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Health in the Pacific Islands: Vanuatu Eliminates Trachoma

Health in the Pacific IslandsHealth in the Pacific Islands recently improved due to the elimination of a disease called trachoma on the island of Vanuatu. This island is located to the north east of Australia in a region called Melanesia. Vanuatu is the first of the Pacific Island countries to eliminate the disease, and the only one of 14 to complete this goal. Health in the Pacific Islands and around the world has improved significantly over time as public health measures reduced the number of people at risk of contracting trachoma by 92% over the past two decades.

Vanuatu

Vanuatu is composed of 83 islands and relies on agriculture. Due to the separation of islands, health in the Pacific Islands, including Vanuatu, is often inadequate. Access to health care remains a challenge to many residents, and there also exists a lack of resources and medical personnel. Though there are six hospitals located throughout the country, many people must rely on health centers due to the rural areas in which they live. The recent success story of the elimination of trachoma follows another success back in 2016 when the country eliminated lymphatic filariasis, a disease that affects the lymphatic system.

Trachoma

The bacterium, Chlamydia trachomatis, causes trachoma, which leads to a visual impairment that is, at times, severe enough to cause the patient to become blind. The bacterium has caused visual impairments in about 1.9 million people in the world so far, and 136 million people remain at risk of contracting the disease as of June 2021. The disease spreads through contact with discharge coming from the eyes or nose, whether through direct contact or intermediates such as flies. Trachoma is classified as a neglected tropical disease (NTDs).

People often find these diseases in countries in Africa, Asia and Latin America. Though there are many NTDs, trachoma is one of the known diseases in this category that can be eliminated from a population through the use of public health measures. Improvements to hygiene and access to clean water help control the spread of the disease, as well as control the spread of possible vectors such as flies. The push to eliminate trachoma began after data from 2014 indicated that trachoma infected 12% of children between the ages of one and nine years old. This means these children were at risk for serious visual impairment that would affect their future. Trachoma also holds a significant economic impact on countries that trachoma impacts, where these countries may lose up to $5.3 billion per year.

A Path Toward Elimination

Other countries can follow the success of Vanuatu by abiding by the recommendations of the World Health Organization (WHO) and mobilizing medical professionals and communities in places of at-risk individuals. The acronym for the policy toward eliminating trachoma is SAFE. It stands for “Surgery for trichiasis; Antibiotics to clear infection; and Facial cleanliness and Environmental improvement to limit transmission.” Communities pair this process with education on avoiding health risks, proper treatment and providing antibiotics to populations, especially rural individuals. Governments, such as the case in Vanuatu, also often partner with international organizations such as WHO, and with organizations that specifically work with treating diseases related to blindness such as the Fred Hollows Foundation.

The Fred Hollows Foundation is particularly important to the regions in and around Australia because it focuses on diseases related to sight. It helps to reduce poverty by providing medical treatments, education and training. It builds health facilities and works with local communities to end preventable blindness.

Looking Ahead

These ongoing partnerships and procedures that WHO outlines eliminate NTDs such as trachoma, allowing medical professionals to greatly improve health in the Pacific Islands. In 1998, WHO set a goal to eliminate trachoma by the year 2020. As of 2020, the new goal for the NTD elimination plan is now 2030. Trachoma remains a health problem in 43 countries. Hopefully, other countries in the Pacific Islands and around the world can use Vanuatu as a role model in eliminating more NTDs to improve health in the Pacific Islands and abroad.

– Kaylee Messick

Photo: Flickr

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Updates From AIDS Conference 2022

AIDS ConferenceThe 24th Annual AIDS conference occurred in Montreal between July 29, 2022 and August 2, 2022. This was the first year the conference employed a hybrid model with both in-person and virtual speakers. As a result, researchers, advocates and leaders from 172 countries attended, and most were from developing countries.

The AIDS conference displayed many breakthroughs in HIV prevention and the intersections between sciences such as clinical, political, social and behavioral. The greatest clinical development, according to the co-chair of the conference Dr. Jean-Pierre Routy, was the research that found that the receipt of a long-acting injection shot of antiretroviral medication every eight weeks is “safe and superior” to daily oral medication.

Necessary Steps

However, though medical science is taking strides forwards, the rollout of these treatments remains behind. Esteban Burrone, the Head of Policy at the Medicines Patent Pool, described the necessary steps to promote the equitable rollout of HIV antiretroviral medication. Each country needs FDA approval, licensing, manufacturing and recommendation in guidelines for a rollout to receive approval. Things that can help fast-track product rollout in countries are “community involvement in demanding access, pursuing early licensing, securing national approval, equitable pricing agreements.” In addition, Dr. Karin Hatzold, a public health physician, discussed how access to “diagnostic strategies such as HIV self-testing… [and] operations research to optimize delivery models” are crucial for a successful rollout and introduction to products.

