The focus in the battle against HIV infections recently shifted to include reducing the stigma surrounding HIV. Organizations dedicated to AIDS prevention challenge underlying discrimination and stereotypes against those infected, particularly in low-income countries.

Now organizations such as Egender Health, an NGO working to reduce infections around the world, provide curriculums on reducing the stigma surrounding HIV along with treatment plans to doctors in the field. Avert, a similarly-oriented organization, uses HIV-education to challenge stereotypes.

In Sept. 2016, WHO outlined an extensive plan for eliminating HIV infections that included a goal of “zero HIV-related discriminatory policies and legislation” by 2030.

This new approach emerged at a very critical point in the battle against HIV and AIDS. HIV has now been declared a “primary health concern” by the World Health Organization (WHO) and European Disease Control. At around 6.5 million, sub-Saharan Africa has the highest concentration of infected individuals. In 2015, UNAIDS estimated about 36.7 million individuals living with HIV globally, 2.1 million of whom contracted the virus within the past year.

While improving treatment options may eventually offer a final solution to the HIV epidemic, fighting stigma is one of the most promising methods of prevention and reduction. Shame frightens away infected individuals from seeking treatment, undermines prevention efforts by limiting health care services and results in poor quality of care for HIV-positive patients.

Additionally, culture-specific stereotypes relating the disease to infidelity, promiscuity, homosexuality, moral failings and death isolate individuals from support networks.

While stigma remains a large obstacle, a study at Tulane University revealed that mass media, counseling, coping skills acquisition and community-based interventions could greatly reduce HIV stigma. Communities that received some form of HIV-education were far more likely to welcome and accept HIV-positive individuals. Additionally, involving some form of anti-stigma training improved the effectiveness of treatment plans.

Confronting stigma is an important factor in AIDS prevention and treatment. This study, along with others, demonstrates that although the war against HIV may be far from over, the battle against stigma and discrimination is on its way to being won.

Kailey Dubinsky

Photo: Flickr

Malaria Epidemic in Indonesia Women Fight
Global organizations have made significant strides in fighting the malaria epidemic in Indonesia by focusing on the health and welfare of pregnant women and children.

In an article published by IRIN, William Hawley, a malaria expert with the U.N. Children’s Fund (UNICEF), highlighted the importance of malaria treatment and prevention against the disease.

“Pregnant women and children are especially vulnerable to malaria, and modern malaria diagnosis and prevention can be delivered via existing maternal health and immunization services in a symbiotic way,” Hawley said.

World health organizations such as UNICEF have been working closely with Indonesian government agencies and world health programs to provide free and affordable care to women and children in the region.

“The malaria program, the antenatal care program, and the expanded program on immunization all benefit, but most important — women and kids benefit,” Hawley said.

According to the article by IRIN, nurses and midwives have been helping pregnant women and infants fight malaria by providing diagnosis, treatment and information regarding the disease. In response, more women have been provided antenatal care and more children have been immunized against malaria.

The Harsh Effects of the Malaria Epidemic in Indonesia

Malaria is a disease spread by mosquitoes causing symptoms including fever, exhaustion, vomiting, and headaches. Severe cases generally include yellowing of the skin, seizures, coma, or, in the most extreme instances, death.

The disease can be more dangerous to pregnant women and infants causing stillbirths, low birth weight, abortion and infant mortality. Malaria can also cause severe respiratory problems in both adults and children.

According to a report published by the World Health Organization (WHO), out of a population of close to 260 million, 190 million people were reportedly malaria free in 2015. This comes after a significant number of cases were reported between 2009 and 2012.

With the help of finances provided by the Global Fund, WHO, and UNICEF, residents of Indonesia have access to preventative measures against the disease in the form of mosquito nets, insect repellents, and insecticides. Residents are also taught the importance of mosquito control measures such as draining water to prevent reproduction.

According to a report by the CDC, with funding from UNICEF, USAID, the Gates Foundation and the Ministry of Health (MOH), many preventative programs have been integrated into immunization and prenatal care programs in five provinces in eastern Indonesia.

These organizations hope to expand to all areas where the disease continuously occurs to help fight the malaria epidemic in Indonesia.

