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HIV/AIDS in Ecuador

HIV/AIDS in Ecuador
Ecuador, a South American country, is a middle-income country. Of its 18 million population, an estimated 9.8% lived on $3.20 per day in 2019. Nevertheless, it has a reputable health care system, scoring 13th in the world according to Bloomberg’s 2014 Most Efficient Heath Care Rankings. Ecuador’s proficient health care system has been effective in combatting the global epidemic known as HIV/AIDS. The first reported case of HIV in Ecuador was in 1983. Below is an assessment of the status of HIV/AIDS in Ecuador.

Current Rates of HIV/AIDS

Globally, there are an estimated 38.4 million people living with HIV, as of 2021. Of these, 1.7 million are children and the remaining 36.7 million are adults. In Ecuador, an estimated 35,000 people are living with HIV. This means that HIV prevalence per 1,000 adults is roughly 0.19% in Ecuador. A 2017 Open Forum Infectious Diseases study revealed that more than 60% of HIV patients are on antiretroviral therapy and most cases are not yet in the AIDS stage.

Government Measures

On December 8, 2016, the Mayor of Quito, Ecuador’s capital and home to 25% of its HIV cases, signed the Paris Declaration Fast Track, a piece of legislation that aims to end the AIDS epidemic once and for all. By signing the Declaration, Mayor Mauricio Rodas has committed to reaching certain targets of HIV awareness and rates of treatment. The high standards set by the Declaration require that 90% of people with HIV are aware of their HIV status; that 90% of people who know their status are receiving antiretroviral treatment; and finally, that 90% of people on treatment are suppressing the viral load. The signing of this Paris Declaration signified a clear determination of the nation’s legislators to eradicate HIV/AIDS in Ecuador.

Looking Ahead

In 2018, an NGO called Diálogo Diverso began its journey in Quito. The organization is the first in Ecuador to work for human rights, including the rights of LGBTI migrants and refugees. Its “Hablemos Positivo” (Let’s Talk Positively) initiative receives support from the United Nations Programme on HIV/AIDS (UNAIDS). Now active in three other locations across Ecuador, including the HIV hotspot, Guayaquil, Diálogo Diverso is spreading the message of tolerance and inclusivity further than ever.

As a result, Ecuador is becoming a safe space for those with HIV from all over South America. This is incredibly encouraging as an important contributor to eradicating the virus is to increase awareness of the real causes of transmission and the many options available for further prevention of transmissions. Furthermore, one activist working with Diálogo Diverso stated that “HIV is one of the reasons why LGBTI people leave the Bolivarian Republic of Venezuela, given the difficulties in accessing antiretrovirals on a permanent basis, the invisibility of their rights and, on other occasions, hate crimes.” With the continuation of the good work of Diálogo Diverso and continued funding of Ecuador’s health care system, the potential for eradicating HIV/AIDS in Ecuador looks promising.

– Max Edmund
Photo: Unsplash

The Truth About HIV/AIDS in South Sudan

HIV/AIDS in South Sudan
The Republic of South Sudan is located in Eastern Africa. Many know it for its newly-gained independence from Sudan and its status of being the youngest nation in the world. However, South Sudan is also one of the poorest nations in the world and is listed as 185 out of 189 countries on the Human Development Index (HDI). Due to ongoing conflict in the region, such as the recent civil wars, South Sudan has seen a spike in issues related to the country’s health system and many of its citizens are impacted by HIV/AIDS. Nevertheless, international and domestic institutions are taking major steps in combating the prevalence of HIV/AIDS in the region.

The Reality of HIV/Aids in South Sudan

One can characterize the issue of HIV/AIDS in South Sudan as being more concentrated in certain social groups and geographical areas. For example, HIV and AIDS are more prevalent in the southern regions of the nation and even more prevalent among female sex workers within those regions.

