Posts

,

Transgender Population and HIV: Uncovering Problems

Transgender Population and HIV: Uncovering Problems
HIV is one of the few viruses to completely alter the landscape of the entire world as a whole. Not since great pandemics such as the Black Death has a sickness decimated families, communities and nations like HIV has.

HIV does not discriminate. The virus infects people from all walks of life: Muslims, Christians and Atheists; Blacks and whites; males and females; even the old and the young. Likewise, to combat HIV, the world needs to fund prevention programs just as indiscriminately.

From the misconceptions as an exclusively homosexual disease to the unity the world has made in dealing with it, one thing is for certain—HIV is still present and must be eliminated.

HIV strategies have been largely successful in combating HIV and preventing AIDS from infecting people at staggering rates. According to UNAIDS, in 2014, 2 million new infections of HIV were recorded. This was down 35 percent from the year 2000 when that number was reported at 3.1 million new infections.

The overall HIV and AIDS mortality rates have also fallen over the course of 15 years. A total of 36.9 million people worldwide are living with HIV, and 1.2 million have died from AIDS. That is down from 2 million in 2005. Almost half the current HIV population is taking antiretroviral therapy (15 million). Currently, $20.2 billion is invested in the AIDS response, right on target of expected funding required at $22 billion.

There is, however, one group of minorities who are of a great deal of concern. They are transgender people. They represent a group of people with the most imbalance of all infected groups.

According to the most comprehensive WHO report on transgenders to date, transgender women have 49 times higher odds of HIV infection than the general population. Among sex workers, transgenders have nine times higher odds of contracting HIV compared to female sex workers.

The imbalance has many factors behind it. They are the largest under-served community when it comes to HIV prevention. This is due to marginalization, lack of access to proper treatment for many mental health-related issues, grouped with homosexuals in prevention tactics and also being a target of violence.

Transgender individuals face many social issues in society. While some may be well off, many transgenders work low-paying jobs due to a lack of equal opportunities for employment. Stigma and discrimination cause many to turn to drugs and sex work as a means of making money.

That lifestyle can lead to many health risks, including drug abuse, homelessness and the lack of access to adequate medicines. Many transgenders also face discrimination when they attempt to receive medical treatment from healthcare workers. It makes them more susceptible to infection.

Another problem is the lack of countries properly defining what gender a transgender person is. Many countries consider transgender sex the same as homosexual behavior. Anti-homosexual laws make transgenders fearful, hiding their infections for fear of death or incarceration. Some fear carrying condoms, as they may be used against them to confirm illicit behavior by law officials.

Inadequate training among healthcare workers to transgender-sensitive issues leads to misdiagnosis and mistrust.  The negative discrimination mentioned also decreases the quality of care they receive. Coupled with the general stigma, this creates a vicious cycle that is not helping with HIV prevention measures.

Transgenders are also vulnerable to higher degrees of violence and rape. There are no feasible studies to measure the number of rapes and murders transgenders experience due to misreported gender identity. Rape victims may contract HIV and not report it due to fear of retaliation.

All these problems have led to poor results in HIV prevention amongst transgender populations in the world. The issue is crucial in the fight against AIDS because some transgender people may have sexual partners with both males and females, making more people susceptible to spreading HIV. The global effort to combat AIDS must include all types of people around the globe.

The next part of this article will demonstrate working solutions and how continuous funding will help reduce HIV.

– Adnan Khalid

Sources: UNAIDS, World Health Organization
Photo: HIV Plus Mag

,

Pilot Program Trains Health Workers for Post-Ebola

Pilot Program Trains Health Workers for Work Post Ebola

After tending to Ebola patients in West Africa for over a year, health workers have begun returning to their regular jobs. Because of the disease’s decline, a pilot training program to prepare these employees to return to work took place in May 2015 in Liberia.

The training program’s aim was to “refresh important skills but also address weaknesses exposed by the Ebola outbreak,” according to Foday Kanneh, a Ministry of Health training coordinator. Dr. April Baller, head of World Health Organization’s (WHO) clinical management and infection control—along with other prevention teams and Ministry of Health and WHO staff—created the training program. It was a rigorous course designed to “support the restoration and strengthening of the health system which virtually collapsed during the epidemic, while also giving health workers the confidence and capacity to respond in the event that Ebola re-emerges,” said Baller.

