Posts

HIV/AIDS in Ukraine
Ukraine has one of the highest rates of HIV/AIDS in the world, with an estimated 260,000 people living with the disease. Odessa, the third-most populous city in Ukraine, has “the highest concentration of HIV/AIDS of anywhere in Europe.” Poverty exacerbates HIV/AIDS in Ukraine and primarily has links with injected drug use, threats to government funding, lack of access to antiretroviral treatment and social discrimination.

Poverty and HIV/AIDS in Ukraine

Ukraine is second to Moldova as the two poorest countries in Europe. The poverty rate in Ukraine increased during the COVID-19 pandemic, from 42.4% in 2020 to 50% as of February 2021. There is a strong connection between poverty and the spread of diseases; it could be both a cause and a result of poverty.

HIV/AIDS causes conditions of poverty when working adults become ill and can no longer support their families. The disease becomes a result of poverty when the conditions of poverty put people at greater risk of contracting it. As an example, women and girls who live in poverty are more vulnerable to sexual exploitation. They are more likely to resort to working in the sex trade. That could put them at dangerous risk for contracting HIV.

HIV/AIDS in Ukraine’s Women and Girls

UNAIDS estimates that out of all people with HIV/AIDS in Ukraine, 120,000 are women over the age of 15 and 2,900 are children aged 14 or younger. Gender inequality, poverty and violence against women and girls are significant factors in the spread of HIV. Women and girls who live in fear of violence may be reluctant to advocate for safe sex, receive testing or seek treatment for HIV and other diseases.

Gender inequality inhibits women’s access to resources for sexual and reproductive health. In rural Ukraine, where the poverty rate is highest, 36% of women do not participate in community or family decision-making. Only 46% are competent with a computer or the internet. Almost 48% do not have access to medical services.

The Lack of Access to Antiretrovirals

As Sky News reported, access to antiretrovirals is a major problem for many people living with HIV/AIDS in Ukraine. Although a law stipulates that antiretroviral therapy should be free to all citizens, limited national resources have resulted in restricted access.

Antiretrovirals are crucial for preventing the spread of HIV to children. The use of antiretrovirals during pregnancy and administered to an infant for four to six weeks after birth can result in a transmission rate of 1% or less. According to U.N. Women, the majority of women living with HIV/AIDS in Ukraine were between 18 and 45 years old. Out of these women, 39% discovered that they were HIV-positive during pregnancy.

Social Discrimination Against People Living With HIV/AIDS

According to WHO, discrimination against people who use drugs and people living with HIV presents a serious challenge to identifying those who need treatment. Harsh drug laws, fear of HIV/AIDS and systematic police abuse undermine efforts to provide HIV information and services such as testing and safe needle exchanges. In addition, the law requires drug treatment centers in Ukraine to register drug users and share the information with law enforcement. This protocol keeps people who use drugs from seeking medical help, which subsequently prevents them from testing and receiving treatment for HIV/AIDS.

The War in Donbas

The war in Donbas has made it difficult for people to receive treatment in a region that previously had one of the highest rates of HIV/AIDS in the country and was home to nearly one-quarter of all antiretroviral recipients. When the war began in March 2014, it displaced 1.7 million people. To compound this, unsafe sex has resulted in an increase of HIV/AIDS within the military. Combined with ongoing military conflict and a shortage of antiretrovirals, Ukraine is experiencing a crisis: the government has failed to keep up with infection rates.

Solutions

In July 2021, Ukraine received a grant of $35.8 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. According to the Ukrainian government, it would use the funds to purchase personal protective equipment (PPE), reduce risks associated with COVID-19 and strengthen the health care system.

Ukraine is collaborating with the Centers for Disease Control (CDC), USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The country wants to implement prevention campaigns, increase access to antiretroviral treatment and target key risk groups, such as people who inject drugs, sex workers and men who have sex with men.

On September 1, 2021, President Biden announced that the United States would provide more than $45 million in additional assistance for Ukraine. The aid would help people the COVID-19 pandemic and the war in Donbas affected. The U.S. is working with USAID-supported programs to provide supplies for Ukrainian health care centers, training for health care workers and psychosocial support for the most vulnerable populations.

