Price Agreement on New HIV Treatment Will Save Lives

In September of 2017, it was announced at the seventy-second U.N. General Assembly that the HIV treatment regimen TLD (tenofovir disoproxil fumarate, lamivudine and dolutegravir) has been made more accessible to low and middle income countries. This has been accomplished with a price agreement established through the partnership of various countries and global aid programs.

Some of the groups that collaborated on the new price agreement include UNAIDS, the Clinton Health Access Initiative (CHAI), PEPFAR, USAID, the World Health Organization (WHO), the Bill and Melinda Gates Foundation and the governments of South Africa and Kenya. Teams in many countries have begun developing plans to transition TLD into use by the end of 2019. Over 50 low or middle income countries have already introduced or are planning to introduce TLD as the favored first-line treatment for HIV.

Improvements to TLD

TLD medication is already considered a preferred method of HIV treatment in the United States. However, with the use of a generic treatment and a pricing agreement, TLD is now expected to cost health programs in low to middle income countries covered by the agreement only $75 per person per year once the treatment has been fully transitioned into use.

The newly released TLD is a generic treatment consisting of a single pill taken once a day containing a dolutegravir base. Studies have shown that the TLD regimen has fewer side effects on the patient and also has less vulnerability to the development of drug resistance that would render it ineffective. This helps because it means that fewer people would have to start new levels of treatment. TLD has also been shown to provide a more rapid repression of viral load.

Effects of New HIV Treatment

Three countries that began using the TLD treatment by the end of 2017 include Brazil, Botswana and Kenya. Within three months of treatment, studies show that 81 percent of patients using TLD in Brazil had an undetectable viral load, as compared to another HIV treatment regimen with an EFV (efavirenz) base, which had 61 percent presenting with an undetectable viral load after three months of treatment. Botswana and Kenya have shown similar success, with 90 percent of those using the treatment reaching full viral suppression in 2018.

In 2016, only 53 percent of people infected with the HIV virus were receiving treatment. Under the licensing agreement that sets a maximum price on the dolutegravir-based medication, 92 low to middle income countries will be able to provide the treatment to their citizens. These countries represent 90 percent of the people living with HIV in low to middle income countries. The TLD pricing agreement will not only be able to reduce the cost of treatment for the people in these countries but will increase availability so that more people can be treated.

A Brighter, Healthier Future

The launch of this new TLD treatment is another step forward in the treatment of people suffering globally from HIV and AIDS. People who did not originally have access to the dolutegravir treatment due to cost and availability will now be able to use this treatment. TLD provides a more reliable treatment regimen that will improve many people’s lives and ultimately bring the world a little further in the fight against HIV.

– Lindabeth Doby
Photo: Flickr

Child Soldiers in Nigeria Require Immediate Assistance

Violent conflicts largely incited by the militant group Boko Haram continue to ravage northeastern Nigeria and the larger Lake Chad region. Due to these conflicts, youths in the area face the unwanted yet real menace of being recruited as child soldiers in Nigeria.

Parties Recruit and Abduct Children for War

In 2016 alone, there were 2,122 cases of deployment of children for military purposes in Nigeria, according to a 2017 United Nations report on children and armed conflict. The report also stated that Boko Haram used four boys and 26 girls for suicide attacks in 2016; 13 more children were killed in November and December by the Nigerian security forces, which suspected them of carrying bombs.

Civilian Joint Task Force (CJTF), a vigilante group that opposes Boko Haram, also recruited child soldiers in Nigeria, though they were mostly used for supporting roles. The Nigerian Security Forces (NSF) was also accused of deploying children in warfare.

A United States 2017 Trafficking in Persons Report pointed out that children merely 12 years old were recruited by NSF. The report also explains that some of the child soldiers in Nigeria were originally arrested or detained for alleged connections with Boko Haram and might have been forced into military operations by the state.

“Human Bombs”

Some suicide bombers were as young as seven or eight years old. In a bombing in Maiduguri in December 2016, two young girls set off explosions in the middle of a crowded market, killing at least one and injuring 17 people.

