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women in sub-Saharan AfricaEducation has long been an uphill battle for women in sub-Saharan Africa who disproportionately lack the opportunity to go to school. The U.N.’s Education Plus Initiative aims to empower adolescent girls and young women, particularly in regard to HIV/AIDS prevention, through secondary education. A recent UNAIDS study suggests a correlation between HIV education and completing school, which also leads to a better socioeconomic future.

Education and Disease Among Young Women

Sub-Saharan Africa has become a hot spot of population growth. With more than 60% of the region’s population aged 25 and younger, a new generation of African citizens waits to meet the world on a global scale. But, educational attainment has long presented a hurdle for many sub-Saharan countries.

Relatively few African children receive higher education, with young women being the least likely. According to a recent study from the United Nations, more than 80% of the world’s women (aged 15-24) with HIV/AIDS are located in sub-Saharan Africa. Such health issues create a barrier to pursuing further education. A 2014 Millennium Development Goals Report shows a strong correlation between disease and missed educational opportunities, reporting that more than 33 million children in sub-Saharan Africa are out of school, with 56% being girls.

The Millennium Declaration, a set of goals adopted by world leaders to reignite education and fight disease, says that incorporating education into young women’s lives in sub-Saharan Africa promotes poverty reduction, improves mental health and decreases rates of HIV/AIDS.

AIDS and HIV in Africa

The HIV/AIDS epidemic has ravaged entire countries in sub-Saharan Africa. More than 50 girls die from AIDS-related women’s illnesses every day worldwide and more than 90% of adolescent HIV/AIDS deaths happen in sub-Saharan Africa. According to a 2019 study from UNAIDS, young women in Africa generally lack sufficient sex education. Thus, young women in sub-Saharan Africa face disproportionate exposure to many diseases. This includes two of the most threatening in terms of both education and life expectancy: HIV and AIDS.

HIV/AIDS has become prevalent in sub-Saharan Africa because of arranged child marriages and early pregnancies. A recent study from UNESCO found that nearly 52% of Sudanese girls older than 18 were already married, numbers that are mirrored throughout sub-Saharan Africa. Empowerment at the legal level decreases women’s chances of forced marriages and pregnancies, thus reducing rates of HIV and AIDS.

Michel Sidibé, the executive director of UNAIDS, stated, “When girls can’t uphold their human rights — especially their sexual and reproductive health and rights — efforts to get to zero exclusion, zero discrimination, zero violence and zero stigma are undermined.”

More than 79% of new HIV infections occur among girls aged 10-19, according to a 2019 UNAIDS research study. Young women and girls in sub-Saharan Africa need educational and health support. Fortunately, several organizations are working to empower them.

The Education Plus Initiative

UNICEF, in collaboration with UNAIDS, UNESCO, UNFPA and U.N. Women, has created a new initiative in sub-Saharan Africa called Education Plus. Education Plus focuses on empowering young women and girls and achieving gender equality through secondary education. According to UNAIDS, sexual education has helped empower tens of millions of young women throughout sub-Saharan Africa.

Education Plus aims to revolutionize policies related to women’s sexual education in order to improve their quality of life. Education Plus will begin in 2021 and run through 2025. It plans to create policies that add sexual education to young women’s school lessons, launch tech-based publicity programs to promote women’s rights and expand upon HIV and AIDS prevention, treatment and recovery, among other initiatives.

A UNICEF study revealed just how important education is to empower young women in sub-Saharan Africa. When young girls finish secondary school, they are six times less likely to marry young. The study also found that if a child’s mother can read, the child has a 50% better chance of survival.

Moving Forward

Education Plus is set to run for five years to help women and girls achieve social, educational and economic success. UNICEF, UNAIDS and several other organizations have come together to make supporting young women in Africa a priority.

Moving forward, empowering young women in sub-Saharan Africa, one of the world’s highest poverty areas, requires an array of solutions. Organizations like UNAIDS hope the area can one day flourish as an oasis for young women and girls, who will, in turn, have the educational and social resources to create a more stable Africa.

Mario Perales
Photo: Flickr

Children in Pakistan
Pakistan is a mostly Muslim country between Afghanistan and India in South Asia. The country gained independence in 1947 and the government operates as a parliamentary democracy. In recent years, the country has adopted Sunni Islam’s essence, with Northern Pakistan facilitating a sanctuary for various Islamic extremist groups. The life expectancy in the country averages 67 years. In 2015, an Asian Development Bank report determined that 24.3% of Pakistanis live below the poverty line and UNAIDS claimed that 190,000 Pakistani are HIV positive. The organization also stated that the number of deaths from HIV cases has increased by 385% since 2010, with only 12% of patients receiving treatment. Unfortunately, the number of children in Pakistan with HIV has been significant.