Reaching Rural Areas

Tackling the difficulty of delivering medications to vulnerable populations in developing countries, however, is Dr. Rosalind Parkes-Ratanshi. Parkes-Ratanshi discussed a pilot project in Uganda where medical drones help distribute HIV medication in remote locations and for mobile populations. Her medical drone project is also used for COVID-19 and STI sample delivery. Although this does not address the policy required to roll out new products in other countries, it is a step to reaching rural populations with already approved antiretroviral medication.

New Framework

Furthermore, representatives from the World Health Organization (WHO), Global Fund and the International Aids Society (IAS) presented new people-focused guidelines that the WHO has adopted to focus on structural barriers. This includes reducing stigma and eradicating “punitive laws.” The new framework also works to target key populations who make up 70% of new HIV infections according to UNAIDS. Each presenter at the AIDS conference including the WHO strives to progress the global community toward the UNAIDS 95-95-95 target, a goal that states by 2030, 95% of people living with HIV will know their HIV status, 95% of people who know their status will be receiving treatment and that 95% of people on HIV treatment will have an undetectable viral load making the chance of infecting others very low.

PEPFAR News

PEPFAR, the U.S. President Emergency Plan for AIDS Relief, announced that 5.5 million babies across the world have been born HIV-free due to the program’s efforts. PEPFAR’s efforts to expand treatment and prevention services to many target populations across the globe have reached millions. U.S. Global AIDS Coordinator and Special Representative for Health Diplomacy Ambassador-at-Large Dr. John Nkengasong described the prevention program that made this possible. “In collaboration with countries, communities, and our partners, PEPFAR supported comprehensive HIV prevention programming for adolescent girls and young women, voluntary medical male circumcision, and we scaled up treatment for women and men with viral suppression.” Other PEPFAR announcements included reaching the 90-90-90 UNAIDS target in at least 12 “high HIV disease burden countries” and treating approximately 20 million men, women, and children with antiretroviral medication.

These were only a fraction of the many positive advancements that researchers discussed at the 2022 AIDS conference. Much progress has occurred in understanding other barriers such as the social, political and economical barriers to reach the UNAIDS 95-95-95 goal by 2030. Check out the AIDS 2022 website for more information about the 24th Annual AIDS conference.

– Jordan Oh
Photo: Flickr

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Social Entrepreneurship Empowers Disability Justice

Social Entrepreneurship Empowers Disability JusticeThe MIT Enterprise Forum (MITEF) is carrying out its 16th edition Pan-Arab Startup Competition. Since 2016, the yearly program awards competitors in three categories: ideas, startups and social entrepreneurship. The competition highlights how social entrepreneurship empowers disability justice, among other issues. Winners receive equity-free funding based on scalability, social impact, financial sustainability and innovation. Participants receive top-notch mentoring from some of the leading minds in entrepreneurship and technology, and they also gain networking opportunities with a global entrepreneurial community and investors.

Social Entrepreneurship Track

Social entrepreneurship is quickly gaining popularity in the world of innovation. It is an initiative that pursues an innovative idea to address the root causes of communal issues such as poverty, water scarcity, disability justice and much more.

MIT recognizes the potential of social entrepreneurship. Hala Fadel, the Founder and Chair of MITEF Pan-Arab, commented that “the entrepreneurship and innovation ecosystem has reached an inflection point as 450-plus alumni are leading their way through the domains of renewable energy, sustainable agriculture and environmental infrastructure.”

Money goes into social businesses to create social impact, not to maximize dividends on investment. Without pressure from opportunistic stockholders to optimize profit, these peace-driven projects can expand impact and be self-sustaining and ethical.

A fundamental principle of social entrepreneurship is a pledge to higher than standard working conditions and wages. These initiatives provide proper employment for locals who are working to confront their communities’ problems. The emergence of this new wave of entrepreneurship is productive for social health, innovation and middle-class development. Social entrepreneurs may become major drivers of poverty reduction action in the future.

Social Business Highlight: Entaleq

Entaleq, one of the program’s successful alumni, is a mobile phone application aiming to improve accessibility for people with disabilities in Egypt. The Helm Foundation developed the app, and the nonprofit works to fight poverty and domestic violence.

The Helm Foundation’s mobile app positively influences people’s lives in North Africa. Entaleq allows users to comment and review locations that have disability access. The Helm Foundation also helps build and advocate for accessibility infrastructure in Egypt. As the 2020 winner of MITEF’s social entrepreneurship track, Entaleq hopes to reach the global market shortly.