“They got out of a rickshaw and walked right in front of me without showing the slightest sign of emotion. I tried to speak with one of them, in Hausa and in English, but she didn’t answer. I thought they were looking for their mother. She headed toward the poultry sellers, then detonated her explosives belt,” local militia member Abdulkarim Jabo told United Press International.

In only the first eight months of 2017, 83 children were made into “human bombs,” more than doubling the number of child suicide attacks in the entire year of 2016. Most of the children used were girls.

Reintegration for Child Soldiers in Nigeria

Children who were able to escape from Boko Haram often suffered further from rejection as they tried to reintegrate into civilian life, as the use of child soldiers in Nigeria aroused fear and distrust among the general public. Child soldiers also have to endure severe physical, psychological and sexual abuse. Those who return home often face discrimination and even ostracization by their families, including girls who were forced to be “wives” in captivity.

The United Nations calls for the unconditional release of children from armed forces worldwide and the increase of resources for the purpose of reintegration and education of released children. The United Nations Children’s Fund (UNICEF) estimated in 2017 that 65,000 children worldwide had been released from armed groups in the past decade.

U.S. Government (USG) Programs Support Highly Vulnerable Children

On June 7, 2018, U.S. Ambassador to Nigeria Stuart Symington announced a $112,000,000 donation to assist with humanitarian efforts in the region. USAID will manage the use of funds via Food for Peace, Foreign Disaster Assistance and the U.S. State Department’s Bureau for Population, Refugees and Migration. Ambassador Symington said that among its recipients, the donation would go toward helping child victims of the violent conflicts in the area, many of whom have been forced to separate from their families.

USAID and other USG agencies have cooperated to mediate similar humanitarian programs around the world. A USAID program based in the Democratic Republic of Congo (DRC) helped reintegrate previous child soldiers through communication campaigns that directly talk to local community leaders, psychosocial counseling, family tracing, education, financial support, etc.. In a single year, the program identified 1,905 children and provided them with health and psychological support.

More attention must be given to the children being exploited by these groups. With the continued efforts of government programs, there is still hope for child soldiers in Nigeria.

– Feng Ye

Photo: Flickr

Understanding How the U.S. Benefits from Foreign Aid to Djibouti

A tiny, desert-like East African nation, Djibouti is more synonymous with counter-terrorism and the piracy concerns of its southern neighbor than economic ties to the U.S. However, substantial U.S. foreign aid is indirectly creating opportunities for U.S. exporters. Additionally, the U.S. benefits from foreign aid to Djibouti by securing efficient and reliable trade routes to other nearby African countries such as Ethiopia, in which the U.S. has key commercial interests.

Home to roughly 875,000 people, as well as a significant U.S., German, Japanese, French and most recently Chinese military presence, Djibouti has a decidedly disproportionate amount of foreign military within its borders. The U.S. pays $60 million each year to Djibouti for the rights to maintain its only permanent sub-Saharan military base.

But, U.S. foreign aid coming into the country is equally important in Djibouti for the majority of citizens looking for work. Although U.S. investment in the country pales in contrast to that of new entrants into the region such as China, the actual workforce of Djibouti is benefiting from the more nuanced and domestically-oriented U.S. foreign aid.

New ventures in the construction of ports, pipelines, international airports and railways have somewhat failed to raise the standard of living and stimulate employment. Accounting for 70 percent of GDP, the new port projects have only added a few thousand jobs. According to the U.N., despite recent Chinese soft loans toward these various infrastructure projects, the unemployment rate in Djibouti still stands at 60 percent.

This high level of unemployment is partly due to a lack of qualified candidates in many sectors of the economy. Workers looking for jobs simply do not have the necessary skills required to fill many of the possible vacancies.

Through the Workforce Development Project (WDP), the United States Agency for International Development and Djibouti are working together to reduce unemployment and create a more modern labor force. Investments of nearly $25 million over five years (2016-2021) are aimed at increasing competitiveness by tailoring the workforce to the needs of a modern economy.

