not receiving immunizations due to different vaccination beliefs and the availability of vaccines. UNICEF is trying to address the issue; however, Xavier Crespin, UNICEF’s chief of health in the Democratic Republic of Congo, said it has been difficult.
  4. Global vaccination coverage has stayed the same since 2010: The global vaccination rate has stayed between 85 percent to 86 percent for the past eight years. This is due to the low availability of vaccines reaching areas of countries that are experiencing high poverty and warfare. False vaccination beliefs are also a factor in holding back coverage. The Global Vaccine Action Plan (GVAP) is working to address the issue by setting up vaccination stations in these countries as well as solving any vaccination challenges that stand in the way of vaccinating people. 
  5. New Respiratory Syndrome from Wuhan, China: Chinese health authorities have confirmed a case of new coronavirus in January 2020. The number of deaths has reached 80 with more cases expected. The virus has spread to Malaysia, Vietnam, Hong Kong, Korea and the United States, and the situation is on its way to becoming a global epidemic. WHO is closely monitoring the situation and issuing health advisories to affected countries.
  6. Preparing for Ebola in South Sudan: South Sudan is preparing for Ebola as its neighbor, the Democratic Republic of the Congo, had an outbreak. Warfare has devastated the country’s health system; health experts are suggesting ways to prevent and treat diseases. The country’s health governance deployed fully-immunized health workers to support prevention efforts with 32 outposts for screening and care along the border.
  7. Antiretroviral treatment (ART) reduces HIV mortality in Kenya: The use of antiretrovirals to treat HIV has reduced HIV-related death rates in Kenya as one researcher at the CDC Zielinski-Gutierrez confirmed. The CDC is leading the AIDS-control effort as part of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) all over the world including Kenya (PEPFAR Kenya).
  8. Shigella developed resistance to azithromycin and ciprofloxacin: In a research study, the virus that causes Shigella in men who have sex with men (MSM) has developed resistance to azithromycin, trimethoprim-sulfamethoxazole and ciprofloxacin. WHO put preventative measures in place like the Water and Sanitation Decade Development Project to promote water sanitation and hand-washing education.
  9. Tuberculosis (TB) is low in the U.S. but not globally: Residents who were born outside of the U.S. are much more likely to contract tuberculosis and carry latent TB infection. The CDC stated that 69.5 percent of newly diagnosed TB cases are of those who were born outside of the U.S. compared to 29.5 percent of those who were born in the U.S. Furthermore, countries other than the U.S. have higher TB death rates. The United Nations and WHO are targeting to end TB in 2030 and 2050 respectively.
  10. Donors pledge to donate $2.6 billion to end polio: Donors pledged to donate $2.6 billion at the Polio Conference in Abu Dhabi to help put an end to world polio. Donations come from the Gates Foundation, the U.K., the U.S., Pakistan and Rotary International. WHO will use the funding to vaccinate 450 million children each year.

Global health challenges are ongoing; however, many are working to address these challenges. Global health efforts will not go unnoticed as the world will become a healthier, happier and safer place for all. Finally, global health news updates are an excellent way to communicate all global health trends, challenges and ongoing projects. 

– Hung Minh Le
Photo: Flickr

TB in TanzaniaTanzania is a country located in East Africa that is home to 54 million people. Unfortunately, tuberculosis is a big issue within the country. Tanzania currently ranks within the top 30 countries worldwide that are most affected by tuberculosis. While the national TB budget has consistently stood at around $60 million. However, NGOs like APOPO are also doing their part to fight TB in Tanzania.

Why APOPO is Needed

Historically, Tanzania has struggled to supply clinics with rapid forms of testing. But this is where APOPO helps to bridge the gap. APOPO is an NGO fighting TB in Tanzania by using specially trained rats to detect cases of the disease. Along with the work this group does in Tanzania, it also helps fight against tuberculosis in Mozambique and Ethiopia. Since the program in Tanzania first launched in 2007, the group grew from collaborations with four government clinics to 57 clinics.

How APOPO Fights TB

Many forms of testing for tuberculosis are quite inaccurate. The better quality methods of testing can be quite expensive and take a longer time to get results. Cheaper forms of testing can often yield false results. Due to cheap testing, people will be given an inaccurate diagnosis. Government clinics in Tanzania mainly use smear microscopy tests due to the test’s affordability.

This method of detection has very low sensitivity rates that range from 20 to 60 percent. To combat the current inadequate forms of testing for tuberculosis, APOPO has implemented a program that uses specially trained rats. These rats can detect cases of tuberculosis at a fast and more accurate rate.

The rats at APOPO’s facilities can test 100 samples in 20 minutes, as opposed to technicians who can only check 25 samples per day. APOPO’s labs can get test results within 24 hours. APOPO’s rats have increased detection rates of tuberculosis by 40 percent.

APOPO’s Effect

APOPO is an NGO fighting TB in Tanzania that has seen success in its initiative to incorporate innovative tactics in the fight against tuberculosis. From 2000 to 2018 there have been decreases in total incidents of TB as well as a decrease in new and relapse cases in Tanzania.

Tuberculosis currently ranks within the top 10 causes of death across the world. APOPO already works with 57 clinics in Tanzania. This group’s success through alternative methods of testing can serve as an example of how to fight against the spread of tuberculosis.

