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tuberculosis in madagascar
Madagascar, a country off the southeastern coast of Africa, comprises of tuberculosis cases among its citizens of low socioeconomic status. In 2012, 70.7% of the Malagasy population was living below the poverty line and in 2017, the incidence rate for tuberculosis in Madagascar was 233 cases per 100,000 people. Encouraged and perpetuated by poverty, this disease makes Madagascar the perfect candidate for an outbreak.

Tuberculosis, commonly known as TB, is the most infectious fatal disease in the world. Although it is a very treatable illness, it kills more than 1 million people annually across the globe. The vast majority of TB diagnoses and deaths derive from individuals residing in poor, developing nations.

Risk Factors

Lack of quality living conditions, nutrition and healthcare amplify the risk of getting tuberculosis in Madagascar. Limited access to toilets and handwashing facilities for the majority of Malagasy people have left many at risk. According to CIA World Factbook data, sanitation facility accessibility in Madagascar was unimproved for 88% of the total population in 2015. TB is also the leading cause of death for people with HIV. As of 2018, there were roughly 39,000 Malagasy people diagnosed with HIV but only 20,865 known TB cases that also had documented HIV statuses. Without quality systems in place to document HIV and TB rates across the country, solving the epidemic in Madagascar will not be easy.

The Global Fund Support

The added historical stigma surrounding TB makes matters worse. While already struggling financially, patients often fear that exposing their diagnosis will cause them to lose their jobs. This stigma is combated through support systems like The Global Fund, an organization that provides relief for epidemics through fundraising and education for those affected by TB. The fund’s employees act as a support system, thus debunking the shame that infected patients may feel due to their diagnosis.

In 2018, The Global Fund’s donations and work helped cure 33,000 patients with tuberculosis in Madagascar. For 2020-2022, the organization projects that a total of $18,045,448 will go toward tuberculosis management in Madagascar. In 2017, these funds helped increase Madagascar’s TB treatment success rate to 84%.

Biotechnological Solutions

Although TB is preventable and curable, Madagascar lacks the necessary medical tools to diagnose and treat this disease. Not only are there minimal supplies, but there is also a need to expand and strengthen Madagascar’s ability to analyze TB samples according to Niaina Rakotosamimanana, the head of the mycobacteria unit at the Health Institute of Madagascar.

Researchers from the Health Institute of Madagascar, Stony Brook University and Oxford University are also collaborating to find solutions for this issue. These institutions are working together to grant access to a portable and affordable tool, the MinION. The MinION helps to diagnose and efficiently test the resistance of TB strains to antibiotics, while at the same time being a cheap, affordable option that is accessible to Malagasy people.

Tuberculosis is still one of the top 10 leading causes of death in Madagascar, but the country is making significant progress towards the eradication of the disease. The efforts Madagascar is taking in tracking TB are positive steps that contribute to the fight against this epidemic.

