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Fight Disease in the DRC
With 80 million hectares of arable land and over 1,100 precious metals and minerals, the Democratic Republic of the Congo has quickly established itself as a large exporter in the lucrative diamond industry. Despite this, the DRC ranks 176th out of 189 nations on the UN’s Human Development Index and over 60 percent of the 77 million DRC residents live on less than $2 a day. Internal and external war, coupled with political inefficacy and economic exploitation, has hindered the country’s ability to combat poverty and improve health outcomes. Listed below are some of the most deadly diseases that are currently affecting individuals in the DRC and the different strategies that governments and NGOs have taken to fight disease in the DRC.

3 Deadly Diseases Currently Affecting Individuals in the DRC

  1. Malaria

The DRC has the second-highest number of malaria cases in the world, reporting 15.3 million of the WHO-estimated 219 million malaria cases in 2017. Of the more than 400 Congolese children that die every day, almost half of them die due to malaria, with 19 percent of fatalities under 5 years attributed to the disease. However, some are making to reduce malaria’s negative impact.  For example, the distribution of nearly 40 million insecticide-treated mosquito nets, or ITNs, has helped lower the incidence rate by 40 percent since 2010, with a 34 percent decrease in the mortality rate for children under 5. The DRC government procured and distributed the nets with international partners such as the Department for International Development, Global Fund and World Bank. In addition, the President’s Malaria Initiative, a program implemented in 2005 by President Bush and carried out by USAID, has distributed more than 17 million nets. UNICEF has also been a major contributor in the efforts to fight malaria and recently distributed 3 million ITNs in the DRC’s Kasaï Province. However, the country requires more work, as malaria remains its most frequent cause of death.

  1. HIV/AIDS

Among its efforts to fight disease in the DRC, the country has made significant progress recently in its fight against HIV/AIDS. As a cause of death, it has decreased significantly since 2007, and since 2010, there are 39 percent fewer total HIV infections.

This particular case illuminates the potential positive impact of American foreign aid. The DRC Ministry of Health started a partnership with the CDC in 2002, combining efforts to fight HIV/AIDS. PEPFAR, signed into U.S. law in 2003 to combat AIDS worldwide, has invested over $512 million since 2004, which has helped to fund antiretroviral treatment for 159,776 people. In 2017, it funded the provision of HIV testing services for 1.2 million people.

The country is also addressing mother-to-child transmissions. In the DRC, approximately 15 to 20 percent of mothers with HIV pass the virus onto their child. The strategy to end mother-to-child transmissions involves expanding coverage for HIV-positive pregnant women, diagnosing infants with HIV earlier and preventing new infections via antiretroviral drug treatment. UNAID, The Global Fund and the DRC Ministry of Health have undertaken significant work to accomplish these objectives and their efforts have resulted in the coverage of 70 percent of HIV-positive pregnant women.  However, much work remains to cover the remaining 30 percent of pregnant HIV-positive women.

Overall, there is still a lot of necessary work to undergo in the fight against HIV/AIDS in the DRC and around the world.  In total, UNAIDS estimated that HIV/AIDS was the cause of 17,000 deaths in the DRC in 2018.  While this is a decrease from previous years, it shows that the DRC still has a long way to go in order to fully control the spread of the disease.  Additionally, there must be more global funding. The U.N. announced on July 2019 that annual global funding for fighting HIV/AIDS decreased in 2018 by almost $1 billion.

  1. Ebola

Since 2018, the DRC has undergone one of the world’s largest Ebola outbreaks. On July 17, 2019, WHO declared the outbreak an international health emergency. Since August 2018, more than 2,500 cases have occurred, with over 1,800 deaths.

However, the country is making efforts to prevent the transmission and spread of Ebola in the DRC.  Recently, more than 110,000 Congolese received an experimental Ebola vaccine from Merck & Co. The vaccine is called rVSV-ZEBOV, and studies have shown the vaccine to have a 97.5 percent efficacy rate.  This vaccine provides hope that people will be able to control Ebola breakouts in the near future.

While there have been attempts to fight disease in the DRC in recent years, such as malaria, HIV/AIDS and Ebola, each disease remains a major issue. In the coming years, the country must continue its efforts.

