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African Governments Combating HIV/AIDS
The threat of the COVID-19 pandemic is still a major problem today. A variety of problems continue to affect the globe, such as poverty and HIV/AIDS, the latter of which has severely affected Africa for years. Globally, estimates indicated that HIV infected 33.9 to 43.8 million people by the end of 2021 and nearly two-thirds of those infected were Africans. However, the situation is far from hopeless as African governments are combating HIV/AIDS and some progress is occurring on that front.

The Current Situation in Africa

According to reports by the Joint United Nations Programme on HIV/AIDS (UNAIDS), new HIV infections have declined by 14% between 2010 and 2015 in Eastern and Southern Africa. Similarly, there was an 8% decline in West and Central Africa. Despite the small percentages, progress is obvious. In 2000, only 11,000 people were getting antiretroviral treatment (ARV) for HIV. Now, more than 12 million people today are receiving the treatment. African governments that are combating HIV/AIDS have also expanded prevention methods to stop the spread of HIV/AIDS. Some of the prevention methods are voluntary medical male circumcision and tests for pregnant women to see if they are HIV positive. Those who are positive receive medicine in order to prevent the transmission of HIV/AIDS to their unborn babies. Hence, there has been a decrease in infections throughout the region.

Despite the progress, the epidemic still severely affects African countries. Poverty and the COVID-19 pandemic only further exacerbate this issue. HIV/AIDS affects the region socially and economically. There are still a large number of people who are not receiving the treatment they need and the cure has yet to emerge. Sub-Saharan Africa suffers the most as it is the world’s epicenter of HIV/AIDS, accounting for two-thirds of the global total of new HIV infections. Progress continues to be slow and multiple challenges remain.

Response and Progress to End HIV/AIDS

Currently, African governments are aiming to put an end to the HIV/AIDS epidemic worldwide by 2030. They have partnered with multiple organizations such as UNAIDS, PEPFAR and other global health organizations to realize this goal. Together, they are working tirelessly to respond and accelerate progress in the continent. Access to condoms and lubricants for men is increasing, programs encouraging changes to sexual behavior are undergoing implementation and affordable methods to prevent infections are spreading.

The United States Global AIDS Coordinator and Special Representative for Health Diplomacy, Ambassador Dr. John Nkengasong launched “Reimagining PEPFAR’s Strategic Direction, Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030.” According to UNAIDS, it focuses on key priority areas that include addressing health equity for children, adolescent girls, young women and other key populations. It also focuses on maintaining long-term sustainability, enhancing global health security, nurturing transformative partnerships and leading with science. UNAIDS has reported considerable success in many sub-Saharan African countries. The number of deaths that HIV/AIDS has caused in Sub-Saharan Africa has declined by 35% in recent years.

The Global Mission to End HIV/AIDS

Global efforts addressing the epidemic have shown promising signs. People in resource-poor countries like Africa that are receiving HIV treatment have increased dramatically over the past decade. PEPFAR has provided HIV testing services for more than 50 million people as of 2021. Additionally, 2.8 million babies were born HIV-free from parents living with it. The battle continues as African governments combating HIV/AIDS continue to work around the clock. They are strengthening public health systems and local capacity for preparedness and response to other diseases. Progress may be slow but efforts put forth by various organizations continue to provide promising results. Research is also progressing as many around the globe work to prevent further HIV infection and find a cure someday. So long as Africa and its people continue to fight the good fight, the goal to end the pandemic by 2030 may just be achievable.

– Aaron Luangkham
Photo: Flickr

Alergia is one of the largest countries in North Africa, both by size and population. Like any other country, Alergia is not perfect, as the upper middle-income nation has a poverty rate of 14.6%. That high rate can be connected to issues such as femicide, stagnant economic growth, a decline in the hydrocarbon sector and a private sector struggling to energize the economy. However, a number of charities in Algeria are working to address poverty conditions among the most vulnerable groups.

