Information and stories about issuers with malaria.

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Efforts for Improving Health Care in Nigeria

Health Care in NigeriaNigerians have faced a growing crisis in health care access in recent years. Nigeria has a population of more than 200 million people, marking it as one of the most populated countries in 2024. The country has a diverse group of people, cultures and languages. Although the country has a huge potential for widespread affluence due to its oil and natural resources, its systems are lacking in meeting the needs of all its citizens. For its health care system, as of 2023, Nigeria was ranked 157th out of 167 countries. Improvement within the system is essential for the well-being of the Nigerian people to be guaranteed.

Malaria

Malaria is a life-threatening disease found in primarily tropical countries and is transmitted to humans by mosquitoes. In 2021, approximately 619,000 people died from malaria, with more than half of all malaria deaths worldwide occurring in four African countries. Nigeria’s health indicators are some of the worst in Africa. Nigeria continues to undertake the highest level of malaria cases globally, which is the leading cause of child illness and death. Professor Olubenga A. Mokuolu oversees all malaria work in the country.

In an interview, he gave one reason for Nigeria’s high malaria burden: the country’s environmental management. “In terms of environmental management, Nigeria leaves a lot to be desired. The country has open refuse sites and blocked drainage systems and because people lack piped water, they store water at home in containers. These all provide ideal sites for mosquitoes to breed.” While the number of malaria cases has gone down in recent years, they are not at a level where people can fully be at ease.

Lack of Access

Health care access in Nigeria is very limited due to factors within the health system. The Nigerian primary health care (PHC) system is the lowest level and entry point for Nigerians to receive health care services such as visitations, preventative, curative and rehabilitative services. Although initially, the PHC system was seen as a guiding policy for further health improvements, there were many flaws with its enactment.

Vivien O. Abah, a Nigerian health care researcher, stated that “The PHC system was deployed to the grassroots, but geographical access did not translate to access to health care as the populations did not utilize the majority (80%) of these facilities.” Not only was the lack of geographical access difficult but the quality of care in these primary health facilities was proven difficult for some as well.

What Is Being Done

The Nigerian health care industry has faced serious setbacks in recent years due to a lack of funding, as well as the mismanagement of creating accessible quality care for the population. This does not mean that the country has given up, as there have been various measures taken into consideration to improve the system.

In 2018, the government approved the second National Strategic Health Development Plan (SHDP), which sought to ensure all Nigerians have access to health care in the country, with a focus on preventing the trend of citizens traveling abroad for medical care. The Former President of Nigeria, Muhammadu Buhari, said that the SHDP will be a transparent and accountable mechanism implemented to ensure the health of all citizens and to forbid corruption from affecting funding.

The government has also focused on individual epidemics and issues that have affected Nigerians, as its preventative measures for malaria have saved tens of thousands of lives, most of them children. The country’s health care system provides more than 25 million children aged less than 5 with preventive chemotherapy for malaria, which has considerably reduced the children’s mortality rates.

Improving Health

Improvement of the Nigerian health care system will be a long and arduous process. and its efficiency highly depends on whether or not the government prioritizes high-quality care and population outcomes. In the past, people have had tremendous trouble seeking high-quality care, with some having to leave the country to receive treatment.

Health care in Nigeria has undergone significant changes and is moving in the right direction, but there is still progress to be made. With a growing population in a country known for diseases and limited medical access, the health care system cannot currently guarantee treatment for all its citizens. 

– Oliver Martin

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

Photo: Pixabay

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The Fight Against Mosquito-Borne Diseases

The Fight Against Mosquito-Borne Diseases Mosquitoes play dual roles in ecosystems worldwide as major pollinators and a key food source. They also spread life-threatening diseases such as Malaria, Zika Virus and Dengue Fever, making them the world’s deadliest organism. Mosquitoes cause between 750,000 to 1,000,000 deaths annually and cost the global economy more than $12 billion each year. Despite the impact of mosquito-borne diseases, particularly in low to middle-income countries, mosquitoes remain ecologically important. As a result, scientists are striving to develop creative solutions that prevent, reduce and eradicate these diseases without disrupting natural ecosystems.