Drew Hazzard

Photo: Flickr

Hepatitis has become a global epidemic. Such viral infections can cause cirrhosis of the liver and hepatocellular carcinoma. Nine percent of the global population, or 550 million people, are infected and one million die from the disease every year. Most of these deaths are in lower-income countries. Hepatitis infections have definitive links with poverty beyond death rates; poverty is an identified risk factor for the disease. Here are four ways poverty impacts the hepatitis epidemic:

  1. Poverty Impedes Diagnosis
    Many people are unaware they have hepatitis. Indeed, 90 percent of people with hepatitis C are not diagnosed. Undiagnosed people may not take precautions in preventing transmission.Many diagnostic tests are expensive, putting them out of reach for lower-income countries. For example, the liver biopsy test is not only expensive, but it requires trained histopathologists to analyze the tissue sample. In Africa, medical professionals who are experts in liver diseases are generally not common. This includes those who would analyze the histology sample.Furthermore, lower-income countries don’t typically have high-quality laboratories that can test for hepatitis. The centers that do exist are usually found in urban areas, neglecting those in rural locations.
  2. Poverty Reduces Access to Treatment
    Lower-income countries have limited access to hepatitis treatment. Forty-one percent of the population lives in places without public hepatitis funding. One treatment, known as PEG-INF/RBV, can cost EUR 25,000 for full course therapy in Europe. This figure does not consider any of the follow-up care or further tests.There are also tests which guide the treatment of hepatitis. They identify the strain and how much virus is in a person. They’re expensive and as such not always routine.
  3. Patents Make Drugs More Expensive Than They Need to Be
    Drugs are protected as intellectual property by patents. These protection laws prevent other companies from creating comparable, generic drugs at lower prices for twenty years after invention. The intention is to encourage research and development by drug companies. In reality, when only one company makes a drug the company has free range with pricing and often sets a high price tag. These patents make some hepatitis drugs too expensive for patients in lower-income countries.
  4. Reuse of Syringes is Common in Lower-Income Countries
    Syringes can be contaminated with hepatitis. When they are reused without sterilization, they can pass along the infection. One reason that dirty syringes are reused is because of poorly trained healthcare workers. Also, lack of funding forces medical professionals to reuse syringes. If this practice continues, so will the epidemic.The good news is that there are treatments and cures for hepatitis. There is a complete cure for the hepatitis C strain and preventative vaccines for hepatitis A, B and E. The World Health Organization (WHO) is optimistic in defeating the hepatitis epidemic. They have prioritized its eradication and are creating guidelines to help countries with this process.

Previously, the WHO prioritized fighting a global epidemic during the HIV outbreak. HIV therapy once cost $10,000 per patient, per year. That is now down to $100. Today 10 million people receive treatment, in contrast to the mere 20,000 who were once treated in developing nations.

Hopefully, with focus and funding, the future of hepatitis can follow the pattern set by the HIV outbreak, and poverty’s impact can be eliminated.

Mary Katherine Crowley

Photo: Flickr

Portable Device for Early Diagnosis of Sepsis
Sepsis is one of the leading causes of death worldwide. In the United States alone, sepsis and related complications claim more lives annually than AIDS, prostate cancer, and breast cancer combined. According to the Centre for Disease Control, more than 1 million patients are hospitalized each year with sepsis in the United States.

Sepsis – or Septicemia, as it is otherwise known- is an immunological response to infections which targets tissues and organs of the body itself. It usually is a consequence of infections- particularly of lungs and urinary tract- as well as a post-operational complication of surgery.

Immune response from the body often triggers increased blood clotting and reduced blood flow through vessels. This can result in fatal blood pressure drops, or septic shock, in which vital organs of the patient stop functioning.

The usual diagnosis for sepsis is difficult, as sepsis can arise unpredictably. However, with close monitoring of post-op patients, as well as patients hospitalized for various infections, the disease can be identified early enough for successful treatment.

Blood tests conducted for elevated leukocyte (white blood cells) and lactate levels are the main way for diagnosing sepsis.

In developing countries, sepsis is an even bigger threat. In the absence of consistent healthcare system and access to laboratories for diagnostic testing, sepsis is often left undiagnosed.

Research done by private institutes as well as data collected by the World Health Organization suggest the lack of proper resources and ignoring Surviving Sepsis guidelines in developing nations, including Tunisia, Mongolia, and Pakistan.

