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Providing Water Services To the Poor

Water Services to the Poor
Water services to the poor are severely lacking around the globe. The World Health Organization estimates that 2.1 billion people lack access to safely managed drinking water services. Moreover, more than twice as many people lack safe sanitation. Consequently, 361,000 children less than the age of five die from diarrhea, every year. Of the people who do not have safely managed water, 844 million do not even have basic drinking water services. These conditions compel 263 million people to collect water from sources far from home — a process that takes over 30 minutes per trip. A further 159 million people still drink untreated water from surface water sources, such as streams or lakes.

At the current pace, the world will fall short of meeting the United Nations’ Sustainable Development Goal (U.N. SDG) of universal and equitable access to safe and affordable drinking water for all by 2030. Accelerating efforts to meet this goal will cost as much as $166 billion per year for capital expenditures alone. It seems that to achieve this U.N. SDG, something must change and soon.

A New Funding Approach

Private finance could play an important role in expanding access to improved, reliable water services to the poor. However, most providers that serve the poor are not privately financeable in their present state and will continue to require subsidies. Hence, development assistance and philanthropic funds are of utmost importance to protect the global poor.

A global funding model, known as a conceptual Global Water Access Fund (GWAF), has been established in other sectors to raise additional funds for targeted interventions. It pools resources in a way that provides incentives for access and utility performance for poor households.

This method is tried and tested. Gavi, the Vaccine Alliance, received $15 billion in pledges and yielded a net increase in funding. Unitaid, an organization that accelerates access to high-quality drugs and diagnostics in developing countries, generated more than $1 billion through a levy on airline tickets.

Investments in the poor are often perceived as having low or even negative returns. Therefore, pro-poor utilities face challenges entering financial markets. This also explains why profitable utilities are hesitant to expand their services to the global poor. GWAF changes this by bridging the funding gap and placing pro-poor utilities in stronger positions to attract capital for further service investments.

Making Individual Change

Though funding seems like a larger issue, there are ways for individuals to support clean water for all. Many nonprofits focus on bringing clean water services to the poor. Here are three organizations that are dedicated to the proliferation of clean water services to the world’s poor.

3 Nonprofits Tackling Global Water Services for the Poor

  1. Pure Water for the World works in Central American and Caribbean communities. The organization aims to provide children and families with the tools and education to develop sustainable water, hygiene and sanitation solutions. They directly connect fundraising dollars with impact, which immediately helps potential supporters see how their donation or peer-to-peer fundraising campaign will make a difference for the people they serve.
  2. Blood:Water is another nonprofit that works to bring clean water and HIV/AIDS support to over 1 million people. They partner with African grassroots organizations to make a change in 11 countries. Blood:Water works to provide technical, financial and organizational support to grassroots organizations. In this vein, they aim to help strengthen their effectiveness in their areas of operation.
  3. Drop in the Bucket’s mission is another organization that works towards water sanitation. They build wells and sanitation systems at schools throughout sub-Saharan Africa, enabling youth to fully harness the life-changing power of education. They teach the importance of clean water, hands and living spaces. Furthermore, the organization encourages girls to go to school, instead of spending hours fetching water.

Remaining on Track

Although sustainable development goals seem a difficult achievement to reach, innovative techniques such as GWAF and individual efforts through donations take steps in the right direction in ensuring water services to the poor. With nonprofit organizations such as the aforementioned as well as assistance from international organizations and governments like, there is still hope in reaching the U.N. SDGs.

–Elizabeth Qiao
Photo: Pixabay

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Immunization Rates Worldwide During COVID-19

Immunization Rates Worldwide
As COVID-19 continues to spread across the globe, there is growing concern that immunization rates worldwide will be drastically impacted. Impoverished nations are particularly susceptible to declining vaccination rates due to COVID-19. Therefore, it is critical that routine vaccinations continue to be delivered globally to avoid the resurgence of preventable diseases in the years to come.

