UNDP Supports Universal Immunization Program in IndiaWith high risks of communicable diseases like bacterial diarrhea, malaria, hepatitis A and E and typhoid, there’s a rising necessity for a proper immunization program in India. The United Nations Development Programme (UNDP) has partnered with the Indian government and Ministry of Health and Family Welfare to design and put into effect an Electronic Vaccine Intelligence Network (eVIN). This project, known as Improving Efficiency of Vaccination Systems in Multiple States, has already run since 2014 and is to run until 2021 to strengthen the evidence base for policy-making related to vaccine delivery, procurement and planning, and ensure equity in availability.

As the world’s largest immunization program, eVIN technology has already shown results in enabling real time information on cold chain temperatures and vaccine stocks and flows in all 371 implementing districts in India. It has managed to achieve over a 98 percent reporting rate from vaccine storage areas, with over 2 million transactions logged each month, and developed the skills of over 17,000 government staff in store keeping, data operating or cold chain handling in over 550 batches of training programs.

The eVIN is setup on a mobile application that easily allows cold chain handlers to log stock positions at the end of each routine immunization day, which is then relayed immediately onto a web interface for assessment by health officials. In India, this can come to play an important role as geography and communications can pose an issue, like in the small hill-state of Manipur, where vaccine vials are carried over extensive distances to session sites by auxiliary nurses and midwives. Instances of stock-outs have decreased by more than six times here, and eVIN has enabled staff to learn how to use a smartphone and other technology, improving quality of work and management in the process.

This immunization program in India has also significantly empowered women health workers, giving them the opportunity to work with technology after attending regional and district eVIN training sessions. This allows them to manage stocks and temperatures themselves, bridges the digital divide in rural parts of India and ensures transparency alongside accuracy. Over 50 percent of cold chain handlers are women, and many are from older age groups.

EVin has taken India out of the unproductive days of delayed decision making, shortages and expirations, and has created an efficient health system that allows for valuable state-wide geographic, stock-out or excess stock and temperature overviews on each district’s centers. It also allows for large savings by reducing vaccine wastage and allowing for timely and quality injections, as in Rewa, where around $70,000 was saved after six months of eVIN activation.

Though led by the UNDP and Ministry of Health and Family Welfare in India, the Universal Immunization Program is largely supported by GAVI, a global vaccine alliance established in 2000. With support from GAVI and the Indian government, the Universal Immunization Program in India has immunized at least 65 percent of India‘s children and expects to immunize 27 million more each oncoming year.

Zar-Tashiya Khan

Photo: Flickr

In India, 1.2 million children die every year from preventable diseases. Pneumonia, which is preventable through a vaccine, is the single-largest cause of death among children under the age of five. Nearly one of every four deaths of children under five years old is caused by pneumonia. As part of India’s Universal Immunization Program (UIP), the government will begin to provide the Pneumococcal Conjugate Vaccine (PCV) for free beginning in 2017. By offering PCV in India for free, up to 180,000 lives may be saved annually.

As Indian health minister JP Nadda notes, pneumonia kills more children under five than it does adults. Their weaker immune systems make it more difficult to fight off the illness’s symptoms as compared to older children and adults. Thousands of children have been hospitalized annually due to the spread of pneumonia. The inability of underprivileged families to afford the PCV in India has been a direct cause of increased illnesses among the child population.

Before now, the vaccine was accessible only via the privatized market to those able to afford it. By adding PCV to the vaccines given for free under the UIP, the underprivileged population will be on more equal footing in terms of health care access.

With free access to the PCV in India, child mortality rates are expected to decrease substantially. Millions of children will be protected against pneumonia in various states throughout India, including Uttar, Himachal Pradesh and Bihar. In addition, global healthcare alliance groups such as the World Health Organization and UNICEF remain dedicated to providing aid in support of the immunization plan.

The introduction of the vaccine will not only save children’s lives, but it will also drastically reduce health care costs for their families. Free and readily available access to the PCV in India will inevitably result in a healthier population and stronger economy.