Although Ebola is in decline, no one knows when it could return. This disease first appeared in 1976 and did not resurface in human beings between 1977 and 1994. With such erratic exposure, health workers need to be trained for the post-Ebola environment.

Doris Sannoh, a trainee and social worker in Liberia, said that she normally worked in an outreach capacity to prevent HIV and gender-based violence. During the outbreak, she found herself working in the triage area of the hospital, counseling and assisting sick patients. “I never had any infection prevention training as a social worker, but I needed it. As health workers, we all need training like this.”

The training sessions were led by 40 trained facilitators and assisted by Ebola survivors. The survivors role played the parts of patients and critiqued the trainees on the quality of care they administered. In order to ensure that the training acquired during the sessions was used regularly and effectively, on-site mentoring and monitoring was crucial, according to Kanneh. Currently, the Ministry of Health and the WHO are evaluating the course and, if appropriate, will refine it and expand it throughout the country.

According to the WHO, “The West African Ebola outbreak has been the largest, most severe and most complex in human history.” When the outbreak began in March 2014, health workers from all over the world stepped up to work with the WHO to stop the epidemic. It peaked in September 2014 and is now in decline. Guinea, Liberia and Sierra Leone reported a combined total of 27,705 confirmed, probable and suspected cases up to July 19, 2015. Deaths from confirmed as well as probable and suspected cases totaled 11,269.

The good news is that in the week before July 19, Guinea reported only 22 new confirmed cases, and Sierra Leone reported four. This good news gets even better: Liberia has not reported any new cases in the week before July 19. Currently in Liberia, 56 people who have had contact with Ebola patients are under follow-up care. Eighteen have completed the 21-day surveillance period. If no new cases arise, all contacts will complete follow-up by August 2.

– Janet Quinn

Sources: WHO 1, WHO 2, WHO 3
Photo: World Health Organization

, ,

Breeding Superbugs

SuperbugsResearchers have been tracking the increase of the global spread of antimicrobial-resistant infections, also known as superbugs. But the reason for this increase surprised the researchers — drug co-pays seem to have increased superbugs.

Superbugs are defined as “strains of bacteria that have changed (or mutated) after coming into contact with an antibiotic. Once this happens, these bacteria are ‘resistant’ to the antibiotic to which they have been exposed, which means the antibiotic can’t kill the bacteria or stop them from multiplying.”

Many individuals may suggest going back to a doctor and receiving a new prescription for a different antibiotic. But in the developing world, many individuals cannot afford the co-pays for multiple doctor visits, let alone the cost of multiple antibiotic prescriptions.

With the rising costs of prescriptions, many individuals are turning to informal or black markets for their prescriptions. The pills that they buy from black markets may be lower quality, prescribed inappropriately or dosed incorrectly. All of these factors can lead to the spread of superbugs.

According to an analysis of data from 47 countries published in the Lancet Infectious Disease Journal, the amount people spend out-of-pocket on healthcare has turned out to be a better predictor of antibiotic resistance than poverty, sanitation or livestock production.

In the first major report last year, the World Health Organization (WHO) has called antibiotic resistance “a growing public health threat.” This report, which tallied the level of antibiotic resistance in each country, warned that “many of the available treatment options for common infections in some settings are becoming ineffective.”

According to the Centers for Disease Control, each year superbugs cause 2 million people in the United States to become sick, killing 23,000. With the advanced healthcare available in the United States, what effects do superbugs have on the developing world?

With the WHO report in mind, researchers from Stanford University in California and Gandhi Medical College & Hospital in India set out to determine whether the levels of resistance in low and middle income countries were linked to the direct healthcare costs that patients pay.

The researchers found that in countries where patients paid a higher share of healthcare costs, there was a higher level of antibiotic resistance. But this was also only evident in countries that charge co-payments for prescriptions.

While this data does not prove that higher prescription costs cause greater antibiotic resistance, it does show that the two are linked.

