Dementia in AfricaDementia is universally feared and stigmatized because it is mistakenly viewed as a gradual part of aging. There has been no research found to treat these symptoms, but there are ways to care for and uplift those in need to reduce the risk of dementia around the globe — including Africa.

5 Facts to Raise Awareness About Dementia in Africa

  1. Dementia is an umbrella term under which Alzheimer’s disease can fall. Dementia is categorized as a syndrome and does not have a definitive diagnosis. It is a group of symptoms that affect mental cognitive tasks such as memory and reasoning, Health Line reported. According to Health Line, as dementia progresses with age, it can have an impact on the ability to function independently, placing an emotional and financial burden on families.
  2. Dementia currently affects more than 47 million people worldwide. More than 75 million people are expected to be living with dementia by 2030. Dementia in Africa will rise over the next decades due to an aging population, an increase in noncommunicable diseases and the effects of the HIV pandemic. Even though there has been a reduction in HIV contractions, the disease still leaves its mark as a conduit for dementia. According to The Conversation, South Africa accounts for 17 percent of the global burden of HIV infection. HIV is linked with cognitive decline and leads to HIV-associated dementia (HAD). The Conversation stresses that health care and social care systems are a crucial step toward getting society involved and aware. The World Health Organization (WHO) had a conference in 2015 to discuss global action against dementia. The committee stated that raising generational awareness was essential for encouraging action from younger generations. There is a need to search for disease-modifying therapy, improve care and quality of life and reduce the risk of dementia in Africa.
  3. The WHO emphasized that people must embed a rights-based approach in all interventions. Specifically, the WHO’s committee illustrated the importance that people living with dementia deserve empowerment. The goal is to provide support to exercise their rights and have access to enhanced autonomy to reduce the risk of dementia in Africa. Margaret Chan, director-general at the WHO, offered her view on the conference and its goals.“I can think of no other disease where innovation, including breakthrough discoveries to develop a cure, is so badly needed,” Chan said.
  4. The First WHO Ministerial Conference on Global Action Against Dementia sought to promote a better understanding of dementia, raise public awareness and engagement, demand respect for the human rights of people living with dementia, reduce stigma and discrimination, and foster greater participation, social inclusion and integration. The approval of the WHO Global Action Plan on Dementia in May 2017 allowed Alzheimer’s Disease International to put greater pressure on governments to take the issue with urgency and reduce the risk of dementia in Africa. In the African continent, there is a need for new studies to evaluate dementia prevalence, incidence, mortality and to monitor changes over time. According to WYLD Network, these studies are crucial to emphasize to governments, local and international organizations the necessity to target health policies for older people and the development of strategies for dementia care in sub-Saharan Africa.
  5. As the WHO progresses toward awareness to reduce the risk of dementia in Africa, it instilled an international surveillance platform, the Global Dementia Observatory. The WHO established this for policy-makers and researchers to facilitate monitoring and sharing of information on dementia policies, service delivery, epidemiology and research.

While there is no cure for dementia, several plans like the Global Action Plan on Dementia pave the way for successful care of those developing dementia. Updated research to reduce the risk of dementia in Africa is essential to inform officials of the development and empowerment for the most vulnerable.

Carolina Chaves
Photo: Creative Commons

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

Impeding Access to Vaccines

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

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

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

Improvements Made in Vaccinations

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

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

The Future of Disease Control

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

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

– Aria Ma
Photo: Flickr

African Programme for Onchocerciasis Control’s Tremendous Success in Eliminating River Blindness in Senegal
Onchocerciasis, more commonly known as river blindness, is a skin and eye disease transmitted to people by infected blackflies. The infection is classified as a Neglected Tropical Disease (NTD) due to its prevalence and intensity. The World Health Organization reports that river blindness is the “world’s second leading infectious cause of blindness.” This process prevents adults and children from participating fully in everyday life, thus perpetuating the cycle of poverty. Fortunately, the African Programme for Onchocerciasis Control has shown tremendous success in eliminating river blindness in Senegal.

