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Global Opioid Crisis
Political pundits and policymakers have acknowledged the severity of the U.S. opioid crisis. However, there is also a drug that is quietly wreaking havoc on developing nations. Many have touted tramadol as a safer alternative to other opioids. However, it has instead fostered addiction in the poorest nations and bankrolled terrorists. Authorities fear that the drug’s growing popularity may even destabilize entire regions, causing the global opioid crisis.

Is Tramadol Safe?

At first glance, it is not clear how tramadol is fueling the global opioid crisisIn 2021, the National Institute of Health (NIH) released a study declaring that tramadol has “a low potential for abuse” and has a significantly lower rate of nonmedical use than comparator opioids.

In addition, the World Health Organization (WHO) Expert Committee on Drug Dependence has reviewed the drug several times. It recommended against regulation in its most recent report. The main reasons are its concerns that regulation may hinder access to the drug in developing nations.

However, a closer look at the drug and its effect on the developing world demonstrates clearly how tramadol is fueling the global opioid crisisTramadol is an opioid that medical professionals use to treat moderate to severe pain. It may cause nausea, dizziness, constipation, headaches, respiratory depression and even death.

Tramadol and the Global Opioid Crisis

Despite its presentation as a safe alternative to opioids such as Vicodin, there are plentiful examples of how tramadol is fueling the global opioid crisis:

  1. The illicit market for tramadol is booming. Grünenthal, a German company, originally manufactured the drug for medicinal purposes. However, inadequate access to medicine in the developing world allowed the illicit market to blossom. Lower prices and immediate access to illicit painkillers relieved the shortcomings of poor health care structures, as UNODC reported. Most of these drugs are coming from India. Pill factories have been meeting the demand for tramadol pills by shipping them across the planet in illegal amounts. The demand for these drugs and the absence of regulation keep such illicit trade profitable. U.S. law enforcement has estimated that its seizures of tramadol tablets leaving India in the 2017-2018 period exceeded 1 billion.
  2. Tramadol addiction is rampant in West Africa. According to the UNODC report, “opioids and their nonmedical use have reached an alarming state in West Africa.” The report collected data from Ghana, Burkina Faso, Benin, Niger and Togo. Tramadol seized in West Africa in 2017 accounted for 77% of the tramadol seized globally. It also acknowledged that non-medical use of tramadol is ubiquitous in Niger, where it is the narcotic people are most familiar with. The number of narcotics seized in Nigeria nearly doubled from 53 to 92 tons between 2016 to 2017. The report showed that overall, tramadol is the most popular opioid as it accounts for 91% of all pharmaceutical opioids seized in West Africa in 2017.
  3. The UNODC report on tramadol in West Africa highlighted one of the most sinister aspects of how tramadol is fueling the global opioid crisis. The report stated that “it cannot be denied…that there may be a link between tramadol trafficking and terrorist groups.” The report cited examples of Al Qaeda prompting its followers to trade tramadol to finance its terrorist operations as well as Boko Haram fighters depending on the drug before attacks. The statistics support these claims. According to CSIS, law enforcement intercepted $75 million worth of tramadol heading to the Islamic State group from India in 2017. Authorities also confiscated another 600,000 tablets bound for Boko Haram and found 3 million in a truck in Niger. In May 2017, authorities seized 37 million pills in Italy. Isis had bought them and intended to sell them for profit.

Tramadol Trouble Shooting

Despite the growing problem, many have paid attention. For instance, UNODC met in July 2019 to discuss its West Africa report. Representatives from West Africa, India, the European Union (EU), Interpol and WHO were a few of the guests that attended the meeting to discuss how tramadol is fueling the global opioid crisis.

Not only are organizations, nations and individuals paying attention, but they are also actively strategizing to mitigate the crisis. The meeting highlighted the need for international cooperation and increased law enforcement. Lastly, there was great emphasis on the need for uniform regulation of the pharmaceuticals, in hopes that cooperation would crush the illicit market while meeting demand.

– Richard Vieira
Photo: Unsplash

Diseases in Nigeria
Nigeria ranked 142 out of 195 countries in a 2018 global health access study. However, although Nigeria has a challenging health care system, the country has improved the infrastructure that has helped it fight diseases such as polio, measles and Ebola. Nigeria now has centralized offices called Emergency Operation Centers (EOCs) that serve as a base for government health workers and aid agencies to coordinate immunization programs and collect data. While there is progress, many diseases still plague Nigeria.