Co-payments are usually used to discourage people from seeking unnecessary healthcare but are currently having the opposite effect. With higher co-payments, patients that cannot afford the cost must look elsewhere for their prescriptions: the black market.

Not only are patients endangering themselves with unknown prescriptions and doses, but they are also enabling antibiotic resistance. There needs to be a change so that patients are able to receive needed antibiotics at a reasonable price. If not, antibiotic resistance will become a major problem in the future.

– Kerri Szulak

Sources: ABC Health & Wellbeing, Bloomberg Business
Photo: Live Science

, ,

Low Cost Vaccine Production for Developing Countries

vaccine_production

The World Health Organization (WHO) officially recognized Vietnam recently as a valid producer of vaccines for the world market. The WHO carefully assesses countries’ vaccine production capabilities, and if requirements are met, national regulatory authority recognition is granted, which pre-qualifies a nation to export their vaccines.

This move comes after the Biomedical Advance Research and Development Authority (BARDA) of the U.S. Department of Health and Human Services, the WHO and global health nonprofit PATH, have partnered to source low-cost influenza vaccines in places such as Vietnam, working through Vietnam’s public Institute of Vaccines and Medical Biologicals (IVMB).

Latin American and Asian countries have traditionally been instrumental in producing and exporting what are known as Expanded Program on Immunization (EPI) vaccines. EPI is a WHO initiative, which for many years has made sourcing and distribution more efficient for vaccines, which prevent diseases such as malaria, tetanus, tuberculosis and whooping cough. These diseases have a disproportionate impact on the poor, who may lack even basic access to healthcare and face a higher disease burden. Fortunately, initiatives like the EPI have been very effective at improving the availability of vaccinations; WHO initiatives have totally eliminated smallpox, and almost completely eradicated polio and measles. Previously, these diseases killed millions every year.

However, ensuring that these immunizations are easy to produce is essential to their distribution to the people who need them most. This is not always possible because new vaccines sometimes require technologies and production methods that are simply not available to low-cost producers. Since its inception in 2000, the organization GAVI, which focuses on vaccine production for the developing world, had been managing the distribution of DTP3, a combined immunization product that protects against diphtheria, pertussis and tetanus. There was only a single manufacturer of these vaccines until 2006.

According to a joint report by Doctors Without Borders and Oxfam, the handful of large companies that produce vaccines for distribution to developing nations offer reduced pricing to organizations such as GAVI. However, this pricing is still greater than that which would be possible with greater competition and low-cost, high volume production taking advantage of economies of scale by emerging producers. These emerging producers account for up to 86% of the volume of traditional vaccine production globally, but have a hard time producing rarer, more expensive vaccines in the same volume. However, several public sector firms such as Vietnam’s IVMB, Brazil‘s BioManguinhos and China’s Chengdu are greatly expanding research and development for these vaccines.

There are a few barriers for emerging producers trying to break into the vaccine market. Vaccines often have intellectual property protections, which prevent other producers from developing a generic version. Potential low-cost producers might also struggle to meet pre-approval standards for the WHO, a barrier that Vietnam overcame. This barrier can sometimes be a huge impediment for vaccine distributors, which target the poor like GAVI and must source over half of their vaccines from emerging producers to be effective.

Increased competition from emerging producers, reducing unnecessary patent protections and simplifying production methods are the only things that can reduce the price of immunizations. Thus, adequate, publicly funded research and development, as well as initiatives such as those mentioned at the beginning of this article that assist low-cost producers in breaking into the market, are needed. Otherwise, private multinational pharmaceutical companies tend to dominate market share of expensive vaccines, which are less likely to make their way to the parts of the developing world where they are sorely needed.

– Derek Marion

Sources: Thanhnien News, PATH, WHO 1, WHO 2, Oxfam MSF, Gavi
Photo: Thanhnien News

, ,

New Technology Improves Cancer Testing

cancer_testing
Cancer. The dreaded disease kills millions around the world. It sometimes seems like everyone knows someone that it has cursed with its cruel touch. But even in the developing world, it is having a huge impact on thousands of people.

