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hiv epidemic in the philippinesThe HIV epidemic in the Philippines is the fastest-growing in the Asia and Pacific region. According to UNAIDS data, HIV prevalence in the Philippines increased by 207% from 2010 to 2019. AIDS-related deaths rose by 338% in the same period. In 2019, an estimated 97,000 people were living with HIV in the Philippines. Of those, 73% knew their status and 44% were receiving antiretroviral treatment.

Although these statistics indicate some progress, the Philippines still falls far below the 90-90-90 target set by UNAIDS. Aimed at ending the HIV epidemic by 2020, the program wanted to ensure that 90% of people living with HIV would know their HIV status. It also strove to give 90% of people with a diagnosed HIV antiretroviral therapy and induce viral suppression in 90% of those receiving treatment. Unfortunately, the world is not on track to meet these goals, and new targets are being developed for 2025.

Populations Most Affected

The prevalence rate of HIV in the Philippines among adults ages 15 to 49 was 0.2% in 2019. This national rate, however, masks alarmingly high prevalence rates among specific populations. The groups most affected by the HIV epidemic in the Philippines often face social stigma, isolation and legally sanctioned discrimination. These populations include people who inject drugs (PWID), men who have sex with men (MSM), sex workers and transgender people. However, new technologies, programs and initiatives are working to lessen the burden of disease and stigma on these populations.

People Who Inject Drugs

According to UNAIDS, the HIV prevalence rate among people who inject drugs in the Philippines is 29%. Among PWID, only 26.9% have been tested and are aware of their status. Key factors fueling the HIV epidemic in the Philippines among PWID include hostile public opinion and brutal law enforcement. These constitute major barriers to HIV testing and awareness. While official statistics released in 2018 revealed that over 4,500 drug users were victims of extrajudicial killings, civil society estimated the true toll to be as high as 20,000.

Progress in HIV testing is crucial to reduce HIV prevalence among PWID, who struggle to access services due to their criminalized status. Various alternative testing methods, such as rapid finger-prick testing, can reduce barriers to testing for PWID. In particular, self-testing kits, which allow people to test in private, have attracted a large proportion of first-time testers in Thailand and have achieved impressive success in China.

Men Who Have Sex With Men

The HIV prevalence rate among men who have sex with men is 5%, the second-highest among key affected populations. MSM who fear social stigma and discrimination often do not participate in HIV prevention programs. As a result, the participation rate for these programs is 14.6%, and the majority of MSM lack awareness about HIV. Condom use in this population is also low at 40.1%. However, condom distribution and sex education programs would benefit MSM, many of whom reported not using condoms because they were “not available.” Fighting the HIV epidemic in the Philippines means tailoring help to MSM.

Sex Workers

Female sex workers in the Asia and Pacific region are 29 times more likely to be living with HIV than other adult women of reproductive age. The HIV prevalence rate among sex workers in the Philippines is now 0.6%. This group has the highest rates among affected populations for coverage in prevention programs and condom use, which are 71.8% and 85.3%, respectively. Many important national HIV prevention programs raise awareness about HIV and encourage condom use among sex workers. These programs include the 100% Condom Use Program, the HIV Counseling and Testing Service, and programs led by the Philippine National AIDS Council.

Transgender People

Transgender people are one of the populations most affected by the HIV epidemic in the Philippines, with a prevalence rate of 3.9%. However, there is little information or research about the effects of HIV on the transgender community in the Philippines. A key problem is the lack of transgender visibility due to social exclusion and widespread stigma. This challenges efforts to obtain health data and develop targeted programs to support transgender individuals. To raise awareness about gender identities and transgender acceptance, sexual health education and gender studies programs must be more inclusive. This would help reduce the stigma and barriers to healthcare for transgender people in the Philippines and engage them in HIV prevention and treatment programs.

The Effect of COVID-19

Lockdowns in the Philippines due to COVID-19 have blocked access to essential services for HIV patients, including treatment and testing. Eamonn Murphy, UNAIDS regional director for Asia and the Pacific, stressed that the Philippines needs to do more to convince those in high-risk populations to seek out HIV-related services.

Continued attention to these key affected populations is necessary to reduce HIV prevalence rates and make progress toward HIV eradication. In this way, focused programs can work toward lessening the severity of the HIV epidemic in the Philippines.

– Alice Nguyen
Photo: Flickr

HIV/AIDS in JamaicaAs of 2018, 32,000 people were living with a positive HIV diagnosis in Jamaica, with 44% of this population receiving treatment. This has been attributed to the stigmatization of HIV/AIDS, which can make those who live with it unwilling to pursue help. In response, Jamaican activists have campaigned and advocated for the destigmatization of HIV/AIDS because they believe it is the first step to completely eradicating the disease in Jamaica.