Cholera

Cholera is a water-borne disease that results in a quick onset of diarrhea and other symptoms such as nausea, vomiting and weakness. It is one of the many diseases impacting Nigeria in 2021. If people with cholera do not receive treatment, the disease may kill them due to dehydration. A simple oral rehydration solution (ORS) can help most infected people replace electrolytes and fluids. The ORS is available as a powder to mix into hot or cold water. However, without rehydration treatment, about half of those infected with cholera will die, but if treated, the number of deaths decreases to less than 1%.

In August 2021, Nigeria began to see a rise in cholera cases, especially in the north, where the country’s health care systems are the least prepared. The state epidemiologist and deputy director of public health for Kano State, Dr. Bashir Lawan Muhammad, said the rise in cases is due to the rainy season. It is also because authorities have been dealing with Islamist militants in the north. In Nigeria, 22 of the 36 states have suspected cholera cases, which can kill in hours if untreated. According to the Nigeria Center for Disease Control, 186 people from Kano have died of cholera since March 2021, making up most of the country’s 653 deaths.

Malaria

Malaria is another one of the diseases affecting Nigeria. Through the bites of female Anopheles mosquitos, parasites cause malaria and transmit it to humans. Globally, there were 229 million malaria cases in 2019, with 409,000 deaths. Children under the age of 5 years old are the most susceptible group, and in 2019, they accounted for 274,000 or 67% of worldwide malaria deaths. That same year, 94% of malaria cases and deaths occurred in the WHO African Region. Although the disease is preventable and curable, the most prevalent malaria-carrying parasite in Africa, P. Falciparum, can lead to severe illness and death within 24 hours.

The President’s Malaria Initiative (PMI), which USAID and the CDC lead, works with other organizations to help more than 41 million Nigerians. Despite the difficulties that COVID-19 presented in 2020, the PMI was able to assist Nigeria to distribute 14.7 million treatment doses for malaria, 8.2 million of which went to pregnant women and children. Besides that, the “PMI also distributed 7.1 million insecticide-treated mosquito nets (ITNs), provided 7.2 million rapid test kits, and trained 9,300 health workers to diagnose and treat patients” of malaria. Before the PMI, only 23% of Nigerian households had bed nets, but since 2010, that number has risen to 43%. The PMI also aims to improve health systems and the skill of health workers to administer malaria-related services.

HIV

HIV (human immunodeficiency virus) attacks the immune system, leading to AIDS (acquired immunodeficiency syndrome). One can control the virus with proper medical care, but there is no cure. The disease is prevalent in Africa because it originated in chimpanzees in Central Africa. The virus likely spread to humans when the animals’ infected blood came into contact with hunters. Over the years, HIV spread across Africa and other parts of the world, becoming one of the diseases impacting Nigeria today.

The CDC works with the Federal Ministry of Health (FMOH) and other organizations to create and sustain HIV response programs in Nigeria. The CDC’s “data-driven approach” and prevention strategies and treatment strengthen the collaborative system in Nigeria. These include HIV treatment, HIV testing, counseling, services to help prevent mother-to-child transmissions and integrated tuberculosis (TB) and HIV services. TB is the leading cause of death among people living with HIV.

From October 2019 to September 2020, nearly 200,000 Nigerians tested positive for HIV and began treatment. During the same period, over 1 million HIV-positive people tested for TB. More than 5,000 of those individuals tested positive and began treatment for TB. By the end of September 2020, nearly 25,000 orphans and other vulnerable children received HIV/TB services through the CDC. Not only that, but all facilities in Nigeria that the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supports now use TB BASICS, which is a program that “prevents healthcare-associated TB infection.”

In 2021, Nigeria will face many diseases. On the other hand, great strides are occurring to educate the Nigerian population on diseases like HIV, malaria and cholera. Despite efforts, there is still much more necessary work to reduce illness in Nigeria.

– Trystin Baker
Photo: Flickr

Low Health Literacy in Developing Countries
While developing countries often face pressing issues such as inadequate health care, a less obvious but equally threatening problem is low health literacy rates. In comparison to developed nations, health literacy rates in developing nations are significantly low. However, if society as a whole works to educate and empower individuals to make better choices regarding their health, low health literacy, also known as the “silent killer,” will see a drastic reduction. Here is some information about low health literacy in developing countries.

Defining Health Literacy

The World Health Organization (WHO) defines health literacy as an individual’s ability to adequately comprehend health information and to implement this knowledge into their everyday life in order to “maintain or improve quality of life.” An individual with lower health literacy is more likely to make questionable health choices and is less likely to take preventative action against manageable diseases.

Limited health literacy also correlates with unhealthy lifestyle choices, increased hospitalization rates and higher mortality rates. These impacts make it clear to understand how inadequate health literacy serves as a “silent killer,” especially within developing nations where these rates are prominently low.

