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Algeria: Public Health Strategy to Combat Antimicrobial Resistance

Antimicrobial ResistanceOn September 9, the World Health Organization (WHO) published Algeria’s updated National Action Plan, which aims to target antimicrobial resistance (AMR) as a critical threat to public health. The report offers an overview of previous achievements and identifies the next stage of solutions to be implemented from 2024 to 2028.

Antimicrobial Resistance

AMR is the ability of a pathogen to withstand treatment, complicating the targeting of infections caused by fungi, viruses and other microbes. According to Health Data Source, approximately 3,400 deaths in Algeria were directly attributed to AMR. Furthermore, a total of 13,600 deaths were associated with related health complications.

Globally, health care professionals find that the mutation of microbial and bacterial diseases often outpaces the development of new and effective treatment options. Antimicrobial medicines offer protection against infections and viruses during medical procedures and treatments. However, pathogens usually develop immunity to these procedures, increasing the risk of infection and risking the spread of disease.

Populations Affected by Antimicrobial Resistance

The WHO identifies humans, animals and agriculture as the primary organisms endangered by AMR. The spread of resistant pathogens threatens food safety and the integrity of food supply networks. These pathogens and bacteria, resistant to medical treatments, can proliferate within human and animal populations. Indeed, they become increasingly dangerous with each mutation.

Inequities in access to health care and services make women particularly vulnerable to AMR pathogens. Cultural perceptions of women, along with biases held by health care providers, often lead to delays in the quality of care and services they receive during medical visits. Many women face exposure to unsafe and contaminated environments in their daily activities. For instance, as the primary water collectors in their households, Algerian women risk contracting fungi or viruses from contaminated water sources.

On a positive note, Algerian women are among the most likely to seek medical advice for personal and family health concerns. To address these issues, Algerian officials, along with the global community, are working to enhance the infrastructure of their health care system to tackle AMR-related health conditions.

Algeria Proposes an Updated Action Plan

Algeria will focus on monitoring cases of treatment-resistant bacterial infection to prevent the rapid spread of disease among people, livestock and the food supply. The updated strategy would provide more data for preparing and launching health initiatives and research. Algeria’s newest goals coincide with the One Health system, a collection of health care principles embraced by nations worldwide. The One Health campaign organizes the management of infectious diseases into five divisions:

  1. Surveillance and Disease Intelligence
  2. Emergency Preparedness and Response
  3. Laboratory Systems
  4. Public Health Institutes and Research
  5. Disease Control and Prevention

This organization allows for better tracking of infectious diseases and regulating efforts to implement solutions before major medical emergencies arise.

Goals

The following goals summarize the Algerian government’s participation in reducing the threat of AMR in global communities:

  • Create awareness campaigns about the issue of Antimicrobial Resistance. Additionally, educate the public at the grade school, collegiate and professional levels.
  • Implement a training program for health care, veterinary and agricultural workers.
  • Create better surveillance and data reporting networks to monitor the issue of antimicrobial resistance.
  • Better equip laboratories as centers for research and observation of antimicrobial resistance.
  • Develop and promote treatment options that can serve as alternatives to antimicrobial medications.
  • Establish a system to monitor antibiotic consumption.
  • Prevent and control infection in neonatal settings by updating known hygienic protocols, promoting breastfeeding for new mothers, revisiting the issue of mother-fetus infection and more.
  • Prevent and control community infections by promoting rapid tests for bacterial blood; include private doctor offices, laboratories and hygienic clinics in antimicrobial research.
  • Establish a therapeutic standard on the issue of antimicrobial resistance.
  • Establish a community-based monitoring system for local developments in AMR.
  • Prevent and control infections at the farm level.
  • Create a ranking system for the critical stages of AMR and establish an antimicrobial committee accessible to local Wilaya hospital committees and the private sector.
  • Monitor antimicrobials in human and veterinary health.
  • Develop a therapeutic recommendation for the treatment of AMR in human medicine.
  • Develop a good practice guide for the use of antimicrobial medicines in veterinary settings.
  • Strengthen regulations and training around the use and availability of antimicrobials.
  • Create a documentation system for antimicrobial research and develop financing.
  • Develop research collaborations with universities and create international and national partnerships.
  • Create committees and oversight groups to monitor the implementation of the antimicrobial action plan and develop funding for AMR research.

These goals will promote research campaigns dedicated to understanding, tracking and controlling the transmission of diseases prone to AMR.