According to the World Health Organization (WHO), around 7.9 million people around the world die from cancer each year. While many think of this as more of a developed world problem, 5.5 million of those cancer-related deaths take place in the developing world. That is 70 percent of cancer deaths across the globe. Once a disease associated with the affluent, it is now an affliction of the poor.

Worse, cancer deaths are to increase to 6.7 million by the end of this year and further to 8.9 million by 2030 in the developing world. During the same time frame, cancer deaths are expected to remain at current levels in the developed world.

A few factors will contribute to this expected rise within the next 15 years of cancer-related deaths. First is the globally aging population. To go along with this is a increase in rapid, unplanned urbanization as well as the globalization of unhealthy lifestyles.

Most health infrastructures in developing countries are designed to respond to infectious diseases. Cancer requires more resources financially, as well as treatment technology, equipment, staff or training than most countries have access to.

There is not only an issue here of deaths but also needless suffering. Sadly, there is very large lack of response capacity in the developing world. There is a lack of preventatives, treatment, public education and diagnosis. Early diagnosis in particular is a problem, and once diagnosed it is usually the rich that have access to treatment, whether surgery, chemotherapy or radiotherapy out of country. This is especially the case in Africa.

After all that, it might appear that everyone is doomed. However, recent good news about new technology to diagnose cancer early in the developing world has things looking up.

Early diagnosis is key in cancer. If the disease is not recognized early through cancer testing, then treatment is usually not effective. Seventy percent of those that even get diagnosed in the developing world do at this late stage when treatment is essentially useless.

Important to detecting cancer are biomarkers – cells or molecules along with “any other measurable biological characteristic that can be used as an objective way to detect disease.” Glycoproteins are especially useful biomarkers. They are found throughout the body, in blood, mucus and sperm.

New technology is using glycoproteins to detect cancer early. The lock and key method takes a disease biomarker, like a glycoprotein of prostate cancer, and makes a cast of it. “The prostate cancer glycoprotein is tethered to a surface and detection molecules are assembled around it. When the glycoprotein is removed, it leaves behind a perfect chemical ‘cast’.”

Essentially, the lock and key technique means that only another cancer glycoprotein will fit the mold – others might be the same size, but they will not have the specific molecules needed to bind to the lock created by the original one.

As this method of diagnosis does not rely on antibodies, it does not require special storage. The lock and key cancer testing method is a simple and effective way to detect cancer early, and can even be molded to specific cancers and other diseases. The advantages are obvious, but time will tell if the method of testing becomes wide-spread in the developing world.

– Gregory Baker

Sources: The Conversation, WHO
Photo: The Conversation

, ,

Off-Grid Vaccine Refrigerators Improve Immunization

Immunization
Most vaccines are heat-sensitive and must remain in a cool, controlled environment. However, this is easier said than done when the vaccines must be transported over a great distance, arriving at a remote location with frequent power outages or no electrical grid at all.

Introducing the direct-drive solar refrigerators: a solar-powered fridge that keeps vaccines cool for long periods of time without relying on gas or kerosene. Off-grid refrigerators were introduced in the 1980s in areas without electricity, but recent technological improvements have made them more efficient and accessible than ever before.

The new technology, sponsored by PATH and the World Health Organization, has “direct drive” technology that uses the sun’s energy to freeze water, creating an ice “bank” that the fridge can tap into during the nights and cloudy days.

A direct-drive solar refrigerator could prove to be invaluable to developing countries. Immunizations would be more stable and more accessible, meaning people would get treated faster.

But the fridges are not the simplest of innovations—any given country will need a long-term plan upon making the initial investment for semi-regular maintenance and repair. On top of that, an experienced professional would have to install the fridge to ensure it is done correctly, and then train local technicians to maintain and repair them.

Despite the drawbacks, the direct-drive solar refrigerator is already working. In the Philippines, a solar refrigerator called the Sure Chill is storing vaccines for longer than previously possible, helping rebuild the cold chain infrastructure after the typhoon in 2014. The Sure Chill fridges uses solar and water power and can run without electricity for up to 10 days. These fridges have a big price tag, about $2,600 each, but are already proving to be extremely worthwhile.