– Drew Mekhail
Photo: Flickr

Reducing Malaria in Liberia
The Republic of Liberia, located on the western coast of Africa and bordered by Sierra Leone and Guinea, has a population of 4.7 million people. About 50 percent of the population, or 2.35 million people, fall below the national poverty line, meaning that they have less than $2.00 a day on their disposal.

Liberia Health Care System

Liberia’s health care system suffered a lot after a 14-year civil war that ended in 2003. Almost 95 percent of doctors were lost or were forced out of the country after the war, leaving staff shortages throughout the nation, and hospitals and other health care services were confined to the capital city of Monrovia. Organizations such as Hospitals of Hope that donated $1.1 million worth of medical supplies to the JFK Hospital, helped Liberia’s health care system recover after the civil war.

Malaria in Liberia

Although Liberia’s health care system continues to improve, the civil war left the country susceptible to many communicable diseases, including HIV/AIDS, diarrhea, respiratory illnesses and malaria. Malaria is the number one cause of inpatient death in Liberia, accounting for 44 percent of all inpatient deaths among children. In 2016, the prevalence of malaria parasitemia in children under the age of 5 was on average 45 percent. This number is even higher in some areas in the country, reaching levels over 60 percent.

President’s Malaria Initiative

In order to reduce malaria in Liberia, USAID works with the U.S. Centers for Disease Control and Prevention to implement the President’s Malaria Initiative (PMI). PMI first started in 2005 as a five-year program, intending to reduce malaria in Liberia by 50 percent. However, after 14 years and a 70 percent decrease in malaria, PMI created a new strategy for the period from 2015 to 2020, having in mind recent progress that was achieved. The current PMI strategy has a long-term goal of complete malaria elimination.

In Liberia, PMI supports four different malaria prevention and treatment methods: diagnosing and treating malaria, supplying citizens with Insecticide Treated Nets (ITNs), preventing and managing malaria during pregnancy and monitoring malaria outbreaks. PMI also supports the Liberian Ministry of Health (MOH) after Ebola outbreaks.

When it comes to treating malaria in Liberia, every little detail counts. In April 2017, a PMI warehouse used to store medications and medical supplies caught on fire, so USAID quickly transferred these supplies to the remaining warehouse. The result was a consolidated, centralized warehouse that made security and transportation cheaper and easier. This is just one example of how USAID and PMI are logistically jointly working to reduce malaria in Liberia. The goal of PMI in the following years is to reduce malaria-related illnesses and deaths by another 50 percent. Other goals for the benchmark year 2020 include:

  • Increasing prompt diagnosis and effective treatment by 85 percent
  • Ensuring that 80 percent of the population is protected from malaria
  • Teaching up to 95 percent of the population to the preventive measures

Since 2003, Liberia has been slowly recovering from the detrimental civil wars, and episodes of malaria, an illness that is still a lingering issue in the country, have greatly decreased. With help from organizations and programs such as USAID and PMI, the country can continue to progress in this fight until malaria in Liberia is finally gone for good.

– Natalie Dell

Photo: Flickr

Top Malaria Nonprofits
Malaria is the most deadly disease facing the world’s poor today. In 2016, roughly 445,000 people died due to malaria, and the illness still remains in 91 countries and threatens half of the world’s population. The fight against malaria is far from over, and many nonprofits are still working on achieving a world without malaria. Here are five of the top malaria nonprofits to be aware. 

Malaria No More  

Malaria No More (MNM) launched in 2006 alongside the President’s Malaria Initiative. The goal of the organization is to create “a world where no one dies from a mosquito bite.” MNM aims to end malaria by mobilizing advocates and securing funding to combat malaria. Their work focuses on three countries, including Kenya.

MNM started work in Kenya in 2014, and their work’s focus is to protect pregnant women and babies who are both at a higher risk for contracting malaria than any other populations. In Kenya, MNM partners with several other nonprofits to make malaria a top political priority. MNM also spreads awareness about malaria through meetings with politicians and events with celebrities.

As a result of MNM’s work, roughly 1,800 mothers and pregnant women received mosquito nets, two Kenyan counties increased funding for malaria elimination and millions of people received information on malaria treatment and prevention via radio.