Recent HIV Outbreak

Between April and July 2019, medical professionals diagnosed 735 children in Pakistan with HIV. The World Health Organization (WHO) has labeled the epidemic as a Grade Two Emergency. This implies a moderate approach to combating the problem since, according to WHO, Pakistan is one of the lowest spending countries when it comes to funding for health. Pakistan utilizes only 3% of its GDP for healthcare, whereas its neighbor, Afghanistan, allots 10%. Per person, Pakistan spends less than $45 on annual healthcare.

With the COVID-19 pandemic, many essential health issues have received neglect. In September 2020, Lancet Global Health constructed an investigation around how the pandemic has affected other health crises. In its findings, reports determined that deaths for HIV have increased by 10% since the beginning of the pandemic. The medical system has been under stress due to the pandemic, leading to a decrease in medical support for HIV. During this time, a local reporter named Gulbahar Shaikh, who had been covering a story in Ratodero around this time, decided to have his children tested to be safe. He was reportedly stunned when his daughter, Rida, came back positive for HIV.

Solutions

In November 2019, cases of HIV-positive children in Pakistan started to emerge in Ratodero, a city just north of Larkana. In fact, reports stated that 1,132 children had HIV in Ratodero. As soon as possible, the local government sent experts to respond. During their investigations, it came to light that many of the patients did not have infected parents, which set off a red flag to officials. They later found that many of the infected children saw a doctor named Muzaffar Ghanghro. He was a cheap, in-town physician working primarily with children. Finding this, officials made Ghanghro obtain a test for HIV too. Even when his results came back positive for HIV, he denied the results.

The officials found Ghanghro fully responsible for the increase in outbreaks within children in Ratodero, and police arrested him. He spent about two months in jail but the pediatrician has not received any charges.

In 2019, $6.3 million went into funding investigations for children in Pakistan with HIV, resulting in the shutting down of 300 medical facilities in Ratodero. However, unlicensed private clinics still function on “nearly every block,” and several facilities do not even have a place for physicians to wash their hands.

Save the Children

In 2020, UNAIDS and the United Nations HIV program reported that 2.8 million individuals under 20 were living with HIV. Additionally, over 50% of those individuals were under 10 years old.

An organization fighting for the betterment of children named Save the Children works in Pakistan. Together with the National Health Emergency Preparedness and Response Network, the organization provides reputable health facility managers to implement more humane health responses. The Mothers, Newborn and Child Health Program (MNCH) is an integral part of what Save the Children offers for healthcare. The program provides improved services from households to hospitals to moms and their children. The program’s focus is on the already existing primary healthcare facilities within areas of poverty in Pakistan. The program ensures a healthier emergency and medical experience for children in Pakistan.

Save the Children also has an initiative explicitly targeting individuals with HIV/AIDS. The project consists of providing more support to the physicians practicing in Pakistan. This program provides care to People Living with HIV (PLHIV) through Community and Home-Based Care services. The service actively raises awareness on transmission causes along with referring cases to further investigations. Together with the other efforts, Pakistan hopes to change the trend of rising HIV numbers.

– Libby Keefe
Photo: Flickr

In 2020, the Joint United Nations Program on HIV/AIDS (UNAIDS) undisclosed its global strategy to end AIDS by 2030. The strategy, which started in May 2020 and will continue for the next decade, is a complex global program. This strategy defines AIDS as a public health threat and its main goal is to end it.

A Complex Timeline

UNAIDS’ global strategy is based on equity and human rights. Consequently, it aims to increase public awareness about AIDS, end discrimination toward those infected and improve access to treatments. This plan focuses on increasing the international response to people with AIDS to end the active transmission of the virus.
The ten-year-long plan contains various steps and phases. UNAIDS’ strategy includes meeting different targets inside these phases. For instance, within the ten-year plan, the 2025 target focuses on the need for global social and health services for infected people. By 2025, UNAIDS intends to improve the global response to poverty, discrimination and treatments to people living with AIDS.

Past Targets and Current Phases

Phase one of the long-term strategy began in May 2020 and ended in August of the same year. It consisted of quantitative surveys, interviews, consultations and discussions with stakeholders. The goal of these discussions was to gather data on the last UNAIDS strategy (2016-2020).
In 2020, UNAIDS discussed different issues concerning HIV with more than 10,000 stakeholders. They considered crucial topics such as political leadership, partnerships, COVID-19 and health coverage about AIDS.
The second phase of the UNAIDS plan is still in progress. During phase two, UNAIDS focused on analyzing and synthesizing the data gathered in phase one. In March 2021, UNAIDS introduced the results and new strategy to the Programme Coordinating Board (PCB). Reviews represent an essential part of UNAIDS’ strategy development process.