DTP3 Vaccination Rate

The concern that routine vaccination rates will drop in 2020 stems primarily from data collected in the first four months of this year. The most widely-used indicator of vaccination coverage in a country is the number of children completing the full course of DTP3; this course consists of injections of the vaccines against diphtheria, tetanus and pertussis. In 2019, the vaccination rate for completing this indicator vaccine reached 85 percent globally. However, in 2020 there has been a large drop in the number of children receiving all three doses of DTP3. If this trend continues for the rest of the year and fails to rise quickly in the coming months, this year could be the first since 1992 to have a decrease in the DTP3 vaccination rate.

Preventable Disease Vaccination

The fall of the DTP3 vaccination rate suggests that the administration of other critical vaccines is following the same pattern. The World Health Organization reports that a minimum of 30 global vaccination initiatives for measles were canceled or are currently at risk. A survey of 82 countries conducted by multiple vaccine providers and affiliates found that 75% of those surveyed reported disruptions to vaccination campaigns due to COVID-19. In addition to challenges in providing vaccines, people refusing to leave their homes and government restrictions are factors in this sharp decrease.

Prior to the COVID-19 pandemic, there was already concern about stalling vaccination rates. The DTP3 immunization rate has hovered around 85%, but a minimum of 95% is recommended to avoid outbreaks. It is critical that routine vaccination rates do not fall in order to prevent the resurgence of diseases. It is estimated that over two million children die every year from vaccine-preventable diseases. Furthermore, these preventable diseases disproportionately affect those living in impoverished countries, which already have lower vaccination rates.

The GAVI Alliance

There are some organizations working hard to face the new challenges to vaccination campaigns brought about by COVID-19. The GAVI Alliance, a vaccine organization, operates in 73 countries, 70 of which have reported COVID-19 cases. The organization has reaffirmed its commitment to providing routine vaccinations, as well as additional funding for health institutions to combat the pandemic. It is also working to establish equitable access to a vaccine for COVID-19 once one becomes available.

If immunization rates worldwide continue to drop this year, it could set back years of progress. This could lead to larger outbreaks of preventable diseases in the near future. Some organizations, such as GAVI, are working to overcome this challenge. However, the World Health Organization’s warning is serious; there are substantial challenges facing routine immunization campaigns during this pandemic that must be mitigated.

– Kayleigh Crabb
Photo: Flickr

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What is Davos? Alleviating Poverty

What is Davos
For the last 50 years, world leaders have been flying across the world to take part in the World Economic Forum’s (WEF) facilitated conversations that might leave people wondering what is Davos, exactly? The small Swiss town, Davos, is home to the annual meeting held by WEF where invited elite address global issues and how to solve them.

In 2019, there were 3,000 people that joined together in the Swiss Alps to propose new initiatives for various issues, including how to help those in developing countries. The organization has been present in the creation of successful initiatives to provide vaccines and water to those in poverty as well as in the development of a project to prevent sickle cell disease in Ghana.

Gavi the Vaccine Alliance

Nearly two decades ago, Gavi the Vaccine Alliance launched at Davos, an organization that aims to provide vaccines and immunizations to children living in poverty. The Bill and Melinda Gates Foundation provided $750 million to get the organization running.

The World Health Organization (WHO) also founded Gavi and began partnering with the United Nations Children’s Fund (UNICEF) in 2008. UNICEF distributes vaccines and immunizations on behalf of Gavi, having spent $1 billion in 2014. In 2018, UNICEF distributed products to nearly 70 countries for Gavi, and plans on doing the same in 2019, according to its shipment plans.

Gavi’s goal is to immunize 300 million children between 2016 and 2020, already having provided 700 million children with immunizations. When people living in poverty receive vaccines to common diseases, it removes a financial burden and could eventually allow them to alleviate their poverty, according to a Harvard Health Policy Review article.

Water.org’s Clean Water Initiative

At the 2017 Davos meeting, Matt Damon and Gary White, founders of Water.org, announced the organization’s partnership with Stella Artois in providing water to 3.5 million people. According to WHO, 2.1 billion people lack access to clean, safe water in their home which can lead to the spread of diseases and death. To combat this phenomenon, Water.org is selling Stella Artois chalices and using a portion of the profits for WaterCredit, a system that allows local communities to take out loans to improve their water situation. This can mean different solutions for different communities allowing them a choice that best serves their needs, according to NPR. This partnership is just one of the initiatives in place by Water.org; Water.org and Stella Artois have been working together since 2015 and have helped over 1.7 million people gain access to clean water.

