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Hepatitis C Drugs
Three years ago, a 90 percent effective hepatitis C medication, called Sovaldi, was released by Gilead Sciences. A three-month round of treatment costs $84,000. Janssen Pharmaceuticals released its own drug, Simeprevir, at $66,000 per round of treatment, and other pharmaceutical companies like AbbVie and Zepatier charged similar prices as they released their own hepatitis C drugs.

Hepatitis C is a blood-borne disease that can lead to liver cirrhosis and liver cancer, as well as other neurological problems. Worldwide, there are four times as many patients infected with hepatitis C as there are with HIV. About 150 million people live with chronic hepatitis C and 500,000 people die of hepatitis C complications every year.

Before Gilead, Janssen and other companies developed their newer, more effective medications, hepatitis C patients were treated with ribivarin and interferon, an antiviral drug and an immune-system modulator. The drugs caused fatigue, nausea and depression, and after one year of treatment, only 50 percent of patients were cured.

The WHO added hepatitis C drugs to their list of essential medicines, which they update every two years and some pharmaceutical companies offered deals with low-income countries. Gilead, for example, sold Sovaldi for $900 per round of treatment in Egypt in 2014.

The Drugs for Neglected Diseases Initiative made a deal with an Egypt-based pharmaceutical company last spring to sell a highly effective drug combination for $300 per treatment round.

Hepatitis C is especially prevalent in Egypt, affecting over 10 percent of the population, because of a vaccination campaign in the 1960s and 70s where syringes were reused for multiple patients. The disease is so widespread that barbers wear gloves and use disposable razors. Hepatitis C has even been spread between family members through sharing toothbrushes and nail clippers.

However, 80 percent of new infections happen in medical centers; in response to these figures, UNICEF and the WHO are working with the Egyptian government to educate both clinicians and the general population about hepatitis C.

Many patients await treatment, but the Egyptian government anticipates treating 1 million people for hepatitis C in 2016. As the cost of treatment decreases and sterilization and infection control practices are improved, the presence of hepatitis C in Egypt and elsewhere will diminish.

Madeline Reding

Photo: Flickr

Antibiotic Resistance in Bacteria
A few of the major issues in attempting to combat bacteria is how quickly they adapt, evolve relative to large organisms and develop antibiotic resistance.

Bacteria are able to replicate on a much greater magnitude than macro-organisms — E. Coli only takes 23 minutes to replicate — and they can adapt functional changes in a very short period of time.

For example, scientists at Harvard Medical School conducted an experiment where they grew E. Coli bacteria in a petri dish that consisted of increasingly strong concentrations of antibiotic. After eleven days, E. Coli strains emerged that could resist antibiotic concentrations that were a thousand times greater than the amount necessary to initially kill them.

As antibiotics have become more prevalent over the past century, bacteria have been evolving at a rate faster than we can keep up with. About 700,000 people are estimated to have died of infections from antibiotic-resistant bacteria last year.

If people do not take action against this problem, by the year 2050 we could have 10 million deaths a year due to resistant strains, meaning that resistant bacteria would be taking more lives than cancer.

A U.N. meeting was called on September 14 to discuss this issue. One factor contributing to the rise of resistant strains is the overuse of antibiotics in humans. Antibiotics tend to be overprescribed or simply used when they are not needed.

It is estimated that less than half the antibiotics people take are actually necessary. Unnecessarily using antibiotics contributes to the rise of resistant bacteria without achieving anything beneficial.

The overuse of antibiotics is seen even more often in the treatment of animals. According to the Huffington Post, over two-thirds of antibiotics use in the U.S. is used to treat livestock. Unnecessary antibiotic use in agriculture leads to resistant bacteria strains in humans as well.

Fortunately, action has been and will continue to be taken to reduce the rise of strains of bacteria that show antibiotic resistance. For example, the development of fish vaccines meant that antibiotics no longer had to be used in Norwegian salmon farming. Over the past six years, the Netherlands have reduced their animal antibiotic use by 56 percent.

Additionally, avoiding infection initially will reduce the need for antibiotics. Hospitals could make it a policy to discharge babies sooner before they have time to be exposed to potential infectious diseases.

Educating mothers on the important role of breastfeeding in building up babies’ immune systems could also contribute to preventing the onset of infection.

