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American Expenditure on EntertainmentExpenditure by the average American consumer unit (henceforth household) each year is substantial compared to what the poor in the world spend. Of the 200 million or so rich people globally, Americans make up the majority; in this decade, as determined by those in the World Data Lab, “the world’s top market segment will be America’s rich” (italicization added). According to the U.S. Bureau of Labor Statistics Consumer Expenditure Survey (BLS CEX), entertainment spending made up 5.3% of the total average annual expenditure of American households in 2018. American spending on entertainment is considerable.

Collectively: Average American Households

Looking at the CEX, in 2018, average annual expenditures rose to $61,224, compared to $60,060 the year before. More specifically, spending on entertainment (EE) increased to $3,226, from $3,203 in 2017. (Inflation was higher than expenditure numbers in 2018. Nevertheless, consider that thousands of dollars went toward entertainment.) There were 131,439,000 households in the U.S. in 2018. When one multiplies that number by EE, one gets $424,022,214,000; hundreds of billions of dollars were spent on entertainment.

That amount of money is more considerable than the gross domestic product (GDP) in 2018 for the entire country of the United Arab Emirates (where Dubai and the tallest building in the world are), which was over $421 billion.

So what does the category of entertainment expenditure include in the BLS CEX?

  1. Fees and admissions, including admissions to sporting events and movies; fees for social organizations; recreational lessons; and recreation expenses on trips.

  2. Television, radio and sound equipment, including video game hardware and musical instruments.

  3. Pets, toys, hobbies and playground equipment.

  4. Other entertainment equipment and services, including indoor exercise equipment, camping equipment, boats, photographic equipment and supplies and fireworks.

Just $2 billion of the $72.56 billion that Americans spent on pets in 2018 is what Gavi, the Vaccine Alliance, was at a minimum seeking to raise as of 7 August. That amount could immunize both those with high susceptibility to the coronavirus and health care workers in Gavi-supported countries, with doses that would be available for use where needed most. Gavi is a public-private partnership that has helped to immunize hundreds of millions of children since 2000; partners include the World Health Organization, United Nations Children’s Fund and the Bill and Melinda Gates Foundation.

America’s Rich

By the end of 2020, there will be an average of $194 to spend per day per wealthy American; this is put forth in a Brookings Institution blog. Possibly an appropriate juxtaposition, in 2018, households and non-profit institutions serving households (NPISHs) final consumption expenditure per capita was $189 in Burundi, a country where most of the population is poor and which has the second lowest GDP in the world.

Using data from the 2018 CEX, one may learn something else concerning American expenditure on entertainment. The top 10% of highest income (before taxes) households in the U.S. had an average of 3.2 persons and spent an average annual expenditure of $142,554. That amounted to around $122 spent per day per person: each person spent approximately $6.64 a day on entertainment. Notice that the $122 is less than the $194 of America’s wealth. 

If each of the 42,134,400 persons of the above top 10% were to have given around $1.20, less than a fifth of what they expended on average on entertainment per day, that would be enough (at least in hard numbers) to meet the net funding requirements from June to November of this year about the World Food Programme in Burundi.

The Bigger Picture

Entertainment may not in and of itself be bad or good. One way that American expenditure on entertainment affects Americans is the amount of time they spend on entertainment. For example, in 2019, the BLS reports that watching television on average took up the most leisure time. Although Americans possibly can inform themselves about the poor in the world via television, Americans could use some of the time spent watching television to ask their representatives to support legislation that could help reduce poverty.

Kylar Cade
Photo: Flickr

COVID-19 Relief
As the COVID-19 pandemic surges around the globe, world leaders are trying their best to help their people by providing masks, personal protection equipment (PPE), testing kits and treatment for the disease. However, who transports and delivers these items? That responsibility goes to logistics firms. These firms are responsible for shipping and handling items, including healthcare necessities such as PPE, testing kits and medicine. The United Parcel Service (UPS) is one such company that has been doing an outstanding job providing such logistics globally. Its main focus, however, is providing logistics to the least developed countries in their fight against COVID-19. UPS is at the frontlines using its resources to help the poor in receiving COVID-19 relief and essential healthcare supplies to fight this pandemic.

COVID-19 Relief Efforts

UPS has been at the frontlines at the fight against COVID-19 since February 2020 during the early stages of the pandemic. The company transported medical supplies—2 million masks, 11,000 protective suits and 280,000 pairs of medical gloves—to China free of cost in February. This action provided Chinese health clinics and hospitals the resources they needed at a faster rate.

The logistics company has also partnered with the drone delivery service Zipline to provide blood bags, medicine, vaccines and healthcare equipment to remote regions in Rwanda and Ghana. It has completed about 44,900 flights throughout the pandemic. This has helped Ghana and Rwanda receive life-saving medication, assistance and other equipment in short amounts of time. Such supply chain innovation systems have put UPS at the center of the logistics scene in providing essential supplies to developing countries.