Sophia McGrath
Photo: Pixabay

Malaria is a leading cause of death in Sub-Saharan Africa. In 2018, among 228 million cases of malaria globally, there were 405,000 deaths, 94% of which were in Sub-Saharan Africa. Although treatment has gotten much better in recent years and deaths due to malaria have begun to decline globally, in the time of the COVID-19 pandemic worries have arisen that those who receive treatment for malaria will be unable to continue to do so. (https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/maintain-essential-services-malaria.html)Recent results from the Global Fund’s biweekly survey of HIV, TB, and malaria treatment programs found that 73% of malaria programs reported disruption to service delivery, with 19% reporting high and very high disruptions. Activities within the programs are being canceled due to lockdowns, restrictions on the size of gatherings, transport stoppages, COVID-related stigma, and clients not seeking health services as usual. With these disruptions to important malaria treatment services, such as insecticide-treated net campaigns and antimalarial medicine administration, the World Health Organization predicts that deaths from malaria in Sub-saharan Africa could double. (https://www.theglobalfight.org/covid-aids-tb-malaria/) These deaths would return countries' malaria mortality levels from the year 2000, regressing on the progress that malaria treatment has reached in the past 18 years. It has never been more vital than now that countries continue to mitigate malaria treatment in their communities and sustain essential services that have helped save so many lives of those affected by malaria. (https://www.who.int/news-room/detail/23-04-2020-who-urges-countries-to-move-quickly-to-save-lives-from-malaria-in-sub-saharan-africa) The Global Fund is a partnership designed to help eradicate HIV, TB, and malaria epidemics. It raises and invests more than $4 billion a year to support local programs for these epidemics. They partner with local experts in countries, as well as governments, faith-based organizations, technical agencies, the private sector, and those affected by these diseases to raise money, invest it, and implement strategies to give aid. (https://www.theglobalfund.org/en/overview/) The Global Fund has created an urgent mitigation plan to curb the effect of COVID-19 on delivering essential health services, such as malaria relief, as well as making $1 billion available to other countries as part of their response. They plan to adapt malaria programs to mitigate the impact of COVID-19, protect frontline workers with protective equipment and training, reinforce supply chains, laboratory networks, and community-led response systems, and fight COVID-19 by supporting testing, tracing, isolation, and treatment. The Global Fund is seeking an additional $5 billion to mitigate the impact of COVID-19 on countries receiving treatment for malaria, TB, and HIV. (https://www.theglobalfund.org/en/covid-19-plan/) Along with the Global Fund and the WHO, the CDC has also created a set of key considerations for continuing essential malaria prevention, while safeguarding against the COVID-19 pandemic. In addition to recommending that a representative from the National Malaria Control Program should be considered for membership on the country’s National COVID-19 Incident Management Team, the CDC recommends continued access to Insecticide-Treated Nets for populations at risk, physical distancing during spray treatments, and the continuance of essential routine entomological monitoring activities while abiding by social distancing and wearing protective gear. The CDC also recommends that countries monitor their supply chain and adapt their malaria treatment programs if needed, due to higher costs or less resources. Countries should continue to collect data on COVID-19 and malaria illness in the population. It is important that countries communicate their continuation of malaria treatment to their citizens and educate them on how to seek treatment while also protecting themselves from COVID. (https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/maintain-essential-services-malaria.html)
The leading cause of death in Sub-Saharan Africa is malaria. There were 228 million cases of malaria globally in 2018. Additionally, there were 405,000 deaths, 94% of which were in Sub-Saharan Africa. The treatment improves in recent years and malaria has begun to decline globally. However, concerns about receiving treatment for malaria occurs during the COVID-19 pandemic. Recent results from the Global Fund’s biweekly survey of HIV, TB and malaria treatment programs found that 73% of malaria programs reported disruption to service delivery. Around 19% reports high and very high disruptions.

Lockdowns canceled activities within the programs. There are restrictions on the size of gatherings, transport stoppages, COVID-related stigma and patients are not seeking health services as usual. The World Health Organization predicts that deaths from malaria in Sub-saharan Africa could double due to disruptions to important malaria treatment services. For example, insecticide-treated net campaigns and antimalarial medicine administration. It is extremely vital that countries continue to mitigate malaria treatment in their communities. Additionally, the countries should sustain essential services that have helped save many lives affected by malaria.

The Global Fund

The Global Fund is a partnership that helps eradicate HIV, TB and malaria epidemics. It raises and invests more than $4 billion a year to support local programs for these epidemics. The organization partner with local experts in countries, governments, organizations, the private sector and those affected by these diseases. The aim of the partnership is to raise and invest money and implement strategies to give aid.

Furthermore, The Global Fund created an urgent mitigation plan to curb the effect of COVID-19 on delivering essential health services. The plan includes making $1 billion malaria relief available to other countries as part of their response. In addition, The Global Fund plans to adapt malaria programs to mitigate the impact of COVID-19 and protect frontline workers with protective equipment and training. It also reinforce supply chains, laboratory networks and community-led response systems. The Global Fund fights COVID-19 by supporting testing, tracing, isolation, and treatment. It seeks an additional $5 billion to mitigate the impact of COVID-19 on countries receiving treatment for malaria, TB and HIV.

