Posts

Ending Malaria in ChinaHistorically, malaria has been extensive in China. In the 1940s, 90 percent of the population was considered at risk. In the 1970s, the country suffered 24 million cases of the disease. With the introduction of anti-malarial medicine and urbanization, massive strides have been made to end malaria in China.

In 2010, China launched the National Malaria Elimination Plan (NMEP) with the aim of eradicating malaria from the country by 2020. It pushed for rapid responses to reported cases of the disease, with the 1-3-7 plan outlining a report within one day, investigation within three, and treatment within seven. The plan saw great success and in 2017, no indigenous cases of malaria were detected.

China is not yet completely free of malaria. It is difficult to contain the disease at the country’s borders and those in poverty are especially at risk.

Background

The Yunnan Province consistently experiences a high number of malaria cases due to its constant interaction with neighboring counties. The wealthiest counties in Yunnan are central and surround the capital city Kunming. Among the 26 border counties, only two have an infection rate below one in 10,000, and nine have rates above 10 in 10,000. In addition, 21 of these counties are the poorest in the province. Researchers have called for more resources to be diverted to Yunnan.

The remaining cases of malaria in China pour in from neighboring countries, with 19,154 cases from 68 countries documented between 2011 to 2016. In the majority of cases, the disease was carried by returning Chinese workers, mostly from Myanmar, Ghana or Angola, all countries that rank below 160th highest GDP per capita in the world.

Despite these challenges, the country has made significant strides to combat malaria. The first major effort began in 1955, with the launch of the National Malaria Control Programme, a push to improve irrigation and insecticide use throughout the country. China reduced malaria deaths by 95 percent, and suffered only 117,000 cases of the disease, by 1995.

In 2003, China received aid from the Global Fund to fight AIDS, tuberculosis and malaria. Global Aid distributed over $100 million throughout the world over two years. In China, this reduced the number of annual cases below 5000.

The 2010 Program was a synthesis of a national effort. About 13 departments came together, including the ministries of health, education and the military to end malaria. According to He Qinghua, Deputy Director-General of the Bureau of Disease Prevention and Control at China’s National Health Commission, a large portion of the effort focused around involving the government at every level of control. If a ruling was made in the capital, it had to be translated into every local government.

Since 2014, the Chinese government has paid for the entirety of its fight against malaria, though it recognizes the importance of early support from external funds like the Global Fund. Yang Henling, a professor at the Yunnan Institute for Parasitic Diseases, further states the need to continue efforts, lest malaria return.

China Turns to Help Other Nations Eradicate Malaria

New South, a Chinese company, has begun working to eliminate malaria in Kenya, where 70 percent of the population is at risk of the disease. New South has already been working in Comoros.

New South advocates for the use of MDA, the primary drug involved with treating malaria in China. While many western organizations, including the Bill and Melinda Gates Foundation, focus on preventing mosquitoes from spreading malaria, New South emphasizes treatment in humans. Dr. Bernhards Ogutu, who has been fighting malaria in Kenya for decades, believes that Chinese support will have malaria eradicated in some areas of Kenya within only five years.

– Katie Hwang
Photo: Flickr

Disease in EthiopiaAs of 2018, Ethiopia has a population of over 107 million people. The country also boasts the highest livestock population in Africa, with around 52 million cattle and 36 million sheep. With nearly 80 percent of Ethiopia’s people dependent on livestock for income and sustenance, they are in constant contact with these animals. This puts them at high risk of contracting zoonotic diseases. In order to prioritize and prevent disease in Ethiopia, the United States CDC developed a semi-quantitative tool and held a workshop to identify the biggest concerns for human and animal health.

High-Risk Diseases

Forty-three contractible zoonotic diseases were evaluated at this workshop. Criteria were based on the severity of a disease in humans and the proportion of human disease based on animal exposure. The five diseases that were identified as having the highest need for prevention were rabies, anthrax, brucellosis, leptospirosis and echinococcosis. The goal of this workshop was to focus on better prevention and control strategies and to create programs that will better prepare the population to prevent diseases in Ethiopia.

Along with facing a higher risk of contracting zoonotic diseases than other countries in Africa, Ethiopia also experiences high risks of other deadly illnesses, such as malaria and AIDS. As of 2016, diarrheal diseases and lower respiratory infections cause the most deaths in Ethiopian children. With water sometimes being hard to access, due to a massive drought starting in 2011, the citizens are forced to drink water that can carry many kinds of life-threatening bacteria.