Lael Pierce

Photo: Flickr

The UN Commits to New Efforts in the Fight Against Cholera in Haiti
The United Nations Secretary-General, Ban Ki-moon, recently issued an apology for the organization’s role in instigating the 2010 cholera outbreak in Haiti. Expressing his regret, the Secretary-General admitted: “we simply didn’t do enough with regard to cholera and its spread in Haiti.” In attempts to make amends, the U.N. is escalating its role in eradicating cholera in Haiti.

In 2010, U.N. peacekeepers introduced cholera in Haiti. The outbreak took a terrible toll, affecting 788,000 Haitians and taking the lives of 9,000 others. In the aftermath, the U.N.’s slow response tarnished its reputation. Now, the U.N. has recognized the necessity of making amends and leading a public health movement to eradicate the disease.

Action in the fight against cholera has not always been adequate, but progress is underway. International efforts have resulted in a 90 percent decrease in cases since the original outbreak. In the current period, the number of reported cases is lower than in the same period of 2015 and 2014. Rapid response resource teams had once decreased from 70 to 32, but the U.N. has redistributed resources to now supply 88 teams.

Through the use of material assistance packages and increased funding, the U.N. has intensified its efforts to reduce and eliminate cases of cholera. The organization has taken steps to improve access to care, address long-term water concerns and improve health care systems. For example, nearly $200 million has been raised to overhaul water and sanitation infrastructure. Additionally, recent vaccination efforts reached 729,000 people, helping to halt the spread of cholera.

A significant initiative to combat cholera is the U.N.’s Water Capture and Distribution project. Efficient and safe water transport is crucial in the eradication effort, as only 42 percent of Haitians have access to potable water. The endeavor will transport clean water through 5,000 meters of underground pipes and benefit 60,000 people. By using underground pipes, the project will help prevent potential future contamination and destruction of infrastructure. The U.N. hopes to replicate this project and bring safe water to 100,000 people across the country.

The recent gains in the fight against cholera in Haiti show the potential of proper funding and political will. The Secretary-General’s apology should act as the beginning, not the end, of a committed and sustained effort to the people of Haiti.

McKenna Lux

Photo: Flickr

Indonesia Facing Diseases
Humans struggle with diseases all around the world, but they become much more life threatening in impoverished countries. As a tropical country, Indonesia facing diseases is paramount in the attempt to improve development.

In Java, Indonesia there is a resurgence of diphtheria in children, mainly due to parents’ resistance to vaccinating their children. Lymphatic Filariasis (elephantiasis), polio and bird flu have all taken a great toll on Indonesia and its inhabitants. These diseases in Indonesia not only affect individuals’ lives, but also negatively impact Indonesia’s social and economic development. In order to control infectious diseases, the government must be able to implement effective interventions.

For bird flu specifically, all suspected infected poultry must be reported and then killed. The government has been very inconsistent in applying this rule but must take action if it wants to eliminate bird flu. Many farmers hide their flocks in fear of having their birds killed; the farmers care more about their loss of livelihood than the spread of disease.

In the peer-reviewed journal, PLOS Neglected Tropical Diseases stated that Indonesia has some of the world’s highest concentrations of tropical diseases, holding back Indonesia’s emerging market status. High rates of disease are commonly found in low-income countries due to poor economic growth. However, Indonesia has experienced economic growth at an average of 6 percent over the recent years and its middle class is projected to double in size over the next decade.

Indonesia is the only country in Southeast Asia with prevalent schistosomiasis, a parasitic disease prevalent in communities deprived of potable water or sufficient sanitation. Adding to that, almost 10 percent of the world’s leprosy cases are in Indonesia. Additionally, the World Health Organization is cautioning individuals about the emerging threat from dengue fever in Indonesia, which Indonesia is already spending a lot of money on — 323 million in 2010.

