Stigmatization of DiseasePeople often understand diseases as solely biological: an infectious pathogen harms the body and requires medical aid to defeat. However, disease also has social implications. Various social factors can impact not only someone’s likelihood of contracting a disease but also their likelihood of receiving quality medical care. One significant social implication affecting these factors is the stigmatization of disease.

Stigma, as defined by sociologist Erving Goffman, is an “attribute that is deeply discrediting.” Though we normally think of attributes like race, religion, ethnicity, sexuality and gender identity, stigma can also involve disease. The stigmatization of disease refers to the notion that a particular type of person, country or community are the carriers or source of a disease. Like all stigmatization, this involves the process of “othering,” or creating a “them” and an “us.” People attempt to keep the “us” safe by ostracizing the “them.” In the case of the stigmatization of disease, the stigmatized group becomes “them.” Here are four examples of the stigmatization of disease throughout history.

The Stigmatization of Disease: Four Examples

  1. Cholera is a bacterial disease that causes extreme dehydration and diarrhea. It is fatal without immediate treatment. The end of the 1800s saw a global cholera pandemic, with a high prevalence in Europe. This led to the United States quarantining immigrants when they arrived in the U.S., creating a dangerous association between immigrants and cholera. At the time, President Harrison declared that immigrants were “a direct menace to the public health.” This association between immigrants and disease lasted long after the threat of cholera was gone.
  2. Yellow fever is a viral infection carried by a specific species of mosquito. It causes fever, headache, nausea and, in severe cases, fatal heart and liver conditions. By 1850, yellow fever was rampant in southern American states. Cities like Charleston, Mobile and New Orleans faced the brunt of the disease. Because of tensions leading up to the Civil War, the North used the disease to attack the South. Northerners “denounced the South for its unhealthy conditions and people.” This stigmatization helped fuel the separation between “us” and “them” in the North and South. As such, it had lasting impacts on regional divides in the U.S.
  3. HIV/AIDS appeared in the United States in the 1980s. HIV is an aggressive virus that attacks people’s autoimmune system and can eventually lead AIDS. Because early cases affected gay men, doctors named the disease Gay-Related Immune Deficiency or GRID. This initial naming demonized gay men and made them appear to be the source of HIV. Later, the disease was renamed AIDS (Acquired Immunodeficiency Syndrome) when doctors realized that anyone can contract HIV. Despite this renaming, the association of gay men with HIV remains strong. Accordingly, fear and stigma continue to be a barrier to getting treatment in the U.S.
  4. COVID-19 first appeared in China in late 2019. Due to its origin, many people have engaged in racist and xenophobic attacks and discrimination against those of Asian heritage. The use of language such as the “Chinese virus” and “Wuhan virus” in the media and from political leaders has encouraged hate speech and physical attacks. In the U.K., citizens have punched and beaten Asian people. In Australia, two women beat Chinese students while yelling, “Go back to China.” In Texas, a Burmese family was attacked with a knife. This illustrates how the stigmatization of COVID-19 has resulted in extreme discrimination and violence against Asian people around the world.

How Stigma Impacts Care

As indicated above,  stigma creates barriers for stigmatized people to access quality care. Dana McLaughlin, a global health associate at the United Nations Foundation and graduate student at Johns Hopkins, elaborates on how stigma creates barriers to health. She understands stigma as having three components that can dissuade someone from seeking care and reduce the quality of care they receive:

  1. Internalized or Self-Stigma: This occurs when an individual with a disease internalizes the stigma. They may feel shameful about themselves and their condition. They might also fear telling family, friends and their communities about their condition because of possible ostracization. Either way, this internalized fear may prevent someone from seeking medical care.
  2. Public Stigma: This stigma refers to the general population’s opinions  about behaviors associated with people who have a certain disease. In other words, this is a negative cultural context that surrounds a disease. This can vary greatly between countries and cultures, so it’s important to recognize that the public stigma may not be universal.
  3. Structural Stigma: This refers to the social institutions that reflect and reinforce the stigmatization of diseases. For example, structural stigma may manifest as a lack of resources for care, like a limited number of doctors in marginalized communities. One of the most prominent manifestations of structural stigma is the criminalization of certain behaviors associated with specific diseases. With HIV, many countries criminalize sex work and intravenous drug use and stigmatize people who engage in these behaviors. This stigmatization may prevent individuals from receiving care for fear of arrest or punishment. On the other hand, stigmatized individuals may “go underground” and engage in even riskier behaviors, like sharing needles, to avoid police discovery.