Centers for Disease Control and Prevention (CDC)

The CDC created a set of key considerations for continuing essential malaria prevention while safeguarding against the COVID-19 pandemic. The CDC gives four recommendations during the COVID-19 pandemic. First, a representative from the National Malaria Control Program should be considered for membership on the country’s National COVID-19 Incident Management Team. Second, continued access for Insecticide-Treated Nets for populations at risk should be put in place. Third, physical distancing during spray treatments should be imposed. Lastly, the continuance of essential routine entomological monitoring activities while abiding by social distancing and wearing protective gear.

For countries that impacted by malaria, the CDC advises the countries to monitor their supply chain and adapt their malaria treatment programs. Countries should continue to collect data on COVID-19 and malaria illness in the population. It is important that countries communicate their continuation of malaria treatment to their citizens and educate them on how to seek treatment while also protecting themselves from COVID-19.

Giulia Silver
Photo: Flickr

Tuberculosis in Impoverished CountriesThe largest infectious cause of death in the world is Tuberculosis (TB), resulting in over 4,000 deaths a day. Many factors make people living in poverty more susceptible to undiagnosed and untreated active TB, notably its interaction with HIV/AIDS. A lack of information and adequate healthcare systems also make Tuburculosis in impoverished countries a major threat, requiring a rapid response from the global community.

10 Facts About Tuberculosis in Impoverished Countries

  1. Tuberculosis is more common in impoverished countries. People in severe poverty often live and work in crowded areas with poor ventilation, which are the optimal conditions for the spread of TB.  They’re also more susceptible to conditions that lower their immune systems such as malnutrition or other infectious diseases. These factors make them more likely to catch and spread TB, as well as less likely to be able to fight it.
  2. COVID-19 is expected to increase TB. Two large effects of the COVID-19 pandemic are economic crises and quarantining. For people living in poverty, quarantining can increase the transmission of TB as households may be more crowded with less ventilation. Losing one’s job can increase undernutrition or malnutrition which lowers your resistance to TB.
  3. The cure rate is low in developing countries. The cure rate for TB in many developing countries is less than 50%. This is a result of many factors, but it is mainly because of a combination of the fear and stigma around TB in impoverished countries. It leads to delayed treatment or refusal to seek treatment, and inadequate healthcare systems in place that are tasked with treating the disease.
  4. TB often spreads because of delayed treatment or refusal to seek treatment. A person with active TB can spread it to 10-14 people a year, which may not seem like a lot, but allows cases to multiply in places that are suffering from other lethal infectious diseases as well. This makes tuberculosis in impoverished countries more deadly and harder to treat.
  5. TB interacts with HIV. HIV patients develop active TB at a much higher rate. The progression of TB and HIV is sped up when a person has both diseases, which usually leaves little room for treatment in countries that are struggling to provide adequate healthcare. Almost 70% of HIV-positive people live in sub-Saharan Africa, where 41% of people live in poverty. The risk of getting TB increases 19-fold when a patient also has HIV because of their weakened immune systems and their environment. Of reported TB cases, 56% have been among those who are also HIV-positive. This leads to at-risk individuals contracting both of these diseases which are much more difficult to treat together.
  6. Drug-resistant TB is on the rise. A strain of the TB that is resistant to the traditional course of antibiotics is starting to spread. It is particularly dangerous for people with TB in impoverished countries because many may not have adequate resources or information to follow their TB treatment methods. This results in infectious, drug-resistant strains that are harder to treat. When a drug-resistant strain of TB appeared in the U.S. during the 90s, the quick government response helped to decrease cases by 67% over five years. A similar approach would help to quell the current spread of TB in impoverished countries by providing resources that lead to better diagnoses and tracking of new infections.
  7. TB is curable and preventable. The reason people in developed countries don’t hear a lot about TB is because developed countries have better-funded healthcare systems. These systems can monitor for the disease effectively and have access to drugs that can treat it quickly. More than 95% of all TB cases and deaths happen in developing countries where healthcare systems often don’t have the same reach or resources.
  8. USAID is helping in the fight against TB. USAID focuses on providing locally generated solutions to fight TB. By training healthcare workers, USAID is able to improve the detection of TB, as well as the treatment and overall treatment success rate. In 2018 the organization was able to train 40,000 healthcare workers in key areas to fight TB in impoverished countries and saw a 14% increase in case notifications. USAID also set the tremendous goal of having another 40 million people diagnosed and enrolled in treatment, and another 30 million people enrolled in preventative therapy by 2022.
  9. Poverty and TB connect. TB cases would fall by more than 80% by eliminating extreme poverty. There is a strong link between extreme poverty and TB. If combined, programs directly targeting TB and programs targeting the eradication of poverty can help slow the transmission and increase the response rate by improving healthcare services and raising the quality of life.
  10. The TB Alliance is working to affect change. The TB Alliance is researching affordable treatment for those in need. By forging partnerships in many different sectors, this non-profit is chasing the goal of ending TB deaths. The organization is developing faster-acting drugs that can be circulated to both treat and prevent TB. This development has already transformed how TB is approached in the medical research field and could help millions of patients struggling to access affordable and fast treatment options.