Final Note

Combating AMR bacteria will prepare the medical community to limit the spread of complex diseases, protecting a population of 42 million. While the updated program is in the early stages, the Algerian government has committed to partnering with public and private institutions to educate communities nationwide and to ensure long-lasting results.

– Karina Dunn

Karina is based in Mesquite, TX, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Poverty in Pakistan: Ongoing Reduction Efforts

Poverty in PakistanAffected by political turmoil, Pakistan has faced numerous socioeconomic challenges. By 2018, these issues culminated in record levels of poverty, with more than 39% of Pakistan living below the poverty line. Amid widespread unemployment, the government has also grappled with nutritional poverty, particularly affecting the youth. This has led to significant issues, such as nationwide stunting in growth, which is directly linked to these dietary deficiencies. Here are some of the initiatives that are tackling these problems:

Prime Minister’s Youth Skill Development Program

This initiative, led by Prime Minister Shehbaz Sharif, offers vocational training in various industries, helping young people haul themselves out of poverty and find work. With more than 25,000 youths trained nationwide, the program has played a crucial role in decreasing national poverty. Most notably, the focal point concentrating on an intake of 35% girls has ensured that the marginalized remain a focus. Ultimately, these efforts have contributed to the limitation of poverty and increased job prospects among the youth.

The Sehat Sahulat Program

Initially launched in 2015, the Sehat Sahulat Program is a social health insurance initiative providing free health care services for Pakistan’s underprivileged groups. As a result of the program, the most disadvantaged are supported by free health care. The initiative covers a range of conditions, including cancer and diabetes. Ultimately, the scheme provides financial protection and access to sustainable, quality health care to those most in need.

UNICEF Nutrition Counseling

With more than a third of children suffering from severe food poverty, the country faces an endemic in which its young are at a heightened risk of malnutrition and an unbalanced, scarce diet. The United Nations Children’s Fund’s (UNICEF) initiative develops cooking demonstrations tailored to new and soon-to-be mothers, ensuring their children can be fed and energized correctly.

Alongside nutritional education, the sessions aim to educate women about the importance of hygiene and its strict relationship with food, with a particular emphasis placed on washing hands before and after preparing food. This focus has been adopted worldwide and in 2022, UNICEF counseling reached 79.3 million people globally.

Combat Against Nationwide Stunting

In Pakistan, more than 40% of children younger than 5 are stunted. A product of long-term malnutrition, stunting “impairs cognitive and physical development, which in turn impacts a child’s potential and productivity.’’ With a large proportion of pregnant women living below the poverty line, many children experience stunted growth in the womb due to their mothers’ poor diet, leading to inhibited development.

The government has launched several initiatives to fight malnutrition to address this issue, with the Ehsaas Nashonuma Program being the most prominent. The program provides nutritional education and cash transfers to pregnant or nursing women. The quarterly stipend is about $5 for mothers and boys and $7 for girls. Nongovernmental organizations (NGOs) have also played a crucial role in the fight against stunting. Water, Sanitation and Hygiene Services (WASH) initiatives have thrived with the support of NGOs like HANDS. In 2022-23, HANDS conducted 16 WASH projects in 34 districts and nearly 2,000 villages in Pakistan, benefiting more than 1.8 million people.

Nutritional awareness is fundamental to the resurgence of the health of the next generation in Pakistan, pulling them out of poverty. The government has guaranteed that various schemes are in place to tackle widespread poverty. Additionally, it has ensured that the health and hygiene of the population of Pakistan are also addressed. It’s both transparent and reassuring that while the government recognizes this importance, various NGOs share the same concern.

– Jonny Wilkinson

Jonny is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Pexels

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Leading The Way: Cabo Verde’s HIV Fight

cabo verde's HIVCabo Verde, a West African country consisting of islands in the central Atlantic Ocean, has become a leader in the fight against HIV and AIDS in Africa through its health care investments and social initiatives. Currently, Cabo Verde is estimated to have an HIV prevalence of around 0.6%. At the same time, AIDS-related deaths decreased from around 200 in 2004 to less than 100 in 2022. This progress has involved declining poverty, which dropped to 28.1% in 2022 from 56.8% in 2001. Cabo Verde’s HIV fight is now focused on projects directed at vulnerable groups, such as pregnant women, children and disabled people.

Investment in Communities

Combating HIV and AIDS requires involving both the general public and individuals living with HIV in decision-making processes. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has reported that the West Africa region is not on track to meet the goal of eradicating AIDS by 2030, a target set during the Africa Rising Forum in 2014.