A Global Effort on Different Levels

UNAIDS intends to build programs that will help support everyone infected with AIDS. The internal units of UNAIDS work together to achieve both secondary and primary goals toward ending AIDS. For instance, UNAIDS staff, secretariat and advisory group cooperate to reach marginalized people.
In addition to internal collaboration, UNAIDS works on a global scale. For instance, UNAIDS works jointly with civil society organizations, individual experts, academia and research experts, development agencies, marginalized and key individuals or communities and inter-governmental organizations. UNAIDS staff collaborate with the private sector, associations, PCB partners and member states. This complex and effective system enables UNAIDS to achieve its goals, get international support and reach people on a global scale. UNAIDS embodies collaboration at international levels.

HIV Organizations Intensify their Efforts

Local non-profit organizations are part of the global effort to end AIDS. When UNAIDS revealed its next strategy to end AIDS, local HIV organizations intensified their efforts to work conjointly with UNAIDS. One organization, Together! ACT Now, a local HIV non-profit organization, stepped up to reach the UNAIDS 2030 commitment. This non-profit focuses on raising awareness in Malawi through education, theatres and group discussions. For instance, the organization put together a program called “Stronger Together! Community HIV Village Group”. This program provided workshops with AIDS experts, art sessions to express creativity and mobile clinics.
Together! ACT made progress in Malawi: it helped 90% of seropositive people aware of their status. 87% of these people are now receiving treatment.
UNAIDS’ next strategy to end AIDS by 2030 shows promise as it considers past failures, reviews and adapts to the current challenging sanitary context. To efficiently fight stigma, discrimination and virus transmission, it remains crucial to work on all levels simultaneously.  International collaboration coupled with national processes and local fieldwork is essential in fighting a global health issue, especially during a global pandemic.

-Soizic Lecocq
Photo: Flickr

Progress Against HIV/AIDS in ThailandIn the last decade, Thailand has made significant efforts to reduce HIV/AIDS transmission and deaths, resulting in a dramatic decrease in one of the world’s most stigmatized diseases and an effective model for other countries to follow.

HIV — first identified in 1981 — is a viral infection that attacks the human immune system and spreads through bodily fluids. If left untreated, it can cause AIDS, a condition with which most people only survive a few years. There is no cure for HIV/AIDS, but there are treatments such as antiretroviral therapy that can keep the infection from progressing to AIDS.

HIV/AIDS in Thailand

The first case of HIV/AIDS in Thailand was in 1985, and the country continues to have one of the highest rates of the disease in Asia and the Pacific. An estimated 470,000 people are living with HIV/AIDS in Thailand, and 14,000 AIDS-related deaths occurred in the country in 2019.

Like in other countries, the Thai populations most at risk for HIV/AIDS are those living in poverty or otherwise on the margins of society. These circumstances can reduce access to healthcare and testing, which is made worse by the heavy stigmatization of the disease.

Progress in Thailand

However, the Thai government has made substantial progress against the virus after making it one of the country’s prioritized health initiatives. In 2006, Thailand incorporated HIV services into its universal healthcare system, and now testing and treatment are free for anyone who might need them.

Awareness campaigns have also had a large impact on the state of HIV/AIDS in Thailand. The government has partnered with civil society groups to increase public knowledge both about the disease and preventative measures. Another important aspect of these partnerships has been specific efforts to reduce the stigma associated with HIV/AIDS.

Since 2010, the rate of new infections in Thailand has dropped 65%, and AIDS-related deaths have fallen 44%. These improvements have directly resulted from the efforts to increase awareness and improve access to healthcare and testing. Of the Thai population living with HIV, 80% are on antiretroviral treatment, and 78% have suppressed viral loads preventing the infection from progressing to AIDS.

Thailand is also the first country that has nearly eliminated mother-to-child transmission of HIV/AIDS. Now, less than 2% of children test positive for HIV after being exposed. This has significantly reduced the number of children who are infected and need antiretroviral care.

Future Goals

With all of this progress, the government is in a strong position to continue reducing the prevalence of HIV/AIDS in Thailand. The country still has not met UNAIDS’ 90-90-90 targets where 90% of those HIV positive are aware of their status, 90% are on antiretroviral treatment and 90% have suppressed viral loads. However, Thailand’s efforts remain an important international model of effective policy against HIV/AIDS.