Although TB poses a threat to impoverished countries, there is a lot being done to prevent TB deaths. The Global Fund is ensuring that grants are provided for countries combating the dual-threat of COVID-19 and existing diseases like TB, HIV and malaria. With effective treatment regimens already on the market and faster-acting versions in development, increased U.S. foreign aid and funding for aid programs could expedite the end of TB in impoverished countries.

– Eleanor Williams

Photo: Flickr

Tuberculosis in Madagascar
Tuberculosis, commonly known as TB, is the most infectious fatal disease in the world. Despite the fact that it is treatable, TB kills more than 1 million people annually across the globe. The wide majority of diagnoses and deaths occur in poor, developing nations. Here is some information about tuberculosis in Madagascar.

Tuberculosis in Madagascar

Tuberculosis cases plague Madagascar, a country off the southeastern coast of Africa, especially among the citizens of low socioeconomic status. As of 2012, 70.7% of the Malagasy population lived below the poverty line. As a result, in 2017, the tuberculosis incidence rate in Madagascar was 233 cases per 100,000 people. TB is a disease that poverty perpetuates, making Madagascar a likely candidate for an outbreak.

Lack of quality living conditions, nutrition and health care all amplify the risk of tuberculosis infection in Madagascar. Proper toilets and handwashing facilities are scarce for the majority of Malagasy people. According to CIA World Factbook data, as of 2015, sanitation facility access in Madagascar remained unimproved for 88% of the total population. As for health care, not only is TB deadly in itself if it does not receive treatment, but it is the leading cause of death for people who suffer from HIV. As of 2018, there are 39,000 Malagasy people who receive a diagnosis of HIV, however, only 20,865 TB patients also had documentation of their HIV status. Without quality systems in place to document HIV and TB status, solving the epidemic in Madagascar will not succeed.

The Global Fund’s Support

The added historical stigma surrounding TB makes matters worse. While already struggling monetarily, patients are often fearful that, if their diagnosis is public, they will risk losing their jobs. However, various groups are making progress in reducing this stigma while aiding those with TB. The Global Fund, an organization that assists in funding relief for epidemics, is hiring employees to administer medication and encourage TB patients in Madagascar to stay on track with their antibiotics. These employees act as a support system as well and are working to debunk the shame that patients may feel surrounding their diagnosis.

The Global Fund is continuing to make huge strides in combating this disease. In 2018, the organization funded the cure of 33,000 patients in Madagascar. For 2020-2022, there is a projected $18,045,448 that will contribute to tuberculosis health care in Madagascar. These huge sums of money should significantly diminish the problem. As of 2017, based on the recorded percentage of new cases of TB, the treatment success rate was 84%.

Biotechnological Solutions

Although the disease is incredibly preventable and curable, there is a lack of medical tools in Madagascar necessary to diagnose and treat TB. Not only are there minimal supplies, but the head of the mycobacteria unit at the Health Institute of Madagascar, Niaina Rakotosamimanana, said that “we have a collection of [TB] strains at the Pasteur Institute… about 9,000 strains. We have been thinking about expanding and strengthening our ability to analyze those samples.”