Sickle Cell Screening in Ghana

At the 2019 Davos meeting, the government of Ghana signed a five-year Memorandum of Understanding (MOU) with Novartis, a Swiss pharmaceutical company, to treat sickle cell disease within the country. Two percent of Ghanian newborns are born with sickle cell disease, according to a 2005 study of over 200,000 newborns. Director of Ghana Health Service, Dr. Anthony Nsiah-Asare, stated at Davos that he hopes that the MOU will allow for the placement of treatment centers in all regional hospitals and the screening of every newborn while also collecting and analyzing data on the disease.

As of March 2019, 5,600 doses of Hydroxyurea, a daily drug treatment for the disease, went to Ghana for sale at a reduced price, according to Ghana Business News. By September 2019, 40,000 more doses should enter the country.

In answering the question, “what is Davos?”, it is a small city where big leaders have been working towards making changes for more than 20 years, like the alleviation of poverty through acts such as providing vaccines, clean water services and disease screenings to countries in need. At varying levels of success, these initiatives have reached millions of people suffering from poverty and seem to be maintaining momentum.

– Makenna Hall
Photo: Flickr

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Important Facts to Know About HPV in the Developing World

All You Need to Know About HPV in the Developing World
Human papillomaviruses (HPV) are DNA viruses that infect skin or mucosal cells. Depending on the severity of the infection, HPV can lead to either cervical cancer and other head and neck cancers or low-grade cervical tissue changes and genital warts. Virtually all cervical cancer cases result from a sexually transmitted infection with HPV.

Cervical Cancer and HPV in the Developing World

Globally, cervical cancer is known as the second most common cancer among women, with about 500,000 new cases being diagnosed annually. Of the total deaths that occur due to cervical cancer each year, more than 80 percent are concentrated in developing countries.

Immunization coupled with regular screenings and consistent treatments are the best strategies for reducing the burden of cervical cancer and HPV in the developing world. In resource-poor countries that lack adequate access to cancer screenings and treatment services, it is even more essential that younger girls be immunized before they are sexually active and are exposed to HPV.

The HPV Vaccine

The HPV vaccine protects against the strains that cause up to 90 percent of cervical cancer cases. It is typically available in most routine immunization programs of high-income countries. Historically, the major barriers to reducing the burden of cervical cancer and HPV in the developing world are due to the high costs of the HPV vaccines and the difficulty of reaching adolescent girls.

The GAVI Alliance–formally known as the Global Alliance for Vaccines and Immunization–is a partnership of national governments, the World Health Organization (WHO), the World Bank Group, the Bill and Melinda Gates Foundation, the vaccine industry and many public health institutions. GAVI provides technical and financial support for vaccines in countries that have a gross national income of less than $1,000 per capita and other poverty-stricken countries including China, India and Indonesia.

Thanks to the efforts of GAVI, the HPV vaccine is at a record low price and the poorest countries are able to access it for as little as $4.50 per dose. Additionally, the WHO decided to change the recommended dosage of the HPV vaccine from three to two doses, which helped facilitate the country rollout of the vaccine as well as significantly reducing costs.

The first HPV vaccine demonstration program took place in Kenya in 2013, and since then, 1,000,000 girls have been vaccinated. By the end of 2016, GAVI had initiated HPV vaccine demonstration programs in 23 countries, which is the first step toward introducing the vaccine to national immunization programs. So far, Honduras, Rwanda and Uganda have introduced the HPV vaccine into their national immunization programs.

Potential Roadblocks in the Push for the HPV Vaccine

Unfortunately, the transition from the demonstration programs to national introductions is taking longer than expected for some countries. Consequently, GAVI has developed a new approach to HPV vaccine support, which draws from the valuable lessons learned from previous demonstration programs.