Through its focus on decreasing the number of new infections and improving access to antiretroviral treatment, the prevalence of HIV/AIDS in Thailand has decreased. Along with its prioritization of spreading information and awareness about the disease and its transmission, Thailand has created an effective method for tackling HIV/AIDS.

– Nicole Ronchetti
Photo: Flickr

HIV/AIDS in Lesotho  Africa may not have the densest population; nonetheless, it is the continent with the most HIV-afflicted occupants. Lesotho, a small country in Africa, currently has the highest HIV prevalence in Africa and second in the world with 340,000 infected habitants. From mountain ranges to river valleys, the division of regions causes the country to face issues regarding giving access to healthcare in every village. Women experiencing exposure to HIV/AIDS in Lesotho, which endangers health and safety. Moreover, they can pass it on to their offspring while pregnant. Phelisanang Bophelong, a South African initiative, works in “improving young people’s access to HIV friendly services to engage in sexual health and working with prison inmates to ensure they have access to HIV prevention and care services.”

Healthcare in Lesotho

Lesotho, a developing nation in the south of Africa, has seen improvements in the health sector. Nonetheless, some civilians do not receive healthcare services. Rural areas are most affected because of the lack of infrastructure, such as roads between villages. The public sector has compromised to expand the healthcare sector to reach the rural population. Between the 2000s-2010, Lesotho reported having 62 nurses and five doctors per 100,000 habitants. In 2011, the government built new hospitals, and more doctors joined the workforce. Lesotho sees a bright future ahead of it with the support of NGOs like Phelisanang Bophelong and an emergency relief plan on behalf of the United States.

Rural Health Initiatives

HIV/AIDS in Lesotho has become an alarming problem, yet the government has relentlessly increased human resources. Other countries have contributed to emergency relief aid, such as the United States through UNAIDS, which aims to help test citizens and provide antiretroviral therapy. Currently, the mission has covered 81% of the communities across Lesotho.

In 2006, Lesotho’s government launched a healthcare program in rural areas that served 90,000 people. The Ministry of Health launched a new program that involves testing and counseling. It introduced mobile clinics to rural areas which have shown positive results.

Phelisanang Bophelong in Lesotho

In Lesotho, about 23.6% of people between the ages of 15 and 24 currently have HIV. A big problem in countries such as Lesotho is the lack of information about sexual health. Phelisanang Bophelong works to encourage young people to become aware of HIV and its effects. Phelisanang Bophelong is motivating the young population to prevent HIV. It is also incentivizing prison inmates to access care services to prevent the spread of HIV/AIDS. The NGO managed to diagnose and provide treatment to 200 people with HIV while raising awareness. It has also helped 6,113 young individuals reach out to healthcare services.

While there is always room for improvement, the situation surrounding HIV/AIDS in Lesotho has exponentially improved. NGOs such as Phelisanang Bophelong have promoted sexual health in young adults. This incentive has led to millions of citizens receiving testing for HIV/AIDS while preventing the expansion of it in the country. Meanwhile, relief aid from the United States has prevented illnesses, malnutrition and death in Lesotho. Additionally, the implementation of mobile clinics has given people medical access in harder-to-reach areas.

– Ainara Ruano
Photo: Flickr

UNAIDS’ Treatment Initiatives for HIV/AIDS in BotswanaAccording to a UNAIDS report in 2019, 380,000 children and adults in Botswana are living with HIV/AIDS. The deadly disease has made a prominent appearance in Botswana, which is currently one of the most affected countries in the world. However, with the help of UNAIDS treatment initiatives for HIV/AIDS in Botswana, the country has managed to establish valuable antiretroviral treatment (ART) and raise awareness for HIV/AIDS.

HIV/AIDS: The disease and its symptoms

Human Immunodeficiency Virus (HIV) is a deadly virus that is spread through bodily fluids and targets human immune cells. When the virus fuses with white blood cells, it hijacks the immune system and leaves the victim highly susceptible to disease. Acquired Immune Deficiency Syndrom (AIDS) occurs when HIV goes without treatment and a person’s immune system is weak as a result of the virus.

Properly monitoring and managing the disease is important in slowing down the progression of the virus in its early stages. Symptoms of HIV include skin rashes, a sore throat, a fever and swollen glands. When doctors diagnose and test for HIV, they look for the appearance of HIV antibodies in the bloodstream. International Training and Education Center for Health (I-TECH) in Botswana is a program that conducts HIV testing and posts information about the spread and transfer of the disease.

