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Five Diseases That Thrive in Poor Sanitation
Around 4 billion people in the world lack access to basic sanitation facilities like toilets or latrines and nearly 900 million people still defecate in the open. In addition, USAID estimates that 2.1 billion people currently do not have access to safe drinking water. These dismal conditions pose serious health hazards to the men, women and children living in these communities. Without toilets and latrines to separate human waste from living conditions and water sources, bacteria and virus are easily spread through food, water and direct human contact with waste.

World Health Organization (WHO) estimates that 4 percent of all deaths worldwide are the result of waterborne diseases like diarrhea, cholera, dysentery, typhoid and polio that thrive in unimproved sanitation conditions. This might not sound like a high number, but when considering that these diseases can be relatively easily prevented with inexpensive sanitation and potable water solutions, this percentage sounds absurd. The following list of five waterborne diseases that thrive in poor sanitation provides a glimpse of what is at stake when communities are devoid of proper water, sanitation and hygiene infrastructure.

Five Waterborne Diseases that Thrive in Poor Sanitation

  1. Diarrhea causes approximately 480,000 childhood deaths each year. This condition is linked to several viruses, bacteria and protozoans and ultimately depletes a person of water and electrolytes which, for many without oral rehydration solution, leads to death. One of the most important factors in eliminating diarrheal deaths, next to proper sanitation facilities, is handwashing. Something so simple can save lives and stop the cycle of diarrhea.
  2. Cholera is not just a disease from the pages of a history book, it is currently endemic in 51 countries in the world. It is unknown precisely how many deaths are directly the result of this waterborne disease, but WHO estimates that cholera kills from 21,000 to 143, 000 on a yearly basis. Contact with waste from an infected individual either directly or through food and water perpetuates the cycle of infection at an alarming rate. Proper sanitation is currently the first line of defense needed to curb this disease.
  3. Dysentery can be caused by either bacteria or an amoeba and presents an infection of the intestines. Fortunately, dysentery is usually cleared up on its own without treatment. However, this disease can be easily spread throughout communities without a system to separate waste from food and water.
  4. From 11 to 20 million people are infected with typhoid fever every year, causing up to 161,000 deaths on yearly basis. Typhoid fever is a life-threatening infection caused by bacteria Salmonella Typhi through contaminated food or water and sometimes from direct contact with someone who is infected. Unlike many waterborne diseases, antibiotics and new vaccines can provide treatment and limited immunity. Yet, without proper water, sanitation and hygiene typhoid infection will persist and antibiotic-immune typhoid will spread which will make treatment of the disease more complicated.
  5. Polio transmission has significantly decreased over the past 30 years thanks to aggressive, worldwide immunization. Still, the threat of infection continues to spread as a direct result of poor sanitation. Poliovirus is spread when humans come into contact with the virus from human excreta or poliovirus that survives in the wild. Polio is close to being eradicated and providing sanitation to the areas where the disease persists is imperative if the world hopes to one-day be polio-free.

Strategies to Eradicate Waterborne Diseases

Efforts to control these five waterborne diseases that thrive in poor sanitation come from both government and international aid organizations. There is also a concerted effort to implement strategy and resources to address the need for clean water and sanitation.

On the strategy front, a 2013 call to action from the U.N. Deputy Secretary-General on sanitation that included the elimination of open defecation by 2025, the sixth Sustainable Development Goal that aims ensure clean water and sanitation for all as well as numerous global guidelines and action plans for water and waste management set forth by WHO, UNICEF and partners are paving the way for large-scale change.

Meanwhile, in terms of providing resources, some examples include USAID’s country-based programs between 2012 and 2017 that supplied potable water to 12.2 million people worldwide. Numerous companies are partnering with large development organizations to develop their own campaigns or are developing products like LifeStraw, Life Sack and PeePoople that provide immediate potable water and sanitation solutions to millions around the world. These examples, in addition to new vaccines, antibiotics and other disease-specific campaigns are working together to eliminate the threats posed by unimproved sanitation and to eradicate waterborne diseased that are taking the lives of millions of people across the globe.

– Sarah Fodero

Photo: Flickr

Vaccinations in Egypt
Vaccinations have been proven to be the most powerful and most cost-effective health intervention that can be provided to a population. Vaccinations have been proven to reduce disease, disabilities and deaths, especially in children under the age of five. The majority of unvaccinated children reside in low to middle-income countries where health systems are compromised, such as Egypt. Vaccinations in Egypt have proven incredibly successful, but the country still has a ways to go.