– Jenny Rice
Photo: Unsplash

Mental Health in Guatemala 
Between 1960 and 1996, Guatemala fought in a civil war between the government of Guatemala and several leftist rebel groups, resulting in many deaths due to the destructive violence. This caused many mental health conditions and problems to arise in the people residing in the country. Unfortunately, violence and public security continue to be a concern in Guatemala, deteriorating Guatemalan’s mental health. 

What Does Mental Health Mean and Why is it Important?

The Centers for Disease Control and Prevention (CDC) defines mental health as someone’s emotional, psychological and social well-being, affecting how they experience and perform in their daily lives. To add, it can help determine how people cope with stress and make choices. Mental health is significant for one’s physical health because poor mental health can lead to diseases, such as diabetes, heart disease and stroke.

The Number of People in Guatemala that Have a Mental Health Disorder

More than 3,250,000 people in Guatemala could experience a mental health illness in their lifetime. However, unfortunately, many of them do not seek the help they need. In fact, one in four people between the ages of 18 and 65 have suffered or continue to suffer from a mental health disorder, but only 2.3% took the initiative to consult a psychiatrist to address their mental health issues. Commonly, people do not want to talk about their mental health. The reason is the lack of knowledge and the stigma around mental health in Guatemala.

Furthermore, Guatemala’s poverty rate increased from 45.6% to 47% in 2020. As a result, Guatemalans are at greater risk to develop mental health disorders because they endure more difficulties in their daily lives. The limited mental health sources available to them are insufficient to help alleviate the stress that socioeconomic disadvantages cause.

In the United States, most health care providers do not cover expenses for mental health care. Interestingly, Guatemala does not have a universal health care system, let alone dedicated mental health legislation. As a result, Guatemalans have difficulty seeking help because there is “0.54 psychiatrist available per 100,000 inhabitants,” according to American Psychological Association. Only five of them are outside of the main cities. Guatemala is a low-income country that does not have the resources to make mental health data available to the public. That is why there are not many studies or public data regarding this issue.

The Main Cause of Poor Mental Health in Guatemalan Children

A study that Rosalba Company-Cordoba and Diego Gomez-Baya conducted includes the issue of mental health of children in Guatemala. Interestingly, 50% of Guatemala’s total population is under 18 years old, making it a country with one of the youngest populations. A child’s mental health is valuable because it can have positive or negative long-lasting effects on their development.

Unfortunately, Guatemala’s high poverty rate has led to increased levels of violence because of the struggle to live in desperate conditions in the community. Exposure to violence showed significant effects on a child’s mental health, such as depression and anxiety. Although childhood poverty is prevalent in many areas of Guatemala, the quality of life showed little significance in the study. These symptoms were more common in adolescents than in children because they are more aware of their surroundings and environment. On the other hand, children exposed to low violence from urban areas with educated parents described higher qualities of life.

Violence rates have continued to increase with assaults, shootings, threats and robberies, causing many children to be afraid to go to school. Almost 60% of Guatemalan students would prefer not to go to school due to fear. Many students and teachers have received threats and experienced robberies or know someone who has been a victim of violence. Guatemala remains one of the poorest countries with high rates of violence, causing a higher risk of a child developing mental health disorders.

Living in these socioeconomic disadvantaged areas can cause children to become part of the gangs because there is no other option. The previously mentioned study showed the association between greater parental education level and higher income with lower food insecurity. However, many children do not attend higher education schooling because they have to help their families with household expenses. The number of children living in urban areas is increasing. This leads to more children in unsanitary conditions and a high cost of living. Almost all children attend primary school. However, the completion rate is 15%, which leads to low enrollment rates for secondary school.

Solutions for Mental Health in Guatemala

Many people have taken action to improve the state of mental health in Guatemala, especially for children. First, many citizens are taking to the streets to protest against the continuation of violence. The implementation of the International Commission Against Impunity (CICIG) resulted in reductions in homicide rates. For example, there were fewer homicides per 100,000 each year. The CICIG provided Guatemala with $150 million in international support to help reform their justice system, but President Jimmy Morales thought this violated Guatemalan authority. As a result, he removed the CICIG mandate in 2019, causing a setback.