The International Committee of the Red Cross

Another one of the many nonprofits combating malaria is the International Committee of the Red Cross (ICRC). Since its inception in 1863, the goal of ICRC is to assist victims of war and poverty. Since malaria threatens so many impoverished nations, the organization aids in combating malaria.

The ICRC also focuses on encouraging and assisting communities to band together and fight malaria. In 2008, the organization and its partners distributed 60,000 nets to Burkina Faso and helped educate its people on the importance of nets and how to hang them properly.

The President’s Malaria Initiative

The President’s Malaria Initiative (PMI) started in 2006 with the goal of reducing the malaria death rate by 50 percent. The PMI offers several services to the people of sub-Saharan Africa, including insecticide-treated nets, indoor residual spraying, intermittent preventative treatments for pregnant women, and seasonal chemoprevention treatments.

Since the formation of the PMI, more than 5 million houses received an indoor residual spraying, which protects more than 20 million people. The PMI also distributed 40 million treated nets. Overall, the malaria rate in sub-Saharan Africa dropped 54 percent in the past 17 years.

The World Health Organization

The World Health Organization (WHO) is one of the many nonprofits combating malaria. Founded in 1948, WHO oversees international health through the United Nations and aims to improve health systems and respond to health crises all over the world. Their oversight and work includex fighting to eradicate malaria.

In 2015, the E-2020 plan, which aims to eliminate malaria in 21 countries by 2020, began. WHO is one of several supporters of this initiative and works with 21 countries to reach the elimination of malaria.

Comoros is one of the countries that WHO works with. In 2014, the number of reported indigenous malaria cases reached 53,000; in 2016, that number fell to 1,066. This decrease was the result of a treatment campaign, indoor spraying and the delivery of insecticide-treated nets by WHO.

Nothing But Nets 

Nothing but Nets supplies nets to areas that are vulnerable to malaria. The organization also raises awareness about malaria and mobilizes citizens to take action by contacting their representative or starting a fundraising campaign.

Nothing but Nets raised $65 million for 12 million mosquito nets to be sent to families all over the world. Most of these nets go to sub-Saharan Africa, where malaria is most common and deadly. In 2000, only two percent of the population in sub-Saharan Africa owned mosquito nets; in 2017, 53 percent of people in sub-Saharan Africa possessed a net.

As you can see, these top malaria nonprofits have made it their mission to put a stop to this disease sooner rather than later.

–  Drew Garbe

Photo: Flickr

PMI expansionThe President’s Malaria Initiative (PMI) aims to help reduce malaria in countries all over Africa. As of 2018, the PMI plan has expanded to five new countries, bringing the total to 24 countries receiving help. Some of the countries that have already been receiving aid are Ghana, Ethiopia and Benin. The five new countries that were added to the expansion of PMI are Burkina Faso, Cameroon, Cote d’Ivoire, Niger and Sierra Leone, all in West Africa.

 

Burkina Faso

Of Burkina Faso’s 19 million residents, 80 percent live in rural areas and are at the highest risk for poverty and poor health. The end goal of PMI is to completely eliminate malaria by 2030. Currently, the National Malaria Control Program (NMCP) strategy for 2015-2020 is to reduce malaria death rates and reduce malaria incidence rates by 40 percent each. The PMI expansion into Burkina Faso is also working on 10 focus areas for the NCMP, such as monitoring, evaluation, emergency management and prevention in pregnant women.

 

Cameroon

In Cameroon, 22 million people are at high risk of contracting malaria, especially pregnant women and children. With the PMI expansion, the Cameroon National Strategic Plan (NSP) included six strategic plans that focus on:

  • Prevention
  • Case management
  • Communication
  • Training and research
  • Surveillance, monitoring, evaluation and epidemic response
  • Program management

The stated mission of the NSP is to make malaria care, prevention and treatment efficient and affordable, even for the individuals who are the most marginalized. By 2018, the goal of the NSP is to reduce both malaria morbidity and mortality by 75 percent.