There are three main organizations that supply vaccinations to low-income countries. These are UNICEF, the Pan American Health Organization and the Gavi, the Vaccine Alliance. These organizations understand the impact vaccinations have on the eradication of disease.

Vaccinations in Egypt Have a Track Record of Success

Vaccinations have had a large impact on the health of children in Egypt. The vaccinations in Egypt that have been the most successful are poliomyelitis and neonatal tetanus. These vaccinations are responsible for nearly eradicating these diseases. The last case of polio was recorded in 2004, and by 2005, only 25 cases of neonatal tetanus were recorded.

Egypt established the National Immunization Program in the 1950s, and the first vaccinations introduced to the population were tuberculosis and diphtheria. Pertussis and tetanus vaccinations in Egypt became available in the 1960s. In 1977, the measles vaccination was introduced, followed by the measles, mumps, and rubella (MMR) combination in 1999.

However, better access to vaccinations in Egypt is critical. Measles and rubella were the most common diseases prior to vaccination programs in 1977, and even though it has been estimated that as of 1999, 95 percent of children were vaccinated with MMR, there were still major outbreaks of measles and rubella in Egypt between 2005 and 2007. Measles was considered endemic until 2008, when measles cases were estimated at less than one per every 100,000 people.

International Efforts to Increase Access to Vaccines in Egypt

Egypt has developed a strategy to increase access to vaccinations for the general population. The main organizations that coordinated and funded this plan are the Ministry of Health and Population, UNICEF and the World Health Organization. The plan is to increase access to vaccinations in Egypt in these ways:

  • Target 36 million children between the ages of two and 19
  • Maintain coverage of the vaccinations already supplied
  • Strengthen and increase school immunization programs
  • Obtain stronger disease surveillance
  • Improve social mobilization
  • Establish the Interagency Coordinating Committee

Egypt has put forth great effort to provide vaccinations to all of its children. However, there is still a substantial need for more vaccinations in Egypt.

There are nonprofit organizations that are working to improve this situation for Egypt and other countries in need. The Access to Medicine Foundation is motivating the pharmaceutical industry to aid low to middle-income countries such as Egypt. In 2008, the Access to Medicine Foundation published the first Access to Vaccines Index. This index acknowledges the pharmaceutical companies that are responding to the need for vaccination in low-income countries and highlights each company’s progress. There are many positive actions that are improving access to vaccinations in Egypt and other low-income countries. However, the need is still present and crucial.

– Kristen Hibbett
Photo: Flickr


The Gates Foundation, alongside government organizations from around the globe, is working hard to eliminate the polio virus. Rob Nabors, Director of the Gates Foundation, who oversees policy, advocacy, government relations and communications says he doesn’t think the general public realizes that, in the next two years, polio could be completely eradicated on a global scale.

The poliovirus is passed through contaminated feces and is spread as a result of poor hygiene and sanitation. It is responsible for millions of people becoming paralyzed before vaccines became widely available in the 1950s.

Since the launch of global eradication efforts in 1988, polio incidences across the globe have dropped more than 99 percent. The disease’s occurrence rate plunged to 233 recorded cases in 2012 and occurred in only three countries: Nigeria, Afghanistan and Pakistan. India, which was once considered to have the greatest challenge of eliminating polio, was declared free of the disease in February 2012.

According to the Centers for Disease Control and Prevention, four of the six regions of the World Health Organization have been certified polio-free. This includes the Americas in 1994, the Western Pacific in 2000, Europe in 2002 and Southeast Asia in 2014. This constitutes 80 percent of the world’s population currently living in polio-free areas.

Nabors and the rest of the Gates Foundation work hard to educate nations around the globe on the impact of their help. The organization believes it is up to those educated on polio to explain to audiences in the developed world exactly how important the leadership of polio-free countries actually is.

Unfortunately, budget cuts could have a significant impact on the complete eradication of the disease. Proposed cuts in the United States would shrink the budget from $30 billion in 2017 to $20.7 billion in 2018. These proposed budget cuts would make it difficult for organizations such as the Gates Foundation to interact with federal programs. The result would be that areas in need of polio vaccinations and education would not receive nearly as much help.

If polio were to be eliminated, it would become the second disease, the first being smallpox, to be eradicated globally. Proper funds for the delivery of polio vaccinations to areas in need is crucial for the disease’s eradication.