If Indonesia does not implement better controls to reduce these diseases, their future growth and economic gains could easily be thwarted, mainly due to the country’s negative impact on child development, labor and health.

In order to start controlling these infectious diseases USAID and other NGOs are working to improve health efforts in Indonesia. USAID currently has programs in both maternal and child health, infectious diseases (TB, HIV/AIDS), pandemic threats, neglected tropical diseases as well as water and sanitation issues.

To control infectious diseases USAID is partnering with Indonesia’s National TB Program to help treat and combat the disease for Indonesia’s future. One big step that was made was in 2012 when USAID introduced GeneXpert technology, which diagnoses multi-drug resistant TB in hours instead of months; this act alone has helped save countless lives. For HIV and AIDS, USAID is providing technical support to the Ministry of Health (MOH) to hasten prevention measures being used by the Indonesian individuals.

Lastly, Indonesia facing diseases has caused pandemic threats to the country. USAID has been engaging in a multitude of actions to stop these outbreaks. Along with plenty other assistance, USAID helps the Indonesian government identify and respond to risks as quickly as possible, in addition to increasing access to safe water and sanitation efforts.

Clearly, USAID and other public-health measures have made some progress. A recent study indicates that if it wants to keep the growth train running, Indonesia facing diseases will need to step up its outreach to better eliminate disease, which USAID has started. Hopefully, these positive impacts will end disease in Indonesia soon.

Bella Chaffey

Photo: Flickr

Diseases in Eritrea
Located in the Horn of Africa, the country of Eritrea is bordered by Sudan, Ethiopia and Djibouti and has a population of about 5.6 million. Constant conflicts, the threat of war and severe droughts have transformed Eritrea into one of the poorest nations in Africa. Because the country has little money to spend on health care, many diseases in Eritrea remain a constant threat to travelers and citizens.

According to the Centers for Disease Control and Prevention (CDC), individuals traveling to Eritrea are at risk of contracting typhoid, malaria, meningitis, rabies, yellow fever and hepatitis A and B. These diseases can be contracted through contaminated food and water, sexual contact, mosquito bites or non-sterile medical or cosmetic equipment. Many of them, however, are highly preventable through vaccination.

Diseases such as rotavirus are the leading causes of fatal diarrhea in children under five in Eritrea. In 2010, an estimated 1,201 children under five died from rotavirus.

The Zika virus is also a growing concern among Eritrea’s citizens. As in many countries, non-communicable diseases in Eritrea are steadily growing more prevalent. These diseases include cardiovascular diseases, malnourishment, hypertension, diabetes, chronic obstructive pulmonary diseases and cancer.

However, it is also important to note that Eritrea’s government has made substantial progress in disease control and improving the overall health of its citizens. In 2000, as a member state of the United Nations, Eritrea adopted the eight Millennium Development Goals, committing to further development and human security. Since then, Eritrea has made tremendous strides in providing health care to its 5.6 million citizens.

The World Health Organization (WHO) reports that eight of Eritrea’s major vaccine-preventable diseases are no longer a public health issue. Cost-effective vaccinations for diseases in Eritrea that still pose a concern, such as rotavirus, have also become available.

Public health concerns such as measles, maternal and neonatal tetanus in Eritrea have been reduced to less than 90 percent as of 1991. Eritrea has been certified as dracunculiasis-free and polio-free due to an increase in vaccinations. In addition to this, the country is seeing a steady decline in the prevalence of HIV/AIDS, with HIV infection rates in the population at less than 1 percent.

Shannon Warren

Photo: Flickr

Health Care in CameroonThe World Bank is expanding a program launched in 2011 to tackle health care in Cameroon, a country in Central Africa home to a large number of refugees.

What began as a pilot project gradually extended its reach based on its efficiency.

The program improves health services by monitoring pregnant women, promoting vaccination and educating communities about hygiene practices that prevent diseases such as malaria, typhoid and intestinal parasites.