Innovative Genetic Solutions

Given the current technology, implementing preventative measures to reduce the spread of mosquito-borne diseases has become a priority. Indeed, scientists are searching for more effective and widespread solutions to decrease the population of disease-spreading mosquitoes. One promising approach focuses on genetically modifying mosquitoes to reduce their population.

This strategy involves releasing mosquitoes carrying a “self-limiting gene” that causes female offspring to die before reaching adulthood. By targeting specific mosquito species known to spread diseases, this approach aims to break the transmission cycle. The Centers for Disease Control and Prevention (CDC) states that this method is reversible; ceasing the release of these genetically modified mosquitoes would allow the population to return to normal levels. Controlling the reproduction of disease-spreading mosquitoes, particularly biting females, could potentially prevent deadly disease outbreaks.

Oxitec’s Pioneering Role in Mosquito Population Control

Oxitec, a U.K.-based biotech company, leads the efforts in genetically modified mosquito (GMM) projects. While their stated aim is to help combat the spread of malaria in Eastern Africa and Central and South America, their broader focus includes decreasing the incidence of all mosquito-borne and vector-borne diseases. Oxitec specifically targets three critical mosquito species: Anopheles stephensi, an invasive species originally from Asia now detected in seven African countries, Anopheles albimanus and Aedes aegypti, native to South America.

Brazil’s Fight Against Dengue

Between 2021 and 2022, Brazil experienced a 400% increase in deaths caused by Dengue. In response, the country has ramped up projects to combat mosquito-borne diseases. Despite these ongoing efforts, Brazil is currently grappling with a Dengue Fever outbreak, with confirmed cases surpassing 5 million. Oxitec has initiated the deployment of ‘just-add-water friendly’ genetically modified mosquitoes (GMMs) into the local mosquito populations to help curb this epidemic. Reports indicate that in areas where these interventions have occurred, populations of Aedes aegypti mosquitoes have been nearly halved. Authorities are aiming for an overall reduction of 20% to mitigate the current state of emergency affecting many regions, including the state of Rio de Janeiro.

Panama’s Use of GMMs

Panama first utilized GMMs in 2014 through a partnership between Oxitec and the Gorgas Institute in Panama City, aiming to decrease the Aedes aegypti population to reduce Dengue transmission. More recently, Panama has been confronting a new Malaria epidemic, with cases in rural communities surging by 65% in 2023. The rise in cases is primarily attributed to an increase in the population of the invasive mosquito Anopheles albimanus. This situation has renewed collaboration between Panama and Oxitec, leading to the release of genetically modified ‘friendly’ Anopheles albimanus mosquitoes intended to diminish the number of this malaria-spreading species.

GMMs in Djibouti

Anopheles stephensi, a mosquito known for transmitting Malaria in South Asia and the Middle East, was confirmed in 2012 to have crossed the Red Sea into the Horn of Africa. Since then, it has been found in seven African countries and is suspected in four others. Djibouti, which nearly eradicated Malaria in 2012 with fewer than 100 confirmed cases, saw cases skyrocket to more than 70,000 by 2020. In May 2024, Djibouti became the first East African country to deploy genetically modified mosquitoes (GMMs) to combat the rising tide of Malaria.

Looking Ahead

Innovative solutions such as deploying genetically modified mosquitoes present promising methods for controlling mosquito populations and reducing disease transmission without disrupting ecological balance. Countries like Brazil, Panama and Djibouti are already implementing these advanced techniques, underscoring the critical need to continue investing in and developing effective strategies to combat mosquito-borne illnesses globally.

– Philip Mundy

Philip Mundy is based in Bristol, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Fighting the New Spike Of Malaria in the Philippines

Malaria in the PhilippinesThe Philippines is familiar with the problem of malaria. In 1970, the country’s malaria morbidity rate per 100,000 people was nearly 80%. The mosquitoes that transmit the parasitic disease extend all across the nation. With the devastation that the Philippines faced, its government became very committed to limiting and reducing the damage caused by the disease.

Success in Malaria Reduction

One of the many ways the Philippines fought malaria was through an increase in surveillance systems, working toward finding specific malaria outbreaks to target with boosted treatments. The government’s actions were extremely successful. In 2005, the Philippines achieved a reduction rate of 92% in cases and a decrease in the malaria mortality rate by 98%. Additionally, around 60.9% of the country’s provinces were officially declared malaria-free in 2018.