Drew Hazzard

Photo: Flickr


Thanks to an unprecedented U.N. Children’s Fund operation, five million Yemeni children received vaccinations against polio in early 2017. This record polio eradication campaign consisted of 40,000 people on mobile health teams going door-to-door in Yemen to reach the nation’s vulnerable children. The brave vaccinators courted danger by hiking over mountains, through valleys and across battle lines to reach the children in need. The children also received Vitamin A supplements to bolster their immune systems.

Vigilance is Critical

Despite the encouraging numbers from the vaccination efforts, continued vigilance is vital to prevent new cases. UNICEF‘s Representative in Yemen, Meritxell Relaño, echoed the importance: “In the last two years, more children have died from preventable diseases than those killed in the violence. This is why vaccination campaigns are so crucial to save the lives of Yemen’s children and to secure their future.”

The campaign couldn’t have come at a better time. Relaño indicated that the children in Yemen are especially vulnerable because the nation’s conflict is keeping them from adequate nutrition and healthcare.

Reza Hossaini of UNICEF  also reiterated the need for vigilance: “There is no question that progress to end polio is real and tangible. But – and it’s a big ‘but’ – until all children everywhere are consistently and routinely immunized against polio, the threat is there.”

Eradication on the Horizon?

Significant progress has been made since 1988 when UNICEF joined the Global Polio Eradication Initiative. At that time, there were 350,000 documented cases of the debilitating disease worldwide. These organizations hope to completely eliminate polio by 2019.

Their efforts have been working. By 2014, there were only 359 documented cases worldwide. More than 60 years after the first polio vaccine was developed by Jonas Salk, our planet is finally nearing total eradication of this devastating disease.

Gisele Dunn

Photo: Flickr

Polio-Free Nigeria July 24, 2016, marks Nigeria’s two-year anniversary without any new polio cases. This is a significant step toward certification for polio-free Nigeria in 2017.

Known to mainly affect young children, poliomyelitis (polio) is spread through fecal-oral transmission and by consuming contaminated food or water. The virus multiplies in the intestine, and can invade the nervous system and cause paralysis.

On September 25, 2015, the World Health Organization (WHO) removed Nigeria from the polio-endemic list. The disease only remains endemic in Pakistan and Afghanistan.

This is the longest Nigeria has gone without signs of the poliovirus and is certainly an important milestone.  However, President Muhammadu Buhari highlights that “we have not recorded any case of polio in the last two years, but we should not be complacent.”

In order to declare Nigeria completely polio-free, authorities are now focusing on  vaccinations – and making sure everyone gets them. According to WHO, failure to treat just one person could lead to additional run-ins with the virus, up to 200,000 new cases each year, all around the world.

In 2012, Nigeria accounted for more than half of all polio cases worldwide. However, with the combined efforts of the government, leaders and thousands of health workers, that statistic has greatly diminished and Nigeria is moving toward a polio-free state. Volunteers have immunized more than 45 million children under the age of five.

The establishment and funding of health programs have also had a serious hand in Nigeria’s success. The Hard-to-Reach project has gone the extra mile, operating in high-risk states in Nigeria. While polio is the main focus of these camps, other services such as prenatal care, routine vaccines, basic medicines, screening for malnutrition and health education are also offered.

If the country continues to follow through with the necessary medical procedures and protect new individuals from contracting the virus, a polio-free Nigeria could be a reality in the very near future.

Mikaela Frigillana

Photo: Flickr

Polio in Pakistan and Afghanistan
For the past century, scientists and organizations across the world have diligently fought to eliminate the poliovirus from humanity once and for all. Although this goal is incredibly close to fruition, the presence of polio in Pakistan and Afghanistan holds up the complete eradication of the pervasive disease.

Polio Occurrences and its Slow Eradication

The Australian Broadcasting Corporation, or ABC, reported that the first polio epidemic occurred in 1916 on the east coast of the United States. Gareth Williams, emeritus professor at the University of Bristol and author of the book Paralyzed with Fear: The Story of Polio, wrote that “about 25,000 people were paralyzed in and around New York, and 6,000 of those died.”

The Centers for Disease Control and Prevention (CDC) states that the poliovirus lives in the throat and intestines of the infected person, and that it can only be caught through oral contact with disease-ridden feces. Unlike other diseases, only humans can spread polio, which makes eradication a little easier to achieve.