According to the World Health Organization, even those of us living among the general populace can take action on this issue. We can practice better hygiene to prevent infections.

We should also be careful not to use antibiotics unless specifically prescribed by health professionals and make sure that we take the full course of antibiotics once they are prescribed to us.

Edmond Kim

Photo: Flickr

10 Facts about Malaria
Malaria is a parasitic infection transmitted through the Anopheles mosquito, a genus found on every continent except Antarctica. Humans have known about malaria for thousands of years, but it remains one of the most threatening diseases in the world. Here are 10 facts about malaria and its epidemiology.

1. Malaria threatens almost half of the world’s population.
According to the World Health Organization (WHO), 3.2 billion people in at least 95 countries are at risk for malaria today.

2. Malaria killed nearly half a million people last year.
WHO estimates that malaria killed 438,000 people in 2015 and infected more than 200 million. Children under the age of five account for two-thirds of malaria deaths.

3. Pregnant women are at especially high risk.
Women who contract malaria while pregnant are more likely to die from the illness. The disease also threatens fetal health and can cause a variety of birth-related problems. Babies born to mothers who have malaria are likely to have health problems. According to WHO, malaria is responsible for one-third of all preventable low birth weight cases.

4. Africa suffers the most from the disease.
While malaria is endemic on four continents, Africa bears the brunt of the burden. Last year, Africa accounted for 89 percent of all cases and 91 percent of all deaths from malaria, the vast majority of which occurred in just 15 countries.

5. Drug resistance is an increasing problem.
When malaria patients don’t finish their full courses of treatment, the parasites can develop resistance to the drugs used to treat them. The development of drug resistance has always been an aspect of dealing with malaria, but scientists are reporting alarming multi-drug resistance in the Mekong region of Southeast Asia. The spread of a strain that doesn’t respond to the strongest drugs could undo years of work fighting malaria elsewhere.

6. Malaria reinforces poverty.
Malaria not only threatens people living in poverty; it exacerbates the problem. Where malaria is rampant, economic growth and development suffer enormously.

7. Climate change will expand the scourge of malaria.
Rising temperatures and increased rainfall and humidity will increase the range and number of malaria-carrying mosquitoes. Studies suggest that a rise in global temperatures of just two to three degrees Celsius could put hundreds of millions more people at risk for contracting malaria.

8. Malaria is easily treatable and preventable.
Preventing malaria is as simple as avoiding mosquito bites. Since the mosquitoes that transmit the parasite are nocturnal, sleeping under a bed net at night is generally an adequate prevention measure.

If detected early, malaria can be treated and cured with a course of prescription drugs in a matter of days. The disease becomes dangerous when it is not detected quickly and medicine is not readily available.

9. Globally, humanity is winning the battle.
In the last 15 years, malaria incidence has decreased by 37 percent among at-risk populations. In those same populations, death rates were more than halved. Additionally, the death rate among young children has gone down 65 percent.

10. Malaria can be eradicated.
Adult mosquitoes only live for one or two weeks, and they don’t travel far from the location at which they hatched. If communities have the means to prevent transmission completely, the disease can be erased locally in a matter of weeks. According to Bill Gates, the international community can, with some determination, eradicate the disease globally in the next two or three decades.

Global efforts have proven that eradication is possible. In the past decade, Europe eliminated its indigenous cases of malaria completely, and in September, WHO declared Sri Lanka, a country of more than 20 million people, malaria-free. If Gates is right, the rest of the world may soon follow.

Charlie Tomb

Photo: Flickr

Public Health Challenge: Combating the Top Diseases in Estonia
A member of the European Union since 2004, Estonia is among the wealthiest nations in the Baltic region. Likewise, the country has a modern health system that can reasonably support its population of 1.3 million.

Almost all Estonians are covered by health insurance, and the greatest menaces to public health, like heart disease and cancer, are characteristic of a developed country.

Nonetheless, more than one in five Estonians lives below the poverty line and are especially at risk for certain health problems that are prevalent in the country. Here are some of the top diseases in Estonia and what is being done to combat them.

HIV/AIDS

While the death toll from AIDS is dwarfed by that of heart disease and cancer in Estonia, the country has the highest prevalence of HIV in all of Europe. Around 1.3 percent of the population carries HIV, comparable to rates in Sierra Leone or Mali.

