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The Success of the Global Polio Eradication Initiative

Global Polio Eradication InitiativeMost think of polio as a disease of the past, eliminated from the world through scientific advancement. However, the disease remains present in some countries and runs the risk of spreading again if it is not contained. In the words of Ban Ki-moon in 2012, former Secretary-General of the United Nations, “Wild viruses and wildfires have two things in common. If neglected, they can spread out of control. If handled properly, they can be stamped out for good. Today, the flame of polio is near extinction — but sparks in three countries threaten to ignite a global blaze.” The Global Polio Eradication Initiative (GPEI) seeks to finally eradicate polio throughout the world.

The Global Polio Eradication Initiative

It is a truly global project, led by a partnership between the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention, UNICEF, Rotary International, the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. Furthermore, the Initiative involves 200 countries around the world. The Initiative started “in 1988 after the World Health Assembly passed a resolution to eliminate polio.” Over 33 years, the Initiative has secured more than $17 million worth of contributions from donors and financing.

The Global Polio Eradication Initiative has a well-developed and comprehensive plan which has produced numerous successes and lays out a roadmap to completely eradicate polio. One goal is integration. The GPEI seeks to integrate national governments’ vaccination plans with the polio vaccine, allowing children to get the polio vaccine as part of national immunization schedules. Enhanced integration also includes joint delivery of the polio vaccine with other vaccines, integration of polio surveillance with surveillance of other diseases and harmonizing data systems.

Routine vaccination of children is the crucial part of the plan, along with supplementary vaccination when needed. Areas that are most susceptible to an outbreak often receive supplementary vaccinations in targeted campaigns or through National Immunization Days.

Polio Success Stories

The success of the Global Polio Eradication Initiative since its founding is undeniable. The GPEI estimates that the global incidence of polio has decreased 99.9% since its inception. Polio efforts saved more than 1.5 million lives and prevented 16 million people from polio-induced paralysis. In addition to this, the GPEI administered more than 2.5 billion polio vaccines to children across the world.

Africa is a shining example of the GPEI’s success in eradicating polio. Even after the development of the polio vaccine in 1954, the disease remained endemic for decades and the continent struggled to track cases and vaccinate children. Around 1996, wild polio paralyzed 75,000 African children a year. The GPEI helped to coordinate cooperation between African national leaders and multinational NGOs, leading to greater tracking and quick responses to outbreaks.

As part of the Kick Polio Out of Africa campaign, the GPEI and other contributors provided nine billion doses of the oral polio vaccine and vaccinated 220 million children every year. Thanks to this work, Nigeria became the only country where polio was still endemic by 2016. In 2020, after four years without a polio case, the GPEI declared Africa polio-free. The elimination of a highly contagious and dangerous disease is a remarkable success story.

Remaining Countries and At-Risk Countries

While it is near eradication, polio remains endemic in Afghanistan and Pakistan. While concerning, there were less than 30 reported cases of the disease in these countries in 2018. Children miss out on coverage for polio in Afghanistan and Pakistan for various reasons, including a lack of infrastructure and an unstable political situation. Still, the Global Polio Eradication Initiative continues to vaccinate children, provide surveillance of the disease and work to develop new vaccines, diagnostic tools and antiviral drugs.

The failure to eliminate or contain polio completely could lead to a resurgence. If not contained, this could lead to 200,000 or more global cases a year within 10 years. The GPEI, in support of the governments of Afghanistan and Pakistan, works extensively with leaders in the countries to vaccinate children and provide teams of volunteers.

Children need multiple doses of the vaccine for effective prevention and vaccinations must be widespread in order to prevent any community transmission. For this reason, the GPEI has identified five main at-risk countries that are vulnerable to outbreaks and require greater surveillance:

  1. China
  2. Indonesia
  3. Mozambique
  4. Myanmar
  5. Papua New Guinea

Approaching the Finish Line

The Global Polio Eradication Initiative has had major successes so far and is nearly at the finish line of eradicating polio from all nations of the world. Unprecedented global cooperation and collaboration have been the driving forces behind its achievements. Global collaboration is integral for addressing all aspects of global poverty.

– Clay Hallee
Photo: Flickr

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Dr. Walensky and the Global COVID-19 Response

Global COVID-19 Response
President Joe Biden’s selection of Dr. Rochelle Walensky to run the Centers for Disease Control and Prevention (CDC) will be instrumental in strengthening the agency’s global COVID-19 response moving forward. By strengthening the agency in three key ways, Dr. Walensky will benefit the CDC’s pandemic response both at home and abroad.