4 Poverty-Fighting Charities in Algeria

  1. Oxfam in Algeria: Oxfam is an international charity that focuses on alleviating global poverty. While the nonprofit functions around the world, its focus in Alegria has been on Alegria’s Sahrawi refugee camps. Since 1975 Sahrawi refugees have remained dependent on humanitarian aid to provide basic necessities. Oxfam works to combat poverty for those living in the camp by improving food security through increasing access to fresh produce. Importantly, it is also teaching Sahrawi refugees to develop and run small-scale agroecological farms. Since most Sahrawi families lack access to the United Nations High Commissioner for Refugees (UNCHR) recommended 20 liters of fresh water a day, Oxfam concentrates on improving family water storage tanks, installing strong hosepipes to homes and other similar technical upgrades for water access and capacity enhancements. Because a number of highly-educated young women and men in the camp become frustrated with their lack of socioeconomic opportunities, Oxfam also focuses on community engagement for these young adults.
  2. World Food Programme: The World Food Programme (WFP) helps tackle the issue of malnourishment which is a problem, especially for Sahrawi refugees in Algeria. Luckily, in 2021 alone, the WFP supported 138,421 people in Algeria and provided nearly a million dollars worth of cash-based food assistance. Targeting anemia, stunting and malnutrition, the WFP runs 29 nutrition centers that offer both treatment and prevention strategies. The WFP also provides daily school snacks to nearly 40,000 children to encourage them to enroll in school. Finally, the WFP focuses on resilience-building projects like low-tech hydroponics and fish farms.
  3. Algeria UNAIDS: The United Nations Programme on HIV/AIDS (UNAIDS) UNAIDS is leading efforts to reduce AIDS from a public health threat by 2030. UNAIDS attempts to increase awareness and decrease the stigma of HIV around the world and Algeria is no exception. As of 2021, 21,000 Algerian adults and children live with HIV. Unfortunately, this number is on the rise. UNAIDS in Algeria is focusing on the prevention of mother-to-child HIV transmission. It is also specifically investing in programs that promote support in terms of education, rights and leadership for women, girls and young people.
  4. SOS Children’s Village: SOS Children’s Village is a global charity that operates in Algeria. Human rights organizations have criticized Algeria’s “Family Code” which severely limits rights for women. Underage marriage is prevalent and women who do want to marry face strict guardianship rules. Thousands of children wander the streets without parents or without support from their families.  SOS Children’s Village focuses on protecting children without parents or who come from abusive families. Specifically, SOS provides daycare and medical care. Also, SOS mothers provide support for suffering children in SOS families.

These charities in Algeria are not only helping to eradicate poverty, but they are also changing the overall landscape of the country for the better.

– Luke Sherrill
Photo: Flickr

HIV/AIDS in MalawiWhile it remains in the top 10 countries with the highest HIV rates, there is a significant reduction in the rates of HIV/AIDS in Malawi. This plummet, from 14.9% in 2000 to 8.1% in 2020, is likely to continue its decrease with the improvements to the diagnosis and care system.

The introduction of the Malawi Population-based HIV Impact Assessment (MPHIA) in 2016 has made it easier to track the progress of testing and treatment for HIV/AIDS in Malawi. The data from the 2022 assessment shows that Malawi has met two-thirds of the UNAIDS targets, with at least 95% of those aware of their status initiating treatment and 95% of those on treatment experiencing viral suppression.

Prioritizing Testing

The one target that Malawi must still meet is for 95% of persons with HIV to be “aware of their status.” In Malawi, where 88.3% of those with HIV are diagnosed, this target is not out of reach, according to the Population-Based HIV Impact Assessment (PHIA).

HIV self-testing is becoming more common in Malawi and studies show that community-led delivery of self-tests is safe, economical and reliable.

However, money and availability are not the only barriers to accessing HIV tests. There is a global need to overcome the stigma surrounding HIV; with a strong correlation between prejudicial attitudes toward HIV and reluctance to test. For many sufferers, attending a testing site is a deterrent, which is another explanation for why many remain untested. The increasing number of home tests could be vital to overcoming this hurdle.

COVID-19

The pandemic saw a 35% drop in HIV tests, according to Nuha Ceesay, UNAIDS country director, exacerbating the struggle to reach the 95% target.

As we come towards the end of the COVID-19 health emergency, education to combat stigmas and increasing testing services are integral measures for Malawi to reach UNAIDS targets. COVID-19 exacerbated existing stigmas with the misconception that those with HIV are more likely to catch Coronavirus. The pandemic birthed a new discriminatory term for people diagnosed HIV positive, “corona carrier,” Reuters reports.