Making Sure Vaccines Are Available for All

UPS is also partnering with Gavi, The Vaccine Alliance. The partnership is working to ensure that unvaccinated individuals receive the COVID-19 vaccine upon development. UPS subsidiary company Marken specializes in supply chain logistics for healthcare, science and clinical supplies. Marken is preparing for providing transportation and logistics for the COVID-19 vaccines when they are available. The company believes that if it keeps transportation and resources ready, delivering vaccines will be faster and easier, especially to developing regions.

UPS has also committed to donating $3 million to provide free medical supplies and automated stock management systems to Uganda. UPS will soon help the country receive vaccines at a faster and efficient rate.

A Humanitarian Foundation

UPS has a separate nonprofit organization called the UPS Foundation. It focuses on providing humanitarian relief, environmental sustainability and inclusiveness within communities. UPS is at the frontlines in disaster response and humanitarian aid throughout the globe. The UPS Foundation assists many countries during disasters. The COVID-19 pandemic has mobilized the foundation to continue its work in struggling countries. The UPS Foundation invested about $20 million in disaster relief just last year in 2019 and has given U.N. agencies at least $6 million in grants to fight against COVID-19.

UPS and its humanitarian foundation has been essential in the fight against COVID-19. The private business works to improve the lives of those in need and continues to do so in the face of this pandemic.

– Sadat Tashin
Photo: Flickr

Healthcare in Zambia
Zambia, a landlocked country in Southern-Central Africa, faces several ongoing health challenges. In 2017, Zambia’s public health expenditure was 4.47% of the GDP, one of the lowest rates in southern Africa. Two ministries that provide information about health and deliver health services, administer public healthcare in Zambia. These are the Ministry of Health and the Ministry of Community Development, Mother and Child.

Problems in the Healthcare System

As public healthcare in Zambia remains incredibly underfunded, pharmacies in Zambia are not always well-stocked, and many deem emergency services inadequate. Additionally, inequities in public health care service access and utilization exist in the country. While 99% of households in urban areas are within five kilometers of a health facility, this close access occurs in only 50% of rural areas.

As a result of these deficiencies within the system, UNICEF reports that Zambia’s under-5 mortality rate is 57.8 deaths per 1,000 live births. In 2009, 980,000 people lived with HIV/AIDS in Zambia, and 45,000 of those people died the same year due to the disease.

Lack of clean water has resulted in water- and food-borne diseases and epidemics that have been devastating Zambia for decades, including dysentery and cholera. These issues mainly affect impoverished areas, as overcrowding leads to sanitation issues. In the Kanyama slum in Lusaka, 15 households share one latrine when the weather is good. During the rainy season, Kanyama’s high water table causes the filling of 10,000 latrines with water. Areas like Kanyama require long-term infrastructure measures, such as sanitation, sewage lines and piped water.

The Path to Development

Centers for Disease Control and Prevention (CDC) established an office in Zambia in 2000 to address HIV, tuberculosis, malaria and other diseases. CDC support in Zambia includes expanding academic and clinical training programs with advanced technology at the University of Zambia and the University Teaching Hospital, and the development of a National Public Health Institute to strengthen public health surveillance. Moreover, CDC instituted a Field Epidemiology Training Program (FETP) to train a workforce of field epidemiologists to identify and contain disease outbreaks before they become epidemics. Exactly 42 epidemiologists have graduated from the program since December 2018.

In 2018, Zambia presented to the World Health Assembly in Geneva regarding the cholera outbreak by citing its efforts regarding vaccination, water safety and waste management. Additionally, Gavi, the Vaccine Alliance, worked with Zambia to fund and deliver 667,100 oral cholera vaccine doses to Lusaka slums after an outbreak that affected more than 5,700 people.

Looking Ahead

Most recently, Zambia embarked on the first round of its annual Child Health Week campaign from June 22- 26, 2020 to deliver child survival interventions to protect children and adolescents from deadly diseases. Furthermore, to promote fairness and equality, the campaign aims to improve children’s health by ensuring essential services reach children who do not benefit from routine health services. This campaign accelerates the country’s progress toward attaining the U.N. Sustainable Development Goals (SDGs) for reducing child deaths by two-thirds by 2030, improving healthcare in Zambia overall.

The infrastructure for healthcare in Zambia is overall poor due to a lack of funding, poorly maintained facilities and supply shortages of medications and medical equipment. However, one step to a better healthcare system is to ensure equitable access to health services, especially for those who live in rural areas or slums. To reduce inequities, Zambia must strengthen primary facilities that serve the people who live in these regions and dismantle the existing barriers.