The group’s Executive Director expressed the need for “policies and programs that focus on people not diseases.” This involves community-led HIV testing to reach more people. Furthermore, support groups for mothers living with HIV and individual visits by social assistants are also key. One assistant in Cabo Verde expressed how this work allows patients to “have a good quality of life and avoid stigma and social marginalization.”

Regional Asymmetry

A key challenge for Cabo Verde is the disparity in resources between islands, which affects HIV patients’ ability to access care. At independence in 1975, the country had only 13 doctors. However, the health system has since expanded in both size and sophistication, with 80% of the population now living within half an hour of a health facility. The decentralization of smaller health centers has improved access to care, enabling HIV patients to receive antiretroviral therapy to manage the disease. UNAIDS estimates that by 2023, 72% of individuals living with HIV in Cabo Verde were accessing antiretroviral therapy.

Free Health Care

Cabo Verde’s economy has grown significantly since the ’90s, driven by foreign investment and tourism. This growth has led to increased health care spending, rising from $65 per person in 2001 to $165 in 2013. Citizens are entitled to free basic health care, including preventive care and treatment for HIV and AIDS. The country’s social protection efforts are supported by widespread health education, facilitated by high literacy rates and good access to electricity, fostering greater public awareness and engagement.

Advocacy for the Disabled Community

Despite Cabo Verde’s broad progress, vulnerable communities, such as those with disabilities, continue to face challenges. Handicap International, active in Cabo Verde since 2006, has worked to include disabled individuals in the fight against HIV. The organization improved data on the biological vulnerability to HIV infection and promoted inclusive education on HIV and AIDS.

Research found that the HIV prevalence rate among people with disabilities in Cabo Verde is 2.3%. Additionally, about 79% of disabled participants unaware of available HIV care and support. However, the study itself led to 96% of participants gaining an improved understanding of HIV and AIDS.

Preventing Vertical Transmission

Preventing vertical transmission of HIV from mother to fetus is a key priority for Cabo Verde in reducing new infections. Minister of Health Arlindo Nascimento do Rosário emphasized, “Every child has a right to be born healthy and to live a healthy life.” As part of the free health care system, pregnant women are offered HIV testing. If they test positive, they receive antiretroviral drugs and antenatal support to minimize the risk of transmission.

In 2019, the World Health Organization (WHO) shared the story of Leila Rodrigues, a mother who discovered she had HIV just weeks before giving birth. Thanks to the care her son received, transmission was prevented. Rodrigues later joined the National Network of People with HIV of Cabo Verde.

Final Note

Cabo Verde’s progress in HIV health care has not come without challenges. However, the country has become a model for investing in change and empowering communities. The WHO Africa Health Forum has highlighted Cabo Verde as an exemplar, with participants visiting to observe how innovations have built a strong health care system. Emulating Cabo Verde’s commitment to social inclusion, universal health coverage and decentralized HIV testing could enable the West African region to more effectively combat the disease.

– Daisy Outram

Daisy is based in Kent, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Wikimedia Commons

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Elderly Poverty in Hong Kong

Elderly poverty in hong kongHong Kong is a city of two halves: while some enjoy wealth and luxury, 23.6% of the population live in poverty, struggling to share in the city’s economic prosperity. Elderly poverty is a significant problem in Hong Kong, with 45% of citizens aged 65 and older—about 583,600 people—living in poverty. Furthermore, Hong Kong has faced criticism for its inadequate poverty measures, which do not accurately represent the true scale of the issue, suggesting that even more people could be affected than officially recorded. Perhaps more concerning than these high rates is the fact that elderly poverty has increased significantly in recent years, up from 27.7% in 1991.

Causes

Elderly poverty in Hong Kong is driven by several factors, including a prevailing attitude that discourages reliance on welfare. As a result, there is limited government assistance available to provide financial protection for those struggling with poverty. Culturally, there is also an expectation for families to care for their elderly, with the Chinese government introducing a law in 2013 that demands children see and “greet” parents regularly, which made little difference. As times are changing, many families do not want to or are not able to care for their elderly.

While values are changing for some, the state has not adapted to this; existing welfare benefits (particularly the Social Security Allowance Scheme) for older people are rarely enough to cover living costs. Therefore, older adults are often seen collecting recyclable rubbish, such as cardboard and glass, in order to make enough money to survive. Pensions are a real concern, with the city having no pension scheme and many retirement funds being continually offset. This means that many are forced to remain in employment well past retirement age.

