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Investing in International Mental Health Aid

International Mental Health Aid
Although widely underreported in many countries, the World Health Organization’s (WHO) 2022 World Mental Health Report, identifies one in eight people in the world currently living with mental illness. Between 2000 and 2019, people living with mental disorders increased by 25%. Mental illness is a burden on both the person experiencing mental illness and on society. Those who live with mental illness deal with impacts on their education and relationships and can lead to disability. The broader economic impact of mental health disorders and illnesses includes the costs associated with individuals, communities and nations. These costs relate directly to health services, as well as the indirect costs resulting from loss of work, education and social opportunities, which lead to “stigma, discrimination and reduced life expectancy.”

Reasons to invest in international mental health aid include lowering the costs for nations and individuals and protecting peoples’ quality of life while increasing healthy years lived. In addition, mental health conditions continue to increase across the world as global threats like growing social and economic equality and public health emergencies remain prominent, according to WHO.

The Costs of Mental Illness

The global cost of mental illness was $2.5 trillion in 2010 with projections of the cost to increase to $6 trillion by 2030, according to WHO. A 2020 cost-of-illness global study found that the annual average societal cost of mental illness is between $1,180 to $18,313 per person treated. These costs include the cost of treatment and other costs like lost production and income. Depression and anxiety alone cost the global economy $1 trillion a year, yet the median of government health expenditures toward mental health globally is less than 2%. Other costs of mental illness include loss of life and opportunities.

The burden of mental health and substance use disorders is best described as a “disease burden,” which focuses on the impacts of both mortality and morbidity. Disease burden is measured by Disability Adjusted Life Years (DALYs), which measures deaths plus the years lived with the disease. The metric of one DALY equates to losing one healthy year. According to Our World in Data, in 2019 mental disorders caused 125.31 million DALYs globally. Global DALYs attributed to mental illness have increased to 4.9% in 2019. In addition to the loss of healthy years and opportunities, as of 2019, about 703,000 people lost their lives to suicide globally making the global suicide rate nine per 100,000, according to WHO.

Global Benefits of Investing in Mental Health Aid

International mental health aid reduces human suffering, advances public health and stops human rights violations experienced by those living with mental health conditions. According to WHO. improving people’s mental health also improves educational outcomes and leads to more participation and productivity in the workforce, which benefits all of society. It also improves people’s physical health, which expands people’s lifespan, ability to work and general happiness. Investment in mental health means ensuring access to quality, affordable mental health care, addressing stigma, discrimination and abuse and addressing the underlying economic and social inequalities that shape citizens’ mental health.

Investing in international mental health aid is that it leads to extra years of a healthy life, which generates productivity gains for the country that is investing in mental health care. The countries to benefit the most from investing in mental health care are lower-middle-income countries. Jamaica, a middle-income country, is an example of a country that invested in mental health care and received economic benefits. Jamaica invested $115 million into treatment for depression, anxiety and psychosis from 2015 to 2030. The benefits of this investment include an increase in psychosocial treatment from 15% to 50%, WHO reports. The economy has seen $434 million in saved money due to mental health care.

Supporting Sustainable Development Goals

According to WHO, not only is providing mental health aid beneficial to a country’s economy, but it also supports the U.N.’s Sustainable Development Goals, specifically SDG 1 to eliminate global poverty. Mental illness and poverty create a “cycle of disadvantage” because those living in poverty lack the finances to maintain basic necessities, have fewer educational and employment opportunities and are less likely to have access to quality health care. All of these stresses lead to a higher chance of experiencing a mental health condition. In addition, those experiencing severe mental health conditions are more likely to experience poverty due to increased health expenses and stigma and discrimination in the workforce, which leads to unemployment. “More than 80% of all people with mental disorders live in low- and middle-income countries,” WHO reports. These people lack access to welfare and effective treatment.

Moving Forward

In 2019, WHO began the Special Initiative for Mental Health: Universal Health Coverage for Mental Health, which works to make affordable, quality mental health care accessible in nine countries, covering 100 million people. This program focuses on the prevention of mental disorders, suicide prevention, mental health policy and legislation, mental health support in humanitarian emergencies and workforce development for mental health.

In Jordan, WHO’s Special Initiative for Mental Health is supporting the Ministry of Health’s efforts to implement Jordan’s National Mental Health Plan. This involves increasing community-based services and expanding the Caregiver Training Skills organization for families of children living with developmental disabilities. In addition, Jordan’s Special Initiative for Mental Health is supporting inpatient units in general hospitals and scaling up the implementation of the WHO regional School Mental Health program.

