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How to Bring Medicine to the PoorThere are many diseases plaguing the developing nations of the world. There is also much that can be done to improve the state of health across the globe. This is especially true with regards to measles. Measles is a serious problem, particularly in African nations, including Nigeria. Nigeria desperately needs people to bring medicine to the poor.

The CDC reported 176,785 confirmed cases of measles in Africa between 2013 and 2016. While the frequency of measles cases has been on the decline since 2013, the disease is still too widespread to be considered a solved problem. This is especially true for children between nine and 59 months old; they are the most vulnerable to this disease.

Starting in 2013, Nigeria had 50,585 known cases of measles. By 2016, this number had dropped to 11,499 known measles cases, leaving it still the most highly infected African nation. This seems like an exceptionally great dilemma to members of the developed world who are accustomed to the high cost of vaccines. In the United States, the CDC’s five recommended childhood shots can cost an average of $937 per person. Considering how much these vaccines cost Americans, how could it be possible to combat an epidemic in a nation as poor as Nigeria?

According to the World Health Organization, it is actually quite cost-effective to immunize nations such as Nigeria from measles. While vaccines are quite expensive in nations such as the United States, they are relatively inexpensive to use when manufactured for mass immunization projects. The World Health Organization has estimated that mass immunizations could be performed in countries such as Nigeria for roughly $1 per child vaccine.

What can be done to bring medicine to Nigeria? A simple solution would be to write and call your Congress representatives to encourage them to support immunization projects. Donating to the Borgen Project is also a great way to put forth efforts to increase U.S. spending on global disease prevention. To make a direct impact, it is also possible to contact the World Health Organization to ask how you can contribute to the fight against measles. From these steps, there will be an improved capacity by many organizations to bring medicine to the poor.

Tim Sherwood

Photo: Flickr

GaviIn his proposed 2017-2018 budget, President Donald Trump has pledged to fulfill the U.S.’s $1 billion commitment to Gavi, the Vaccine Alliance. The program has helped immunize hundreds of millions of children and lowered the cost of vaccinations since its creation in 2000.

Gavi, the Vaccine Alliance is an international organization that “aggregates demand” for vaccines from the countries it supports— 60 percent of the world’s births take place in Gavi-supported countries. This demand sends “a clear signal to manufacturers” that these countries are viable markets for vaccines. Countries supported by Gavi pay for a portion of their vaccine programs, but as “a country’s income grows, its co-financing payments gradually increase to cover the full cost of vaccines.” Gavi relies on large donors to run this business model.

In January 2015, USAID dedicated $1 billion to Gavi in support of the organization’s plan to “immunize 300 million additional children and save at least 5 million lives by 2020.” The Obama administration was vocally supportive of global poverty reduction efforts— Obama addressed extreme poverty in three of his State of the Union addresses— but the Trump administration was not expected to contribute to poverty reduction efforts to the same extent. Trump’s pledge to Gavi is refreshing in the midst of the 32 percent overall cuts to international aid proposed in his budget.

Gavi’s website lists the U.S.’s contribution to the program for the period of 2016-2020 as $800 million. If Trump were to have cut the U.S.’s funding for Gavi, the organization would have lost close to a ninth of its $9.2 billion budget. Reducing aid to Gavi would have further damaged the U.S.’s aid reputation, as it spends the least on foreign aid of all developed countries, especially since other countries fund the majority of Gavi’s budget. Notably, the U.K. has contributed $2,515 million, Norway $922 million, and Germany $676 million for the same 2016-2020 cycle.

It is important that the U.S. continue to support international vaccination programs like Gavi, the Vaccine Alliance as they allow healthier populations to become more stable, self-sustaining and economically stronger. Gavi projects $100 billion in economic gain worldwide as more people are immunized and the world moves closer to global poverty eradication.

Caroline Meyers

Photo: Flickr


Preventable diseases continue to claim thousands of lives each year in Africa, but leaders of state have taken a bold stand against this reality. An official pledge in January affirmed their commitment to realizing the goal of universal access to immunization by the year 2020.

African Union Commission Chairperson Nkosazana Dlamini-Zuma stated in a press release following the Addis Declaration on Immunization (ADI) summit: “With political support at the highest levels, we are closer than ever to ensuring that all children in Africa have an equal shot at a healthy and productive life.”