Furthermore, many cannot afford the help they desperately need; on average, it takes 19 months to receive subsidized home care services, leaving many older people alone without the support they need to live a fulfilling life.

Organizations Providing Aid

Efforts are underway to reduce elderly poverty in Hong Kong. Oxfam has launched the Concerning Home Care Service Alliance’s “service matching” scheme, which connects caregivers with seniors to assist with daily tasks like cooking, cleaning and accompanying them to appointments. Seniors pay just $0.64 for the service, while caregivers receive a stipend in addition to this small fee.

The Society for Community Organization (SoCO) also advocates for better support for older adults, assisting them in applying for existing welfare programs and accessing health care. These support systems are crucial for improving the quality of life for elderly individuals living in poverty. SoCO assists more than 1,000 seniors to apply for “social security or public housing each year.”

Furthermore, the Elder Academy supports the mental well-being of older adults by partnering them with academic institutions, offering opportunities for lifelong learning and fostering a sense of community inclusion. Last year, the organization received $10 million in government funding, demonstrating a commitment to improving the livelihoods of older adults.

– Eryn Greenaway

Eryn is based in East Sussex, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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6 Things to Know about Vietnam’s Economic Development

Vietnam’s Economic DevelopmentVietnam’s economy is steadily growing, with remarkable development following decades of economic reform and strategic investments. Once an underdeveloped nation, Vietnam has significantly reduced poverty. This economic growth is driven by reforms, industrialization, infrastructure development and improved access to education and health care.

Doi Moi

Vietnam implemented the Doi Moi reforms in 1986, transitioning from a strictly communist economy toward a more open market with socialist influences. Before these reforms, the country was considered “underdeveloped.” The Doi Moi reforms modernized Vietnam’s trade economy, setting the foundation for its subsequent economic boom.

Industrialization and Infrastructure Development

Industrialization in Vietnam began in the early ’90s and continues today, driving economic development as the country transitions from a primarily agricultural economy to a more diversified and advanced industrialized one. Vietnam now manufactures products such as cars, electronics and textiles. Between 2020 and now, the country’s manufacturing, construction, services and industrial sectors grew from 81.1% to 85.2%.

Investment in public infrastructure has been one of the fundamental driving forces behind Vietnam’s economic development in recent decades. The country has mainly focused on roads, airports and seaports. Private and public investment in infrastructure has accounted for as much as 5.7% of the gross domestic product (GDP) in recent years. This is the second highest in all of Asia, following China.

Better Access to Education

Since gaining independence in 1945, Vietnam has prioritized education and reduced illiteracy rates. Today, the country places even greater emphasis on improving education. In 2002, the government allocated 3.9% of its GDP to education, which increased to 6.3% by 2014. Vietnam has enhanced access to education by ensuring universal preschool education through public spending and engaging communities and the private sector. The country has also improved learning outcomes, with Vietnamese students outperforming the average students in Organisation for Economic Cooperation and Development (OECD) countries.

In 2012, Vietnamese youth ranked 8th in science, 17th in mathematics and 19th in reading out of 65 countries. The Vietnamese government also prioritizes equity in education, contributing to these high learning outcomes. The central government allocates more funding per capita to geographically disadvantaged provinces and teachers in these areas are paid more than those working in cities. Vietnam’s progress in education has been a critical factor in its ranking of 48 out of 157 countries on the Human Capital Index.

Better Access to Health Care

Along with the economic growth, the health of the Vietnamese people has improved between 1990 and 2020. Life expectancy grew from 69 to 75. The aged than 5 child mortality rate decreased from 30 to 21 per 1000 live births. While the health care system has improved significantly in the past decades, Vietnam stands before an inevitable challenge: it has one of the fastest-growing aging populations in Asia.

Looking Forward

Vietnam’s transition from a centrally planned to a market economy has transformed it from one of the poorest countries in the world into a lower-middle-income nation. Since the Doi Moi reforms, GDP per capita has increased sixfold. Economic growth is projected to reach 5.5% by the end of 2024. Vietnam aims to become a high-income country by 2045, requiring an average annual growth rate of about 6% per capita to achieve this goal.

Vietnam has experienced significant development over the past few decades, with investments in health and human skills playing a central role in this progress and delivering substantial economic benefits. Despite this development, the country faces significant social issues. Vietnam is dealing with an aging population, persistent inequalities in the education sector and ongoing economic effects from the pandemic. Like many other countries, Vietnam’s economy faced a downturn in 2023 due to post-pandemic challenges. However, Vietnam’s economic development is now on the rise again.