Of all the people infected, 90 percent live in African Regions, particularly around fertile river valleys. In these areas around 50 percent of men over the age of 40 have been blinded because of the disease. There have been around 37 million people affected by onchocerciasis. Although the numbers remain high, they illustrate a tremendous improvement in reducing river blindness. Some countries have even been able to eliminate the disease.

Senegal

World Food Programme reports Senegal as having “persistently high poverty rates” typically around 75 percent of people living in chronic poverty. Additionally, 17 percent of people living in rural areas are food insecure. With high poverty rates often comes vulnerability to disease often due to a lack of resources and access to healthcare facilities.

In 2009, the World Health Organization (WHO) reported that river blindness in Senegal showed a drastic disappearance after just 15-17 years of annual treatments. By 2016, 7.2 million people had received treatment for various NTDs. For river blindness alone, the overall treatment coverage had increased from 51 percent to 69 percent that year. This means around 629,000 people received treatment in 2016 while 915,000 were pending treatment in Senegal.

African Programme for Onchocerciasis Control (APOC)

Much of the success in eliminating river blindness in Senegal is accredited to the African Programme for Onchocerciasis Control. In 1995, the African Programme for Onchocerciasis Control (APOC) was launched to control onchocerciasis outbreaks throughout endemic countries in Africa. With funding from the World Bank’s Trust Fund mechanism, APOC was able to allocate money in accordance with each country’s unique needs. As of 2007, APOC had spent $112 million over 12 years of operations, which is relatively low.

In 2010, a total of 75.8 million people of APOC participating countries had received treatment. Projections show that by 2020, APOC will have eliminated river blindness in 12 countries. The program is unique in that it establishes a platform for community involvement. Rural communities feel a sense of empowerment at being able to take control of the situations and help the people in their community.

Community-Directed Treatment of Invermectin (CDTI)

The African Programme for Onchocerciasis Control uses resources readily available in the participating communities, particularly citizen volunteers who conduct most of the local healthcare. Getting to rural areas is incredibly difficult due to terrain, so the implementation of mobile units was found to be ineffective. Often higher risk communities needed a response quicker than what the mobile units could execute, which is where having local volunteers is so vital.

Volunteers are locally elected and trained by professionals in APOC. Their main goals are to collect and administer the ivermectin tablets, the main medicine for treating river blindness. WHO advises a yearly dose for around 10-15 years.  Within their communities, they track and detect signs of infections. In cases were treatments require more care, volunteers are expected to help their patients get to the nearest health facility. In this process, the communities gain a sense of empowerment and engagement by being involved in solving their own health and development.

Successes

By 2006, 11 years after the program’s initial launch, APOC was able to treat 46.2 million people. By 2015, the number more than doubled to 114 million people. World Health Organization reports that in 2014, more than 112 million people were treated for onchocerciasis within 22 countries in Africa- representing 65 percent of global coverage.

World Health Organization has made plans to model the efforts of APOC. The involvement of the community in the process of medicinal distribution proved revolutionary in eliminating the presence of river blindness in Senegal. Additionally, to meet the Millennium Development Goal number one, poverty alleviation, WHO’s Strategic and Technical Advisory Group for Neglected Tropical Diseases has created a guide for further eliminating river blindness throughout Africa. Most of these goals will be reviewed in 2020.

Progress is happening. APOC was able to accomplish the seemingly impossible task of almost eliminating the presence of river blindness in Senegal. Projects will continue to be successful if they use techniques like monthly treatments and the incorporation of the people in local communities to continue in the fight against neglected tropical diseases.

Taylor Jennings
Photo: Flickr

ending child deaths
Each year pneumonia and diarrhoea kill 1.4 million children under the age of five, which is an amount greater than the deaths from all other child illnesses combined. Children in poorer nations are more likely to be victims of these illnesses, hindering long-term growth and development in these countries.