Prevalence and Primary Modes of Communication

HIV/AIDS is most commonly spread through broken wounds and contaminated bodily fluids. Participating in sexual activities without protection or HIV-prevention medicine can result in the transmission of the virus. HIV/AIDS cannot pass through saliva, sweat or urine unless they contain traces of infected blood. Using needles with HIV-contaminated blood, as well as rare cases of blood transfusions present a risk of being exposed to the virus. Less common ways of contracting HIV/AIDS include infection during birth and pregnancy from mother to child.

In Botswana, female sex workers and youth are at the biggest risk of contracting HIV/AIDS. A 2012 study by the Ministry of Health found that 61.9% out of 4,000 female sex workers in Botswana have HIV. Additionally, of those surveyed, 18.6% of female sex workers did not wear condoms out of force, and 23.9% for money. Similarly, a lack of awareness and information about HIV/AIDS transmission has caused youth under the age of 15 to participate in sexual activities without protection. This has created even more HIV/AIDS cases among the youth of Botswana.

UNAIDS’s Approach to HIV/AIDS Treatment

Receiving treatment for HIV early on plays an important role in stopping the progression of the virus before it develops into AIDS. Early treatment can increase life expectancy and make living with the virus more manageable. In the United States, HIV does not often progress into AIDS. This is because frequent treatment at correct intervals can significantly slow down the rate at which the virus replicates. However, treatment is not easily accessible or cheap in many developing countries such as Botswana. This is a challenge that UNAIDS is currently helping to overcome.

In response to Botswana’s move to offer free treatment to non-citizens, UNAIDS Executive Director Gunilla Carlsson stated, “This measure will save lives and help the entire country progress toward ending the AIDS epidemic — it is another example of Botswana’s leadership and its determination to leave no one behind in the response to HIV.”

UNAIDS Treatment Initiatives for HIV/AIDS in Botswana

UNAIDS has maintained a plan to end the HIV/AIDS epidemic by 2030 through the implementation of ART for all Botswanians and collaborative work with the government of Botswana. As of 2017, 320,000 people of the 380,000 inhabitants of Botswana living with HIV now have access to treatment. Carlsson asserted that “the main challenge that Botswana is facing in its AIDS response is complacency. If the country can overcome this challenge, then it will show the whole world that it can be done.”

UNAIDS’s goal is to prevent the spread of the virus by educating the public and obtaining funding. Due to the combined effort of the government of Botswana and UNAIDS, Botswana was the first country in Eastern and Southern Africa to offer free HIV treatment regardless of living status or citizenship. It has also adopted a strategy that allows immediate treatment for those who test positive for the virus. This has decreased the cases of AIDS and improved the quality of life for those living with the disease. Among other exemplary HIV/AIDS programs, UNAID treatment initiatives for HIV/AIDS in Botswana are helping save millions of lives.

– Esha Kelkar
Photo: Flickr

HIV/AIDS In LiberiaAround 4.9 million people are currently living with HIV in western and central Africa, including a percentage of those living in the small African country of Liberia. With a population of 5.1 million, roughly 1.5% of Liberians aged 15-49 live with HIV/AIDS. While this sounds like a small percentage, this equates to an estimated 47,000 people currently living with HIV/AIDS in Liberia, including 3,600 children.

HIV/AIDS in Liberia

While the percentage of HIV/AIDS in Liberia is lower than in surrounding countries and other regions of Africa, the country still struggles with treatment plans, education on the disease and breaking down stigma that could help prevent further spread. In 2019, UNAIDS released a comprehensive report detailing the spread and effect of HIV/AIDS in the country. The report states that only 33% of those living with HIV are receiving ART treatment. This amounts to 15,000 people currently receiving antiretroviral therapy (ART), a daily medication that reduces HIV in the system. Persons with HIV who do not receive ART treatment are more likely to develop AIDS and spread the virus. Of the 15,000 receiving treatment, 763 are children, which amounts to only 21% of all infected children in the country.

Additionally, only 58% of those living with HIV know their status. Lack of education on HIV testing and little access to testing centers has led to only a little more than half of those infected knowing their status through accurate testing. This lack of education heightens the threat of further spread, putting the health and safety of the entire population at risk. HIV/AIDS is not limited to sexual encounters. It also spreads through shared drug injections and even spreads to infants through breastfeeding. Unfortunately, stigma and discrimination continue to prevent progress.

According to UNAIDS’ 2019 report, roughly 53% of those surveyed in Liberia answered no when asked if they would purchase produce from a vendor who was HIV positive. This kind of stigma and cultivated ignorance around HIV and AIDS further inhibit people from getting tested as they may fear public ridicule. The fear of a positive test prevents the country from creating accurate and beneficial response plans.