3 Ways Dr. Rochelle Walensky Will Benefit COVID-19 Global Response

  1. Dr. Walensky’s previous work improving access to HIV testing brings hope that, under her leadership, the CDC will strengthen the global COVID-19 response by determining effective testing measures and increasing access to testing. Scientists continue to call for increased testing to effectively manage and control the spread of COVID-19 as the number of confirmed cases remains uncertain due to insufficient testing worldwide. Dr. Walensky has received international recognition for prior work on cost-effective HIV testing, care and prevention. Her previous research has emphasized the importance of providing treatment to those living with HIV while also highlighting the need for greater access to HIV testing in order to reduce the spread of the disease. Given Dr. Walensky’s knowledge and experience demonstrating the cost-effectiveness of increased access to HIV testing, expectations have determined that she will similarly advocate for more accurate COVID-19 testing as the head of the CDC.
  2. A study by Dr. Walensky and other researchers demonstrates the need for greater investments in overall vaccine distribution if countries hope to control the spread of the coronavirus through immunization. While Dr. Walensky’s expertise in HIV prevention will prove to be essential as COVID-19 vaccines become available, growing concerns exist regarding vaccine distribution in low-income countries. The wealthiest countries have purchased the two leading COVID-19 vaccines, threatening to delay access to vaccines in poorer nations. This situation could be devastating for developed and developing countries alike, as even countries that achieve herd immunity could be vulnerable to outbreaks if the world’s poorest countries do not bring the virus under control. While the researchers’ research centers on vaccine distribution within the United States, the concerns they present apply to vaccine distribution in developing countries, where proper investments in vaccination campaigns will be necessary to ensure equitable distribution of vaccines to all people. By placing these concerns at the forefront of vaccine distribution, the CDC under Dr. Walensky will benefit the agency’s ability to assist vaccination campaigns internationally.
  3. Dr. Walensky’s colleagues and mentors have praised her for her ability to bring cultural sensitivity to her work, a practice that will endure as she leads the CDC. Her previous work has equipped Dr. Walensky with the experience necessary to provide tailored knowledge and COVID-19 support to developing countries within the respective contexts. With limited COVID-19 funding, the CDC will benefit from Dr. Walensky’s guidance, as she recognizes the importance of addressing underlying factors that contribute to the spread of COVID-19, including poverty and the living conditions of the impoverished. Additionally, others know her for her effective communication within underserved and marginalized communities.  By improving adherence to CDC guidelines in communities that have historically experienced exclusion or mistreatment by Western medical professionals, Dr. Walensky will further benefit the CDC’s response.

Although the CDC has previously lacked in its ability to respond to the pandemic both domestically and internationally, Dr. Walensky’s leadership will benefit the global COVID-19 response by strengthening the agency’s focus on adequately combating the virus globally. Her prior experience and research insights will help shine a light on those at risk of being left behind.

– Emely Recinos
Photo: Flickr

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US Foreign Health Assistance Programs Change Lives

U.S. Foreign Health AssistanceThe beginning of the 20th century saw the United States begin to take its place at the forefront of the international stage. Fast forward to the middle of the century and the end of WWII and the United States took its place as a world superpower. With this newfound responsibility, the government of the United States began to do more to secure the safety and health of citizens of any nation in its sphere of influence.

Key Aspects of U.S. Foreign Health Assistance

  • U.S. foreign health assistance began with the Foreign Assistance Act of 1948, better known as the Marshall Plan. The plan’s goal, which it accomplished successfully, was to economically rebuild a war-torn Europe. This included hospitals and universities to train doctors.
  • The United States Agency for International Development (USAID) was founded in 1961 by President John F. Kennedy as a tool to better aid allied countries and countries teetering on the edge of the West and Communism. The organization also brought all of President Eisenhower’s foreign assistance programs under one agency.
  • U.S. foreign health assistance in the USAID is under the jurisdiction of The Bureau of Global health. For 55 years, the Bureau for Global Health has worked towards strengthening health systems, combating HIV/AIDS, combating other infectious diseases and preventing child and maternal deaths. Past Presidents have each had a hand in improving the operation and mission of the Bureau for Global Health.
  • Between 2000 and 2015, Presidents George W. Bush and Barack Obama both introduced plans to combat malaria and HIV/AIDS. An estimated 6.2 million malaria deaths were prevented around the world.