The Situation in Developing Countries

Low health literacy rates link to inadequate education systems and health systems because these structures hold the responsibility of relaying health information to the general public. Thus, nations that lack these proper systems are more likely to have insufficient health education levels.

A survey of adult citizens in Isfahan, Iran, indicates that almost 80% of respondents did not have sufficient health literacy. Most of the respondents with inadequate health literacy were females with “low financial status” and limited education. This data suggests that an overwhelming number of individuals in developing nations lack satisfactory health education, particularly women. The reason for this is likely issues of gender equality — women lack access to education, essential services and employment opportunities. Furthermore, poverty disproportionately impacts women all over the world.

Taking Action

There are several ways to improve health literacy rates, and therefore, improve global health. It is crucial to educate the population on their health and to empower them to effectively manage their well-being. Several interventions have proven effective. In South Africa, providing individuals with informative yet easy-to-read pamphlets that include graphics is improving health education in the country. Meanwhile, in China, findings determined that “periodic training of health educators is essential for improving health knowledge” among the general public.

Media is yet another way to improve health education. In Uganda, “more than one in three used the internet to search for health information.” In Iran, secondary school students cited television as their most helpful source of information on HIV/AIDS. In Israel, “a model of Media Health Literacy (MHL)” showed potential in improving health literacy among younger citizens.

Across Asia, the Asian Health Literacy Association (AHLA) works to understand and improve health literacy rates. This organization aims to raise awareness of this issue “among researchers, officials, healthcare organizations as well as experts in health and education, corporations and media” in order to formulate effective interventions to improve these rates in Asia. AHLA sees this as an essential  part of improving the quality of healthcare “and reducing health disparities between communities, groups and nations.” Ultimately, the AHLA aims to improve global health, starting with Asia.

Moving Forward

Increasing health literacy rates in developing countries is an effective way to improve global health and eliminate inequalities. Through education programs, improved communication and dedicated organizations,  these rates can improve. By educating individuals on matters of health, people all over the world can live an improved quality of life.

– River Simpson
Photo: Flickr

Poverty and Mental Health in Afghanistan
Forty years of turmoil and armed conflict fuels poverty’s role on mental health in Afghanistan. Poverty and increased violence exacerbate Afghanistan’s poor mental health. It is a cycle that has been going on since the Cold War’s end, creating an environment that forces people into poverty rather than them receiving the assistance they require.

Aside from the cold facts that Afghanistan imports the majority of its electricity and that the majority of the country still lacks access to it, Afghanistan also suffers from severe famine, drought and a lack of basic sanitary needs. Combined with years of civil war, terrorism uprisings and military coups, the high number of poverty and mental health issues does not seem so surprising.

Mental Health Suffers in Afghanistan

Although little data on mental health in Afghanistan has undergone compilation, Afghanistan has had an increased number of mental health conditions and poverty among its population over the years, primarily since 2001. Currently, the poverty rate in Afghanistan sits at 72% but projections have determined that it could rise to 97% due to the Taliban’s takeover. In addition, the expectation is that poor mental health in Afghanistan will worsen as a result of current violent regime changes in a country with a history of violence, uncertainty and civil war.

The World Bank reported in 2011 that, “Conflict and other factors such as unemployment, general poverty, breakdown of community support services, and inadequate access to health services have not only damaged the social infrastructure of the nation, but also caused mental health disorders mostly in vulnerable groups like women and disabled people.”

Support is Necessary and Overdue

Since then, the number of conflicts, impoverished and mentally impaired people in Afghanistan has increased. The International Psychosocial Organisation (IPSO) has provided the most recent data on mental health in Afghanistan out there in an annual report from 2019 which covers the drastic gap in mental health needs and facilities. The report states that 70% need mental health support.

Another report, from the Refugee Documentation Center in Ireland, found that in 2019, more than 50% of the population suffers from anxiety, depression or post-traumatic stress disorder (PTSD) while only 10% could actually seek help. Although many of these cases are due to exposure to violent conflict over the last four decades, many organizations also suggest a strong link between extreme poverty conditions and mental health. About 40% of Afghanistan’s people, who suffer from PTSD, relate their experience back to a lack of food and running water.

The National Mental Health Symposium, which the Ministry of Public Health of the Government of Afghanistan held in 2019 explains how poverty, conflict and unstable living conditions contribute to the rise in poor mental health in Afghanistan.

The Taliban’s Effect

As the Taliban transforms the government of Afghanistan to how they see fit, mental health facilities and doctors are at risk of shutdown due to the Taliban’s negative views of Western practices. Both the World Bank and the IPSO report that religious and cultural traditions create barriers to treating mental health in Afghanistan.