Programs and Progress

In 2017, the African Union, in partnership with UNAIDS and others, implemented a series of “catch-up plans” for countries in western and central Africa to combat these issues. These plans included a 90-90-90 goal by 2020, meaning 90% of the people will know their HIV positive status, 90% of HIV positive people will have access to ART treatment and 90% will have viral suppression. The UNAIDS’ full 2020 report for Liberia is not available yet but the 2019 report already showed improvements in the country’s fight to eradicate the disease.

Compared to a 2016 report, the percent of children receiving ART treatment rose from about 17% to 21% in 2019.  Additionally, the percentage of HIV-positive pregnant women receiving ART treatment has increased from 19.3% in 2015 to 90% in 2019. This massive increase helps prevent infants born with HIV and decreases the risk of spread through sexual partnerships. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported the African Union and UNAIDS’ efforts in Liberia and significantly aided in the reduction of HIV-related issues. Therefore, PEPFAR supports health and treatment facilities in four Liberian counties and supported ART treatment for 15,000 HIV-positive persons in 2020.

All these improvements show progress toward the eradication of HIV/AIDS in Liberia. These advancements bring optimism as hope for an HIV/AIDS-free country remains strong.

– Kendall Couture
Photo: Flickr

HIV/AIDS in Iran
Iran discovered its first case of HIV/AIDS in 1987. Now, over 30 years later, UNAIDS estimates that more than 59,000 people are living with HIV/AIDS in Iran. While Iran has had success managing its HIV/AIDS epidemic in the past, shifting conditions surrounding the spread of the disease has made prior prevention plans obsolete. Iranian non-governmental organizations (NGOs) are taking a new approach to help tackle the present crisis.

HIV/AIDS in Iran

Avert is an organization working in HIV/AIDS education. According to its reports, the Middle East and North Africa (MENA) region, the area where Iran is located, has the fewest HIV/AIDS infections in the world. However, a concerning aspect of the region’s HIV/AIDS epidemic is that so few people are aware of their infected status. Of the estimated 59,000 people living with HIV (PLHIV) in Iran, UNAIDS estimates that only 22,000, or 37%, know that they are carrying the disease. By comparison, only about 15% of PLHIV in the United States are unaware of their status.

This lack of awareness amongst Iranian PLHIV is concerning both in its implications for the quality of life of those individuals, but also in its potential to increase the spread of the virus. This is part of the reason why Iran continues to see the steady spread of HIV/AIDS. According to UNAIDS, while new infections are down from a spike in 2004, Iran saw more than 4,000 new infections in 2019. The AP reports that this increase could be due to the rising prevalence of sexually transmitted cases of HIV/AIDS in Iran, where infection by contaminated drug injection has traditionally fueled the country’s crisis.

Knowledge and Perceptions of HIV/AIDS in Iran

The unknown status of many Iranian PLHIV results from larger issues surrounding Iran’s attitude towards the virus. Specifically, a lack of education regarding HIV/AIDS and prevailing cultural stigma towards PLHIV impacts how Iranians treat the virus and those living with it.

A 2013 survey showed that public education about HIV/AIDS in Iran is limited. The survey included 4,950 participants, each of whom had to fill out a questionnaire regarding their understanding of and attitudes towards HIV/AIDS.

The results of this survey showed that more than 80% of participants were aware that HIV/AIDS could spread through sexual contact or the sharing of a needle with a person with HIV/AIDS. In addition, 70% of participants knew that the use of a condom decreases the likelihood of contracting the virus during sex. However, despite this understanding, only 21.8% of respondents consistently used a condom during sex. This is particularly concerning given the rising role of sexual transmission in the spread of the disease in Iran.

The survey also revealed high stigmatization of PLHIV by respondents. Among respondents, 43% believed that HIV was a “fair punishment,” for “sins of the past,” and 48.6% said that they would stop interacting with somebody who contracted HIV.

Stigma towards PLHIV in Iran results from numerous factors. Misunderstandings about the spread of HIV/AIDS are part of the equation. Due to cultural norms, the association of HIV/AIDS with drug use, homosexuality and premarital sex have led to the widespread nonacceptance of PLHIV, a sentiment echoed in the aforementioned survey.

A New Approach to HIV/AIDS in Iran

Fortunately, NGOs in Iran exist that are advancing a more compassionate and effective approach to HIV/AIDS. The Tehran Positive Club is one such organization. The club devotes itself to assisting Iranian PLHIV, educating the public about HIV/AIDS and reducing the stigma against PLHIV. It provides services to PLHIV including counseling, group therapy, material support and vocational training.