Leveraging Digital Technology

By employing new digital technology, specifically its Online Malaria Information System, the Philippines is able to catalog, process and distribute information on malaria outbreaks. This allows for speedy treatment and prediction of future outbreaks by monitoring reports made by locals. This system is available to everyone on Android, so it is very accessible to the Filipino people.

Current Challenges and Advanced Strategies

Due to significant humanitarian aid and government infrastructure expansion, the Philippines experienced a general decline in malaria cases. However, in 2023, the country saw a sharp increase in cases, about 6,248, nearly doubling from the previous year, which was 3,245. Many health professionals attribute this rise to the relaxation of restrictions in the post-COVID-19 world. Nonetheless, new health centers are now focused on eliminating and preventing the spread of malaria.

Filipino health centers collect data on patients and the environment to monitor potential malaria outbreaks. Quick identification leads to quick treatment and with sufficient treatment, the Philippines aims to be entirely malaria-free by 2030. The approach is more complex than merely distributing surveys or looking for common symptoms.

The health centers are exploring advanced diagnostic and geographical mapping tools, improved surveillance technology and the identification of less common and often overlooked symptoms of malaria. With better diagnostic tools, medical professionals can assess patients more quickly and determine which strain of malaria is affecting them, enabling faster and more effective treatment.

The geographical mapping tools allow people to monitor the spread of outbreaks, see where the infected mosquitoes are moving and act proactively against the disease. As the World Health Organization (WHO) advises, surveillance is one of the best ways to prevent and combat malaria, so the Philippines is looking to improve its preexisting system to fight this current wave of malaria.

Conclusion

Malaria is one of the most notorious and dangerous diseases and humanity has been fighting it for decades. The Philippines, in particular, has a long and difficult history with malaria but has developed effective systems to combat it. The Filipinos’ active efforts to reduce malaria in their country offer hope for a malaria-free world, evidenced by the 72 provinces that are now officially malaria-free.

Another promising development in the fight against recent malaria outbreaks is the emergence of new vaccines that provide immunity against various strains of the life-threatening disease. With a vaccine in the works and new health centers being established, the Philippines is optimistic about seeing a reduction in malaria cases soon.

– Paige Tamasi

Paige is based in Los Gatos, CA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Unsplash

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Efforts and Successes in Combating Disease in Sri Lanka

Disease in Sri LankaSri Lanka, the neighboring island nation to India in South Asia, is a developing country making many efforts to increase its standard of living. One of these central efforts is the fight against disease and illness, which Sri Lanka has reduced with great success. Malaria, Leprosy and noncommunicable diseases (NCDs) have been reduced or eliminated from the country.

The Efforts

Disease in Sri Lanka comes in two forms: communicable diseases and NCDs. Considering the side of communicable diseases, Sri Lanka has taken great strides to reduce two of the most prevalent diseases within the nation: Malaria and Leprosy.

The Anti-Malaria Campaign (AMC) has taken on malaria and its prevalence within the region in full force. This initiative, supported by country collaborations, technical leadership and financial investments from the World Health Organization (WHO) and the Global Health Fund, has supplemented a national budget dedicated to the fight against malaria.

Leprosy shares a similar story. Successful campaigns and efforts against the disease caused Sri Lanka to experience a considerable decline in the prevalence of leprosy in the years following 1983, with the introduction of multidrug therapy (MDT) by the WHO.

However, communicable diseases in Sri Lanka were only responsible for 14,265 deaths in the year 2019. In contrast, NCDs such as heart disease and diabetes were responsible for the deaths of 96,072 people in the same year.

Public Health in Sri Lanka

Public health in Sri Lanka relies not only on funding from the WHO and the Global Health Fund but also on grassroots efforts to educate the public about the dangers of a sedentary lifestyle. Managing NCDs requires a preventive care approach, leading to a reorganization of the country’s health care system through the globally funded Primary Health care System Strengthening Project (PSSP). This project aims to support the government in enhancing the utilization and quality of health care, with a primary focus on the detection and prevention of NCDs.

The Successes

Since the turn of the century, Sri Lanka has made excellent progress in reducing the prevalence of malaria—the total number of cases in Sri Lanka was reduced by 78%, from 22.9 million to 5 million. The budget from the Global Health Fund and the WHO supplemented the efforts to successfully eradicate malaria as a common disease in Sri Lanka.