Combating Stigma and Providing Care

McLaughlin explains that in the context of global health, it is important to understand the syndemic (occurring simultaneously) nature of stigma and disease. These two aspects are “correlating challenges that the global health community has to be able to respond to.”

For McLaughlin, responding to stigma requires prioritizing the needs and experiences of stigmatized people. This might mean allowing them to speak openly about the daily struggles they face due to stigma. It’s also essential that “the people who are most impacted and know the day-to-day challenges of stigma are at the root of planning.” This ensures that interventions and projects actually meet the needs of stigmatized communities. If people do need to change their behaviors, this message should come from respected community leaders. This will ensure that people trust public health advice, making them more likely to follow it.

Though the stigmatization of disease is a powerful force, viruses don’t pick and choose whom they infect. Association between certain types of people or places, behaviors and disease develop from fear and misinformation. Ultimately, it’s essential to question these associations and dismantle stigma by listening to stigmatized groups.

Paige Wallace
Photo: Flickr

COVID-19 Vaccine
The World Health Organization (WHO) is making plans for how a life-saving COVID-19 vaccine could be distributed around the globe.

COVID-19 Vaccine Distribution

There are concerns about countries “hoarding” stores of vaccines for their own citizens. The countries that have the most money on hand will have the ability to buy a larger portion of available vaccines for citizens. While global leaders have come together to pledge $2 billion towards the creation of a vaccine, there is currently no formal worldwide plan to successfully manage the future COVID-19 vaccine and its distribution.

The public-private partnership that lead to this $2 billion pledge, Gavi, focuses on increasing childhood vaccinations in underdeveloped countries. It has support from WHO, UNICEF and the Bill and Melinda Gates Foundation. Bill Gates himself has promised $1.6 million towards Gavi, along with $100 million to help countries that will need aid to purchase COVID-19 vaccines.

U.S. Involvement and WHO

The U.S. government has decided to stay out of the recent Gavi-organized funding pledge. The country has also pulled monetary support from WHO. In the past, the U.S. has been a large supporter of the creation of the HPV and pneumococcal vaccines, which has left many experts confused by the recent moves of the U.S. to disassociate itself from the larger global race towards a COVID-19 vaccine.

Beyond hoarding concerns, there are always issues surrounding legal and sharing agreements between countries, quality control, civil uprising and unrest and natural disasters when it comes to vaccine distribution.

A recent example of how the world dealt with vaccine distribution during a pandemic is the 2009-2010 H1N1 swine flu pandemic. With the money they had, wealthier countries purchased most of the vaccine available through early orders, leaving developing countries to scramble for leftover vaccine stores. Eyjafjallajökul’s eruption in Iceland in April of 2010 also created vaccine shipping delays. Many countries, such as the U.S., Australia and Canada would not let vaccine manufacturers ship vaccines outside of their countries without fulfilling their people’s needs first.

Going Forward

To create a successful global vaccination program requires the cooperation from all countries involved, not just a few. Many may die without the equitable sharing of vaccines as this pandemic will flourish in underdeveloped nations. It may be seen by the rest of the global community as selfish to not try and help other countries in their fight against the virus.

Even after a vaccine is created, different strains of COVID-19 could easily return to Australian, Canadian or American shores, wreaking havoc all over again. While there are efforts being made to prevent distribution issues with the future vaccine, without the help of the United States,—one of the wealthiest countries on Earth—it may be long before a COVID-19 vaccine is fairly distributed.