Some of these lessons include:

  1. The fact that school-based delivery works very well when administering the vaccine to young girls. It is more cost effective to integrate HPV immunization efforts into routine immunizations at existing health clinics and schools.
  2. When promoting HPV vaccination programs and cervical cancer prevention, the facilitation of effective and factual communication within the community is particularly critical.
  3. GAVI has made tremendous progress in reducing the prevalence of HPV in the developing world through its vaccination initiatives. Eight GAVI-supported countries have integrated the HPV vaccine into their national vaccination programs and 30 countries have started a demonstration program.

However, despite the strong signs of interest from GAVI-eligible countries and the rapid and effective integration of the HPV vaccine, GAVI’s original goal of immunizing 40,000,000 girls by 2020 may be at risk due to supply constraints.

GAVI chief executive Dr. Seth Berkley stated, “Scaling up cervical cancer prevention and control strategies should not be delayed, as we have the tools to achieve this goal. With the right commitment from vaccine manufacturers as well as political support, strategic partnerships and investments, this particular battle to improve women’s health can be won.”

Thus far, GAVI has helped low-income countries access the HPV vaccine at affordable and sustainable prices. Dr. Berkley is confident that the organization is capable of meeting its goal. GAVI is dedicated to ensuring that its progress is maintained and that millions of girls in the poorest of countries are protected from the perils of HPV and cervical cancer.

– Lolontika Hoque
Photo: Flickr

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Vaccines Seek to “Spread What Works”

vaccines
When the eight Millennium Development Goals were created in 2000, one of the goals to be reached by 2015 became to reduce the mortality rate in children under five by two-thirds.

While the ambitious goal of a two-thirds reduction has not been met, the United Nation’s Children’s fund has recently reported that in the past thirteen years, death rates in children under five have been cut in half.

Studies show various ways death in children have been reduced by more women giving birth in hospitals or with skilled and educated health workers. Improvements have also been seen with increased awareness of the importance of skin-on-skin contact with a newborn and mother, breastfeeding, family planning and immunizations.

Immunizations are simple and effective ways to prevent diseases that take lives of many children a year.

While immunizations are effective in saving lives, the report showed more than six million children die per year from preventable causes. That’s almost 17,000 children dying every day from the inability to receive a vaccine that would prohibit a disease from taking their lives.

Among common life-threatening diseases are pneumonia, malaria, diarrhea and measles. All these diseases can be prevented with a vaccine. UNICEF’s head of global programs, Dr. Mickey Chopra, said, “The challenge is to spread what works. It is very, very easy to prevent … diseases from killing kids. An antibiotic is 10, 20 cents, and that saves the life basically.”

While these vaccines cost very little, vaccine packages that treat about a dozen diseases have increased in price by almost 2700 percent between the years of 2001 and 2011. In the latter year, the UNICEF Supply Division performed a study and found that “Western companies often charged UNICEF twice as much for its medication than Indian and Indonesian companies.” It is noted however, that as competition arose in the pharmaceutical market, prices have not shifted.

Though prices are high and funding for vaccinations that would prevent death in millions of children seems at times like a lost cause, there is hope in sight. In June of this year, the GAVI Alliance Board announced plans to immunize 300 million children between 2016 and 2020, hoping to save between an estimated five to six million lives in just four years.

The GAVI press release stated it is projected nearly 50 percent children in 73 GAVI- supported countries will receive all 11 immunizations recommended by the World Health Organization by 2020- a more than 45 percent increase than is seen today.

Chair of the GAVI Alliance, Daginn Hoybraten, said of the Alliance has the opportunity, “to build and strengthen immunization programs that will benefit the children of today as well as generations to come.”

– Kori Withers

Sources: GAVI Alliance, Think Progress, Huffington Post World Health Organization

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Effective Public-Private Partnership

Effective Public-Private Partnership
A significant challenge to the work of nonprofits and NGOs is finding funds and negotiating with private companies to provide goods and services. The GAVI Alliance, however, does just that. Founded by the Bill & Melinda Gates Foundation, the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunizations) has taken public-private partnerships to a new level in the years since 2000.

