Cancer-Related Deaths in InfantsOut of the 7 million cancer-related deaths worldwide, 5 million occur in low and middle-income countries (LMCs), according to a National Library of Medicine study. Cancer accounts for 10% of the yearly death toll in LMCs. Yet, it is not acknowledged as a grave threat because diseases such as AIDS, Malaria and other infectious diseases run rampant in these countries and pull the focus away from the crucial problem of cancer-related deaths in infants.

Communicable and Non-Communicable Diseases

Due to an increase in awareness of diseases, especially in infants, there have been significant strides in the development of vaccinations against childhood infections. Other initiatives have helped provide antibiotics to fight bacterial infections in LMCs, and with heightened awareness, the general cleanliness of places of residence has also improved in many areas. All these factors have lowered the infant mortality rate from infectious childhood diseases, but in turn, have increased the mortality rate for cancer and cardiovascular-related deaths in infants.

LMCs Lead in Cancer-Related Deaths

According to The Cancer Atlas, “The childhood cancer burden is strongly related to the level of development.” Better-developed countries have lower cancer-related deaths in infants. According to a dataset that measured the frequency by which infants undergo cancer tests, North America ranked highest at 97.2%, while Asia and Africa scored 6.3% and 5.3% respectively. Unfortunately, this factor contributes greatly to the growing threat of cancer in Africa.

The Lancet Global Health conducted a study on cancer mortality in LMCs and found that sub-Saharan African countries are the most vulnerable to cancer-related deaths in infants. The study also revealed the following:

  • “Significant associations between childhood cancer mortality and numbers of hospital beds per capita, external beam radiotherapy units, nuclear medicine physicians, pathology services and transplantation services.” Most of these resources and facilities were not sufficient in most places.

  • An increase in resources and money led to an increase in diagnosis and treatment as well.

  • Other factors such as maternal education and lowered health care costs also boosted the frequency of cancer diagnosis and treatment in infants.

Poverty and a lack of education and some of the leading factors that contribute to the increasing ‘cancer burden’ in LMCs. Focusing on educating individuals and alleviating poverty, along with providing access to medical facilities is a crucial step toward increasing successful diagnosis and treatment of cancer in infants.

Cancer Preventions

Between 30% and 50% of cancers are preventable by avoiding risk factors such as tobacco, ultraviolet radiation and pollution, according to the World Health Organization (WHO). Additionally, 1 million cases of cancer are preventable through vaccination against HPV and Hepatitis B. Early diagnosis, before the cancer spreads, is essential to the treatment process according to WHO. “In [the] absence of early diagnosis, patients get their diagnoses at late stages when curative treatment may no longer be an option.”

Advanced Initiatives

Among initiatives that aim to improve the frequency of testing in LMCs and for the overall benefit of patients, are the following:

  • Specialized medical training: Providing specialized medical training and increased resources can improve patient outlook, as cancers such as leukemia and lymphoma in children have a high cure rate with effective treatment.

  • Palliative care: This is a treatment that focuses on relieving symptoms of cancer. It is an imperative aspect of cancer-related treatments. Palliative care serves to reduce the suffering of cancer patients and improve their quality of life. Due to the low diagnosis rate in sub-Saharan Africa, many individuals get their cancer diagnosis when curative treatments are no longer viable, and have to rely solely on palliative care.

These advanced initiatives are carried out by WHO, along with the Agency for Research on Cancer (IARC) and other U.N. Organizations under the banner of ‘the U.N. Interagency Task Force on the Prevention and Control of Non-communicable Diseases.’

This task force aims to reduce premature mortality from cancer and other non-communicable diseases by 25%. It was established in 2013 by the U.N. Secretary-General and over 40 U.N. agencies, encompassing developmental banks and intergovernmental agencies, are a part of it. The task force provides direct medical aid to LMCs by mobilizing resources to inaccessible areas. It also advocates for the necessary global governmental aid required to fight cancer and other non-communicable diseases.

Looking Ahead

Through various avenues such as monitoring the global “cancer burden,” conducting detailed research on causes of cancer and providing technical assistance in LMCs, WHO and the U.N. hopes to significantly reduce cancer-related deaths in infants. Success in this endeavor will help many more children enjoy good health and long life.

– Vahisté Sinor
Photo: Flickr

Mental Health and PovertyAwareness around mental health is increasing globally, not least as depression ranks third in the global burden of disease, with predictions that it will take the lead in 2030. However, in some parts of the world, poverty rates can be two times higher among those with mental health disorders than among those without disabilities. It is crucial to realize the strong relationship between mental health and poverty in order to better tackle both problems. Here are 10 facts about the link between mental health and poverty that everyone should know.