The first case of HIV was diagnosed in 1988, and the rate of incidence remained minuscule until the turn of the century. According to a report by the World Health Organization (WHO), the disease exploded in 2000, mostly among drug users.

Since then, the incidence rate has declined, but still more cases are reported each year. Epidemiologists have found that heterosexual transmission has increased in recent years, adding to the more than 9 thousand Estonians who have been infected.

Estonia has seriously grappled with HIV/AIDS for decades. All treatment for HIV-positive patients is free, and education about the disease is standard in Estonian classrooms. Some trends have epidemiologists in the country hopeful: according to UN AIDS, both safe sex practices and HIV testing are on the rise among Estonians.

Tuberculosis

Like AIDS, tuberculosis is not one of the major killers in Estonia, but the disease poses complex challenges for the country’s health system. Estonia has one of the highest multi-drug resistant tuberculosis burdens in the world. In many ways, tuberculosis in the country is tied to the issue of HIV: the prevalence of TB/HIV co-infection in Estonia is one of the highest in Europe at 15 percent.

Beyond people who suffer from AIDS, tuberculosis also particularly threatens Estonians who use intravenous drugs or drink heavily — a population that reports from WHO suggest could be large.

The rate of tuberculosis incidence is decreasing, indicating that Estonia is winning its battle against the disease. But according to WHO, as the incidence decreases, new challenges will arise. As the issue shrinks in magnitude, political and financial commitment may also dwindle — something that Estonia’s government must avoid if the disease is to be defeated in the country.

Obesity

There is still controversy over whether obesity is actually a “disease,” but reports and data on public health in Estonia have outlined it as a clear issue. Sources disagree, but 2014 research from the University of Tartu found that as many as one in three Estonians are clinically obese (a body mass index of over 30).

Obesity can greatly increase the risk of a myriad of health issues, including diabetes, heart disease and stroke. Heart disease and stroke accounted for nearly half of all deaths in Estonia in 2012 (48 percent), so many physicians believe the issue should be taken seriously as one of the top diseases in Estonia.

The issue may be correlated to modernization. WHO estimates that nearly half of Estonian adults are insufficiently active, while salt intake is growing.

Obesity is not an easy issue to tackle, but growing scholarship and research on obesity has helped Estonia assess its magnitude and effects. In recent years the government has implemented some policies to promote consumer awareness and healthy eating habits in schools.

Estonia faces unique but surmountable public health challenges. The government likely has the means to solve such issues, and the nation, therefore, serves as a good example of how funding is not the only weapon fights like these; there must be political attention, commitment and patience. Coming years will tell the extent Estonia’s diligence in the realm of health, and likely provide valuable lessons for nations facing similar issues.

Charlie Tomb

Photo: Flickr

VisionspringThe importance of manual labor in the global economy is a key component in the fight against poverty in developing nations.

The World Economic Forum foresees that, despite predictions of technological advances, employment in the manufacturing and agricultural sectors will continue to grow for years to come.

A New York-based social enterprise sees the solution clearly: to alleviate poverty in developing nations, we must first focus on elevating the labor force.

The World Health Organization estimates that 90 percent of the world’s visually impaired live in developing countries, while nearly 80 percent of visual impairments can be prevented or cured. Without affordable vision care services, an estimated 703 million people in developing countries suffer from visual impairment and lack access to eyeglasses.

These problems are compounded by the nature of labor-intensive manufacturing jobs in developing countries, such as textile, clothing and machine/computer assembly – which require clear eyesight. As a result, vision problems pose significant obstacles to workers, by either hindering their productivity or rendering them unemployable.

With these looming statistics and the understanding that “if you can’t see, you can’t work,” founders and optometrists Jordan Kassalow and Scott Berrie established Visionspring in 2001 with the aim of providing vision care and eyeglasses to combat poverty in developing nations.

Visionspring considers the lack of optic care in low-income areas a market failure, and intends to address poverty in developing nations by fundamentally restructuring the market for eyeglasses.

Visionspring relies on partnerships with local NGO’s and small businesses in over 40 countries. Local entrepreneurs are trained by Visionspring to operate satellite optical shops. The shops provide high-quality care, and sell glasses that cater to a variety of customer needs, including bifocals, single vision, and photocromic lenses.

Rather than providing donated eyeglasses, which are costly to ship and often damaged upon arrival, Visionspring supplies new pairs of glasses to its customers around the world, thus stimulating production and providing lenses to those who need them most.