– Sigrid Nyhammer

Sigrid is based in Bergen, Norway and focuses on Good News and Politics for The Borgen Project.

Photo: Pexels

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A Look at Yellow Fever in Gabon

A Look at Yellow Fever in Gabon Gabon, located on the Atlantic coast of Central Africa, has a relatively high GDP for the region at $8,820, compared to nearby Nigeria at $2,162. Despite this high income, wealth distribution in Gabon is highly unequal, leading to widespread poverty. Of its 2.4 million residents, more than 900,000 live below the poverty line, subjecting a significant portion of the population to numerous hardships, including diseases. A particularly severe challenge in Gabon is Yellow Fever.

Yellow Fever Transmission and Risks in Gabon

Yellow Fever is a viral disease transmitted by mosquitoes and can spread in three primary ways. The intermediate cycle, most commonly observed in Africa, involves semi-domestic mosquitoes that contract and spread the disease. Although a vaccine is available, Yellow Fever is a fast-spreading illness that poses a significant danger and has the potential to spread internationally, making it a global threat. Effective management is crucial whenever outbreaks occur.

Health Infrastructure and Yellow Fever Preparedness

Currently, Gabon does not have any active Yellow Fever outbreaks, but the country remains at high risk for potential outbreaks. Gabon’s health system receives minimal government funding, amounting to only 3% of the country’s GDP. The World Health Organization (WHO) reports that vaccination rates for Yellow Fever in Gabon are suboptimal, with less than 85% coverage nationwide. The risk of Yellow Fever has increased since the COVID-19 epidemic, which disrupted immunization services. Although the disruption was brief, it has increased the number of people susceptible to otherwise preventable diseases.

Yellow Fever Epidemics Strategy in Gabon

The WHO has designated Gabon as a high-priority target within its Eliminate Yellow Fever Epidemics (EYE) strategy. WHO and its partner organizations are focusing primarily on maximizing vaccination rollout as part of this strategy. Alongside vaccinations, vector control measures have been implemented in urban centers across Gabon to eliminate potential wildlife carriers of the disease. WHO is also committed to educating travelers about the risks of Yellow Fever. Entry into Gabon requires a Yellow Fever vaccination and travelers are informed about the symptoms and signs to ensure prompt treatment if infected. This proactive approach helps prevent the international spread of the disease, which is one of the most critical aspects of managing Yellow Fever. The EYE strategy has proven effective not only in reducing cases in Gabon but also across Africa.

Looking Ahead

Gabon faces significant challenges in managing the risk of Yellow Fever due to unequal wealth distribution and a health system with limited funding. Although the country has no current outbreaks, it remains highly vulnerable. WHO’s Eliminate Yellow Fever Epidemics strategy focuses on increasing vaccination coverage and implementing vector control measures to mitigate this risk. These ongoing efforts aim to safeguard Gabon’s population and prevent the potential spread of Yellow Fever beyond its borders.

– Tyra Brantly

Tyra is based in Los Angeles, CA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Addressing Health Crisis in Mali: Efforts and Challenges

Transforming Health Access in Mali Mali, an inland sub-Saharan country in West Africa, ranks among the poorest in the world. The country has suffered from ongoing conflicts, notably the 2012 Tuareg rebellion and the subsequent Mali war, alongside challenges such as unemployment, food insecurity and extreme climate variability. As a result, Mali’s health care system has also been severely compromised.

Current Health Crisis in Mali and Barriers

A 2024 UNICEF Health Crisis in Mali report states that 5.4 million people require health assistance and 2.5 million need nutritional support. In a special interview with The Borgen Project recently, an International Medical Corps field operator discussed several challenges in providing health care in Mali. These include a lack of quality infrastructure and medical equipment, insufficient electricity and difficulties accessing remote areas.

UNICEF’s Response

Amid the conflict, UNICEF stepped in to assist, particularly during roadblocks, by deploying community health agents who acted as frontline responders, equipped to combat diseases such as diarrhea, pneumonia and malaria. In 2018, UNICEF achieved significant milestones, including eliminating maternal and newborn tetanus in six regions. Throughout the year, Mali also maintained its polio-free status. It continued to strengthen the national health system’s capacity to deliver life-saving emergency health interventions and services, including vaccination services in the northern conflict-affected regions.

