Air Quality
The COVID-19 pandemic has renewed interest in air quality as lockdowns and public health restrictions have led to improved quality in many areas. Additionally, research has found a link between poor air quality and poor COVID-19 outcomes. The decline in pollution will be only temporary, and in many areas was actually smaller than scientists anticipated.

The impacts of poor air quality on global health beyond COVID-19 are numerous. However, curbing emissions and improving quality where it is already poor are huge undertakings. Nonetheless, looking at those living in urban areas where quality is monitored, more than 80% of people are experiencing air pollution in excess of the limits suggested by the World Health Organization (WHO). This makes air quality a pivotal global health issue.

Another important factor in addressing this issue is the distribution of the negative effects of poor air quality. In other words, the development of any program or policy interventions ought to consider the inequitable distribution of those effects. Research in the United States and the United Kingdom indicates that while wealthier people tend to be responsible for the majority of air pollutants, those living in impoverished areas disproportionately experience the harmful effects of those pollutants.

A. What Compromises Air Quality

There are two main categories of air pollutants: those naturally occurring and those human-made. While dust storms and wildfires can introduce harmful particulate matter, there are also numerous sources of pollution driven by human activities. These include automobiles, certain types of power plants, oil refineries and more. In addition to particulate matter, other pollutants that adversely affect health include sulfur dioxide, nitrogen dioxide and ozone.

Finding new yet affordable ways to decrease the pollutants we release into the air is challenging but not insurmountable. Putting this into perspective, 90% of people around the world are breathing unclean air according to WHO guidelines.

B. What Poor Quality Air Does to Our Health

Beyond the link between air pollution and poor COVID-19 outcomes, research also shows the negative impact air pollution has on the risk of stroke and heart disease, certain types of cancer, lung infections and diseases and even mental health. Furthermore, both air quality and environmental quality tend to be worse in areas of the world already comparatively disadvantaged.

According to research on the effectiveness of European climate and pollution policies, the number of people prematurely dying after exposure to fine particulate matter pollution decreased by approximately 60,000 between 2018 and 2019. Better yet, between 2010 and 2020, there was a 54% drop in premature deaths attributable to nitrogen dioxide pollution. Despite these positive outcomes, they also demonstrate the extent of the damage airborne pollutants can do to human health.

C. What Has Proven Successful in Protecting Air Quality

Like health policy progress, innovations in air quality programs and policies often start at the local government level. According to the Environmental Defense Fund (EDF), cities around the world are implementing ultra-low and zero-emission urban access zones, deploying hundreds of thousands of electric buses, and learning from their own successes in moving to clean municipal transportation in order to teach other cities to do the same.

The EDF notes the importance of gathering detailed data on air quality. This data allows organizations to identify communities disproportionately affected by pollution and develop targeted approaches to protecting and improving air quality. This type of data can help localities not only measure levels of pollutants over time but pinpoint hotspots. Hotspots include, for example, those caused by construction sites and manufacturing facilities. The need for this type of data is worldwide, but developing nations are in particular need of the tools necessary for thorough air quality monitoring.

Highlighting the successes experienced in air pollutant reduction efforts in wealthier counties may seem counterintuitive given the importance of addressing inequalities across the world. Still, they also represent numerous lessons for developing cities and countries to learn. The negative experiences of areas already developed have yielded data, technology and sample policies from which leaders worldwide can draw. Moving forward, it is essential that organizations and leaders around the world prioritize improving air quality.

Amy Perkins
Photo: Pixabay

5 Ways the DRC Can Slow the Spread of COVID-19
On November 18, 2020, the World Health Organization (WHO) and government officials in the Democratic Republic of the Congo (DRC) announced the end of the latest Ebola outbreak. This outbreak started in June 2020 amid the COVID-19 pandemic and was the 11th Ebola outbreak in the DRC since the first recognition of the disease in 1976. “It wasn’t easy, but we’ve done it!” tweeted the Regional Director of WHO, Dr. Matshidiso Moeti. The DRC, one of the most impoverished countries on earth, emerged from the wake of the most recent Ebola outbreak after learning some important lessons. The information gained from this occurrence has offered insight that can help slow the spread of COVID-19 on a global scale.

At the start of the pandemic, the country’s COVID-19 mortality rate was 10%. In just six months, that rate decreased to 2.5%. Here are the five key components the DRC discovered are vital in its attempt to slow the spread of a viral outbreak.