With more legislation, prevention, intervention and support for mental health conditions, mental health aid internationally could decrease lives lost, productivity losses and DALYs for countries, as well as increase productivity and economic gains, increase quality of life and further the SDGs.

– Arden Schraff
Photo: Flickr

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Eradicating Sleeping Sickness in Ghana

Sleeping Sickness
The World Health Organization (WHO) has commended Ghana for its tremendous and successful efforts in eliminating a number of neglected tropical diseases (NTDs). The country has gotten extremely close to eradicating sleeping sickness, or human African trypanosomosis, a parasitic disease transmitted to humans through tsetse flies. Ghana has been following a global plan to try to eliminate all neglected tropical diseases by 2030 and has found recent success in eliminating three of the 20 most common tropical diseases.

About Sleeping Sickness

Sleeping sickness, which is a parasitic disease that infected tsetse flies carry, is an epidemic in 36 African countries. If not treated, the condition is almost always fatal. Sleeping sickness disproportionately affects those who live in rural areas because the residents of those areas rely heavily on agriculture, fishing and hunting, which exposes them to these infected flies. Once someone has sleeping sickness, those infected experience fevers, headaches, enlarged lymph nodes, pain in their joints and itching during the early stages of infection. If left untreated, sleeping sickness begins to affect the central nervous system. This begins to affect the patient’s neurological condition where they start to lose coordination, see changes in behavior and personality, confusion and the symptom where the disease gets its name, an interrupted sleep cycle.

Ghana’s Success

Many, including the World Health Organization (WHO), have commended the success that Ghana has had in eliminating sleeping sickness. Ghana has eliminated sleeping sickness while also successfully eradicating two other neglected tropical diseases, guinea worm disease and trachoma. The World Health Organization director-general Dr. Tedros Adhomnom Ghebreyesus commended the government and health workers, saying “This is a historic achievement, proving once again that with dedication and teamwork, we can,” on Twitter.

The fight to eliminate these neglected tropical diseases was elevated when more funding was provided after there was a sharp decline in those receiving proper drugs to help prevent these tropical diseases from 2019 to 2020, where they saw a 34% decline. Ghana received around 19 billion units of medicine and more than $1 billion through foundations in order to help eradicate these diseases.

The Importance

The president of Ghana, Nana Akufo-Addo, said in a statement in regard to the benefits of investing in programs that help alleviate these diseases that these programs, “leads to better education, health and employment outcomes, an Africa free from neglected tropical diseases is possible.” Making sure that these programs exist to help fund proper medicine to help fight these diseases while also providing proper education and awareness about these illnesses in order to counteract the stigma associated with them. President Akufo-Addo also explained the domino effect that these programs have, saying, “it leads to better education, health, and employment outcomes, and transforms lives and communities.” These programs help alleviate the hardships that these diseases cause on the people while also having everlasting impacts on these areas for the better.

– Olivia MacGregor
Photo: Flickr

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Aid in the Horn of Africa

Aid in the Horn of Africa
A historically long drought in the Horn of Africa has displaced millions of families while pushing people into poverty and forcing them to resort to extreme measures to ensure their survival. The disregarded effects of extreme weather events, which disproportionately affect poverty-stricken countries and communities, have resulted in very little U.S. congressional action. However, the introduction of a resolution may be the beginning of collective governmental action to provide aid in the Horn of Africa. Rep. Karen Bass [D-CA-37] introduced a resolution (H.Res.1137) for the “drought and endemic food insecurity plaguing the Horn of Africa” in May 2022, acknowledging the role of extreme weather events in the crises afflicting the Horn of Africa.

The Role of US Foreign Aid

The resolution reaffirms the importance of USAID and the role it plays in “meeting humanitarian obligations, cultivating enduring self-reliance in developing nations, ensuring the stability of global financial markets and mitigating the likelihood of conflict in accordance with our national security interests.” Furthermore, the resolution highlights the significance of funding for emergency humanitarian aid in the most disadvantaged countries. “Supporting the development of sustainable agricultural sectors in developing nations and assisting with the international resettlement of refugees escaping droughts and extreme hunger” is also of utmost importance.

The resolution calls on the Biden administration, the Department of State and USAID to take urgent humanitarian action. The U.S. must offer “technical and material assistance, as appropriate and to the extent allowable under Federal law and congressional appropriations,” and must support not only the governments of the countries afflicted but also the organizations aiming to resolve the crisis in the Horn of Africa in order to “alleviate hunger and deliver food aid to communities impacted by the drought in the Horn of Africa.”

While a resolution does not have legal force, it represents the non-binding position of the House or Senate and the Chambers can use it to deal with internal affairs.