Leprosy has also wavered greatly in recent years. Assisted by the creation of MDT by the WHO, the country achieved a WHO elimination goal of leprosy cases, yielding less than one for every 10,000 people in the population by the turn of the 21st Century. The formative research provided by outside organizations, along with the campaign’s efforts to increase social awareness about the disease and its communicability, successfully reduced the rate of Leprosy.

NCDs are also being addressed, however, in a drastically different manner than that of communicable diseases. The people in Sri Lanka have been informed of the dangers of communicable diseases yet are ill-informed of the dangers of a sedentary lifestyle and how being proactive is healthy for the body. This is being curbed through efforts established by the PSSP and its association with Primary Medical Care Institutions (PMCI).

Primary Medical Care Institutions

According to the World Bank, curative primary health care services in Sri Lanka are delivered mainly through PMCI. This includes district-level hospitals and Primary Medical Care Units situated around the nation. In March 2022, about 350 of the 1,030 PMCI in Sri Lanka were strengthened under the PSSP initiative. However, by the end of the project in 2023, this number reached a minimum of 550.

The lack of information regarding the dangers of a sedentary lifestyle is slowly being overturned through an increasingly active information campaign. Alongside this are initiatives to raise awareness of the importance of daily exercise and how a proper diet is beneficial to overall health. These efforts by the PSSP are effectively paving a path toward a healthier nation.

Final Remark

Sri Lanka has yet to eradicate diseases completely. Even with the successful efforts to combat malaria and leprosy, there is still a great risk of their return. Diseases are always on the cusp of coming back. However, with the continued dedication of organizations around the world and commitment from the leadership of Sri Lanka, it will always be at the forefront.

– Luke Scroggins

Luke is based in Dallas, TX, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Breakthroughs in Malaria Treatment and Global Advocacy

Breakthroughs in Malaria Treatment and Global AdvocacyIn 2022, more than 40% of countries experienced malaria outbreaks, resulting in approximately 249 million infections. Although malaria is preventable and curable, the most severe cases occur in regions with fragile health care systems, primarily in the developing world’s poorest countries. Malaria treatment is crucial in these areas, where the disease is both a cause and effect of poverty.

Malaria’s Impact and Transmission

Malaria, a deadly parasite, spreads through specific mosquito species and not directly from person to person, except through contaminated needles or blood transfusions. This disease can cause severe illness and death within just 24 hours of infection. In 2020, malaria claimed more lives in Africa than COVID-19, with four countries alone contributing to 50% of the global malaria death toll. Tragically, in Africa, 80% of malaria fatalities among children occur before their fifth birthday. An estimated 40 million children in the region could benefit from a malaria vaccine.

Celebrity Advocacy: David Beckham’s Role

David Beckham, an iconic English football star, achieved fame playing under Sir Alex Ferguson at Manchester United, where he contributed to winning six Premier League titles. Since retiring, Beckham has leveraged his status to advocate for various causes. As a UNICEF Goodwill Ambassador since 2005, he supports the #TogetherBand Campaign and has long championed the fight against malaria. He has backed Malaria No More UK since 2009 and was the face of the world’s first voice petition to end malaria with MalariaMustDie in 2019.

Advances in Malaria Treatment

Scientists have actively pursued new malaria treatments and vaccines since the 1980s, achieving notable success with the RTS,S/AS01 (RTS,S) vaccine. Since 2019, this new treatment has been administered in Ghana, Kenya and Malawi, reaching more than two million people and reducing early childhood deaths from all causes by 13%. The vaccine primarily benefits children who lack other forms of malaria protection. An expanded rollout to 18 additional countries has been approved, although vaccine supplies remain limited.

In 2023, the successful introduction of the first malaria vaccine was followed by the launch of the R21/Matrix-M vaccine, which boasts a 75% efficacy rate, meeting a World Health Organization (WHO) target that the 2019 vaccine did not meet. Adrian Hill, the chief investigator for the R21/Matrix-M malaria vaccine, asserts that it represents the most effective single intervention against malaria due to its scalability and affordability, costing only $3.90 per dose.

