Five Things to Know About Healthcare in Ghana

Ghana, a country in West Africa, gained its independence in 1957 and now has a population of 28.2 million people. Though it has been considered one of the most stable countries in the region since 1992, Ghana still faces issues, one of which is the health of its population.

For men and women in Ghana, the life expectancy at birth is 64 and 66 years, respectively. These life expectancies are both below the global average, which, in 2015, was reported to be 71.4 years when considering both men and women.

Ghana faces a multitude of health issues that affect its population’s life expectancy. Below are five things to know about healthcare in Ghana.

1. Accra, the country’s capital, is one of the centers of Ghana’s medical system. This city, which is one of the largest cities in Ghana, has a population of about 2 million people. Accra is where the Ghana Health Service is located, thus making it an important city for health in Ghana.
2. HIV/AIDS is one of the top ten causes of death in Ghana. This virus killed 10,300 people in Ghana in 2012, which was 4.9 percent of the country’s population. At this rate, HIV/AIDS was ranked as the fifth leading cause of death in Ghana, in 2012, by the World Health Organization (WHO).
3. In 2012, Malaria killed 8.3 percent of Ghana’s population. At this rate, Malaria ranked higher than HIV/AIDS, at number three, in the leading causes of death in Ghana, as reported by the WHO in 2012. When considering children under five, Malaria was the leading cause of death, killing 20 percent of this group in 2012.
4. As of 2016, the Center for Disease Control and Prevention (CDC) has trained 125 people in Ghana to better monitor and evaluate the spread of infectious diseases. The CDC is working with Ghana to help citizens better recognize, treat and prevent infectious diseases.
5. The education system for medicine and health in Ghana has improved over the last few decades. Many institutions that focus on educating Ghanaians in medicine have been founded since 1976. The Ghana College of Physicians and Surgeons (GCPS), which was founded in 2003, trained approximately 300 residents in 2014.

Though HIV/AIDS and malaria continue to be two of the leading causes of death in Ghana, the country’s work with the CDC and its improved education in medicine have certainly made progress towards improving healthcare in Ghana.

– Haley Rogers

Photo: Flickr

90-90-90: A Bold New Goal in the Fight Against HIV/AIDS

When the U.N. met its goal to provide 15 million HIV-affected people with treatment by 2015, it did not pause to celebrate its victory. Two years prior, in 2013, the organization had already crafted a new goal in the fight against the HIV/AIDS epidemic. By 2020, UNAIDS hopes to see a world that has accomplished something miraculous: 90-90-90.

90-90-90 is a target comprised of three interconnected objectives:

1. By 2020, 90 percent of people living with HIV will know their diagnosis.
2. By 2020, 90 percent of all HIV-positive individuals who have been diagnosed will receive antiretroviral therapy.
3. By 2020, 90 percent of all HIV-positive individuals undergoing treatment will achieve viral suppression.

While the plan is straightforward and succinct, UNAIDS has self-awarely deemed it a “bold new target,” which may seem impossible to achieve to some. However, many countries around the globe are well on their way to achieving the elusive 90-90-90.

Most of the nations closest to 90-90-90 are part of the developed world, including Australia, Denmark and the UK. Unfortunately, poverty and weak healthcare systems make developing regions particularly vulnerable to the transmission of HIV. In fact, HIV is the second leading cause of death in developing countries.

HIV is more prevalent in Africa than in any other continent. Since the start of the AIDS epidemic, African countries such as Zimbabwe, Uganda and Botswana have exhibited average life expectancies up to 20 years lower than the rest of the world.

Despite HIV’s lethal presence in the developing world, there are methods that can be implemented to decrease HIV transmission and facilitate treatment in all nations.

In order to increase the amount of HIV-positive people who know their status, HIV testing must become more proactive. Some individuals infected with the HIV virus may not present symptoms and, therefore, will not be tested for the disease and never learn their status. Health campaigns in Uganda have increased their coverage of HIV status by 72 percent, simply by incorporating HIV tests in routine healthcare visits.

In many countries, HIV treatment is flawed due to its reliance on CD4 cell count. CD4 T-cells are the immune cells destroyed by the HIV virus. Ordinarily, HIV treatment is only given to people whose CD4 levels are low enough to put them at risk of developing AIDS. However, without treatment, anyone with HIV can pass on the virus, regardless of CD4 levels.

In 2002, Botswana began offering antiretroviral treatment to anyone infected with HIV. Botswana is now closer to 90-90-90 than almost any other country in Africa.