Health Mobile Clinics in Mopti

In the Mopti region, the European Union (EU) and its humanitarian partner Save the Children provide free health care to vulnerable individuals through mobile clinics. Each month, more than 1,500 people benefit from services that include consultations, prenatal check-ups and immunizations tailored for displaced individuals. These clinics treat various diseases and malnutrition and educate patients through sessions that raise awareness about good health practices. These sessions cover COVID-19 prevention, sanitation, vaccinations and more.

Novartis Foundation’s Contribution

Consulting a doctor typically costs around 1,000 CFA, valid for a week, while a prenatal consultation might cost about 2,500 CFA, which is quite expensive. The comprehensive survey on household living conditions (EICVM 2018 – 2019) reveals that 51% of Malians skip health care due to financial reasons.

The Novartis Foundation has significantly transformed health care in the region of Ségou. Covering 13 health areas and reaching a population of 200,000 people across 210 villages, the foundation’s commendable efforts include strengthening health insurance schemes, providing microcredit to women’s saving groups, investing in small businesses, diversifying farmers’ incomes and more.

Strengthening Health Care in Mali: The PACSU Initiative

The government of Mali, with funding from the World Bank, launched a four-year initiative called the Accelerating Progress toward Universal Health Coverage Project (PACSU). This project not only strengthens community health services but also establishes a robust emergency fund allocation system for responding to disasters and crises. Strengthening health infrastructure, ensuring accessibility and promoting economic stability are crucial for Mali’s future. As the world focuses on this nation, a collective effort is necessary to address the health crisis in Mali and solidify its health care system.

– Malaikah Niyazi

Malaikah is based in New Delhi, India and focuses on Global Health for The Borgen Project.

Photo: Flickr

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3 Solutions to Elderly Poverty in Japan

Elderly Poverty in JapanJapan has some of the world’s highest rates of elderly poverty. While the average poverty rate for seniors among the Organization for Economic Cooperation and Development (OECD) countries is 14%, Japan’s rate is notably higher at 20%. There are many potential causes, the most obvious being the country’s rising population of older adults. In 2020, 29% of Japan’s population was older than 65.

Many seniors rely on national pensions for necessities like food and medical expenses. However, a 2019 survey found that approximately $10,000 is needed annually to cover these daily necessities. In contrast, individuals above 65 receive an annual basic pension of only about $6,000, falling significantly short of the required amount. The pension system is also heavily patriarchal, as single, divorced and widowed women are at a heavy disadvantage. For example, around 44.1% of elderly, single Japanese women live in poverty and that rate is much lower for men (30%).

One reason for this could be from the post-war era when women were socially expected to raise children. At the same time, their husbands would work and earn money for the family. The pension system was therefore built to support men and families, not single women. To address this issue of elderly poverty, Japan has offered solutions that include the continuation of employment, improving health care and city accessibility. 

Encouraging Lifelong Work

By encouraging lifelong work, older people can continue to earn money and support themselves. Almost 40% of Japanese companies keep elderly employees and these companies have started programs that aim to keep elderly employees with specialized skills. And company jobs aren’t the only source of work.

More than “70% of the temporary or part-time workers at convenience stores and supermarkets, security guards, custodial workers, care providers, workers at call centers and so on” are above 65. Taxi firms are also increasingly hiring elderly drivers. In addition to these job markets, each municipality in Japan has a “Silver Work” center that helps older adults find jobs.

Improving Health Care

Improving health care can help older individuals stay healthy and remain in the workforce, reducing their reliance on pensions. Better health also decreases the costs associated with medical care and medication, thereby mitigating elderly poverty. One foundation, in particular, has made it its mission to achieve this goal.

The Nippon Foundation and MetLife Foundation initiated the “Better Life Better Place” for the Elderly and Children Program. The program aims to develop 12 care facilities for older people and children by the end of the year. These care facilities will operate like hospice care homes for older people, with volunteers from MetLife Japan employees helping run the homes.

Making Cities More Elderly-Friendly

Creating more elderly-friendly cities can support active lifestyles among seniors, leading to improved health, reduced health care costs and decreased elderly poverty, ultimately fostering happier lives. Some Japanese cities have begun implementing such changes. For instance, Akita has launched initiatives to encourage social engagement among older adults, including a one-coin bus service that provides affordable transportation for seniors.