A 2007 Impact Assessment performed by Visionspring measured the effect of providing reading glasses to those in the developing world. The study found that reading glasses have the potential to increase a worker’s productivity by 35 percent.

A follow-up study done by the William Davidson Institute at the University of Michigan reported a consequent increase in monthly income by 20 percent for those whose vision was corrected. The result is a higher disposable income for the world’s poor, and eventually elevation out of poverty.

By addressing a specific need and empowering local people to provide essential services to their communities, the Visionspring model is globally viable. In 2012, Visionspring celebrated its millionth pair of eyeglasses sold in the developing world.

Eye care continues to gain ground as an important topic in the global health arena. In 2013, the World Health Assembly approved an action plan for universal access to eye health, which aims for a 25% reduction of avoidable visual impairments by 2019.

Visionspring will play an integral role in the achievement of this goal, as it keeps its sights on addressing the needs of workers and alleviating poverty in developing nations.

Laurel Klafehn

Photo: Flickr

Breastfeeding Advocacy Initiative
Only 38 percent of infants are exclusively breastfed for their first six months of life. Improper and insufficient breastfeeding contributes to nearly 800,000 preventable child fatalities every year. A breastfeeding advocacy initiative would not only challenge the social pariah of the practice but also contribute to the improvement of mother and children health worldwide.

Breast milk contains all of the nutrients that babies need in their first six months and has the ability to strengthen a child’s immune system to protect against illness. Breast milk has also increased children’s physical and cognitive development.

The benefits of breastfeeding extend beyond a baby’s health. Mothers who breastfeed reduce their risk of suffering from postpartum hemorrhage, which is a leading cause of death among new mothers. Mothers also find themselves at reduced risk for diabetes and breast cancer.

Why Breastfeeding is No Longer the Norm

So why then are such a small percentage of babies exclusively breastfed? One reason for low breastfeeding rates is the issue’s generally low prioritization by political leaders and policy makers.

Women also feel that breastfeeding is looked down upon in the workplace and the public sphere. For instance, if women cannot find a comfortable place to breastfeed at work, then their child is less likely to receive his or her’s natural source of nutrients. Additionally, there are many companies that sell formula and aggressively market the concoction as being a better alternative to breastfeeding.

To improve breastfeeding statistics, there is a global breastfeeding advocacy initiative underway with support from organizations such as UNICEF and the World Health Organization. Initiatives focus on educating mothers and communities about the benefits of breastfeeding, and supporting policies and programs that spread this message.

In the west African nation of Guinea-Bissau, one in ten children will die before they reach five years of age. Organizations such as UNICEF and the non-governmental organization CARITAS work tirelessly to improve this statistic, and a fruit of their labor has been the nutrition bungalows that now exist in Guinea-Bissau.

Nutrition Bungalows

At these bungalows, mothers of children under five years old are invited to gather monthly for information sessions. The sessions are often interactive and they focus on promoting health for mothers and children. Mothers can also have their children measured and weighed to ensure that they are meeting developmental milestones.

These nutrition bungalows and all other projects incorporating a global breastfeeding advocacy initiative aim to spread awareness and increase support for exclusive breastfeeding in both the political and social spheres. In doing so, lives of mothers and children can be saved and their quality of life improved.

Nathaniel Siegel

Photo: Pixabay

Health in AfricaOn August 26, the World Bank and the Global Fund to Fight AIDs, TB and Malaria (Global Fund) committed to investing $24 billion to accelerate universal health coverage in Africa. The funding aims to achieve universal health coverage in Africa (UHC) by 2030 as part of the Sustainable Development Goals (SDGs).

The announcement of funding was made at the sixth annual Tokyo International Conference for African Development (TICAD-VI). The investment will fund UHC in Africa: A Framework for Action, a plan launched by the World Bank, World Health Organization (WHO), the government of Japan, Japan International Cooperation Agency, Global Fund and the African Development Bank.

The framework targets specific areas that will greatly contribute to the achievement of UHC in Africa including financing, service delivery, targeting vulnerable populations, mobilizing critical sectors and political leadership.

Over the next five years, the World Bank plans to contribute $15 billion under the Global Financing Facility, Power of Nutrition, early childhood development, pandemic preparedness, targeting the poor, crisis preparedness and response and leveraging the private sector. The Global Fund has committed an additional $9 billion in funding between 2017 and 2019 to treat and prevent HIV, malaria and TB.