5 Ways the DRC Can Slow the Spread of COVID-19

  1. Community engagement is of extreme importance in slowing the spread of COVID-19. The Ebola aid response initially failed due to significant mistrust from people in the communities that needed help. The continuous conflict between the militant groups and the government made it difficult to earn the trust of DRC citizens. As the outbreak grew, aid workers realized that spending more time directly engaging with individuals in affected communities made them more trusting. Workers built confidence by increasing the community’s knowledge of the virus. Engagement from spiritual advisors, educators and other community leaders in addition to politicians and law enforcement is essential. These varying perspectives are useful in soothing fears, offering guidance and rooting out rumors and misinformation.
  2. Involving social scientists as soon as possible is paramount. Epidemics often sow seeds of resentment and suspicion within communities. As a result, these “seeds” often impede recovery and prevention efforts if allowed to grow. When scientists use their experience to analyze community structures, they can quickly identify areas of distrust. Their unique perspective on human behavior and cultural practices can then assist in developing solutions that are acceptable to all. Communities are then more likely to take ownership and come together to work towards strategies to slow the spread of the disease.
  3. Prioritizing the patient experience is mutually beneficial to the infected person as well as those providing the treatment. Stigma often follows survivors of Ebola with families and communities, with others expressing fear toward individuals even after they have recovered. Those recovering from COVID-19 often experience similar shaming. Conditions that result in trauma or embarrassment for the patient provide those who the virus may infect with a reason to ignore their treatment options. Performing care with respect, empathy and dignity offers a positive experience. This increases the chance that newly infected patients will seek help. Outreach in the form of education can reduce a community’s discontent. A better grasp of how the virus works and the recovery process provides understanding and relief.
  4. Deploying familial leaders for monitoring, early case detection, contact tracing, quarantine and follow-up is beneficial. As many see the leader in their family as a protector, this role is uniquely advantageous in increasing understanding of the disease itself. Family leaders are also in good positions to be the ones who take on the role of bolstering understanding of personal and family precautionary measures. An entire household working to slow the spread of COVID-19 can have a greater impact than individual effort.
  5. Taking action to ensure swift turnaround times for labs is important. One priority during the Ebola outbreak was getting lab results back to patients as quickly as possible. Primarily, this is to relieve any existing anxieties for the patient and the patient’s family. Additionally, quick turnaround allows for quick, public safety protocol execution to prevent the further spread of disease. This strategy is equally effective in the effort to slow the spread of COVID-19.

Even with one lethal and viral outbreak in the DRC finished, COVID-19 remains a very real and deadly threat. Through surviving Ebola, the DRC government grasped valuable, global lessons. The DRC government is using the tactics that proved successful in defeating the Ebola virus outbreak to slow the spread of COVID-19. As world leaders plan and devise strategies, the DRC’s successes serve as experienced examples in this globally critical situation with little precedent.

– Rachel Proctor
Photo: Flickr

Congenital Anomalies
Worldwide, congenital anomalies cause approximately 295,000 deaths of children within their first 28 days of life. Every year, about 7.9 million children are born with life-threatening defects and 3.3 million children under the age of five5 die from congenital disabilities. According to the World Health Organization (WHO), congenital anomalies are structural or functional aberrations that occur during intrauterine life. The most common congenital disabilities include heart defects, cleft lip (palate), down syndrome and split spine (also known as spina bifida). Although 50% of all congenital disabilities do not have a single definite cause, common causes include genetic mutation, environmental factors and various other risk factors.

Geographic Disparities

Although congenital disabilities are widespread globally, they are particularly prevalent in developing countries. Developing countries account for 94% of worldwide congenital disabilities.

The level of income -both individual and national- in developing countries is a crucial factor that indirectly influences the high incidence of congenital disabilities. Low income affects the incidence of congenital disabilities in developing countries in the following ways:

  • Poor Access to Adequate Maternal Healthcare for Women During Pregnancy: About 99% of the global maternal mortality cases occur in low-income countries due to inadequate maternal care.
  • Poor Maternal Nutritional Condition: Deficiency of vitamin B can, for instance, escalate chances of birthing a baby with neural tube defects.
  • Excessive Prenatal Alcohol Consumption: Pregnant mothers’ consumption of alcohol increases their risks of giving birth to a child with Fetal Alcohol Syndrome (FAS). FAS is a total of the damage – both physical and mental – to an unborn child as a result of their mother’s alcohol consumption.
  • Presence of Other Infections: Some sexually transmitted diseases can transfer from a pregnant mother to her child. For example, syphilis during pregnancy accounts for an estimated 305 000 fetal and neonatal deaths annually. It also jeopardizes 215,000 infant lives due to congenital infections, prematurity or low-birth-weight.