This announcement marks the continuation of ongoing efforts to provide immunizations to citizens of 40 separate countries by Gavi, the Vaccine Alliance. To date, Gavi has saved more than 4.5 million lives by providing vaccines.

“African leaders are making a sound economic investment in future generations,” Dr. Seth Berkley, the CEO of Gavi, said in response to the announcement.

Berkley’s comment is not figurative. According to a 2016 study by Johns Hopkins University, when factoring in quality of life and reduction in economic disease burdens, every 1 dollar invested by the U.S. in vaccination among the 94 poorest countries on Earth yields a staggering 44 dollars in returns. In those countries directly supported by Gavi, the figure rises even higher, to 48 dollars.

The extensive list of diseases prevented by such immunizations includes polio, whooping cough, tetanus, yellow fever, diarrhea, cervical cancers and the most deadly of all, measles. Due to its highly contagious nature, measles alone was the cause of nearly 40,000 deaths in Africa in 2013, based on a survey by the World Health Organization.

The African government is not alone in supporting immunization efforts for children. Africa United, a platform for raising awareness of global health issues, has enlisted star football athletes to provide public service adverts during this year’s Total Africa Cup of Nations tournament. “Football unites people from all across Africa and beyond,” stated Issa Hayatou, the President of the Confederation of African Football, the governing body of professional football for Africa. “Together we can help ensure millions of African children are immunized by 2020.”

Though great strides have been made during the past 15 years, approximately one in five young people in Africa still do not have access to vaccines that prevent these life-threatening diseases. This pledge may mark the first step in reducing that number to zero by providing universal access to immunization.

Dan Krajewski

Photo: Flickr

Vaccine Stabilizers
Immunizations are lauded as one of the greatest achievements in public health; the eradication of polio standing as a tremendous accomplishment and testament to this. According to one study, pre-vaccination incidence rates were used to predict polio occurrence and cost between 1970-2050. The program would have saved more than $128 billion in medical costs and more than 800,000 lives. By preventing millions of cases of paralysis, the polio vaccine has also significantly impacted the number of disability-adjusted life years. Unfortunately, success with other preventable diseases has been limited. One of the major barriers to immunization for other diseases has been storage requirements, and that is where vaccine stabilizers come in.

Several major childhood vaccines require strictly regulated storage conditions. One such vaccine is the rotavirus vaccine. Rotaviruses are the most common cause of diarrheal disease in children worldwide. According to the World Health Organization, more than 200,000 children under five die each year from rotavirus infections. One in 70 infected children requires hospitalization. Two vaccines are available and equally recommended for the prevention of rotavirus infection. Though one comes as a lyophilized powder, both must be stored at between two and eight degrees celsius. For resource-limited countries, where most rotavirus-related deaths occur, sustained temperature control is often unfeasible.

Researchers at the Ecole Polytechnique Fédérale de Lausanne are working to break down this barrier to immunization. They experimented with three additives that eliminate the refrigeration requirement. These vaccine stabilizers could prove to be the next breakthrough in public health. The researchers discovered that nanoparticles, polymers and sucrose each have the potential to prolong the stability of viral vector vaccines, by limiting the heat-induced fluctuations that destabilize vaccines.

If these vaccine stabilizers could be successfully applied to more vaccines, the public health benefits would be tremendous. The polio program has already demonstrated the efficiency and effectiveness of vaccination efforts. The returns are well worth the investment. If the onerous refrigeration requirements could be eliminated, several other preventable diseases could potentially be eliminated, or at least be drastically reduced, and the global health benefits would be immense.

Rebecca Yu

Photo: Flickr

Vaccination can Combat Poverty
Vaccination has perpetually been a vital aspect of the fight against poverty. Global health is one of the most imperative causes and immunization is the foundation for global health. Consequently, organizations like GAVI, WHO, MSF and UNICEF have put in their combined efforts into promoting this cause. Their endeavors have also highlighted how vaccination can combat poverty.

The efficient provision of vaccination and immunization schemes has been augmented by the exponential progress that the medical field has experienced over the past few years.

An estimated 2-3 million children, 1.5 million of which are under the age of five, die every year due to diseases that could have been averted by more readily available vaccines.