TABISH in Afghanistan, a nonprofit humanitarian organization that provides mental health support, education and human rights support suspended its operations just one week after the Taliban took over the government. “There is no international support because we cannot have staff in our organization. Not just for us but many organizations [and] there is no guarantee for our staff if we find support,” Dr. Aria, the founder of TABISH, said in a phone call with The Borgen Project. “There is a high demand for mental health right now, people are traumatized.”

Aria also noted that the majority of the staff at TABISH in Afghanistan were women, and the sudden change in women’s rights, aside from the loss of income, are causing even greater mental health strains now. “Going from conflict to conflict, poverty, discrimination against women, high unemployment and many more things are causing a high demand for mental health services in Afghanistan,” Dr. Aria said. In the preceding weeks, Dr. Aria left Afghanistan with his family due to safety reasons. They are staying in the United States at the moment.

Help is More Possible Now More than Ever

Mental health support has become more readily available in Afghanistan over the last decade. World organizations, such as the World Bank, the World Health Organization (WHO) and the United Nations, are making it a top priority to help stabilize the health systems in the country.

Through continued international support—not just from organizations but individual countries as well—the conflict-torn country’s mental health community can gain the facilities, power and attention needed to begin the end-cycle of poverty and poor mental health in Afghanistan.

– Ali Benzerara
Photo: Flickr

Emotional Support Programs Save Lives in Low-Income Communities
Emotional support programs for children and pregnant women in low-income communities can improve participants’ mental and physical health. Daily challenges of living below the poverty line often result in high-stress levels that can lead to a variety of health complications in children, pregnant women and babies. Emotional support programs save lives in low-income communities by reducing stress and resultant health issues.

The Benefits for Pregnant Women and Babies

Emotional support groups for pregnant women can make impactful differences in their lifestyles and health. A study by psychologist Greg Miller found that pregnant women who took part in a support group called Centering Pregnancy had less inflammation in their placentas than pregnant women who received standard prenatal care. Inflammation within the placenta can restrict the flow of nutrients, oxygen and blood from mother to child, potentially leading to health complications. Within Centering Pregnancy, pregnant women received guidance on nutrition, stress management and parenting. As a result, they had lower stress levels and less inflammation in their placentas, allowing them to have more relaxed and healthy pregnancies.

Groups like Centering Pregnancy can be particularly valuable in low-income communities where women experience high-stress levels from everyday challenges linked to poverty. For example, a study that a teaching hospital in Lahore, Pakistan conducted found that during their pregnancies, 25% of women in the antenatal clinic experienced depression and 34.5% experienced anxiety. In developing countries like Pakistan, emotional support programs save lives by improving pregnant women’s health and, in turn, the health of their babies.

The Benefits for Children

According to the National Scientific Council on the Developing Child, conditions with links to poverty, such as “‘overcrowding, noise, substandard housing, separation from parent(s), exposure to violence, [and] family turmoil’” can have toxic effects on the developing human brain, just like drug abuse and alcoholism. Cortisol, a hormone that helps manage stress, can be overly abundant in children who grow up in poverty, which can lead to stunted brain development over time. As a solution, mentorship programs for children in low-income communities can improve kids’ emotional and physical wellbeing. A study by Miller and fellow Psychologist Edith Chen found that a single supportive, high-quality relationship with someone like a teacher, friend or mentor can substantially minimize a child’s risk of cardiovascular disease in a low-income community. Mentorship programs help children relieve stress and resolve social conflicts, potentially leading to fewer long-term health concerns.

Organizations at Work

Mental health organizations work across the globe to help people of every age improve their mental, emotional and sometimes even physical health. For example, United for Global Mental Health is an international organization that began in 2017 to improve mental health around the world, including in Pakistan, Nigeria, France, Canada and Japan. The website provides an extensive list of international mental health resources, including organizations that specifically focus on supporting children. United for Global Mental Health’s goal is to improve mental health globally and make mental health resources accessible to everyone, despite socioeconomic status. The organization works alongside partners such as UNICEF and the World Health Organization (WHO) to advocate for rights, financing, systems and educational resources that improve mental health around the world.

Organizations like Mothers2Mothers (M2M) also work to help pregnant women and new mothers to achieve the best mental and physical health possible in developing countries. M2M began in 2001 when South Africa was facing a record number of HIV infections. The organization employs women with HIV in nine African countries, including Ghana, Kenya and South Africa, to work as Mentor Mothers. Mentor Mothers are community health workers who serve women and adolescents in 10 countries across Africa by providing support, education and medical services. M2M has created more than 11,000 jobs for women with HIV and has provided over 13.5 million people in sub-Saharan Africa with crucial health services. The organization models how emotional support programs save lives in developing countries.