Thanks to Jonas Salk and Albert Sabin’s invention of extremely effective vaccines, most of the industrialized world was free from the threat of polio by 1960. Unfortunately, their admirable mission still needs to be completed — there is still polio to eradicate. Due to this need, the Global Polio Eradication Initiative (GPEI) formed in 1988 when the World Health Organization (WHO), joined by Rotary International, CDC, UNICEF and the Bill and Melinda Gates Foundation, made ending polio an urgent mission.

Since its formation, the ABC reports that this team of organizations has been able to cut rates of polio “from 350,000 per year to less than two-dozen cases so far in 2016.” Today, Pakistan and Afghanistan are the only two countries where polio has not been eliminated; but this is sure to change.

The Ongoing Battle

The continued prevalence of polio in  Pakistan and Afghanistan is a result of multiple factors. The ABC stated that most of the polio cases in Afghanistan this year have occurred in a small part of the Shigal district, which is staunchly anti-government and does not allow vaccinators to enter.

In Pakistan, the Taliban attack health workers and immunization centers, believing that vaccinations are used by the U.S. and other countries to sterilize and spy on Muslims. Also, the border between the two countries is easy to traverse and allows for the disease to travel easily from one region to the next.

According to their website, the Bill and Melinda Gates Foundation “contributes technical and financial resources to accelerate targeted vaccination campaigns, community mobilization, and routine immunization.”

The foundation is working alongside local scholars and religious leaders to achieve multiple goals: convince families to vaccinate their children, create updated maps and programming to help workers locate children that need vaccines, develop new vaccines and work with other GPEI organizations to improve fundraising for the elimination of polio in Pakistan and Afghanistan.

The eradication of polio in Pakistan and Afghanistan is near. In a recent article, The National wrote, “by the end of this year, or early next at the latest, Afghanistan and Pakistan will declare themselves free of poliomyelitis.” Such an accomplishment will be one step for Afghan and Pakistani health, and one giant leap for the health of humankind.

Liam Travers

Photo: Flickr

Health Care in Afghanistan
Since 2002, the improvement of health care in Afghanistan has been great. According to USAID, “9 percent of Afghans lived within a one-hour walk of a health facility.” Today, over 50 percent of the population has access to a health care facility, the infant and child mortality rates have decreased and maternal mortality rates have declined as well.

The country’s turbulent history, filled with war and internal strife, has contributed a deteriorated health care system. The old Taliban regime stifled access to adequate medical facilities and professionals. With the help of groups like UNICEF, WHO and USAID the Afghan people are seeing tremendous progress within their country.

On May 16, 2016, a campaign to vaccinate every child under five years of age for polio was launched. Afghanistan and Pakistan are the only two countries still struggling against the illness. According to WHO, the campaign could put an end to the disease in the next few months.

This is just one example of the efforts being made to improve health care in Afghanistan. U.S. support in the country has also led to success in fighting tuberculosis. Data from 2012 reports daily TB treatments to have a 91 percent success rate.

Women’s health has improved immensely over the last decade. With the help of the U.S. government, more trained midwives were available in Afghanistan. As a result, by 2010, 60 percent of women had care prior to birth. This is an enormous step forward from 2002 when only 16 percent had this same access.

Despite its progress, the country still has a long journey ahead in improving the health care system. According to the Thomas Reuters Foundation, nearly 1.2 million Afghans have been internally displaced.

These individuals have little to no access to healthcare, which is a major problem as they also struggle for food and clean water. Violence against medical facilities has not helped the issue either. In 2015, 42 people were killed in a Doctors Without Borders hospital in Kunduz.

Increased foreign aid and peace efforts are necessary to solve the health care crisis in Afghanistan. This will involve supporting organizations already involved in the country as well as increased pressure on foreign governments for humanitarian action.

Saroja Koneru

Photo: Flickr

Polio Eradication in Afghanistan
On Sept. 30, 2015, the Minister of Public Health of Afghanistan, Dr. Ferozuddin Feroz, officially introduced the Inactive Polio Vaccine (IPV) into the vaccination program for all children under the age of 1 in Afghanistan. The vaccine is now available, free of charge, at health facilities across the country.

There were 12 reported cases of polio in Afghanistan in 2015. Afghanistan is one of three countries in the world which are still labeled “polio endemic” by the World Health Organization (WHO). The goal of this new vaccine is to enable polio eradication in Afghanistan.