Disability Justice and Poverty Reduction

Disability justice is essential for global poverty alleviation. According to a report from the International Labor Organization (ILO), people with disabilities are typically among the world’s poorest demographics, especially in low-income countries. According to a U.N. report, people with disabilities are likely 7% to 10% of any nation’s population.

Furthermore, there is an undeniable connection between disability, conflict and poverty. War continues to wound the bodies and minds of people around the world. People from conflict-heavy areas are more likely to have limited support and decreased job opportunities. A focus on disability justice is vital for recently post-conflict countries as they navigate reconstruction and poverty reduction.

Disability justice is often limited to caregiving. However, conceptions of disability justice may expand to more inclusive design and improvements to daily living which the Entaleq app does in Egypt.

How MIT’s Annual Pan-Arab Competition Helps Entrepreneurs

MIT’s annual Pan-Arab Competition is sure to bring together some of the brightest young entrepreneurs in the Middle East and North Africa. Participants will gain valuable training and exposure to a global network of innovators. Successful startups receive equity-free funding to advance projects. MITEF’s ideas, startup and social entrepreneurship tracks offer several routes for budding innovators.

Entaleq won funding in the 2020 social entrepreneurship track. The platform allows people to review disability accessibility at locations around Egypt. There are deep intersections between disability and poverty, and this technology enhances app users’ mobility and agency. Innovative social initiatives such as Entaleq prioritizing community care are making transformative impacts, showing how social entrepreneurship empowers disability justice.

MITEF’s Pan-Arab competition may be used as a model for sprouting innovation. Government funding in social entrepreneurial education will reap benefits, from local communities to the macro global economy. The MITEF Pan-Arab Competition’s proven success is designing a new identity for the world of technology and innovation.

– Samson Heyer
Photo: Flickr

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MAB Improves Visual Health in Malaysia

MAB Improves Visual Health in MalaysiaThe Malaysian National Eye Survey in 1996 estimated that 54,000 Malaysians experienced bilateral blindness. The most recent survey in 2018 reports that 86.3% of blindness causation was preventable with timely treatment. The Malaysian Association for the Blind (MAB) is a nonprofit organization working on the issue. By providing health services and employment opportunities, MAB improves visual health in Malaysia and supports those with visual impairment. Founded in 1951, MAB’s mission statement explicitly focuses on blindness prevention and empowering those with visual impairment through services and opportunities that include them in society.

The Gurney Training Center for the Blind

The Gurney Training Center for the Blind is MAB’s vocational training school for those with visual impairment. This center provides both vocational training and rehabilitation services. The center’s vocational courses allow people with visual impairment to receive proper training in a field. Some of the vocational training courses include skills such as woodworking, massage therapy, telephony, industrial work and computer programming. The center also offers rehabilitation services, including physical therapy, counseling, casework, mobility training, communication and social skills, and recreational activities.

Taman Harapan Agricultural Training Center

The Taman Harapan Agricultural Training Center teaches skills for various farming and breeding methods. Other related courses offered include ones such as horticulture and craft making. Like Gurney’s, the center also provides rehabilitation services such as techniques for daily living.

Information Technology

MAB also provides training in how to use assistive devices and software. Additional services include the repair and replacement of this adaptive equipment. The organization also advocates for those with visual impairment by prompting employers and policymakers to provide Information and Communication Technologies facilities (computer labs, laptops, tablets, etc.) in the workplace.

Job Placement

MAB provides a job placement program to help its clients find stable work and improve the economic mobility of Malaysian people with visual impairment. MAB provides work placement by offering different resources, such as placing trained individuals into appropriate employment opportunities, helping with loans for assistive equipment needed for jobs, and working with the Department of Social Welfare and the Ministry of Human Resources to address employment matters.

Assistance to Blind Children Centers (ABC)

ABC Centers are several early intervention programs that provide essential services to children with visual impairment. These children are provided with physical training, basic living skills, preschool activities, recreational activities and counseling services. This center also aids parents by providing services such as education and counseling on visual impairment.

Public Transportation

Safety while riding public transportation is a recurring issue for people with visual impairment. In a broad collaboration with several government ministries, Nongovernmental Organizations and MAB, the Mass Rapid Transit Corporation in Malaysia installed directional tactile tiles on the Putrajaya MRT Line. These tiles give tactile feedback to commuters along the most efficient path from the entry point to the rail platform. The tiles also help indicate where an elevator or escalator is.

MAB improves visual health in Malaysia by promoting such inclusive designs and providing various services. With more efforts like MAB’s, people with visual impairment in Malaysia can integrate into a more inclusive society with improved opportunities for economic mobility.