Next, people are beginning to seek support for their mental health in Guatemala due to more specialized centers offering psycho-emotional support services to the public, such as Federico Mora National Hospital for Mental Health, for a low cost. According to American Psychological Association, there are about seven psychologists for every 100,000 people, which is a number that continues to increase.

Lastly, schools are doing their part in fighting against gang violence to make children safer in Guatemala and other countries. With support from UNICEF and the Ministry of Education, the schools created a Peace and Coexistence Committee. The idea is to promote an environment where they do not tolerate violence, as Theirworld reported. The schools are trying to lead by example and show their students that violence is not always the answer. They found over the years that there are fewer arguments between the children because they have conversions to handle any dispute.

As Guatemala continues to be a low-income country, crime rates and violence will increase, leading to mental health problems. Mental health in Guatemala will suffer the consequences of the stigma and the lack of resources. The country is working toward a better future by spreading awareness about mental health and fighting violent trends.

– Kayla De Alba
Photo: Unsplash

Diseases in Nigeria
Nigeria ranked 142 out of 195 countries in a 2018 global health access study. However, although Nigeria has a challenging health care system, the country has improved the infrastructure that has helped it fight diseases such as polio, measles and Ebola. Nigeria now has centralized offices called Emergency Operation Centers (EOCs) that serve as a base for government health workers and aid agencies to coordinate immunization programs and collect data. While there is progress, many diseases still plague Nigeria.

Cholera

Cholera is a water-borne disease that results in a quick onset of diarrhea and other symptoms such as nausea, vomiting and weakness. It is one of the many diseases impacting Nigeria in 2021. If people with cholera do not receive treatment, the disease may kill them due to dehydration. A simple oral rehydration solution (ORS) can help most infected people replace electrolytes and fluids. The ORS is available as a powder to mix into hot or cold water. However, without rehydration treatment, about half of those infected with cholera will die, but if treated, the number of deaths decreases to less than 1%.

In August 2021, Nigeria began to see a rise in cholera cases, especially in the north, where the country’s health care systems are the least prepared. The state epidemiologist and deputy director of public health for Kano State, Dr. Bashir Lawan Muhammad, said the rise in cases is due to the rainy season. It is also because authorities have been dealing with Islamist militants in the north. In Nigeria, 22 of the 36 states have suspected cholera cases, which can kill in hours if untreated. According to the Nigeria Center for Disease Control, 186 people from Kano have died of cholera since March 2021, making up most of the country’s 653 deaths.

Malaria

Malaria is another one of the diseases affecting Nigeria. Through the bites of female Anopheles mosquitos, parasites cause malaria and transmit it to humans. Globally, there were 229 million malaria cases in 2019, with 409,000 deaths. Children under the age of 5 years old are the most susceptible group, and in 2019, they accounted for 274,000 or 67% of worldwide malaria deaths. That same year, 94% of malaria cases and deaths occurred in the WHO African Region. Although the disease is preventable and curable, the most prevalent malaria-carrying parasite in Africa, P. Falciparum, can lead to severe illness and death within 24 hours.

The President’s Malaria Initiative (PMI), which USAID and the CDC lead, works with other organizations to help more than 41 million Nigerians. Despite the difficulties that COVID-19 presented in 2020, the PMI was able to assist Nigeria to distribute 14.7 million treatment doses for malaria, 8.2 million of which went to pregnant women and children. Besides that, the “PMI also distributed 7.1 million insecticide-treated mosquito nets (ITNs), provided 7.2 million rapid test kits, and trained 9,300 health workers to diagnose and treat patients” of malaria. Before the PMI, only 23% of Nigerian households had bed nets, but since 2010, that number has risen to 43%. The PMI also aims to improve health systems and the skill of health workers to administer malaria-related services.

HIV

HIV (human immunodeficiency virus) attacks the immune system, leading to AIDS (acquired immunodeficiency syndrome). One can control the virus with proper medical care, but there is no cure. The disease is prevalent in Africa because it originated in chimpanzees in Central Africa. The virus likely spread to humans when the animals’ infected blood came into contact with hunters. Over the years, HIV spread across Africa and other parts of the world, becoming one of the diseases impacting Nigeria today.