The arena of bio-engineering has in the recent past revolutionized accessibility to medical care. Millions of patients across the globe can measure their blood sugar levels, test for HIV/AIDS, and evaluate their optic health through portable devices in the privacy of their own homes.

Building upon the idea of portable diagnostic devices, a European team has built initial prototypes of a device for diagnosing sepsis.

The device will use an imaging technique to differentiate white blood cells in the body from red blood cells, and calculate the concentration of the former in the blood. This “leukometer” will provide information on any abnormal spike in white blood cells as an immune response, which can be prior to the manifestation of visible symptoms.

All three of the prototypes rely on micro-imaging through a lens placed on the skin, so the process in non-invasive. The portable device will enable easy and reliable in-home testing in areas where access to medical care is limited.

The project is being financed by MIT and its affiliates in Madrid. The device prototypes are being geared for clinical trials in hospitals across Boston and Madrid, including Massachusetts General Hospital, Boston University, and the Spanish National Cancer Research Center (CNIO).

The product is expected to release for consumers in 2017, barring any logistic difficulties. The success of this device in early diagnosis of sepsis will be another milestone in the advancement of biotechnology to offer innovative solutions for each and every patient in need.

Atifah Safi

Sources: NIH, Science Daily, WHO
Photo: Pixabay

The Democratic Republic of Congo is facing the worst measles outbreak since 2011, according to Doctors Without Borders. So far this year, over 23,000 cases of measles were reported in the Katanga region of the country. The UN and Doctors Without Borders have calculated over 400 deaths.

The epidemic started in February of this year. In just one village with a population of 500, 30 children died in just 2 months. Despite the number of deaths, the central government in Kinshasa hadn’t recognized the measles epidemic and the deaths caused by it until earlier this month.

Doctors Without Borders has vaccinated over 300,000 children, despite the difficulties of having to keep the vaccine cold and requiring 2 shots, weeks apart for effectiveness.

An additional difficulty has been the lack of infrastructure with bad roads and railroads that are usually never fixed or where fuel runs low. Some villages are hardly accessible, only way to get there is by foot, motorcycle or canoe.

The UN has estimated $2.4 million to vaccinate everyone. The vaccine is effective enough it has wiped out the measles outbreak in western countries. The problem in countries such as the DR of Congo is children’s immune systems have been weakened from malnutrition, malaria and cholera.

The vaccine while effective, cannot prevent death when complications such as blindness, encephalitis, severe diarrhea and related dehydration, or severe respiratory infections.

In addition, vaccination has proved difficult in a region which has tried to become independent from the rest of the country. The ongoing fighting between local militia and Congolese army over mining areas leads to villagers fleeing for days or weeks. However, efforts are ongoing to improve the current living conditions for Congolese citizens, especially children.

Paula Acevedo

Sources: New York Times, Yahoo
Photo: CDN

In 2010, the Global Burden of Disease published a study that pointed to obesity as a more widespread health problem than world hunger. The study stated that about 30 percent of the global population was overweight or obese and that the latter caused approximately 5 percent of all deaths.

The problem of transitioning from widespread hunger to widespread obesity tends to occur in island countries termed ‘banana republics’, or those known for their direct economical dependence on trade relations with developed nations. Said dependence leads to a massive overconsumption of processed foods imported from the West and soaring rates of obesity.

A poster child for this phenomenon is Nauru: a Pacific island whose people were starving until a U.K. company discovered the country’s potential for phosphate mining. What followed the invariable economic boom was a precipitous rise in average weights as fast food largely replaced the Nauruans’ fresh fish and tropical fruits. Today, approximately 94 percent of Nauru’s population is overweight.

Unfortunately, banning fast foods will not solve the problem. Companies such as Dunkin Donuts and McDonalds have such tremendous political and economic clout that illegalizing their products would mean eliminating thousands of (barely) paid jobs and “food” products that nonetheless quell starvation.

Powerful as they are though, their products make it possible for a person to be obese and undernourished simultaneously. No impoverished individual is going to look at the nutritional labels on food, however deceptive they may be, if she is holding her first meal in a week.

The saddest part is that so-called banana republics cannot afford to buy their own food. Between the menaces of deforestation, immoral trading practices, and perpetuated poverty, their people are increasingly dependent upon foreign aid for unhealthy imports and foodstuffs each year.