The WDP emphasizes creating stronger connections between worker training programs and employers. Specifically, through more meaningful ties between vocational education centers and businesses, the future workforce will be better suited for the demands of firms and will likely have greater hiring potential.

Although not as flashy as the new Doraleh Port or the new electrified railroad connecting Djibouti City and Ethiopia’s capital, Addis Ababa, the WDP will create thousands of new consumers to U.S. exports. This is especially promising since the soaring unemployment rate allows for ample economic improvements should this transformation of the workforce take place. USAID, centered on workforce assimilation, is therefore fostering job growth that will be more sustainable than temporary employment based on glitzy infrastructure projects.

Another way in which the U.S. benefits from foreign aid to Djibouti is by promoting ongoing access to the substantial trade flows emanating from regional neighbors. A prime example of this is Ethiopia. Much of Ethiopia’s exports—including coffee, vegetables and cosmetics—are routed through Djibouti on their way to the U.S. Meanwhile, as of 2016, 90 percent of all Ethiopian imports were brought via ports in Djibouti.

U.S. foreign aid indirectly contributes to these regional trade routes of East Africa by creating a more prosperous and modernized workforce in Djibouti. A thriving, educated and healthy Djibouti society will undoubtedly increase the opportunities for cross-border trade.

One byproduct of this increasingly interconnected region around Djibouti would be more timely and reliable shipment of goods and lower associated transportation costs. As in Ethiopia, the U.S. benefits from foreign aid to Djibouti are amplified when stability across the wider East African region is maintained.

On this last issue, there is little doubt that the military presence plays a prominent role. However, U.S. programs aiming to reduce unemployment such as the WDP, by indirectly promoting a more sustainable domestic environment in Djibouti, also contribute to regional stability. Garnering less attention than the massive infrastructure spending, transforming the country one worker at a time will lead to continued U.S. benefits from foreign aid to Djibouti

– Nathan Ghelli

Photo: Flickr

Understanding the Negative Effects of Budget Cuts to USAID

Recently, the Trump administration, in collaboration with congressional leadership on Capitol Hill, has hammered out a deal to prevent a government shutdown while effectively gutting the State Department and agencies like USAID of their funding. This move not only signals a sidelining of diplomacy but marks one of the biggest budget cuts to USAID and the State Department since the early 1990s.

The effects of the budget cuts to USAID are undoubtedly going to hinder diplomatic agencies in eliminating poverty around the globe and increasing diplomatic relations with the countries that depend on us the most. The United States Agency for International Development (USAID) is the State Department’s main tool for dispensing aid to foreign countries and strengthening diplomatic relations.

USAID currently operates in roughly 100 countries, fighting the spread of poverty and disease while working to improve economic conditions worldwide. The proposed budget cuts to USAID weigh in at approximately $9 billion, a staggering defeat to those working toward the end of poverty worldwide.

The President’s proposed budget cuts to USAID amount to nearly one-third of its total budget, in what seems to be a strategic move away from diplomacy and toward military strengthening. Regardless of the President’s agenda, this move away from soft power and diplomacy has been condemned by many members of the military.

A total of 151 retired senior military commanders, including former chiefs of the Navy, Army, Air Force, Marine Corps and Special Operations Command, have warned that a reduction of this magnitude could have detrimental effects around the globe. As threats to the United States’ national security continue to grow, it is a risk to decrease diplomatic ties at such a pivotal moment.

Many civilians and government employees agree with the opinions of their military leaders. Former USAID Administrator Andrew Natsios said, when facing the 1999 budget cuts to foreign aid, that it is likely budget cuts could have detrimental effects toward the technical expertise of USAID and could mark the beginning of a disaster in the long-term.

As well as the statement above, Natsios describes budget cuts toward foreign aid and agencies such as USAID as an “evisceration of the most important tool of American influence in the developing world.” Other staffers from USAID warn of the spread of disease in the United States rising as foreign aid spending is cut. Outbreaks such as the Ebola outbreak may become much larger and harder to contain with a lack of funding to agencies such as USAID. These concerns are still relevant and even more serious today.