The transmission of HIV is a topic that is studied at length to combat the spread of the virus. According to the South Sudan Mode of Transmission Report (MoT), a study that occurred in 2014 regarding forms of transmitting HIV, the majority of the newest cases came from heterosexual sexual relations and mothers transmitting to their newborn children. Mother-to-child transmission often happened in cases of birthing, breastfeeding and pregnancy.

Another statistic that researchers often analyze when discerning the severity of the issue within a certain region is the percentage of the general population that has the virus. The U.N. Progress Report for monitoring HIV/AIDS in South Sudan states that around 2.5% of adults (ages 15-49) are living with HIV. This number, however, is improving due to help from institutions such as the Ministry of Health (MoH) and the U.N. These institutions are working on new ways of preventing the spread of HIV and treating those who have already been affected.

Something else that institutions take into consideration when attempting to combat viruses such as HIV is the general public’s knowledge of that virus. According to a survey on the attitudes and knowledge of HIV in Nimule, most adolescents had “fair” knowledge of HIV with 82% of the surveyed youth being aware that HIV can spread through sexual intercourse and 98% being aware that it can spread through blood. While the researchers concluded that there were some misconceptions surrounding the virus, it is commendable that most adolescents in the survey had a basic knowledge of the subject.

How Institutions are Battling HIV/AIDS in the Region

According to an article that the U.N. published, the prevalence of HIV/AIDS in South Sudan – and Africa as a whole –  is declining rather quickly. This is due to international institutions such as UNAIDS and the governments of Africa funneling money into their health programs. However, this article also stresses the need for continued monetary support to help these countries become healthier and safer.

One way that UNAIDS and African governments are helping combat this virus is through HIV testing. According to the MoH, there were around 32 facilities in South Sudan that provided HIV-related assistance, like testing. The South Sudanese government has also made it its mission to “Test and Treat all.” These testing efforts have made it a lot easier for institutions to pinpoint certain concentrations of affected individuals and allocate their resources accordingly. These measures to “test all” have been successful. The total number of people receiving antiretroviral treatment increased by around 20,300 between March 2013 and March 2018.

Another way in which institutions are helping the cause is by amping up anti-retroviral therapy (ART). This is an HIV treatment that helps to contain HIV replication. This therapy greatly reduces the mortality rate of HIV and even allows some patients to live completely normal lives. The “test all treat all” initiative has certain guidelines, one of which includes a minimum amount of time one can wait to receive treatment after testing positive for HIV (one week). Guidelines like these make it easier for governments and other institutions to manage the spread and treatment of the virus.

The Road Ahead

Although HIV/AIDS in South Sudan continues to be an issue, it is critical to note that governments and organizations are working to combat it. With the help of both international and domestic institutions, the cases of HIV continue to decrease year after year. However, it is still crucial to take into account that the issue has not reached its end, and continued support for South Sudan is of utmost importance.

– Tim Ginter
Photo: Wikipedia Commons

Tanzania’s Investment in Secondary Schools to Fight HIV

Tanzania’s Investment in Secondary Schools
HIV prevalence in Tanzania accounted for 4.8% among people aged 15-49 in 2019. HIV/AIDS’s consequences in a developing country can be devastating, leading to more deaths, slowed economic growth and further misery. HIV and poverty share a critical connection, both acting as the cause and the outcome of one another. The virus poses a more lethal and dangerous threat to the economically vulnerable part of the population that might not always have access to food, medicines and proper health care services. Tanzania has invested in an initiative called Education Plus to eliminate HIV in the country. Tanzania’s investment in secondary schools should fight HIV by ensuring education for girls and young women.

HIV and Education

Sub-Saharan Africa is considered the epicenter of the disease, with 69% of the HIV-positive world’s population living in the region. Another critical characteristic of the epidemic is its relationship with education, where less educated groups tend to be more vulnerable to contracting the disease.

Tanzania’s investment in secondary schools to fight HIV is a plan that will further develop through the country’s commitment to Education Plus. The initiative is the result of the combined efforts of UNAIDS, UNESCO, UNICEF, U.N. Women and others to fight and prevent HIV through the empowerment of adolescent girls and women in sub-Saharan African countries. Their strategy aims to achieve gender equality with secondary education as a central focus. Tanzania became the 13th African country to join Education Plus.