If the current rate holds, nearly half of the world’s adult population will weigh in above a healthy range by 2030. The number will rise most prominently in industrialized regions compared to rural; already that trend has taken ahold of India and China.

What lies at the heart of the epidemic is widespread addiction to a substance of which large swaths of peoples’ ancestors were once deprived. It takes several generations, if ever, for their descendants’ brains to catch up to the sudden abundance. Until then, they subconsciously perceive the unhealthy food as a rare, invaluable delicacy and gorge down as much of it as possible.

Education is not enough to stop the obesity epidemic because emotion will always trump logic. The first step to solving the problem does not lie with educators or the educated; it lies with policy-makers.

It is policy-makers who are capable of manipulating the market such that island nations’ exports fetch a higher price on the market so that their people do not have to resort exclusively to fast food. If they have no other feasible options given their budgets, education would be completely useless.

Because people choose which foods to consume based on emotion, educators need to employ compassion. Psychology studies have shown that people are less likely to make unhealthy food choices when their self-esteem is intact. Eating is a social activity, so it is important to also share meals with supportive individuals. Lastly, healthier foods also tend to have more natural ingredients. If there are three or more unpronounceable, unrecognizable ingredients on the nutrition label, don’t buy that product.

– Leah Zazofsky

Sources: ASAHI, Flagler Live, Psychology Today
Photo: Challenged Kids International

ebola patients
The World Health Organization is continuing its struggle to contain the deadly Ebola epidemic in West Africa. It reported July 11 that since the outbreak began in February, there have been 888 total cases and 539 deaths. Recently, numbers have escalated drastically in Liberia and Sierra Leone.

Ebola’s most recognizable symptoms are fever, vomiting, bleeding and diarrhea. The virus is highly contagious, and is spread through contact with bodily fluids of an infected person. Ebola is also fatal 90 percent of the time, but there is a chance for survival if the victim can get proper and timely medical attention. Effective treatment for Ebola requires cooperation from West African locals to allow contacting and assessment of suspected cases. If a person tests positive for the virus, he or she must be isolated in a treatment center.

However, locals have recently begun to mistrust the health centers and foreign aid workers. Because so few of the Ebola patients that enter the health centers make it out alive, the locals have started blaming the facilities. They have become so suspicious that they have begun to avoid treatment, chase away health workers and vandalize health centers.

Many villagers, especially in Liberia, do not even believe that the disease exists.

In two weeks, a treatment center in Gueckedou, Guinea went from treating approximately 25 Ebola patients to one suspected case. What seemed at first to be a success story was in fact the opposite. It is almost certain that rather than the disease waning, a considerable number of suspected cases are hiding out in the forest from medical workers.

Villages are now sealing themselves off to prevent health care workers from entering. They have even started blocking roads and tearing down bridges. Locals are either hiding their sick families and friends or seeking out help from traditional healers.

Due to the contagion risk associated with bodily fluids, authorities say the remains of Ebola victims must be disposed of safely and securely in body bags. But, this interferes with West Africa’s traditional methods of burial, in which the family of the deceased must wash and bury the body.

Many locals believe that cadavers are being dismantled and used for experiments or witchcraft rituals, so they try to recover the bodies. In Sierra Leone, authorities even had to fire tear gas to prevent family members from seizing the body bags.

West African governments met at a WHO sponsored event earlier this month and agreed upon a cooperative regional strategy. A key aspect of the strategy involves checkpoints. At roads leading into and out of Kenema, Sierra Leone, authorities have set up checkpoints at which to question travelers and take temperatures.

Yet, people are so afraid of being screened for Ebola and taken to hospitals that now they have begun to avoid the city.

Experts at the WHO and UNICEF say more effort and funding is needed. Misplaced fear within the communities must be addressed before any strategy can have a chance of success.

 – Mari LeGagnoux

Sources: NPR, Huffington Post
Photo: CBSNews

The U.S. has seen its third case of the MERS virus this past month. Despite showing no symptoms, an Illinois man was diagnosed with the virus on May 2, his infection proving unique: he is the first person to have contracted the virus in the U.S., which is already prevalent in the Middle East.