How WHO is Taking Action

The World Health Organization has taken and implemented various measures to fight congenital anomalies. In the 2010 World Health Assembly, WHO took on a resolution encouraging its member states to fight against congenital anomalies by:

  • Raising awareness throughout governments and the public about congenital disabilities and the risk they impose on children’s lives
  • Developing congenital disabilities surveillance systems
  • Providing consistent support to children affected by congenital anomalies
  • Ensuring that children with disabilities have the same rights and equal treatment as children without disabilities
  • Assisting families whose children have congenital disabilities

In addition to the resolution, WHO designed a manual that showed illustrations and photographs of selected birth defects. The manual’s primary purpose was to foster further development of the surveillance system, especially in low-income countries.

The Global Strategy for Women’s and Children’s Health

In 2016, WHO went an extra mile and published the Global Strategy for Women’s, Children’s and Adolescents Health 2016-2030, an updated version of the Global Strategy for Women’s and Children’s Health devised five years prior. The Global Strategy’s grand theme was “Survive, Thrive, Transform.”

  • Survive: “Survive” encompassed various goals that the Global Strategy hoped to accomplish. These include ending preventable deaths, lowering maternal mortality rates and newborn deaths among others.
  • Thrive: The main target was promoting health and wellbeing by responding to the dietary needs of children, adolescents and pregnant & lactating women.
  • Transform: This objective’s primary goal was to create a safe and nurturing environment by terminating extreme poverty. Poverty one of the leading causes of congenital disabilities.

Results

Over the years, the World Health Organization’s relentless efforts in battling against congenital disabilities have made remarkable progress in alleviating the issue. For instance, the number of newborn deaths has plummeted from 5 million to 2.4 million between 1990 and 2019, thanks to the various innovations and programs put in place. Although the current state of affairs is far from ideal, past accomplishments lay the groundwork and identify clear steps for future progress.

Mbabazi Divine
Photo: Flickr

 Address Neglected Tropical DiseasesOn November 12, 2020, members of the World Health Organization (WHO) voted overwhelmingly to adopt a bold set of plans to address the threat of neglected tropical diseases (NTDs) throughout the next decade. With this vote, the WHO endorsed a “road map” written by the Control of Neglected Tropical Diseases team to address neglected tropical diseases in the world’s most vulnerable regions. The decade-long project aims to establish global programs with international partners, stakeholders and private organizations. These partnerships will work to accomplish an ambitious set of goals that will end the spread of certain neglected tropical diseases and improve the quality of human life in regions susceptible to neglected tropical diseases.

Neglected Tropical Diseases (NTDs)

Neglected tropical diseases are commonly defined by global health organizations such as the WHO and the National Institute of Allergy and Infectious Diseases as a group of diseases that primarily affect those living in tropical and subtropical climates and disproportionately spread in remote areas or regions afflicted by poverty. Among the 20 diseases that the WHO categorizes as neglected tropical diseases are dengue, rabies, leprosy, intestinal worm and sleeping sickness.

Tropical and subtropical regions include Central America and the northern half of South America in the Western Hemisphere, most of sub-Saharan Africa as well as island nations in the Indian and Pacific Oceans. Many of the countries in this range are developing or impoverished nations. A lack of development and healthcare infrastructure in nations that lie in tropical regions, such as lack of access to clean water and health education, creates a more fertile breeding ground for the spread of dangerous diseases.

The reason that these diseases are considered “neglected” is that regions where neglected tropical diseases cause the most damage are populated by people with little political power or voice, a result of widespread poverty, location and other socioeconomic factors. As such, the spread of these diseases goes largely unnoticed and there is little incentive at the international level to take measures to combat these ailments. Though NTDs do not receive high-profile attention in the larger medical community, the WHO estimates that more than one billion people are affected by NTDs. The WHO sees the urgency to address neglected tropical diseases.