COVID-19 has not permanently regressed in the fight against HIV. Despite the pandemic’s detrimental impact on the health care system of the country, it sustained some positive progress. Of those suffering from HIV/AIDS in Malawi, 98.6% were still referred for vital antiretroviral treatment throughout this period.

Women and HIV

Uneducated young women are one of the main disadvantaged social groups at the center of this health care emergency.

Despite making some progress, Malawi is still far from achieving gender equality. Health care access issues are no exception to this and adolescent girls and young women are the most vulnerable to HIV.

Research suggests that women experiencing poor health are likely to delay seeking medical support, prioritizing their family due to social norms and expectations. Connecting issues, such as lack of education and unemployment, leads more women towards sex work, only increasing the likelihood of contraction.

Children and HIV

The lack of testing makes children vulnerable targets of the AIDS crisis, with UNICEF identifying 25% of children with HIV/AIDS in Malawi as unaware of their status and only half of the HIV-positive children receiving treatment.

This is a cycle mostly formed by the 20%-45% risk of HIV-positive mothers passing HIV onto their children. These children often lack lifesaving treatment, with 20% of infants dying before age one without antiretroviral therapy (in sub-Saharan Africa).

Improving resource allocation and support for women and children helps to interrupt this cycle. Through vital counseling on the necessities of treatment, training of health care professionals, education, career prospects and prevention of sex work, the epicenter of the HIV epidemic could be the focal point of change.

The Path Forward

Foreign aid is crucial for Malawi to reach its UNAIDS targets and USAID data shows it is one of the countries in the world most dependent on foreign aid, with 99% of its HIV expenditure coming from international financial support.

Prompting the government to prioritize international aid, such as funding the coronavirus response, would alleviate pressure from Malawi’s health care system and allow the dedication of more time and resources to HIV testing. Organizations such as MANASO, a major advocate and host of Malawi World AIDS Day, are striving toward lower infection rates.

Its current plans include the Family Planning Budget Accountability Project, focused on advocation for the government to fund family planning essentials and for the spending of these funds to be appropriate and effective. It has achieved success in meeting government officials, engaging in advocacy and conducting meetings and workshops with chief security officers (CSOs). The family planning budget has also received more funds, seeing an increase from 2017 to 2019, as a result of this work.

Lobbying one’s leaders and supporting groups like MANASO enables the fight against HIV in Malawi to progress, with international support having a vital impact on treatment, testing and prevention goals.  

– Lydia Tyler
Photo: Flickr

HIV/AIDS in Pakistan
In 2004, an outbreak of HIV/AIDS in Pakistan caused a skyrocketing number of cases in the country. As of 2020, there are an estimated 180,000 people living with HIV/AIDS in Pakistan. However, the vast majority of HIV-registered Pakistanis are receiving treatment and local organizations are making progress to expand treatment to the most vulnerable and stop the progression of the outbreak altogether.

The HIV Outbreak in Pakistan

The 2004 HIV outbreak in the country followed a pattern common in Asian countries, in which the disease grows exponentially within networks of people who inject drugs, before reaching a plateau. Once the disease reaches a plateau, the disease begins to spread to the general population.

About 38% of Pakistani people who inject drugs are HIV positive as of 2017. The common practice of sharing and reusing needles and other drug-injection equipment can explain this. Needles contaminated with HIV-positive blood easily spread the virus among communities struggling with substance use disorder in Pakistan.

There is also an interesting local phenomenon in Pakistan where injection drug users are not able to inject their own drugs. Instead, these individuals utilize “street injectors” who inject the drugs for them. The injectors use a method of injection known as double-pumping, in which blood goes into the needle. As payment for their services, after injecting the individual, injectors keep a portion of the drug solution mixed with blood. The injector then pools it for their own use or for sale to others.