The CDC works with the Federal Ministry of Health (FMOH) and other organizations to create and sustain HIV response programs in Nigeria. The CDC’s “data-driven approach” and prevention strategies and treatment strengthen the collaborative system in Nigeria. These include HIV treatment, HIV testing, counseling, services to help prevent mother-to-child transmissions and integrated tuberculosis (TB) and HIV services. TB is the leading cause of death among people living with HIV.

From October 2019 to September 2020, nearly 200,000 Nigerians tested positive for HIV and began treatment. During the same period, over 1 million HIV-positive people tested for TB. More than 5,000 of those individuals tested positive and began treatment for TB. By the end of September 2020, nearly 25,000 orphans and other vulnerable children received HIV/TB services through the CDC. Not only that, but all facilities in Nigeria that the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supports now use TB BASICS, which is a program that “prevents healthcare-associated TB infection.”

In 2021, Nigeria will face many diseases. On the other hand, great strides are occurring to educate the Nigerian population on diseases like HIV, malaria and cholera. Despite efforts, there is still much more necessary work to reduce illness in Nigeria.

– Trystin Baker
Photo: Flickr

HIV/AIDS In Zimbabwe
HIV/AIDS in Zimbabwe has become prevalent, mainly due to unprotected sexual transmission. The U.S. Embassy in Zimbabwe reported that in 2020 there were “approximately 1.23 million adults in Zimbabwe living with HIV.” Zimbabwe has the sixth-highest HIV/AIDS rate in the world, considering that the nation has roughly 31,000 new infections annually. However, despite the common misconception, the high rate of HIV/AIDS does not stem only from sexual activity. High case rates have become common among children as infected mothers pass HIV/AIDS on to their kids during childbirth. Organizations are working to reduce the prevalence of HIV/AIDS in Zimbabwe.

What is HIV/AIDS?

The human immunodeficiency virus (HIV) “is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases.” When an HIV/infected person goes without treatment, the condition can develop into acquired immunodeficiency syndrome (AIDS), a “late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus.” There is no cure for HIV/AIDS to this day, despite extensive research since the virus was initially identified in 1981. However, by taking antiretroviral drugs, people “can live long and healthy lives and prevent transmitting HIV to their sexual partners” and children.

Action to Address HIV/AIDs in Zimbabwe

The Centers for Disease Prevention and Control (CDC) supports an HIV/AIDs program in Zimbabwe that began in 2004. In 2019, the program achieved a milestone, extending the reach of antiretroviral treatment coverage to 82% coverage for infected men and 88% coverage for women. In 2017, a UNICEF-led HIV program helped achieve the target of “ensuring that 80% of pregnant women, new-born, children and adolescents have equitable access to cost-effective and quality health interventions and practice.” With the support of organizations, overall, Zimbabwe has had success in “expanding access to HIV testing and treatment, including prevention of mother-to-child transmission (PMTCT) and lowering HIV prevalence.”

Data from the Zimbabwe Population-based HIV Impact Assessment survey (ZIMPHIA 2020) shows the nation’s progress. The survey indicates that almost 87% of HIV-infected adults knew their status. In addition, of the population “aware of their status,” 97% were receiving antiretroviral treatment. Finally, “among those on treatment, 90.3% achieved viral load suppression,” meaning they are now unable to transmit the disease to other people. With this progress, Zimbabwe is on its way to achieving the UNAIDS target of eradicating AIDS by 2030.

Looking Ahead

Although HIV/AIDS has been a significant public health crisis in Zimbabwe for quite some time, the government is taking the necessary steps to reduce its prevalence. Increasing diagnosis rates have set off a chain reaction in Zimbabwe as people seek the necessary treatments and educate themselves on the condition and preventative measures to protect themselves and others. There is still much work that needs to occur, however, the country is doing its part to safeguard the lives of its citizens through early detection measures and access to treatment.

– Sara Jordan Ruttert
Photo: Flickr

COVID-19’s Impact in Bolivia Since September 2020, COVID-19’s impact in Bolivia has greatly improved. The country’s COVID-19 cases have reduced, possibly due to the fact that 25% of the population is fully vaccinated. Compared to the fact that less than 0.1% of the population was fully vaccinated in March 2021, this is good progress.

Small Town Controversies

In the small town of San Jose de Chiquitos, they immobilize the virus for a period of time via a controversial method. They use a chlorine dioxide solution (CDS), which is produced from the public university of Santa Cruz de la Serra, and administered by professional healthcare workers to treat people with coronavirus strains.