– Max Cole
Photo: Flickr

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Impact of COVID-19 on Poverty in Malaysia

Impact of COVID-19 on Poverty in MalaysiaMalaysia saw its first confirmed case of COVID-19 on January 24, 2020. The Malaysian government implemented the Movement Control Order (MCO or PKP) around two months later in response. This mandate restricted travel, work, assembly and established quarantine measures jeopardizing the financial integrity of Malaysian households. Here is some information about the impact of COVID-19 on poverty in Malaysia as well as the country as a whole.

The World on Pause

For fully vaccinated individuals, the MCO ended in November 2021. However, under the mandate, conditional and variable ordinances ultimately played a part in the impact of COVID-19 on poverty in Malaysia.

Working in multiple phases, the MCO developed into the Conditional Movement Control Order (CMCO/PKPB), Recovery Movement Control Order (RMCO/PKPP) and the National Recovery Plan (NRP/PPN). These restrictions prevented movement between states, travel to and from Malaysia and mass gatherings in addition to the closure of schools, government and private premises except those considered essential. Those who violated the MCO were at risk of receiving fines or facing jail time.

Hurting Those Already Struggling the Most

Three-quarters of the Malaysian population live in urban areas, with the majority of individuals falling into the 15-64 age group. A four-part research study that UNICEF and UNFPA conducted titled “Families on the Edge” found that a typical Malaysian household has an average of 5.5 members.

The head of these households are mostly married Malay males around 46 years old with low educational attainment. These workers face a high risk of unemployment, pay cuts or other stresses to household income as they were in jeopardy before the pandemic.

Reports have indicated that a 5% increase in employment occurred between March 2020 and June 2021. Despite the rise, a third of those employed before the crisis experienced work disruptions and 27% faced income reduction.

The World Bank found that around 65% of jobs in Malaysia cannot occur remotely even after modifying them so that they were in an online format. This is because approximately 51% of jobs require close physical proximity. With the MCO restrictions, these jobs were most vulnerable with one-fourth of heads of households experiencing unemployment during this time.

The Impact of COVID-19 on Food and Education

The impact of COVID-19 on poverty in Malaysia consequently affected access to food and quality of education. With little to no income, households spent around 84% less on education and 4% less on food between December 2019 and June 2020. While expenditure on food reduced, approximately 30% reduced food intake itself to cope with financial difficulties.

While employees adjusted to remote working, children needed to transition to online learning. Two-fifths of children do not have access to the required equipment (such as a computer) or internet connection to resume their education.

Closures have also prevented children from impoverished families from accessing meals provided at school-distributed supplemental food programs. This food insecurity pushed households to adopt cheaper and less healthy diets, further threatening the country’s child malnutrition crisis.

A Citizen’s Surrender

Some low-income residents resorted to waving white flags from their flats during the government-mandated lockdown to express the financial stress they were experiencing. This Bendera Putih, or “White Flag” movement emerged to help families ask for assistance. The white cloth outside their homes would encourage others to donate food.

In response, three computer science students from Multimedia University Cyberjaya urgently developed and released the “Sambal SOS” app within the same month the White Flag Movement gained traction. More than 7,000 users registered on the site just two days after its launch.

Here, users could digitally and anonymously report that they needed help. They then could connect with other users ready and able to provide aid.

An Economic Recovery Plan

Prime minister Tan Sri Muhyiddin Yassin announced the Pelan Jana Semula Ekonomi Negara (PENJANA), also known as the Economic Recovery Plan, in June of 2020. This stimulus package totaled RM35 billion (more than $7 billion) allocated to 40 initiatives organized into “three key thrusts:”

  • Empower People
  • Propel Businesses
  • Stimulate the Economy

Some initiatives to empower people included a wage subsidy program, social protection for the gig economy workforce and the internet for education and productivity. PENJANA funded entrepreneurship financing to propel businesses while supporting small enterprises through e-commerce and tourism financing. Initiatives to stimulate the economy included a campaign to buy Malaysian products and financial relief for those working in the agriculture/food sector.

Although poverty rates are still higher than before the COVID-19 pandemic, poverty levels have decreased by 16% between May 2020 and March 2021. Government assistance increased overall average household income since 2019, including disabled-headed households.

Households rely on savings, government and Zakat assistance for financial support as the labor market recovers. While PENJANA has proven to help boost the economy temporarily, many families still do not receive registered business-related aid and do not have social protection or insurance. The impact of COVID-19 on poverty in Malaysia emphasized that social protection assistance still needs to improve its scope of coverage to help the urban poor rebuild post-crisis.