Due to positive results, the program received additional funding to expand in 2014. The World Bank Group’s Board of Executives approved a $127 million project to upscale the program in May 2016, a huge step toward improved health care in Cameroon.

The funding will go toward upgrading laboratory equipment, restocking the pharmacy, installing solar panels and building living quarters.

The World Bank joined the efforts of the Cameroonian government and other international organizations combatting maternal and infant mortality in the region.

Presently, a lack of health care services and medical professionals leaves the population vulnerable to fatal birth complications and diseases. In northern Cameroon, close to 20 percent of children die prior to their fifth birthday.

Nearly one-fifth of those deaths are caused by malaria. Additionally, 36 percent of children under five have stunted growth due to a lack of sufficient nutrition, according to the World Health Organization.

Cameroon maintains an open border for asylum-seekers. Hundreds of thousands of refugees flee to Cameroon each year from the Central African Republic and Nigeria due to violent conflict. The refugee communities in particular need health centers to respond to their needs.

The mistrust among many indigenous populations of health care services is a pressing challenge. Women prefer natural remedies and familiar surroundings to being hospitalized.

The program addresses these issues by implementing a community-based approach to healthcare: health agents visit households twice a month to monitor and identify health conditions in the village. They accompany ailing or injured people to health facilities and promptly administer care.

Additionally, health agents spread awareness about the importance of preventative health measures.

“By promoting equitable access to basic health services, this approach will make it possible to provide better care to the country’s poorest and most vulnerable,” said Paul Jacob Robyn, Health Specialist in the World Bank’s Human Development Global Practice Group.

Emily Ednoff

What is Meningitis?

Meningitis is an infection that causes the membranes around the brain and spinal cord, also called the meninges, to become inflamed, which in some cases leads to damage of the nerves and the brain.

Neisseria meningitis is the one with the potential to cause large epidemics. There are 12 serogroups of N. meningitis that have been identified and 6 of them namely A, B, C, W, X, and Y can cause epidemics. It is reported that the geographical distribution and epidemic potential differ according to serogroup.

According to the NHS, there are “two types of meningitis namely: viral…and bacterial”

Whilst the viral form is caused by viruses that can be spread through coughing, sneezing and poor hygiene, the bacterial form is caused by bacteria such as the Neisseria meningitides or Streptococcus pneumonia and through close contact.

Bacterial meningitis is the most severe. The NHS urges that this form should “be treated as a medical emergency.” If left untreated, it can cause severe brain damage and infect the blood.

Viral Meningitis on the other hand, though most common especially in children, is less serious. It is reported that it is difficult to estimate the number of viral cases because symptoms are often so mild that they are often mistaken for flu.

According to WHO, “meningitis tends to hit Africa in cycles. Cases of meningitis C have risen since 2013, first in Nigeria 2013 and 2014, and then in Niger in 2015.” Between 2011 and 2012, there were around 2,350 cases of bacterial meningitis and septicaemia in the U.K.

In terms of treatment, the viral infection is reported to usually get better within a couple of weeks with plenty of rest to treat the headache and anti-sickness medication for vomiting. With the bacterial infection, treatment normally involves intravenous antibiotics as well as admission into the hospital.

It is advised by healthcare centers that, the best way to prevent the infection is to get a vaccination.

In order to ensure the development and growth of nations, it is imperative that diseases such as Meningitis are prevented. Being proactive and preventing the infection not only saves lives but it also saves costs associated with treatment.

Vanessa Awanyo

Sources: Web MD, NHS, WHO
Photo: Flickr

Combating the Zika Virus

The Zika virus is a widespread virus that had previously affected parts of Africa and Southeast Asia but is now impacting parts of South America, Central America and Mexico. The World Health Organization (WHO) officially declared the Zika virus an international health emergency on Feb. 1, 2016.