Conclusion

These three solutions aim to ensure that the elderly remain healthy, enabling them to earn income and lead fulfilling lives. Since health care costs are a significant driver of elderly poverty, improving health and reducing these costs can greatly alleviate financial burdens. By fostering better health, seniors’ overall cost of living could decrease significantly.

– Hannah Chang

Hannah is based in Philadelphia, PA, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Wikimedia Commons

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Prevention and Development: HIV in Eswatini

HIV in EswatiniThe priority of health and well-being is a privilege not all nations can embrace. Eswatini, located in the Southwest of the African continent, has faced significant setbacks in its quest for a healthier nation due to the devastating effects of an HIV epidemic in recent years. With a population of roughly 1.2 million, Eswatini has one of the highest HIV rates globally, leading to widespread suffering, death and low life expectancy. However, development and aid efforts, both governmental and global, are advancing steadily, bringing the prospect of a healthier nation within reach.

HIV in Eswatini

Eswatini has been at the top of the charts in regard to HIV prevalence in the past years. During the peak of the HIV epidemic in 2015, almost one out of every three people in the nation were living with HIV. Although treatment for HIV existed during the mid-’90s, not many citizens in Eswatini had access to the treatment. In 1995, no treatment was made available for the Swazis, leading to 73,000 people contracting the disease and 2,400 people dying that very same year.

The fight for controlling the epidemic has been difficult in the following years, with the implementation of various programs and treatments failing on a widespread level. Currently, the life expectancy for the Swazi people is 54.6 years. Although low in regards to the global comparison, this is actually progress for the nation. In Eswatini, the life expectancy in 2000 was 47 years, which means that it has improved by 7.55 years in the past 24 years.

Relief and Aid

A primary factor in the improvement of controlling the HIV epidemic, as well as increasing the life expectancy of the Swazis, has to do with the partnership between the Government of Eswatini and the United States (U.S.) Presidential Emergency Plan for AIDS Relief, more commonly known as PEPFAR. PEPFAR is the largest commitment by any nation addressing HIV in history, enabled by the support of the U.S. Congress, presidential administrations and many other powerful figures in the U.S. political sphere.

PEPFAR-funded programs such as the REACH and REACH II programs have focused on developing local organizations in the community. These organizations, such as Umliba Loya Embili and Insika ya Kusasa, have aided in the fight against HIV, addressing risks such as miseducation, poverty, child protection and more.

The increase in Swazis taking preventative medication for HIV has also been a major success in the decrease in HIV rates in recent years. The dissemination of drugs, in particular, pre-exposure prophylaxis, more commonly known as PrEP, has been a milestone in aiding the risk and containment of HIV. In 2016, the World Health Organization (WHO) globally recommended the introduction of PrEP among people at high risk of contracting HIV, including adolescent girls, young women and sex workers.

Eswatini was one of these countries and now the number of PrEP users is increasing yearly, going from 2,200 in 2018 to 32,750 in 2022. The increase in protection being available for citizens at their local clinic is a positive step in the right direction, which is openly decreasing the potential for Swazis to contract HIV.

The Future of Eswatini

Addressing the HIV epidemic in Eswatini will be a slow and incremental process, given that large-scale relief and aid have only recently been introduced. The transition from a lack of relief, education and medication to a growing support system marks progress in the fight against high HIV rates. Continued funding for education and medical care is essential for building a healthier future for the people of Eswatini.

– Oliver Martin

Oliver is based in Honolulu, HI, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

Access to Quality Health Care in Jamaica

quality health care in JamaicaIn an interview with The Borgen Project, native Jamaican Shamella Parker describes the dire consequences of a lack of access to quality health care in Jamaica. On an evening in February 2023 in Montego Bay, Jamaica, Parker’s aunt Mary, a live-in cook, shared a dish with her employer containing susumba, commonly known as gully bean, a type of green berry popular in Jamaica. Shortly after the meal, both Mary and her employer fell ill.

The man’s family took him to a nearby hospital. “The hospital that he went to, I believe they treated him on the spot because he was wealthy and I guess known in the neighborhood, but my aunt – not being as wealthy – went to another hospital in the area where she was from,” said Parker. In contrast, Mary went to a hospital in St. Catherine and spent a long time waiting to be attended to in the waiting room despite being an emergency case. Eventually, she lost consciousness and became unresponsive. Nurses and doctors attempted to revive her, but it was too late. Parker and Mary’s husband feel the hospital did not do all it could to save her.