HIV treatment must be sustained in order to reach viral suppression – the final objective. In the Caribbean, 66 percent of individuals receiving treatment attain viral suppression. The ability to ascertain viral suppression status is reliant on viral load testing, which analyzes the amount of the HIV virus in the blood. Unfortunately, the medical technology required for viral load testing is not easily accessible throughout the globe. Recent data shows that the ability to perform these tests will likely inhibit viral suppression in the developing world. However, the work of Diagnostics Access Initiative, which creates sustainable medical labs, has successfully decreased the global price of viral load tests by 40 percent, which will make them more accessible in impoverished regions.

While 90-90-90 may seem like an ambitious or overly optimistic dream, the methodology of efficiently diagnosing and treating HIV has proven successful in many countries. If strategically implemented on a global scale, these methods could feasibly eradicate HIV/AIDS and eventually heal the world of this epidemic.

– Mary Efird

Photo: Flickr

HIV in Swaziland Under Control

Sub-Saharan Africa has become notorious for its high numbers of HIV-positive individuals. However, some countries may finally see the end to these epidemics.

Data from the U.S. President’s Emergency Plan for AIDS Relief show that the HIV epidemic is coming under control across all age groups in Swaziland, the country with the highest HIV prevalence in the world. The latest Swaziland HIV Incidence Measurement Survey has found that new HIV infections have nearly halved among adults.

The prevalence of HIV in Swaziland has had a significant impact on the country. 2015 estimates show that life expectancy in the country is 57 years for men and 61 years for women. Despite the longer lifespan, women are disproportionately affected by HIV, with most women contracting the virus between the ages of 15 and 24. This sharp increase has been attributed to the high level of intergenerational sex that occurs between older men and young, sexually inexperienced women.

Heterosexual sex is the main form of transmission of HIV in Swaziland, accounting for 94 percent of new infections. Low and inconsistent condom use, intergenerational sex, transactional sex, gender inequalities, gender-based violence, multiple and concurrent sexual relationships and a low uptake of male circumcision are all key drivers of Swaziland’s HIV epidemic.

HIV has played a major role in limiting Swaziland’s ability to support its dwindling economy. The epidemic consistently draws resources from other priority areas, placing the health system under considerable stress, and directly affecting capital accumulation and productivity. The impact of HIV has led to the disruption and destabilization of families and communal support systems. Destabilized families result in a dramatic increase in the number of vulnerable children and child-headed households that must use any limited assets to cover medical and burial costs.

With many world organizations working together to stop and reduce the spread of Swaziland’s HIV epidemic, more preventative options are available. Collaboration with the Swazi National Reference Laboratory and the Center for Disease Control resulted in drastically reduced turnaround time for key HIV diagnostics. Care and treatment for HIV has expanded nationwide to include promoting good hygiene, nutritional practices, safe drinking water, abstinence and partner reduction. Antiretroviral treatment reached over 85 percent of those eligible for treatment, and high-quality HIV testing and counseling services have served record numbers of people, especially the most at-risk populations.

The downturn of Swaziland’s HIV epidemic offers hope to other Sub-Saharan African countries that are fighting similar battles. Collaborating with world leaders and local governments has proven to be very productive in expanding the impact and sustainability of all health investments. From here, Swaziland finally has a true chance at becoming a stronger member of the global community.

– Allie Knofczynski

Photo: Flickr

The First Reported Case of HIV Remission in Africa

At the ninth International AIDS Society conference in Paris on July 23, scientists confirmed the first case of HIV remission in Africa. Diagnosed with HIV at 32 days old, a now 9-year-old South African girl has been living without the disease and off treatment for more than eight years.

HIV patients are treated with a combination of antiretroviral drugs to prevent the development of AIDS. Treatment reduces the amount of viral load in the body and bodily fluids. It can also protect the immune system from infections and cancer.

The child in remission took part in a clinical trial called Children with HIV Early Antiretroviral Therapy (CHER) along with 143 other infants. Treatment lasted for 40 weeks with the hope that the virus would reach undetectable levels and of achieving a higher volume of HIV remission in Africa. Of all HIV-affected children, 91 percent live in Africa.

While the virus can reach low enough levels to avoid detection in the blood, there is still not a cure for HIV. But doctors are learning that there is a correlation between early treatment and long-term remission.

According to the World Health Organization, poverty-stricken countries experience HIV epidemics at a much higher volume than wealthy countries. With less money, it is hard to get quality treatment, if any treatment at all. This increases the potential for epidemics by allowing transmission. Poverty is decreasing in the area, but 60 to 65 percent of wealth still lies with the wealthiest 10 percent.

South Africa spends more than $1.5 billion annually on HIV and AIDS programs to treat seven million people.