UNICEF and WHO Are Trying to Save Children’s Lives

Created by UNICEF and The World Health Organization (WHO) in 2009, The Global Action Plan for Pneumonia and Diarrhoea (GAPPD) seeks to reduce the number of children affected and, ultimately, end preventable child deaths from pneumonia and diarrhoea. Progress has been slow, but over the past few years, UNICEF and WHO have increased their commitment to focus on these illnesses, hoping to significantly reduce deaths from pneumonia and diarrhoea by 2025.

Pneumonia is a respiratory infection that primarily affects the lungs and can be caused by bacteria, viruses or fungi. For those who have pneumonia, the alveoli in their lungs fill with fluid, making breathing both difficult and painful. Infants with HIV have an increased likelihood of dying after contracting pneumonia.

Diarrhoea, often caused by Rotavirus or Escherichia coli (e-coli) bacteria, is a symptom of an infection of the intestinal tract caused by viruses, bacteria or other parasitic organisms. This bacteria spreads easily through water, food or from person to person. According to UNICEF and WHO, diarrhoea causes extreme dehydration, which can lead to death. Poor sanitation and hygiene increase the risk of becoming infected.

Younger children are the most likely to die from pneumonia and diarrhoea, with 80 percent of deaths from pneumonia and 70 percent of deaths from diarrhoea occurring during the first two years of life. Additionally, over 90 percent of child deaths from pneumonia and diarrhoea occur in low income countries.

Progress Made So Far

Overall, between 2000 and 2015, significant global progress was made with diarrhoea deaths decreasing by 57 percent and pneumonia deaths decreasing by 47 percent. In spite of this progress, there is still much more that needs to be done.

South Asia and Sub-Saharan Africa are disproportionately affected, as child deaths from pneumonia and diarrhoea in these regions have been increasing. In 2000, 20 percent of pneumonia deaths and 24 percent of diarrhoea deaths occurred West and Central Africa. In 2015, however, these regions accounted for 32 percent of pneumonia deaths and 34 percent of diarrhoea deaths.

By 2025, UNICEF and WHO would like to reduce mortality from pneumonia to fewer than three per 1000 births, reduce mortality from diarrhoea to fewer than one per 1000 births and reduce the incidence of severe pneumonia and diarrhoea by 75 percent, compared to 2010 levels. Additionally, they are working towards 90 percent full-dose coverage of all relevant vaccines and at least a 50 percent increase of exclusive breastfeeding during the first six months of life.

What Steps the GAPPD Are Taking to Reach its Goals

To help meet these goals, the GAPPD uses a Protect, Prevent and Treat framework in their efforts to decrease the incidence of these infections. Protection initiatives focus on ensuring that all infants are exclusively breastfed for six months, that all children under the age of five are well nourished and that they receive vitamin A supplementation.

Prevention tactics include improving the quality of drinking water and overall sanitation, encouraging everyone to wash their hands with soap, providing vaccines (specifically for pertussis, measles, hib, PCV and rotavirus), reducing household air pollution and preventing the spread as well as treating HIV-infected and exposed children.

In order to treat children, the number of families who seek medical attention after their child has become ill due to pneumonia or diarrhoea needs to increase. Globally, only three out of every five children are seeking care for pneumonia symptoms. GAPPD hopes to provide medical centers supplies they need to be better equipped, including ORS (oral rehydration salt solution), which prevents the dehydration that occurs with diarrhoea, and oxygen, which is needed for oxygen therapy for children with severe pneumonia.

Technology to Aid in the Efforts

New innovations from the past few years have contributed to efforts to prevent child deaths from pneumonia and diarrhoea. Gravity-fed water supply schemes, which transport river water through pipes using gravity, help reduce the labor required to carry water long distances and, thereby, increase access to water. UNICEF helps communities in Afghanistan, Madagascar, Timor-Leste and Lao People’s Democratic Republic operate and maintain these systems.

In order to ensure infants and young children have access to breast milk, a small feeding cup has been developed by PATH to help infants with breastfeeding difficulties get the breast milk that they need. There has also been a push for breast milk to be donated to hospitals for premature and sick babies. Brazil now has over 200 milk banks and more than 150,000 Brazilian mothers have arranged to donate their breast milk.