WHO’s 2021-2030 Road Map

The WHO outlined a set of “overarching global targets” that it will pursue over the course of the next decade in work with foreign governments, community organizations and NGOs. These overarching goals, to be accomplished through achieving a number of “cross-cutting targets” are the primary effects the WHO hopes to achieve by 2030:

  1. Reduce number of people requiring treatment for NTDs by 90%. To attain a 90% reduction rate of those requiring treatment for neglected tropical diseases, the WHO altered its approach to disease treatment from a vertical, single disease eradication method to a horizontal, cooperative effort across several countries. This would require 100% access to water supply, greater international investment in healthcare and action at the federal level to collect and report data on infection.
  2. Eliminate at least one NTD in 100 countries. There are a number of neglected tropical diseases that the WHO lists as “targeted for elimination”: human African trypanosomiasis, leprosy and onchocerciasis. In the WHO’s road map, elimination of a disease means complete interruption of transmission, effectively stopping a disease’s spread. For eliminating diseases such as leprosy, the WHO hopes to assist 40 countries to adopt epidermal health strategies in their healthcare systems.
  3. Completely eradicate two NTDs. The two diseases listed as “targeted for eradication” by the WHO are yaws, a chronic skin condition, and dracunculiasis, an infection caused by parasitic worms in unclean water. Both diseases are, according to the WHO, either easily treatable or on the verge of eradication. Dracunculiasis, for which there is currently no vaccine or medical treatment, only affected a reported 54 people in 2019. Yaws is still endemic in 15 nations but can be treated with a single dose of antibiotics.
  4. Reduce by 75% the disability-adjusted life years (DALYs) related to NTDs. The implementation of increased prevention, intervention and treatment can increase the quality of human life in tropical and subtropical countries. This final overarching goal aims to create nationwide efforts to alleviate or eliminate the chronic symptoms of those infected with neglected tropical diseases as well as prevent the further spread of debilitating neglected tropical diseases.

Ending Neglected Diseases

To address neglected tropical diseases, the fulfillment of the goals outlined in the WHO’s road map will require a multilateral and thorough implementation as well as cooperation and leadership from each of the partner countries affected. The WHO seeks to encourage each tropical and subtropical nation to take ownership of their healthcare programs, which will create a sustainable, international network to strengthen global health in some of the world’s most vulnerable regions. Putting the fight against neglected tropical diseases in the spotlight as well as dedicating time and resources to taking on these diseases, can remove the “neglected” from neglected tropical diseases and put the global community on a course toward eradicating these diseases.

– Kieran Graulich
Photo: Flickr

Antimicrobial resistanceAntimicrobial resistance, or AMR, is a growing trend among newly discovered viruses. The World Health Organization (WHO) identifies 30 new diseases that threaten half the world’s population, which are particularly prevalent in developing nations.

Background of Antimicrobial Resistance

Drug-resistant diseases (AMR) have grown in prevalence over the past 40 years. Many of the medicines used to treat common infections like the flu and pneumonia have been around for decades. Eventually, viruses and bacteria develop their own microbial methods of fighting back against these drugs and inevitably become fully resistant to treatments.

Perhaps the most well-known example is the virus known as pneumococcus, or streptococcus pneumoniae. Penicillin has been used to treat pneumococcus since the early 1950s, giving it plenty of time to develop a strong resistance to the drug. Now, pneumococcus is practically untreatable, killing over 300,000 children below the age of 5 annually.

The CDC explains that germs that grow resistant to medications can be almost impossible to treat, often resulting in severe illness or death. This problem is only getting worse, as the U.N. finds that while 700,000 people die every year due to AMR diseases now, by 2050 that number will skyrocket to 10 million people.

The AMR crisis has severe economic implications as well. Antimicrobial diseases affect livestock as well as humans, leaving our international agricultural sector to collapse if not dealt with. All in all, the AMR crisis is projected to cause $100 trillion worth of global economic damage by 2050, only pushing people further into poverty.

Three organizations have stepped up to address the issue of antimicrobial resistance.

The AMR Action Fund

The AMR Action Fund is a financial project created by an international group of pharmaceutical companies. It aims to bring four new antibiotics that combat AMR to the consumer market by 2030. The fund expects to invest over $1 billion into late-stage antibiotic research by the end of 2025.

The AMR Alliance

The AMR Alliance is a massive coalition of more than 100 of the most powerful pharmaceutical companies, dedicated to fighting AMR. In 2016, the AMR Alliance signed the Industry Declaration, an agreement promising the development of anti-AMR medicines.