There are numerous underlying reasons for why vaccination can combat poverty. These mainly revolve around lowering infant mortality rates, dedicating more medical facilities and improving health care services.

Moreover, the rapid yellow fever outbreak that has plagued Angola, along with neighboring Kinhasas and Kwango, is being closely monitored by MSF. As yellow fever can lead to death for 15-50 percent of associated cases, Congolese people in the region are especially threatened.

Fortunately, the entire city of Matadi was successfully vaccinated. This move has culminated in the establishment of more vector-control activities for the people. This will especially be efficacious in improving awareness on household protection.

The inaccessibility of the pneumococcal vaccine has endangered the lives of countless children in developing countries. This malady affects millions of children all over the world.

Despite Pfizer’s advancement in this aspect, MSF has tried to rebuff its patent application as it sees it as a form of monopolistic competition because it restricts the development of the vaccine by other entities.

Furthermore, higher prices for the vaccine will be detrimental as it would not be affordable for people from lower socio-economic backgrounds. Therefore, it is imperative that vaccines of this nature be both affordable and easily accessible.

Vaccination has also played a pivotal role in the U.N. health agency’s emergency response in Nigeria. The polio vaccination programs have been an integral aspect.

Similarly, the Gombe state government of Nigeria approved the polio immunization of 900,000 individuals who have traveled from disputed areas under the control of the Boko Haram militant group. Vaccination can combat poverty by this method as it is a precautionary regulation that can alleviate the pressures of mass influx.

In addition to this, the steady progression that has been made with regards to Zika vaccine trials has accentuated the sense of urgency that is needed to address this crucial issue.

Consequently, the recently proposed approval for the performance of Zika clinical trials on humans will pave the way for a breakthrough that could help thousands of communities in the Americas. The upcoming launch of the leprosy vaccine in India also echoes this resonance of hope.

The GAVI Alliance has invested an exorbitant amount of $800 million for bolstering health care sectors in developing countries. Such maneuvers will hopefully result in stimulating the interests of private and public sectors in the country towards the cause.

Shivani Ekkanath

Photo: Flickr

Khushi Baby
In rural Rajasthan, North India, an innovative necklace has been introduced into the health system to track a child’s vaccination history. It is helping to increase the number of children protected against diseases that can kill them in the first few years of their lives.

Approximately 1.5 million children die every year from diseases that can be prevented by vaccination and India has one of the worst immunization records in the world. Less than 60 percent of children in India are vaccinated, a number far below the World Health Organization’s target of 90 percent.

The necklace is called Khushi Baby (which means ‘happy baby’) and is a small plastic pendant on a black string. A computer chip in the pendant stores vaccination data as well as the mother’s health records.

The chip interfaces with a mobile app for community health workers. The health workers just need to tap the pendant to the back of a tablet, syncing the devices and storing the information in the chip. The Ministry of Health and other health agencies can then easily access the data.

Particularly for families that live far from cities, getting access to vaccinations can be difficult. Rural areas have fewer clinics and parents are not always aware of when or why their child might need a vaccination. “Many mothers don’t understand the importance of vaccines and choose not to take their children to immunization clinics,” says a statement on the Khushi Baby website.

With the help of the necklace, health workers no longer need to carry cumbersome records for every patient. Furthermore, the necklace allows health workers to see which vaccine the child needs and when. “Khushi Baby wants to ensure that all infants have access to informed and timely health care by owning a copy of their medical history,” said Ruchit Nagar, co-founder of Khushi Baby.

According to the BBC, Khushi Baby costs less than US$1 to make. Currently, there are around 1,500 children in the Khushi Baby system. Health workers plan to expand the program to include the 1 million people within Rajasthan’s health system.

Michelle Simon

Sources: BBC, Antara Foundation, CNN, Daily Mail
Photo: Antara

Healthcare in LesothoUNICEF and the German Agency for International Cooperation (GIZ) have announced that they will launch four pilot health centers in 2016. As a result, thousands of rural residents may be able to receive basic health care in Lesotho.

The health centers, called One Stop Shops, are an effort to bring HIV, malnutrition, blood pressure screenings, immunizations and infant checkups to the most remote areas of the country. Community members in mountain regions are currently unable to get these services without traveling to district capitals, which is a severe hardship that often deters them from seeking help at all.