Future Directions and Global Impact

Organizations such as Gavi, the Vaccine Alliance, are actively developing strategies to distribute this lifesaving vaccine. Their roadmap projects a need for up to 60 million doses by 2026 and 100 million doses annually by 2030. Their mission focuses on promoting the equitable and sustainable use of vaccines. They collaborate with major partners including the WHO, UNICEF, the World Bank and the Bill and Melinda Gates Foundation to save lives globally.

Looking Forward: Progress in Malaria Treatment

This new malaria treatment is crucial as previous methods have shown limitations. Mosquitoes carrying malaria have developed resistance to insecticides used to control their population and the parasite itself is increasingly resistant to current oral malaria drugs. In an interview with Nadine Dreyer and HealthWorld, Adrian Hill states that the fight against malaria is gaining momentum and he is aware of other vaccines in development. With ongoing innovations in vaccinations and the expansion of global distribution for existing treatments, there is a greater chance of achieving the Sustainable Development Goals by 2030, which the escalating threat from malaria could otherwise hinder.

– Rachael Denton-Snape

Rachael is based in High Wycombe, UK and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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Malaria in Cabo Verde

Cabo Verde Finally Eliminates MalariaIn January 2024, the World Health Organization (WHO) certified Cabo Verde as malaria-free, making it the third African nation to achieve this status. The elimination of malaria in Cabo Verde resulted from government initiatives and local community engagement. This accomplishment serves as a model for other countries prone to malaria.

Cabo Verde’s Malaria Statistics

Malaria, a potentially fatal illness, caused approximately 608,000 deaths and 249 million cases worldwide in 2022. Africa bore the brunt, with 580,000 (95%) of these fatalities and 233 million (94%) of the diagnoses. Additionally, 80% of malaria deaths among children under the age of 5 occur in Africa.

Cabo Verde comprises 10 small islands located beyond the West African coast and has more than 500,000 inhabitants. The country nearly eradicated malaria on two separate occasions, but neither was sustained. The first attempt involved residents using indoor spray to kill mosquitoes, which ceased in 1969. Consequently, malaria cases resurfaced on Santiago Island in 1973, leading to a nationwide outbreak in 1977. The second attempt in 1978 also aimed to eliminate malaria, resulting in significant case reductions by 1983, except on the Boa Vista and Santiago Islands.

The New Approach

In 2007, the Cabo Verde government enhanced its efforts to eliminate malaria by revising its health care policies. These changes aimed to increase the diagnosis rate, ensure the quick and efficient delivery of medicine and improve the supervision and recording of all malaria cases. In 2017, Cabo Verde was on track to eliminate malaria when an outbreak of 423 cases occurred. This outbreak prompted a change in strategy, leading to the reintroduction and reinforcement of indoor spraying and insecticidal nets, especially in areas most affected by malaria. Due to its successful efforts, the WHO declared Cabo Verde malaria-free on Jan. 12, 2024.

The country achieved this status by recording no malaria transmissions for more than three consecutive years and demonstrating the capability to prevent the re-establishment of transmission. With this achievement, Cabo Verde joined ranks of Mauritius and Algeria in being malaria-free. It is also became the 43rd country worldwide to receive this certification.

The Effect Of Malaria Elimination On Poverty

Infected individuals often participate less in the workforce due to illness, potentially reducing their earnings and pushing them into poverty. Additionally, the risk of malaria can deter investors from putting money into affected countries. This trend suggests that achieving malaria-free status may lead to positive outcomes for Cabo Verde.

Tourism is vital to Cabo Verde’s economy; before the COVID-19 pandemic, it contributed 24% to Cabo Verde’s GDP, accounted for 10% of employment and attracted most of the foreign capital. Cabo Verde’s malaria-free status may encourage more tourists from non-malaria-infected countries to visit without fear of contracting the disease or adhering to strict health precautions. This influx could boost the country’s revenue and increase personal incomes, helping to break the cycle of poverty.

Looking Ahead

Cabo Verde’s achievement as a malaria-free nation sets a precedent for public health success in Africa. Its commitment to maintaining this status could inspire similar strategies across other malaria-prone regions, enhancing global health security and economic stability.

– James McAlinden

James is based in Rosehearty, Scotland and focuses on Global Health for The Borgen Project.