– Hannah Resnick

Sources: Alternative Energy, Science Dev, WHO
Photo: Flickr

, ,

The Jompy Water Boiler: A Lightweight, Inexpensive Solution

water_boiler
From 1990 to 2011, over 2 billion people gained access to an improved water source—that’s a hugely improved standard of living for more children, families and communities worldwide. However, not all water is clean drinking water, which is exactly what Celsius Global Solutions aimed to fix with the Jompy Water Boiler.

The Jompy Water Boiler is a lightweight, inexpensive device that simultaneously enables people to cook a meal and heat water to bacteria-killing temperatures, making the water safe for drinking and bathing.

The boiler itself is a flat metal disk with a handle connected to a container of water through a tube. The flat disk is placed over the heat source. Its shape allows the user to put cooking tools right on top of it. As the disk gets hot, the heat is transferred through the tube to the water container, which quickly heats up, and the water becomes decontaminated. The Jompy Water Boiler works equally well on stovetops and on open fires, making it useful in urban and rural settings.

In 2006, Glasgow University did a test run of the Jompy Water Boiler in Uganda. The test was conducted with 99 families, 49 of which were given water boilers. The World Health Organization set the objective of this research to have zero water-born diseases, such as E. coli, in the families that used the product.

The results were impressive. Of the 49 families with Water Boilers, only one family had a case of E. coli. Meanwhile, of the 50 families without water boilers, there were several cases of the water-born disease.

On top of reducing the risk of disease, families reported that they saved an average of 3 kg of firewood per day and more than three hours of their time due to reduced cooking times using the Jompy Water Boiler. It saves time and effort, all while consuming less fuel and reducing CO2 emissions.

The Jompy Water Boiler is currently used in India, Kenya and Uganda, but it has the potential to make a serious impact on the lives of those living in developing countries. It is efficient, cheap and worthwhile.

– Hannah Resnick

Sources: Empowering People, Jompy, UNICEF, Venture Beat, Wikia
Photo: Siemens

,

A New “Leash” on Life: India’s Stray Dogs

India’s_Stray_Dogs

While the nation of India has found its own new lease on life as it begins to become heavily industrialized, the furry members of its society are facing some new challenges.

For decades India has struggled with the issue of stray animals, and while cows and elephants are considered holy and treated with respect, the dogs and cats of India are facing a much harder time in their attempts to stay alive.

According to the World Health Organization, there are around 18,000 reported cases of rabies every year in India. In order to remedy this, India’s government had called for the euthanization of India’s stray dogs; however, after much discussion, the Animal Welfare Board of India (AWBI) has asked many states to hold off on this action and attempted to vaccinate the stray animals against several diseases. Essentially, the AWBI believes that such actions taken against these animals is inhumane, as there is no clear distinguishing factor that determines whether an animal should be put down or vaccinated.

When walking the streets of India, it is very common to see dogs and cats roaming around, but travelers are advised not to pet them or interact with them, as they often find food in waste piles and are thus highly prone to disease and infection. However, many residents have been taking care of these animals for years; these animals are thought to have migrated over along with the original inhabitants of the land, thus creating a very blurry line as to which animals are stray and which have been domesticated. The issue with the current laws is that there is no defining point at which an animal becomes a family member and at which point it is still a stray. Many animal rights groups working alongside citizens have been fighting for this distinction to be made.

For now, the AWBI is advising the government to hold off on any euthanization or vaccination tactics that may be used to reduce the stray animal population. Some experts have proposed the idea of neutering definitively stray dogs and cats, so as to reduce the population. Many experts have made it clear that the key to reducing this issue is to better understand the animals themselves and their behavior. Most healthy animals will not bite or scratch a human unless they feel threatened, so a better understanding of animal behavior will allow citizens to express proper caution when dealing with them.

While the government of India remains at a standstill, citizens and animal rights groups have begun to press for better adoption systems and more definitive lines as to an animals ownership. Euthanization of these animals is effectively going against the Indian Supreme Court ruling against the killing of animals, and harm and cruelty toward animals. Many petitions and protests have been held against this action, but no decision has been reached. There is still a long road ahead for these furry friends, but it looks like there may be a light at the end of this very long tunnel.