Tara Suter
Photo: Flickr

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

End Tuberculosis Now Act
Kosovo is a country in southeastern Europe that declared independence from Serbia in February 2008. It is Europe’s youngest nation, but also one of its smallest and poorest. Kosovo ranks 137th in the world for GDP per capita and the country’s overall budget is just above $2 billion. Despite the fact that Tuberculosis (TB) is a completely preventable, treatable and curable airborne infection, the virus continues to spread throughout developing nations—including Kosovo—killing more people per year than any other infectious disease. The End Tuberculosis Now Act seeks to address this silent pandemic by refocusing U.S. efforts towards effective TB prevention and treatment in Kosovo and other developing countries. Neither the House nor Senate has held a vote on the End Tuberculosis Now Act since its introduction in August 2019. Kosovo demonstrates the importance of this act and why Congress needs to address it.

Kosovo’s Tuberculosis Rates

Among its neighbors in southeastern Europe, Kosovo has one of the highest TB infection rates, trailing only Moldova and Romania. From 1999 to 2006, total TB cases in Kosovo were declining. This progress has since stopped, with infection rates plateauing at the rate they were in 2006. A limited budget has severely hampered Kosovo’s efforts to combat and eradicate TB.

Kosovo’s insufficient health system is one reason behind the country’s spread of TB. A majority of Kosovo’s residents are dissatisfied with their health service. In addition, the nation’s top health authority is not responsible for contact tracing, testing, treatment or any other method that people use to combat TB. Instead, non-governmental organizations have received this responsibility, resulting in a lack of central planning. The End Tuberculosis Now Act would refocus USAID efforts on TB prevention and treatment in developing nations like Kosovo, providing a unified example of how to properly stop the spread and financially support affected individuals.

Kosovo and COVID-19

For some of the same reasons it struggles with TB, Kosovo is also struggling to stop the spread of COVID-19. Compared to its neighbors, the country’s pandemic response is falling short. Kosovo is much smaller than Albania, Montenegro and Greece, but has many more COVID-19 cases and deaths than these nations.

The COVID-19 pandemic has further exposed the aforementioned weaknesses in Kosovo’s healthcare system. For example, temporary medical facilities built to increase the nation’s hospital capacity have not been properly set up to prevent COVID-19 transmission between healthcare workers and infected patients.

No matter how valiant Kosovo’s efforts to combat COVID-19 are, the country is ultimately limited by its $2 billion yearly budget. The same is true when it comes to their fight against TB. Kosovo simply lacks the capital to properly test, treat and prevent the spread of both COVID-19 and TB. The End Tuberculosis Now Act will give developing nations like Kosovo a better chance of defeating TB while teaching them how to tackle similar pandemics.

Putting the Tuberculosis Fight on Hold

As the COVID-19 pandemic takes center stage, the fight against TB has been put on hold across the world. Despite this, TB has continued its spread. Approximately 80% of worldwide programs to combat the disease have experienced disruptions in their supply chains since the beginning of the COVID-19 pandemic.

Manufacturers of TB tests have pivoted to developing COVID-19 tests, reducing the overall availability of TB testing. This means massive drops in diagnosing TB. In one year, an infected individual can spread the virus to 15 people, making the diagnostic process extremely important. As testing capacities decrease, TB will continue its spread unabated in developing nations. Kosovo was already struggling to contain TB before the COVID-19 pandemic, but it could now get much worse. The End Tuberculosis Now Act is a critical component in increasing testing capacities in Kosovo to combat the spread of TB.

More Important Than Ever

TB is a preventable and treatable disease, yet it continues to kill more people worldwide than any other infectious disease. The End Tuberculosis Now Act would increase investments in TB prevention and treatment measures while saving countless lives in developing nations like Kosovo.

Furthermore, the bill would ensure that nations and non-governmental organizations receiving aid from USAID would stand by their commitments to eradicate TB. This refocusing of aid would provide the World Health Organization and the Stop TB Partnership with more resources to fulfill their missions.