“Without easy access to these service providers, they won’t go after these services,” said district council secretary for Maseru, Mamajara Lehloenya. “One wouldn’t take the initiative to go test your high blood pressure (hypertension) unless you are very sick.”

This is a serious problem in a country facing a number of national health burdens. The most recent reports from the World Health Organization indicate that the hypertension prevalence rate is more than 30 percent. HIV affects over 23 percent of the population. At the same time, Lesotho is experiencing an under-five mortality rate of 100/1000 children.

To remedy this lack of accessible health care in Lesotho, which is taking away lives, UNICEF and GIZ are bringing services to the most accessible level of government: community councils.

After the pilot phase is over, agencies hope that One Stop Shop will be a “reliable information hub” where community members can learn what services they can receive near home and how to receive them. One Stop Shop also aims to strengthen the referral network for more technical services offered in the capitals.

Social workers will also be included in the initiative in order to assist residents with government documents, including birth certificates and identification cards, as these are often necessary to receive help outside of local communities.

Empowering rural citizens of Lesotho to take charge of their health is critical to sustainably improving human and economic development in the country.

“By linking them to services that build their human capital – like health and education – a safety net of public assistance programs can help the poor rise out of long-term poverty,” said UNICEF Social Protection Consultant Betina Ramirez.

The efforts will complement those of the United Nations Development Program (UNDP), which has been working to build capacity in the country, especially in the agricultural sector. UNDP urges that, together, improving health and food security will be critical if Lesotho is to get back on track with the Millennium Development Goals.

Ron Minard

Sources: UNDP, UNICEF, WHO
Photo: Flickr

measles in developing countries
The measles vaccine has saved approximately 17.1 million lives since 2000, however, global targets to eradicate the disease are still off track according to Gavi, the Vaccine Alliance.

Notably, the World Health Organization (WHO) recently reported that while global measles vaccination coverage increased from 72 percent to 85 percent between 2000 and 2010, it has remained unchanged for the past 4 years.

Founded by the Bill and Melinda Gates Foundation, Gavi recently approved a new support package that aims to end measles in developing countries.

The organization’s new support package will help install a strong immunization routine with high coverage. The new Gavin Vaccine will also take advantage of children’s visits to health care facilities to increase the coverage rates of the vaccine.

Gavi will also support data-driven campaigns on measles and rubella to reach children not protected by immunization. These campaigns will be synchronized with other immunization activities to better reach children in isolated communities.

In developing countries measles vaccination involves a series of strategies and large-scale campaigns which rely on the support of the Measles & Rubella Initiative (M&RI).

In 2014, campaigns and immunization activities reached 221 million children. In the African Region, cases of measles dropped from over 171,000 in 2013 to under 74,000 in 2014.

This new support package also requires developing countries to have a five-year rolling measles and rubella plan, together with their long-term routine immunization plans, all of which will be updated annually.

“Countries cannot begin to hope to eliminate measles until they get epidemics under control,” said Dagfinn Høybråten, Chair of the Gavi Board, “The package of support we have agreed on today will save lives and give developing countries a golden opportunity to reform how they protect their children against measles.”

Marie Helene Ngom

Sources: Gavi, WHO
Photo: Flickr

global_immunization_target
Great news from the world of life-saving vaccinations! According to UNICEF and the World Health Organization (WHO), the number of countries with 90 percent coverage of children receiving routine life-saving vaccinations has doubled between 2000 and 2014.

In 2012, 194 WHO Member States endorsed the Global Vaccine Action Plan (GVAP) and committed to delivering vital vaccinations, with the goal of 90 percent diphtheria-tetanus-pertussis (DTP3) vaccination coverage in all countries by 2015. GVAP sought to prevent millions of deaths by 2020 by expanding the access of vaccines. The plan resulted from DoV collaboration, which brought together development, health and immunization experts and stakeholders. It was also made possible with the leadership of organizations such as the Bill & Melinda Gates Foundation and with partnerships in all levels of government, across various segments of society.