Photo: Flickr

Addressing the Top Diseases Impacting Uganda

Diseases Impacting UgandaFor Uganda, a country in East Africa, health is a major concern. Uganda’s population of 47 million has always been heavily impacted by illness and disease, with communicable diseases accounting for over 50% of deaths in the country. Malaria, tuberculosis (TB) and HIV/AIDS are three of the top diseases impacting Uganda and are among the leading causes of death. 

Here is more information about these diseases, and what is being done about them.

Malaria

Malaria is a life-threatening disease spread through mosquitoes that feed on humans, with symptoms such as high fevers and shaking chills. As one of the top diseases impacting Uganda, it is a risk to over 90% of the Ugandan population and is a leading cause of sickness and death, especially in children. Uganda has the highest malaria incidence rate worldwide, with 478 cases per 1,000 people per year, and malaria is estimated to have caused between 70,000 and 100,000 deaths per year, exceeding even the death rate of HIV.

In Uganda’s Ntungamo District, one of the districts most heavily affected by malaria, people have taken action to combat its spread. Village Health Teams (VHT) have been trained by the Ministry of Health and UNICEF to support Ugandan communities in fighting against diseases and assisting health care workers in providing health services. The teams also educate communities on malaria prevention methods, such as insecticide-treated mosquito nets, and prescribe Coartem, an anti-malarial medication that destroys the malaria parasites, to those affected by malaria. The efforts of the VHT have resulted in a remarkable decline in malaria cases — from 8,297 cases in December 2022 to 3,995 cases in March 2023. 

Tuberculosis

TB is an infectious disease that mainly affects the lungs. It is caused by a type of bacteria and is spread through the air when TB-infected people cough. TB is a leading cause of death worldwide, and Uganda is one of the countries with the highest burden of TB. Every day, around 30 people die of TB, and 240 people fall sick with TB in Uganda. Uganda is designated by the World Health Organization to be a TB and HIV high-burden country, with over 12,000 deaths to TB every year, and around half of those deaths are among those who are HIV-positive. Children under 15 account for an estimated 12% of TB cases, with young children vulnerable to developing a more severe version of TB. 

Since 2015, the Ugandan government has made significant progress in improving the coverage of TB preventive treatment that targets those living with HIV, made available at no cost for TB patients. Scaling up the coverage of preventive treatment has resulted in nearly 600,000 people living with HIV initiating this treatment from 2015 to 2019, and from 2016 to 2022, TB preventive treatment coverage for people living with HIV increased from 0.6% to 88.8%. Over the years, Uganda has successfully scaled up the provision of TB preventive treatment to those living with HIV, and the government has pledged to end TB by 2030 by continuing to accelerate the delivery of TB treatments.

HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) is a condition caused by the human immunodeficiency virus (HIV). HIV attacks the human immune system, leaving it vulnerable to infection and disease. Around 1.4 million people in Uganda live with HIV, among whom women are disproportionately affected. About 17,000 people die per year due to AIDS, 22% of whom are children under the age of 15. 

The nonprofit organization mothers2mothers (m2m) contributes to the prevention of mother-to-child transmission of HIV and has virtually eliminated mother-to-child transmission of HIV among its clients. It supports mothers who live with HIV by helping pregnant women access antiretroviral treatment (ART). In 2021, m2m took in and improved the lives of over 150,000 new clients; among these clients, 100% of HIV-positive women have been given lifetime ART, and 100% of HIV-exposed infants have been treated with ART as protection from infection. m2m has also intervened to end child marriage in Uganda’s Kamuli District, protecting adolescent women who are more susceptible to getting infected and increasing access to HIV care. 

Looking Forward

The measures taken to combat some of the most deadly diseases impacting Uganda have led to a decrease in mortality rates over the years. With continued efforts from organizations like m2m and local communities, Uganda will continue to make strides in minimizing the impact of malaria, TB, HIV/AIDS and other diseases. 

– Stephanie Chan
Photo: Unsplash

Health Care in Comoros

Health Care in ComorosAs one of the poorest countries in the world, Comoros experiences numerous challenges. This is exacerbated by the country’s history of political instability and a devastating socioeconomic climate. Poor health care has both a dramatic effect on the lifespan of Comorians and on their quality of life.