Isabella Thorpe
Photo: Flickr

COVID-19 response in developing countries The COVID-19 response in developing countries has become the primary focus for health workers all over the developing world. The volume of COVID-19 patients is placing a strain on hospitals and health systems globally. This trend is especially notable in developing countries that already have limited health resources, medical supplies and medical staff

Other major global health focuses such as other infectious diseases, diarrheal diseases, cholera, Ebola and so many more are not getting the same level of attention. Basic health services such as maternal care, family planning and vaccination programs are being impacted. Health workers are being reassigned to COVID-19 patients and resources are redistributed to prioritize the pandemic. While lessons can be drawn from previous health crises such as the 2014 Ebola outbreak in West Africa, COVID-19 has spread on a global scale and will have a large impact on essential health services.

Immunization Programs

According to GAVI, the Vaccine Alliance, vaccine shortages due to border closures and limited air travel have been reported in at least 21 low- and middle-income countries. Additionally, 14 vaccination campaigns supported by GAVI have been delayed. These programs would have vaccinated 13.5 million people for diseases including polio, measles, cholera, HPV, yellow fever and meningitis. GAVI expects these numbers to increase as more programs are delayed. Outreach vaccination programs, where health workers travel to various communities with vaccines, and routine immunization programs are also negatively affected. Lockdowns and distancing efforts, as well as hygiene guidelines, are contributing to program delays. GAVI is planning to support large immunization programs as soon as the COVID-19 safety measures are no longer in place in order to address these disparities.

PATH Solutions

PATH proposes three steps to ensure the continuation of essential health services during the pandemic. The first action item is to appoint an “Essential Health Services Coordinator” per COVID-19 task force. This coordinator would make sure that COVID-19 distancing guidelines are not preventing individuals from accessing basic services. They would also identify any health service interruption from health management data and collaborate with directors and social groups to act based on community concerns. Second, PATH proposes that COVID-19 public updates should include information about essential health services. This is crucial so that people are aware of what services are available and do not stop requesting medical help for non-COVID-19 related issues. Finally, international agencies such as WHO, UNICEF and Africa CDC should supply developing countries with strategies for the most pressing issues such as protecting health workers, how to provide medical care for the most vulnerable in the population and how to maintain basic health services during the pandemic.

WHO Guidelines for Maintaining Essential Health Services

The World Health Organization has outlined important ways of maintaining essential health services during COVID-19 in developing countries. These guidelines include access to emergency health care 24/7, removing financial barriers that limit access to patients, identifying which services are essential and which can be delayed and taking advantage of telemedicine and digital methods of providing health care. Additionally, the WHO highlights the importance of identifying which individuals are most vulnerable in society, such as marginalized groups and ensuring these individuals have access to health care. The WHO has also outlined several essential health categories to specifically address during the COVID-19 pandemic. These include ethics, health financing, mental health, non-communicable diseases, nutrition and food safety, older people, tuberculosis and sexual and reproductive health and rights. The COVID-19 response in developing countries must ensure the continuation of essential health services.

– Maia Cullen
Photo: PATH

Healthcare in Pakistan
In a study that The Lancet conducted, healthcare in Pakistan currently ranks 154th out of 195 countries in terms of overall system performance. As a developing country with a mere 2% of its GDP allocated for total health expenditures, Pakistan struggles to maintain a proper healthcare system with regard to quality and accessibility.

Pakistan’s numerous cases of communicable and vaccine-preventable diseases highlight its struggling healthcare system. Viral hepatitis, dengue, tuberculosis, malaria, typhoid, HIV and cholera have long been leading causes of death. They are the result of overpopulated cities, poor sanitation, unsafe drinking water and inadequate socioeconomic conditions.

Pakistan has one of the lowest amounts of immunized children, with overall vaccination coverage of just 60%. The result is a high newborn mortality rate: 69.3 deaths per 1,000 live births. Moreover, while the rest of the world is free from polio, experts still consider the disease as an endemic in Pakistan. Documentations determined that there were nearly 150 polio cases in 2019. With these alarming statistics in mind, here are six facts about healthcare in Pakistan.