Global Development Alliances

The USAID Bureau for Global Health is not alone in its fight — Global Health Development Alliances have partnered with USAID since 2001 to provide U.S. foreign health assistance around the world. These partners come from the private sector, and strive to both open new markets and help the local populace in need.

Private medical companies involve themselves in the alliance program — such as “The Utkrisht Impact Bond” led by Merck for Mothers and UBS Optimus — along with other large companies to target infant and maternal mortality in the Rajasthan region of India. Their program currently reaches up to 600,000 people and aims to save 10,000 mothers and children by 2020.

Multilateral and Bilateral Efforts

From 2006 to 2017, the U.S. foreign health assistance programs received a budget increase from $5.4 billion to $10.7 billion. Bilateral efforts comprise 80 percent of the U.S foreign health assistance budget, and one of these efforts is the Family Planning and Reproductive Health Program run by USAID.

The program combats HIV/AIDS, prevents child and maternal deaths and reaches 24 countries on three continents. By 2020, USAID’s goal is to educate 120 million women and girls with family planning information, commodities and services.

Multilateral efforts by the United States government include participation in and funding given to, organizations such as the World Health Organization (WHO) and other multi-government organizations and charities. Unfortunately, the budget request for U.S. health foreign health assistance programs was set at $7.9 billion.

The United States Peace Corps

The United States Peace Corps was founded by President John F. Kennedy in 1960. Its goal then and still today is to help people around the world with the support of the United States government. By helping people in need, Peace Corps Volunteers spread goodwill about the United States and educate people about U.S. citizens and culture. They are probably best known for their English teaching program, but they also specialize in health initiatives.

Such initiatives include participating in programs initiated by Presidents Bush and Obama that reduce people’s exposure to, and number of cases of, malaria and HIV/AIDS. As part of their cooperation with USAID in 2012, the Peace Corps launched the Global Health Service Program to draw the attention of trained health professionals to countries in need.

Members of this program have a one-year service time rather than the usual two years. These volunteers not only help patients in the country, but they also pass on their knowledge and experience to sustainably help these populations in the future.

Center for Disease Control

In 2016, the Center for Disease Control (CDC) was granted $427 million from the United States Congress to participate in combating f HIV/AIDS, malaria and other infectious diseases, as well as promoting immunization and emergency response. The CDC was also granted $10.9 million to participate in recovery efforts in Haiti.

On January 10, 2010, Haiti was hit by a 7 magnitude earthquake. Since then, the CDC has helped the citizens of Haiti in various ways — stopping the spread of infectious diseases through the Haitian health system, educating the Haitian people about the spread and treatment of these diseases and helping the Haitian government reconstruct their health systems. The latter aid is a program first for the CDC.

International Aid Changes Lives

U.S. foreign health assistance has been a major help to many struggling people and countries around the world. Millions of lives have been changed for the better and saved because of the United States’ efforts.

Unfortunately, the budget request for U.S. health foreign health assistance programs was set at $7.9 billion. Although cuts will have to be made in staffing and funding around the world, men and women will not stop trying their best to work with the U.S. government and make a difference.

– Nick DeMarco
Photo: Flickr

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Mustard Gas Effects and the Geneva Gas Protocol

Mustard Gas Effects
Roughly one hundred years ago, one of the deadliest chemicals ever concocted was introduced to the global stage. This chemical creation was mustard gas. Known officially as sulfur mustard, mustard gas was created at the latter end of World War I. Often referred to as the chemists’ war, World War I proved to be a breeding ground for chemical weapons. 

World War I

In July 1917, British soldiers garrisoned in Ypres, Belgium reported a glimmering cloud of vapor in the air. Not too soon after, cases of blisters and sores were reported. British personnel was also reportedly coughing up blood, and according to Cancer Research UK, approximately 10,000 casualties were reported in Ypres alone.

Although British soldiers were issued gas masks per military regulation, mustard gas proved to be deadly regardless of whether an individual was wearing a gas mask or not. Mustard gas can be effective in virtually all conditions. Individuals can be exposed to the chemical through skin and eye contact; additionally, mustard gas is equally deadly if breathed through the air. 

Forms of Mustard Gas

As a chemical, mustard gas can appear in multiple forms. Mustard gas was mainly used as a vapor during World War I; however, it can also appear in the liquid form. For example, mustard gas can be mixed with water which can lead to poisoning of water supplies.

Sulfur gas has been described as having a peppery or mustard-like smell, but mustard gas can also be odorless in nature making exposure difficult to document. 