The GAVI Alliance focuses on negotiating prices for vaccines against such diseases as yellow fever, measles, Human Papillomavirus (HPV), and diphtheria. The vaccine industry often provides these life-saving vaccines at prices far too high for anyone in the developing world to afford, but with the help of the GAVI Alliance, vaccines can be provided at a significantly lower cost.

This practice of public-private partnership allows monoliths in the vaccine industry to provide large amounts of vaccines at manufacturing cost. The high volume of demand can also minimize production costs that contribute to the significantly higher normal costs in the developed world. And while vaccine prices remain high in the developed world, “in a sense,” journalist Gary Stern writes, “wealthier people [in industrialized countries] are subsidizing the lowered prices for poorer people.”

Lower costs can mean life or death for those in the developing world. For example, a recent agreement between GAVI and two HPV-vaccine providers Merck and Glaxo-Smith-Kline brought the price of a $130-dose vaccine to $4.50 a dose for developing countries. These vaccines against HPV — a major risk factor for cervical cancer — are expected to be administered to over 30 million girls by 2020.

The GAVI Alliance also focuses on strengthening health systems in the host country. Instead of GAVI immunization programs operating independently in the midst of poorly developed healthcare systems, the Alliance also provides funding for health system strengthening (HSS) for health service delivery and the establishment of permanent health centers.

With these two focuses, the GAVI Alliance not only contributes where the need is greatest — providing vaccinations for high-risk populations — but strengthens host-countries’ capacity to help themselves in the future, maximizing its effectiveness through a public-private partnership.

– Naomi Doraisamy

Source: GAVI Alliance
Photo: GAVI Alliance

95% Discount on HPV Vaccines for Girls in Poverty

95% Discount on HPV Vaccines for Girls in Poverty

HPV vaccines costing an average of $130 a dose in the United States will now be offered in poor countries for as low as $4.50 a dose, a monumental step made possible by the generous and focused work of the GAVI Alliance. These vaccines help prevent strains of human papillomavirus, or HPV, that cause almost 75% of cervical cancers.

According to GlaxoSmithKline and Merck, the two pharmaceutical companies offering these deeply slashed prices, more than 85% of cervical cancer deaths occur in the developing world. “We hope that this will help reduce the burden of cervical cancer and positively impact future generations,” said GSK President and General Manager Christophe Weber in a press release. GSK already supplies 80% of its total vaccine volume to developing countries.

The GAVI Alliance, formerly the Global Alliance for Vaccines and Immunization, was launched under a generous donation from the Bill & Melinda Gates Foundation in 1999; the Alliance works to partner charitable donations with private pharmaceutical companies by negotiating significantly lower vaccine costs for countries in need. This model has allowed over 370 million children to receive immunizations since GAVI’s founding.

In the next few months, GAVI will provide support to countries worldwide by carrying out demonstration programs that raise awareness among the vaccination target group — pre-adolescents — which will allow countries to incorporate the vaccine into their own immunization programs.

– Naomi Doraisamy

Sources: GAVI Alliance, Merck
Photo: Polifaso

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Bill Gates Responds to Skepticism of Foreign Aid

Bill Gates Responds to Skepticism of Foreign AidUS foreign aid has recently been thrown into the debate of where to cut government spending. Many Members of Congress have expressed doubt as to the effectiveness of foreign aid and the United States’ responsibility of providing foreign aid to third world countries. In his annual letter, Bill Gates wrote a response to these many concerns asserting that foreign aid works and the United States should continue funding this vital program.

Bill Gates begins his argument by addressing concerns that foreign aid is ineffective and only goes into the hands of the corrupt. By using the example of an organization he supports, GAVI Alliance, Gates is able to explain the specifics of foreign aid in a way that is often ignored. GAVI uses all of the donations it receives to provide vaccines to developing countries. Gates reiterates that the organization does not send cash to these countries, only vaccines. This is one way nonprofits and USAid can bypass possible corrupt political leaders.

Another way GAVI ensures its funds are not wasted is by only operating in countries that have provided evidence of a strong enough immunization system to administer the vaccines to a majority of children. These countries are required also to pay a percentage of the cost of the vaccines. Gates reminds us that China was once a recipient of such aid and now pays the full amount for vaccines. He also stresses how methods for measuring accountability and effectiveness have greatly increased and countries failing to meet certain criteria no longer receive assistance.