10 Facts About the Link Between Mental Health and Poverty

  1. Poverty can cause poor mental health. Poverty can increase the likelihood of mental health diseases and therefore is a causal factor. An example of this in action is that higher stress levels due to poverty-related issues can trigger depression.
  2. Poverty can be a consequence of poor mental health. One of the main factors includes an inhibited ability to work leading to unemployment through reduced productivity. Meanwhile, another factor is poor mental health because those afflicted may experience increased health expenditure leading to a lower socioeconomic standing.
  3. Mental health disorders are more prevalent in low- and middle-income countries (LMICs). More than 13% of the world’s burden of disease comes from mental disorders such as depression, anxiety and schizophrenia. From this, nearly three-quarters of this burden exists in LMICs. Yet, in places such as Ghana and Ethiopia, fewer than 10% of those suffering from a mental health condition receive treatment. Overall, in Africa, government expenditure on mental health is only $0.10 per capita.
  4. Growing up in poverty at home seriously impacts cognitive development. Scientific studies have inextricably linked mental health and poverty, showing that experiencing childhood in circumstances of poverty has damaging effects on mental development. Growing up in a stressful environment like poverty can lead to the body producing short-term coping strategies which can lead to long-term health issues such as increased susceptibility to certain cancers. Researchers have also scientifically proven that childhood poverty leads to diminished cognitive performance, as children raised in these environments consistently show lower cognitive performances, especially in language functions and abilities such as memory, planning and decision-making. This continues a vicious cycle of generational poverty.
  5. Stressful life events have a close association with poor mental health and worsening poverty. These events might include violence and crime. Discrimination also acts as a barrier to opportunities and causes poorer mental health as well as a decreased ability to perform. In South Africa, a history of violence, exclusion and racial discrimination have strong links to their high statistics of mental disorders, with 16.5% of the population reporting suffering at least one in 2007.
  6. The preoccupation with scarcity in poverty leads to lower cognitive capacity. When someone is occupied mentally with issues of scarcity, such as money or where their next meal is coming from, this uses up a lot of mental capacity. A study occurred in India proving the effects of scarcity on mental power and performance. Researchers tested more than 460 sugarcane farmers’ cognitive function before their annual harvest, when the farmers were poorer, and after. The results showed a decreased mental capacity of 10 IQ points pre-harvest, the equivalent to a whole night’s sleep. This proves that scarcity due to poverty heavily affects mental capacity and can leave little energy to dedicate to work which can lead to poor performance and unemployment. Equally, if someone is already unemployed, it means little mental capacity remains for seeking ways out of poverty, such as pursuing job training or further education.
  7. The stigma around those living in poverty provokes poorer mental health in this population and continued poverty. Many in the world have the perception that people in poverty are lazy. This stigma decreases the general population’s willingness to help those in poverty. It also affects the latter’s view of themselves as it significantly impacts people’s mental well-being through exclusion, isolation, feelings of helplessness and lower confidence. This can further decrease educational and professional attainment where it may already be lower due to impacted childhood development and decreased mental capacity.
  8. The economic burden of poor mental health is vast. Although mental health is categorically not an economic problem, it does heavily impact the global economy to a shocking extent. Globally, the cost of lost productivity due to depression and anxiety disorders is $1.5 trillion a year. This equates to 4.7 billion days of lost productivity. As well as this decreasing amount of money for the economy, a higher rate of mental health problems requires increasingly more health expenditure, further lessening the economic power of a country.
  9. Poor mental health poses serious problems for LMICs’ development. As well as inhibiting economic productivity, poor mental health also weakens immunity. Therefore, sufferers are more likely to become infected with HIV and malaria treatments are less effective, posing significant problems for national and global health goals. Yet, a decent investment in mental health programs and treatment brings back significant gains. A study in Ghana showed that for every dollar invested in depression and anxiety treatment over a 10-year period, society would respectively receive $7.40 and $4.90. Meanwhile, a lack of investment makes development goals much harder, if not impossible, to achieve.

Concluding Thoughts

The link between mental health and poverty is clear, and therefore the creation of dual poverty-alleviation and mental health programs will lead to increased health and economic prosperity for all.

– Hope Browne
Photo: Unsplash

HIV Treatment
In September of 2017, it was announced at the seventy-second U.N. General Assembly that the HIV treatment regimen TLD (tenofovir disoproxil fumarate, lamivudine and dolutegravir) has been made more accessible to low and middle income countries. This has been accomplished with a price agreement established through the partnership of various countries and global aid programs.

Some of the groups that collaborated on the new price agreement include UNAIDS, the Clinton Health Access Initiative (CHAI), PEPFAR, USAID, the World Health Organization (WHO), the Bill and Melinda Gates Foundation and the governments of South Africa and Kenya. Teams in many countries have begun developing plans to transition TLD into use by the end of 2019. Over 50 low or middle income countries have already introduced or are planning to introduce TLD as the favored first-line treatment for HIV.

Improvements to TLD

TLD medication is already considered a preferred method of HIV treatment in the United States. However, with the use of a generic treatment and a pricing agreement, TLD is now expected to cost health programs in low to middle income countries covered by the agreement only $75 per person per year once the treatment has been fully transitioned into use.

The newly released TLD is a generic treatment consisting of a single pill taken once a day containing a dolutegravir base. Studies have shown that the TLD regimen has fewer side effects on the patient and also has less vulnerability to the development of drug resistance that would render it ineffective. This helps because it means that fewer people would have to start new levels of treatment. TLD has also been shown to provide a more rapid repression of viral load.

Effects of New HIV Treatment

Three countries that began using the TLD treatment by the end of 2017 include Brazil, Botswana and Kenya. Within three months of treatment, studies show that 81 percent of patients using TLD in Brazil had an undetectable viral load, as compared to another HIV treatment regimen with an EFV (efavirenz) base, which had 61 percent presenting with an undetectable viral load after three months of treatment. Botswana and Kenya have shown similar success, with 90 percent of those using the treatment reaching full viral suppression in 2018.

In 2016, only 53 percent of people infected with the HIV virus were receiving treatment. Under the licensing agreement that sets a maximum price on the dolutegravir-based medication, 92 low to middle income countries will be able to provide the treatment to their citizens. These countries represent 90 percent of the people living with HIV in low to middle income countries. The TLD pricing agreement will not only be able to reduce the cost of treatment for the people in these countries but will increase availability so that more people can be treated.

A Brighter, Healthier Future

The launch of this new TLD treatment is another step forward in the treatment of people suffering globally from HIV and AIDS. People who did not originally have access to the dolutegravir treatment due to cost and availability will now be able to use this treatment. TLD provides a more reliable treatment regimen that will improve many people’s lives and ultimately bring the world a little further in the fight against HIV.

– Lindabeth Doby
Photo: Flickr