In general, exposure to sulfur mustard is not fatal. According to the Centers for Disease Control and Prevention, mustard gas accounted for roughly 5 percent of deaths during the Great War. Symptoms of exposure to the chemical vary widely.

The largest factor in the severity of symptoms is the total exposure to the gas itself. Individual symptoms of a mustard gas depend on a person’s susceptibility. Symptoms may not occur until 24 hours have passed. 

Short-Term and Long-Term Effects

The severity of the effects differs greatly between the short- and long-term. Redness and itching of the skin may occur in regard to short-term mustard gas effects. Eye irritation in the form of swelling and tearing are common. Within 12 to 24 hours the respiratory tract may be damaged, leading to a runny nose, shortness of breath, and coughing. Mustard gas impacts the digestive tract in the form of abdominal pain, diarrhea and vomiting. 

Long-term mustard gas effects can include much graver consequences. If sulfur gas is not removed from the skin relatively quickly, second and third-degree burns may appear. Breathing-based exposure may lead to chronic respiratory disease or in some cases death. If not treated, sulfur gas has been documented to cause blindness. A person’s risk for lung and respiratory cancer also largely increases as a result. 

Geneva Gas Protocol

Sulfur gas was officially banned in 1925 at the signing of the Geneva Gas Protocol. After the trauma and horror of the First World War, the global community largely agreed that chemical weapons must be prohibited from use in all cases. 

Upon studying mustard gas effects, it becomes apparent that the Geneva Gas Protocol was essential in protecting human rights across the globe. With chemical weapons banned, the chances of continued use of the substances/liquids/gas has become much rarer. However, chemical weapons are still being used in war-torn areas across the globe today. It is the responsibility of the international community to ensure that all countries adhere to global treaties. 

– Colby McCoy
Photo: Flickr

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Fighting the Marburg Virus in Uganda

Fighting the Marburg Virus in UgandaOn October 19, an official outbreak of the Marburg virus disease was announced in Uganda. The last outbreak of the Marburg Virus in Uganda occurred in 2014.

The virus, which is frequently compared to Ebola because of its clinical similarity to it, causes viral hemorrhagic fever and is known to be fatal, with an average fatality rate of around 50 percent. The virus is transmitted by a species of bat, called Rousettus bats, that live in caves in Uganda and across parts of Africa.

According to the World Health Organization (WHO), the disease is transmitted by direct contact with the blood, body fluids and tissues of infected persons or wild animals (e.g. monkeys and fruit bats).

The first person believed to have had the Marburg virus in Uganda, during the most recent outbreak, was a man who lived near a cave with bats. After he passed away from Marburg-like symptoms, his sister became sick due to her involvement in nursing him and with his traditional burial. After she passed away, it was verified that she had suffered from the Marburg virus. Two days later, the outbreak was confirmed and within 24 hours of confirmation, the WHO had arrived in the affected areas of Uganda. Currently, contact tracing is taking place to find and monitor individuals who may have been in contact with those who are sick.

The WHO has already set up structures to monitor the disease and to work with the communities. In addition to the WHO, the Centers for Disease Control and Prevention (CDC) and African Field Epidemiology Network (AFNET) are also a part of the efforts to stop the spread of the virus in Uganda.

Containment is the first priority of the WHO. Because the Marburg virus currently has no treatment or vaccine, “supportive care” is needed for those who are infected. But, this also means that proper techniques and safety measures must be taken by healthcare workers treating the infected. Precautions have been taken with protective wear being given to healthcare workers and isolation units being created in order to treat possible Marburg patients in areas removed from the general hospital population.

The WHO and its partners have been educating communities in order to increase awareness about the virus and encourage reporting by community members. Because this virus is spread through fluids and close contact, people involved in traditional burials are at high risk of contracting the virus.

All of these precautions and procedures have been set in motion within the past two weeks, many happening just days after it was confirmed that a woman had passed away due to the virus. It is vital that international organizations respond quickly, to treat those with the virus and protect and educate the communities who are affected.

According to the WHO, the Ugandan government and its health officials have responded to the outbreak very quickly in order to keep it contained. With such a rare and fatal virus, it is important that all of these organizations and the government work together to fight it and protect the affected communities. If these procedures work, the fatal Marburg virus in Uganda will not spread and many people will be sheltered from its reach.

– Emilia Beuger

Photo: Flickr

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The Association Between Poverty and Lung Cancer

Poverty and Lung Cancer
Poverty predisposes individuals to a spectrum of conditions that result from an amalgamation of lifestyle factors, health, hygiene and living conditions. Mortality from lung cancer is a more significant factor in impoverished communities compared to developed economies.