The town came about this alternative treatment due to the fact that it does not have a lot of advanced equipment, such as respirators, to keep up with COVID-19’s impact in Bolivia.

Originally, the government did not exactly approve of the treatment; however, the lower house has approved a special bill that authorizes the production and therapeutic use of the CDS. It is known as MMS (Miracle Mineral Solution).

Tourism Hit and Recommendation

Bolivia was one of the most tourism-dependent countries in South America, and the hit was felt by many since tourism provides 110,000 jobs for the people. Even domestic travel has suffered greatly. Even though the total percentage of unemployment in 2020 was only 5.61%, according to Statista, COVID-19’s impact in Bolivia has affect many. These people are eager to get back to work in any way possible.
Travel to Bolivia is still not recommended, and it is not allowed if it is deemed nonessential. According to the CDC, Bolivia is still at level 3, and it is ranked among the 10th highest for coronavirus cases in South American countries and countries in the Caribbean. Those who are fully vaccinated are permitted to go, but upon returning, they should get tested three to five days afterward. According to Statista, due to the lack of tourism, the tourism economy has taken a big hit in domestic tourism, with a loss of $530 million.

Vaccines for Everyone

On September 7, Bolivia received a shipment of 150,000 doses of the vaccine from Mexico. President Luis Arce’s administration estimated that some 7.5 million out of 11 million inhabitants are a vulnerable population that should receive the COVID-19 vaccine as soon as possible. The country has already seen a dramatic increase in vaccinations in just a short period of time.
The country has also been encouraging and promoting everyone who is eligible to get vaccinated, including the indigenous groups in rural areas. The country tends to spread the awareness of the vaccine, and just like many South American countries are now doing, they want to help all of their people.
Rinko Kinoshita, Bolivia’s representative for the United Nations Fund for Population Activities (UNFPA), did a 5-question interview with The Pivot. She stated, “Through United Nations interagency collaboration, we also are supporting the government with communication campaigns to promote COVID-19 vaccination, especially in indigenous rural communities on the border with Brazil”.

– Veronica Rosas
Photo: Flickr

U.S. Foreign Aid During COVID-19The year 2020’s sudden outbreak of COVID-19 caught many countries off guard. The U.S. is demonstrating its status as a global superpower by releasing economic, medical and other foreign aid during COVID-19.

5 Facts About US Foreign Aid During COVID-19

  1. The U.S. Agency for International Development (USAID) has given more than $1.5 billion to different governments and organizations during the pandemic. The government split the money among various humanitarian, developmental and economic programs and organizations. The aid aims to help sustain governments at risk during the pandemic. It also intends to make the public more aware of COVID-19 and how to combat it. Additionally, the aid from the U.S. will go toward improving health education and hospitals, funding quick response teams capable of inhibiting COVID-19’s spread. The U.S. Government has also planned a $4 billion relief fund to aid high-risk countries through COVAX, a program that provides vaccines to low-income countries.
  2. The U.S. State Department works alongside other organizations. USAID and the CDC help the U.S. Government provide the necessary aid to countries at high risk. Congress created an emergency fund of $2.4 billion with the purpose of supporting both humanitarian programs and security and stabilization programs for countries in need. For example, foreign aid helps countries create safe and secure ways for citizens to receive necessary medical care during the pandemic.
  3. The U.S. gave the most foreign aid in 2020. In 2020, the U.S. gave around $35 billion in aid, with Germany close behind at just shy of $30 billion. The global amount of money that has gone toward COVID-19 relief measures is equal to about $16 trillion. U.S. foreign aid during COVID-19 is only around 1% of that. The majority of foreign aid during COVID-19 went toward short-term solutions, such as the aforementioned public health education programs and hospital care programs.
  4. U.S. foreign aid programs help combat more than just COVID-19. Recently, the House of Representatives passed an $11 billion bill to support countries in need, including through the Global Fund to Fight AIDS, Tuberculosis and Malaria.
  5. The U.S. has approved $1.9 trillion in COVID-19 aid. Of that $1.9 trillion, the U.S. has dedicated $11 billion to fight the global pandemic. That $11 billion includes $800 million for aid programs from the U.S. Agency for International Development as well as the CDC Global Fund. The remaining $10 billion will support global health, humanitarian aid and economic aid.