USAID’s Health Policy Project

International initiatives, such as the Health Policy Project, have been an important resource for activists because it focuses on training and educating. This project is a part of USAID’s mission to counter HIV/AIDS around the world and USAID is its chief source of funding. Within the Health Policy Project, HIV positive individuals have been invited to larger conferences where they are able to learn more about how to counter stigmatization and how to mobilize others. Because these individuals are Jamaican and their stories are personal, their message tends to be more positively received by audiences. This has allowed for a greater discussion of HIV/AIDS because it gives faces to those who are being discriminated against.

Governmental Initiatives for Anti-Discrimination

On a legislative level, the Jamaican Government has pushed multiple initiatives and studies to better the living conditions and access to care for those living with HIV. For example, healthcare discrimination is countered through the Client Complaint Mechanism and the Jamaica Anti-Discrimination System by educating the population, monitoring minority communities and training healthcare workers. In addition to that, these organizations collect reports of discrimination from around the country and help to investigate and correct them. These bodies are also working to provide free HIV treatment across the country and hope to accomplish this in the coming years.

Jamaica AIDS Support

Jamaica AIDS Support is the largest non-governmental organization working to counter and destigmatize HIV/AIDS in the country. Besides the promotion of education and treatment, the organization also provides access to mental health treatment for those who are HIV positive. This has allowed for a larger discourse about mental health and how it relates to this disease as well as a greater social acknowledgment of how stigmatization hurts others. In 2016, Jamaica AIDS Support began the Greater Treasure Beach Area pilot project, which aims to educate young people on HIV/AIDS so that in the coming generations there will be more tolerance and acceptance of those living with HIV.

Eve for Life

Local organizations, such as Eve for Life, have also been instrumental in the fight against HIV/AIDS discrimination by approaching the issue through empowerment. Eve for Life specifically works to empower women living with HIV through multiple education initiatives as well as smaller groups meant to support these women. One such group, Mentor Moms, works to help young mothers living with HIV to secure treatment and it provides smaller meeting groups where these similar women can find community. So far, it seems these initiatives have been overwhelmingly successful as more female activists have become involved in the fight against HIV/AIDS, which has led to greater social consciousness about the disease.

Conquering Stigma and Countering HIV/AIDS

Destigmatization initiatives in Jamaica are the key to countering HIV/AIDS and the country is off to a promising start. By utilizing personal narrative and education, activists hope to secure a world that is more welcoming for their children than it was for them. In the words of UNAIDS country director, Manoela Manova, “The more we do to ensure that people feel safe and respected, the closer the country will come to ending AIDS.”

– Mary Buffaloe
Photo: Flickr

HIV in Sri Lanka
Human immunodeficiency virus (HIV) affects 38 million people globally. Spread via the exchange of bodily fluids, it attacks cells that can help fight other infections, making people more susceptible to other illnesses. While new cases have decreased by 23% since 2010, there is still much progress that needs to be made. Fortunately, innovative countries like Sri Lanka have established extensive programs to eliminate HIV.

HIV Around the World

On a global scale, HIV primarily affects people from more disadvantaged countries with low to middle incomes. As a result, HIV often goes hand-in-hand with other humanitarian issues. A majority of countries impacted by high HIV rates also struggle with food insecurity, economic disparities and other infectious disease issues.

While no cure exists for HIV, it is treatable with antiretroviral therapy (ART). By addressing HIV with medication, HIV-positive individuals can live abundant, healthy lives and have minimal risk of passing HIV to others around them. It is essential that more people are able to become aware of their diagnosis and combat it with ART to prevent spreading it further.

Sri Lanka’s Comprehensive Efforts

Recent efforts to reduce HIV have shown some progress, with 81% of HIV-positive individuals aware of their condition. However, there is still considerable progress to be made in providing access to testing and treatment. Fortunately, Sri Lanka, a south-Asian country with more than 21 million inhabitants, has made headway in preventing and treating HIV.

The Sri Lankan government has led efforts to combat and eliminate HIV by 2025. With an admirably low HIV-prevalence rate of 0.01%, it has enacted different social measures to meet this goal. These include educating Sri Lankans on HIV, testing at-risk individuals and providing quality treatment options to those who are HIV-positive.

Some of the government’s online efforts include launching the website Know4Sure.lk. This initiative trained caregivers from the private health sector on providing testing and treatment to those with HIV, in addition to providing a number of services for Sri Lankans. The website provides anonymous appointment scheduling and at-risk assessments, with paid advertisements and influencers encouraging HIV testing.