Moving Forward

Kosovo’s continued fight against TB demonstrates the importance of the End Tuberculosis Now Act. The bill, introduced in August 2019, would save lives in developing nations and help combat a completely preventable and treatable disease. Congress must pass this bill to increase the quality of life for the world’s poor and help eradicate TB in developing nations.

Marcus Lawniczak
Photo: Flickr

Ebola outbreakThe Ebola Virus Disease (EVD) has ravaged countries in sub-Saharan Africa since its identification in 1976. Overall, there have been 34 outbreaks of Ebola in Western Africa, 11 of which have occurred in the Democratic Republic of Congo (DRC). The largest Ebola outbreak, considered a global pandemic, lasted from 2014 to 2016. It mostly affected countries like Sierra Leone, Liberia and Guinea. At the time, a total of 11,310 deaths were reported due to the disease.

The fatality rate for Ebola has ranged between 25% and 90%, depending on the severity of the outbreak and on the healthcare infrastructure of affected countries. The more modern and accessible these systems were, the more efficient the surveillance and treatment options. The second-largest outbreak of Ebola began in the Kivu region of the DRC on Aug. 1, 2018, and was only declared over as recently as June of 2020.

Containment in the DRC

Comparing the 2014 Ebola outbreak with the one that occurred in 2018 reveals a relative improvement. From 2014 to 2016, there were 28,616 EVD cases that resulted in 11,310 deaths. On the other hand, from 2018 to 2020, there were only 3,481 cases and 2,299 deaths reported.

DRC’s commendable public health response to the 2018 Ebola outbreak led to this outcome. Pre-existing infrastructural inadequacies and a lack of trust in health care officials have been the major challenges faced during Ebola occurrences. Though many of these problems continue, the better use of surveillance, contact tracing, prevention strategies and safe burial practices have greatly shaped how the most recent outbreak developed. Additionally, the global health community has made strides in vaccine development and treatment programs, making the defeat and containment of this epidemic possible.

Safe and Dignified Burials

Because the virus is transmitted through direct contact with an infected individual (living or deceased), traditional burial practices that require family members to wash the body pose a significant risk to communities during Ebola outbreaks.

In 2014, rural populations of Sierra Leone experienced surges in reported Ebola cases as a direct result of community members’ attending funerals and touching infected corpses. Since then, the CDC, the Sierra Leone Ministry of Health and Sanitation and the WHO have provided guidelines for safe protocols when handling potentially infected corpses. These protocols involve trained personnel and extensive personal protective equipment (PPE). During the recent contained Ebola outbreak, 88% of funerals utilized safe and dignified burial practices.

Vaccination Efforts

As a result of the most recent epidemic, 16,000 local responders and 1,500 WHO health workers collaborated to provide effective vaccines to 303,000 people. Individuals were considered eligible for vaccination if they had previous contact with an infected individual or were a frontline worker in an affected or at-risk area. Treatment centers, field laboratories and an Ebola national care program were also set up to care for patients, providing weekly test samples and follow-up with survivors.

EVD versus COVID-19

The world has seen other deadly viruses before COVID-19. SARS, Ebola and even the annual flu are some examples. COVID-19 stands out because it is easily spreadable and the rate of asymptomatic transmission is high. Asymptomatic transmission occurs when individuals don’t know they are infected and, as a result, spread the virus without knowing. Even though Ebola is highly contagious toward the end of the infection period, infected individuals show intense symptoms, so it is not easy for the virus to fly under the radar as COVID-19 tends to do.

Moreover, while health responses against Ebola are significant in fighting the spread of the virus, the vaccine and treatments are the real superheroes in protecting large populations and infected patients from the virus. As the world witnessed in the 2014 outbreak, Ebola left a devastating death toll in its wake without a vaccine. There are currently no viable vaccine or treatment options for the coronavirus, although development is currently in progress.

Moving Forward

Because preparedness plays a large role in within-country health responses, it is hopeful that future Ebola outbreaks will be contained. The health responses, vaccination programs and treatment options utilized by the DRC are applicable to other countries as well. Aid from WHO and other health agencies will lessen the threat of Ebola in Western Africa and the world.