Preventing Disease in Ethiopia

Handicap International is doing its part to lessen the spread of disease in Ethiopia by providing clean water. They currently have placed three underwater storage tanks in Ethiopia that fill up with water during the rainy seasons which provide clean drinking water when rain is less abundant. Each tank can provide water for 1,500 people for almost two months.

Handicap International also provides training to health workers and citizens in Ethiopia. When people are more educated about the causes and effects of diseases, they are more capable of doing things to prevent contraction and spread. Along with training, the organization also distributes hygiene kits to various facilities.

The United States CDC is also working closely with Ethiopia’s Ministry of Health to implement a stronger HIV program in the country. With a data-driven approach, they are finding more effective ways of counseling and informing the people of Ethiopia, along with creating more appropriate testing strategies.

With so many possible ways of contracting a disease in Ethiopia, it’s no wonder that many organizations have made prevention and education a priority. Because the citizens of Ethiopia rely so much on livestock, they have a much higher risk of disease than many other countries. By providing them with clean water and the opportunity to learn how to prevent the spread of disease, they are on the fast track to higher mortality rates and less illness.

– Allisa Rumreich
Photo: Flickr

financing for hiv/aids
On April 18, 2018, the Center for Strategic and International Studies (CSIS) partnered with the Kaiser Family Foundation to host a discussion of the current state and future of financing for HIV/AIDS. The Borgen Project was invited to attend this critical summit and hear from the leading voices in this space.

About 36.7 million people worldwide were diagnosed with HIV/AIDS by the end of 2016; one million of those cases resulted in fatality. A disease that still affects so many requires adequate funding for care, treatment and prevention.

The fight against AIDS began in 1981 when the Centers for Disease Control and Prevention (CDC) published a Morbidity and Mortality Weekly Report which detailed one of the first cases of the disease. From there, the CDC began to work on discovering risk factors.

Between 1996 and 2000, spending on HIV/AIDS from major donor countries increased from $248.45 million to $749.37 million. According to Christopher J.L. Murray, one of the panelists and a professor at the University of Washington, “If you cumulate total spend since 2000, the world has spent just around half a trillion dollars on HIV/AIDS.”

The amount of financing for HIV/AIDS continuously increased through the years up until 2011. Murray pointed out current spending trends using a graph. “From basically 2011, with the exception of 2012, we have been flat,” meaning that total spending from donor assistance channels, such as the WHO and World Bank, has not increased since 2011. Though some individual channels may have increased financing for treatment and prevention, others have decreased spending, making total spending fairly consistent in recent years.

Another concern for financing for HIV/AIDS is the limited spending coming from countries with the highest numbers of affected people. The majority of financing is coming from the upper and upper-middle income countries. J. Stephen Morrison, the Senior Vice President and Director of the Global Health Policy Center, pointed out some of the most striking realizations that have come from new data on HIV/AIDS.

“It also begins to show us a way in which there has been an erosion of the financial and political commitment dedicated to those low-income countries with the greatest burden and the greatest prevalence,” Morrison noted. “The most dramatic point was in saying that since 2012, 2013, a 23.7 percent decline in the levels of donor assistance into those countries from just over 12 billion to 9.1 billion dedicated to HIV.”

The stagnant spending is a severe problem considering the rate of population growth. Mark Dybul, one of the panelists and a professor at Georgetown University, pointed out the hypothetical: “You double the population, you’re going to double the size of the infection rate.” A Business Insider estimation claims that more than half of the population growth that will occur between now and 2050 is going to occur in Africa. As Africa is also the site of the highest number of HIV/AIDS cases, this means that the rate of those infected with HIV/AIDS will likely increase significantly.

The future of financing for HIV/AIDS is looking challenging to Dybul given the difficulties in raising funds. “The reality is, there is no argument that’s going to get an increase in donor funding for HIV. We are at the highwater mark, we are not going up.” Dybul suggested that, instead, change will come through smarter investing, including focusing on prevention first, and treatment second.

Additionally, Dybul suggested that some change is needed in how we talk about the epidemic. As he pointed out “Young people in Africa don’t think about HIV anymore, they think about other things.” In this way, raising awareness may be crucial in fighting HIV/AIDS.