The Spread of HIV Throughout Pakistan

Through practices like these, HIV became extremely prevalent within this highly marginalized group. Once the percentage of HIV-infected injection drug users plateaued, the virus spread throughout Pakistan through bridging populations — people in close proximity to those in the high-risk group, such as the spouses of men who inject drugs. A study published in 2021 in the Harm Reduction journal estimated that, in Pakistan, 8.5% of female spouses of men who inject drugs are HIV positive.

Another population key to the progression of the outbreak is truck drivers. Many truck drivers frequently engage in purchasing sex, which puts them at higher risk of contracting HIV. Due to their mobility across the country, truck drivers who contract HIV/AIDS in Pakistan present a risk of a far-reaching and fast spread of the virus.

Progress and Solutions

Identifying at-risk populations and HIV-positive individuals is an important part of stemming the tide of an outbreak. However, the organization Nai Zindagi believes that society should not blame or stigmatize these individuals, but should help them instead. The organization started in 1989 as a small residential drug treatment center in Lahore, Pakistan.

Over the years Nai Zindagi shifted to focusing on street-based people who inject drugs across the whole of Pakistan and came to have a reputation for working with these populations. In 1999, UNAIDS and United Nations Office on Drugs and Crime contracted Nai Zindagi to study “Hepatitis C and HIV among the growing numbers of street-based persons injecting drugs in Lahore.” Through the study, Nai Zindagi became aware of the increasing use of drugs via injections. At the time, the study noted no positive cases of HIV, but it was clear that HIV would spread rapidly once the first case came about within this group. This created a shift in the organization’s response to drug use, with a new emphasis on harm reduction, including reducing the spread of HIV.

Nai Zindagi’s Services

According to the Centers for Disease Control and Prevention, to address an HIV outbreak, a country must diagnose, treat, prevent and respond quickly to each case of the disease. Nai Zindagi provides services in each of these aspects, focusing on marginalized, impoverished people who use drugs and those close to them, such as spouses.

Nai Zindagi specializes in assisting street-based individuals, utilizing mobile treatment vans and testing machines to accommodate those who are experiencing homelessness in Pakistan. The organization provides testing services, counseling, treatment and referrals to clinics that specialize in HIV/AIDS in Pakistan.

It also provides outreach services and training to spread the word about dangerous behaviors such as the use of used or dirty needles. Nai Zindagi even provides syringe exchange services, with the aim of distributing clean needles to those most at risk of contracting HIV. Harm reduction services like these are clinically proven to reduce the risk of diseases spread through injectable drugs.

With the work of organizations like Nai Zindagi, those at risk of HIV are less likely to contract it and those living with HIV/AIDS in Pakistan will have access to treatment that lengthens and improves their lives.

– Grace Ramsey
Photo: Flickr

Ukraine’s Public Health
The war in Ukraine has had several impacts on the world but most importantly on the Ukrainian people through Ukraine’s public health sector. In fact, the Russian army shelled many hospitals which strongly limited the people’s access to medication and proper health care services. Not to forget that war, the movement of big masses of people from one place to another and the lack of access to clean water, create a favorable environment to increase the spread of viruses and diseases. Ukraine has also had a fragile health sector before the war, being one of the countries with the highest number of HIV-infected people in Eastern Europe. Not to forget the COVID-19 pandemic and most recently a poliovirus outbreak that the government did not have time to handle properly.

HIV and Tuberculosis

Two of the main issues in Ukraine’s public health are HIV and tuberculosis viruses. More than 1% of the Ukrainian population is infected with HIV and the ongoing war caused a disruption in the health care system, leading to a potential lack of medicines used to treat HIV and tuberculosis patients. Tuberculosis is the main cause of death among HIV patients in Ukraine, which underlines the importance of providing proper medication for it. Especially since the country has the world’s highest number of multidrug-resistant tuberculosis, meaning that patients must regularly take their medication or else their situation will degrade quickly.

Many people with tuberculosis are seeing their symptoms worsening because of the bad air quality they must deal with in the shelters. This also means that they can transmit the virus to other people present with them, according to Al Jazeera.