The Humanitarian Situation in the Horn of Africa

The Greater Horn of Africa, which consists of  Djibouti, Eritrea, Ethiopia, Uganda, Kenya, Sudan, South Sudan and Somalia, is an Eastern region of Africa with more than 290 million people, according to the World Bank. This region is experiencing a four-year-long drought, largely impacted by the effects of changing weather patterns that continue to worsen over the years. The drought is one of the “most severe and longest” in recent history, the United Nations Population Fund says.

Besides the lack of access to water and food resources, rising food prices and poverty also afflict the region due to the impacts of the COVID-19 pandemic and the war in Ukraine. This economic crisis and food insecurity create a dangerous combination, resulting in starvation and disease as people have to choose between feeding their families or seeking out health care. Many children are especially vulnerable to disease due to malnutrition and vitamin deficiencies, making them that much more at risk.

The World Health Organization (WHO) is providing vital aid in the Horn of Africa for those who face malnutrition and disease, prioritizing the health sector.

The crisis in the Horn of Africa detrimentally impacts women as they make “perilous journeys with their families to makeshift shelters in formal and informal camps and face long distances to fetch water, heightening their vulnerability to rape, abuse and exploitation,” the UNFPA explains.

With situations becoming so dire, families are resorting to extreme measures to ensure survival. Girls are dropping out of school and child marriage is becoming more prevalent as “marrying off a daughter means one less mouth to feed,” the UNFPA says. A lack of education keeps girls in cycles of poverty and child marriage has detrimental impacts on not only the girls themselves but on entire economies.

The Crisis in Numbers

Overall, according to the WHO, in the Greater Horn of Africa, more than 46 million people within the region are experiencing acute food insecurity. In Djibouti, 400,000 people require aid but these needs are more pronounced in rural areas. With such suffering in the region, many had to relocate or flee the country as 6,086 million people face internal displacement. About 37,000 people have become refugees.

In Ethiopia, the drought is especially impactful with effects on 17 million people out of 292 million. While organizations such as the WHO are providing as much aid as possible, 51% of Ethiopia still lacks health partners and resources. About 20.4 million are suffering from acute food insecurity and almost 5 million people face internal displacement.

This drought could affect exponentially increased numbers of people in Somalia. Between April and June of 2023, the region could face famine with 8.3 million potentially experiencing crisis levels of food insecurity or worse, compared to the 6.7 million Somalis enduring this today. The children of Somalia are harshly impacted, with acute malnutrition predicted to reach 1.8 million children, 513,550 of whom may face severe malnourishment.

The resolution for aid in the Horn of Africa is a strong step in the right direction. More concrete action on the part of the U.S. is necessary to resolve the humanitarian crisis in the most impoverished region of Africa.

– Nixi Hults
Photo: Wikipedia Commons

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Near-Elimination of River Blindness in the Americas

River Blindness in the Americas
Three decades ago, river blindness in the Americas stood as a major concern. However, according to the Pan American Health Organization (PAHO) by the end of February 2023, “the region of the Americas [had] largely eliminated the disease, with remaining local transmission only in some areas of the Amazon.” Following tens of years of efforts, Colombia, Ecuador, Mexico and Guatemala successfully eliminated river blindness between 2013 and 2016, thanks to the work of several key organizations. The near-elimination of river blindness in the Americas has also brought economic benefits by decreasing the financial and social impacts of ill health.

Onchocerciasis/River Blindness

Onchocerciasis, commonly known as river blindness, is a parasitic disease that transmits to humans through the bite of infected Simulium blackflies. These blackflies typically breed in fast-flowing rivers, commonly found in rural areas.

According to the World Health Organization (WHO), symptoms of river blindness can include extreme itching, skin disfiguration and in severe cases, visual impairment. Currently, no vaccine exists to protect against river blindness. However, the ivermectin drug, when administered on a six-month basis for 12 to 15 years, can prevent transmission of the disease.

The Impacts of River Blindness

Classified as a Neglected Tropical Disease, most of the people infected by river blindness (about 99%) live in sub-Saharan Africa, particularly in rural areas that are prone to poverty.

River blindness is a debilitating disease that can hinder human progress in more ways than one. Some of the socio-economic impacts it can have are increasing hunger and poverty, causing vulnerability to other diseases and hindering education.

A study led by Caitlin Dunn and others, published in 2015, states that, in particular, river blindness exacerbates poverty by reducing agricultural yields, increasing medical expenses and decreasing worker productivity. To avoid river blindness infections, in Africa, for example, people resort to relocating to less fertile areas, which reduces their agricultural productivity and impacts overall income.