In 2016, the GAPPD developed a Monitoring Visualization Tool that allows them to monitor progress toward 2025 goals both globally and for specific nations. With the knowledge gained from this tool, UNICEF and WHO can more strategically coordinate their efforts

It remains to be seen whether UNICEF and WHO will achieve their 2025 goals. However, with new innovations and continuing progress, the elimination of preventable child deaths from pneumonia and diarrhoea can be achieved, hopefully in the near future.

– Sara Olk
Photo: Flickr

Bloodless Malaria Test Sets Bright Future for Sub-Saharan AfricaBrian Gitta is the first and youngest Ugandan inventor to win the African prize for releasing his highly innovative bloodless malaria test. A device called Matibabu tests for malaria by shining a beam of light onto the patient’s finger and can be downloaded on mobile devices.

Matibabu

This bloodless malaria test is low cost and reusable and doesn’t require a physician’s presence. Gitta, in an interview with United Press International, said: “We are incredibly honored to win the Africa Prize — it’s such a big achievement for us because it means that we can better manage production in order to scale clinical trials and prove ourselves to regulators.” These clinical trials will open up new partnership opportunities for Matibabu and vastly expand its entrepreneurial ability.

Many scholars say that Matibabu is “a game changer” for the thousands of people affected by malaria. Clinical trials show that Matibabu has an 80 percent effectiveness rate in identifying malaria, and with constant technology adjustments, Gitta hopes to bring that number up to 90 percent in the coming months.

Gitta’s team continues to perform research on the device as it awaits examination from global regulators. Until the app’s official approval, support from the academic community continues to surface, offering financial and supportive aid to Matibabu.

Malaria in Uganda

Malaria, as defined by the CDC, is a mosquito-borne disease caused by a parasite. People who become infected often experience flu-like symptoms, such as fever, chills, abdominal pain, vomiting or nausea.

In 2016, there were 216 million cases of malaria and over 400 thousand deaths linked to the disease. Uganda specifically bears a large burden by carrying the highest prevalence of malaria, with a rate of 478 cases per 1000 people on yearly basis.

Major challenges of malaria include high transmission intensity, inadequate healthcare resources and inadequate preparedness and response. Since 2014, the disease has decreased by almost 20 percent, but the prevalence is still striking. Inadequate resources include the inability to correctly diagnose the disease due to unqualified staff and inadequate training.

Several attempts have been made in the past to eliminate malaria. Some examples include insecticides and other chemically stronger indoor residual spraying of insecticides. Another example is the utilization of artemisinin-based therapy, which involves the prescription of two separate drugs used to eliminate the parasite located in the bloodstream.

However, these remedies have not proven to be one hundred percent effective. Data from the last decade shows no convincing evidence that malaria has decreased in Uganda in recent years. Gitta’s bloodless malaria test, however, is giving hope to many Ugandan residents who still face the struggle of diagnosis.

Benefits to the New Test

There are several long-term benefits of tests like Matibabu. The accessibility for the general public is arguably the most beneficial, as rural communities now have access to technology and can easily download the app.

Another benefit is that testing is more beneficial and cost-effective than presumption diagnosing. By affirming that a patient does, in fact, have malaria, available resources for malaria treatment can be distributed in the right way.

Furthermore, the World Health Organization states that: “Prompt parasitological confirmation by microscopy or alternatively by RDTs is recommended in all patients suspected of malaria before treatment is started. Treatment solely on the basis of clinical suspicion should only be considered when a parasitological diagnosis is not accessible.” By confirming a diagnosis, planning and treatments can be better financed through a more efficient allocation of money. For example, money being saved for testing could now be financed toward the research of other diseases in Uganda.

Matibabu plans to continue research in the upcoming months. By studying local transmission rates and local treatment costs, Matibabu is better suited to help the welfare of not only Uganda but many sub-Saharan African countries struggling to fight malaria.