 

Cote d’Ivoire

As of 2016, almost half of all children living in Cote d’Ivoire were infected with malaria. The National Malaria Strategic Plan (NMSP) for 2010-2017 aims to reduce malaria mortality to one death per 100,000 and reduce malaria cases by 75 percent. The revised plan is also working to increase the number of people that are sleeping under an insecticide-treated mosquito net (ITN) from 33 percent to 80 percent with help from the PMI expansion. The end goal for pregnant women is to have 85 percent sleeping under an ITN and 100 percent of all malaria cases in pregnant women to be treated as quickly as possible.

 

Niger

Twenty million people live in Niger, and of those 94 percent are at risk of contracting malaria. According to the PMI, more than 56 percent of all deaths in pregnant women are caused by this disease. However, in 2017, 80 percent of women received three doses of malaria treatment and prevention medication and slept under ITNs. The NMSP goal is to reduce malaria mortality rates and the incidence of malaria by 40 percent. One expected result for NMCS is for 80 percent of Niger’s population to be sleeping under long-lasting insecticide-treated mosquito nets by 2021. All of these goals are more than attainable thanks to the PMI expansion.

 

Sierra Leone

About 6.5 million people in Sierra Leone are at risk of contracting malaria, and about one million children under five years old receive outpatient care because of malaria. Between 2015 and 2020, the primary goal is to reduce malaria morbidity and mortality by 40 percent. The NMCS objective for Sierra Leone is for 80 percent of the population to have access to prevention and treatment for malaria, and that by 2020 a minimum of 95 percent of health facilities will routinely report to the malaria program.

According to the Institute for Health Metrics and Evaluation, in four out of these five countries, malaria is the number one cause of death. In all five countries, malaria was the number one cause of premature death in 2016. The goal of PMI in all countries is to reduce malaria mortality by one-third and reduce malaria morbidity by 40 percent. All of these programs, goals and objectives have the chance to be hugely successful because of this ongoing work and the PMI expansion.

– Amber Duffus

Photo: Flickr

U.S. President's Malaria Initiative Expands to Include Four New CountriesOn September 21, the United States Agency for International Development (USAID) announced that its President’s Malaria Initiative would expand to include four new countries: Cameroon, Cote d’Ivoire, Niger and Sierra Leone.

The President’s Malaria Initiative, which was initially launched in 2005 by USAID, works diligently to decrease the incidence of malaria-related deaths and increase malaria prevention and treatment programs predominately in Sub-Saharan Africa. With the addition of the newly developed programs, the initiative currently works in 24 different countries in Sub-Saharan Africa.

According to USAID, the initiative’s expansion will help approximately 332 million people in order to fight the spread of malaria.

The Center for Disease Control reported in 2015 that the initiative works with other agencies such as the World Bank, UNICEF and non-governmental organizations in order to combat malaria more efficiently.

The initiative is dedicated to providing malaria prevention programs to those at the greatest risk for suffering from malaria-related deaths such as pregnant women and young children. Such interventions include “intermittent preventive treatment for pregnant women” and “indoor residual spraying with an approved insecticide.”

Also, the initiative works closely with the Sub-Saharan African countries in order to address other factors that increase one’s risk of contracting malaria. For instance, the initiative helps with reinforcing infrastructure in developing countries; political instability is oftentimes linked to negative health outcomes.

USAID reported in 2016 that more than six million lives have been saved through the initiative; however, the initiative still has a vast amount of work to do. Malaria spreads quickly in Sub-Saharan African countries, and there is a large number of susceptible pregnant women and children in such countries that need immediate care. The inclusion of four new countries is promising, but President Donald Trump’s fiscal year 2018 budget seems to tell a different story.

The Council on Foreign Relations stated in April 2017 that President Trump’s fiscal year 2018 budget “calls for deep cuts to foreign assistance programs,” which is immensely troublesome.

Programs like the President’s Malaria Initiative are able to thrive and help more people with necessary funds, so it is imperative that the United States government stays on track to further developing this initiative.

