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global_vaccination_programs
When it comes to diseases, it is always preferred to prevent rather than treat. Over the years, vaccinations and immunizations have saved millions of lives and eliminated one of the deadliest diseases in the world: smallpox.

All children are born with an immune system that produces antibodies when a foreign substance, or antigen, is detected. In other words, when the child gets sick, these proteins will not be able to halt the disease from occurring, but the immune system will remember the antigen and give the child immunity when it invades the body a second time.

Vaccines contain those antigens, but in a weaker form. The body will sense an “invader” and still produce antibodies to fight the harmless antigen. Thus, without ever exposing a child to a disease, a vaccination is a safer way to gain protection and produce immunity.

The Centers for Disease Control and Prevention understands the importance of global vaccination programs and has created the Global Immunization Division, which is dedicated to creating a “world without the diseases and deaths that could be prevented with vaccines.”

Worldwide, one in five children do not have access to the most basic vaccines. Consequently, around 1.5 million children die each year from diseases that could be prevented with proper immunizations. By working with a variety of global partners, the CDC has implemented a multitude of routine immunization services and campaigns, in addition to providing bed nets, de-worming medication and safe water systems.

The Bill and Melinda Gates Foundation also invests in global vaccination programs and contributes to the goals of the Decade of Vaccines, an action plan that aims to deliver universal access to immunization. In collaboration with the World Health Organization and other civil society organizations, the foundation is introducing vaccinations into the countries that need it most. They focus on strengthening immunizations systems by supporting the collection and analysis of vaccine-related data, as well as developing new technology to help medical staff “assess population immunity to disease.”

Universal access to vaccinations remains a priority goal for both groups in the next year. Effective vaccination programs saves lives, is inexpensive and easy to administer. Universal availability of vaccines also reduces health inequities, if everyone can have access to life-saving discoveries. Access to vaccines will give all our global citizens a fighting chance to survive.

Leeda Jewayni

Sources: CDC, CDC 2, Bill and Melinda Gates Foundation
Photo: Council on Foreign Relations

cholera
The cholera crisis in South Sudan continues to worsen, as do fears of a probable outbreak in Syrian refugee camps in Iraq. The World Health Organization (WHO) reports that 2,400 people have been infected and 62 have been killed so far. As these numbers rise, the demand for a more comprehensive international response grows. This urgent situation polarizes aid providers into two camps: those advocating for widespread vaccination and those directing their focus toward sanitation.

Cholera is highly contagious and fast-acting. It spreads through bacteria-contaminated food and water, and is most common in places with poor water quality and sanitation. Many at-risk areas lack a widespread and comprehensive strategy for cholera prevention. The effectiveness of vaccines overshadows this issue, especially during time sensitive periods when outbreaks have already begun.

A study by The New England Journal of Medicine about a cholera outbreak in Guinea shows that two doses of a particular vaccine were able to protect people with 86 percent effectiveness.

Doctors Without Borders and the Guinean Ministry of Health were able to vaccinate 75 percent of the affected population, thereby containing the outbreak. Similar results were observed in a larger trial in Kolkata. Another benefit is that the vaccine is inexpensive – at approximately $3 per two doses – making it affordable to patients in vulnerable developing countries.

Successes like those seen in Guinea and Kolkata have encouraged the use of vaccination to control future cholera outbreaks and provide quick, inexpensive protection.

However, vaccines are not always suitable for settings with weak health systems. They require refrigeration – often up to the point of delivery – which, in some areas is impossible. Developing countries often must deal with unreliable electricity, transportation issues, high temperatures and deliveries to remote, rural  communities. Also, it is necessary to mix the vaccine with clean water – a scarce commodity in the poor areas where cholera is most likely to take hold.

Factors such as these have created debates over how best to allocate resources. Instead of spending them solely on vaccines, some argue that resources should be used to develop and strengthen basic water and sanitation infrastructure. Vaccinations, though effective, can only reach a percentage of the population, while proper sanitation benefits all.

Also, vaccinations are often implemented only after an outbreak has begun, rather than as a preventative measure. Water and sewage facilities play a major role in preventing cholera once they have been implemented. The WHO has endorsed the use of re-hydration solutions and antibiotics for the treatment of cholera, rather than advocating for vaccination alone.