In 2018, the AMR Alliance spent a record $1.8 billion in the war against AMR. In 2020, the  AMR Alliance released its second progress report, detailing the progress made so far. The results are promising: 84% of relevant biotechnology companies are in the late stages of research and development for AMR cures and more than 80% of them have strategies in place for releasing the drugs.

UN Food and Agriculture Organization (FAO)

The FAO is taking serious steps to battle antimicrobial resistance. These dangerous antimicrobial superbugs threaten livestock in farms throughout the world. The FAO explains that two-thirds of future antimicrobial usage will be in livestock. These AMR superbugs will only increase in danger over time, as they develop stronger resistance to medicines.

The FAO has worked to improve agricultural practices across the world, specifically in developing nations. The FAO is raising awareness about this issue with rural farmers and is providing millions of dollars in funds to combat AMR.

World Antimicrobial Awareness Week (WAAW) is an annual campaign designed to increase awareness of the issue and encourage best practices among the general public, health workers, and policymakers to avoid the further emergence and spread of drug-resistant diseases. Over the week of November 18, millions of posts are made around the globe in support of antimicrobial resistance awareness. Expanding awareness is key, as the WAAW campaign website explains that less general use of antibiotics could help to mitigate the effects of this issue.

– Abhay Acharya
Photo: Flickr

Healthcare in MonacoWith nearly 40,000 people, Monaco is one of five European micro-states and is located on the northern coast of the Mediterranean Sea. According to the Organisation for Economic Co-operation and Development (OECD), Monaco has one of the best global healthcare schemes. The World Health Organization established that an individual born in 2003 can expect to have, on average, the longest lifespan in Europe. The country also has the third-highest proportion of doctors for its population in Europe.

Healthcare Education in Monaco

Leaders in Monaco believe that prevention and screening are essential to maintaining health and it is customary for young people to access comprehensive health education. This education aims to promote high-quality lifestyles and prevent early-risk behavior, such as tobacco use, drug addictions and sexually transmitted diseases.

Caisses Sociales de Monaco (CSM)

The Caisses Sociales de Monaco (CSM) is the official agency responsible for supervising Monaco’s public health service. Public healthcare automatically covers all citizens and long-term residents who contribute to the agency. French and Italian citizens may also access public health facilities in Monaco upon evidence of regular contributions to their home country’s state healthcare scheme. Foreign visitors can receive health treatment at all public hospitals and clinics. However, without state insurance contributions, travelers and expatriates will be forced to pay for all healthcare expenses accrued from treatment.

Public Healthcare Coverage

Public healthcare insurance operates through reimbursements, so an individual who plans on using coverage provided by the CSM will be required to make up-front payments and then claim costs back. After joining the public healthcare system, an individual receives a card that provides access to medical and dental care. The card contains administrative information necessary to refund medical care.

The public healthcare system provides coverage for inpatient and outpatient hospitalization, prescribed medications, treatment by specialists, pregnancy and childbirth and rehabilitation. Some prescription drugs are also reimbursed through the CSM and emergency care is available to everyone at Princess Grace Hospital, one of three public hospitals. The hospital will be reconstructed to strengthen the complementary nature of all the hospitals in Monoco.

Out-of-Pocket Healthcare Costs

Out-of-pocket healthcare costs in Monaco are high and if the CSM fails to provide sufficient coverage, an individual may supplement with private insurance. Private health insurance is a tool for individuals who want to cover medical services and fees not paid for by the public healthcare system. Doctors fund privately-paid equipment and staff through private contributions. According to an article from Hello Monaco, most Monaco citizens take out extra private insurance to cover ancillary services and unpaid rates.

A Commendable Healthcare System in Monaco

Every resident in Monaco is eligible for public health insurance but private health insurance remains an option for those interested in more coverage. Healthcare in Monaco earned outstanding reviews from the OECD and officials continue to seek improvements by reconstructing medical buildings and providing health education for young people.

– Rachel Durling
Photo: Flickr

Childhood Pneumonia
One of the most common diseases globally, pneumonia can be a silent killer when it infects children under 5. In the developing world, rates of childhood pneumonia cases and deaths are still high despite decreasing in other childhood diseases. However, due to new research and outreach programs to aid developing countries, those numbers may soon fall.