Those infected by river blindness face higher medical costs, the burden of which pushes people further into poverty through medical debt. Besides the usual symptoms such as severe itching or skin disfiguration, the disease also weakens the immune system, making one more susceptible to other illnesses too. This places a significant financial burden on those living in poverty.

River blindness can also reduce people’s ability to work and earn an income due to fatigue, pain and visual impairment. This leads to lower incomes and impacts children’s learning abilities at school.

Fighting Against River Blindness

One of the first programs with the goal of tackling river blindness began in West Africa in 1974. The Onchocerciasis Control Programme (OCP) underwent implementation in 11 countries including Ghana and Senegal. At first, the program utilized vector control methods such as spraying insecticides in areas where blackflies transmitted river blindness. It later included ivermectin distribution to aid treatment.

According to the WHO, the OCP “relieved 40 million people from infection, prevented blindness in 600,000 people and ensured that 18 million children were born free from the threat of the disease and blindness.” Furthermore, people reclaimed “25 million hectares of abandoned arable land… for settlement and agricultural production, capable of feeding 17 million people annually,” the WHO website says.

In an effort to bring forth similar results in the Americas, the Onchocerciasis Elimination Program of the Americas began in 1992. OEPA’s main goal was to halt the transmission of river blindness in 13 endemic areas via mass drug administration of ivermectin. The program received great support from the Carter Center, the Pan American Health Organization (PAHO), the Centers for Disease Control and Prevention, United States Agency for International Development (USAID) and others.

OEPA and similar initiatives saw significant success, according to the Carter Center. Overall, 11 of the 13 endemic areas in the Americas have successfully eliminated river blindness transmission. In 2013, WHO declared Colombia the first country in the world to be free of the disease. Ecuador, Mexico and Guatemala followed soon after.

Looking Ahead

The WHO estimates that river blindness in the Americas currently still affects 28,000 Yanomami Indigenous people who live in parts of the Amazon between Brazil and Venezuela. They continue to receive ivermectin treatments via OEPA.

River blindness elimination programs have seen great success. The programs not only combat diseases but also improve the productivity and quality of life of people living in poverty. According to the World Bank, programs like OCP and OEPA have an economic rate of return of more than 15% annually. Therefore, contributing to the fight against river blindness can mean investing in poverty reduction and economic growth.

– Siddhant Bhatnagar
Photo: Flickr

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Everything to Know About Bird Flu in Ecuador

Bird Flu in Ecuador
Ecuador has received a lot of attention for its avian wildlife—in fact, it was studying birds on the Galapagos Islands where Charles Darwin invigorated his theory of evolution. The intertwining relationship between man and nature is evident, raising a cause for concern when an extremely deadly disease enters the animal kingdom. That disease is the bird flu in Ecuador.

About Bird Flu/H5N1

In 2022, Ecuadorians detected a strain of bird flu (H5N1) in local wildlife—and birds were only the beginning of the infected animals. In Peru, a neighboring country, marine life showed symptoms of H5N1—sea lions and dolphins both tested positive for the disease, causing questions about the progression, transition and mutation of H5N1 in Ecuador. Hundreds of thousands of animals, including; birds, foxes, mink and bears, tested positive for the disease. While H5N1 is rare in humans, human infection is possible.

The Way That H5N1 Works

While H5N1 is extremely contagious to birds and other animals, mammal infection is rare. However, Ecuador reported the first case of human infection in January 2023. When a human contracts H5N1 from close proximity to an infected bird, the case fatality rate (CFR) is about 56%. The World Health Organization (WHO) determined this through data from previous bird flu infections from 2003 to 2023. Of 240 confirmed cases during this time period, 135 cases were fatal, as of February 23, 2023.

H5N1 functions by connecting to receptors in an animal’s respiratory system. Humans lack these receptors in their upper respiratory tract, making infection relatively difficult. However, humans can contract the disease in their lower respiratory tract, which can cause severe pneumonia. Poultry workers—mainly slaughterhouse workers and kitchen workers—are at higher risk and must take further precautions to lower the risk of infection.

Ecuador Taking Action

Ecuador started battling H5N1 by culling thousands of birds—180,000 infected farm birds slowed the transmission of the disease, but not by much. The Ministry of Agriculture and Livestock (MAG) of Ecuador announced a plan to “vaccinate more than 2 million birds.” Companies in Ecuador and Mexico are preparing three-dose vaccines which will protect birds from H5N1 death. While this Ecuador/Mexico alliance is months from being fully enacted, the push for action on both sides is strong. This partnership is a monumental step in ending bird flu in Ecuador.