Spread around the world with a variety of causes, emotional support programs save lives by relieving stress and the health complications that result from it. People experiencing poverty often experience heightened levels of stress, so emotional support programs can be particularly useful to people in low-income areas.

– Cleo Hudson
Photo: Pixabay

Upcycled Water Bottles
The World Health Organization (WHO) has confirmed that, since January 3, 2020, there have been more than 1.6 million official cases of COVID-19 in Thailand. While the country has around 70 million people, the data demonstrate a significant rate of infection. As of October 4, 2021, approximately 55 million of Thailand’s citizens have had vaccines administered to them. Thankfully, this is not the only good news to come out of the country’s battle with the COVID-19 pandemic. The textile company Thai Taffeta has recently come up with a sustainable means of fighting off the virus, involving upcycled water bottles.

Reduce: How Thai Taffeta PPE Came to Be

During the height of the pandemic, personal protective equipment (PPE) in Thailand was alarmingly scarce. This shortage increased medical staff’s risk of contracting COVID-19 while also exposing them to other hazardous diseases and potential injuries. At the same time, as the Southeast Asian country with the second-largest economy, Thailand’s consumerism creates a lot of plastic waste. When the general rate of infection of COVID-19 in Thailand grew and protection gear started dwindling in hospitals, a textile company based in Bangkok introduced a new, life-saving technology. As of September 3, 2021, Thai Taffeta has been using the nation’s overabundance of plastic waste — mostly upcycled water bottles — as an advantage, subsequently saving lives and helping the environment.

Reuse: How Thai Taffeta Makes its PPE

According to Thai Taffeta, it takes about 18 upcycled water bottles to make one PPE suit. Thus far, Thai Taffeta has collected about 18 million plastic bottles to create personal protective equipment. The process is relatively simple and involves reducing the typical resources necessary for making protective gear and breaking down the plastic waste into malleable filaments that then get upcycled. Donated fibers are combined with the upcycled material. The product is the PPE necessary for doctors and medical staff to better equip themselves with while facing the threat of infection.

Thai Taffeta’s executive vice president, Supoj Chaiwilal, said that the fabrics are “made of 100% recycled PET yarns to produce Level 3 PPE coveralls.” This particular level of protection ensures that the suits are water-resistant and can even keep out blood and viruses from the external environment. Manufacturers dye some of the gear a reddish-orange color for a select group of the PPE’s recipients: Buddhist monks.

Recycle: Accessibility of PPE

While Buddhist monks have access to this textile innovation, needing it to conduct cremation processes safely, it is also available to high-risk patients. Though Thailand’s response to the pandemic was relatively strong, it was not without weaknesses. Had the government not responded to the economic crisis with relief measures, the poverty rate in Thailand would have increased to an estimated 7.4% in the span of one year. However, the 6.2% of Thailand’s population living under the poverty line, who are more susceptible to infection and fiscal devastation, could certainly benefit from a maintained social protection program implemented by the country’s government. Therefore, the introduction of sustainable personal protective equipment in Thailand is critical for health safety in the fight against COVID-19. PPE to more individuals better allows for a deceased spread from continuing to permeate and affect the lives of low-income families.

Looking Forward

Thai Taffeta’s website boasts, “All for one[,] the journey of sustainability.” Indeed, the upcycled plastic waste personal protective equipment in Thailand is an innovation many people marvel at. Operating in a cyclically economic mode, the broken down plastic serves to benefit the environment and reduce the number of resources needed to create new goods while also combatting the rate of infection. The slogan also touches on the immense value of a unified fight against the virus, pressing for eradicating disparate circumstances while simultaneously urging the upper classes to be considerate in their consumption and contribute funding toward these suits.

– Maia Nuñez
Photo: Flickr

Marburg Virus in West Africa
Africa is a continent comprising of diseases and illnesses that affect many people’s lives. Notable examples of such ailments include HIV, malaria, Ebola and even COVID-19, impacting the lives of many impoverished communities of Africa. Now, a recent report of the Marburg virus in West Africa is starting to raise concern and officials from the World Health Organization (WHO) are scrambling to address the situation before it intensifies.

The Background

In August 2021, health officials from Guinea confirmed the first case of the Marburg virus disease in a deceased West African man. The patient, who started to develop the illness in late July 2021, went to a local clinic to seek treatment, where he displayed high fever, abdominal pain and external bleeding around his teeth. The man died less than two weeks later in the town of Guéckédou in Southern Guinea, which is in the same region where the Ebola virus broke out in 2014 and 2021.