The Background

In Tanzania, over the last 12 years, the number of HIV infections dropped by almost half and the number of deaths decreased from 52,000 to 27,000 in 2019. Nevertheless, in 2019 the country has seen the number of HIV-positive individuals amount to 1.7 million. Evidence shows a considerable vulnerability in women to develop the infection.

Younger groups between the age of 15 and 24 represent one of the most prominent groups of new infections, making up 30% of the newly infected population, UNAIDS reported. According to UNICEF, the disease does not exist equally across the country, with a prevalence mainly in the southern areas.

The mainly affected population are people injecting drugs, men who entertain sexual relationships with other men, female sex workers, transgender individuals and prisoners. Studies show that crucial contributors to virus transmission are younger age, lack of education, alcohol use and the number of sexual partners.

Socio-economic Backgrounds

Tanzania’s poverty rate was 26.4% in 2018 and HIV is a disease that tends largely affects those coming from lower socio-economic backgrounds.

According to a report from the National Education Profile in 2018, 61% of females aged 14-19 in Tanzania were out of school compared to 51% of males from the same age group. According to UNAIDS, sub-Saharan Africa has the highest rate of child marriage and teenage pregnancy. Such aspects are definitive in keeping young women out of education and about 27% of girls aged between 15 and 19 in Tanzania are either pregnant or already have a child. As of 2019, adolescents and young women constituted 24% of new cases worldwide in sub-Saharan Africa.

Before joining the UNAIDS initiative, Tanzania was already making progress in tackling the issue with the revision of the HIV and AIDS Act, which now permits self-made HIV testing and has lowered the age of consent to take the test.

Education Plus

Research shows that secondary education has a significant role in the reduction of the risk of HIV/AIDS infection. Access to education leads young women to pay more attention to matters of sexual and reproductive health and it allows them to become economically independent later in life and ensure higher incomes for the future. It also decreases the risk of them becoming child brides and teenage mothers.

The initiative Education Plus began with the focus of helping achieve gender equality, ensuring free and good secondary education for all women by 2025 in sub-Saharan African countries. The plan consists of encouraging decision-makers to raise and expand investments and efforts on instructions and teachings for girls and young women. Such measures aim to prevent HIV and offer major social and economic benefits, including to those who already have contracted the virus, UNAIDS reported on its website.

Not only does the initiative give young women the opportunity to complete secondary education, but it also offers “universal access to comprehensive sexuality education, fulfillment of sexual and reproductive health and rights, freedom from gender-based and sexual violence, school-to-work transition and economic security and empowerment,” according to UNAIDS website.

The project relies on the help of influential U.N. leaders and partners and their role as advocates for the education of young girls to encourage further action and investment in the cause. Education Plus is the ideal approach to facilitate Tanzania’s investment in secondary schools to fight HIV.

The country’s high secondary school dropout rate is a risk factor in the development and spread of an epidemic that needs significant attention and intervention.

The Relationship Between Poverty and HIV

The socioeconomic status of people infected with HIV has a significant role in their living conditions. Many of the situations associated with the risk of contracting the virus are the consequences of coming from a disadvantaged background, such as a lack of access to decent food, housing, safety and the need to exchange sex for basic necessities.

HIV also has a negative impact on the socioeconomic state of a population. Poor health conditions can impact an individual’s ability to work and function independently, and according to research, the unemployment rate of those living with HIV/AIDS goes from 45% to 65%, according to the American Psychological Association (APA).

Looking Ahead

Despite the country still being a lower-middle income economy, Tanzania’s financial status is growing and has been so for the last decade. One of the key battles to win in order to ensure the economic reprise of Tanzania is through a strategy that allows for its population to have good health and work at their full potential.

Tanzania’s investment in secondary schools to fight HIV is not only an investment to fight and defeat a fatal disease responsible for 32,000 deaths in 2020, but also to build a country characterized where gender equality and strong economic performance are a reality.