10 Facts About Childhood Pneumonia

  1. Various sources cause the disease. Unlike many other diseases that come from a single source, pneumonia is the name for the lungs’ acute response to an airborne pathogen. While pneumonia can develop from bacteria, viruses or fungi, the most common cause for children is the bacteria S. pneumoniae. The bacteria typically live in the lungs without harming the body, but the body develops pneumonia to kill the bacteria when it begins to spread.
  2. Childhood pneumonia mainly infects children under the age of 5. While people of all ages can develop pneumonia, children under the age of 5 are especially susceptible to the infection. Since their immune systems are not fully developed, their bodies are more likely to trigger a response to a foreign agent’s presence in the respiratory system, leading to pneumonia. These infection rates only increase in developing countries, where children are more likely to be born either malnourished or with a disease that they acquired in utero such as HIV.
  3. Pneumonia is a leading cause of death in children. Although pneumonia is often easy to treat and cure in developed countries, it can be fatal in developing countries. According to the United Nation’s Children’s Fund (UNICEF), childhood pneumonia kills over 800,000 children each year in comparison to 437,000 from diarrhea and 272,000 from malaria. These deaths are typically in children who are malnourished or have other conditions such as HIV that impair the immune system.
  4. South Asia has the greatest incidence of childhood pneumonia. Out of every 100,000 children in South Asia, approximately 25,000 will develop pneumonia each year. However, the majority of these cases — approximately 36% — occur in India. Studies looking into the potential causes for the increased number of cases have found that overcrowding in housing with inadequate ventilation allowed the disease to spread among families. Without effective airflow, children in those households continue to breathe in potentially infected air, increasing their chances of developing pneumonia.
  5. Air pollution increases pneumonia rates. Although a child needs to have exposure to the biological cause of pneumonia to develop the disease, certain environmental factors can increase infection likelihood. In India, a country with one of the worst-rated air qualities in the world, particles of smoke and other forms of pollution in the air weaken lungs when inhaled, making it more likely for a young child to develop pneumonia. These conditions of outdoor air pollution causes approximately 17.5% of all pneumonia deaths in the developing world.
  6. The disease is treatable. With antibiotics or antifungals (depending on the cause), children with pneumonia can recover from the disease. However, this treatment is dependent on the resources available in the country where the child lives. In developing countries such as Nigeria — the African country with the highest pneumonia rates in children — only one in three children with pneumonia symptoms can receive treatment due to the lack of available medicines and other medical resources.
  7. Some are producing vaccines. Although vaccines cannot treat viral pneumonia, they are still an important asset in preventing it. However, most of the produced vaccines are only available in developed countries where doctors recommend them for children under 5. In developing countries, nearly 10 million children are unvaccinated. Through the World Health Organization (WHO), many countries have received vaccines, although there has been great variation between regions of the world. While WHO’s South-East Asian Region has 89% coverage, its Western Pacific region only has 24% coverage.
  8. Less progress has occurred regarding childhood pneumonia. While research on pneumonia as a whole has increased over the past decade, there has been much less progress on childhood pneumonia in comparison to other childhood diseases. Since 2000, deaths for those under 5 from pneumonia have decreased by 54%, while deaths from diarrhea have decreased by 64% and are currently half the number of childhood pneumonia deaths.
  9. Large organizations are helping. Among other large, international organizations, the Gates Foundation has taken efforts to reduce childhood pneumonia rates in developing countries. One of its main methods is the continued distribution of vaccines to children and families in South Asian and Sub-Saharan Africa, specifically India and Nigeria. So far, the organization has sent vaccines to over 37 countries in those regions of the world, slowing transmission and infection rates in those areas.
  10. Rates will continue to drop in the future. Although the number of childhood pneumonia cases each year have not dropped as much as other diseases, long-term progress is still ongoing. If the current level of progress toward eradicating the disease continues, UNICEF predicts that it will save 5.9 million children. At the same time, if resources towards the effort increase, that number will increase to nearly 10 million.

UNICEF and WHO do not expect to meet their goal of eradicating childhood pneumonia until 2030. However, the progress they and many others are currently initiating is making a difference. Soon, pneumonia will become an extinct disease in the developing world so that it will never harm another child.

Sarah Licht
Photo: Flickr

Glasses for developing countries
A variety of NGOs have been working for decades to provide glasses for developing countries. Most models for this operate in similar ways, either by donating glasses or offering low-cost glasses for communities to purchase. These programs have been successful in helping people correct their vision, as well as creating more education and economic opportunity. They only lack one thing — innovation. Choosing to apply a solution designed for a developed country to a remote village is not always the best option. This is where Child Vision comes in.