– Logan Moore
Photo: Flickr

World Health Organization
The World Health Organization (WHO) is a worldwide company first launched in April of 1948. WHO was established as a specialized agency of the United Nations, created to focus on improving the health of our society.

Now employing more than 7000 people in 150 countries around the world, WHO strives to ensure that everyone has access to the most basic needs everyone deserves. The World Health Organization focuses on several important areas, including noncommunicable and communicable diseases, health systems and promoting health through the life course.

Smallpox and Polio

The WHO’s campaigns against two deadly diseases of smallpox and polio were extremely notable. Thanks to the WHO’s multimillion-dollar vaccination campaign, the smallpox vaccine became available around the world in 1967. The campaign was successful, and by 1980, the world was free from the disease.

In 1988, the World Health Organization once again created a vaccine campaign, but this time for polio. Polio was once a disease that affected people all over the world, but thanks to the efforts of the WHO, it is now confined to South Asia and Africa.

The Eliminate Yellow Fever Epidemics Campaign

In April of 2018, WHO announced it would be collaborating with several organizations — including Gavi the Vaccine Alliance, UNICEF and many others — to vaccinate close to one billion people in Africa against yellow fever. The hope is to have reached this goal by 2026.

This campaign is called the Eliminate Yellow Fever Epidemics, and was launched by Dr. Tedros Adhanom Ghebreyesus, who stated, “With one injection we can protect a person for life against this dangerous pathogen.” This is just one of many comprehensive strategies created by this organization to combat the outbreak of deadly diseases across the globe.

The World Health Organization, along with Gavi The Vaccine Alliance and many other organizations, have made an incredible amount of vaccines available all over the world. They have collaborated to provide vaccines for things such as tuberculosis, measles and hepatitis b.

Partnerships of Improvement

January of 2018 also sparked a new collaboration between WHO and U.N. Environment. This new agreement will increase joint action between the two organizations in the effort to increase action on topics such as air pollution, water quality and food and nutrition issues.

These organizations have recognized that the environments in developing countries cause hundreds of thousands of deaths per year, because of pollution and contaminated drinking water. With these two major organizations working closely to implement new programs, the hope is to tackle these major issues and see growth each year. The two organizations will meet annually to discuss strategies and plans for reaching these goals.

Changing Lives, Eliminating Disease

For 70 years, the World Health Organization has been a leader in strategic planning and implementation of new programs around the globe. Hundreds of thousands of people in developing countries contract diseases and suffer from malnourishment each year, but WHO is working with leaders all over the world to ensure everyone is able to access lifesaving vaccines, clean water and shelter.

Working in over 150 countries around the world and raising millions of dollars each year, the World Health Organization strives to end diseases globally, and provide support to countries in need. With the support of world leader and donor countries, the WHO is changing the outcome of countless lives.

– Allisa Rumreich
Photo: Flickr

Diagnostic Exam
For the first time in its history, the World Health Organization (WHO) has released an essential diagnostic exam list, meant to focus on common and priority healthcare concerns. Designating these tests as essential encourages primary healthcare facilities that might not provide adequate diagnostic exams to update their practice.

WHO’s Essential Diagnostic Exams

The list primarily focuses on a collection on in-vitro diagnostic exams (tests that focus on human specimens such as urine and blood), featuring 113 different products that enable the quick and effective diagnosis of various healthcare issues. The first 58 are meant to detect and diagnose common conditions, forming a foundation for patient management and screening. These tests include measurements of liver enzymes, blood sugar, white and red blood cells, and tests meant for one-time events such as pregnancy. The remaining 55 products focus on what the WHO considers “priority” diseases — for instance malaria, HIV and tuberculosis.

The construction of this list mirrors WHO’s revolutionary 1977 “Essential Medicines” list, which revolutionized how access to medicine was perceived. The list’s global reach fostered the idea that certain “essential” medicines were so necessary that they should be widely available, regardless of monetary resources.

Many of the tests listed on the diagnostic exam list are acceptable for primary healthcare facilities in less affluent areas, where diagnostic tests are often poorly resourced or even non-existent. This tool inevitably provides those who might otherwise not have access to these exams accurate diagnosis and more effective treatment.