Risks in Ecuador’s Future

A vaccine for H5N1 in humans is already available. According to the Centers for Disease Control and Prevention (CDC), manufacturers already have the information they need to mass produce the vaccine.

Poverty is rampant in Ecuador, making access to health facilities difficult, even though Ecuador’s 2007 health care reform created access to universal health care. This proved an asset during the COVID-19 pandemic, expanding health care and creating avenues for vaccinations against COVID-19. These still-in-place avenues will be an asset if Ecuadorians require inoculation against bird flu.

The 2007-2017 expansion of universal health care in Ecuador has been a game-changer, with more Ecuadorians trusting health care and turning toward it when needed. Initially, citizens had reluctance to utilize this health care, with 27% of citizens refraining from utilizing the resource. That number decreased to 18% in 2014 and continued to drop as time moved on, which shows a trend of progress in Ecuadorian health care.

While H5N1 is currently not a direct threat to the health of the human population, human cases of the disease have emerged. While poverty is still great in Ecuador, the COVID-19 pandemic may have created new routes for spreading vaccines which could help slow the bird flu in Ecuador should H5N1 mutate to humans.

– Thomas LaPorte
Photo: Flickr

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Reducing Malnutrition in India

Malnutrition in India
Modern India is advancing in the sector of science and technology yet it has a serious rate of hunger and poverty. The Global Hunger Index of 2022 ranks India 107th out of 121 nations in terms of hunger, which equates to a serious level of hunger. The GHI score also reveals that 16.3% of the population in India suffers from undernourishment while 19.3% and 35% of children under 5 suffer from wasting and stunting respectively. The Government of India, however, has pushed the country’s development, specifically in health and education, through digitalization to a great extent. The Poshan Tracker app is one such initiative built with a vision of eliminating malnutrition among children and pregnant/lactating women, two groups that face dire impacts of malnutrition in India, the World Health Organization (WHO) reports. The app also benefits adolescent girls.

The Poshan Abhiyaan

The word “Poshan” is the Hindi word for nutrition. India’s Ministry of Women and Child Development launched the Poshan Tracker app on March 1, 2021, through the National e-Governance Division with the goal to monitor and track malnutrition across the country. The Poshan Tracker is an innovative tool that forms part of the Indian government’s revolutionary flagship program, POSHAN Abhiyaan, a campaign that aims to reduce malnutrition among adolescent girls, pregnant women, lactating mothers and children from 0 to 6 years of age.

The Poshan Tracker helps the government to monitor the activities of the Anganwadi Workers (AWW) and record the progress of the beneficiaries. Anganwadi Worker Centers are central government-sponsored childcare centers designed to combat hunger and malnutrition and improve nutrition among children in India. In total, India has about 1.4 million Anganwadis across the country.

According to the Ministry of Women and Child Development of India, the Poshan Tracker app, available in 22 local languages, enables a full overview of the activities of the AWW and works as a supporting application to manage the complete system of services. These AWWs have to first register in order to access the app and provide services to people. The AWWs help the beneficiaries to register on the app while verifying their identity cards.

A September 2022 POSHAN Abhiyaan e-bulletin says the Indian government has provided more than a million smartphones to the AWWs. The government also grants Rs 200 to the AWW and the lady supervisor of each center for the recharge of their smartphones every month. The POSHAN Abhiyaan bulletin revealed that, by September 2022, more than 1.2 million AWWs received training on using Poshan Tracker.

How the App Works

The Poshan Tracker is an easy-to-use app that one can install on any android mobile phone with an android version above six. The app is not for general public use, hence, beneficiaries can register themselves on the app only with the help of the Anganwadi Workers. One can access the app offline and the app saves offline data input for up to three days. The beneficiaries may take home a free ration for 21 days a month. Children between 3 and 6 are able to access a hot cooked meal at the Anganwadi Centers for 21 days a month. The Centers supplement children experiencing nutritional deficiencies with additional nutritional food too.

The Poshan Tracker allows AWWs to assess the nutritional status of children according to the standards set by the World Health Organization. The Anganwadi Workers pay home visits too to monitor individuals and fill in real-time data on the app. The beneficiaries receive timely health checkups and vaccinations for infants and pregnant women at home at just a click of a button.

Poshan Tracker has proved to be a groundbreaking application to combat malnutrition in India, benefitting 98.4 million people as of September 2022. The hopes for this app and the nutrition scheme of India have increased even more after the government announced a budget exceeding Rs 11 billion for this flagship program for 2022-2023.