Moving forward with financing for HIV/AIDS will be a challenge considering stagnant spending across the board, little spending from low-income countries, and the drastic population growth expected in Africa in the coming years. But with changes in how organizations and governments invest and heightened awareness of the epidemic, it is possible to win the war against HIV/AIDS.

– Olivia Booth

Photo: CSIS


The Elimination 8 was created in 2007 by eight African countries with an initiative of abolishing malaria in Africa by 2030. By 2020, the E8 hopes to terminate malaria in the four low transmission countries of Botswana, Namibia, South Africa and Swaziland. By 2030, the E8 aims to terminate malaria in the four middle to high transmission countries of Angola, Mozambique, Zambia and Zimbabwe.

The E8 created a strategic plan to focus on strengthening efforts at cross-border and regional levels. The five core objectives of the plan are:

E8’s Five Core Objectives

  1. Strengthen regional coordination in order to achieve elimination in each of the E8 member countries. While countries continue to pursue their own malaria elimination efforts, the E8 serves as a platform of communication and guidance between countries to advance regional-level efforts. The E8 coordinates a regional structure for all countries to follow in an attempt to stop malaria from spreading across borders. It also partners with the E8 scorecard, which actively monitors the malaria statistics and progress of the countries’ efforts on an annual basis.
  2. Elevate and maintain the regional elimination agenda at the highest political levels within the E8 countries. The E8 relies on partnering with several organizations in order to continue shrinking malaria in Africa. The Ministers of Health and their partners act as additional leadership for malaria elimination. Through ALMA and SARN, the E8 has the ability to publish the E8 scorecard, which is crucial in holding countries accountable for their malaria efforts. Senior political officials help raise awareness for the E8 and can help to secure financial partners.
  3. Promote knowledge management, quality control and policy harmonization to accelerate progress towards elimination. Africa experiences heavy population movement throughout its countries that contribute to the spread of malaria. The E8 created regional maps that outline statistics such as the risk of transmission across borders and human mobility patterns. The main goal is to uncover the “sources and sinks of malaria,” or the areas that export malaria to other countries and the areas that receive malaria from outside sources.
  4. Facilitate the reduction of cross-border malaria transmission. The E8 countries are expected to follow a minimum set of standards in their efforts of shrinking malaria in Africa including the use of insecticides, insecticide resistance and management planning and case classification. The E8 provides guidance through managing information and relaying it across countries.
  5. Secure resources to support the regional elimination plan, and ensure long term sustainable financing for the region’s elimination ambitions. In order for the initiative to succeed in shrinking malaria in Africa, the E8 requires substantial funding. The E8 has decided on a resource mobilization strategy that attempts to fund regional activities from long-term partners. Although this strategy does not fund individual country initiatives, the E8 provides intelligence to support each country.

The Back-and-Forth

The E8 countries experienced a 50 percent decrease in malaria cases over a five year period, from 14 million cases in 2007 to eight million cases in 2012. One particular country, Swaziland, experienced a drastic decline in malaria cases. In 2010-11, Swaziland reported 478 malaria cases during the transmission season with only three malaria-related deaths.

However, in the 2016-2017 malaria season, seven out of the eight countries reported an increase in malaria cases with outbreaks reported in Botswana and Namibia. Through the E8, health ministries held a meeting to determine the source of the alarming rates.

Two main factors were found in the cause of the increase. First, mosquitos were becoming resistant to insecticides and countries were not meeting their spraying targets; and second, insufficient use of surveillance systems caused late responses and a lack of epidemic identification.

Hope for the Future

In spite of the increase of malaria rates, the E8 is continuing to better their efforts to continue shrinking malaria in Africa. “I’m still optimistic and looking at 2025-2030,” says Richard Nchabi Kamwi, former Namibian Health Minister and now the E8 Ambassador for Malaria Elimination.

“Swaziland, for example, is far ahead– for the past five years it did not record a single malaria death. Botswana unfortunately during the last season experienced some local deaths, but I was impressed with the aggressive way in which they responded to the epidemic and how they persevered with their plan. Now it’s 2017, so maybe eradication by 2020 will not happen, but I am looking at 2025, with the final four countries following suit by 2030.”

The countries have modified their action plans for the next malaria season and have prepared epidemic response plans — hopeful omens for the future.

– Anne-Marie Maher

Photo: Flickr

What Are the World’s Deadliest Diseases?In 2015, the top five of the world’s deadliest diseases accounted for more than 23 million deaths. The top two deadliest, heart disease and stroke, have been the two leading causes of death in the world since 2000 and account for 65 percent of the 23 million deaths.