Polio

Back in October 2021, a few months before the beginning of the war and 19 years after Europe was declared polio-free, a young Ukrainian child received the diagnosis of polio. Later, positive polio cases started to increase and the government in collaboration with the World Health Organization (WHO) started a vaccination campaign on February 1, 2022. Unfortunately, this campaign has stopped with the start of the war and although many children received their vaccines there remain around 100,00 who need to receive vaccines to consider this outbreak under control, TIME reports. Polio which was already a serious threat to Ukraine’s public health, given the low vaccination rate during COVID-19, is now very difficult to handle due to the war and its highly contagious characteristic.

The danger of these infectious diseases in times of war and displacement of many individuals all around Ukraine but also the rest of the world is the spread of these viruses without the capacity to track the refugees who might be carrying them and thus transmit them to other populations.

Solutions

When the war started, the UNAIDS stated that Ukraine has only a few weeks of medicines in reserve for its HIV patients. To preserve Ukraine’s public health and avoid the spread of the virus, the WHO along with the United States President’s Emergency Plan for AIDS Relief provided the Ukrainian government with enough antiretroviral medication for the next 12 months. Without forgetting of course the civil society in Ukraine and the help it is providing to make sure that medicines reach every patient on time.

Concerning polio, UNICEF along with Ukrainian health workers is setting up “blue dot centers” all along the refugees’ route, vaccinating a maximum of people against polio, according to TIME. Thus, limiting its spread in the countries, they are fleeing to.

Hence, among the numerous impacts that the Russian invasion of Ukraine had on the country is the destabilization of Ukraine’s public health. With an already fragile health sector, Ukraine had to deal with several health issues with relatively no proper means due to the war. Nonetheless, the country can count on foreign aid to preserve the health condition of its people and also prevent from spreading of different illnesses around the globe.

– Youssef Yazbek
Photo: Flickr

NGOs in UkraineUkraine has a long history of political turmoil and foreign interference since it achieved independence from the Soviet Union in 1991. From the annexation of Crimea in 2014 to Russia’s covert war in the Donbas, Russia has consistently engaged in undermining the territorial and political integrity of Ukraine. Remaining in line with these actions, on February 24, 2022, Russian President Vladamir Putin authorized a military invasion, or what he dubs a “special military operation,” against neighboring Ukraine. During the first week of the invasion, 1 million refugees fled the destruction and warfare taking place in Ukraine. In light of the destruction that the Russian invasion caused, NGOs in Ukraine are trying to funnel much-needed aid from international donors to Ukrainians.

Medical Assistance

The Russian invasion of Ukraine has led to an abysmal shortage of necessary medical supplies. Ukraine is “facing shortages of zeolite,” a necessary material for the manufacturing of medical oxygen, and by March 1, 2022, UNAIDS announced that Ukraine has “less than a month’s” supply of HIV/AIDS medication. In addition, Ukraine has had to abruptly pause efforts to contain Polio “as health authorities shift to emergency care.”

With the lack of medical supplies, NGOs in Ukraine, including Doctors Without Borders and Project HOPE, have been funneling medical aid to alleviate the critical medical shortages in Ukraine. Doctors Without Borders is organizing kits of both medicine and medical equipment to alleviate Ukraine’s medical shortages from Doctors Without Borders’ logistical bases in Bordeaux and Brussels. To increase the supply capacity for medical assistance, Doctors Without Borders is also establishing warehouses in Western Ukraine.

Project HOPE, with more emphasis on supporting Ukrainian refugees, is operating in Eastern Europe to deliver crucial medical supplies to fleeing Ukrainians in coordination with government agencies. In Moldova, Project HOPE has been coordinating with Moldova’s Ministry of Health to deliver medical supplies for Ukrainian refugees, which includes an Interagency Emergency Health Kit designed to assist 10,000 individuals for a span of three months. The Interagency Emergency Health Kit consists of one ton of medical resources, such as medical supplies, topical treatments, oral therapeutics and medical devices.

Refugee Assistance

Aside from NGOs in Ukraine delivering medical assistance, NGOs are also operating outside of Ukraine in Eastern Europe to support refugees. In particular, “CARE’s partner organization” is operating with aid workers on the Slovak-Ukrainian borders to establish heated tents for people to rest as well as sanitation facilities and portable toilets. For refugees, emergency relief teams are also providing “crisis intervention and psychosocial assistance” services.