Agencies such as USAID are pivotal in diplomatic relations and national security. By providing funds, resources, goods and trade to other countries, the U.S. invests in itself as well as others. By providing healthcare to those in need, USAID prevents the spread of communicable diseases, prevents premature death and builds a market for low-cost medical technologies.

By providing food and farming technologies, the U.S. prevents world hunger and promotes market trading of produce and other consumable goods. By providing foreign aid, the country also helps form more efficiently-run governments and promotes democracy wherever possible. All of these efforts also prevent bigger catastrophes around the globe, such as mass migrations, food shortages and natural disasters.

At the end of March, Congress approved an omnibus appropriations bill for FY18 that will keep the government open through September 30, 2018. When it comes to funding for development and diplomacy, the omnibus overwhelmingly rejects the deep and disproportionate cuts proposed by the Administration in FY18 – highlighting the strong bipartisan support in Congress for these critical programs. Still, there is more work to be done to protect funding for the foreign aid budget in FY19 and beyond. 

Email Congress in Support of the International Affairs Budget

– Dalton Westfall

Photo: Flickr

Humanitarian Aid to Kyrgyz Republic Promotes Development

The Central Asian Republic of Kyrgyzstan, also known as Kyrgyz Republic, is a landlocked and a largely mountainous country with a population of about six million. Humanitarian aid to Kyrgyz Republic has helped the country’s economy recover from the 2009 financial crisis and the 2010 inter-ethnic clashes.

U.S. and Kyrgyz Republic

In 2010, the United States announced a $32 million assistance plan for humanitarian relief, reconstruction and community stabilization efforts in the violence-plagued regions of both Kyrgyz Republic and Uzbekistan.

Kyrgyz Republic is one of the five republics of Central Asia and is very prone to natural disasters such as landslides, floods, earthquakes, droughts and melting glaciers. These natural disasters disrupt the normal flow of life and cause substantial damage to developmental projects.

European Commission

The European Commission (EC) has assisted people in the aftermath of these natural disasters via various projects. These efforts include improving food security in the wake of the harsh winter climate and providing small-scale support after floods, avalanches and earthquakes.

The EC also manages a disaster risk reduction program called DIPECHO which has funded more than 110 projects at the cost of €47 million (about $58 million dollars). DIPECHO’s tenth action plan for Central Asia (2017-2018) has encouraged EC’s partners to replicate previous successful community-based disaster risk reduction models to foster more local and national self-sufficiency and development.

Project HOPE

In 2017, aid organization Project HOPE donated $243,000 to medical facilities and non-government organizations. This humanitarian aid to Kyrgyz Republic was used to provide free health services and medical supplies to over 35,000 people. Project HOPE has been active in the Kyrgyz Republic since 2006.

The U.S. State Department noted in 2010 that the U.S. humanitarian aid to the Kyrgyz Republic has improved the country’s economic growth, promoted democratic reform by strengthening the civil society and helped the government combat international threats. Basic reforms in education, agriculture, energy and other ongoing priorities have also been instituted.

USAID

The United States Agency for International Development (USAID) has helped the Kyrgyz Republic maintain a parliamentary democratic system even as the country oscillated between two bouts of authoritarianism. Democratic reforms are especially important as Kyrgyz Republic is the only freely elected parliamentary democracy in post-Soviet Central Asia.

USAID works with the regional USAID Mission to Central Asia to propel the New Silk Road initiative which is aimed to strengthen the economic and cultural connections of South and Central Asian people which, in turn, helps propel the stability and prosperity of the region.

Diversification and Humanitarian Aid to Kyrgyz Republic

The World Bank has said that the Kyrgyz Republic needs to diversify its economic activities by increased private sector development and occupational training, especially to the young. Humanitarian aid to Kyrgyz Republic can thus help the government improve its governance at both local and national levels and promote the country’s economic and social development.

– Mohammed Khalid

Photo: Google