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HIV/AIDs in BulgariaBulgaria is a country in southeastern Europe bordered by Greece, the Aegean Sea and Turkey to the south, North Macedonia and Serbia to the West, Romania to the North and the Black Sea to the east. Though the fight against HIV/AIDs in Bulgaria has had its ups and downs, the country has made substantial progress during the past 20 years in providing accessible treatment and diagnoses to its citizens.

Demographics

The prevalence of HIV/AIDs in Bulgaria is higher among men than women and new cases are most common in people 30 to 40 years old. By far the most common mode of infection for men and women is sexual contact, representing 89% of all new cases, while the remainder is mostly drug use by a needle. The rate of new cases is also drastically more likely in urban areas, 40% of all new cases being from the capital city Sofia alone. Al Although 17.7% of Bulgaria’s population resides in Sofia, this is still a much higher per capita rate than elsewhere in the country.

History

In 2004, The Global Fund, an international organization sponsored by many private and governmental agencies, provided Bulgaria with significant financial support to expand its fight against AIDS, tuberculosis and malaria. With this money, the Bulgarian Government expanded HIV/AIDs resources through its Health Ministry as well as sponsored many NGOs dedicated to implementing wide-reaching services for HIV/AIDs treatment and diagnosis.

While the steady increase in documented AIDs cases since the Global Fund’s intervention might make it seem as if the problem is actually getting worse, this apparent setback is just a result of more widely available testing and is not necessarily indicative of an increase in HIV/AIDs cases. In fact, these measures were largely effective and continue to contribute to the relatively low rate of HIV/AIDs in Bulgaria.

However, due to the country’s success, in 2014 the Global Fund determined Bulgaria was no longer eligible for aid and by 2017 the government spent the remaining Global Fund money. Due to these changes, many NGOs dedicated to fighting HIV/AIDs have either dissolved or shrunk, Politico reported. While the government is doing well in maintaining treatment and diagnoses for its citizens, NGOs were primarily responsible for reaching marginalized and impoverished communities with on-the-ground testing and prevention efforts and the extent of inclusion of these is difficult to determine.

On the Bright Side

The fight against HIV/AIDs in Bulgaria is largely successful even in the absence of Global Fund support. The rate of diagnoses is only 3.7 per 100,000 people as opposed to the EU average of 5.4 per 100,000 people, making it a success story among eastern European countries. Treatment of HIV/AIDs in Bulgaria is also a success with 98% of its infected population receiving antiretroviral therapy, a marked difference from the 68% world average, Radio Bulgaria reported.

Additionally, according to WHO, due to stigma as well as limited access to resources and transportation, many people simply will not or cannot access the treatment or testing they need. By using private, at-home tests, the experimenters sought to circumvent these factors and it showed many people who otherwise would not have had access utilized the at-home option. Projects like this foreground a bright future in the fight against HIV/AIDs in Bulgaria.

Lastly, after observing several similar instances of countries struggling to transition to the absence of support from the Global Fund, the organization revised its policy to account for an adjustment period. These revisions include “investing in the development of robust National Health Strategies, Disease Specific Strategic Plans… and requirements to ensure that Global Fund financed programs can be implemented through country systems.” With these changes, countries dealing with the same process in the future could be better able to maintain their fight against HIV/AIDs.

– Xander Heiple

Photo: Unsplash

Health Care in LuxembourgLandlocked and located in Europe, the small country of Luxembourg features beautiful landscapes and diverse intercontinental ties. Amidst these features, health care in Luxembourg has been established so there is a plan for all citizens to access the needed tools to stay healthy.

The National Health Fund

Prior to 2008, Luxembourg retained separate health insurance in various sectors as well as the Union of Health Insurance Funds. However, in 2008, these separate institutions joined to create the National Health Fund.

The National Health Fund coordinates the health care system and social security provides funding. People apply for reimbursements for their medical bills after seeking medical care. In other instances, such as prescriptions or charges from the hospital, third parties provide insurance and coordinate directly with the National Health Fund. The individual pays for the remainder of the bill that insurance does not cover. Citizens additionally have the option of private insurance, often offered through employers.