– Aishah French
Photo: Flickr

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2 Diseases Impacting Afghanistan

Diseases Impacting AfghanistanSince the early 2000s, Afghanistan’s disease prevention and treatment services were far below sustainable, with only 11 physicians and 18 nurses per 100,000 civilians working in 2003. As foreign aid began to pour in, these numbers slowly improved. However, infant, child and maternal mortality rates remain the highest globally, alongside many other diseases impacting Afghanistan today. Currently, two diseases impacting Afghanistan include tuberculosis and polio, which the Western world is well equipped to diagnose with far less difficulty.

Tuberculosis

Tuberculosis is a highly infectious, airborne disease impacting many Afghan people. Tuberculosis symptoms include a dry cough (sometimes with blood), fatigue, loss of appetite, night sweats and others. Yet, early diagnosis and quality treatment are easily accessible in the United States, preventing mass outbreaks.

The World Health Organization states that tuberculosis kills around 13,000 Afghans yearly, making it a disease that impacts Afghanistan severely. In 2014, Afghanistan had approximately 58,000 new tuberculosis cases. Only 56% of these cases were diagnosed and provided with adequate treatment. Keeping the disease at bay only becomes more challenging with up to 25,000 Afghan people left undiagnosed and untreated.

However, with WHO’s help, BRAC Afghanistan and USAID started a community-based TB DOTS program to control tuberculosis outbreaks. Through the program, diagnostic facilities for tuberculosis expanded and existing facilities were further equipped with microscopy screening technology. After the initiation of these health programs, more Afghans saw doctors and received treatment for tuberculosis: Since the program’s launch in 2004, access to dots has expanded from 15 to 121 clinics two years later. By 2006, more than 6,000 community health workers had trained under the program, of which 53 percent of trainees were women. Through the continued funding and advancement of the TB DOTS program, tuberculosis may slowly begin to lose its footing and become a lower-risk illness.

Poliomyelitis (Polio)

Polio is a viral illness that can lead to severe nerve damage and injury, eventually leading to paralysis and sometimes death. Afghanistan, Nigeria and Pakistan remain the only countries worldwide that have yet to eradicate polio. Due to inconsistent vaccination rates at birth, polio remains a disease impacting Afghanistan heavily today. In the 2015 report by the polio eradication initiative, researchers found that reported polio cases in Afghanistan had decreased since years prior. However, Afghanistan is still far from eradication.

In efforts to eradicate the polio virus worldwide, UNICEF worked with WHO to find innovative ways to give every child polio vaccines. The program implemented three National Immunization Days (NIDs) to increase access to polio vaccines and potential treatment if necessary. NIDs aim to reach nearly 10 million children through house-to-house and health facility-based approaches.

Furthermore, in collaboration with UNICEF and WHO, Afghanistan’s Ministry of Health is investing in a polio program to support vaccinators, community mobilizers, influencers, volunteers and campaign coordinators to reach children in need of vaccines. According to UNICEF, 392,000 polio branded items were distributed in 2020 to Afghan students to raise awareness about the disease’s severity, prevention and symptoms. As efforts continue, polio may become a disease impacting Afghanistan far less than before.

Why it Matters

Though efforts to improve health care access and treatments in Afghanistan have increased, much work still needs to be done. Today, tuberculosis is a disease that the U.S. quickly diagnoses and treats, while, in Afghanistan, the disease is often more threatening.

Afghanistan’s Ministry of Public Health and emergency operating system know how to help their people lead healthier lives yet lack the resources to do so. In funding programs that help international organizations and ministries provide the support needed for their people, both tuberculosis and polio can become low-priority diseases for all.

– Opal Vitharana
Photo: Flickr

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How Living With Hope is Helping People with Disabilities in Africa

Living With HopeFounded in 2018, Living With Hope is an organization that is devoted to providing resources and training for people with disabilities in Africa. South Sudan native Michael Panther was left in a wheelchair due to illness and war in his country. After receiving care himself, Panther built Living With Hope to offer support for this often marginalized demographic.

People living with disabilities anywhere in the world face challenges, but these challenges are especially tough for those living in Africa. Approximately 80 million people in Africa are living with mental or physical disabilities and the barriers that they face every day have fundamental impacts. Some families in Africa feel ashamed of members who have disabilities and will sometimes hide them from the community to avoid social stigmas, discrimination and even death. There is a substantial lack of medical care or services to help people with disabilities in Africa and the widespread poverty in the country means that the needs of able-bodied people are put before those of disabled people. 