Furthermore, the program set up a peer network to call for more testing, treatment and social awareness of HIV. Mobilizers within this network encourage peers to get tested and communicate with others via a multimedia effort. Founded on the principle that “Your Life Matters,” this movement combats the transmission of HIV by instilling hope and optimism about one’s career and livelihood. HIV is preventable and treatable as long as Sri Lankans follow safe-sex practices, get tested regularly and take preventative measures.

Success and Global Impact

Sri Lanka’s commitment to eliminate HIV has already seen success. In 2018, the nation stopped vertical transmission – the transmission from mother to child – of the virus entirely. All pregnant women diagnosed with HIV are provided with ART treatment, assuring their health and the health of their unborn child. The elimination of vertical transmission is the culmination of the steadfast, multifaceted government effort to provide testing and treatment to all men and women.

HIV impacts people on a global scale. By establishing preventative measures and treatment programs, Sri Lanka has pushed back against HIV and taken significant steps to eliminate HIV by 2025. These efforts can be an example for other countries experiencing HIV outbreaks and setbacks. Hopefully, with more government efforts dedicated to fighting HIV, the virus will soon be eliminated worldwide.

Eliza Cochran
Photo: Flickr

HIV in MadagascarMadagascar, an island nation off the southeast coast of Africa, has one of the lowest rates of HIV in Sub-Saharan Africa at below 0.3%. This is due to the country’s location as an island and its low rate of urbanization. However, the number of HIV cases in Madagascar has been on the rise, with an estimated 54% increase since 2010. Only around 8% of individuals have been tested for HIV in Madagascar. As a result, the threat of the virus could be more significant than the recorded numbers tell.

HIV/AIDS Statistics in Madagascar

Around 5.5% of the 191,200 sex workers in Madagascar are living with HIV. About 14.9% of the estimated 17,000 men who have sex with men living with HIV and around 57.2% use condoms. Approximately 5% of women and about 13% of men in Madagascar use condoms. Around 13% of adults and children in Madagascar receive antiretroviral therapy (ART) coverage, and about 25% of pregnant women receive ART. Among children up to the age of 14, around 9% receive ART. Less than 25% of people living with HIV in Madagascar are aware of their status. Among the population of ages 15 to 24, about 24.1% have awareness about HIV prevention.

Stigma

Many factors lead to HIV in Madagascar, such as high poverty levels, education rates, lack of awareness of HIV prevention and limited access to treatment. Many of those living with HIV not only face the direct consequences of the virus but the impact of stigma and potential discrimination due to testing positive. Lack of knowledge about the transmission of HIV leads to this stigma.

Often people living with HIV will avoid being tested due to a fear of stigma. According to data gathered in Madagascar from the Joint United Nations Program on HIV/AIDS (UNAIDS), when asked the question, “Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had HIV?” 63.4% responded no. HIV stigma is a prevalent issue in the country. However, education on how to prevent HIV can solve the problem.

Project Mitao Responds to HIV/AIDS in Madagascar

Additionally, in the Anosy region of Madagascar, over 90% of the population has not been tested for HIV. Therefore, Sustainable Environment, Education & Development in Madagascar (SEED), a British charity, created Project Mitao in support of people in the Anosy region. Through Project Mitao, SEED Madagascar conducts research to gain a better understanding of healthcare in the area. SEED Madagascar found that 64% of high school students lack knowledge of using a condom correctly. Moreover, Project Mitao is to educate the youth of the region and guide them in HIV prevention.

USAID, UNAID and UNICEF

Furthermore, Madagascar also relies on foreign support as a solution to HIV. In 2012, the United States Agency for International Development (USAID) provided $60 million for a health program, including HIV prevention and treatment. USAID is also supporting HIV/AIDS programs to influence behavior change, such as increasing the use of condoms to decrease the prevalence of HIV in Madagascar.

UNAIDS and UNICEF created the All In! to #EndAdolescentAIDS plan to reduce AIDS-related deaths and the number of HIV cases among adolescents. Doing this would eventually achieve the goal of ending the AIDS epidemic by 2030. AIDS is a leading cause of death among the youth in Africa. Therefore, All aims to improve the quality of healthcare in its approach to testing and treating HIV. Also, All In plans on addressing discrimination against those living with HIV to make care more accessible.

– Zoë Nichols
Photo: Flickr

The Future of Pediatric Aids
The Elizabeth Glaser Pediatric Aids Foundation (EGPAF) strives for a future that prioritizes equal treatment, healthcare and research for children with HIV. It is playing a significant role in shaping the future of pediatric AIDS.