To conclude, the U.S. has provided more aid than any other nation to help countries combat the COVID-19 pandemic. This has allowed many at-risk countries to minimize or at least lessen the impact of the disease.

Jake Herbetko
Photo: Flickr

Native American communities During COVID-19
As of July 20, 2021, the World Health Organization (WHO) reports more than 190 million confirmed COVID-19 cases with almost 4 million deaths and the administering of almost 3.5 million vaccine doses. The Centers for Disease Control and Prevention (CDC) reported in December of 2020 that Native American communities are 3.5 times more likely to fall sick with the novel coronavirus and 1.8 times more likely to die from COVID-19 than non-Hispanic white people.

Harvard field research teacher Eric Henson calls what the tribes are having as “the worst of both worlds at the same time.” Businesses entirely stopped their services at the start of this health crisis. These communities had their tax base reduced entirely to zero. All tribal businesses closed. Like other minority groups, Native American communities often work jobs that do not provide proper medical insurance. Many of these jobs are ‘essential work,’ meaning these individuals nevertheless face an increased risk of contracting COVID-19. However, efforts are providing aid to Native American communities during the COVID-19 pandemic.

COVID-19 Vaccine for Minorities

Native American communities during COVID-19 are accepting safety measures to prevent the novel coronavirus. Early discussions considered giving priority to minorities with the first vaccine dose, at odds with the Trump Administration. While little data exists regarding vaccination rates amongst ethnicities during the vaccine rollout under President Biden, several prominent Native Americans were prioritizing vaccines in their communities. As a result of the American Indian communities’ core values of putting the community first before the individual, their stance to accept the first wave of vaccines is for the health of their whole tribe as well. One individual’s health protected through the vaccine keeps other non-infected community members in a safer environment.

A recent survey that the Urban Indian Health Institute conducted showed that 75% of Native Americans are willing to receive vaccinations. Surveys show 75% of American Indians are concerned with side effects from novel coronavirus protection measures. However, two out of three participants are confident they are safe.

Funding For Native Americans During a Global Pandemic

The CDC has given $219.5 million to aid tribal communities during this health crisis. Its approach has ensured that these communities have access to necessary materials to prevent, provide for and respond to outbreaks. The U.S. Congress directs $165 million of the funding from the CDC through two acts. The acts are H.R 6074, a bill providing $8.3 billion in emergency funding for COVID-19, and the CARES Act, a bill protecting the healthcare system, employed workers and the economy against the health pandemic.

The Administration for Native Americans has a branch referred to as the Administration of Children and Families (ACF). The branch exists within the U.S. Department of Health and Human Services. ACF has supported Native American communities during COVID-19. Its website provides resources to grant programs providing Native tribes, families and individuals access to funding for the pandemic. Resources include administrative relief, human services activities and natural disaster alleviation for Native Americans during COVID-19.

A Return to Normalcy

The effects of COVID-19 are detrimental to many communities, especially those already in the minority before the pandemic. As Native Americans are some of the first to receive vaccines, the families are back on their way to normalcy.

Libby Keefe
Photo: Flickr

Dr. Angeli Achrekar
On January 20, 2021, President Joe Biden appointed Dr. Angeli Achrekar as the new U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy, which means she will be leading the President’s Emergency Plan for AIDS Relief (PEPFAR).

Who is Dr. Angeli Achrekar?

Dr. Achrekar is remarkably qualified for her position. She has earned her doctorate from UNC-Chapel Hill, a master’s degree from Yale and her bachelor’s degree from UCLA. In addition to her academic accomplishments, Dr. Achrekar has a career of public service under her belt, involving combating HIV/AIDS around the globe, public health development and women and girls’ health. She originally worked in India and with UNICEF. She then started working with the CDC starting in 2001, where she led the National Initiative to Improve Adolescent Health. This initiative spanned across multiple agencies and consisted of professionals from a variety of disciplines in more than 100 organizations.