One of the major predisposing factors for high lung cancer mortality rates in developing countries is smoking. Cigarette smoke contains toxic particles which can inflict damage to cells present in the airways. Over time, these affected cells can become abnormal and lose their normal function.

The World Bank has established that smoking is more prevalent among poor groups compared to the rich, not only as a consequence of poverty but also in part due to the education individuals receive. Due to incognizance of the health risks associated with smoking, poor individuals may engage in this habit as a result of stress or poor family relationships.

Strategies to reduce lung cancer mortality in developing countries should focus on increasing access to education. Increased education can be achieved by building schooling facilities, implementing laws where education is compulsory until a certain age and subsidizing education for families who are unable to afford school fees.

A composition of diet also plays a crucial role in the development of lung cancer in impoverished countries. Some households are likely to be contingent with foods that are often processed, cheap and have poor nutritional value. As a result of low intake of fruit and vegetables, individuals are likely to be deficient in essential vitamins, minerals and antioxidants that play an important role in the body’s defense mechanisms against cancer development.

Measures to overcome poor dietary habits can include campaigns educating individuals about healthy eating. Subsidies can be offered to local supermarkets to ensure that fresh, affordable produce is readily available to individuals.

Rural communities often have poor access to health care services which can impede their ability to seek professional help at early stages. This prevents cases of lung cancer from being diagnosed and treated in the inchoate stages. Cancer can eventually progress to a serious stage where it is completely incurable and has a risk of significant mortality. Higher mortality in poor communities can also stem from a reluctance to utilize health care resources, possibly as a result of personal prejudice or concerns about a financial expense.

A recent study published by the Centers for Disease Control and Prevention states that 40 percent of identified cancer cases are associated with tobacco usage. This represents a significant proportion of cases that can be attributed to smoking, which is a preventable risk factor.

Widespread smoking cessation campaigns in both developing and developed countries can be implemented to encourage individuals to reduce smoking gradually. This can be done through advertising, counseling with health care professionals or even offering alternatives to smoking such as nicotine replacement therapy.

With greater than 36 million smokers in the United States alone, urgent action must be taken to ensure both poverty and lung cancer are reduced through a combination of corrective measures such as education, health care advice, and smoking cessation campaigns.

– Tanvi Ambulkar

Photo: Flickr

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Obesity and Hunger: Solutions in Improved Farming

Improved_Farming
In America, obesity has become a major issue.  According to Centers for Disease Control and Prevention Department, more than one third of United States adults are obese and as of 2012, more than a quarter of American children are obese.  Alongside the U.S., obesity has become a major issue abroad in countries such as China.

Obesity leads to serious health problems such as heart disease, stroke, type 2 diabetes and certain types of cancer.  Obesity increases the medical cost for individuals by more than $1,400 per year and government spending on healthcare costs by $147 billion.  Obesity also decreases the productivity of individuals, which with all of these combined demonstrate its negative effect on the economy.  As obesity is a highly emphasized global concern, much of that sentiment can be equally shared to its counter: the issue of hunger.

Even though it might seem that obesity and hunger are entirely different issues, they resurrect from the same origin – a nutritional system.  Understanding the causes of these two issues will further establish the significance to this underlying connection. Take, for instance that while the cause of obesity is an excessive consumption of unhealthy food and lack of exercise, the cause of hunger is a lack of food or conduct to establish a healthy diet.  For both, the root of the problem is the farming industry.

Most of the food supply comes from developing countries.  If the farmers do not have access to good farming equipment and farming technology, they will be more likely to use toxic farming chemicals on their land and cattle. In result, the produced food contains several unsafe chemicals that contribute to the potential causes of obesity.

In a TED talk, Ellen Gustafson suggested the solution to both of these problems is to increase the funding for farming industries and feed the hungry children in developing countries. By increasing the fund for farming, farmers can have access to better farming technology to enable producing healthier food for their home countries and exporting countries.  Additionally, more healthful diets help children in poverty countries grow up with both a healthy physicality and mental ability.

On a further note, hunger is a primary reason that children in poverty countries cannot go to school.  Improving the ethics in the farming industry and food supply to laborers, children in poverty can go to school, get educated, earn a better income and acquire a better livelihood while also contributing back to their society.

– Phong Pham

Sources: Ted Talks, Centers for Disease Control and Prevention, Obesity Society