The global immunization target has seen an incredible push forward, with 90 percent of children receiving the required three doses of DTP3 vaccines, in 129 countries as of 2014. Currently, DTP3 immunization coverage stands at 86 percent for all 3 doses, and at 91 percent for infants receiving at least one dose. This is a great improvement from 2000, when 21 million children did not receive the first dose of DTP3, which is now up to 12 million.

Another great improvement is India’s current immunization rate. India has the largest number of unvaccinated children and is now at 80 percent of DTP3 coverage. According to the WHO, India is one of the three countries where almost half of the world’s unvaccinated children live. The other two countries are Indonesia and Nigeria.

Improvements in meeting other immunization targets have been made. Hepatitis B, which is common in East Asia and sub-Saharan Africa, has seen an increase in vaccinations from 2000 to 2014, from 30 percent receiving 3 doses to 82 percent. The number of children protected from Hepatitis B is high and increasing.

Another improvement in meeting immunizations targets have occurred with the rotavirus, which is the most common cause of severe diarrhea in children and infants, and is widespread in developing and under-developed countries in East Asia and sub-Saharan Africa. More countries are using vaccines against the rotavirus and pneumococcal conjugate vaccine.

Despite these incredible improvements, there is still more room for improvement. According to the WHO, 65 countries need to improve their strategies for meeting the GVAP goal. These include six countries with less than 50 percent coverage with DTP3: Central African Republic, Chad, Equatorial Guinea, Somalia, South Sudan and the Syrian Arab Republic.

We’re on the right path to meeting the global immunization targets considering it has doubled, we just need to develop better strategies to speed up the process to make sure we can get to 100 percent of all children receiving routine life-saving vaccinations.

Paula Acevedo

Sources: International Business Times, World Health Organization
Photo: International Business Times

Measles
The Nuba Mountains in Sudan were once seen as a sanctuary but because of their remoteness and ongoing military struggle in the area, the largest measles crisis in years is currently sweeping across Sudan. Due to the power struggle between the government and rebels, children have been denied access to immunization.

The measles virus is spread by respiratory transmission and is highly contagious. Up to 90 percent of people without immunity who are sharing a house with an infected person will catch it.

According to UNICEF, Sudan has already seen 2,700 cases of measles this year. “Of these roughly one in 10 will die. The fear now is that, with around 150,000 children under 5 in the Nuba Mountains who have had no reliable access to immunization since 2011, the situation could explode.”

Without immunization, there is a real potential that more lives will be lost to measles than to the recent Ebola outbreak in West Africa. However in this case, the majority of lives lost will be children.

Sudan’s recent outbreak of measles is not caused by lack of immunization efforts. In April 2015, UNICEF launched an immunization campaign to first vaccinate children in the highest risk states, and then expanding into other areas identified to be at risk.

Geert Cappelaere, UNICEF Representative in Sudan said, “Measles is a life threatening disease but on that can easily be prevented with timely immunization. Every girl and boy must be reached no matter where they live. There are no excuses and no child can be left out.”

Children are the most at risk for contracting measles; children who are malnourished are even more vulnerable. For malnourished children, measles can cause serious health complications including blindness, ear infections, pneumonia, and severe diarrhea.

“In Sudan, some 36 percent of children are stunted and the country has one of the highest levels of malnutrition in Africa. Of the total number of reported measles cases in Sudan 69 percent are below 15 years of age, including 52 percent under the age of five.” A large portion of the children in Sudan is at risk to contract measles.
With the dispute over border territory around the South Kordofan region, the region has struggled to see vital humanitarian aid that is a crucial lifeline. Since 2011, the region has not seen food and medical supplies.

For the partners of Gavi, the Vaccine Alliance, there are few options left to deliver the much-needed vaccines. UNICEF and the World Health Organization have put their support behind the efforts of the Ministry of Health.

Another option is to try to get vaccines delivered by partner organizations that are still working in the area. These organizations include Doctors Without Borders and faith based organization such as Caritas. However, these organizations are not given immunity and vaccines cannot be promised to be delivered.

In light of this situation, it is also a learning opportunity. Governments must be more proactive about not just responding to humanitarian disasters but by also preventing them. The warning signs need to be recognized. “After all, for any country to have a future it must protect its children.”

Kerri Szulak

Sources: CNN, UNICEF
Photo: Flickr