The world’s deadliest diseases can be either communicable or non-communicable. Communicable disease are contagious and threaten the population with the spread of the disease. Common communicable diseases include respiratory infections and diarrheal diseases. Non-communicable disease are not contagious.

In 2015, as compared to 2000, there are fewer communicable disease in the top global causes of death. This means that medical treatments are working and more people have the ability to access treatments and preventive measures for those diseases.

The World’s Deadliest Diseases as of 2015

  1. Heart disease
    The risk of heart disease comes from both genetic and lifestyle factors. While genetic factors cannot be controlled, changing unhealthy habits to lower the risk of heart disease can be life-saving.
  2. Stroke
    Stroke is caused by a temporary disruption of blood flow to the brain, depriving it of oxygen. That oxygen deprivation can lead to long-term brain damage or death. Education about the warning signs of stroke can lead to life-saving early identification.
  3. Lower respiratory infections
    These infections, such as pneumonia, are contagious but treatable. Greater access to medical care will lead to early diagnosis to prevent their spread among the population and antibiotic treatments that can help lower their prevalence.
  4. Chronic obstructive pulmonary disease (COPD)
    COPD is an inflammatory lung disease that killed more than three million people in 2015. It is caused by exposure to irritating gases, most often from cigarette smoke or burning fuel. Ensuring healthy environments and education on the harms of tobacco can decrease COPD.
  5. Lung cancers
    This includes trachea and bronchus cancers as well, most often caused by smoking or exposure to secondhand smoke. Avoiding smoking and being in the presence of others smoking is the most effective way to prevent lung cancer from developing.

Even though these are the world’s deadliest diseases, diseases do not affect the entire population equally. In countries of lower economic status, the diseases most likely to harm the population differ due to varying access to life-saving resources, such as healthcare and knowledge of best health practices.

In low-income economies, the prevalence of communicable diseases is higher and affects the population more severely. In these countries, the top two killers are lower respiratory diseases and diarrheal diseases. Also in the top 10 deadliest diseases in low-income economies are HIV/AIDS, tuberculosis and malaria, all of which are communicable.

Even though these communicable diseases currently threaten the populations of low-income countries, they are all treatable diseases. With appropriate access to healthcare, healthy environments and knowledge of health practices, the spread of these diseases can be slowed. Preventing these diseases would greatly increase the average lifespan for citizens of low-income countries.

Globally, access to healthcare is important in preventing and treating any of the world’s deadliest diseases. Even though they are the diseases most likely to kill, they can often be avoided with healthy lifestyles and increased access to medicine.

– Hayley Herzog

Photo: Flickr


In the United States, the summer months often mean one thing: mosquito season. With their annoying buzzing and itchy bites, mosquitos are definitely a nuisance, but they are not a life-threatening issue.

Mosquitos and Malaria

For almost half of the world’s population, however, mosquito season means something entirely different: malaria. Malaria, a disease transmitted by mosquitos in many parts of the world is a dangerous and often life-threatening problem. Becoming familiar with the top 14 facts about malaria is crucial to the understanding of the disease and its implications.

Although entirely preventable and treatable, malaria is a fear that continues to persist in the 21st Century for billions of people. Often rampant among the poorest countries of the world, here are the top 14 facts about malaria and what is being done to fight the disease.