– Aanchal Mishra
Photo: Pixabay

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The Link Between Literacy and Child Mortality

Literacy and Child Mortality
While many might not think there is a connection between child mortality and literacy, there most certainly is. In fact, a closer look at the link between literacy and child mortality indicates that the more educated a woman is, the higher the chance of her baby’s survival.

Global Child Mortality and Literacy

Child mortality refers to the number of children that die before reaching age 5 per every 1,000 live births. This issue is prevalent to some degree everywhere around the world, but some regions have higher rates of child mortality than others. According to the World Health Organization (WHO), global child mortality rates have significantly improved since 1990, reducing from 93 per 1,000 live births to 37 in 2020.

In terms of global literacy, the ability to read and write, today the rate stands at 87% in comparison to 12% in 1820. However, strong regional disparities still exist — countries in sub-Saharan Africa still have the lowest literacy rates. For instance, in Mali, literacy rates decreased to 31% in 2020 due to the disruption of conflicts. Additionally, South Sudan’s literacy rate stood at 35% and Afghanistan noted a 37% rate.

The Link

According to research from the Harvard Kennedy School, when a woman can read and write, her child has a 36% higher chance of living past the age of 5 than if the mother was illiterate. In fact, when mothers receive a basic education (six years of schooling and the ability to read and write), child mortality rates drop 68%. Furthermore, for women in this same study with no education whatsoever, “38.5% have had a child die.”

Unfortunately, many individuals in developing countries do not receive a quality education even if they complete many years of schooling. An Annual Status of Education Report assessing students aged 14 to 18 in rural India found that even though “[more than] 80[%] had completed grade 8, roughly half or less could do simple division, calculate how much a price discount of 10[%]would save them, follow simple instructions or understood measuring length with a ruler.”

Many developing countries do not have the funds to pay for high-skilled educators, training and quality educational materials, which leads to a subpar classroom experience. This creates a cycle: when the quality of education is low, families become reluctant to use their minimal resources to send their children to school, leading to another generation of uneducated people. Still, attending school has proven to be beneficial in the sense of lowering child mortality.

Women and the Effects of Schooling

Education empowers women in developing countries by giving them the tools and knowledge to make informed choices throughout their lives. But, research also shows that attending school, aside from just the knowledge one attains, also helps women to build social networks, which is very important in empowering women.

An educated woman understands how to take care of herself and her unborn baby during pregnancy and knows how to detect early warning signs of complications so that she may seek assistance from a health care professional.

Education also increases women’s bargaining power within their own houses, which, in turn, decreases their risk of domestic violence and helps improve the quality of life of the women and children.

Despite various issues with education in developing countries, there are still many benefits women receive from an education. These benefits directly correlate with higher chances of survival for their children, showing a link between literacy and child mortality.

– Evelyn Breitbach
Photo: Flickr

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Cervical Cancer In Nigeria

Cervical Cancer In Nigeria
Cervical cancer in Nigeria is a major public health issue, as the country has 56.2 million women who are at risk of having the disease. Cervical cancer ranks second on the list of most common cancers in women ranging between the ages of 15 and 44, in Nigeria.

Human Papillomavirus (HPV)

Human papillomavirus (HPV), which is a virus that commonly transmits through sex, causes cervical cancer. It can transmit from mother to child. Cervical cancer is treatable when one detects it early and manages it clinically. According to WHO, HPV 16 and 18 are responsible for 70% of cases of cervical cancer.

In a 2021 report, the HPV Information Center stated that there were 12,000 new cases in 2020, while almost 8,000 women die annually from cervical cancer in Nigeria. This type of cancer affects the cervix. The cervix connects the uterus to the vagina in a woman and is located between the uterus and the vagina. The cervix functions in various processes such as menstruation, fertility, pregnancy, childbirth and also the protection of reproductive organs.

Treating Cervical Cancer in Nigeria

The poor health service system makes accessibility to the treatment of cervical cancer in Nigeria difficult. Being a low and middle-income country, Nigeria’s health system lacks cervical cancer services. Cervical cancer is preventable and treatable, but without the necessary vaccines and other health services, prevention and treatment are difficult.

Although HPV vaccines are effective, they cost a lot and are quite unaffordable. A dose of  HPV vaccine costs no less than 13,000 Naira ($29.18), three doses are necessary and the doses are only available in private health facilities. The scarcity of vaccines also stresses the ones who can afford them.

In November 2022, the World Health Organization (WHO) launched a cervical cancer screening and treatment project in Anambra state, Awka. The project aims at the treatment and prevention of cervical cancer in women of productive age across the state.