Emphasizing the importance of good health for economic productivity, the President of the World Bank Group, Jim Yong Kim, stated, “African countries can become more competitive in the global economy by making several strategic investments, including investing more in their people, their most prized resource.”

Today, millions of impoverished people cannot afford proper health care and are further entrenched in poverty as a result. The provision of universal health care in Africa would create boundless opportunities for individuals to access health care and work towards prosperity.

Not only does ill-health have devastating effects on an individual basis, but it also drastically affects the economy. Poor health impedes impoverished populations from working and prevents children from attending school. Well-designed universal health care can help alleviate the burdens of poor health, including creating employment opportunities in the healthcare industry.

In 2012, the U.N. called on the international community to substantially increase its funding for health care in developing nations. Marking December 12 as ‘Universal Health Coverage Day’ and turning it into an international movement, the global community increasingly emphasizes the positive outcomes of UHC and the importance of new, innovative ways to reach the most impoverished populations.

Recognizing the importance of achieving UHC, African Heads of State, in conjunction with the World Bank and Global Fund, have vowed a commitment to the push for UHC across the continent. Through international funding, a strategic framework and both regional and global support, UHC in Africa could be an obtainable MDG by 2030.

Anna O’Toole

Photo: Flickr

Diseases _AfghanistanAfghanistan is the 15th least developed country in the world, where thousands of people die each year from preventable diseases. The World Health Organization (WHO) uses age-adjusted rates to compare these diseases and see which ones cause the most deaths. Age-adjusted rates are the rates/dates that would have existed if the population under study had the same age distribution as the “standard” population. Based upon this data, the following are the top 10 diseases in Afghanistan:

  1. Coronary Heart Disease: A disease in which a plaque builds up in the coronary artery and blocks oxygen-rich blood from reaching the heart muscle.
    Based on an age-standardized death rate taken in 2014, coronary heart disease ranks number one of the top diseases in Afghanistan taking thousands of lives each year. Of all the deaths in Afghanistan according to the 2014 data, coronary heart disease accounted for a little more than 9 percent. The age adjusted death rate for this disease calculates to 193.21 per 100,000 people ranking Afghanistan twentieth in the world.
  2. Pneumonia: Lung inflammation caused by bacterial or viral infection.
    Influenza: Also known as the “common flu.”
    According to data recorded in 2014, deaths caused by influenza or pneumonia totaled 28,841 people. The age-adjusted death rate is 97.78 per 100,000 people making it the second most prominent disease in Afghanistan. Unfortunately 72 percent of children who suffer from pneumonia are unable to reach the necessary care of a doctor.
  3. Tuberculosis: a bacterial disease caused by growth of nodules in the tissues.
    The age-adjusted death rate for tuberculosis as of 2014 is 70.41 per 100,000 people. This ranks Afghanistan number 13 in the world regarding mortalities from tuberculosis. Early treatment and proper diagnosis needed to cure tuberculosis and therefore upwards of 13,000 Afghans die each year from the preventable diseases in Afghanistan.
  4. Diarrheal Diseases: Loose bowel movements that often cause dehydration.
    In 2014, 15,977 people or 7.10 percent of the population died because of diarrhoeal diseases. This often can be prevented by drinking safe, clean water and access to adequate sanitation which many Afghans cannot accomplish. Only 48 percent of those with a diarrhoeal disease receive the proper rehydration needed to survive. With many diseases causing early childhood deaths, diarrheal diseases account for 25 percent of them.
  5. Diabetes Mellitus: The most common form of diabetes.
    In 2015 there were 935,800 cases of diabetes in Afghanistan and 19,698 deaths. The age adjusted death rate for tuberculosis as of 2014 ranks diabetes mellitus in Afghanistan number 71 in the world regarding mortalities.
  6. Lung Disease: A problem with the lungs that prevents the lungs from working properly.
    Lung disease caused 2,874 deaths according to data recorded in 2014. The age adjusted death rate is recorded as 27.77 per 100,00 people ranking Afghanistan number 43 in the world regarding lung disease mortalities.
  7. Rheumatic Heart Disease: The age adjusted death rate for this heart disease is 27.57 per 100,000 people as published by data in 2014. Rheumatic heart disease is a condition in which heart valves are damaged (caused by the rheumatic fever). The rheumatic fever is a disease caused by untreated strep throat or scarlet fever.
  8. Hypertension: Abnormally high blood pressure.
    The age adjusted death rate ranks hypertension in Afghanistan at 25th in the world for deaths from hypertension. Without the proper access to professionals and doctors, diagnosing then implementing a way to fix hypertension is extremely difficult.
  9. Breast Cancer: A group of cancer cells that begin in the breast and often spread to other parts of the body.
    One in eight Afghan women are affected by breast cancer. According to the Minister of Public Health Affairs, “[Breast cancer] is not a fatal disease if we seek treatments.” However, the age adjusted death rate of breast cancer ranks Afghanistan number 20 in the world.
  10. Liver Disease: Some type of damage or disease to the liver.
    One of the most serious liver diseases in Afghanistan is hepatitis or inflammation of the liver. In 2013, almost 30,000 cases of viral hepatitis were diagnosed. The WHO is dedicated to fighting the “silent killer” by raising awareness and providing cures.