Political Instability and Health Care

The nation has struggled with political unrest since its independence from France on July 6, 1975. Because of recent laws, the average duration of each government has not been longer than six months. These political fluctuations have caused a major toll on health care in Comoros. 

During these 41 years of political unrest, Comoros experienced 21 coups, causing a massive health care crisis among the islands. These turbulent years made it harder to implement institutions that provide medical care to all people no matter their socio-economic status. 

Health Care Workers

Often, very skilled medical workers choose to migrate out of Comoros. Additionally, ever since its independence, the islands have struggled to distribute health care workers evenly across the country. This demands imperative action in Comoros to increase health care workers and organize better health care distribution processes so all people in Comoros can access safe and effective health care.

Health Issues

A weak health care system leads to illnesses and disorders that go undiagnosed or untreated. In Comoros, the most common health issues include malaria, diarrhea, diabetes, intestinal parasites, respiratory infections and HIV/AIDS, which is less common but equally fatal. These diseases and illnesses left untreated cause significant deaths, most commonly in children and pregnant women. 

The revival of old diseases like cholera, chikungunya, malaria and HIV/AIDS points to the political turmoil playing a big role in the poor health services in Comoros. It isn’t just diseases that cause health issues in Comorians, however. Over the years, children have continued to die from chronic malnutrition, illustrating the adverse state of poverty the nation is in. 

What is the Problem?

The years of political instability in Comoros have had drastic effects on poverty and health care. As there is no national health insurance in Comoros, the average Comorian will pay 45% of the cost of a health visit out of pocket. This elite group highlights the economic disparities people face in Comoros. Due to the national poverty levels, 60% of health workers in public facilities are unpaid volunteers.

Help in Times of Hardship

Because of the urgent need for a change of health care in Comoros, in 2019, the World Bank approved the Comprehensive Approach to Health System Strengthening Project (COMPASS). It has invested $30 million into the improvement of primary health care in Comoros. Its goal is to prioritize delivering aid to women and children under the age of five as well as to the general population.

The World Bank continues to reinforce better health care in Comoros by providing more accessible and affordable services to the general public. The organization creates better health institutions, trains more workers and provides rehabilitation services to patients. The World Bank also has also given Comoros a large quantity of equipment and vehicles that help medical workers on the islands. The project hopes to deliver quality and time-efficient care to patients with disease and illness outbreaks in Comoros. 

Comoros Takes Action

In recent years, Comoros has fought to control malaria, and the nation is close to succeeding, currently in the pre-elimination phase. Furthermore, the Comoros government has worked to reduce health care costs by more than 40% since 2010. 

Moreover, the islands have adopted a new national health policy for the period of 2015-2024. This initiative aims to end the cycle of poverty keeping people from accessing the health care that they need in Comoros. By creating more accessible health care the country can help combat the rising amount of devastating diseases that create a huge toll on the population. 

– Marina Blatt
Photo: Flickr

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The First Malaria Vaccine

Malaria VaccineIn October 2021, the World Health Organization (WHO) recommended a vaccine for the prevention of malaria. This malaria vaccine, called the RTS,S, is the first and only the WHO has recommended for malaria prevention.

Devastating Impact

Malaria has a devastating impact on countries where the disease is common. In 2020, there were 241 million malaria cases and 627,000 malaria deaths. In Africa, where 82% of malaria cases occur, 80% of malaria deaths consist of children under 5. In addition to the high death toll, malaria causes an estimated loss of $12 billion every year in lost productivity.

Over the past several decades, improved preventative measures including mosquito nets, antimalarial medications and efforts to reduce mosquito habitats have helped to contribute to a decline in the prevalence of malaria. Since 2015, however, progress in efforts to combat malaria has slowed, according to WHO. Some countries with especially high malaria transmission rates have even experienced an increase in malaria cases. After a slump in progress in recent years, though, the success of the RTS,S vaccine offers a ray of hope.

The Vaccine

Due to the complexity of the parasite that causes malaria, this vaccine took more than 30 years to develop. Research on the RTS,S vaccine began in the 1990s with the first clinical trial on it published in 1997. However, several more decades of trials would pass before researchers proved the vaccine to be safe and effective against malaria in children.