Some of the medical equipment and supplies that WHO donated include “four examination couches, 20 anglepoise lamps, 50 Cusco’s speculum, 15 instrument trolleys with wheels, 50 disposable aprons, 50 kidney dishes, 20 mackintoshes standard size, 100 packets of swab sticks, 10 punch biopsy forceps, 150 liters of 90% ethanol solution, etc.”

WHO has decided to train 100 health workers on the processes involving cervical cancer screening services and also provide ongoing technical support to ensure the project achieves its goal.

Planned Parenthood Federation of Nigeria (PPFN)

Planned Parenthood Federation of Nigeria (PPFN), collaborates with local government authorities and primary health care systems, in a bid to eliminate cost barriers, it also “conducts mobile outreach clinics offering a wide range of sexual reproductive health services, including cancer services, to vulnerable communities in hard-to-reach, poor and marginalized areas” free of cost.

The intervention of WHO and PPFN in various states of the country brings more awareness about cervical cancer. Making screening more available will make early detection and prevention possible.

– Oluwagbohunmi Bajela
Photo: Flickr

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Trial Ebola Vaccines Arrive in Uganda

Trial Ebola Vaccines
On December 8, 2022, a shipment of trial Ebola vaccines reached Uganda, the first of its kind, that will undergo further evaluation in a clinical trial to determine efficacy against the Sudan ebolavirus. The arrival of these 1,200 doses of trial vaccines comes only 79 days after Uganda announced an Ebola outbreak on September 20, 2022. The speed of this response is unprecedented.

Background

Preceding the arrival of the trial Ebola vaccines in Uganda, the Ugandan Ministry of Health and the World Health Organization (WHO) announced an Ebola outbreak in Uganda on September 20, 2022, after confirming a lethal case of Ebola in Mubende District due to the Sudan ebolavirus.

As the outbreak continued, authorities placed lockdowns in certain districts in Uganda. Additionally, authorities restricted travel and ended school terms earlier. These measures seem to have been largely effective: since November 27, Uganda reported no new cases.

Health in Uganda

As a low-income country, the threat that Ebola outbreaks pose is severe. In 2019, the GDP of Uganda stood at $35.35 billion, with 3.83% of the GDP going toward health expenditure.

According to WHO data from 2018, Uganda faces challenges to its health situation as a result of high rates of communicable diseases. Additionally, “malaria, HIV/AIDS, TB and respiratory, diarrhoeal, epidemic-prone and vaccine-preventable diseases are the leading causes of illness and death,” the WHO reported. These diseases are responsible for more than half of the nation’s morbidity and mortality statistics.

The health care conditions and the availability of medical care vary widely depending on the area. More specifically, rural and remote areas face a shortage of supplies and a lack of human resources, resulting in less patient care, poor health information, limited access to health services and the inappropriate usage of medications.

Current Situation

There are no vaccines available to protect against the strain of Ebola responsible for the outbreak in Uganda, the Sudan ebolavirus species, which is why the trial is necessary. WHO has noted that the arrival of trial Ebola vaccines in Uganda in less than 100 days since the initial outbreak is a “historical milestone in the global capacity to respond to outbreaks.”

The organization went on to emphasize how this vaccine’s fast availability is the result of many international organizations and researchers collaborating and working together. It also comes as a direct result of investments from countries such as the United States to allow WHO to coordinate and focus work on priority health concerns, like Ebola.

Potential Global Impact

The arrival of the trial Ebola vaccines in Uganda offers a promising global impact. Dr. Matshidiso Moeti, the WHO Regional Director for Africa, noted in a statement to WHO, “[The trial] showcases the power of scientific research on our continent and how working in collaboration with international partners we can develop critical tools that will limit the lethal effects of Ebola.” The speed and collaboration that brought about the trial of Ebola vaccines may help combat other diseases and global health concerns in the future.

Impact for Uganda

Once trials reach completion and a vaccine proves effective against the Sudan ebolavirus, this will have a direct impact on the country’s population. Uganda has seen Ebola outbreaks due to the Sudan ebolavirus in nine different districts of Uganda, with 142 confirmed cases by December 5, 2022. From these confirmed cases, Ugandan authorities noted 55 deaths.

Outbreak control for this virus requires several different interventions, including case identification, contact tracing, sufficient laboratory capacity, safe burials, proper hygiene and sufficient treatment early on. As Uganda is a low-income country, recently impacted by food insecurity, severe weather and the COVID-19 pandemic, disease outbreaks can be devastating. Thus, a vaccine to prevent further outbreaks will significantly assist Uganda.