– James Turner
Photo: Flickr

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. MeaslesMeasles 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. MeningitisMeningitis 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

10 Facts About Life Expectancy in Comoros
Comoros is a small country comprised of four islands located just off Africa’s eastern coast. Poverty is widespread across the island due to limited access to transportation to the mainland and very few goods that could be exported to encourage economic growth. These 10 facts about life expectancy in Comoros will demonstrate how poverty and other factors contribute.

10 Facts About Life Expectancy in Comoros

  1. The population of Comoros is rapidly growing with poor health services unable to keep up. As of 2018, the average was 350 people per square mile. Anjouan has the largest population of the Comoros islands. Overcrowding makes resources scarce and health is rapidly declining. The life expectancy of any person on the islands rarely exceeds the age of 65; in 2018, the CIA reported that only 3.98 percent of the population was 65 years or older. Most of the population are children from infancy to the age of 14 at 38.54 percent.
  2. Overcrowding on the island has led some to attempt illegal immigration to the French island of Mayotte. In 1995, the French government declared travel to Mayotte without a visa illegal. Immigration for the people of Comoros is more challenging, but it does not stop them from fleeing to find a better life outside of the overpopulated islands. As of 2017, 40 percent of the population of Mayotte comprised of illegal immigrants from Comoros. The journey is certainly not safe; The New Humanitarian estimates 200 to 500 deaths every year are a result of attempted immigration to Mayotte in the tiny fishing boats that the Comoros people call kwassa-kwassa. The majority of those who cross are children that parents send in search of a better life, contributing to the high mortality rate of children in Comoros.
  3. The overcrowding is due in part to the high birth rate as compared to the death rate. Despite the low age of life expectancy, the death rate overall is only seven deaths per 1,000 people as reported by the CIA. In comparison, the birth rate is 25 births per 1,000.
  4. The infant mortality rate, however, is extraordinarily high. The country ranks number 17 on the CIA’s list with an estimated 58 deaths per 1,000 births. The problem is, in part, due to the limit of financing toward health care and hospitals. Financing has not exceeded 5 percent in total government spending within the last few decades according to the African Health Observatory (AHO).
  5. Illness, as a result of low attendance to health care facilities, runs rampant in Comoros. Malaria was once the deadliest disease until 2011 when it finally began to decline. The Comoros government launched the Residential Spraying campaign to provide insecticide and treatments to the water. Transmittable diseases, according to a table released by the AHO, are the prime suspect for illness and fatality on the islands. Sixty-six percent of all deaths related to diseases are a result of transmittable illnesses, while only 25 percent are non-transmittable and 9 percent are due to injury or natural causes.
  6. Cardiovascular disease (CDV) is on the rise, according to a report by the World Health Organization (WHO); as of 2016, CDV has fatally affected 17 percent of the population of Comoros. The AHO links CDV to malnutrition and the consumption of less than adequate food to survive. Since 2005, cerebrovascular heart disease and ischemic heart disease have increased by 4.2 percent and 5.4 percent respectively. As of 2015, these diseases were the third and fourth most deadly in Comoros.
  7. Tuberculosis is also rampant on the islands; WHO estimates 28,000 of Comoros became infected with the deadly disease in 2017. Twenty-one thousand of those infected with TB died. Only 10 percent of the population receive a preventative for TB, clearly demonstrating the need for better health care access to increase life expectancy in Comoros.
  8. The leading cause of death as of 2015 is lower respiratory infections. This includes bronchitis, influenza and pneumonia, among others. According to WHO, 47 percent of all deaths in the country as of 2016 are due to communicable diseases such as these infections. The Institute for Health Metrics and Evaluation (IHME) reported that between 1990 and 2010, lower respiratory infections remained the deadliest issue in Comoros with an estimated 27,000 years of life lost among the younger generations fatally affected.
  9. Though illnesses are slowly declining, other health issues are beginning to arise in their place. A lack of adequate nutrition is beginning to plague the people of Comoros. The CIA estimates that Comoros exports roughly 70 percent of all food it grows, leaving very little for its people. According to a report in 2011 by the World Bank, 44 percent of children in Comoros are malnourished and one in every four children is born with low birth weight. This contributes to the infant mortality rate mentioned earlier. Vitamin A deficiency and anemia are the leading causes of health issues among those who are malnourished in Comoros.
  10. Sanitation issues are on the rise due to the overcrowded population. Water sanitation is one of the top concerns. The islands have very little freshwater resources; Grande Comoro, the main island, has no surface water at all and the people import water from the mainland. Meanwhile, the other 50 percent of the population in rural communities rely on collecting rainwater. The United Nations Development Program (UNDP) wants to change this dangerous way of living and ensure that all the citizens of Comoros have access to safe drinking water. With the government of Comoros, its goal is to increase the freshwater supply to 100 percent for all by the year 2030. With all parties assisting, the project has $60 million at its disposal.

These 10 facts about life expectancy in Comoros show that in recent years, aid to Comoros has increased, especially with sanitation. The life expectancy in Comoros is only one part of the problem that the people of the country faces. Comoros must come to an agreement with Mayotte and other countries accept the refugees who are seeking a better life.

– Nikolas Leasure
Photo: Flickr