Researchers from the Health Institute of Madagascar, Stony Brook University and Oxford University are collaborating to help grant greater access to a portable and affordable tool, the MinION. The MinION helps to diagnose and efficiently test the resistance of TB strains to antibiotics. It is a cheap, affordable option that is accessible to Malagasy people. While developed countries have the technology to create complex, expensive tools to prevent the spread of TB, low-income countries, where the disease is affecting more people, have considerably less information. Because developing nations often cannot support Western medical technology, tools like the MinION are incredibly beneficial.

Tuberculosis in Madagascar is still one of the top 10 leading causes of death in the country, but Madagascar is making significant progress towards the elimination of the disease. The efforts Madagascar is taking in tracking TB are positive steps contributing to the mitigation of the epidemic.

Sophia McGrath
Photo: Flickr

Improve Global Health
In June 2018, German Chancellor Angela Merkel introduced a new plan for Germany to become a front-runner in global health. This plan was to fully come into action by the end of 2019. In addition, the BMJ Journal reported that the plan involved bringing in non-governmental representatives to provide their knowledge to develop a strategy for Germany to improve global health.

What is the Plan?

Germany worked with the World Health Organization (WHO) to develop the Global Action Plan for Healthy Lives and Well-Being for All program. One of the main goals of this initiative is to accelerate progress in seven key areas:

  1. Primary health care
  2. Sustainable financing
  3. Community and civil society
  4. Determinants of health
  5. Innovative programming in fragile and vulnerable settings and for disease outbreak responses
  6. Research and Development, Innovation and Access
  7. Data and digital health

These seven points focus on the main areas of mobilizing and enabling communities. They also focus on providing governments with the necessary funding and knowledge to help their people and ensuring the research and money is going to the areas that most need it.

Funding

Germany began working towards many of these goals as early as 2018. The Global Fund reports that Germany pledged 1 billion euros (roughly $1.094 billion) towards The Global Fund’s fight against diseases such as HIV, malaria and AIDS. Also, the website states that this was a 17.6 percent increase from its previous pledge. Germany is pledging this amount for a three-year period.

The website Donar Tracker notes that Germany donated 47 percent of its development assistance fund to multilateral, or multi-country, organizations. The website states that the main recipients of this funding were the previously mentioned Global Fund, the E.U. and Gavi. Gavi is an organization focused on giving impoverished countries access to vaccines.

Cooperation

The Global Health Hub Germany is a website that Germany hosts to improve global health. This website calls itself the platform for Global Health. The World Health Summit, which Berlin, Germany holds annually, helped to organize the launch of The Global Health Hub, claiming that its mission statement is one of cooperation.

The Global Health Hub Germany aims to inform people, get them working together and develop new ways for the world to improve global health. Additionally, it hosts frequent events and conferences aimed to give people the information they need to help improve global health. The website launched on October 29, 2019. Since then, it gained 555 members as of November 2019. Its members consist of activist groups and experts in the health field. The Global Action Plan for Healthy Lives and Well-being for All states Germany’s mission statement going forward to improve global health. Funding, cooperation and mobilization are just some of the ways that Germany aims to improve global health.

Jacob Creswell
Photo: Flickr

Auction Raised Money to Fight AIDS
Even as the world enters a new decade, AIDS remains a serious epidemic. It is a widespread and deadly disease that mostly affects poor countries. There are many organizations that work to fight this harsh truth, including one called (RED). In December 2019, the “PAINT (RED) SAVE LIVES” auction raised money to fight AIDS.

About (RED)

Bono and Bobby Shiver founded (RED) in 2006 by Bono and Bobby Shiver. (RED) works to raise money to help the fight against AIDS, specifically in sub-Saharan Africa. It does this by partnering with leading brands to make and sell (RED) products, identifiable by their actual red coloring, and sending all of the money to HIV/AIDS programs in sub-Saharan Africa.

Every company that (RED) partners with offers a different type of red-colored product. Johnson & Johnson sells special (BAND-AID) RED bandages. Twenty cents from each sale goes to the fight against AIDS. Stella Luna sells red sneakers and chain sandals to contribute to the cause, while Vilebrequin sells T-shirts, swim trunks and beach bags. Bank of America has a web page where people can donate to (RED). Bank of America matches donations.