– Sumita Tellakat

Sources: CNN, BBC
Photo: CNN

New Vaccine to Protect Children in Côte d’Ivoire

New Vaccine to Protect Children in Côte d’Ivoire-TBP
Under the recommendation from the Polio Eradication and Endgame Strategic Plan 2013-2018, the Ivorian government has introduced the Inactivated Polio Vaccine (IPV), a new vaccine to protect children, into routine immunization programs.

The plan was drawn up due to the spread of polio to over 20 virus-free countries in the past 10 years from regions still considered endemic areas.

Côte d’Ivoire has been implementing strategies from the Global Polio Eradication Initiative (GPEI), which has members who support the plan, since 1997, the last time a polio type 2 case was reported. There has been no detection of wild polio cases in the country since July 2011.

By introducing IPV into routine immunization programs, Côte d’Ivoire will ensure the protection of 650,000 children every year from the virus. The first vaccines were administered at a ceremony on June 26.

The Polio Eradication and Endgame Strategic Plan 2013-2018 focuses on four objectives. The plan aims to identify and disrupt the transmission of the virus, create a stronger immunization system and withdraw the oral polio vaccine (OPV), contain the virus and use the knowledge, and help address other global health goals.

By removing OPV from immunization programs, Côte d’Ivoire is eliminating the chance of vaccine-derived polio, a small risk associated with the vaccine.

IPV, however, will increase the protection of children in the West African nation.

The plan was originally endorsed by the World Assembly in 2013 and organizations such as the World Health Organization, Centers for Disease Control and Prevention, and United Nations Children’s Fund are helping to spearhead the plan.

– Matt Wotus

Sources: Gavi 1, Gavi 2, Global Polio Eradication Initiative
Photo: All Africa

,

Why This Year’s Flu Epidemic May Be the Worst One Yet

Why this year's flu epidemic may be the worst one yet - TBP

Every winter, the elderly line up at their local drug store and people start walking around cities with face masks—all hoping to avoid getting this year’s strain of the flu. But much like many other diseases, the flu hits people in undeveloped countries, who have minimal access to quality healthcare, harder than it hits those in the United States. This summer, poultry farmers in West Africa are hit particularly bad as the flu epidemic spreads between their livestock.

“[Poultry farming] was our main activity for revenue,” said Naba Guigma, a poultry farmer from Burkina Faso’s Boulkiemde province, a region hit particularly hard by this strain, told IRIN. “Now I have no more poultry. The henhouse is empty.”

Millions of other farmers find themselves in the same situation as Guigma, as the sector has been steadily growing in West Africa since 2005. In Cote d’Ivoire alone, jobs in poultry farming have increased by 70% between 2006 and 2015, according to the U.N.’s Food and Agriculture Organization (FAO). This kind of job growth means that this epidemic does not only affect individual farmers but damages the entire regional economy.

The strain was confirmed to be H5N1, a particularly deadly strain of the bird flu or H1N1 that circled Africa, America and beyond in 2008 and 2009. First identified in January in Nigeria, this poultry flu has since shown up in Cote d’Ivoire, Burkina Faso, Ghana and Niger. Before January, what is commonly known as “bird flu” had not been seen in the region since the epidemic in 2008.

This strain of the disease is particularly dangerous because it can kill the chickens before it is recognized. Guigma initially thought his chickens and guinea fowl were sick with the Newcastle virus, a routine poultry disease. Just two weeks after Guigma first noticed the signs of disease, all of his 120 birds—worth up to $515—died, leaving Guigma without any source of income and with higher prices for poultry in his region.

“At this point, we don’t know very much about these viruses,” said CDC officer Alicia Fry at a press conference with the International Business Times in April. However, given that the virus kills animals in a radius of a contaminated copse and the main way of dealing with exposed animals is killing them on compensating their owners, the future does not look bright for these poultry farmers.

“Nothing about influenza is predictable—including where the next pandemic might emerge and which virus might be responsible,” the United Nations health agency told International Business Times in March. According to the World Health Organization, if this flu is not well-monitored, it could be worse than the 2009 swine flu outbreak that killed over 284,000.

– Eva Lilienfeld

Sources: IB Times 1, IB Times 2, Irin News
Photo: Newshunt