In 2013, the “Mississippi baby” was in remission for two years after early aggressive treatment. However, in 2014 the child had to restart treatment after the virus reemerged. Another child in Vancouver was in remission for 11 years following a failed six-week treatment and a six-year, four-drug treatment.

The benefits of long-term remission are obvious. Symptoms of the drugs subside and the financial burden of drugs and treatment lessen. The cases of remission are encouraging, but the widespread effects of early treatment are still unknown.

“Further study is needed to learn how to induce long-term HIV remission in infected babies,” Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said in a news release. “However, this new case strengthens our hope that by treating HIV-infected children for a brief period beginning in infancy, we may be able to spare them the burden of life-long therapy and the health consequences of long-term immune activation typically associated with HIV disease.”

– Madeline Boeding

Photo: Flickr

Successes Combating Common Diseases in Tanzania

Gender inequality, limited access to safe water, lack of sanitation, poor hygiene and a recent drop in immunization are major issues Tanzanian citizens face in urban and rural areas of the country. These factors have contributed to the rampant spread of three common diseases in Tanzania: HIV and AIDS, cholera and malaria.

The most common disease affecting the Tanzanian populace is HIV and AIDS. HIV is a virus that attacks the immune system, the body’s natural defense against disease. The immune system is destroyed when left untreated and the person cannot recover from infections, big or small. At this stage, the person has AIDS.

According to the World Factbook, in 2015, almost 1.4 million people in Tanzania were living with AIDS. This is the most recent estimate. Also reported by the same source, Tanzania ranks sixth in comparison to the rest of the world with the number of its citizens living with the disease.

HIV is the main source of adult mortality in the country. The World Factbook states that in 2015 an estimated 35,700 Tanzanian adults died from the disease, placing the country in fourth place in comparison to the rest of the world.

According to the charity organization, AVERT, the populations most affected by HIV in Tanzania are people who inject drugs, men who have sex with men, mobile populations and sex workers. Of all HIV infections, 80 percent of them result from heterosexual sex. Tanzanian women are infected more than men due to having older partners, getting married earlier and neglecting negotiating skills for safer sex due to gender inequality.

The second of the most common diseases in Tanzania population is cholera. Cholera is a bacterial disease usually spread through contaminated water. Cholera causes severe diarrhea and dehydration. Cholera kills infected persons within hours when left untreated.

According to the World Health Organization (WHO), by April 20, 2016 there was a total of 24,108 cases of cholera in Tanzania, including 378 deaths. The majority of the cases were reported from 23 regions in mainland Tanzania (20,961 cases, including 329 deaths). Neighboring Zanzibar islands reported 3,057 cases of the disease, including 51 deaths.

The disease spread quickly due to conducive conditions such as limited access to safe water in poor households, sanitary problems and poor hygiene found in both mainland Tanzania and Zanzibar. In addition, the nation’s water supply institutions lacked the capacity to disinfect water and conduct regular water quality monitoring and assessments.

Recently, there has been a decline in the number of newly reported cases of cholera. However, the conditions that helped the disease to persist still have not changed, so risk for more infections remains high.

The final common disease affecting the Tanzanian population is malaria. Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. Mild symptoms include fever, headache and chills. Severe symptoms include anemia, difficulty breathing due to fluid-filled lungs and cerebral malaria in children. In adults, organ failure is also frequent.

The World Factbook reports malaria is a leading killer of children under five in Tanzania. According to the Malaria Spot website, Tanzania has the third-largest population at risk of malaria in Africa. Over 90 percent of the population live in areas where there is malaria. Each year, 10 to 12 million people contract malaria and 80,000 die from the disease, most of them children. There is no vaccine for malaria. This fact contributes to why the disease continues to be a threat for Tanzanians.

Common diseases in Tanzania are prevalent because the geographical and economic conditions of the country favor their spread. While HIV and AIDS, cholera and malaria have been a threat to the population there has been positive strides. The Center for Disease Control (CDC) has been working with the government of the United Republic of Tanzania and more than 60 partner organizations since 2001 to address HIV, malaria, and other health threats by helping support service delivery and strengthen health systems and infrastructure. The CDC partnership has seen success, including:

• 637,875 people are currently receiving HIV treatment
• 74,430 pregnant women have received medication to reduce transmission to their babies through PEPFAR (The United States President’s Emergency Plan for AIDS Relief) since 2010
• 1,155,833 men have been circumcised to prevent new HIV infections since 2010
• New malaria infections have decreased from 18 percent to 10 percent in children 6-59 months in 2011-2012

With continued aid and improvement in living conditions for the Tanzanian people, common diseases in Tanzania will no longer remain common.

– Jeanine Thomas

Photo: Flickr