The Story Behind the Organization

In 1981, Elizabeth Glaser gave birth to her first child, Ariel. During labor, she contracted the AIDS virus through a necessary blood transfusion. Unknowingly, she then passed it to her daughter through breast milk and then to her son, Jake, in utero.

Due to the insufficient research-tested pediatric AIDS treatments, Ariel lost her life in 1988. Fearing for her son’s life in the wake of this tragedy, Glaser decided to put her fear and hopes into action. She soon joined her two friends, Susan DeLaurentis and Susie Zeegan, and founded the Pediatric AIDS Foundation. Their central aim has not changed since then: to fund research and provide treatment and care for children suffering from AIDS. These ideals were at the forefront of Glaser’s first visit to Capitol Hill.

At the 1992 Democratic Convention, two years before she lost her own battle with AIDS, Glaser presented a moving speech. Drawing on the loss of her daughter and her own experience with AIDS, Glaser’s speech called for change. More specifically, it called for a stronger response to pediatric AIDS. Glaser remarked that “this is not politics. This is a crisis of caring.” With this statement, she made it clear that this was not only about her life or her children. Rather, she wanted to prepare the nation to help children with HIV and shape the future of pediatric AIDS. Since then, EGPAF has become the leading nonprofit organization fighting against pediatric AIDS globally.

Recent Statistics

According to the World Health Organization (WHO), approximately 1,800,000 children under the age of 14 required treatment in Sub-Saharan Africa in 2011. Roughly 27% of those diagnosed received antiretroviral coverage.

HIV in children has two primary sources: mother-to-child transmission and infections in medical hospitals. Rates are higher in countries with few resources and little healthcare and regulation. Although it is the most common contraction method, mother-to-child transmission is preventable. If the mother has access to antiretroviral therapy, the chances of her passing the virus to her child via breastfeeding or delivery, or in utero, greatly decrease. As Glaser’s experience demonstrates, healthcare malpractice can also result in the transmission of the virus. In order to prevent this, healthcare workers must strictly regulate sanitation practices and blood transfusions.

By recognizing and addressing these means of contraction, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other organizations like EGPAF increased treatment to cover 70% of the affected population in Africa by the end of 2019.

The Impact

The steady advancements in global pediatric AIDS treatment are by no means a signal to slow down. At least for EGPAF, an organization committed to eliminating childhood HIV and AIDS completely, this is only a part of the journey. Focusing on countries in Sub-Saharan Africa, EGPAF treated 96,716 HIV-positive pregnant women to reduce the risk of mother-to-child transmission in 2019. By improving access to HIV services, it also tested over 8,000,000 individuals and facilitated treatment to approximately 86,537 children.

EGPAF’s in-house research division has also performed extensive work in the clinical and operational fields, strategizing and altering treatments. For example, The Kabeho Study was one of the first studies that assessed the implementation of lifelong antiretroviral therapy in pregnant women. Its findings suggested a decline in mother-to-child transmission when mothers receive proper treatment. Project Acclaim also showed that engaging community leaders led to the greater prioritization of newborn and child health.

From early congressional meetings and calls for change, EGPAF’s impact has grown immensely. As the organization continues to advocate for the cause and raise awareness, it simultaneously provides healthcare for children without the financial means – not only in the United States but also overseas.

Samantha Acevedo-Hernandez
Photo: Flickr

HIV prevention in AfricaHuman Immunodeficiency Virus (HIV) is known to have impacted the world for approximately 40 years. Considering the fact that the virus was equally as aggressive as it was untreatable, first world countries like the United States and France were more able to provide for their citizens. Doctors could properly and continually perform research in order to educate citizens on the virus. Additionally, they could hastily link HIV prevention and methods of protection and treatment. Unfortunately, in sub-Saharan African countries, accomplishing the same feats proves more difficult. Therefore, 66% of newly diagnosed HIV cases worldwide come from sub-Saharan African countries.

HIV/AIDS’s Effect on Africa

Eswatini, Lesotho, Mozambique, parts of South Africa, regions in Zambia, Namibia, Southern Malawi and Kenya are the countries in Africa whose populations have the highest rates of being infected or affected by HIV. In Kenya, only about 30% of sexually active individuals practice safe sex methods. Additionally, only 47.5% of adolescent women could properly identify methods that would prevent them from contracting HIV sexually. With that said, women are at an extremely high risk of contracting HIV in sub-Saharan Africa.

An Increased HIV/AIDS Risk Factor for Women

One of the main factors contributing to women being at a higher risk of contracting HIV in sub-Saharan Africa is that the rate of school attendance is extremely low for girls in sub-Saharan Africa. Girls are more likely to be exposed to social and economic scenarios that could potentially threaten their survival and put them at an increased risk of contracting HIV. Therefore, it is important to increase both the school attendance rate for girls and the amount of sex education offered at school. This would include information on HIV and STI prevention.