While deadly, the top 10 diseases in Afghanistan are treatable with the proper awareness and care.

Casey Marx

Photo: Flickr

Health and Climate
The Second Global Conference on Health and Climate met to set a new agenda for tackling health problems rising as a result of climate change. As the global state of climate shifts over the coming decades, this pantheon of experts, hosted by the government of France, hopes to address the way public health professionals deal with the resulting complications.

The objective of this conference was to demonstrate the commitment of the public health community to implementing the Paris Agreement, an historic treatise whose goals are to better treatment of the world and create a sustainable future.

With the Paris Agreement in mind, the countries committed to it should see a change in their public policy. The aim of the agreement is to make tangible changes through proper legal channels as quickly as possible. The right to health is at stake for many people, and this is precisely what the conference hoped to address in its talks of health and climate.

In response to the seven million people per year who die of pollution-related ailments such as strokes or lung cancer, the conference made it a goal to encourage countries to curb their pollution output. Thankfully, this recommendation aligns with the  global goal to reduce greenhouse gases and carbon emissions.

Among other topics, the panel discussed how to best implement and use renewable and safe energy sources to improve health and climate. Additionally, to assist in best promoting these difficult changes to countries, attendees of the conference made it a goal to calculate the economic benefits of switching to cleaner energy.

To further these aims, the WHO announced a focus on developing a new approach to health economics and climate change. They hope that by closely monitoring the changes in policy of each country every five years, the world will begin to see health and climate improvements for not only the seven million affected by pollution-borne diseases, but by all earthly inhabitants.

Connor Borden

Photo: Zimbio

International AIDS ConferenceThe International AIDS Society (IAS) hosted the 21st International AIDS Conference in Durban, South Africa from July 18 to July 22. The conference discussed the various improvements in HIV/AIDS science as well as challenges the medical community needs to address.

The theme of this year’s conference was “Access Equity Rights Now.” The event was designed to tackle inequalities in access to medical treatment, including barriers such as poverty, gender, race and location.

South Africa has the highest HIV/AIDS prevalence in the world. According to UNAIDS, anywhere between 6.7 and 7.4 million people live with HIV in the country. Yet, more than 60 percent of those infected are not on antiretroviral treatment.

The previous International AIDS Conference held in Melbourne, Australia called for the Victorian State government to repeal a law discriminatory to the HIV-positive population. Additionally, the 2012 conference in Washington, D.C. led to the government removing the country’s travel ban on individuals with HIV.

The equity rights movement within the 2016 conference is a push toward equality for marginalized communities affected by the virus.

According to the World Health Organization (WHO), two-thirds of new HIV infections occur in Sub-Saharan Africa. Men who have sex with men, drug users and sex workers are among the various groups that are at a higher risk of infection. Even women face higher chances of transmission and greater barriers to treatment.

The International AIDS Conference brings together health professionals to improve the state of HIV/AIDS detection and treatment around the world. While there is still a long way to go in the struggle against this virus, statistics over recent years show promise.

The WHO reports a 35 percent decrease in new HIV cases in addition to a 28 percent decrease in deaths due to AIDS since 2000. With the majority of HIV cases in low and middle-income countries, the support of the international community is crucial to saving lives.

Saroja Koneru

Photo: Flickr