The Auction

The “PAINT (RED) SAVE LIVES” auction took place in December 2019. It was an art auction that featured red paintings from 30 different artists. Twenty-five murals in 25 cities around the world served as advertisements for the event.

Bidding for the auction closed on December 17, 2019. Fifty percent of the proceeds from every sale went to the Global Fund to fight AIDS, tuberculosis and malaria. The sales contributed to the Global Fund reaching its goal of earning $14 billion by the end of that year. It is hoped that these proceeds will contribute to saving 16 million lives in AIDS-prone countries, especially in sub-Saharan Africa.

Impact

The “PAINT (RED) SAVE LIVES” auction raised money to fight AIDS. The proceeds that it earned were the latest in a long line of accomplishments by (RED). The organization has raised more than $600 million since its founding and sent money to numerous AIDS organizations in sub-Saharan Africa. Thanks to these organizations and donations, 24 million people with HIV have access to medicine.

(RED) is aware that medicine is not the sole solution to the AIDS epidemic. Its funding has also helped with other initiatives. The organization is helping condoms become available to prevent the spread of HIV. It is also aiding in the development of new medications and medical procedures to reduce the risk further. Thanks to new testing procedures, 79 percent of people with HIV now know that they have it, allowing them to receive treatment sooner and live longer. Furthermore, 82 percent of HIV-positive pregnant women are receiving antiretroviral treatment to prevent passing AIDS to their children. The organization is providing funding to make sure that adolescents receive education about AIDS and its risks.

The AIDS epidemic remains a big problem, especially for poor areas like sub-Saharan Africa. Roughly 400 babies are born with HIV each day and one teenager suffers infection every three minutes. AIDS continues to kill more people than any other disease. The “PAINT (RED) SAVE LIVES” auction raised money to fight AIDS, and the funds are helping to eradicate AIDS in sub-Saharan Africa.

Cassie Parvaz
Photo: Flickr


The UN’s 2016 High-Panel report on global access to medicine opens with an inspiring message: “Never in the past has our knowledge of science been so profound and the possibilities to treat all manner of diseases so great.” It is hard to debate that recent advancements in targeted cancer therapy and HIV drug development indicate a bright future for the Rx world. The potential for positive change may go unrealized, however, if access to medicine remains limited. To serve the 3.5 billion people without basic medical services, along with the 100 million who find themselves in extreme poverty because of high medical costs, governments and organizations have to confront the complex economic forces undermining global access to medicine. This article will discuss two such forces and consider how international actors have responded.

Too Big to Heal?

Economic orthodoxy holds that the equilibrium of a product’s supply and demand will determine its price, but medication prices do not adhere to this rule. This is because firms in the pharmaceutical industry possess the key to market distortion. Monopoly power or the ability for firms with outsized market shares to raise prices without experiencing a corresponding drop in sales. Pharmaceutical companies tend to obtain monopoly power for several reasons, such as:

  1. High entry costs, especially those associated with research and development. This excludes smaller, potentially disruptive firms from the market.
  2. The continuation of company consolidation. In the past 20 years, a group of 60 different pharmaceutical companies shrank to a mere 10.
  3. Large profits. Profits are huge, with the 10 highest-earning companies netting a 20 percent profit margin on average. This allows these companies to fortify their already-large market share. Most importantly, once a company patents a drug, it holds exclusive title to the production and distribution of that drug for 20-25 years.

During that period, no lower-priced, generic substitutes can enter the market. Equipped with this uncontested control, these companies can charge high prices for their products, as those who need them will have no other choice but to bear the cost. Yet some, especially individuals in poorer countries dealing with diseases like Hepatitis C and cancer, simply cannot afford these costs.