Sex Education’s Impact on Adolescent Health and Choices

UNAIDS analyzed a series of studies in order to determine whether or not sex education makes a significant impact on school-aged children’s sexually based decisions. Out of a total of 53 studies, 22 studies showed that, after sex education was implemented, three things changed– individuals waited a longer amount of time to initially have sex, the number of sexual partners per person decreased and the number of unplanned pregnancies and STI diagnoses decreased. Additionally, 27 studies showed that HIV/AIDS rates, alongside overall sexual health, did not improve or worsen the amount of sexual activity, pregnancies or STI rates.

Overall, the results of these studies support the claim that implementing sex education in schools’ curricula is an efficient way to reduce practices that could result in the spread and contraction of HIV/AIDS and other STIs in school-aged children.

Africa’s Implementation of Sexual Education

South Africa has taken the initiative to create and implement a plan for discussing HIV prevention in the school setting. The priorities of this plan include generating attention toward HIV/AIDS for both students and teachers, including information on HIV/AIDS in the school’s curriculum and creating models that display the effects of HIV/AIDS on the school district. This initiative also ensures the protection of students’ and teachers’ constitutional rights and confidentiality about HIV/AIDS status.

Due to these precautions, HIV-positive individuals will not be discriminated against. In order to ensure that the students are learning the best methods of HIV-AIDS prevention, the curriculum will remain up-to-date and teachers will be trained accordingly.

Comprehensive Sexuality Education

Eleven sub-Saharan countries have introduced various courses into their schools’ curricula to educate them on sex education in varying degrees. Rwanda and Zambia adhere to what the United Nations has deemed necessary for students to learn through sex education. These classes fall under the category of “Comprehensive Sexuality Education” (CSE). These classes discuss healthy relationships between genders and how to decrease sexual violence; in addition to sex education in a way that is appropriate for younger children and adolescents. The main objectives of CSE are to teach children:

  • to acknowledge their “health, well-being and dignity”
  • to create considerate relationships, both sexually and socially
  • to analyze their choices and consider how the potential consequences will affect themselves and others
  • how to comprehend and protect their rights throughout their lives
There has recently been evidence of CSE being used at an increased rate in certain areas of Africa. Burundi, Senegal, Nigeria, Mozambique and Zambia have all ensured that their teachers and educators receive the proper education and training on CSE. Zambia’s program has been especially praiseworthy because the costs of instruction for sexual and reproductive health are included in the budget for education.

Various projects and initiatives throughout the world have provided crucial information pinpointing which countries need HIV prevention through sexual education implementation. The collaboration between many organizations has allowed third world countries to access resources that would be more difficult to achieve independently. Fortunately, the difficult challenges that impoverished countries have faced to prevent the spread of HIV in sub-Saharan Africa are becoming more attainable.

– Amanda Kuras
Photo: Wikimedia Commons


Kenya is a coastal country located in East Africa. The nation is developing significantly in terms of economy and healthcare provision. However, since there is a high prevalence of natural disasters and poverty, there are recognizable problems when it comes to healthcare in Kenya. For instance, there are 8.3 nurses and 1.5 doctors per 10,000 people. These numbers fall drastically short of the WHO recommendation of 25 nurses and 36 doctors per 10,000 people. Here are six of the major issues related to healthcare in Kenya and how the country is addressing them.