According to Mary’s husband, the forensic pathologist was away at his wife’s time of death. For example, in 2015, the Jamaican government employed only two forensic pathologists who perform autopsies for everyone who does not have insurance. When Mary’s husband returned, the pathologist deemed Mary died of an accident – consumption of a poisonous seed. But, to Mary’s family, unequal access to prompt and quality health care in Jamaica stood as the true cause.

A Public Health Crisis

Jamaica’s iconic reggae and beaches backdrop a public health crisis. The legacy of the colonial slave-based economy birthed the traumatic, post-emancipation public health care system present in Jamaica today. Health care is a dimension of poverty on the island; the Multidisciplinary Poverty Index (MPI) of 2022 estimated that 78,000 Jamaicans lived in multidimensional poverty in 2020. The Index splits poverty into three dimensions – health, education and standard of living – and scales the intensity of deprivations for each. Compared to selected other Caribbean and Latin American countries at that time, health care deprivation was greatest in Jamaica, at 52.2%; the next highest was Trinidad and Tobago at 45.5%.

Insurance and Unequal Access to Quality Health Care in Jamaica

The National Health Plan estimates that 500,000 out of 2.7 million Jamaicans have insurance. This means roughly 80% of Jamaicans do not have it and have to rely on public hospitals. These hospitals do not have enough equipment to meet this demand, with World Data estimating that there are 1.32 primary care doctors per 1,000 civilians and 1.7 hospital beds.

Many Jamaicans do not have insurance due to inflated premiums, rendering insurance inaccessible. Even those who have it are discouraged from exceeding the lifetime maximum benefit. As a result of poor insurance or lack thereof, many reserve medical attention for emergencies.

Just taking her aunt to the hospital, Shamella Parker said, meant “it was a serious thing… we do not just go to the hospital for anything.”

Health Education

Non-communicable diseases (NCDs) comprise 79% of mortality in Jamaica. These include diseases such as diabetes, heart disease or cancer. Teaching healthy habits is one way to combat NCDs. Though there is a National School Feeding Programme, public schools increasingly apply the protocol with “unevenness,” according to the Ministry of Education and Youth (MOEY) report.

As it is, many schools are not mandated to provide nutritional food, exercise programs or health classes that destigmatize illness. According to the Jamaican Health and Wellness Minister Dr. Christopher Tufton: “…there is actually a lost generation around that crisis, a cohort of citizens who unfortunately will have to spend the rest of their lives trying to make themselves as comfortable as they can…”

Transportation Infrastructure

Hospitals are difficult to reach. People often live far away from health centers and hospitals. Reliable infrastructure is essential for continual access to health care in Jamaica. However, rural roads are often unpaved, secluded and vulnerable to climate damage. Bad weather resulting in landslides and flooding is common and may disrupt transportation by “cut[ting] off access to health care, education and other essential services,” according to a 2018 report. Blocked roads complicate transporting patients. Jamaica’s “limited funding” for transportation maintenance causes drawn-out repairs when roads erode and bridges collapse.

Ongoing Efforts

In 2020, the Jamaican government signed the Vision for Health 2030, a 10-year health improvement strategy to reorder Jamaica’s fragmented care. Alongside the Pan American Health Organization (PAHO), this plan tackles noncommunicable diseases and maternal health by increasing the number of hospitals on the island and modernizing services to boost equity and efficiency while delivering “higher technical quality.”

In 2019, the government introduced the National School Nutrition Policy. This legislation forms part of the government’s efforts to mandate healthy eating and exercise in young people. Its provisions include measures such as color-coding foods permitted in schools and providing competitions to incentivize healthy eating, according to the MOEY report.

Additionally, various efforts are underway to reform infrastructure, according to the National Development Plan (NDP). Goal 9 of the NDP includes the country’s largest infrastructure project worth up to $800 million to upgrade roads and access to water, sewage and internet.

In 2016, UNICEF began assisting the government in adopting regulated, cold-chain transport. It is a temperature-controlled supply chain essential for reducing waste and improving the integrity of goods necessary for health services.

Looking Ahead

Efforts to address the public health crisis and improve access to quality health care in Jamaica are underway. The government’s Vision for Health 2030 and collaboration with organizations like PAHO and UNICEF aim to modernize health care services, tackle noncommunicable diseases and enhance infrastructure. The introduction of the National School Nutrition Policy highlights efforts to promote healthy habits among young people. As these initiatives progress, there is hope for a more equitable healthcare system that prioritizes the well-being of all Jamaicans.

– Caroline Crider
Photo: Unsplash