The organization People in Need is also providing heated tents, designed to provide a space for Ukrainian refugees to rest, capable of holding up to 200 individuals. The organization is also providing water, hygiene items, food and SIM cards for communication on the Slovak-Ukrainian border. Furthermore, People in Need has also established facilities for Ukrainians waiting for border control near Velky Berezny to vet them.

The humanitarian crisis in Ukraine is critical: the U.N. estimates that an additional 4 million individuals “may flee Ukraine.” While the Russian invasion of Ukraine is dim, there is hope as NGOs in Ukraine are providing aid and local organizations are working to alleviate the refugee flow from Ukraine into Eastern Europe.

– Alexander Richter
Photo: Flickr

HIV in Haiti
With an estimated “2.2% of adults” noting an HIV-positive status in 2010, Haiti faces “the largest [HIV] epidemic in the Caribbean.” In 2020, 150,000 children and adults in Haiti lived with HIV. People older than the age of 15 made up 93% of this population. In addition, 20% of Haitians living with the disease are unaware that they are HIV-positive. To help reduce the prevalence of HIV in Haiti, several initiatives are currently underway, run by the Centers for Disease Control and Prevention (CDC), UNAIDS and the Elizabeth Glaser Pediatric AIDS Foundation.

CDC Initiatives

Since the CDC’s Division of Global HIV & TB opened its office in Haiti in 2002, the CDC has launched several initiatives to address the country’s HIV epidemic. The first aim is to strengthen health systems by training medical personnel, supporting staffing needs and strengthening the Haitian Ministry of Health’s governance. The CDC has also aided in the development of the iSanté national electronic medical record (EMR) software to better monitor and track HIV patient data. These innovative tools help inform evidence-based treatment for this disease. In 2018, iSanté, “along with two other EMR systems,” could monitor the data of “96% of HIV care and treatment sites.”

Another goal of the CDC office in Haiti helps improve laboratory resources. Through a collaboration with the National Public Health Laboratory and GHESKIO, a medical treatment, research and training center in Port-Au-Prince, Haiti, the CDC has helped develop and expand several HIV testing methods. In addition, the CDC assisted in developing “an external quality assurance program and a training curriculum” to support lab accreditation.

Community-led Monitoring

With support from UNAIDS, the Ministry of Public Health and Population and the U.S. government via the United States President’s Emergency Plan for AIDS Relief (PEPFAR), Haiti’s Civil Society Forum Observatory has initiated “community-led monitoring,” a program through which people living with HIV hold each other accountable throughout treatment. Community members are familiar with HIV patients from their community, and when patients do not follow through on treatments or follow-ups, community members know how to best communicate with them and encourage them to return. Community-led monitoring can provide valuable feedback on service delivery from a patient perspective, helping to improve on existing issues “to retain people in care.”

Community-led monitoring reveals the weaknesses of treatment plans for HIV in Haiti and brings corresponding solutions to light. For example, due to insight from community-led monitoring, the Civil Society Forum Observatory brings to light a need to increase the window of service hours and decrease patient wait times. It also recommends that stable HIV patients receive a six-month supply of antiretroviral medication. Through community-led monitoring and other resources, Haiti was able to allocate multiple months’ supplies of antiretroviral medicines to 88% of HIV patients during the COVID-19 pandemic.

Elizabeth Glaser Pediatric AIDS Foundation

The Elizabeth Glaser Pediatric AIDS Foundation strives to combat pediatric HIV worldwide through advocacy, research and initiatives for prevention and treatment. Although most HIV patients in Haiti are adults, 8,000 children younger than 15 lived with HIV in Haiti in 2020. Thus, addressing pediatric HIV in Haiti is an important health initiative.

Toward the latter part of 2020, the Foundation began its work in Haiti with the Delivering Technical Assistance Project. The project offers “cost-effective technical assistance (TA), capacity building and program implementation services” to HIV reduction programs. The technical assistance includes program management training, mentorship, consultations and workshops for health care workers.

These strategies, and many others throughout the country, are successfully helping lower HIV rates in Haiti. As organizations continue to implement HIV reduction plans, the severity of the HIV epidemic in Haiti may see a decline in the years to come.