– Nye Day
Photo: Flickr

Dengue Fever in Bangladesh
Dengue fever is a severe virus that claims the lives of hundreds of thousands of people every single year. It is present in over 100 countries worldwide, including the Philippines, Honduras and Sri Lanka; however, the country of Bangladesh is currently experiencing the worst outbreak in history.

Not only is dengue fever in Bangladesh a serious threat, but according to the World Health Organization (WHO), the virus is now a rising threat to the entire world.

What is Dengue Fever?

Mosquito bites spread the virus dengue fever. There are multiple strands and severities of the sickness, including severe dengue, which is the deadliest. Symptoms of dengue, which include a fever accompanied by a rash, nausea, vomiting and pain, can last up to seven days. Severe Dengue will make itself manifest within 24-48 hours of infection and generally occur after the fever has dissipated. These symptoms are more severe in nature and include pain, vomiting blood, bleeding from the nose or gums, fatigue, irritability and restlessness.

One of the Top 10 Threats to Global Health

Although dengue specifically affects mosquito prone areas, these areas still include over 100 countries worldwide and 300 million people. This equates to almost 40 percent of the world’s population who are at risk of contracting dengue.

Every year, the virus infects close to 400,000 individuals. From there, over 22,000 die from severe dengue. This virus has slowly increased in prevalence and severity throughout the years, and in 2019 the World Health Organization (WHO) announced that dengue fever is one of the top 10 threats to global health in 2019. The organization explained this was not only due to the hundreds of thousands of cases that emerge every single year, resulting in horrible death tolls across multiple countries but also because the prevalence of dengue has increased 30 percent in the last 50 years.

What is Happening in Bangladesh?

Bangladesh is currently experiencing the worst outbreak of dengue fever to date. Dengue has been a growing threat for decades, with longer seasons of infection, rising death tolls and changing symptoms. Now, dengue has infected Bangladesh with previously unforeseen ferocity.

Since January 2019, there have been almost 40,000 cases of dengue in Bangladesh alone. The virus has spread throughout all of Bangladesh, but over 86 percent of cases of dengue fever come from the capital, Dhaka. The number of reported deaths in Bangladesh due to dengue is 29. However, that number could be much higher. This is due to the difficulties of determining if a death was the direct cause of dengue. Without proper blood samples and information from those who pass away, determining if a death was the direct cause of dengue is impossible.

Efforts to Aid the Dengue Fever Situation

With such a severe outbreak in the country, Bangladesh is doing all it can to ensure the health of its people. For example, The Communicable Disease Control (CDC) unit of The Directorate of General Health Services (DGHS) releases regular updates on the situation of dengue fever in Bangladesh in order to inform the public of the outbreak and it is doing. It reported that as of August 2019, almost 30,000 dengue patients were able to go home since the beginning of the outbreak. On the other hand, there are almost 10,000 currently admitted patients, and this number is rising by the hundreds every single day.

In order to combat dengue, the DGHS has implemented several strategies. At the beginning of August 2019, doctors in all 64 districts of Bangladesh received training on dengue treatment and management. The DGHS is also focusing on informing the public of prevention measures against dengue by sending messages of awareness through various media platforms and informing journalists in media briefings on various preventative measures.

Dengue fever is a severe and often fatal illness, and a serious threat to global health. Bangladesh is not the only country at risk, and the outbreak of dengue fever in Bangladesh could very well develop in countless more countries. Without serious attention given to the treatment and eradication of this virus, dengue fever will continue to claim more and more lives.

– Melissa Quist
Photo: Flickr

HIV/AIDS in Botswana

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

“Masa” Program

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

UNDP Efforts

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

“90-90-90” Targets

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

New Health Strategies

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

– Hayley Jellison
Photo: Flickr

Ebola in the Democratic Republic of the Congo

In August of 2018 the Democratic Republic of Congo declared an Ebola outbreak. The first case of the virus erupted in the city of Goma, located on the border of Rwanda. As the tenth Ebola outbreak in Congo within 40 years, the virus became a public health concern for the over 1 million people that call Goma home. Goma also acts as a popular transit hub for many people crossing the border into Rwanda putting the population at a heightened risk for the disease to spread. The International Health Regulations Emergency Committee has met four times following this initial Ebola case.