As one of the countries hit hardest by the Zika virus, Brazil is implementing creative, experimental methods to help combat the spread of the virus. According to the Guardian, Brazil is using an irradiation process where they are “zapping millions of male mosquitoes with gamma rays – sterilizing them to stop the spread of the virus.”

Kostas Bourtzis, a molecular biologist with the International Atomic Energy Agency (IAEA), stated: “It’s a birth control method, the equivalent of family planning for humans.”

Another method that Brazil is using to combat the Zika virus involves radiation. The Fiocruz biomedical research institute has released 30,000 sterile mosquitoes on Fernando de Noronha, an island 217 miles off the coast of north-east Brazil. Fiocruz researcher Alice Varjal said, “The pilot project seeks to replicate lab results in which 70 percent of the eggs laid by the females were sterile.”

An additional method that is being used in Brazil involves mosquitoes being genetically modified so their offspring will die before reaching adulthood, which reduces the chances of mosquitoes being able to reproduce. The biotechnology company Oxitec developed this technique.

So far in the U.S., approximately 50 cases of the Zika virus have been reported. President Barack Obama sent a request to Congress for close to $2 billion to contribute to combatting the continuous spread of the Zika virus.

In an interview done by CBS News, President Obama said, “The good news is, this is not like Ebola. People don’t die of Zika, a lot of people get it and don’t even know that they have it.” President Obama continued to discuss plans for the Zika virus, stating: “We’re going to be putting up a legislative proposal to Congress to resource both the research on vaccines and diagnostics, but also helping in terms of public health systems.”

Senate Democratic leader Harry Reid of Nevada said, “It is critical that we approve the funds immediately and give our government the resources it needs to fight the virus.” He continued to say, “We also need to make sure that our nation’s response to the virus includes increasing access to contraceptives for women in Zika-affected regions who choose to use them.”

Once the funding is approved by Congress, it is estimated that $200 million would go toward vaccine development, $335 million toward foreign aid and $250 million would be distributed to Puerto Rico.

WHO has asked for $25 million, which would be contributed toward fast-tracking vaccines and virus control. Right now, there is no cure for the Zika virus but there are several plans underway to help slow down or stop the spread of the virus.

Aleia Bynum

Sources: NY Times, Huffington Post, CNN, The Guardian
Photo: Flickr

Cholera Outbreaks in IraqCholera outbreaks are not altogether uncommon in Iraq. The bacterial infection is endemic to the region and reported cases usually spike every two to three years around November. Due to this regularity, the Iraqi Ministry of Health has developed a multidimensional approach to combating these outbreaks—but this year has been different.

An unprecedented at-risk population has emerged, as more than 250,000 Syrian refugees have fled their homes to Iraq at the same time that Iraqis are becoming internally displaced by the ongoing conflict with ISIS in the north. Funding has been diverted away from municipal services to pay for defense, and authorities have been unable to fully address community wells that have been contaminated by sewage from flood drainage.

More than 2,000 cases of cholera have been reported over the last three months, including six that have been fatal. One in five of these cases affect young children, and many are being diagnosed in the 62-refugee and Internally Displaced Person camps across the country.

Health officials may also face being inundated with additional patients due to the millions of Shi’ite Muslims expected to make their pilgrimage to Iraq in observance of Arbaeen, a ritual marking the end of mourning over the death of Hussein. When these travelers return home, there is a good chance they will take the bacteria with them, and this will compound an outbreak that has already spread to Syria, Kuwait and Bahrain.

“There is, unfortunately, a high risk that cholera will reach more areas affecting marginalized and displaced children, women and their families, in particular,” UNICEF Representative in Iraq, Peter Hawkins, said. In response, the Health Ministry, UNICEF and the World Health Organization are ramping up their campaigns to vaccinate refugees, treat patients and educate communities on practices that will reduce the risk of transmission.Cholera_outbreaks

In late October, health officials trained 1,300 vaccinators and 650 social mobilizers to carry out a first-phase vaccination deployment. Since early November, more than 91 percent of targeted Syrian refugees received the oral vaccine and will receive a second dose by the end of December. The second round will guard against cholera for at least five years. It was a desperately needed victory for Iraq, but the World Health Organization stressed that vaccinations should not divert attention from other prevention measures.