The Treatment of People with Disabilities in Africa

The treatment of people with disabilities is not only lacking in comparison to the rest of the population, but also in comparison to each other. A study published in the 2016 African Disability Rights yearbook found that parents of girls in Africa with disabilities are more likely to abandon or kill their daughters at birth and the girls who survive are more likely to be victims of abuse as they grow up. Women with disabilities are three times more likely to have unmet needs for health care and two times less likely to find jobs.

Mental and physical disabilities disproportionately affect African people living in poverty as this population has little to no access to medical care. Around 20% of people with disabilities are living in the poorer regions of Africa. Additionally, 35 million people who require a wheelchair do not have access to one and are not granted the mobility to attend school or work, surrendering them to a life in poverty.

Mobility Device Distribution from Living with Hope

Living With Hope is helping people with disabilities in Africa by teaching them skills that will help them achieve their potential and live independently. It collaborates with other international disability ministries to change the conversation surrounding people with disabilities by reaching out to families, schools, churches and local organizations to strengthen awareness and action. Living With Hope mainly focuses on mobility device distribution, such as manual wheelchairs, crutches, walkers and canes, as well as wheelchair cushions and trays. It allows donors in various locations to drop off any mobility device they are willing to donate or make a payment to the organization so that they can purchase one. Living With Hope is also helping people with disabilities in Africa by working to raise funds to send affected children to school, so that they may grow up to participate in society as adults. 

A Look Ahead

Africans facing the challenges that come with having a mental or physical disability are severely under-acknowledged and underserved. Very little research has been done on this population, which is necessary to design effective intervention plans. Organizations similar to Living With Hope are trying to help people with disabilities in Africa by raising awareness for and expanding the discussion surrounding this community.

– Ava Lombardi
Photo: Unsplash

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War Puts HIV-Positive Ukrainians at Risk

HIV-positive UkrainiansThe war in Ukraine disrupted its supply chain of HIV medication and necessary health services. More than 40 health facilities that provided services for HIV treatment and prevention are now closed. What is more, it may not be safe for HIV-positive Ukrainians to leave their shelters to pick up their medications, and even if it is, pharmacies are not guaranteed to have the drugs. People fleeing also do not have adequate amounts of medication. They may have a one-month or two weeks supply, but not enough to sustain them before they have access to more medication. The people in Russian-occupied territories along with those who are unable to relocate to a safe place are currently the most vulnerable.

HIV Medication Explained

Antiretroviral therapy (ART) involves taking a combination of HIV medications daily. Though ARTs are not a cure for HIV, they help prevent transmission and let HIV-positive people live longer healthier lives. ART reduces a person’s viral load, the amount of HIV in a blood sample, to an undetectable level. If a person’s viral load level is undetectable, meaning that a viral load test cannot detect it, then that person cannot transmit HIV to others.

Before the war, approximately 260,000 people were living with AIDS. Of this population, only 58% had access to daily antiretroviral medications. Now, with the war resulting in reduced access to ARTs, UNAIDS reported the possibility of the “resurgence of Ukraine’s AIDS pandemic.”

How PEPFAR Has Been Providing ARTs

HIV-positive Ukrainians are now depending on international support for treatment. The United States President Emergency Plan for AIDS Relief (PEPFAR) invested $13 million in antiretroviral medications for Ukrainarinas in need. PEPFAR began in 2003 and is the largest commitment by any nation to address one disease. Its funding, which totals more than $100 billion, includes funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). The Global Fund also provided emergency aid for ART medication in Ukraine.

The first wave of medication from PEPFAR delivered 18 million doses of ARTs to the Public Health Center of the Ministry of Health in Ukraine and 100% Life, the “largest organization of people living with HIV in Ukraine” to distribute. This portion of life-saving treatment will cover six months of treatment for HIV-positive Ukrainians, less than that of PEPFAR’s commitment to cover one year, or 51 million doses of ART medication in Ukraine. PEPFAR flew the antiretroviral medications to Poland. From there, trucks transported the medication to medical facilities in Ukraine.

UNAIDS’ Efforts

Civil society organizations are making great efforts to distribute drugs and medical supplies to vulnerable people in locations that are difficult to reach. UNAIDS put forth an initial $200,000 in emergency funds for medical supplies to be distributed in seven cities with large HIV populations: Chernihiv, Dnipro, Kharkiv, Kryvy Rih, Kyiv, Odesa and Poltava. UNAIDS has requested an additional $2.24 million to fund civil service organizations in Ukraine that are providing HIV treatment and refugees in other countries that are experiencing HIV. Civil society organizations that receive support from UNAIDS are helping to get HIV-infected individuals ARTs in the Republic of Moldova and the European Union. In addition, the World Health Organization (WHO) helped push Viiv Healthcare, a pharmaceutical company, to provide HIV medication donations to the Czech Republic, Poland and other countries in the European Union that are hosting Ukrainian refugees.