Following her leadership of the National Initiative to Improve Adolescent Health, Dr. Achrekar started her work with PEPFAR to fight HIV/AIDS around the world in 2003. In working with PEPFAR, she traveled to South Africa. There, she coordinated with local governments to assess risk patterns that occur through drug use and among sex workers. Dr. Achrekar then became Senior Public Health Manager for the CDC in its Division of Global HIV/AIDS. Lastly, she started in 2011 with the U.S. State Department where she helped come up with and develop the Saving Mothers program, as well as the Giving Life program.

Developments Since Her Appointment

Since her appointment, Dr. Achrekar has already made strides in her position to fight AIDS and other diseases around the world. Notably, under her leadership, PEPFAR has been part of a joint effort with other organizations and agencies including USAID which will bring a new treatment to TB patients in Ghana, Ethiopia, Kenya, Mozambique and Zimbabwe. Rather than patients needing to take a combination of drugs for treatment, the new treatment will combine two drugs so patients will be able to take fewer drugs in total. The new development is a big leap forward and Dr. Achrekar said, “The availability of a shorter, more easily tolerated, and safer regimen for TB prevention that is also affordable is critical for accelerating the fight against TB. The new development is big news as latent tuberculosis is said to affect up to a quarter of the world’s population.”

The Importance of Fighting AIDS in Relation to Global Poverty

PEPFAR’s work to fight AIDS holds much significance to the fight against global poverty because the two interconnect considerably. AIDS disproportionately affects those in poverty. Considering that the prevalence of AIDS has been commonly linked with poverty, a critical component of fighting the disease is fighting poverty. In his article “Is HIV/AIDS Epidemic Outcome of Poverty in Sub-Saharan Africa?” Noel Dzimnenani Mbirimtengerenji wrote, “Unless and until poverty is reduced or alleviated, there will be little progress either with reducing transmission of the virus or an enhanced capacity to cope with its socio-economic consequences.”

Sean Kenney
Photo: Wikipedia Commons

Lead Poisoning in Children
For more than a century, the people of Kabwe, Zambia have lived with devastatingly high levels of lead exposure. In 1994, after 90 years, Kabwe’s lead mine shut down. More than 25 years later, the people of Kabwe still suffer the consequences of decades of unstable mining and nearly nonexistent clean-up efforts by mine owners. Environmental health authorities say Kabwe has unprecedented levels of lead contamination leading to lead poisoning in children.

The EPA “defines a soil lead hazard as 400 parts per million (ppm) in play areas and a 1,200 ppm average for bare soil in the rest of the yard.” Black Mountain, a favorite place for Kabwe’s children to play, measures a staggering 30,000-60,000 ppm. The “mountain” is a massive heap of refuse. Adults often crawl through make-shift tunnels mining for lead, copper, manganese and zinc to sell. With more than half of Zambia’s population living below the poverty line, mineral scavenging provides vital income. Many people who venture beyond the “DANGER KEEP AWAY!” warning outside the mine site, say the risk of lead poisoning is a necessity if they want to feed their families.

Children at Risk

Lead poisoning in children is at a disproportionate rate due to children’s developing bodies and brains. Children absorb four to five times more lead than their parents. Lead exposure can result in skin rashes, poor appetite, weight loss, cough, stunted growth, learning disabilities and death. Often, lead poisoning goes undetected until it is too late. Many families will hide their lead-poisoned children because they fear stigma due to their child’s symptoms. In Zambia, 45.5% of children live in extreme poverty. As a result, they do not often have access to proper healthcare to treat lead poisoning.

The World Bank Project

The World Bank is funding a $65 million project, the Zambia Mining and Environment Remediation and Improvement Project (ZMERIP). The project aims to reduce environmental risks in lead hot spots. It also seeks to assist the Zambian government in addressing the dangers of lead exposure and implementing safety protocols, providing health intervention and engaging mining companies in expanding awareness of their environmental and social responsibilities.

In 2020, the ZMERIP began the largest health intervention to address blood lead levels (BLLs) in children in Zambia. More than 10,000 children received lead poison testing. The CDC recommends a BLL in children of no more than 5 µg/dl. Of the children tested, 2,500 had BLLs of 45 µg/dl or more. Chelation therapy, “which binds the lead into a compound that is filtered out through the kidneys”, is the preferred treatment for children who test 45 µg/dl or higher. Children who test lower, receive vitamin supplements, iron and protein as treatment.