What is the Marburg Virus?

Marburg is a type of virus that comes from the same family as Ebola and causes hemorrhagic fever in the individual who contracts it. Anyone infected is prone to experiencing internal bleeding, which affects vessels, organs and the body’s ability to regulate itself. Because of the severity of the damage, Marburg virus disease is extremely dangerous with an average case mortality rate of around 50%. In past outbreaks, fatality rates reached as high as 88%. The last noted presence of the virus was in 2008 with the last major outbreak occurring in 2005 in Angola.

Though Marburg has the potential to be very deadly, viruses that cause hemorrhagic fever are rare and are usually limited to areas with specific animals that host the viruses. In 2020, the Centers for Disease Control and Prevention found that fruit bats carry the virus, meaning that a human can only become infected through prolonged exposure in caves or similar habitats. However, once the virus infects one person, the Marburg virus is easily transmittable through direct contact with another individual. The timeline in which a person will start to display symptoms can be anywhere between two and 21 days after infection Although only a single case was confirmed so far, the WHO found the need to declare an outbreak in West Africa due to how easily the Marburg virus can spread.

What are Health Officials Doing?

Due to the concern that the Marburg virus could trigger an epidemic in West Africa, the WHO is taking precautions to ensure that the virus does not spread much further. Since the discovery, Guinea has attempted to track anyone who interacted with the patient. The country is monitoring at least 172 people, ordering them to quarantine to prevent transmission. The WHO has also dispatched a team consisting of epidemiology and socio-anthropology experts, who are now on the grounds of the virus site and are assisting with the investigation of Marburg virus cases. Efforts are also going into improving cross-border surveillance. Since Guéckédou is relatively close to Sierra Leone and Liberia, the WHO is working with authorities to ensure the virus does not spread outside of Guinea.

Disease and Poverty

As it currently stands, there is no known cure for Marburg virus disease, though remedies are in development. Right now, the best way to treat someone infected with the Marburg virus is through supportive care and rehydration. Doing so will reduce the likelihood of the disease becoming fatal. With that said, this current situation in Guinea speaks volumes about the healthcare system in Africa and the specific vulnerabilities of Africa.

Africa is the most disease-prone continent in the world, yet most of its people do not have access to treatment that will help protect against these viruses. In Guinea, which is home to 13 million people, not even 4% of the nation’s population has received full vaccination against COVID-19. If people in West Africa have limited access to a globally distributed COVID-19 vaccine, the likelihood of them easily obtaining treatment for a disease like Marburg or Ebola is slight. For these reasons, officials need to prioritize addressing health inequities and improving access to healthcare in developing regions such as Africa.

– Eshaan Gandhi
Photo: Wikimedia Commons

Asia's Economy
The COVID-19 pandemic has caused severe economic disparities globally. Specifically, those living on the Asian continent have experienced significant economic damage and hindrance to their broad economic goals. About 15 million Southeast Asians have become impoverished since the onset of the pandemic in 2019. The delta variant, along with a resurgence of national lockdown measures, has caused another case of economic damage. Through analyzing COVID-19’s effects on Asia’s economy, it is clear that the continent can implement strategies in order to combat these high rates of poverty and economic disparity.

Low Vaccination Rates

Overall, Southeast Asia has lower-than-average vaccination rates compared to the rest of the world. However, some Southeast Asian countries have better vaccination rates than others. Singapore has the highest vaccination rate, at 77.3%, whereas Vietnam has the lowest vaccination rate at 7%. As Southeast Asia is Asia’s major area for good economic production, this has led to a decline in economic growth. These low vaccination rates have allowed COVID-19’s effects on Asia’s economy to be extremely negative as low-income countries have had low vaccine rates due to their economic disadvantage. Around 55% of individuals who live in higher-income countries have been vaccinated with at least one of two vaccination dosages whereas 1% of individuals who live in lower-income countries have received one of two vaccinations.

National Lockdowns

In Southeast Asia, as cases have risen due to the delta variant beginning in July 2021, strict lockdown restrictions have become reimplemented. The implementation of lockdowns worldwide in 2020 was common as countries felt this would be an effective way to quickly decrease the number of people who contracted COVID-19. Lockdowns were extremely effective in decreasing the spread of COVID-19; however, they also caused a negative effect on the global economy. In Asia, lockdowns caused a severe drop in retail sales. For example, vehicle sales in China have been steadily decreasing each month; more recently, they decreased by 11.9% in July 2021. Factories have also stopped production as a response to the surge of cases since July 2021. Southeast Asian countries have also had to enter lockdowns again. This has caused the negative effects of COVID-19 on Asia’s economy to resurface, with yet another decrease in retail sales.