Based out of Iran’s capital, the Tehran Positive Club has thousands of members and multiple branches throughout the country, including in populous cities like Isfahan, Kermanshah and Qom.

By providing material support, the Tehran Positive Club hopes to alleviate the social and psychological trauma that societal stigmatization causes PLHIV. And by increasing public understanding about the disease, it seeks to eliminate the prevailing cultural stigmata that result from misinformation. Reducing stigmatization creates empathy for PLHIV and raises the likelihood that more Iranians will receive testing for the disease, thereby reducing its spread and increasing the chances of survival for the unwittingly infected.

In 2016, the Tehran Positive Club received the Red Ribbon Award from UNAIDS for its work with the HIV/AIDS epidemic in Iran. Though the organization already has powerful allies at home and abroad, including the Iranian Research Center for HIV/AIDS and the United Nations Development Program, increased foreign aid would undoubtedly help further its mission and turn the tide of Iran’s HIV/AIDS epidemic.

– Joseph Cavanagh
Photo: Creative Commons

Côte d’Ivoire Health Care
Côte d’Ivoire health care has faced challenges in recent years and even more so during the COVID-19 pandemic. According to a 2020 Helen Keller International report, Moriame Sidibé, a mom and homemaker from northern Côte d’Ivoire was a “Vitamin A Hero” because every six months for the past three years she spent three full days walking door to door and village to village to give young children Vitamin A and deworming pills. Sidibé faced challenges because sometimes she needed to convince mothers of the importance and safety of the pills, coax the children to swallow the pills and mark the children’s fingers with black ink so she would not accidentally give them a second pill.

Sidibé left her own four young children to do this, but it was worth it to her because she has training as a community health volunteer who is part of a collaboration between the Ivorian government, Helen Keller International, the United Nations International Children’s Fund (UNICEF) and Nutritional International fighting the extreme form of malnutrition in children called micronutrient deficiency or “hidden hunger.”

The Situation

Twenty-five percent of Ivorian children get enough calories, but not foods with sufficient Vitamin A, zinc, iodine or iron.  That “hidden hunger” puts one in four Ivorian children at risk of blindness, impaired brain development and some fatal infections. Deworming pills kill the parasites that prevent children from absorbing micronutrients including Vitamin A, and together the deworming pills and the Vitamin A can save children’s lives. In December 2019, the campaign reached 5 million children or 98% of all Ivorian children, an incredible accomplishment of a ministry of health working with international non-governmental organizations (NGOs) and trained community health volunteers.

Côte d’Ivoire, the West African nation of 25 million, enjoyed a strong 8% average GDP growth between 2011 and 2018. According to the World Bank, the country had one of the strongest economies in sub-Saharan Africa due to an expanded middle class that supported demand in industry, agriculture and services. The Côte d’Ivoire health care indicators, however, lagged behind other less-developed nations, and in 2018, Côte d’Ivoire ranked 165 of 189 countries on the U.N. Human Development Index.

As noted in a 2020 Oxford Business Group report, planned increases in health care spending should improve these indicators. Côte d’Ivoire spent $1.8 billion on health care in 2016, $2 billion in 2019 and intends to spend $2.3 billion in 2021. The country invested in access to services, renovation and building of medical facilities, and development of technical platforms aligned with international health standards. The Ivorian government worked with a number of programs like the Helen Keller International Vitamin A Heroes; however, then the COVID-19 pandemic hit.

Despite COVID, Côte d’Ivoire Health Care Initiatives Regroup to Persevere

Based on the World Health Organization COVID-19 transmission guidance, the Vitamin A Heroes collaboration discontinued its door-to-door campaign. Nevertheless, during the pandemic, the campaign has resolutely distributed Vitamin A and deworming pills at local health clinics when children come with their families for other reasons. Once the pandemic subsides, it will renew its crucial Vitamin A Heroes campaign.

Predicted to Rebound Post COVID and Target Health Care

Côte d’Ivoire’s pre-COVID targeted investment in health care services, facilities and technical innovation gives Côte d’Ivoire health care a positive outlook according to the Oxford Business Group report. The International Monetary Fund predicts that Côte d’Ivoire’s GDP growth will climb back up to 8.7% in 2021 as the new investment in Côte d’Ivoire health care parallels the successful investment in other sectors.