– Caterina Rossi
Photo: Flickr

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New Global Alliance Launched to Eradicate AIDS in Children

AIDS in Children
In August 2022, numerous intergovernmental agencies, civil society movements and a dozen countries congregated in Montreal, Canada to establish the Global Alliance for Ending AIDS in Children by 2030. Recognizing that only 52% of children with HIV access treatment, the newly created alliance strives to guarantee that all children living with HIV can access treatment by the end of the decade. Specifically, by closing the treatment gap between children and adults living with HIV, the alliance aims to ensure that all youth deserve the chance to progress into adulthood unimpeded by HIV.

Tackling HIV Treatment Disparities

According to the U.N., one of the most significant issues affecting AIDS response is the disparity between treatment provided to adults versus children. While 76% of adults received anti-retroviral therapy (ART) in 2021—treatment designed to control HIV infection—only 52% of individuals ages 0-14 years accessed ART. Furthermore, only 55% of children ages 15-19 in 21 sub-Saharan countries were on treatment in 2021. Despite technological advancements in HIV testing, “800,000 children and adolescents living with HIV (0-14 years) are untreated,” and “another estimated 400,000 adolescents (15-19 years) many of whom were likely recently infected are not receiving treatment.”

In recognition of these devastating figures, the U.N. believes that the low prioritization of HIV treatment on a national scale is the root of this problem. Specifically, inadequate investment in treatment strategies and national plans to mitigate societal inequalities has exacerbated the discrimination targeting those living with HIV. Although numerous similar plans have been implemented in recent decades—such as the Global Plan towards the Elimination of New HIV Infections Among Children by 2015 and the Start Free Stay Free AIDS Free Partnership—previous movements primarily focused on raising awareness and fostering engagement among leaders.

The Formation of a Global Alliance

Hoping to expand HIV treatment to millions of youths across the world, the alliance prioritizes creating a sustainable framework for HIV prevention in the next 8 years. UNAIDS, UNICEF and WHO are primarily leading the Global Alliance for Ending AIDS in Children by 2030. Beyond U.N. agencies, the alliance consists of “civil society movements…national governments in the most affected countries, and international partners.” The 12 countries involved in the alliance include Angola, Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo (DRC), Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia and Zimbabwe.

The alliance’s mission is four-fold:

  1. “Close the treatment gap among breastfeeding adolescent girls and women living with HIV and optimize the continuity of treatment.
  2. Prevent and detect new HIV infections among pregnant and breastfeeding adolescent girls and women.
  3. Promote accessible testing, optimized treatment, and comprehensive care for infants, children, and adolescents exposed to and living with HIV.
  4. Address gender equality, and the social and structural barriers that hinder access to services.”

The Global Alliance for Ending AIDS in Children by 2030 seeks to foster a sense of unity within the international community. The alliance stresses how collaboration is the key to eradicating HIV; only by pooling resources, committing to global mobilization, and creating holistic solutions can the world prevent AIDS in children by the end of this decade.

A Promising Future

Going forward, the alliance will ensure that there is accessible treatment and care for children and adolescents living with HIV for at least the next eight years. According to a report published by UNAIDS, the alliance will promote leadership to execute plans on a national level, advance previous programs hoping to end AIDS, collaborate with global organizations to promote advocacy, ensure that governments have access to financing and advance accountability by fostering a sense of collective responsibility. As the Global Alliance for Ending AIDS in Children by 2030 continues to expand HIV treatment to millions of deprived children, the world will inevitably see a new generation devoid of stigma and discrimination surrounding HIV—a promising future that allows children to prosper as they venture into adulthood.

– Emma He
Photo: Flickr

How African Governments Are Combating HIV/AIDS

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

4 Poverty-Fighting Charities in Algeria

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

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HIV/AIDS in Malawi

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

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

Impact of The War on Ukraine’s Public Health

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

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How NGOs in Ukraine Alleviate Poverty During War

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