6 Facts About Healthcare in Pakistan

  1. Healthcare in Pakistan includes both private and public sectors. The private sector serves approximately 70% of the population. Private hospitals and healthcare institutions consistently outperform their public counterparts, as measured by the overall quality of healthcare and patient satisfaction.
  2. A common misconception is that healthcare services in the public sector are free of charge to Pakistani citizens. This is not the case, as 78% of the population continues to pay for healthcare out of their own pockets.
  3. Healthcare in Pakistan has been a focal point after the country signed the U.N. Millennium Development Goals (MDGs). Pakistan began to initiate healthcare programs, establishing both Basic Health Units as well as Rural Health Units. Basic Health Units are assigned to NGOs, who manage the day-to-day operations, administer medicine and overlook the facilities.
  4. Reports estimate that there are roughly 175,000 doctors registered to serve the population. However, many Pakistani doctors choose to practice abroad due to poor service structure, increased workload, lack of funding and a rise in hostility by some. Moreover, many female doctors have stopped practicing due to family and social compulsions. Taking into account all these factors,  the doctor to population ratio stands at one doctor for every 1,764 persons. For adequate population coverage, Pakistan needs at least two doctors for every 1,000 persons.
  5. Healthcare in Pakistan has gradually improved over time. Currently, 92% of the rural population and 100% of the urban population have access to health services. Such improvement has been a direct result of Pakistan meeting the MDGs. Despite measures to increase the quality of healthcare facilities, most of the population prefers to consult private doctors and practitioners.
  6. Pakistan continues to commit to the MDGs in order to eradicate a multitude of preventable diseases. The introduction of immunization programs, such as the Expanded Program on Immunization (EPI), has increased vaccination coverage in Pakistan from 5% to 84%. EPI partnered with the Global Alliance for Vaccines and Immunization (GAVI), a global health organization dedicated to increasing immunization in low- and middle-income countries. With this partnership, countless people are working to eradicate vaccine-preventable diseases, such as measles, polio and neonatal tetanus.

With the arrival of COVID-19, Pakistan’s healthcare system is under immense pressure and is struggling to deal with the thousands of cases arriving each day. Frontline workers are taking the brunt of the virus. An estimated 3% of the total cases in the country consist of healthcare workers. Medical professionals are resorting to strikes and protests over the lack of protective gear necessary to safely treat patients.

In light of the unrest, Prime Minister Imran Khan announced new healthcare reforms to fix the faults of the health sector. The reforms allocate $300 million to pay for additional ventilators and other medical equipment. Additionally, major cities are setting up isolation centers to increase hospital capacity for infected patients.

These six facts about healthcare in Pakistan determine that the country will need to radically transform its health system performance in the following years in order to confront outbreaks that continue to threaten the population. The World Health Organization has recommended that Pakistan’s Ministry of Health increase healthcare expenditures to 5% of its GDP. Doing so would not only put an end to controllable diseases, but it will also ensure that the healthcare system will be able to deal with dangerous outbreaks in the future.

–  Abbas Raza
Photo: Flickr

 

Improve Global Health
In June 2018, German Chancellor Angela Merkel introduced a new plan for Germany to become a front-runner in global health. This plan was to fully come into action by the end of 2019. In addition, the BMJ Journal reported that the plan involved bringing in non-governmental representatives to provide their knowledge to develop a strategy for Germany to improve global health.

What is the Plan?

Germany worked with the World Health Organization (WHO) to develop the Global Action Plan for Healthy Lives and Well-Being for All program. One of the main goals of this initiative is to accelerate progress in seven key areas:

  1. Primary health care
  2. Sustainable financing
  3. Community and civil society
  4. Determinants of health
  5. Innovative programming in fragile and vulnerable settings and for disease outbreak responses
  6. Research and Development, Innovation and Access
  7. Data and digital health

These seven points focus on the main areas of mobilizing and enabling communities. They also focus on providing governments with the necessary funding and knowledge to help their people and ensuring the research and money is going to the areas that most need it.

Funding

Germany began working towards many of these goals as early as 2018. The Global Fund reports that Germany pledged 1 billion euros (roughly $1.094 billion) towards The Global Fund’s fight against diseases such as HIV, malaria and AIDS. Also, the website states that this was a 17.6 percent increase from its previous pledge. Germany is pledging this amount for a three-year period.

The website Donar Tracker notes that Germany donated 47 percent of its development assistance fund to multilateral, or multi-country, organizations. The website states that the main recipients of this funding were the previously mentioned Global Fund, the E.U. and Gavi. Gavi is an organization focused on giving impoverished countries access to vaccines.

Cooperation

The Global Health Hub Germany is a website that Germany hosts to improve global health. This website calls itself the platform for Global Health. The World Health Summit, which Berlin, Germany holds annually, helped to organize the launch of The Global Health Hub, claiming that its mission statement is one of cooperation.

The Global Health Hub Germany aims to inform people, get them working together and develop new ways for the world to improve global health. Additionally, it hosts frequent events and conferences aimed to give people the information they need to help improve global health. The website launched on October 29, 2019. Since then, it gained 555 members as of November 2019. Its members consist of activist groups and experts in the health field. The Global Action Plan for Healthy Lives and Well-being for All states Germany’s mission statement going forward to improve global health. Funding, cooperation and mobilization are just some of the ways that Germany aims to improve global health.