Access to clean water and sanitary conditions are necessary to effectively control and eliminate cholera. It may be a challenge to focus on these basic needs when the research behind vaccines is so promising. Though providing better hygiene infrastructure for communities will not only help prevent diseases, but also set the foundation for growth in other areas such as health and development.

It is hopeful that both vaccination and sanitation will be used in tandem to provide a multifaceted, integrated approach to preventing and controlling cholera in the future.

– Mari LeGagnoux

Sources: The Guardian 1, The Guardian 2, New England Journal of Medicine
Photo: The Guardian

waziristan
Shortly after the recent attacks on the Karachi International Airport, the government of Pakistan announced an offensive attack against Taliban militants based in the Waziristan region. This was the first major offensive that the Pakistani government has launched since 2007, when government leaders signed an unofficial non-aggression pact with pro-government militias. The main target for this offensive is the Matchis Camp. The camp was originally set up as a refugee camp for Afghans fleeing the ongoing war in their country, but over the course of time, it eventually turned into a hub for local and foreign militants.

Since the offensive started it has been estimated that at least 350,000 people that live in the region have been displaced. Most of the people are fleeing to the nearby town of Bannu, where only a rudimentary camp has been created so far. Many refugees that have spoken to media outlets have said that they don’t want to go there, largely because the town lacks basic necessities like food, water and sanitation. Local aid organization are doing what they can to help the situation, but the continual influx of people is beginning to strain resources.

Siraj Ahmed, the highest government official in the region, released a statement as the offensive started that strongly urged people to leave the region as soon as they could. However, officials in Pakistan say that approximately 80 percent of the 7 million people living in the Waziristan region, which is in the northern part of the country and borders Afghanistan, still remain there despite the escalation of military strikes and continuous conflict.

One particularly striking aspect of this most recent influx of refugees is that many of the children that are fleeing are at a high risk for infectious diseases. This is thanks to the Taliban imposing a ban on the vaccination of children that lived in the region. While there are many diseases that the children are susceptible of catching, of particular concern is the spreading of polio. Living in a refugee camp, particularly like the one in Bannu, only increases the chance of these children contracting various diseases.

From here the military offensive is only going to get increasingly deadly as more helicopters, soldiers and drones enter the region. The human toll is only going to get worse from here, especially considering the large amount of civilians still in the region, unless aid efforts are increased exponentially.

— Andre Gobbo

Sources: BBC Asia, Reuters, The New Yorker
Photo: Insight on Conflict

Polio_Reemergence_in_middle_east
Diplomacy saves lives. Not only can good foreign relations prevent the outbreak of war and violence between and within countries, but it also allows for the trust and respect necessary for global development initiatives to work.

In 1988 UNICEF and the Rotary Club International joined forces to eradicate polio across the globe. The project was shockingly successful and, as a result, the number of estimated polio cases decreased from 400,000 to 7,000 between 1980 and 1999. The Bill and Melinda Gates Foundation contributed to the cause and helped immunize 2.5 billion young people in 200 countries with the help of almost 200 million volunteers. By 2003 only 784 cases of polio remained on the planet.

Yet as promising as these numbers appear, the goal stated in 1988 was to eliminate polio by the year 2000. This did not happen. In 2003, the number of polio cases dwindling, a conspiracy theory transpired. In a primarily Muslim region of Nigeria, a few imams surmised that the polio vaccine contained sterilizing agents that would make their daughters infertile. The life-saving vaccination was conclusively dubbed to be a CIA plot. As this rumor spread to Afghanistan and Pakistan, groups such as the Taliban spoke out against the previously well-received shot. The number of polio cases in children grew to 2,020 by 2006. In 2008 only Afghanistan, India, Nigeria and Pakistan still had polio circulating through water supplies and infected children.

In 2013 polio cases of the same strain found in Pakistan were discovered in Somalia and Syria. Both countries trained their military’s in Pakistan. Iraq reported its first polio case in 14 years this March 2014, and the United Nations has branded Syria’s climb to 38 reported cases of polio “the most challenging outbreak in the history of polio eradication.” Fears are skyrocketing that the dreadful disease is spreading throughout the Middle East.

Many claim that violence and displacement are primary causes of the setback in Iraq. Polio, an incurable disease, spreads quickly in overcrowded regions prone to poverty and malnourishment. It is preventable, though, and it’s a shame that less than favorable political and ideological relations contributed to its present resurgence.

– Jaclyn Stutz

Sources: Foreign Policy, The Guardian, IRIN
Photo: CNN