There are many individuals and corporations who are attempting to solve this problem, however. For example, GlaxoSmithKline (GSK), a pharmaceutical company based in London, England, is trying to put an end to exorbitant prices for prescription drugs in low-income countries. In March 2016, it announced that it would not seek patent protection for its drugs in 50 of the world’s poorest countries. By doing this, the company opened the path for smaller companies to bring lower-priced, generic versions of their drugs to the market. So far, the approach has been effective, earning GSK the top spot in the 2018 Access to Medicine Index. The positive publicity it receives from the ranking will hopefully motivate other companies to follow suit.

R&D Incentives

While the economics of monopoly power generates the problem of overpricing, the incentives of research and development make it such that many medicines needed in low-income countries go underproduced. As mentioned above, patents spell large rewards, but it costs $800 million on average for a company to obtain one and to bring a drug to the market. This pressures companies to develop the drugs that are most likely to produce a substantial financial return. Additionally, as the UN High-Panel notes in its report, this means that widespread, treatable diseases can oftentimes go unaddressed. For example, antimicrobial-resistant viruses and parasites threaten to kill as many as 10 million people annually by 2050, yet drug companies worldwide have developed virtually no new antibiotics in the past 25 years. In the absence of this innovation, however, public-private R&D partnerships have proven to be a successful substitute. The Global Fund is an example as it has saved 27 million people that malaria, HIV/AIDS and tuberculosis threatened by raising money from both public and private sources and collaborating with domestic task forces and commissions.

A Reconceptualization

Economic barriers to improve global access to medicine remain, but more and more people are starting to conceptualize the problem as an ethical one rather than an economic one. However, ensuring access to health care and maintaining market efficiency are not mutually exclusive. For example, cost-efficient drug production techniques are necessary to disseminate medicines at reduced prices. But other times “policy incoherencies,” as the UN High-Panel report calls them, force decision-makers to choose between the promotion of economic innovation and the provision of public health. Thanks to leading companies like GlaxoSmithKline and compassionate organizations like the Global Fund, the international community is starting to opt for the latter.

James Delegal
Photo: Flickr

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

End Neglected Tropical Diseases ActApproximately one billion people are affected every year by Neglected Tropical Diseases (NTDs) in an estimated 149 countries. In tropical and subtropical areas, NTDs abound in a variety of 17 communicable diseases, including Chagas disease, dengue fever, leprosy, river blindness, rabies, worms (round, whip and hook) and trachoma to name a few. This is why the End Neglected Tropical Diseases Act was created.

Rep. Christopher Smith introduced the End Neglected Tropical Diseases Act to the U.S. House of Representatives on Jan. 28, 2019. The proposed bill addresses international development regarding NTDs as well as provides funding for those who strive to help end NTDs. The bill also states that it will expand the U.S. Agency for International Development’s Neglected Tropical Diseases program and the Global Fund. Here are five facts that explain the primary objectives of the End Neglected Tropical Diseases Act.

Five Facts About the End Neglected Tropical Diseases Act

  1. The bill proposes that USAID help individuals suffering from or at risk for contracting NTDs by providing drug treatment packages. Rep. Smith also urges beginning similar programs that target large at-risk communities, particularly children five and up. These programs will have a high impact with relatively low costs.
  2. These programs will also attempt to coordinate with USAID and its development sectors. Specifically, the program aims to organize with USAID regarding aspects such as “education (including primary and pre-primary education), food and nutrition security, maternal and child health and water, sanitation and hygiene.”
  3. The End Neglected Tropical Diseases Act addresses the need for the Global Fund to start recognizing and working with NTDs. The Global Fund is a public-private entity that focuses on assisting people with AIDS, Tuberculosis and Malaria. The bill urges the Global Fund to focus on female genital schistosomiasis in addition to providing treatment for HIV/AIDS.
  4. Rep. Smith’s proposed bill also addresses the need for a center of excellence. This section of the bill addresses the provisions for obtaining a cooperative agreement or a grant. The grant can be given to either a public or private nonprofit organization. It will fund the basics costs needed to create the centers in order to “conduct research into, training in and development of diagnosis, prevention, control and treatment methods for neglected tropical diseases.” These funds can be used for basic operating costs such as staffing and administrative duties as well as patient care costs. The grant funds may also be used for the training and continued education of health professionals as well as for establishing programs to educate the public on NTDs.
  5. The bill would create a panel for worm infections. The Secretary of Health and Human Services would use this panel to research worm infections and deworming solutions and medicines. It will also develop five strategies for preventing recurrent infections, providing sanitation solutions, developing safer, better medicines and improving the cost-efficiency of the existing programs regarding worm infections.