Boosting Efficient Treatment in Impoverished Populations

Accessible diagnostic exams are particularly necessary for impoverished, rural communities that suffer from exposure to high levels of said “priority” diseases. According to the Center for Disease Control and Prevention, approximately 445,000 people died from malaria in 2016, the majority of which were sub-Saharan African children – diagnostic tests that can detect and diagnose children for acute malaria do not require electricity or trained personnel to be safe and accurate.

Limiting the spread of infectious, “priority” diseases is impossible without an accurate diagnosis, as accurate diagnosis ensures the fastest and most effective treatment (preventative or otherwise). Although increasing levels of poverty favor the spread of infectious disease, educating both the public and healthcare facilities of the necessity of certain diagnostic tests ensures the development of programs that can prevent infectious disease transmission.

In the case of malaria, the introduction of rapid diagnostic tests — such as those featured on WHO’s list — significantly increased disease surveillance data. Accurate data collection enables healthcare workers and researchers to discern an approximate number of malaria cases, as well as follow trends related to the disease over time. Such findings decrease the risk of either over or under diagnosis, and enable communities to prepare effectively for disease control.

Equipping the Vulnerable

The term “diagnostic exam” refers to any test used to accumulate clinical information with the intention of diagnosis (formulating a clinical decision), including both in-vitro tests and physical ones such as x-rays and ultrasounds. There are more than 40,00 different diagnostic exams available to doctors and patients, covering a plethora of medical conditions. Diagnostic exams account for a small portion of healthcare expenditure, only 2.3 percent in the U.S. and 1.4 percent in Germany, however, they impact approximately 70 percent of all healthcare decisions.

In the future, WHO hopes to add a “devices” category to their essential diagnostic exams list focusing on diagnostic equipment, including automated blood analyzers, fiber-optic scopes and CT scanners. The WHO hopes that the list will serve as a tool that will benefit even the most vulnerable within society, and help all countries effectively concentrate their funds on essential tests.

– Katherine Anastas

Photo: Google

Global Preparedness Monitoring Board
After the West Africa Ebola outbreak in 2014, the U.N. Secretary-General’s Global Health Crises Task Force reported the need for more vigilant and efficient monitoring of global health emergencies. As of late May 2018, the World Health Organization (WHO) and World Bank Group (WBG) have come together to address enhancing global health security.

WHO and World Bank Group

The WHO is an organization that works within the United Nations’ system to direct and coordinate authority on international health. They focus on health systems, noncommunicable and communicable diseases, promotion of health, preparedness and corporate services.

The World Bank Group focuses on every major area of development of financial products and technical assistance that creates sustainable economic growth. WBG also fosters resiliency to shocks and threats so that afflicted areas can be better prepared in emergency situations.

Global Preparedness Monitoring Board

By combining their health initiatives used in developing countries, the WHO and WBG created the Global Preparedness Monitoring Board. Its main purpose is to enhance the world’s handling of health preparedness on a global and regional scale. The Global Preparedness Monitoring Board includes political leaders, heads of U.N. agencies and internationally distinguished health experts.

The Global Preparedness Monitoring Board is centrally aimed at undertaking outbreaks, pandemics and health emergencies. It utilizes a strict system of regular independent monitoring and reporting of preparedness across the board of national governments, U.N. agencies, private sectors and civil society. The Board also advocates for keeping health crisis preparedness on the political agenda. It intends to keep the world focused on the importance of being prepared in emergency health situations.

The GPMB was created shortly after the declaration of the most recent Ebola outbreak in the Congo. This was a quick reminder of the unpredictability of outbreaks and the importance of preparedness in those types of emergency health situations. The Board’s focus on monitoring and preparedness ensures that the world never be taken by surprise again.

Breaking the Panic Cycle

Dr. Jim Yong Kim, co-leader of the GPMB creation and president of World Bank group, said, “For too long, we have allowed a cycle of panic and neglect when it comes to pandemics: we ramp up efforts when there’s a serious threat, then quickly forget about them when the threat subsides.” The GPMB is quickly working to break the cycle of panic and neglect against the recent Ebola outbreak by not allowing progress to slow at the sight of eradication.