The war in Ukraine has deepened the threat of HIV deaths for positive Ukrainians. Although foreign aid has played a pivotal role in obtaining and dispersing antiretroviral medications throughout the nation and to Ukrainians abroad, there is still a high demand for ARTs in difficult locations and to continue after the one-year investment from PEPFAR concludes. Ukraine’s Public Health Center created a website with more support for HIV-positive people. The website includes information about where individuals can continue ART therapy and provides information about how to find HIV help. It also provides contacts for Ukrainian refugees with HIV. The need to get medication to HIV-positive Ukrainians is urgent, and the threat of another AIDS pandemic is not over.

– Jordan Oh

Photo: Flickr

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Repairing Madagascar’s Health Information System Through Singing

Madagascar’s Health Information SystemMadagascar’s exotic flora and fauna belie a broken and underdeveloped health information system. According to the World Health Organization (WHO), the probability of dying by the age of 5, per 1,000 live births in Madagascar is 50.24. The problem is not only a lack of access to health care but also lags in timely information, which prevents Malagasy people from taking proper precautions against infectious diseases.

Although 77% of Madagascar’s population is literate and 57% have access to mobile phones, people in the rural areas are still hampered by low literacy rates and a lack of a proper telecommunication system. Consequently, people share the majority of health-related facts orally, leading to the rampant spread of misinformation. In an effort to debunk myths and reform Madagascar’s health information system, a local NGO called Doctors for Madagascar, initiated a project that utilizes a unique tool for its success: singing.

Beginning of the Project

In 2018 and 2019, the measles epidemic in Madagascar caused more than 200,000 cases and over 1,000 deaths. During this time, health workers observed a deficiency of knowledge among rural people in southern Madagascar about measles vaccination.

To dispel the false rumors circulating, Doctors for Madagascar teamed up with local singer/songwriter Ebera to start the “Singing Sensitization” project as a medium of “getting accurate health information to isolated, rural communities in the country’s south.”

Free live music performances took place in places such as markets so that it could reach as many different demographics as possible. The song “The Measles” by Ebera became vastly popular among the rural Malagasy people for its educative lyrics and lilting tune.

The lyrics contained all information from verifiable sources such as the WHO and the Malagasy Ministry of Health. The song warned — “measles — they’re lethal” and advised them to take their children to the hospital if they showed symptoms like coughing, sneezing, vomiting, or diarrhea, instead of bringing them to “a shaman or a witch.” In addition, the song also urged villagers to get the measles vaccination as it would help protect them better against the disease.

Melodies During COVID-19

The success of “Singing Sensitization” during the measles outbreak in Madagascar encouraged the NGO to continue its project during the COVID-19 pandemic. During the first wave in 2020, songs focused on the importance of wearing masks, washing hands regularly with soap and water as well as social distancing. The productions also placed emphasis on the origin and spread of the virus.

According to the WHO case study, these performances were conducted sporadically “at eight to nine locations each month (or bimonthly in each village) in Ampanihy until August 2021.” The infrequency was a result of compliance with social distancing rules proposed by the government.

The Song of Victory

Conveying facts through songs sung in local dialects has proven effective especially since the performances conclude with an informative Q&A session, where health workers address additional questions and concerns.

This created trust between the villagers and the health workers. The project members often held focus group sessions and informal interviews with “community leaders, health care workers, and local health authorities” to understand how much the villagers had learned and retained as well as identify what was lacking in their knowledge, WHO case study reports.

The team modeled additional performances based on these discussions, focusing on filling the “knowledge gaps” and denouncing any inaccurate information.

Additionally, these discussions helped the “Singing Sensitization” team infer that the reach of their performances was approximately 60–70%, with “a positive uptake of the initiative by the local population,” WHO case study reports.

Making it Large Scale

“Singing Sensitization” has greatly helped in improving rural Madagascar’s health information system. As of now, the biggest challenge is getting funding, recruiting more local performers and expending time and energy on translating lyrics into different local languages.

Nonetheless, the team wants to expand its project and take it to other “hard-to-reach” rural communities. One of their goals is to introduce a radio network for easier and wider transmission of information.