6 Facts About Healthcare in Kenya

  1. In 2016, malaria was the leading cause of mortality in Kenya. The CDC reported that there are nearly 3.5 million new clinical cases and 10,700 deaths each year. Nevertheless, treatments are on the rise. Long-lasting insecticide-treated mosquito nets and artemisinin combination therapies (ACTs) have proven to be effective prevention and treatment. ACTs are fast-acting and “artemisinin-based compounds are combined with a drug from a different class” to make the treatment. Since the early 2010s, access to ACTs has increased significantly, though there is still a need for access to them in rural areas. In 2019, the WHO reported that Kenya became the third country to implement the world’s first malaria vaccine. Children receive this vaccine as part of routine immunizations, and experts expect it to lower malaria cases significantly in Kenya.
  2. Kenya has one of the highest rates of HIV-infection in the world. UNAIDS reports that, in 2018, 1.6 million Kenyans were living with HIV. Of this population, Avert, a resource for information on HIV and AIDS, states that more than half are unaware of their HIV status. Fortunately, the Kenyan Ministry of Health has announced that HIV cases are decreasing, with the HIV prevalence standing at 4.9% as of February 2020. To improve HIV status awareness, the Kenyan government has partnered with the EGPAF to invest in door-to-door testing campaigns and self-testing kits. The program has emphasized aiding counties with high or rising HIV prevalence. Additionally, UNAIDS reported that 91% of HIV-positive pregnant women were able to access antiretroviral treatment in 2018.
  3. Kenya is one of the most highly industrialized countries in East Africa, meaning that pollution is prevalent. Air pollution in Kenya causes death both directly and indirectly. The State of Global Air reports that, in 2017, air pollution directly caused 4,710 deaths in Kenya. Indirectly, air pollution has increased cases of pneumonia, tuberculosis, water pollution and diarrheal diseases, which are among the top fatal diseases in the country. The combined direct and indirect deaths from air pollution total approximately 18,000 each year. However, there is hope for improvement. Inventions like air sensors can report data about air quality. Kenyans are using these sensors to report data via social media and pressure leaders into making change.
  4. Cancer cases in Kenya are on the rise. As a noncommunicable disease, cancer is one of the leading causes of death in Kenya. The Union for International Cancer Control (UICC) reports that Kenya has 47,000 new cases every year. The UICC also notes that cancer tends to appear in the younger population, and this trend is attributed to lifestyle and environmental changes. To address this crisis, the country is investing in cancer research and support. Additionally, the Kenyan Parliament passed a law to address proper cancer management.
  5. Infant deaths are one of the greatest challenges facing healthcare in Kenya. UNICEF reports that 74,000 children in Kenya die before the age of five each year. These deaths are often caused by poverty, as many families cannot easily access the resources needed for child healthcare. One such resource is insurance. According to the WHO, in 2018, 80% of the Kenyan population did not have any insurance. As a result, the government set aside $40-45 million to establish Universal Health Coverage to help more people to access appropriate healthcare services.
  6. There is a stigma surrounding mental health in Kenya. As a result, there are limited resources allocated to mental health awareness, and Kenyans resist seeking help for mental health issues. Despite this stigma, there is intensive research being done to engage both informal and formal health practitioners in addressing mental health problems to improve healthcare in Kenya.

 

Kenya is determined to address the most challenging problems related to healthcare in the country. There is an emphasis on research and investing in resources to help more people to access better and more affordable healthcare services. Healthcare in Kenya is expected to see improvement in the coming years.

Renova Uwingabire
Photo: Flickr

Poverty in ChadLocated in Central Africa, the country of Chad is the fifth largest landlocked state and has a poverty rate of 66.2%. With a total population of approximately 15.5 million, a lack of modern medicine, dramatic weather changes and poor education have riddled the country with deadly diseases and resulted in severe poverty in Chad.

Poor Health Conditions in Chad Lead to Disease

The most common types of disease and the primary causes of death include malaria, respiratory infections and HIV/AIDS. Malaria, usually spread through mosquito bites, is a potentially fatal disease and is quite common in the country of Chad. Due to poor sanitation, Chadians are more susceptible to malaria; the most recently estimated number of cases was 500,000 per year.

Along with malaria, lower respiratory diseases contribute to Chad’s high mortality rate – the most common and deadliest of those being meningitis.  Lower respiratory tract infections occur in the lungs and can sometimes affect the brain and spinal cord. A lack of available vaccinations in the country has increased susceptibility to meningitis. Meningitis is most deadly in those under the age of 20, and with a countrywide median age of 16.6 years old, Chad has seen a rise in total meningitis cases and overall deaths.

As of 2015, there were an estimated 210,000 Chadians living with HIV. According to UNAIDS, there were 12,000 AIDS-related deaths just last year, along with 14,000 new cases. Those living with HIV/AIDS are at a higher risk of death with their compromised immune systems. They are unable to fight off diseases and, with the preexisting severe risk of malaria and meningitis, they are more susceptible to death.

Harsh Weather and Its Role in Food Insecurity and Disease

Due to its geography, Chad is one of the countries most severely affected by climate change. Approximately 40% of Chadians live at or below the poverty line, with the majority relying heavily on agricultural production and fishing. The drastic change in rain patterns and the consequent frequency of droughts have placed a significant strain on their food supply. Fishing in particular has been sparse. Lake Chad, the country’s largest lake, has diminished by 90% in the past 50 years. The rising temperatures in Chad have caused a decrease in both crop yields and good pasture conditions, placing more strain on those who depend on Lake Chad for food and the nutrients it adds to farming.

In addition to affecting poverty in Chad, intense weather patterns have also increased the number of infectious diseases. The infrastructure of the country has not been able to keep up with the rapidly growing population in urban areas. This results in poor sanitation. The sanitation services are overwhelmed during floods: which contaminates the water supply.