Jacob Creswell
Photo: Flickr

10 Facts About Life Expectancy in Guinea-Bissau
Guinea-Bissau, a small country in Western Africa, has a low life expectancy of 57.67 years.  However, life expectancy in Guinea-Bissau of both men and women increased by seven years over the last 17 years. In 2001, life expectancy in Guinea-Bissau was 50.368. Currently, men in Guinea-Bissau have a life expectancy of 55.6 while women have a life expectancy of 59.62. The increase in life expectancy in Guinea-Bissau is due to improvement in health care services, education, preventive measures and a reduction in child mortality.

10 Facts About Life Expectancy in Guinea-Bissau

  1. Child Mortality: The infant mortality rate in Guinea-Bissau continues to decrease. Child mortality was 125 for every 1,000 children in 2008 and that number decreased to 81.5 for every 1,000 children in 2018. Guinea-Bissau’s investments to provide mothers with children under the age of 5 with better access to health care contributed to the reduced child mortality rate. In addition, a U.N. report determined that an increase in vaccinations was extremely effective in reducing the child mortality rate. This was possible because of collaboration from organizations like the United Nations Children’s Fund, the World Health Organization and GAVI. However, there is still more that people can do to improve life expectancy in Guinea-Bissau, such as training more medical professionals to help with childbirth. In 2014, only 45 percent of childbirth had trained professionals available. The leading causes of death for children under 5 are communicable diseases, particularly malaria, diarrheal diseases and respiratory illnesses.
  2. The Leading Causes of Death: The leading causes of death in Guinea-Bissau in 2012 were lower respiratory infections including whooping cough and infection of the lung alveoli, along with HIV/AIDs, malaria and diarrheal diseases. Although malaria-related death is common, that number is declining due to both government and donor efforts from organizations like the Global Fund. These efforts include providing insecticide-treated bed nets and increasing education about malaria.
  3. Spending on Health Care: In Guinea-Bissau, both the government and individuals spend little money on health care. In 2016, the per capita average that people spent on health care was $39 while the government spent 6 percent of its GDP on health care. A U.N. report stated that in 2001, the African government pledged to increase health care expenditures to 15 percent. However, Guinea-Bissau has not yet reached that goal. In addition, the most vulnerable population that suffers from preventable illness and diseases, women and children, receive less than 1 percent of health care funds.
  4. Politics: One of the reasons the government faces difficulty in increasing health care funding is because of instability in Guinea-Bissau’s politics. Since Guinea-Bissau’s independence in 1974, the country has had four successful coups and 16 failed coups. The instability causes constant changes in government officials who are responsible for policies.
  5. National Institute of Public Health: In 2011, the creation of the Instituto Nacional de Saúde Pública (INASA) or the National Institute of Public Health helped bring different components of Guinea-Bissau health care together in order to provide adequate services. INASA works with both international donors, institution and the government to help with disease surveillance and preparation for health emergencies. The responsibility of INASA is to help create health policy in the country as well as to help place health care workers and officials throughout the country.
  6. Lack of Trained Medical Personnel: Guinea-Bissau does not have enough health care workers. It has 1.7 doctors for every 10,000 people, 1.4 midwives and nurses for every 1,000 people, three pediatricians and four obstetricians. For example, in 2014, Guinea-Bissau lost some of its health care workers due to brain drain (trained medical personal moving to other countries). In addition, the lack of adequate pay and failure by the government to pay its medical workers on time have led to strikes. According to a U.N. report, Guinea-Bissau would need to create incentives in order to better retain its health care workers.
  7. Training of Health Care Workers: Training health care workers in Guinea-Bissau is difficult because the country relies on international help from countries like Cuba. One of the main problems is that the training material is in Spanish instead of Portuguese. In addition, some of the reading materials are in e-book formats and students may not have access to computers to read the content. Furthermore, during medical training, there are not enough specialists to oversee or conduct the necessary training. There is hope, however, as the United Nations Population Fund (UNFPA) is helping provide some advanced training for medical professionals who require it.
  8. Vaccine Coverage: Although the lack of political instability has limited government spending in health care, Guinea-Bissau’s coverage rate is 80 percent due to help from the World Health Organization (WHO) and other non-government agencies. Children receive rotavirus and pneumococcal vaccines to help with respiratory and diarrheal illnesses.
  9. Accessibility to Health Care Facilities: In Guinea-Bissau, it can be difficult to visit a medical facility because of the lack of adequate roads. Although there are motorized boat ambulances, it can still be difficult to get to a medical facility in some regions in Guinea-Bissau. However, there are plans to build surgical centers in places like the Bijagos region to provide better access to health care.
  10. Community Health Programs and Workers: Community health programs and outreach have been effective in helping with the Guinea-Bissau health care system. These programs that community health workers (CHW) administer provide a community-based approach in helping with the health needs in Guinea-Bissau. Programs include spreading knowledge of childhood nutrition, malaria prevention, pneumonia and household hygiene, and providing several health services. There are around 4,000 community health workers and they are each responsible for visiting 50 households every month. During their visits, community health workers encourage families to adopt the 16 key family practices that can help reduce the number of diseases children may experience. These family practices include the promotion of mosquito nets and six months of breastfeeding, and handwashing, etc.  Community health workers also play a vital role in helping with literacy because of the high illiteracy rate in the country.