– Anushka Raychaudhuri
Photo: Flickr

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New Cancer Therapies Bring Ray of Hope 

Cancer TherapiesIn 2020, the estimated number of cancer cases of all sexes and ages was 19,292,789 and the number of cancer-related deaths was approximately 10 million. Data suggests that about 400,000 children procure cancer on an annual basis. This goes to show that cancer is still a leading global health problem that has an economic cost of trillions of dollars. According to the World Health Organization (WHO), about 30-50% of cancers can be prevented simply by early detection, correct diagnosis and avoiding risk factors such as tobacco, alcohol, UV radiation and more. Although basic cancer treatments such as radiotherapy and surgery exist, recent advancements show that a number of new cancer therapies developed can significantly increase the survival rate of patients.

A Panacea for Rectal Cancer

On June 5, The New York Times published a piece about a small clinical trial conducted at New York’s Memorial Sloan Kettering Cancer Center. In this trial, 18 patients with stage three rectal cancer were given a drug called Dostarlimab “every three weeks for six months.” Dostarlimab is an immune checkpoint inhibitor. This means that the drug itself does not attack the cancer cells. Dostarlimab instead exposes the cells and allows the patient’s immune system to then “identify and destroy them.”

All 18 patients were miraculously cured of their cancer, leaving no trace of tumors to be found in any physical examinations or body scans. Scientist Dr. Luis A. Diaz Jr stated that “I believe this is the first time this has happened in the history of cancer,” in regards to this study.

The reason why this experiment is so revolutionary in the field of cancer research is because of its implications. According to Dr.Hanna Sanoff of the University of North Carolina’s Lineberger Comprehensive Cancer Center, rectal cancer patients traditionally have to bear severe consequences after surgeries or chemotherapy.

Sanoff stated in an NPR news interview, “I have had patients who, after their rectal cancer, have barely left the house for years – and in a couple of cases, even decades – because of the consequences of incontinence and the shame that’s associated with this.”

Side Effects and Effectiveness of Dostarlimab

In contrast, this new cancer immunotherapy didn’t bring with it any significant clinical complications for patients. The side effects, if any, were sparse and less in intensity.

However, this study has proven to be useful for only a “subset of patients” who have a specific gene mutation known as mismatch repair gene deficiency. About 5% of cancer patients have such gene abnormalities and they are the ones who will respond well to the Dostarlimab drug.

To gauge the true effectiveness of this research study, a more broad and diverse sample needs to be experimented upon. Nonetheless, this is a hopeful beginning that shows that cancer therapies can cure cancer for good.

New Drugs Synthesized treat Hard-to-Cure Breast Cancers

A new study published on July 5 in the New England Journal of Medicine focused on treating cancer patients with low levels of HER2, a protein “which is a common villain in breast and other cancers.”

Previously, it was found that drugs attacking HER2 only worked for patients who had high levels of the protein. However, 80–85% of breast cancer patients have low levels of HER2 (“a condition known as HER2-low”), making the usage of these drugs unhelpful.

In this clinical trial, 557 patients with HER2-low metastatic breast cancer were divided randomly into two groups. Two-thirds of patients were intravenously injected with a drug called trastuzumab deruxtecan (T-DXd) every three weeks. The rest received standard chemotherapy.

The results showed that patients who had taken T-DXd “survived for a median of 23.4 months overall, while those in the chemotherapy group survived for a median of 16.8 months.” The unique thing about T-DXd is that it contains an antibody attached to a chemotherapy drug. When T-DXd finds a cancer cell with HER2 on it, “the chemotherapy drug separates from the antibody and kills the cell.”

The Impact of T-DXd and Foundation of ERX-41

Breast cancer specialist Jane Meisel, M.D. of Emory University’s Winship Cancer Institute, who was not part of the study, believes that the findings will “change how metastatic HER2-low breast cancer is treated, and are ‘a huge win for [the] patients.’”

In another experiment published on June 9,  UT Dallas associate professor Dr. Jung-Mo Ahn synthesized a new compound called  ERX-41, which helped in destroying tumor cells in the breast. This compound proved especially effective in treating patients with triple-negative breast cancer (TNBC) and is novel because traditionally, there have been “few treatment options for patients with TNBC.”  ERX-41 also proved to be helpful in treating pancreatic, ovarian and brain cancers.

A New WHO Initiative

On June 4, WHO announced its collaboration with the American Society of Clinical Oncology, Inc. (ASCO). The primary goal of this partnership is to reduce inequalities and improve the quality of cancer care, both globally and locally. The emphasis is on low-income countries where “comprehensive treatment” is found in less than 15% of places.

Through innovation, network-building and pooling of resources and tools, the WHO and ASCO will lift the cancer burden on many patients and provide them with effective treatment.

A Look Ahead

Much progress has been made in developing new cancer therapies that would have been unfathomable even a few years back. The road ahead is long and yet there is light at the end of the tunnel.

–Anushka Raychaudhuri
Photo: Unsplash