Emily Santora

Photo: Flickr

Diseases in Guinea
Although experts thought Ebola had been eliminated in Guinea, there have been fears of the disease coming back after a few cases were documented in the past two years. People are still skeptical after the largest Ebola outbreak in March 2014 even though experts have claimed that the outbreak ended at the end of 2015. However, with the country still lacking in health resources, diseases in Guinea, which could otherwise be preventable and treatable in another developed nation, are rapidly distributed. Here are the top three diseases in Guinea.

  1. Malaria: According to the Center for Diseases Control, 10% of deaths in Guinea are caused by malaria. In 2015, tens of thousands of malaria cases went untreated. Because of the ebola outbreak, people avoided health clinics for fear of being sent to an isolated Ebola treatment center. People might have died from malaria more than Ebola, and the entire population is at risk for malaria. To try to control this disease, the President’s Malaria Initiative distributes insecticide-treated nets (ITNS) and supports malaria diagnostics, as well as treatments at health facilities.
  2. HIV/AIDS: AIDS plagues so many parts of Africa, and Guinea is no exception. Four percent of deaths are caused by HIV or AIDS, and almost 7,000 children are living with HIV. AIDS has been considered a death sentence since only 27% are receiving antiretroviral medication. Hopefully, treatment will come to more people. The countries of Ethiopia, Ghana, Malawi, Namibia and Tanzania have been receiving antiretroviral treatment programs from the Global Fund since 2010.
  3. Lower Respiratory Infections: Currently, lower respiratory tract infections are the leading cause of death among children under the age of five. Forty-two percent of these deaths occur in Africa, and the infections can cause pneumonia, influenza and bronchitis.

Guinea has one of the poorest populations in West Africa. Little of its people have access to good healthcare. Diseases in Guinea can be curable and treatable if organizations continue to provide healthcare to treat these diseases.

Emma Majewski

Photo: Flickr

presidents_malaria_initiative
In 2005, George Bush launched the President’s Malaria Initiative (PMI) to work towards eradicating malaria across 15 high-risk African countries.

By acting quickly and efficiently, PMI has helped to reduce malaria mortality by 50 percent since 2005. Over 6 million people are alive today – without the influence of PMI, they would have died from malaria.

Since its creation, PMI has expanded and has helped hundreds of millions of people by core preventative strategies: providing people in high-risk zones with durable and insecticide-treated mosquito nets, antimalarial treatment options, fast-acting diagnostics, indoor anti-mosquito spray and prevention options for pregnant women.

Malaria is a disease carried by mosquitoes, which bite and infect people, leaving them ill with fevers, chills and symptoms associated with the flu. If the disease is not treated, people are at risk of death. In 2013, 198 million cases of malaria were reported, and of those, half a million people died. Many of these deaths were children under the age of 5.

The World Health Organization estimates that 106 countries and 3.4 billion people are at risk of malaria infection.

Mali is an example of where PMI has contributed to improving the quality of life of citizens through malaria treatment. The entire population of Mali is at risk of contracting malaria with 90 percent of citizens living in the central and southern regions where the disease is endemic.

People in transit, perhaps fleeing their homes due to displacement, are even more at risk because of their weaker immune systems. Malaria is the primary cause of death in Mali, especially for children under the age of five.

Despite malaria’s omnipresence in Mali, the devastation caused by malaria has diminished since PMI’s inception in 2005. The mortality rate of children under the age of 5 has decreased by 50 percent in 2013.

PMI’s success is not limited to Mali – the Initiative has made incredible progress across Africa. It has distributed over 31 million mosquito nets, sprayed over 5 million households with insecticides (impacting 18 million people), given over 13 million antimalarial medications for pregnant women and trained over 27,000 health workers.

According to the Bill and Melinda Gates Foundation on their website, Impatient Optimists, “Malaria is clever, resilient and capable of evading our most dependable interventions. If we aim for a malaria-free world, the global response must constantly evolve and adapt to challenges that don’t even exist yet.” The strategies that have worked in the past may not work in the future. Eradicating malaria fully will be a constantly transforming process.

In partnership with the President’s Malaria Initiative and other organizations, the Gates Foundation is committed to eradicating malaria in the future. On Impatient Optimists, the Foundation highlighted its goals broadly: “We need to expand access to prevention, diagnosis and treatment, which PMI has proven capable of doing on a massive scale. We also need to build stronger health systems and introduce new tools and strategies, an increasingly important part of PMI’s work in recent years.”