Lack of Education Affects Poverty in Chad

Despite the relatively large population, less than half of school-aged children are enrolled in school. With attendance rates so low, the literacy rates in individuals between the ages of 15 and 24 fall; currently, they only reach 31%.  According to UNICEF, attendance rates are astonishingly low; 8% for children in upper secondary school and 13% for lower secondary school. With education rates so low, income inequality, infant and maternal deaths and stunting in children continue to rise; as a result, the overall economic growth of the country declines.

Enrollment is low in Chad due to the lack of resources in schools. With the country in severe poverty, schools remain under-resourced, both in access and infrastructure. Some schools have no classrooms and no teaching materials. Furthermore, teachers are often outnumbered 100:1. As a result, the quality of learning decreases, as does the overall attendance rate.

As of now, only 27% of primary-school-age children complete their schooling. According to UNESCO, if adults in low-income countries completed their secondary education, the global poverty rate would be cut in half. Even learning basic reading skills could spare approximately 171 million people from living in extreme poverty. Educated individuals are more likely to develop important skills and abilities needed to help them overcome poverty. Education also decreases an individual’s risk of vulnerability to disease, natural disasters and conflict.

Poverty in Chad is widespread, and the rate of impoverished people will continue to grow if it is not addressed. Poor health conditions and a lack of education are just a few of the many problems people face; while the living conditions may seem dire in Chad, a gradual decrease in overall poverty rates proves that there is hope.

Jacey Reece
Photo: Flickr

HIV in Djibouti
According to the United Nations Development Program (UNDP), addressing poverty means first reaching those who feel the greatest impact; progress does not necessarily trickle down to the population that is most disadvantaged. The 2016 Human Development Report found that one-third of the world’s population lives in low human development circumstances. Furthermore, some sectors of society are more disadvantaged than others. Inequalities and social exclusion that people such as those living with HIV face present larger barriers to development and access to health programs. For this reason, the World Food Programme, alongside UNDP, UNAIDS and the national network of people living with HIV in Djibouti (RNDP+), have created an income-generation program that provides loans for people living with HIV. Such loans are empowering women with HIV in Djibouti to live dignified and successful lives.

Men and Women with HIV in Djibouti

As of 2017, 1.3 percent of the adult population in Djibouti was living with HIV, a decrease from 1.6 percent – or 9,900 people – in 2014. Social and cultural norms, destructive policies, improper medical services and restrictive laws impede HIV treatment and prevention measures. In Djibouti, women are most vulnerable to stigma and social exclusion and therefore often suffer the most.

The Income Generation Programme

The World Food Programme’s income-generation initiative supports and empowers women through longterm aid. By providing a regular, stable income, the World Food Programme is creating financial security for women with HIV in Djibouti. The money that women receive typically goes toward starting and running a retail business. These loans generally range from $141 to $148 per person and include a training program teaching effective business skills.

How it Works

Recipients of the loan become chosen from two networks in Djibouti that specifically support those living with HIV: ARREY and Oui à la Vie – Yes to Life. Oftentimes, those diagnosed with HIV are susceptible to deteriorating conditions, are unable to hold down a job and face discrimination, causing the citizens to be unwelcome in public sectors. Women with HIV in Djibouti that receive these loans are able to make a consistent income for themselves and overcome the stigma that some associate with HIV. Further, these women are able to take back control of the lives they previously led.

The Outcome

One such recipient of the loan stated that she was “no longer a desperate woman.” She now makes enough to support her family and other dependents. Additionally, once this loan gave her the capital to launch a sustainable business, she was able to repay the loan in only 10 months. During that time the recipient was also able to expand the retail business to include furniture and electronics.  

The World Food Programme’s income-generation initiative aids the Sustainable Development Goal of ending HIV by 2030, and furthermore, leaving no person behind. According to UNDP’s findings, development itself does not automatically ensure that the entire population is included. Programs such as this target the multidimensional factors involved in people receiving proper aid.

Empowerment is an essential part of development; without the ability to feel successful and fulfilled, women often lack the means to seek treatment and make educated decisions regarding health. The loan initiative empowers women living with HIV in Djibouti to combat the associated stigma and obtain financial investment necessary to develop a sustainable business. With a stable income, women are able to seek health services that might not have been previously accessible. 

Laurel Sonneby
Photo: Flickr

Life Expectancy in Macedonia
North Macedonia is a landlocked country in the Balkan Peninsula, home to 2.074 million people. Macedonia has struggled with poverty for many years, and while some problems still linger, citizens have been making great leaps in technology, security and medicine to increase the country’s average life expectancy.