Although Guinea-Bissau’s life expectancy is low, there is hope that it will continue to increase due to continuous investment by international donors and non-government organizations. One of the best ways that Guinea-Bissau can provide better health care for its citizens is to strive to be more politically stable.

– Joshua Meribole
Photo: Flickr

 

Improving Ghana's Local Health
Ghana is a small West African country located on the Gulf of Guinea. Agricultural and mineral outputs mostly make up the country’s income. Ghana was the first African state to gain independence in 1957 and has a population of approximately 28,102,471 people. Although Ghana is one of the more stable countries in Africa and has one of the lowest reported HIV infection rates, the country still faces a multitude of health care issues. However, there has recently been a partnership between the Ghanian government and a tech company to work towards improving Ghana’s local health.

Illnesses in Ghana

A variety of illnesses in Ghana are similar to those occurring in developed countries, however, some of these illnesses can be more potent in areas like Ghana. These illnesses include trauma, women’s health issues, pregnancy complications and infections. HIV/AIDS hit Ghana slightly less than other African countries, but it still caused the deaths of 10,300 people in 2012. HIV/AIDS now stands at number six on the list of the top 10 causes of death in Ghana after malaria, lower respiratory infections, neonatal disorders, ischemic heart disease and stroke.

The anopheles mosquito can transfer malaria, but people can also transmit the illness through organ transplants, shared needles or blood transfusions. Malaria most commonly affects pregnant women and children. In 2012, malaria caused the deaths of 8.3 percent of the Ghanian population. It was also the leading cause of death among children under 5, dealing fatal damage to 20 percent of children in that age group. One of the primary reasons for visits to the hospital is infections. Medical professionals can easily treat most malaria cases with three days of pills from the government, however, some may suffer repeated bouts of malaria and it can be fatal is they do not receive treatment.

Ghana’s Medical Drone Delivery Program

In April 2019, Quartz Africa detailed that a community health nurse at the New Tafo Government Hospital in Ghana’s Eastern Region, Gladys Dede Tetteh, ran out of yellow fever vaccines. Mothers and their babies had to wait in a long line in the hot weather. The facility made an order for more vaccines, but in the past, deliveries often took two hours or more to arrive by road from the central medical stores. However, 21 minutes later, from 80 meters in the sky, a drone released a box onto a small lawn quad in the hospital. New Tafo Government Hospital was the first to sign up for Ghana’s new medical drone delivery program to receive medical products from unmanned aerial vehicles. The aim of this program is to reach hard-to-reach communities quickly and efficiently.

The Ghana Health Service’s Partnership with Zipline

The Ghana Health Service recently began a partnership with Zipline, a drone company with the mission of giving every person instantaneous access to medical supplies. Ghana’s Vice President, Mahamudu Bawumia, officially launched the medical drone program on Wednesday, April 24, 2019. Zipline is a partner of the United Parcel Service (UPS), which also provided support when it opened its Rwanda program. Zipline also gained support from the Bill and Melinda Gates Foundation and Pfizer. Zipline’s Omenako center in Ghana is the first of four centers that the company plans to construct by the end of 2019. Zipline also plans to provide supplies to 2,000 health care facilities in order to serve 12 million Ghanaians once it completes all four centers.

Each distribution center will have 30 drones that will work together to make 500 deliveries a day. Zipline approximates that it will be able to make 600 delivery flights a day in total. Many claim that the drones are some of the fastest delivery drones in the world. The drones can fly up to 75 mph, transport around four pounds, fly as high as 99 miles and operate in various types of weather and altitudes.

Zipline’s Role in Reducing Deaths and Providing Vaccinations

The World Health Organization states that “severe bleeding during delivery or after childbirth is the commonest cause of maternal mortality and contributes to around 34% of maternal deaths in Africa.” Ghana’s policymakers expressed that they believe that this new drone delivery system is the first step to improving Ghana’s local health by decreasing maternal and infant mortality rates.