Trials completed in 2015, which followed a schedule of three or four vaccines for children between 5 and 17 months of age, found the RTS,S vaccine to reduce malaria-related hospitalization by 37% in the first four years of vaccination.

Over the course of three years, the pilot program, which included trials in Ghana, Kenya and Malawi vaccinated more than 900,000 children. The pilot program confirmed that the vaccine, while not perfect, reduces the frequency of severe malaria infection and demonstrated that large-scale vaccine distribution is feasible, according to WHO.

Based on the findings of the trials, the WHO expects that vaccinating one child could save the lives of 200 of them, according to its report. The WHO estimates that, if widespread vaccination is achieved, the RTS,S vaccine could save the lives of 40,000 to 80,000 children every year. Following the success of the pilot program, the WHO officially recommended the use of the vaccine for areas with high to moderate malaria transmission in October 2021.

In April 2022, the WHO reached the milestone of having 1 million children in Malawi, Kenya and Ghana who have received at least one dose of the vaccine.

A Historic Breakthrough

After several years of stagnation, this malaria vaccine represents what Dr. Mary Hamel, a medical epidemiologist who works on malaria prevention, called “a historic breakthrough.” In addition to being the first vaccine to provide protection against malaria, the RTS,S vaccine is the first vaccine for the parasitic disease, meaning the development of this vaccine represents not only a breakthrough in malaria research but a breakthrough in the world of vaccine development.

Though the vaccine’s efficacy is modest, its success is a major breakthrough in a decades-long fight against a disease that kills hundreds of thousands of people every year. As the first WHO-recommended malaria vaccine, this vaccine has the potential to save tens of thousands of lives every year and serve as a stepping stone toward future innovations in the realm of malaria prevention.

– Anna Inghram
Photo: Flickr

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Formative Supervision Improves Healthcare in Angola 

Formative SupervisionWith a population of about 30 million, many Angolans do not have access to adequate healthcare. The limited access to quality healthcare is due to decreased funding due to the Angolan Government’s budget restrictions. The lack of funding affects the quality of public healthcare which people can receive at no cost. The public healthcare sector in Angola does not have enough healthcare providers with proper training and resources. The lack of resources in healthcare reflects in the low ratio of about one health center per 25,000 people and more than 50% of people are without access to healthcare services. In recent years, USAID’s Health for All project, using the Health Network Quality Improvement System (HNQIS), has implemented formative supervision in Angola. Implementing formative supervision in Angola has shown to improve the quality of healthcare by increasing the number of healthcare providers with proper training.

USAID’s Health for All Project

USAID’s Health for All program is a five-year project that began in 2017. It works with the Angolan Government to help improve the quality and access to healthcare in the country. The project’s focus is on addressing the issues of malaria and reproductive health since those are two of the main health concerns affecting the people of Angola. With the current funding being at $63 million, the program has been able to train 1,489 health professionals on how to diagnose and treat malaria and created reproductive health services in 42 health facilities.

The program’s use of formative supervision in Angola has helped in educating and providing healthcare workers with the necessary tools to effectively care for patients. The Health Network Quality Improvement System is the main tool that USAID uses to help improve the quality of healthcare because the system is used to evaluate the performance of individual healthcare providers. By tracking the performance of the healthcare providers in Angola, USAID can more easily determine which areas of the healthcare system need improvement. Under the Health for All program, USAID has been using formative supervision with healthcare providers who specifically tend to cases of malaria and reproductive health.

The Benefits of Formative Supervision

From October 2019 to March 2020, the Health for All project recorded improvements in the quality of healthcare through the use of formative supervision in 276 out of 360 Angolan health facilities with prenatal services. In addition to tracking the performance in maternal and reproductive health, the supervision has also helped in finding the areas in which the management of malaria has been lacking. There are now about 1,026 health providers that have been properly trained in managing malaria cases as a result of the project. This has in turn indirectly improved the quality of care regarding maternity since malaria causes 25% of maternal deaths in Angola.

Besides increasing the amount of funding that goes toward healthcare, the Health for All project has used such funding to be more interactive with healthcare facilities through the use of formative supervision in Angola. Formative supervision has shown to drastically improve the quality of care in the areas of malaria and reproductive health as supervision allows trained health officials to identify and fix integral issues pertaining to healthcare in Angola.

– Zahlea Martin
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