The Statistics

The World Health Organization (WHO) estimates that nearly 80% of all persons in Africa have unaddressed vision impairment. Additionally, 33% of the world’s poor population suffers from vision impairment. There are 123.7 million people with a refractive error, which can be solved with glasses that have the correct strength. On average, glasses cost approximately $343, despite the average manufacturing cost of $10. Clear vision drastically reduced education access for children, which in turn created less economic opportunity as they moved into adulthood. Lack of clear vision loses $202 billion in global productivity each year.

The Standard

Some of the biggest names in glasses for developing countries are NGOs like Eyes on Africa, Vision for a Nation, VisionSpring and the WHO.

The WHO has been working on the Global Action Plan for eye health since 2014. The plan has one main objective — to encourage and enhance global eye health. The Global Action Plan has several initiatives. These include identifying what is causing vision impairment, understanding where the gap is in eye health access and bringing cataract surgery to developing countries. VisionSpring works by allowing those in developed countries to purchase glasses for developing countries through the VisionSpring website. VisionSpring donates those as well as letting communities purchase low-cost glasses. It also provides bulk purchase discounts and sell glasses individually and by the box. On average, one pair of bifocals in a box set costs just 85 cents. The price point is low, but still unmanageable for many villages, especially in areas with little to no internet access.

Child Vision

Child Vision is a program within the Centre for Vision in the Developing World (CVDW). The CVDW looked at the statistics of vision impairment then accepted the challenge of creating a solution that worked for the developing world. The main struggles the CVDW found in the traditional programs were a lack of optometrists and the high cost of traditional glasses. There is one optometrist per 1 million people in the population in developing nations. While 85 cents for a pair of glasses may seem affordable, it is a great financial strain for the world’s poor, many of whom survive on less than a dollar a day.

Child Vision, after identifying the root problems with getting glasses to developed countries, created a successful prototype within two months. The CVDW created an inexpensive, adjustable lens that sets into durable frames.

How the Glasses Work

The round lens is composed of two walls made of a flexible plastic membrane that the wearer fills with liquid silicone. The lens is then set into plastic frames that have dials on both temples of the glasses. The plastic frames are filled with the same liquid silicone that is in the lens. The wearer puts on the Child Vision glasses, covers one eye and using a tumbling “E” chart, adjusts a side knob to move more or less fluid into the lens until they can see clearly. They then repeat on the other side.

The wearer simply removes the knobs from the glasses and throws them away after the lens is set. They now have durable, functional, cost-effective glasses. With a $20 donation, CVDW can provide a pair of self-adjusting glasses to a developing country. A 1–2-hour training session with a local community leader to show them how to use the tumbling “E” charts to check vision and make sure the glasses are adjusted correctly is also provided. This is not only an immediate solution and innovation to provide glasses to developing countries but it creates generational empowerment of checking eyesight and promoting educational and economic growth within each community.

– Madalyn Wright
Photo: Flickr

Infertility in Developing CountriesAn estimated 49 million to 180 million couples  suffer from infertility, globally. Moreover, the majority of those affected live in developing countries. The most common cause of infertility in developing countries are STDs and pregnancy-related infections. With the focus of most poverty reduction efforts aimed at lowering overpopulation the health concern of infertility is often overlooked. Women who suffer from infertility in developing countries often face ostracization and struggle to get the healthcare they need. Thankfully, there has been an emergence of programs to help these women.

Causes of Infertility in Developing Countries

The most common cause of infertility in developing countries is untreated STDs since treatment is often unavailable or costly. In Africa, more than 85% of women’s infertility resulted from an untreated infection compared with 33% of women, worldwide. The most common STDs involved are chlamydia and gonorrhea. Other risk factors increasing the chance of infertility are poor education, poverty, negative cultural attitudes towards women. Finally, a lack of access to contraception is a huge risk factor.

The Sexist Effects of Infertility

The burden of infertility in developing countries falls on women although male infertility is the cause in 50% of cases. When a woman is unable to conceive, her husband will often divorce her or take another wife if permitted in the country. Women who are deemed infertile also suffer discrimination from the community.  In some cultures, society views these women as having a “bad eye”, which can pass on infertility from person to person. This results in infertile women missing important events such as weddings and other social gatherings since they receive no invitations.