The drones will deliver to 500 health facilities from the Omanako center which has vaccines and medications. With the aid of Ghana’s Expanded Program on Immunization (EPI), Zipline drones will be able to provide support to those suffering from yellow fever, polio, measles & rubella, meningitis, pneumococcal, diphtheria, tetanus and more. Gavi provides the vaccines, which is an international organization with the intention of improving children’s access to vaccines in poor parts of the world. Drones will be able to pass where ground vehicles cannot, such as where there is underdeveloped or poorly maintained road infrastructure. Many also expect that the drone delivery program will reduce wastage of medical products and oversupplied hospitals.

Zipline aims to improve access to vital medical supplies, which in turn will hopefully reduce mortality rates and add to efforts in improving Ghana’s local health. Zipline’s mission in Ghana has only just begun, but so far it has been able to significantly reduce the time it takes to deliver important health supplies. Getting medical supplies and vaccines faster may be able to save a few lives in the future as well. Health issues and diseases like malaria continue to be the major causes of death in Ghana, but Zipline and the Ghanian government are making steps towards improving access to health care.

– Jade Thompson
Photo: Flickr

Vaccines in Developing Countries “Thanks to vaccines, more children are now living to see their fifth birthday than at any point in history.” Dr. Seth Berkley, CEO of Gavi, said.

While this is an inspiring fact, the truth is that immunization rates in some developing countries are becoming stagnant.

The Plateau of Immunization Rates

The immunization rates of the vaccine for diphtheria, tetanus and pertussis (DTP) usually reflect the quality of the overall immunization coverage within a nation. In the last three years, the immunization rate for the third dose of DTP in Chad has remained at 55 percent. The immunization rate for DTP in Somalia has been about the same since 2009. Guinea, whose DTP immunization rates used to be around 70-80 percent 10 years ago, now has had a rate of 63 percent for the last four years.

This data is somewhat shocking, considering a global effort to prioritize vaccines began in 2000. The same year, Gavi, a global Vaccine Alliance, was created with the help of a $750 million donation from the Bill & Melinda Gates Foundation. Since 2011, Gavi has surpassed its own goals of decreasing child mortality, averting future deaths and increasing child immunization in the more than 60 countries that are Gavi-supported. In just five years, Gavi was able to provide vaccines to 34 million more children than what was anticipated, and the group began administering vaccines for pneumococcal and rotavirus one year ahead of schedule.

Maintaining the Vaccine Schedule

Nonetheless, groups like Gavi struggle to keep immunization active in developing countries after the child is no longer an infant. For example, the vaccine for human papillomavirus (HPV) is typically administered in two doses within 1-2 years for children above the age of nine. HPV can cause cancer, especially in those with weak immune systems, so it is important to time the vaccine administration effectively in order to be nearly 100 percent protected. Since there is no health plan that puts emphasis on older children, HPV becomes more of a threat in countries that do not enforce the strict vaccine schedule.

The World Health Organization has a plan to fix this. The Global Vaccine Action Plan (GVAP) is set to address health program expansion to include services beyond infancy by 2020. Ministers of Health from 194 countries agreed to support the GVAP, which includes nation-specific health program monitoring and strengthened leadership.

Negative Attitudes About Vaccines

Despite intervention from non-governmental groups, the plateau of immunization rates still exists. This may be due to negative attitudes towards vaccines in developing countries. The attitudes stem from the idea that vaccines are harmful or that the health workers are ingenuine. Citizens of three Nigeran states believed that the administration of the polio vaccine would spread AIDS in 2003, and in India, people believed that vaccines were a Western plot to instigate an undercover method of family planning to threaten Muslims. Researchers cite that a way to eliminate this anxiety is to take into account sociocultural behavior when implementing vaccine programs and to strengthen communication and advocacy in order to increase participation.

While negative attitudes towards vaccines contribute to plateauing immunization rates, the expensive price of vaccines may also be a contributing factor. In 2001, six vaccines from the World Health Organization cost less than $1. Now, 12 vaccines from the WHO cost up to $45.59. This can obtaining a vaccine for someone living in Madagascar extremely difficult – the monthly salary in Madagascar is $33.

Immunizations Eradicate Disease

By increasing immunization rates, diseases can begin to disappear. In the U.S., immunization rates in 2000 were at 91 percent for the measles, mumps and rubella vaccine, and the Center for Disease Control declared measles to be officially eradicated. Since then, diagnoses of measles have increased slightly among populations that are unvaccinated.

Despite these few diagnoses, the majority of the U.S. will never come in contact with measles. Dr. Jean Campaiola, hospital psychiatrist, describes this result as “herd immunity.” Herd immunity occurs when a certain percentage of the population receives the vaccine for a particular disease. For some diseases like measles, the percentage is at least 90-95, but for polio, the percentage is 80-85. This means that 20 percent of people could deny receiving the polio vaccine and still be protected from the disease because the remaining 80 percent were vaccinated.