The IPV, coupled with the Oral Polio Vaccine (OPV), which is already in the routine immunization schedule, boosts the immunity of children against polio and prevents polio transmission. IPV provides immunity to all three types of polio viruses.

Dr. Richard Peeperkorn, World Health Organization country representative, stated, “The introduction of IPV is a crucial step towards securing a polio-free Afghanistan and protecting the health of children.”

“Provision of the IPV vaccine is a key step to protect children from polio, and this should be supported by an ongoing effort to make parents and caregivers of children aware of the importance of IPV and all other vaccines,” said Akhil Lyer, UNICEF representative in Afghanistan.

The introduction of IPV would eventually require the removal of OPV once polio transmission has been interrupted in order to sustain a polio-free environment. However, since polio in Afghanistan is still prevalent, it is suggested that Afghans accept OPV and IPV when offered.

Marie Helene Ngom

Sources: Health Canal, WHO
Photo: Polio Eradication

 

Polio_Eradication
On March 27, 2014, the World Health Organization (WHO) certified that the South-East Asia region, home to a quarter of the world’s population, was polio-free.

The beginning of the WHO Global Polio Eradication Initiative (GPEI) in 1988 was faced with 350,000 cases of poliovirus infections, in 125 countries worldwide. This 2014 achievement now means 80 percent of the world’s population is polio-free.

Mass immunization efforts are the most effective when dealing with the spread of the poliovirus. In the Horn of Africa, it has been over one year since the last reported case of Polio due to the synchronized efforts to vaccinate every child with the oral polio vaccine (OPV).

The June 2015 Horn of Africa outbreak assessment deduced that poliovirus transmission has been interrupted.

Nigeria is currently the last country in Africa with the poliovirus, however, they are making progress. In 2013 there were 49 reported cases of polio, however, this year Nigeria has reported only six cases.

This dramatic drop in poliovirus infection is due to the OPV for type 1, 2 and 3 polioviruses. Vaccines are also administered to children of all ages and even at birth.

In February 2015 the Inactive Polio Vaccine (IPV) was introduced into the immunization program. It is predicted that by September 2015, Nigeria could be removed from the WHO’s list of polio-endemic countries.

Poliovirus lives in an infected person’s throat and intestines and is spread through feces especially in unsanitary environments. Even though some persons infected with the poliovirus do not show any symptoms they can still pass on the virus. Moreover, there is no cure for polio which is why immunization is the most effective method to stop the spread of polio.

Marie Helene Ngom

Sources: World Health Organization South-East Asia, Scientific American, The Atlantic, World Health Organization Africa, Center for Disease Control and Prevention
Photo: Polio Eradication

Polio Cases on the Rise in Pakistan
The focus on the fight against polio has shifted from Africa to Pakistan and Afghanistan, according to the World Health Organization (WHO). There have been no cases in Africa this year, with Nigeria to be removed from the list soon. Africa will have to go with two years of no polio cases before it can be considered “polio-free.”

There have been 34 polio cases this year, 28 of them have occurred in Pakistan and the rest have occurred in Afghanistan. There have been 28 cases of polio in Pakistan, 13 of which occurred in Khyber Pakhtunkhwa and 8 in Peshawar. Just last year, Pakistan saw the highest number of polio cases since 1998, a total of 296 polio cases.

The campaign to end polio faces a number of challenges. These vaccination campaigns have to deal with political instability and internal conflict in the region. They are often attacked by militants who believe immunization teams and polio workers might be a cover for espionage.

The political instability and internal conflict have caused a large population of refugees and slum areas where people are unaccounted for and have little to no access to health care.

There is also a lack of education regarding the effectiveness of polio vaccinations. In the region, there are rumors claiming they cause infertility. Before the vaccine was developed in the 1950s, polio affected everyone, rich and poor, and caused irreversible paralysis within hours.

The good news is, this past year, Pakistan ran its first eradication program. The World Health Organization (WHO) even reported more vaccinations in tribal areas where the government has less control.

WHO estimates that $50 billion could be saved in the next 20 years if polio is eradicated. In contrast, not eradicating polio could lead to 200,000 new cases every year within 10 years. Polio is on track to being the second infectious disease to be eradicated after smallpox.

Paula Acevedo

Sources: Dawn, Thomson Reuters Foundation
Photo: Google Images