The reduction of malaria in the world so far illustrates the potential for completely eradicating malaria in the future — a goal that will save millions of lives.

– Margaret Mary Anderson

Sources: CDC, Impatient Optimists, PMI
Photo: Impatient Optimists

fighting_malariaIn 2005, President George W. Bush launched the President’s Malaria Initiative, an effort to make the U.S. a technical and financial leader in fighting malaria. In 2008, the signing of the Tom Lantos and Henry J. Hyde United States Global Leadership against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act extended the existing legislation and tripled the budget for the cause.

The effort has been largely successful, due partly to the range of methodology. The following are all ways that PMI is seeking to address the spread of the disease.

  1. Raw equipment: Over 102 million insecticide-treated mosquito nets (ITNs) have been distributed by PMI.
  2. Prevention: Over 243 million antimalarial treatments, 107 million rapid diagnostic tests and over 25 million preventive treatments for expectant mothers have been distributed by PMI.
  3. Education: Collectively, over 170,000 health care workers were trained in treating malaria in the fiscal year of 2014 alone.
  4. Finances: The funding level has increased from $30 million in 2006 to $669 million in 2015.
  5. Partnerships: PMI works with National Malaria Control Programs (NMCPs), as well as independent nonprofits, community groups, academia, the private sector and government agencies.
  6. Technology: The constant expansion of technology has allowed for ever-more efficient combat against malaria. For example, smartphone GPS systems allow health officials to map out routes for the transportation of insecticide used for Indoor Residual Spraying (IRS). This way they can avoid areas inaccessible by car, sensitive areas that they should not spray (such as organic crops) and other potential hazards.
  7. Specific goals: The PMI targets 20 “focus countries,” and sets both short-term and long-term goals to keep careful track of its progress.
  8. Looking to the future: The new six-year strategy (launched at the beginning of 2015) has goals that include reducing malaria mortality by over 80 percent from the original 2000 baseline levels.

Em Dieckman

Sources: CGDEV, PMI 1, PMI 2, USAID
Photo: Alliance for Malaria Protection

Because of the prevalence of malaria as one of the greatest health crises, many governments and non-governmental organizations (NGOs) have been taking action to combat the disease. Below are just three organizations that have been instrumental in fighting the disease and how they have impacted the larger global fight in eradicating malaria.

The Bill & Melinda Gates Foundation

The Bill & Melinda Gates Foundation has become recognized as one of the leading global health nonprofit organizations. In 2013, it launched the Accelerate Zero campaign to completely eradicate malaria. The campaign has three primary functions. Firstly, improvement of treatment, specifically to the most afflicted areas and at-risk demographics (pregnant women and young children,) will help maximize the effectiveness of current resources. Secondly, investing in new research in vaccines and treatment plans can help expand the potential for medicinal treatment. Finally, the foundation hopes to garner attention and support in eradicating the treatable disease and create a multinational unified front against the disease.

Malaria Eradication Project (MEP)

Though MEP only works in Uganda, there are similar organizations in India and Peru. Founded in 2011, MEP is a research-based organization that is seeking the cheapest treatment plan that can help the most people. Using research methods to target the most afflicted, the goal is to tailor treatment plans based on geographic locations. The model of Uganda can be transported around the globe for targeted specific treatments since a variety of factors affect the epidemiology of the disease.

President’s Malaria Initiative (PMI)

Conceived in 2005, PMI is a program designed to reduce malaria by 50 percent in Africa by expanding health care coverage and making treatments more affordable. The program expanded in 2008 and rose to importance as part of the Global Health Initiative. Along with taking preventative measures like spraying millions of houses and expanding treatment, the initiative has also supplied training to over 16,000 staff.

Though each of these programs are in different stages of development, they demonstrate the multifaceted combat against malaria. These are just three of the many organizations dedicated to assisting malaria-afflicted areas and eradicating the disease once and for all.

Kristin Ronzi

Sources: Bill and Melinda Gates Foundation, Malaria Eradication Project, President’s Malaria Initiative
Photo: The Guardian