Top 14 Facts About Malaria

  1. Malaria is caused by five different parasites species and is transmitted through bites from infected mosquitos. One of the types of mosquitos in question is Anopheles, which are mosquitos bred in areas of clean, unpolluted water such as swamps, the edges of rivers or temporary rain puddles.
  2. Children under five and pregnant women are particularly susceptible to malaria. Of the deaths that occur from malaria, 70 percent of them are among children under the age of five. This is because children, in particular, are prone to infection and illness.
  3. Although it was eliminated from the United States in the early 1950s, mosquitos carrying malaria are found on every continent except Antarctica. In places where the disease has been eliminated, re-introduction of the disease is still a possibility.
  4. Malaria mortality rates are falling. Since 2010, global malaria mortality rates have fallen by approximately 29 percent and 35 percent among the age group of children under five.
  5. Insecticide-treated bed nets have been shown to reduce malaria illness. Bed nets are barriers put around people to prevent mosquitos during sleep. Bill Gates is an avid supporter of eliminating malaria and works with his charity to provide netting to countries where the risk of malaria is high.
  6. Two billion people remain at risk of malaria, roughly half of the world’s population.
  7. Sub-Saharan Africa has an extremely high malaria presence. It is estimated that 90 percent of all malaria deaths occur in this region.
  8. Cooperation among organizations working to fight malaria has proven to be successful. Addressing malaria is at the forefront of the international community’s thoughts with support from the United Nations, the World Bank, and a variety of other non-governmental organizations. Reducing the world’s burden of malaria was one of the first eight Millennium Development Goals introduced by the United Nations.
  9. Malaria is treatable if caught quickly and appropriately. Early diagnosis of the disease is key to treating it, and catching the disease quickly also helps reduce the transmission of malaria.
  10. Indoor residual spraying is another way countries are fighting malaria. This method works by spraying insecticide indoors and is currently effective for 3 to 6 months.
  11. Malaria impedes economic development in countries where it is extremely prevalent. In some African countries, GDP falls by 1.3 percent per year due to malaria’s economic consequences. Malaria also discourages investment from outside countries and impairs many children’s ability to go to school.
  12. The World Bank is very dedicated to controlling malaria. In previous years, the organization has contributed nearly $1 billion to the cause.
  13. Malaria-related deaths have decreased by 50 percent since the disease’s peak in the early 2000s.
  14. In 2018, the World Health Organization plans to pilot a project of a first-generation malaria vaccine. The project will be targeted in sub-Saharan Africa.

Road to Improvement

The universal elimination of malaria is possible in the 21st Century. The cooperation, funding and persistence to find solutions to the disease exist in ways never before thought possible.

– Sonja Flancher

Photo: Flickr

Working to End the AIDS EpidemicAcquired Immune Deficiency Syndrome (AIDS) is the result of an advanced human immunodeficiency virus (HIV) infection which destroys the body’s immune system. AIDS affects millions of people around the globe. Inadequate medical knowledge leads to a delay in the early treatment of HIV patients.

Since the early 1980s, when AIDS was first clinically recognized, it has claimed nearly 39 million lives worldwide. This has necessitated a global effort to find a cure for this mass epidemic. PEPFAR, The Global Fund and UNAIDS are some of the largest organizations who are working to end the AIDS epidemic by the year 2030.

Poor education is one of the leading contributors to the spread of the AIDS epidemic, since many people suffering from AIDS do not have the necessary knowledge to recognize early signs of the disease and be treated appropriately.

So that AIDS may hopefully be eradicated by the year 2030, UNAIDS has created a program called “90-90-90: treatment for all”. This program ensures that 90 percent of people affected by AIDS will know their medical status and will therefore be able to receive antiretroviral therapy.

Currently, there is no effective AIDS vaccination. However, a combination of antiretroviral therapies administered early in the disease blocks the HIV virus from multiplying in the bloodstream, preventing the development of clinical AIDS.

Before PEPFAR, another organization working to end the AIDS epidemic, only 50,000 people in Africa were being treated with antiretroviral therapy. Now with the help of PEPFAR, over 13.3 million people are being treated globally. Due to these preventative measures, HIV prevalence rates and new HIV infections are on the decline.

To end the AIDS epidemic, countries suffering from high incidences of HIV require more healthcare workers to provide safe communities and treatment for all. Accordingly, The Global Fund invests nearly $4 billion every year in the mobilization of healthcare workers.

UNAIDS has gathered the world’s largest data collection on HIV epidemiology, the best treatment methods, program coverage and finance that is vitally important in order to end the AIDS epidemic.

UNAIDS data enables this organization, as well as others, to accomplish the goals set at the General Assembly of the 2016 United Nations Political Declaration on Ending AIDS. By following this track, these organizations will hopefully eradicate AIDS by the year 2030.

Ending the AIDS epidemic, while saving millions of lives, can serve as a model for revolutionizing worldwide health in other ways. It can motivate other organizations to promote more global health and development efforts, demonstrating that much can be achieved through global unity and evidence-based action.

Too many people worldwide are still affected by HIV and AIDS. Thanks to the work done by organizations such as PEPFAR, The Global Fund and UNAIDS, the goal of ending the AIDS epidemic by the year 2030 is becoming more of a reality each and every day.