While the GPMB has a strong global focus, it also accentuates the importance of local monitoring. It works to engage local communities in the importance of preparedness, detection, response and recovery to emergency health situations. It also holds all actors accountable for doing their part in generating sustainable financing, ensuring necessary research and development is conducted and completing essential public health capacities.

Although the creation of the GPMB is very new, it is predicted to make monumental strides in the enhancement of global health security.

– Samantha Harward
Photo: Flickr

All You Need to Know About HPV in the Developing WorldHuman papillomaviruses (HPV) are DNA viruses that infect skin or mucosal cells. Depending on the severity of the infection, HPV can lead to either cervical cancer and other head and neck cancers or low-grade cervical tissue changes and genital warts. Virtually all cervical cancer cases result from a sexually transmitted infection with HPV.

Cervical Cancer and HPV in the Developing World

Globally, cervical cancer is known as the second most common cancer among women, with about 500,000 new cases being diagnosed annually. Of the total deaths that occur due to cervical cancer each year, more than 80 percent are concentrated in developing countries.

Immunization coupled with regular screenings and consistent treatments are the best strategies for reducing the burden of cervical cancer and HPV in the developing world. In resource-poor countries that lack adequate access to cancer screenings and treatment services, it is even more essential that younger girls be immunized before they are sexually active and are exposed to HPV.

The HPV Vaccine

The HPV vaccine protects against the strains that cause up to 90 percent of cervical cancer cases. It is typically available in most routine immunization programs of high-income countries. Historically, the major barriers to reducing the burden of cervical cancer and HPV in the developing world are due to the high costs of the HPV vaccines and the difficulty of reaching adolescent girls.

The GAVI Alliance–formally known as the Global Alliance for Vaccines and Immunization–is a partnership of national governments, the World Health Organization (WHO), the World Bank Group, the Bill and Melinda Gates Foundation, the vaccine industry and many public health institutions. GAVI provides technical and financial support for vaccines in countries that have a gross national income of less than $1,000 per capita and other poverty-stricken countries including China, India and Indonesia.

Thanks to the efforts of GAVI, the HPV vaccine is at a record low price and the poorest countries are able to access it for as little as $4.50 per dose. Additionally, the WHO decided to change the recommended dosage of the HPV vaccine from three to two doses, which helped facilitate the country rollout of the vaccine as well as significantly reducing costs.

The first HPV vaccine demonstration program took place in Kenya in 2013, and since then, 1,000,000 girls have been vaccinated. By the end of 2016, GAVI had initiated HPV vaccine demonstration programs in 23 countries, which is the first step toward introducing the vaccine to national immunization programs. So far, Honduras, Rwanda and Uganda have introduced the HPV vaccine into their national immunization programs.

Potential Roadblocks in the Push for the HPV Vaccine

Unfortunately, the transition from the demonstration programs to national introductions is taking longer than expected for some countries. Consequently, GAVI has developed a new approach to HPV vaccine support, which draws from the valuable lessons learned from previous demonstration programs.

Some of these lessons include:

  1. The fact that school-based delivery works very well when administering the vaccine to young girls. It is more cost effective to integrate HPV immunization efforts into routine immunizations at existing health clinics and schools.
  2. When promoting HPV vaccination programs and cervical cancer prevention, the facilitation of effective and factual communication within the community is particularly critical.
  3. GAVI has made tremendous progress in reducing the prevalence of HPV in the developing world through its vaccination initiatives. Eight GAVI-supported countries have integrated the HPV vaccine into their national vaccination programs and 30 countries have started a demonstration program.

However, despite the strong signs of interest from GAVI-eligible countries and the rapid and effective integration of the HPV vaccine, GAVI’s original goal of immunizing 40,000,000 girls by 2020 may be at risk due to supply constraints.