The World Bank attempted another project similar to the ZMERIP in 2011 but achieved little progress. With lessons learned, the World Bank is hopeful this new project will be successful. If the project attains the goals it has set out to complete, more than 70,000 people including 30,000 children will benefit from the information. While some Zambians have yet to realize the risks of lead exposure, the World Bank reports mostly positive responses to their health advocacy.

The Future for Zambia

For the children of Kabwe, the ZMERIP offers hope of reducing lead poisoning in children. It offers hope that play is not a risk and a toddler’s appetite for a fistful of dirt is not a life sentence by lead poisoning. The key to the project’s success is continuing prevention practices, education, remediation and the Zambian government’s obligation to enforce safety regulations after the project’s completion expected in 2022. The ZMERIP’s commitment places focus on improving the lives and futures of Kabwe’s most vulnerable and valuable asset, its children, the country’s future.

Rachel Proctor
Photo: Wikipedia Commons

Healthcare in South Africa
With a population of 57.78 million people and with approximately 49.2% of the adult population living below the poverty line, AIDS and healthcare in South Africa are two of the country’s main issues. In particular, the unequal distribution of healthcare resources has worsened the country’s fight against HIV and AIDS. During recent years, South Africa has begun to take steps toward change. Here are five facts about the AIDS and healthcare crisis in South Africa.

5 Facts About AIDS and Healthcare in South Africa

  1. Systems of Healthcare in South Africa: South Africa’s healthcare system is severely divided between the public and private sectors. The public sector (the healthcare provided by government funding) covers about 84% of the population. In South Africa, 70% of doctors work in the private sector, as people who can afford private healthcare tend to pay better, and private doctors have access to better resources. Furthermore, per capita expenditure in the private sector, or the cost per person, was about $1,400 in 2014, while per capita expenditure in the public sector was about $140. For comparison, the United States’ per capita healthcare expenditure is about $11,200.
  2. Rural vs. Urban Communities: As in many countries, there is significant inequality in access to healthcare between rural and urban communities. In South Africa, people living in rural areas tend to rely on public healthcare. Unfortunately, there is an inadequate number of trained healthcare professionals in the public sector. A study conducted in 2002 revealed that urban areas of South Africa were more likely to have higher percentages of HIV infections. However, as a result of the inequality of healthcare, people in rural South Africa were two times less likely to receive testing for HIV or AIDs.
  3. AIDS Epidemic: In South Africa, 7.7 million people live with AIDS, the highest case rate in the world. About 20% of the world’s HIV cases are in South Africa, and within the country, about 60% of women have HIV. Even in areas in which testing is available, many choose not to partake, as they are afraid of receiving a positive result. A lack of resources, including education for young people and proper training for healthcare workers, has created issues surrounding awareness of the disease, proper diagnosis and access to PrEP. This drug reduces the possibility of infection by 99%.
  4. ART Program AID: In 2003, South Africa rolled out the largest Antiretroviral Treatment plan (ART) in the world. Offered through the public sector, ART serves as the primary HIV intervention for both children and adults. An important aspect of its implementation was affordability, as only 13.7% of South Africans have medical insurance. With the help of CDC South Africa, government facilities and mission hospitals, more people were able to access and benefit from the program.
  5. The Good News: ART has proved to be successful, as adult HIV deaths peaked in 2006, with 231,000 deaths, and then decreased dramatically. In 2014 there were 95,000 deaths, which was a reduction of 74.7%. In total, from the very beginning of the program in 2003 to 2014, the ART program reduced HIV adult deaths by an estimated 1.72 million, a clear positive trend. Most recently, in 2018, 71,000 people died from AIDs-related illness, which was a 50% decrease from 2010. Furthermore, 62% of people with HIV had access to treatment. 87% of pregnant women with AIDs also received antiretroviral medication, preventing 53,000 HIV infections in newborn babies. These statistics are all improvements from previous years.

While there is still work to be done to improve AIDS and healthcare in South Africa, much progress has been made. Increased funding and support for new programs and access to antiretroviral medication have had a significant impact. Moving forward, it is essential that these programs expand their efforts to further reduce deaths caused by HIV and AIDS.

Alyssa Hogan
Photo: Flickr