The End Neglected Tropical Diseases Act aims to produce programs that will help eliminate tropical diseases that are rampant in developing countries. If it passes, it could bring much-needed hope for approximately one billion people in developing countries around the world.

– Logan Derbes
Photo: Flickr

Top 5 Nonprofit Foundations
Throughout the world, millions of people face the development of disease. Many of these diseases are not yet curable, which has forced many to be fearful for their lives. Several organizations have come up with ways to fund research and provide information to those suffering from these diseases so that they can live longer and happier lives. These top 5 nonprofit foundations are among the many nonprofit organizations that have dedicated their lives to curing disease.

The March of Dimes Foundation

The March of Dimes Foundation is a U.S. nonprofit organization that works to improve the health of mothers and babies. Formed the day before World War II, the March of Dimes Foundation, formerly the National Foundation for Infantile Paralysis (NFIP), became very popular like its founder, Franklin D. Roosevelt. With the war in full effect, the Foundation was able to gain its rise through “radio, Hollywood and the personal appeal of the president.” The organization established the Office of Global Programs, that allowed worldwide partnerships with communities in Latin America, Europe and Asia bringing in prenatal education and care. The March of Dimes Global Network for Maternal and Infant Health has supported programs in China, Brazil, Lebanon, the Philippines, Malawi and Uganda.

United Way

United Way’s mission is to improve lives by mobilizing the caring power of communities around the world and advancing the common good. The organization collaborated with the Shanghai Charity Foundation to provide teacher training, a place for children to learn, educational toys and other learning materials for 20 kindergarteners. In 2010, the United Way worked with the Airbus Corporate Foundation to create the Flying Challenge, which encourages at-risk middle and high school students to stay in school. So far, the challenge has allowed more than 600 students from Wichita, Kansas to Getafe and Cadiz, Spain the opportunity to receive mentorship through the Flying Challenge initiative.

The Global Fund

Among the top 5 nonprofit foundations listed, the Global Fund is the newest organization to raise, manage and invest the world’s money towards infectious diseases. Since 2002, the Global Fund has focused on three infectious diseases; AIDS, TB and malaria. The organization has invested more than $4 billion a year to support programs in more than 100 countries. Many of these programs are occurring in countries within Eastern Europe, Central Asia, North Africa, the Middle East, Latin America, the Caribbean, the Pacific, and mainly, Sub-Saharan Africa.

The WHO

The World Health Organization formed in 1948 and is a specialized agency of the United Nations that is concerned with international public health. WHO has six regional offices, including its headquarters in Geneva, Switzerland. The WHO regional office in Africa and the Africa Centres for Disease Control and Prevention work together to end disease outbreaks and build stronger health systems. WHO has provided technical leadership in surveillance, vaccination and case management, and has deployed 700 international experts that respond to disease outbreaks. On July 2019, the Ministry of Health reported 2,620 Ebola cases with 1,762 deaths and 737 survivors.

UNAIDS

UNAIDS is the main advocate for accelerated, comprehensive and coordinated global action on the HIV/AIDS pandemic. Young women between the ages of 15 and 24 are more likely to obtain the virus. Four in five new infections in Sub-Saharan Africa among adolescents aged 15 to 19 years are girls. More than 35 percent of women around the world have experienced physical and/or sexual violence at some time in their lives. This makes it 1.5 times more likely for them to obtain HIV than women who have not experienced this form of violence. Towards the end of 2018, UNAIDS used $19 billion towards the AIDS response in low-and middle-income countries, which was $1 billion less than the previous year. UNAIDS believes that the AIDS response in 2020 will require $26.2 billion.

These top 5 nonprofit foundations have continued to raise money to fund research for cures that impact millions of people in the world. They have made it their responsibility to ensure that patients and their families gain the necessary care to gain power over their lives.

– Emilia Rivera
Photo: Flickr