  1. A Widespread Disease: Congo’s ongoing Ebola outbreak is now the world’s second-largest. According to The World Health Organization (WHO), the virus has infected 2,512 people and killed 1,676. The largest Ebola outbreak on record took place in West Africa killing more than 11,300 people. WHO continues its efforts to stop the spread of the disease in Congo with its team of medical specialists. In the worst cases, death and uncontrollable bleeding have resulted from the viral hemorrhagic fevers of the disease.
  2. A Global Issue: On July 17, 2019 the World Health Organization (WHO) declared the Ebola outbreak in Congo a global health emergency. Following the first case of Ebola, intensive training for the prevention and control of the virus heightened for more than six months. News of a female traveller from Beni that contracted the virus, and then visited Uganda sparked growing concern in Uganda and Congo. Between June and July of 2019 an estimated 245 confirmed cases of Ebola were reported in the North Kivu and Ituri provinces of Congo. WHO makes the continuous effort to monitor the cases of those infected, as well as travel and trade measures in relation to the virus.
  3. Dangerous Territory: The Ebola response teams in the Democratic Republic of Congo face violent attacks. David Gressley, the United Nations’ secretary-general, became the deputy of the U.N. missions in Congo and witnessed it firsthand. Gressley requested a force of peacekeepers along with the health officials to assist him amid the attacks. The violent attacks often hinder the Ebola responders from treating people with the virus, and still no one knows the reasoning or people behind the attacks. The U.N. estimates that due to the attacks about 1,200 have been shot or slashed to death with machetes. One popular theory points to Congolese politicians orchestrating the attacks in order to undermine political rivals. On the other hand, the Congolese government blames the Mai Mai militia. Rumors continue to swirl that the U.N. responders fail to treat Ebola patients, and intentionally spread the virus which makes them even more susceptible to these attacks.
  4. Catching Ebola: Common diseases such as measles and malaria share initial symptoms of Ebola. Many medical specialists in Congo believe that to put a stop to this epidemic they first must isolate the disease. Most Ebola patients receive a diagnosis too late, and go through multiple health facilities before getting treatment. Response teams understand that controlling the transmission of Ebola, and catching the disease in its early stages has the potential to save an entire community.
  5. The Ebola Vaccination: More than 111,000 people have received the Ebola vaccination. Developed by Canadian scientists, the Ebola vaccine (also known as the rVSV-ZEBOV vaccine) consists of an animal virus that can wear a non-lethal Ebola virus protein, which results in the human immune system developing a pre-emotive defense to the disease. Health care professionals, and family members of Ebola patients are the majority of those vaccinated. Health care responders in Congo ensure that all the contacts of Ebola patients receive a vaccine to stop the epidemic. Reports show no deaths from individuals that developed Ebola symptoms more than 10 days after receiving the vaccination.
  6. Promoting a Disease-Free Environment: Medecins Sans Frontieres/Doctors Without Borders (MSF) promotes healthcare and community engagement in Congo. This organization sends teams to determine and assist the medical needs of populations in crisis with exclusion from healthcare. Among the Ebola outbreak in Congo, MSF continues to provide free healthcare for non-Ebola needs, such as malaria and urinary tract infections. First starting in the city Goma, the MSF has now shifted aid to the Ituri province to limit infections with sanitation activities, and provide access to clean water.

These six facts about the Ebola outbreak in Congo demonstrate global organization’s enthusiasm to assemble in times of crisis. Countless organizations continue to lend support to the Democratic Republic of Congo, and in due time the country will be at its best with a healthy population.