“We need to intensify health promotion and education to help communities protect themselves,” WHO Representative, Atlaf Musani, said.

To that end, UNICEF has supported a massive public education campaign. Cholera prevention methods are being sent out on social media, in text messages, by volunteers taking pamphlets door to door and on billboards in affected areas. People are being urged to use water only from protected sources and to get seen by a doctor as soon as symptoms of cholera present themselves.

Primary school children at a refugee camp in Dohuk were taken from regular classes to learn how to properly wash their hands and blow their noses. Officials are hoping that by reaching students, the information will get back to families as well. “Families can protect themselves in simple ways,” Hawkins said.

For communities already infected, or at risk of infection, health officials and UNICEF have undertaken an aggressive treatment campaign. Bottled water has been distributed to 37,000 people, community wells capable of serving 15,000 people have been built, 820,000 packets of rehydration salts are being given out and 3.1 million water treatment tablets will reach households across the country. Some schools have even delayed the beginning of classes for at least a month.

As with most humanitarian missions, the fight against Cholera outbreaks in Iraq is being hampered by a limited budget. If UNICEF is to continue supporting the Iraqi government, a $12.7 million funding gap will need to be filled. For the most vulnerable patients, this funding will mean life or death.

Ron Minard

Sources: WHO, Reuters, UN, UNICEF

Photo: Islamic Relief, Pixabay

meningitis_A_vaccineA new report published in Clinical Infectious Diseases suggests that meningitis A is nearly eliminated in Africa.

We can thank a vaccine developed only five years ago. It was produced to help curb meningitis A, a strain that only impacts Africa.

The need to create the vaccine became apparent in 1996 when more than 250,000 people became infected with the disease and 25,000 people died.

While meningitis can be fatal, prevention is possible. Brown University estimates that a simple vaccination can prevent up to 70 percent of meningitis bacteria strains.

However, for those living in impoverished conditions, accessing life-saving medications may not always be possible. In 2010, the United Nations reported that approximately 28 million people in sub-Saharan Africa lived on less than $1.25 per day.

The meningitis epidemic prompted action from African health ministers. Answering that call was the Serum Institute of India, which produced a low-cost vaccine that only costs 50 cents a dose.

The vaccine was made possible in large part to the generosity of the Bill and Melinda Gates Foundation that provided $70 million to initiate its development.meningitis_A_vaccine

“The disease is highly feared on the continent; it can kill or cause severe brain damage within hours,” the World Health Organization (WHO) said.

“But just 5 years after an affordable meningitis A vaccine was introduced, its use has led to the control and near elimination of the deadly meningitis A disease in the African ‘meningitis belt’ stretching across the continent from Senegal to Ethiopia.”

The success of the vaccine is incredible. In 2013, WHO revealed that there were only four laboratory-confirmed cases across the 26 countries in Africa’s “meningitis belt.”

“We have nearly eliminated meningitis A epidemics from Africa, but the fact is the job is not yet done,” said Dr. Jean-Marie Okwo-Bele, WHO’s director of Immunization, Vaccines and Biologicals. “Our dramatic gains against meningitis A through mass vaccination campaign will be jeopardized unless countries maintain a high level of protection by incorporating the meningitis A vaccine into their routine childhood immunization schedules.”

The vaccine does more than prevent the deadly meningitis A strain. A WHO study suggests “90 percent of people who received the vaccine still have the antibodies 5 years later.” Additionally, an added benefit is a protective boost against tetanus.

According to the WHO, more than 237 million people across 16 countries have been treated. However, 10 additional countries still need to implement the vaccination.

Alyson Atondo

Sources: UN 1, Columbia University, University of Minnesota Twin Cities, UN 2
Photo: Flickr, Pixabay