– Adrienne Tauscheck

Photo: Flickr

Treating HIV in Saint PetersburgIf Saint Petersburg were the same today as it was ten years ago, it would be known as one of the top five cities in the Russian Federation affected by the HIV virus. However, it is now the fourteenth most affected city. Treating HIV has been a top priority for the city, and as a result it has been able to get the epidemic under control. Saint Petersburg is the first city in the Russian Federation to achieve a steady decline in HIV infections, and fewer people are becoming infected with the virus throughout the city.

Last year, about 1,750 people were newly diagnosed with HIV in Saint Petersburg alone, a number that was even higher in the years before. In total, 42,000 people in the city were living with HIV. The city was able to get 80 percent of the people affected access to services at the Center for AIDS Prevention and Control.

The Center for AIDS Prevention and Control provides antiretroviral therapy (medicine that directly treats HIV), useful information and specialized medical care as well as prevention medicines for both pre-exposure and post-exposure.

Affected citizens in Saint Petersburg can also visit the city AIDS center, where they are able to get new syringes, sterile equipment and other preventative tools such as condoms. Saint Petersburg has also partnered with community organizations that have contributed to treating HIV by testing women for HIV, giving out free condoms and talking to consultants. Unfortunately, Saint Petersburg is one of the only cities in the Russian Federation that provides affected citizens with such a wide range of prevention and treatment.

An important factor in reducing the number of people affected by HIV was the availability of quick HIV testing. That way, someone who is affected can know immediately to begin taking antiretroviral therapy to both treat the disease and prevent any new infections.

The government has been supporting an outdoor advertising campaign teaching residents about HIV prevention services and public service announcements. The advertising has three main messages regarding HIV: the importance of testing, the availability of treatment and the elimination of stigma and discrimination against people with HIV.

Saint Petersburg is a good example of a city that was greatly affected by the HIV epidemic, but through a variety of preventative and treatment measures was able to take control of the epidemic and achieve a drastic shift in the number of people diagnosed.

– Chloe Turner

Photo: Flickr

PMI expansionThe President’s Malaria Initiative (PMI) aims to help reduce malaria in countries all over Africa. As of 2018, the PMI plan has expanded to five new countries, bringing the total to 24 countries receiving help. Some of the countries that have already been receiving aid are Ghana, Ethiopia and Benin. The five new countries that were added to the expansion of PMI are Burkina Faso, Cameroon, Cote d’Ivoire, Niger and Sierra Leone, all in West Africa.

 

Burkina Faso

Of Burkina Faso’s 19 million residents, 80 percent live in rural areas and are at the highest risk for poverty and poor health. The end goal of PMI is to completely eliminate malaria by 2030. Currently, the National Malaria Control Program (NMCP) strategy for 2015-2020 is to reduce malaria death rates and reduce malaria incidence rates by 40 percent each. The PMI expansion into Burkina Faso is also working on 10 focus areas for the NCMP, such as monitoring, evaluation, emergency management and prevention in pregnant women.

 

Cameroon

In Cameroon, 22 million people are at high risk of contracting malaria, especially pregnant women and children. With the PMI expansion, the Cameroon National Strategic Plan (NSP) included six strategic plans that focus on:

  • Prevention
  • Case management
  • Communication
  • Training and research
  • Surveillance, monitoring, evaluation and epidemic response
  • Program management

The stated mission of the NSP is to make malaria care, prevention and treatment efficient and affordable, even for the individuals who are the most marginalized. By 2018, the goal of the NSP is to reduce both malaria morbidity and mortality by 75 percent.

 

Cote d’Ivoire

As of 2016, almost half of all children living in Cote d’Ivoire were infected with malaria. The National Malaria Strategic Plan (NMSP) for 2010-2017 aims to reduce malaria mortality to one death per 100,000 and reduce malaria cases by 75 percent. The revised plan is also working to increase the number of people that are sleeping under an insecticide-treated mosquito net (ITN) from 33 percent to 80 percent with help from the PMI expansion. The end goal for pregnant women is to have 85 percent sleeping under an ITN and 100 percent of all malaria cases in pregnant women to be treated as quickly as possible.

 

Niger

Twenty million people live in Niger, and of those 94 percent are at risk of contracting malaria. According to the PMI, more than 56 percent of all deaths in pregnant women are caused by this disease. However, in 2017, 80 percent of women received three doses of malaria treatment and prevention medication and slept under ITNs. The NMSP goal is to reduce malaria mortality rates and the incidence of malaria by 40 percent. One expected result for NMCS is for 80 percent of Niger’s population to be sleeping under long-lasting insecticide-treated mosquito nets by 2021. All of these goals are more than attainable thanks to the PMI expansion.