– Aimée Eicher
Photo: Flickr

HIV/AIDS in Africa
The HIV/AIDS epidemic remains a significant public health problem in southern Africa. In the last decade, infections have drastically dropped while awareness of HIV status and availability of treatment has increased. This progress aligns with the UNAIDS 90-90-90 goal. Meeting this goal means that at least 90% of people with HIV are aware of their status, 90% are receiving antiretroviral drug treatments and 90% are virally suppressed. Viral suppression means that the virus will not negatively affect a person and that that person will not be able to transmit it to another person. Some of the most HIV-afflicted countries in Africa have met and even exceeded the 90-90-90 goals. Eswatini has the highest HIV prevalence in the world today at 26.8%. It has reached 95% in all categories and is on its way to reducing new infections.

HIV/AIDS and Conflicts

Despite recent progress, international aid has been focusing on HIV/AIDS less and less, especially as the COVID-19 pandemic has become a more imminent global threat. Sub-Saharan Africa still has the highest rates of HIV/AIDS in the world. It is also one of the most conflict-ridden regions in the world.

HIV/AIDS has a history of destabilizing political and social institutions in countries and leaving them vulnerable to violent conflict. The International Crisis Group estimated that one in seven civil servants, including government employees, teachers and the armed forces in South Africa were HIV-positive in 1998.

How Does HIV/AIDS Affect Civil Servants in Africa?

  1. The disease affects the productivity of the military and its ability to respond to armed conflicts. In 2003, the Zimbabwe Human Development Report estimated that the Zimbabwe Defense Forces had an HIV prevalence rate of 55%. With such a high rate of illness, the military has high training and recruitment costs, as soldiers get sick and are unable to work. In addition to this, HIV can transmit through sexual contact. It disproportionately affects younger populations which typically make up the bulk of the armed forces.
  2. The HIV/AIDS epidemic breaks down political institutions by limiting their capacity to govern. According to former president Robert Mugabe in 2001, AIDS had a significant presence in his cabinet, killing three of his cabinet ministers in the span of a few years and infecting many more. The disease wipes out workers essential to the function of a state, like policymakers, police officers and judicial employees.
  3. HIV/AIDS threatens the quality and accessibility of education. A UNICEF report found that more than 30% of educators in Malawi were HIV positive. If children cannot receive a quality primary education, they are less likely to receive secondary education and start professional careers. Instead, crime may open up opportunities for security that education could not provide. With increased antiretroviral use and awareness of the disease, HIV rates and deaths among educators have likely dropped along with overall rates in the last decade.

Civil Servants

The impact of HIV/AIDS on civil servants in Africa has been immense. The disease affects vulnerable populations such as gay men, sex workers and young women disproportionately. However, it has also affected those who work as civil servants. Civil servants are integral to the functioning of governments. Without them, countries are vulnerable to conflict and violence. Furthermore, HIV/AIDS prolongs conflict in countries already experiencing it.

While there are many other causes of violent conflict, the breakdown of political and social institutions fueled by HIV/AIDS only exacerbates conflict. War can also be a vector for the further spread of the disease. According to UNHCR, both consensual and non-consensual sexual encounters happen more often during the conflict. Rape has been a weapon of war in conflicts in Rwanda, the Democratic Republic of Congo (DRC) and Liberia in recent years and has likely contributed to the spread of HIV.

Solutions

Combating HIV and AIDS is a very important step in stabilizing economic, political and social structures across Africa. USAID programs like PEPFAR have had a significant role in combating HIV and AIDS. PEPFAR has invested nearly $100 billion in the global AIDS response in various ways. Most notably, it has provided 18.96 million people with much-needed antiretroviral treatment.

PEPFAR also aids in prevention care. For example, it has supported more than 27 million voluntary medical male circumcisions as well as testing services for 63.4 million people. In 2012, there was a government campaign in Zimbabwe to promote circumcision, in which at least 10 members of parliament participated.

These campaigns and USAID programs have had tangible results. In 2013, a study by the South African National Defense Forces showed an 8.5% HIV prevalence rate among its soldiers, much lower than the 19% prevalence in the general population. Given the successes in decreasing HIV/AIDS infections across Africa, perhaps economic, political and social stability is to follow.

– Emma Tkacz
Photo: Flickr

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