Not only are assistance organizations addressing corruption and government accountability, but studies have also shown these organizations to be achieving their goal of reducing global poverty and hunger. GAVI has contributed to the decrease in children dying each year (down by one quarter) by providing 370 million children with vaccinations. That means 2.4 million children’s lives have been saved in about thirteen years, since GAVI was created in 2000.

Gates acknowledges that there is still some corruption when dealing with foreign aid, but that does not mean the US should stop sending assistance. Foreign aid is working, and eventually recipient countries will build their economies to the point where they no longer require aid. The implications of such development mean a larger market for US products and a more secure world, not to mention drastically better living standards for formerly impoverished people.

Bill Gates calls for US politicians to be the moral leaders of the world. Such actions will not only ensure international respect but also international influence. He urges the US to follow the example of Britain and other countries devoted to foreign aid and continue funding for foreign assistance programs.

– Mary Penn
Source: Daily Mail
Photo: Gates Foundation

8 Developing Countries Get HPV Vaccination Programs

8 Developing Countries Get HPV Vaccination ProgramsThe GAVI Alliance announced on February 4 that it will provide HPV immunization programs to 8 developing countries. HPV is the leading cause of cervical cancer which 275,000 women die from annually, and 85% of that number live in developing countries. That’s a life lost every 2 minutes due to cervical cancer. Without changes in the current situation, cervical cancer-related deaths are predicted to increase by 430,000 annually, starting in 2030.

The GAVI Alliance will start demonstration programs in Ghana, Kenya, Laos, Madagascar, Malawi, Niger, Sierra Leone and Tanzania. The demonstration programs are the selected countries that will educate through experimentation and subsequently make an informed decision as to whether the programs should be expanded nationwide.

Seven of the countries will start providing HPV vaccines to girls 9 to 13 starting in 2013. Cervical cancer is best prevented through the immunization of girls before exposure to HPV infection making 9 to 13 the ideal age range. Once a person is infected with HPV, the vaccination is no longer effective.

Tanzania will wait until 2014 to participate. GAVI-eligible countries with already instated systems to distribute vaccines nationwide can apply for funding without undergoing the demonstration programs.

The vaccinations will be provided through schools and community health programs so that even girls who don’t attend school will have access. Through these demonstration programs, an estimated 180, 000 or more girls will be protected from HPV.

The HPV vaccines are administered in three doses. More than half a million doses will be necessary for the first round of HPV vaccines. This could be incredibly expensive, but GAVI aims to provide the HPV vaccines at a very affordable price in order to guarantee that the programs remain sustainable. To date, the best price is $5 a dose, which is a 64% reduction on the current lowest price.

UNICEF will procure the vaccines through the competitive pharmaceutical market. Currently, Merck and GlaxoSmithKline (GSK) are the only manufacturers who have prequalified for the HPV vaccines.

A series of challenges face the implementation of demonstration programs in developing countries. Many of the countries don’t offer regular health services for girls aged 9-13. Additionally, it is difficult to ensure that the girls at the highest risk will be reached, and difficult to ensure that sexually transmitted cancer-causing infections are identified and prevented.

Yet, the initial HPV programs that have been implemented through schools in Africa, Asia, and Latin America have had positive results.  Moreover, the introduction of HPV vaccines may also create the opportunity to improve other adolescent health services that focus on nutrition, HIV, as well as sexual and reproductive health.

Professor Ian Frazer, creator of the HPV vaccine said, “Today’s announcement of country approvals for HPV pilot projects is another big step forward to ensuring that girls living in developing countries enjoy the same access to HPV vaccines as girls elsewhere in the world.”

By 2015, GAVI intends to help more than 20 countries establish HPV vaccination programs that should protect an estimated one million girls. GAVI also expects to have more than 30 million girls vaccinated in over 40 countries by 2020.

– Kasey Beduhn

Source: allAfrica, NZweek
Photo: GAVI Alliance