Moving Forward, Côte d’Ivoire to Roll Out Planned Health Care Initiatives

One example of a Côte d’Ivoire health care collaboration of governmental, NGO and local organizations that launched during the COVID-19 pandemic in 2020 is Harness the Power of Partnerships. Harness the Power of Partnerships is a Côte d’Ivoire health care initiative to use faith-based organizations in the HIV response. Faith-based leadership is working with the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Joint United Nations Programme on HIV and AIDS (UNAIDS) on long-term strategies to reduce the stigma of HIV/AIDS and to keep Ivorians on their antiretroviral therapies. This PEPFAR/UNAIDS program exemplifies how the Ivorian government continues to partner with non-government groups, including local groups, in order to improve Côte d’Ivoire health care indicators.

Improving Côte d’Ivoire health care will not be an easy task, but creating collaborations with international powerhouses like PEPFAR, UNAIDS, Helen Keller International and local nonprofits and community leaders is definitely a strategy worth watching as COVID-19  subsides and the Ivorian economy rebounds.

– Shelly Saltzman
Photo: Wikipedia Commons

The Netherlands' Foreign Aid
The Netherlands leads in refugee advocacy, COVID-19 relief and environmental protection and occupies a significant place on the world stage because of its commitment to foreign aid. The Netherlands is the world’s seventh-largest donor country, spending 0.59% of its gross national income, or $5.3 billion USD, on official development assistance (ODA) in 2019. The Dutch government plans to increase ODA by $2.7 billion between 2019 and 2022 to compensate for budget cuts the previous administration made and increased its development budget by $354 million in September 2020 in response to the ongoing COVID-19 pandemic. The Netherlands aims to assist unstable regions of West and North Africa and the Middle East through a focus on four major priorities: law and security, water management, food security and reproductive health. The Netherlands’ foreign aid is a key aspect of the country’s public policy and shapes its reputation for philanthropy worldwide.

Human Rights in the Netherlands

Human rights are a cornerstone of the Netherlands’ foreign aid. The country has a commitment to increasing protection for marginalized communities both at home and abroad. The Netherlands welcomed 94,430 refugees and asylum seekers in 2019 and over 100,000 each of the preceding three years. The government has also taken steps to support refugees, allocating $453 million, or 9% of the ODA budget, to refugee housing costs in 2021. Additionally, the Netherlands allocated additional funding to fight the root causes of poverty, migration, terrorism and environmental challenges in Africa and the Middle East. The Netherlands hopes to address the root causes of these problems in their countries of origin to reduce the number of refugees and improve the quality of life for the global poor.

The Netherlands leads the world in advocacy for gender equality and sexual health through funding for international organizations such as the United Nations Population Fund, UNAIDS and the Global Financing Facility. These organizations work to prevent infant and maternal mortality, end HIV/AIDS and end child marriage and female genital mutilation in developing countries. For example, the Global Financing Facility provides high-quality affordable health care to women and children focused on ending infant and maternal mortality and providing necessary health services to children and teenagers. Since its founding in 2015, GFF has made significant strides in advancing health care in its partner countries. Tanzania improved from an average of 35.8% of pregnant women receiving antenatal care visits in 2014 to 64.1% in 2018.

COVID-19 Relief in the Netherlands

During the COVID-19 pandemic, the Netherlands’ foreign aid is important in protecting global health in vulnerable regions. The Netherlands has taken the initiative to allocate pandemic relief aid to the world’s poorest countries, joining other E.U. states to contribute $459 million USD to COVAX, which helps ensure universal access to the COVID-19 vaccine. COVAX aims to distribute two billion COVID-19 vaccines to developing countries by the end of 2021, ensuring global protection against the virus. The country also donated $590 million to global COVID-19 relief efforts in 2020 and plans to contribute a further $548 million from its budget for the upcoming years.

In January 2021, the Netherlands announced it would donate a further €25 million to COVID-19 relief following an appeal by the World Health Organization (WHO). Together, the WHO and its global partners will earmark $5 billion to ensure the distribution of 1.3 billion vaccines in countries with limited or insufficient funds. Development minister Sigrid Kaag emphasized the responsibility of the Netherlands to help more vulnerable countries by providing vaccines, diagnostic tests and medicine, which will also help to protect Dutch interests. The €25 million will come from the development cooperation budget and will cover five million vaccine doses.

The Netherlands uses its global platform to advocate for marginalized communities, particularly at-risk populations in North and West Africa and the Middle East. Foreign aid is a cornerstone of Dutch foreign policy that has grown the wealthy country’s reputation for philanthropy. By welcoming refugees, advocating for human rights and funding global efforts to combat COVID-19, the Netherlands affirms its commitment to foreign aid and funds solutions for some of the most pressing global problems.

– Eliza Browning
Photo: Wikipedia Commons