“If this occurs rarely in a population, it’s not a big deal, but if it becomes more common, then previously eradicated diseases could make their way back into the general population,” says Dr. Campaiola. She said fears that the anti-vaccine attitude in the U.S. could cause previously eradicated diseases to re-emerge.

By administering more vaccines in developing countries, an entire community can be protected by herd immunity. Those most vulnerable to diseases (infants and the elderly) can be immune to certain diseases if more people around them receive vaccines.

In third world countries, governments spend $29 for each person’s health. In the U.S., the government spends $4,499. There is a clear need for vaccines in developing countries around the world, including a larger-scale project to improve coverage. Gavi’s next step in revolutionizing immunization is a five-year program to introduce sustainable health programs in low-income countries and to increase equitable use of vaccines. The U.S. has the power to spread the good message of vaccines, and someday, we can eradicate most major diseases all around the world.

– Katherine Desrosiers
Photo: Wikimedia

vaccine accessibility
Vaccines are second only to clean water in reducing the rate of infectious disease. Vaccines prevent about 6 million deaths every year, and those that have been in use for decades show a 99 percent decrease in the rates of people contracting those diseases. Unfortunately, vaccines are not affordable for many people living in poverty throughout the world, making them much more vulnerable to infectious disease. Several factors contribute to the current lack of vaccine accessibility in many parts of the developing world. However, there are also significant improvements that are being made in decreasing the financial gap between those who receive vaccinations and those who do not, helping make vaccines more accessible to everyone.

The Current Situation

The price of the vaccine doesn’t always reflect the cost: People in developing countries are not only paying for the cost of manufacturing the vaccine, but also for expensive shipping costs, refrigeration, tariffs on imports, and taxes on medical supplies. These additional costs are often much more than the cost of the actual vaccine, and they make what would otherwise be an affordable vaccine inaccessible to a lot of people.

Clinic visits cost money too: In addition to buying the vaccine with all of its fees piled on top, people also have to pay to visit a clinic to receive these vaccines. The hours of health clinics are often inconvenient as well, forcing people to forgo wages from work in order to see a doctor.

Many vaccines require multiple rounds: A lot of vaccines, such as RTSS for malaria, MMR for measles and the HPV vaccine require multiple rounds of vaccination in order to be effective. This simply compounds all of the other barriers to vaccine accessibility; those receiving the vaccine have to pay for treatment again as well as take time off of work to visit a clinic.

Doctors are few and far between: In many parts of the developing world, there are very few doctors, and these doctors are limited in the number of patients they can treat each day. Therefore, even if one can afford to pay for the vaccine and can make it to a clinic, there is no guarantee that they will be able to be seen by a doctor.

Improvements to Vaccine Accessibility

Local health centers’ capacities are being strengthened: Gavi, a non-governmental organization dedicated to providing vaccines to the developing world, is working to strengthen the capacity of existing health centers to deliver immunizations. Gavi is working to increase the proportion of people who are receiving a full cycle of vaccines rather than “dropping out” after the first dose by providing sustainable funding to health clinics across the developing world.

Foreign aid decreases the price of vaccines: Providing foreign aid specifically for vaccines decreases the cost to those receiving treatment, and in turn, spares families from having to pay far more for treatment if someone contracted an infectious disease. Foreign aid for vaccinations has the highest return on investment of any type of aid besides education.

People are going beyond wanting to vaccinate to actually vaccinating: The Poverty Action Lab at MIT is implementing research on how to motivate people from desiring to vaccinate to doing it. This research is increasing the numbers of people receiving preventative immunizations in the developing world and reducing the rates of disease.

Infrastructures to keep vaccines cold for cheaper: The governments of Ethiopia and Gambia have created cold chain infrastructures in order to reduce the cost of transporting vaccines that need to be refrigerated. These infrastructures are far from perfect, as some cold storage facilities in Ethiopia have not been kept as cold as they need to be in order to protect the vaccines.

However, progress is still being made in reducing the cost of vaccines and allowing them to be more accessible to those living in poverty. Gavi is working to implement more cold chain infrastructures in other countries in Sub-Saharan Africa.

Moving Forward

There is clearly still a long way to go in ensuring vaccine accessibility to everyone who needs it, but a lot of progress has been made in breaking down the current barriers to accessibility. Vaccines are much cheaper than the cost of treatment for those who have the diseases vaccines aim to prevent, and investing in vaccinations relieves the world’s poor of the additional burden of treatment costs. Vaccines are one of the greatest assets in our toolbox to fight poverty, and great strides are being made in the effort to make accessibility a reality.

Macklyn Hutchison
Photo: Flickr