GAVI chief executive Dr. Seth Berkley stated, “Scaling up cervical cancer prevention and control strategies should not be delayed, as we have the tools to achieve this goal. With the right commitment from vaccine manufacturers as well as political support, strategic partnerships and investments, this particular battle to improve women’s health can be won.”

Thus far, GAVI has helped low-income countries access the HPV vaccine at affordable and sustainable prices. Dr. Berkley is confident that the organization is capable of meeting its goal. GAVI is dedicated to ensuring that its progress is maintained and that millions of girls in the poorest of countries are protected from the perils of HPV and cervical cancer.

– Lolontika Hoque
Photo: Flickr

ban on trans fatThe World Health Organization is fighting against trans fat in an effort to save thousands of lives. On May 14, WHO announced that it plans to ban trans fat from the global food supply by 2023. The reason behind this ban on trans fat is to reduce the number of those who die from cardiovascular disease.

Why the Ban on Trans Fat is Important

While this global charge has been in effect in other countries such as Denmark and the United States, it has been harder to implement in the developing countries of North Africa, the Middle East and South Asia. Cardiovascular disease is the number one cause of death globally, averaging 500,000 premature (under the age of 70) deaths every year. Over 75 percent of this number takes place in low and middle-income countries.

Cardiovascular disease is linked to an unhealthy diet, lack of exercise, smoking and being overweight. While all of these may be linked to cardiovascular disease, an unhealthy diet generates a greater risk than the other three. An unhealthy diet accounts for an estimated 11.3 million deaths annually. One of the greatest contributors to an unhealthy diet is trans fat.

How Trans Fat Disproportionately Affects the Poor

Since many vegetable oils and fats are relatively cheap, there is a greater increase in fat consumption in low-income countries. Along with trans fat and certain oils being cheaper for those in low-income countries, it is also one of the most common ways food is cooked in these regions.

There is a correlation present in these developing nations that with the increase in trans fat consumption, there is an increase in cardiovascular disease. This becomes even more detrimental in that at least half the world does not have access to essential health coverage. There are also about 100 million people falling into extreme poverty because they have to pay for health care.

For example, the probability of dying before age 70 in Iran for males was 47 percent and for females, 39 percent; a majority of this has to do with cardiovascular disease caused by unhealthy diets. In Iran in 2004, 12 percent of the calories consumed were from hydrogenated vegetable oil, which is the main source of trans fat.

Because of this hefty consumption of food cooked in trans fat, Iran, at one point in the past decade, had the second highest cardiovascular death rate in the entire world. Iran then made it a goal to cut down its trans fat consumption to less than one percent. To work toward this goal, it found ways to replace hydrogenated vegetable oil with a different type of vegetable oil.

As Iran has worked with reducing its consumption of trans fat, it is closer to following WHO’s goal and initiative with the ban on trans fat to reduce premature mortality from noncommunicable diseases. One way WHO is implementing its ban on trans fat in other countries is by using the acronym REPLACE. This six-step strategy allows others to make the steps toward a healthier lifestyle.

The following is each step of the REPLACE method that is seen on the World Health Organization’s website:

  1. RE: Review dietary source of industrially-produced trans fats and the landscape for required policy change.
  2. P: Promote the replacement of industrially-produced trans fats with healthier fats and oils.
  3. L: Legislate or enact regulatory actions to eliminate industrially-produced trans fats.
  4. A: Assess and monitor trans fat content in the food supply and changes in trans fat consumption in the population.
  5. C: Create awareness of the negative health impact of trans fats among policymakers, producers, suppliers and the public.
  6. E: Enforce compliance with policies and regulations.

Working Toward a Healthier Future

Noncommunicable diseases are closely linked with poverty. Those in developing countries have a greater risk of being exposed to unhealthy dietary practices with limited access to healthcare.

The only way to go about reducing the number of noncommunicable deaths is to look at the risk factors head-on. With this ban on trans fat, lives will be saved, not just those in higher social positions and economically well off, but those in low-income countries with inadequate health care as well.

– Victoria Fowler
Photo: Flickr