The Center for Disease Control and Prevention (CDC) has already begun to issue public warnings regarding the virus and its prevention methods. Yet while CDC response team leader, Dr. David Swerdlow, sees no immediate threat as the disease has had “no sustained transmission” in the U.S. like other viruses such as the flu, MERS is proving to spread rapidly overseas. According to Reuters, about 30 percent of those infected with the virus have died.

While we still know little regarding the origin of the MERS virus, it is characterized as a “severe, acute viral respiratory illness caused by MERS-CoV, a beta coronavirus,” meaning that, according to the CDC, most people will at some point in their life contract the virus. Spread person-by-person, the illness — for which there is still no vaccine  — is on the rise, and while it has not yet been characterized by the CDC as a global health emergency, the virus is continuing to result in an increasing number of fatalities.

While cases of the virus have emerged in nations of varying degrees of wealth, including Egypt, the Netherlands and Jordan, by far the worst-hit country has been its originator, Saudi Arabia. Deaths in Saudi Arabia as a result of the MERS virus have hit a whopping 163 as of May 17. Yet while the country — known for its vast oil wealth and a relatively strong GDP placement compared to other nations  — may not be the most prime example of impoverishment, a startling 20 percent of the nation’s population is still, almost secretly, living in poverty. Crippled by impoverished conditions, the world’s poor may be among those most at risk of contracting the severe virus.

While the future for the virus is still relatively unknown, appropriate actions by the CDC are being put into place in order to ensure proper combativeness in case of a pandemic. Forced now to wait and see the true effects of the virus characterized as a “deadlier, less transmissible cousin of the SARS virus,” the CDC ensures that they are prepared for whatever the outcome.

– Nick Magnanti

Sources: CNN, Al Jazeera, TIME 1, Washington Post, Public News Service, AL, Boston, TIME 2
Photo: ICCS

Recently, insurgents have kept polio teams out of vulnerable areas. Distrust of all things American and the belief that the polio vaccine was being used to control the population has led to outspokenness against the treatment from some, and outright violence from others. In the latter part of last year alone, there were eight polio workers that were killed due to such rhetoric. However, the latest casualty in this battle is a child less than one year old, who died in a hospital.

The child’s father, Taj Muhammad, said that polio teams had not been to their area in three years due to such activity. The child joins 257 children that have succumbed to the disease in the past two years in Pakistan.

The Pakistani government suspended UN-supported vaccinations following the shooting of two female polio workers on May 28th. Radio Free Europe’s Pashto station Radio Mashaal has nevertheless been working to connect aid workers to the communities that need them. Radio Mashaal’s approach, which includes inviting religious and secular figures of authority such as mullahs and doctors to engage in discussion has, according to one doctor, led to a 50 percent drop in the number of parents who refused to administer polio drops to their children.

Yet, Pakistan—along with Afghanistan and Nigeria—remains one of the few places on the planet where polio remains an epidemic.

– Samantha Mauney

Sources: Radio Free Europe, LA Times
Photo: Gates Foundation

Doctors Without Borders and Measles in the Democratic Republic of Congo
There has been a threat from measles in the Democratic Republic of Congo (DRC) since 2010. Three months ago, the disease reached epidemic levels. Although much is being done to combat the spread of measles, tens of thousands of people are still affected.

Over the past year, Doctors Without Borders has inoculated nearly half a million children against measles, having to treat nearly 20,000 for the disease itself. Mortality rates can vary from 15 to 25 percent; the manager of a medical team “counted 35 dead in one village…traveling from village to village, we hear just one word: measles.”

Perhaps the most awful thing about measles outbreaks is that the disease itself is extremely treatable. Vaccines can be purchased for a pittance, but the problem in the Democratic Republic of Congo lies in getting the medicine to those who need it. Without modern infrastructure extending navigable roads to many villages, the vaccine cannot always be kept cold in transit. One health center “has only two refrigerators and one broken motorcycle to serve an area half the size of Switzerland.”

Doctors Without Borders put out the alert back in December, hoping that increased attention to the epidemic would bring more donations, and therefore more treatment. Tens of thousands of lives can be saved for barely a few dollars each. The only thing standing between those who are suffering and their good health is the vacillation of foreign donors.

Jake Simon

Source: Doctors Without Borders