The Delta Variant

The COVID-19 delta variant is more infectious than the original COVID-19 strain, causing a spike in cases for Southeast Asian countries that began in July 2021. The delta variant of COVID-19 has caused both a surge in COVID-19 cases worldwide and a resurgence of the 2020 economic downturn that came with the very beginning of the COVID-19 pandemic. The effects of Southeast Asia’s low rates of vaccination have caused a spike in COVID-19 cases in addition to the delta variant, factoring into the reasoning behind the reimplementation of national lockdown measures.

Looking Ahead

A large and overarching goal of Asia in its entirety is to increase rates of vaccination in each Asian country as a response to this economic decline. The World Health Organization’s (WHO) regional director of Southeast Asia, Dr. Poonam Khetraapal Singh, has a goal to have the Southeast Asian population 40% fully vaccinated by 2021. This strategy against economic disparity uses the COVAX initiative, a plan that WHO put in place that advocates for global access to COVID-19 vaccines. The COVAX initiative especially targets low-income countries and works to help them gain equitable access to not only vaccines but also to COVID-19 testing and treatments.

If Asia successfully increases its vaccination rates, there is hope that the Asian economies will be able to continue with their goals of economic growth.

– Francesca Giuliano
Photo: Unsplash

TB Affects RefugeesTuberculosis (TB) is one of the most commonly reported diseases among refugee populations. It affects the lungs and can be extremely infectious. Symptoms include coughing up blood and mucus for a long period of time, pain when coughing, fatigue, fever and chills. TB is a highly contagious disease and can spread through droplets in the air when an infected individual sneezes or coughs. TB affects refugees who usually become infected while they are in their home countries. Poverty increases during wartime, and so do TB rates.

The Diffusion of TB

Although many refugees contract TB from their home countries, their journies worsen the disease’s effects. The malnutrition that many displaced peoples experience weakens the body’s ability to fight the disease, and underlying health conditions lead to more life-threatening effects.

TB affects refugees in camps. Currently, 2.6 million refugees live in refugee camps all around the world.  Tens of thousands of individuals can cram into each camp.  In fact, one camp in Jordan, for example, is home to about 80,000 Syrian refugees. Camps do not have an adequate amount of food, and sanitation is well below average. In fact, 30% of refugee camps do not have access to proper latrine systems. Additionally, TB affects refugees where HIV rates are high. For example, many refugees live in sub-Saharan Africa where the HIV rate is 9%, one of the highest in the world.  Further, when those placed in camps leave, general community members are also at risk.

Access to Treatment

The majority of refugees today are living in a state of poverty. For example, a report by the United Nations High Commissioner for Refugees (UNHCR) and the World Bank Group shows that in 2014  90% of the Syrian refugees in Jordan and Lebanon are considered to be below the poverty line in each of those countries. Economic barriers prevent many refugees from TB treatment. Without money, displaced peoples have little defense against TB.

Although affordability plays a large factor in a refugee’s inability to access treatment, fear also plays a role in limiting refugee access to treatment. Particularly for undocumented refugees, the fear of deportation prevents many from receiving a diagnosis. For documented refugees, the legal technicalities of receiving such care are complex. Treatment is mainly available to those who are employed because employers provide insurance that covers treatment costs. However, approximately 65.1% of refugees around the world are currently unemployed and unable to receive these benefits. Financial and emotional walls are blocking refugees from receiving vital healthcare.

Global Response

The extreme ways in which TB is affecting refugees have garnered international attention. To combat its fatal consequences, the World Health Organization (WHO) has created a response called The End TB Strategy. The program’s ultimate goal is to reach an 80% drop in TB cases by 2030. One of the program’s main strategies is to implement screening, especially for high-risk groups. If a refugee arrives from a country such as India where TB rates are high, they will go through a screening process. Through these procedures, early detection of TB is possible, and the disease can be effectively treated.

Organizations like the Centers for Disease Control (CDC) have already implemented screening measures and require refugees to undergo TB tests before they can cross US borders. Proper understanding of the disease is also a focus of The End TB Strategy. The WHO is developing research on and treatment plans for TB that should lower infection rates. In general, the strategy emphasizes the importance of early detection, screening and proper treatment for all individuals.

Looking Forward

Tuberculosis is a deadly disease. It is one of the top ten causes of death in low-income countries. Refugees can become infected in their home countries, throughout their journeys or in refugee camps. TB easily spreads from person to person, and it can infect entire communities. Poverty and fear of deportation and unemployment prevent refugees from accessing and receiving treatment.