COVID-19 Health Care Response

An evaluation of health care in Luxembourg must include an assessment of the country’s response to the COVID-19 pandemic. This crisis naturally tests the system’s response. Efforts to combat the pandemic included a task force, named Research Luxembourg, that coordinated communication of health information between various research institutions. The Luxembourg Institute of Health also focused on educating the public about ongoing research.

Similarly, Luxembourg remains a member of The Global Fund, which contributes to battling diseases such as AIDS, tuberculosis (TB) and malaria. During the pandemic, Luxembourg donated to the fund to lessen the impact of COVID-19 on already existing programs for AIDS, TB and malaria. Particularly important is the donation’s impact on low-income countries in fighting both COVID-19 and the organization’s prior infectious disease focuses.

Caritas Luxembourg works to reach vulnerable members of the community including youth, migrants and those without a home. During the COVID-19 pandemic, a group of nurses alongside others in the medical network created a program to provide hygiene and health care to Luxembourg’s homeless. These are individuals that might not have access to health care in Luxembourg in the traditional ways.

Current Efforts

Luxembourg fights poverty by making commitments to improve the health of mothers and adolescents. For example, the government offers a birth allowance that mothers apply for after the birth of their child. To receive the allowance, mothers must attend medical examinations for themselves and the child before and after birth.

Furthermore, Luxembourg is a key contributor to the World Health Organization (WHO), ranking seventh in the years 2020-2021. It is a supporter of the WHO Health Emergencies Programme and the Contingency Fund for Emergencies. Finally, Luxembourg provides funding for “Healthier Kosovo” in an endeavor to improve health issues related to air pollution in the environment.

International Health Cooperation

In addition to improvements to health care in Luxembourg, the country prioritizes health in other contexts. The Small Countries Initiative includes Luxembourg. The WHO created this group in 2013 between eight European countries to facilitate communication on reporting health information within their systems and to the public. The members periodically attend meetings to discuss the United Nations Sustainable Development Goals.

Luxembourg also partnered with the United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF) and the WHO to create a program for Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) in Lao People’s Democratic Republic (PDR). The program aims to improve the health of those listed in its title with the goal to reduce poverty within the country. The program began the third phase in 2022.

In addition to their partnership with Laos PDR, Luxembourg also partners with Burkina Faso, Cabo Verde, Mali, Niger and Senegal in the Universal Health Coverage (UHC) Partnership, according to WHO.

Initiated in 2011, the UHC Partnership connects Luxembourg with a variety of global actors including the WHO, the European Union, Japan and Canada. The organization works to provide assistance in planning systems to facilitate access to health care. It ensures that people receive health care at both an individual and community level. Thus far, the partnership has impacted 115 countries. It also incorporated more than 120 advisors to engage in the dialogue necessary to implement these systems.

For example, in Rwanda, the addition of health posts improved access to health care by decreasing travel time from an average of 95 minutes to 47 minutes to receive services with future goals to further decrease this time.

Luxembourg continues to provide innovative solutions to domestic health care systems as well as improve health abroad. Its solutions contribute to progress in decreasing global poverty through the medium of health.

– Kaylee Messick
Photo: Flickr

Malaria in NigeriaAccording to the World Health Organization (WHO), “Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes.” In 2019, nearly half of the world’s population was at risk of malaria exposure. Despite being preventable and curable, there were still a staggering 229 million global cases and 409,000 malaria-related deaths. With a population of around 201 million people at the time, Nigeria accounted for 23% of those deaths. Children under 5 are especially vulnerable and constituted 67% of all malaria deaths in 2019. Though malaria is present in various tropical areas around the world, Africa accounts for 94% of malaria cases and deaths, with Nigeria maintaining the highest percentage of both.

GBCHealth

GBCHealth is a partnership of companies and organizations that invest resources into improving global health. The nonprofit encourages its network to use its power and resources to progress the health of society and achieve the United Nations’ Sustainable Development Goals (SDGs) in innovative ways.