 

Sierra Leone

About 6.5 million people in Sierra Leone are at risk of contracting malaria, and about one million children under five years old receive outpatient care because of malaria. Between 2015 and 2020, the primary goal is to reduce malaria morbidity and mortality by 40 percent. The NMCS objective for Sierra Leone is for 80 percent of the population to have access to prevention and treatment for malaria, and that by 2020 a minimum of 95 percent of health facilities will routinely report to the malaria program.

According to the Institute for Health Metrics and Evaluation, in four out of these five countries, malaria is the number one cause of death. In all five countries, malaria was the number one cause of premature death in 2016. The goal of PMI in all countries is to reduce malaria mortality by one-third and reduce malaria morbidity by 40 percent. All of these programs, goals and objectives have the chance to be hugely successful because of this ongoing work and the PMI expansion.

– Amber Duffus

Photo: Flickr

The Fight Against Measles and Polio in Yemen
After two-and-a-half years of war, Yemen is left in ruins and struggling to overcome health, social and economic problems within the country. Demolished hospitals, crippled bridges, bombed industries, and poor sanitation and nutrition contribute to the devastating situation imparted by the war on the country and its citizens.

A Failing Healthcare System in Yemen

The health status of the population in Yemen is currently described as “catastrophic.” Damage from the war has transformed the nation into a fertile environment for cholera due to the highly contaminated water, which amplified the proliferation of fecal bacterial infections.

Since sewage systems have failed and garbage has piled up to cover entire neighborhoods and regions of the country, more Yemenis rely on polluted water sources for drinking and cooking. Alongside cholera, a quarter of all health facilities in Yemen are no longer operating or have already closed down; this situation escalated rates of morbidity and mortality among citizens, particularly those needing surgery or emergency care such as patients with chronic kidney failure who are dependent on life-saving support.

The shortage of qualified health professionals and physicians created a gap in primary healthcare — especially among children — as lower immunization rates led to a significant rise in the number of polio and measles cases reported.

To create a temporary and effective solution, the World Health Organization (WHO) trained more than 50 mobile medical teams and 20 fixed emergency care teams to provide people with increased access to primary health care services, and to support the operation of 72 health facilities as a way to prevent their closure.

The Fight Against Measles and Polio in Yemen

On August 15, 2017, WHO launched the fight against measles and polio in Yemen through its nationwide vaccination campaign. More than 3.9 million children under 5 years go age were vaccinated against polio and around 860,000 children aged 6 months to 15 years were immunized against measles in high-risk areas.

UNICEF also joined efforts toward the fight against measles and polio in Yemen by collaborating with WHO to ensure effective vaccination interventions for vulnerable populations, such as children and pregnant women. Julien Harneis, UNICEF Representative in Yemen, asserted that UNICEF’s mobile teams and staffs sacrifice their lives and endanger their health during their daily outreach activities within the community due to the hazardous conditions present in the country.

The medical and public health professionals work to overcome all obstacles in preventing additional deaths and morbidities associated with preventable diseases such as polio and measles.

Dr. Gamila Hibatulla, Nutrition and Health Officer for UNICEF in Aden-Yemen, explained that mobile teams rely on public sites, such as mosques, to deliver necessary health services. Vaccination is a central goal to both international agencies of WHO & UNICEF so as to prevent and manage any infectious diseases that could create an additional burden for the government and a crumbling healthcare system. Ms. Hibatulla praised the parents of young children for collaborating with the agency’s work by ensuring that their kids get immunized against serious diseases.

Challenges & Setbacks

Despite the national campaign’s accomplishments in the fight against measles and polio in Yemen, Dr. Ahmed Shadoul, the WHO Representative from Yemen, stated that the positive results generated from the campaign were only “the tip of the iceberg” in terms of the international organization’s response. According to Dr. Shadoul, only a portion of the population was reached by these efforts, as a result of limited funding and failure to reach people residing in war zone areas.

Future plans are being developed to render vaccination and primary prevention efforts more effective, and through continuous coordination, cooperation and collaboration between international agencies and the Yemeni community at large, such a goal can be obtained.

– Lea Sacca

Photo: Flickr