10 Facts About Life Expectancy in Macedonia

  1. According to the Central Intelligence Agency, the average life expectancy in Macedonia is 75.9 years. In 2018, males lived an average of 73.8 years while females lived for around 78.2 years.
  2. In 2015, 21.5 percent of all Macedonians lived below the poverty line. Poverty has a direct link to life expectancy and one can see this all around the globe, even in the United States. In 2018, The Independent reported that U.S. citizens living below the poverty line died almost 10 years younger than the rich and found that those living in poor sectors showed a higher death rate due to illness.
  3. The main causes of death in Macedonia are stroke and heart disease, with strokes causing 23.3 percent of deaths and heart disease causing 20.5 percent of deaths in 2010. This is an almost 10 percent rise from the rate in 1990 when there was a 16.6 percent mortality rate for stroke and a 14.8 percent mortality rate for heart disease. In recent years, the Stroke Alliance for Europe (SAFE) and other health organizations have been providing free screenings to determine a patient’s risk of stroke and established four stroke units around the country in order to combat this epidemic.
  4. Deaths due to tuberculosis have decreased to less than 20 percent of the rate in 2000, dropping from five out of 100,000 citizens to one out of 100,000 citizens. The World Health Organization also reported an 88 percent success rate in tuberculosis treatment in 2016. This change is due to more efforts to provide necessary medication to those afflicted and is likely responsible for the increase of the average lifespan of Macedonian citizens.
  5. In 2018, there was a 12 percent increase in murders, a 21 percent increase in attempted murders and a 31 percent increase in acts of violence, according to the Overseas Security Advisory Council. Poverty and crime correlate, so it is likely that Macedonia’s poverty rate and crime rate are connected. While there have been improvements in quality of life, a rising crime rate, especially in violent crimes, may cause an unnecessary drop in the average Macedonian’s lifespan.
  6. UNAIDS reports that the amount of people living with HIV in Macedonia has increased from around 250 in 2013 to more than 500 in 2019. As the number of people living with HIV has increased, UNAIDS has been making efforts to increase treatment. Starting in 2010, UNAIDS has implemented antiretroviral therapy to more and more citizens as the rate of affliction has risen. Due to these efforts, UNAIDS treated over 50 percent of the afflicted population in 2018, and the amount of AIDS-related deaths per year remains under 100 to this day.
  7. Macedonia suffers from heavily polluted air. In 2018, Macedonia’s two biggest cities, Tetovo and Skopje, reported air pollution indexes of 95.57 and 83.53 respectively. In contrast, New York’s air quality index stagnates between 40-45. Macedonia’s heavily polluted air has unquestionably affected the health of its residents, causing 1,469 deaths due to respiratory illness between 2015 and 2016. Recently, people like Gorjan Jovanovski have made great strides, who is a resident of Macedonia and developed an app to protect people from the densely polluted air. Jovanovski’s app draws information from air quality measuring stations around Macedonia and reports the air quality of the users’ general area based on readings from the nearest station.
  8. The CIA reports that people use North Macedonia as a hotspot for illegal drugs like heroin and cocaine to pass through from Asia and Europe. The European Monitoring Center for Drugs and Drug Addiction reported that Macedonia suffered 14 drug-related deaths in 2011 and 18 in 2012. Reports also say that there were 47 cases of drug-related infectious diseases between 1987 and 2004. These diseases and deaths could be a strain on the average life expectancy in Macedonia.
  9. In 1990, UNICEF reported that the infant mortality rate in Macedonia was 36.7 deaths per 1,000 lives births, usually due to preventable diseases or injuries. In 2019, the rate is only 13.7 deaths per 1,000 live births. This steep drop in child mortality is due to the implementation of more in-depth medical practices. In 2017, 93 percent of children that supposedly had pneumonia went to a health care provider, 91 percent of all infants received three doses of DTP vaccine and 97 percent of children received a second dose of the measles vaccine.
  10. Unclean water has a direct link to the health and life expectancy of those who drink it. UNICEF estimated that, globally, 2,000 children die due to diseases that spread through unclean water sources. In 2013, the World Health Organization began an initiative to improve Macedonia’s drinking water and sanitation, after reporting that the country was disposing of most of its wastewater into its rivers and lakes. In 2015, North Macedonia reported that 99.4 percent of its citizens had access to clean drinking water.

Altogether, life expectancy in Macedonia is well within the world average. While there are still changes that the country could make, the quality of life has only gotten better in recent years. Macedonians have clean drinking water, few deaths due to AIDS and some citizens are even working to combat the pollution in the air to provide a better future for them and their country.

Charles Nettles
Photo: Flickr