Fortunately, plans such as the WHO’s End TB Strategy are working on improving the current state of tuberculosis among refugee populations. Hopefully, these programs will reach their goals and protect refugees from TB’s deadly hands.

– Mariam Kazmi
Photo: Flickr

HIV/AIDS in Afghanistan
HIV/AIDS in Afghanistan is prevalent. However, reliable data on HIV/AIDS in Afghanistan is scarce due to a lack of reporting cases and common failure to seek medical treatment. The World Bank recognizes unsafe paid sex and injecting drug users as the most likely cause of the epidemics spread. Many know Afghanistan as dangerous considering its consistent involvement in devastating wars; however, less known is the massive struggle Afghanistan faces in combating drug usage. In accordance with this, HIV/AIDS is predominantly among those who inject drugs, prisoners, female sex workers and men who have sex with men.

About HIV/AIDS

HIV, also known as AIDS, is a human immunodeficiency virus that people can transmit through bodily fluid. HIV/AIDS first emerged through human interaction with a certain type of chimpanzee located in Central Africa. HIV then spread from Africa to other parts of the world and became prevalent in the United States around 1975. HIV/AIDS can cause flu-like symptoms a few weeks post contraction before remaining dormant until progressing to AIDS. AIDS severely weakens a person’s immune system causing an increase in the likelihood of a person getting a severe illness. There is no cure for HIV/AIDS but there are medications that can help infected people live healthier longer lives. The CDC has written about the severity of HIV/AIDS stating that “without treatment, people with AIDS typically survive about three years.” Here are some of the most common ways people can contract HIV/AIDS.

  1. Engaging in sexual intercourse without the use of a condom.
  2. Mother-to-child transmission.
  3. Sharing injecting equipment (most commonly, needles during drug usage).
  4. Contaminated blood transfusions and organ transplants.

Doing the Math

These affected populations rarely have the means necessary to seek treatment. In fact, the World Health Organization (WHO) has stated that “In 2017, the number of people living with HIV (PLHIV) in Afghanistan was estimated to be 5900…by December of 2017, 800 PLHIVs were enrolled for treatment.” This means that of the people in Afghanistan who have tested positive for HIV/AIDS, only 13.5% of them have received treatment. Furthermore, from this, one can conclude that the 5,100 people who have tested positive but have not received treatment could die within the next three years.

Disproportionate Effects on the Poor

The disproportionate effects of HIV/AIDS in Afghanistan on the poor are clear as female sex workers, prisoners and those who use injectable drugs are often living on or below the poverty line. An Open Society Foundations article explored the connection between poverty and sex work as it highlights, “The vast majority of sex workers choose to do sex work because it is the best option they have. Many sex workers struggle with poverty and destitution and have few other options for work.” This need for money to support their basic life needs drives women into prostitution putting them at greater risk for HIV/AIDS. Furthermore, refugees make up another category of impoverished individuals who end up at greater risk of contracting HIV. According to WHO, refugees are “stuck in limbo with nothing to do, under great pressure and with drugs abundantly available, many of these refugees have become addicted to drugs.”

Not only does poverty enable greater exposure to HIV/AIDS in Afghanistan, but it also prevents Afghans from affording potential treatments. Estimates for HIV/AIDS treatments run from $1,800 USD to $4,500 USD per month during a person’s lifetime. The average salary for someone living in Afghanistan converts to $18,505 USD per year, making it impossible for even middle-class citizens to pay for treatments, let alone those facing poverty.

The Good News

Afghanistan developed a National Strategic Plan to investigate and respond to the HIV/AIDS epidemic. The World Health Organization (WHO) outlined that this National Strategic Plan took effect in 2016 and reached its full effect in 2020. It includes five priority areas:

  1. Greater accessibility to and effectiveness of HIV prevention tools.
  2. Increase accessibility to treatment/support.
  3. Provide documentation and information to allow patients to make informed decisions on medication and treatment paths.
  4. Enable an environment that will allow the national response to HIV/AIDS to be both effective and sustainable.
  5. Strengthen and manage government programs at national and provincial levels.

Looking Ahead

The continued implementation of this plan and increased foreign aid, are helping curtail the devastating effects of the HIV/AIDS epidemic over time. However, the COVID-19 pandemic and the Taliban’s takeover of Afghanistan have thrown progress off track. A New York Times article explains the health care situation in Afghanistan stating that “The country’s health care has been propped up by aid from international donors. But after the Taliban seized power, the World Bank and other organizations froze $600 million in health care aid.” Major strides have occurred in Afghanistan with regards to female health and epidemics however this progress is now at risk of reversing as organizations withdrawal their aid from Afghanistan amidst the Taliban’s reign.

– Lily Vassalo
Photo: Flickr