– Nia Coleman
Photo: Flickr

10 Scary Facts About the Zika Virus
The Zika virus was first discovered in Uganda in 1947 through a group of diseased monkeys. In 1952, the first infected human was found in Uganda and the United Republic of Tanzania. The Island of Yap is the first location where a large scale outbreak of the Zika virus was recorded. This incident took place in 2007. There are currently no countries facing a sizeable Zika outbreak, however, there may be a risk of contracting the disease in regions where the Aedes species of mosquito is prevalent. This article looks at the top 10 scary facts about the Zika Virus.

10 Scary Facts About the Zika Virus

  1. People are more likely to contract the Zika virus in poor countries. Mosquitoes that carry Zika often breed in stagnant water. These buildups of stagnant water are found in areas where communities lack adequate plumbing and sanitation. According to the United Nations Development Programme, poor households are least equipped to deal with the virus and are most likely to be exposed to the disease.
  2. Women face the biggest consequences during a Zika outbreak. Health ministers throughout Latin America have told women not to get pregnant during a Zika epidemic. In poorer countries, women lack access to sexual education, which leaves them vulnerable to misinformation. Furthermore, women may be blamed for contracting the virus during pregnancy, which carries an unfair social stigma.
  3. Zika poses a threat to unborn children. In some cases, when a pregnant woman is infected by the virus it disrupts the normal development of the fetus. This can cause debilitating side effects like babies being born with abnormally small heads and brains that did not develop properly. This condition is called microcephaly. Symptoms of microcephaly are seizures, decreased ability to learn, feeding problems, and hearing loss.
  4. Even though a mosquito bite may be the most well-known way to contract the Zika virus, it is possible to get the disease through other avenues. It is possible to get the disease during unprotected sex with a partner, who already have been infected by the virus. Individuals can also contract the virus during a blood transfusion or an organ transplant.
  5.  Symptoms of a Zika virus infection may go unnoticed. The symptoms can be described as mild. If symptoms do occur they can present themselves as a fever, rash or arthralgia. This is especially dangerous for pregnant women because they may not know that they have been infected, unknowingly passing it on to their unborn baby. There is no treatment available to cure this disease once it has been contracted.
  6. There are other birth defects associated with the Zika virus. Congenital Zika syndrome includes different birth problems that can occur alongside microcephaly. Some malformations associated with congenital Zika syndrome include limb contractures, high muscle tone, eye abnormalities, and hearing loss. Approximately 5-15 percent of children born to an infected mother have Zika related complications.
  7. The cost of caring for a child born with Zika related complications can be quite expensive. In Brazil, each kid born with the disease could cost $95,000 in medical expenses. It would cost approximately $180,000 in the U.S. to care for the same condition. Some experts believe the numbers are higher when taking into account a parent’s lost income and special education for the child.
  8. Even though there are more than 10 scary facts about the Zika Virus, there are also measures being taken to prevent future outbreaks. Population Services International (PSI) is working with the ministries of health in many different Latin American countries to spread contraception devices. This promotes safe sex practices. This also gives the women the power to decide if and when she wants to become pregnant.
  9.  The World Health Organization (WHO) is also implementing steps to control the Zika virus. Some of these steps include advancing research in the prevention of the virus, developing and implementing surveillance symptoms for Zika virus infection, improving Zika testing laboratories worldwide, supporting global efforts to monitor strategies aimed at limiting the Aedes mosquito populations and improving care to support families and affected children alike.
  10. The good news is that there are currently no major global outbreaks of the Zika virus. This is a sign that steps around the globe have been successful to lower the number of Zika cases. However, this doesn’t mean that precautions shouldn’t be taken when traveling to areas where the Aedes species of mosquito is prevalent. Even though they are no major outbreaks the disease still exists and may cause problems if contracted.

Conclusions

Even though the Zika virus may currently not be a threat worldwide, it is still something that needs to be accounted for. Zika has serious repercussions in poverty-stricken countries where people can’t afford adequate medical care. The Zika virus is also more likely to be contracted in poorer regions. The Zika virus has a strong correlation with poverty.

– Nicholas Bartlett
Photo: Flickr