Combating Infertility in Developing Countries

A campaign initiated by the Merck Foundation, “Merck More than a Mother,” seeks to heighten access to education and change the stigma for infertile women in developing countries. The program has provided training for fertility specialists and endocrinologists with more than 109 specialists trained since 2016.

Also, the foundation has created music videos, songs and fashion shows in African countries to send the message that women should not be blamed if they cannot have a child. More than 14 songs have featured singers from Gambia, Ghana, Kenya, Rwanda and Sierra Leone.

Women Deliver

In 2016, women’s infertility was a topic of discussion at Women Deliver — the world’s largest women’s health and rights conference held in Copenhagen. There were more than 5,500 conference participants, including government ministers, policymakers, business leaders, NGOs and activists. The WHO brought the topic to the conference, with the Director of Reproductive Health and Research giving a speech about the detrimental effects of infertility.

The WHO and Women Deliver, along with the International Committee Monitoring Assisted Reproductive Technologies and the International Federation of Gynecology and Obstetrics have partnered to increase global advocacy for infertility in developing countries. The partnership aims to achieve this through advancing education and research in the field.

Hopefully, with these increased advocacy efforts, the world will start to recognize the health concern of infertility in developing countries.

Rae Brozovich
Photo: Wikimedia Commons

Maternal Health in Yemen
The Yemen civil war, which began in early 2015 and still devastates the nation today, has created the world’s worst humanitarian crisis. A total of 24 million people require assistance. This crisis affects all aspects of life in Yemen, including healthcare. Millions are without access to life-saving medical treatment and supplies, leading them to die of preventable diseases, such as cholera, diabetes and diphtheria. Pregnant women and infants are particularly vulnerable during this health crisis as adequate medical care throughout pregnancy and birth is essential. Maternal health in Yemen is of the utmost concern now.

Yemen has one of the highest maternal mortality rates in the world with 17% of the female deaths in the reproductive age caused by childbirth complications. Maternal health in Yemen has never been accessible to all women. This crisis has escalated even further during the Yemeni civil war. However, global organizations are acting to save the lives of these pregnant women and infants who desperately need medical care.

Yemen’s Maternal Health Crisis: Before the Civil War

Even before the war began in 2015, pregnant women were struggling to get the help they needed. Yemen is one of the most impoverished countries in the world — ranking at 177 on the Human Development Index (HDI). Poverty is a large factor in the insufficiency of maternal health in Yemen as impoverished women lack the finances, nutrition, healthcare access and education to deliver their babies safely.

Many Yemeni women are unaware of the importance of a trained midwife during childbirth. Of all the births in rural areas, 70% happen at home rather than at a healthcare facility. Home births increase the risk of death in childbirth as the resources necessary to deal with complications are not available.

The Yemeni Civil War Increased the Maternal Health Crisis

Since the civil war began, the maternal mortality rate in Yemen has spiked from five women a day in 2013 to 12 women a day in 2019. A variety of factors caused this spike. The war has further limited access to nearly every resource, including food and water. This, in turn, depletes the health of millions of women and thus their newborns.

Also, the civil war has dramatically decreased access to healthcare across the nation. An estimated 50% of the health facilities in the country are not functional as a result of the conflict. Those that are operational are understaffed, underfunded and unable to access the medical equipment desperately needed to help the people of Yemen. This especially affects pregnant women — who require medical care to give birth safely.

Organizational Aid

Though the situation in Yemen remains dire, various global organizations are acting to assist pregnant women and newborns. The United Nations Children’s’ Emergency Fund (UNICEF) is taking the initiative to help millions across Yemen, including pregnant women. The organization has sent health workers and midwives into the country’s rural areas to screen and treat pregnant women for complications.

Similarly, USAID trained more than 260 midwives and plans to send them into Yemeni communities to help pregnant women and infants. USAID is partnering with UNICEF, the World Health Organization (WHO), the Yemen Ministry of Public Health and Population and other organizations to ensure that maternal health in Yemen, as well as all types of healthcare, are adequate and accessible for all affected by the civil war.

Maternal health in Yemen, while never having been accessible for many, is now in crisis as a result of the Yemeni civil war. While the situation is still urgent, organizations such as USAID and UNICEF are fighting to ensure that all pregnant women and infants in Yemen have access to the medical care they desperately need.

Daryn Lenahan
Photo: Flickr