Moving Forward

Ultimately, the arrival of trial Ebola vaccines to combat the Sudan ebolavirus in Uganda shows that through collaboration it is possible to create countermeasures against serious viruses in a minimal amount of time. For the country of Uganda, it is a message of hope and assurance that the international community is capable and prepared to work together and build solutions for further Ebola outbreaks that may arise.

– Johanna Bunn
Photo: Wikipedia Commons

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What to Know About Schistosomiasis in Tanzania

Schistosomiasis in Tanzania
The World Health Organization (WHO) considers schistosomiasis “a disease of poverty.” Schistosomiasis is categorized as a neglected tropical disease (NTD) as it primarily affects tropical locations “where people do not have access to clean water or safe ways to dispose of human waste.” Schistosomiasis is “highly endemic” in Tanzania — it has the second highest number of cases in sub-Saharan Africa behind Nigeria. As a result, efforts are underway to help counter the spread of this disease.

The Background

Schistosomiasis, more commonly known as bilharzia, is an infectious disease that affects around 240 million individuals globally, according to WHO. After malaria, bilharzia is the second most devastating illness that parasites cause, the Centers for Disease Control and Prevention (CDC) says. WHO says “infection is prevalent in tropical and sub-tropical areas, in poor communities without potable water and adequate sanitation.”

A person can become infected when the skin comes into contact with freshwater contaminated with Schistosoma parasites. More significant signs of infection, such as fever and muscle aches, begin within one or two months. “Symptoms of schistosomiasis are caused by the body’s reaction to the eggs produced by worms, not by the worms themselves,” the CDC says. This immune reaction can cause damage to the organs and bring about other health issues.

There are two main forms of the disease: intestinal and urogenital. Children who become infected with these parasites several times “can develop anemia, malnutrition and learning difficulties.” Furthermore, “after years of infection, the parasite can also damage the liver, intestine, lungs and bladder,” according to the CDC.

Chronic schistosomiasis arises when the parasites remain in the body for a long time and the body produces immune responses against the parasitic eggs once they reach body tissue. Cases of chronic schistosomiasis in Tanzania are common and may limit people’s capacity to work.

Past and Current Epidemiology

During the 70s and 80s, Tanzania noted a pressing need to build new irrigation systems and dams to provide clean water for the growing population. However, these innovations had a negative effect on the expansion of the disease since schistosome parasites that live inside snails grow optimally in fresh water. Furthermore, the prevalence of the disease seems to rise as the country’s population size expands. In Tanzania, in 1977, the prevalence rate stood at 19% but swelled to 51.5% (more than 23 million people) by 2012. In 2019, around 15 million people in Tanzania required treatment for schistosomiasis in Tanzania.

Efforts to Tackle Schistosomiasis in Tanzania

WHO recommends “large-scale treatment of at-risk population groups, access to safe water, improved sanitation, hygiene education and snail control” to adequately address schistosomiasis. WHO endorsed treatment for the disease involves the administration of an anti-parasite drug known as praziquantel. In Tanzania, praziquantel is distributed on a large scale to schools and communities.

According to WHO, Tanzania received approximately 33 million praziquantel treatments for mass administration from 2009 to 2018, with a focus on school children.

Thanks to the Zanzibar Elimination of Schistosomiasis Transmission (ZEST) program, which took place from 2011 to 2017, the prevalence of the disease was reduced. Among children aged 9-12, prevalence decreased from 6.1% to 1.7%, while among adults aged 20-55, prevalence decreased from 3.9% to 1.5% by 2017. This successful project, launched by the Zanzibar government, mainly focused on the distribution of praziquantel twice a year, snail control measures and behavioral adjustments among the populace.

However, knowledge about the disease and how to prevent or treat it is integral for reducing future cases. Many people still do not have access to treatment and others prefer not to take the treatment due to a lack of information. This, added to the fact that one can become reinfected, shows why control is difficult. For example, in Mtama, a city that belongs to the Lindi region in Tanzania, the prevalence of the disease is still more than 50%. This is due to a lack of knowledge, interrupted access to praziquantel and unhygienic water practices, among other reasons.

WHO Guideline

In February 2022, WHO released a guideline for the control of schistosomiasis in affected nations. The guideline covers several evidence-based recommendations, including:

  • Snail control measures to decrease transmission risks.
  • Water, sanitation and hygiene efforts in approaches to control the disease.
  • The “expansion of preventive chemotherapy to all in need, including adults and preschool-aged children.”

Schistosomiasis in Tanzania is still a problem that affects a large part of the population, despite the control systems implemented throughout the years. In a country with a population of about 58 million in 2019, 15 million people required treatment for this disease. Implementing comprehensive measures will safeguard the well-being of citizens in an endemic country.

– Carla Tomas
Photo: Flickr