One of the organization’s initiatives to eliminate malaria is the implementation of the Corporate Alliance on Malaria in Africa (CAMA). CAMA serves as a platform for African corporations to share successful approaches, create new alliances, gain visibility and advocate for malaria control and prevention across Africa. The initiative also acts as a networking forum for businesses to engage and develop relations with key government and civil society stakeholders whose focus is combating malaria. GBCHealth stated that “CAMA companies both lead and support innovative malaria prevention, control and treatment activities and collectively deploy millions of dollars to programs that serve the needs of malaria-affected people and communities.”

Status of Malaria

Despite the improvements in malaria control over the past decade, long-term success in reaching the WHO Global Technical Strategy goals for Malaria 2016-2030 is still far off. The 2020 World Malaria Report stressed that countries in Africa continue to struggle to make significant or consistent gains in the fight against malaria. In 2006, Marathon Oil launched CAMA in Nigeria with members such as Chevron, Access Bank, ExxonMobil, The Aliko Dangote Foundation and Vestergaard. The alliance works with global partners, including The Roll Back Malaria Partnership and The Global Fund, to fight AIDS, tuberculosis and malaria. Together, these organizations are making strides in the fight against malaria.

CAMA Strategic Plan

CAMA’s 2021-2023 Strategic Plan aims to improve awareness and scale up prevention efforts through private sector initiatives. The End Malaria Project, a major initiative under the new strategic plan, will increase private sector resources in Nigeria and then expand to other high-burden countries, rescuing 50,000 lives in Africa. The project will further the government’s efforts in achieving a malaria-free Nigeria by 2023 and channel private sector resources and capabilities into reducing the incidence and prevalence of malaria in the most endemic communities in Nigeria.

Although malaria has presented a significant challenge to Nigeria, the country is benefiting from the work of GBCHealth. Through its efforts, Nigeria is well on its way to becoming free of malaria.

– Nelia Blackman
Photo: Flickr

Leading Cause of Death
The World Health Organization (WHO) estimates that one-third of the global population has latent tuberculosis. Though a vaccine exists for this fast-spreading virus, tuberculosis is a leading cause of death in the world.

While some may think of tuberculosis, formerly known as consumption, as a virus of the past, it has begun to reemerge and create public health crises in multiple countries. The evasive nature of the virus has resulted in its continued spread. Additionally, many underlying factors contribute to the continuation of this illness.

Immigration and Movement of People Between Countries

Despite the efforts of many countries, the complete eradication of tuberculosis is near impossible due to the influx of immigrants leaving and entering endemic countries. The CDC claims that without proper treatment and health services for all immigrants, this disease will continue to spread. Containing and quarantining the infected would be of little use since only 10% of tuberculosis carriers present outward signs.

How it Compliments Other Epidemics

The destructive manner in which tuberculosis attacks the respiratory system creates an even deadlier combination when paired with another disease. For example, the United States experienced a spike in both tuberculosis and HIV cases around the same time, due to the nature of both diseases. With a weakened immune system, HIV patients struggled to fight the disease on their own, leading to the re-emergence of tuberculosis.

Poor Government Structures and Funding to Facilitate Care

As the COVID-19 pandemic made evident, many governments are poorly equipped to facilitate proper care to combat TB epidemics. However, movements to eradicate it have resulted in mandatory testing for nearly all hospitals and universities. While developed countries have made large strides in the positive direction, the lack of governmental structure and resources in poverty-stricken countries allows tuberculosis as a leading cause of death.

Vaccine Resistant Strains

As with any virus, TB has evolved to include many vaccine-resistant strains. These strains stand in the way of eradication. Furthermore, the CDC has discussed the threat this strain poses if used as a bioweapon. WHO has set a goal of wiping out tuberculosis by 2035, but without a method of controlling or stopping vaccine-resistant strains, this goal is challenging.

NGOs Working to Address Tuberculosis

The Global Fund, WHO and USAID are all working to address tuberculosis, the leading cause of death, through new health technologies. These organizations use technologies to monitor antibiotic administration, side effects and maintain patient charts on a virtual platform. This virtual platform allows healthcare workers to navigate data conveniently. Some platforms use safety precautions to eliminate issues of miscommunication and over-administration of medications.

– Venus Wang
Photo: Flickr

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