Posts

Measles in Bulgaria
Though the increased distribution of vaccines has nearly eradicated measles around the world, countries have recently seen returning outbreaks. Bulgaria’s outbreak is one of the worst. However, the nation is working to control the measles outbreak with the help of vaccinations and strict government procedures. Here are the top 7 facts about measles in Bulgaria.

7 Facts About Measles in Bulgaria

  1. Between 2009 and 2011, Bulgaria faced a sizable measles outbreak after not reporting any cases since 2001. This outbreak was the largest in Bulgaria since 1992. All regions in Bulgaria were affected and a total of 24,364 cases were reported during this time.
  2. The Ministry of Health (MoH) and the Bulgarian National Programme for the Elimination of Measles and Congenital Rubella Infection managed the outbreak well. Both teams contacted physicians who reached out to families and educated them on the importance of timely vaccinations. These teams also advised the hospitalization of patients with measles to avoid spreading the disease to the community.
  3. Following the outbreak, the MoH distributed information about measles prevention to the national media. MoH also distributed educational materials on measles to all Bulgarians. These efforts made families in remote areas aware of the vaccinations their children should receive.
  4. Bulgaria’s measles vaccine was introduced in 1969, and the second dose was introduced in 1983. Between 2003 and 2008, more than 94 percent of the Bulgarian population had received the first dose, and more than 89 percent had received the second. Following the 2009 outbreak, health officials distributed the vaccine to those aged 13 months to 20 years who had not yet received the two doses. It also became available to those over the age of 30 who were in need of it.
  5. Children that have parents with low education levels have less access to vaccinations. This was found by a study performed by the European Journal of Public Health. Although Bulgaria has consistent access to measles vaccinations, the education level of parents appears to have an impact on vaccination access. In a survey of 206 Bulgarians from the region of Burgas, the mean number of years of education mothers completed was 5.20, while fathers on average completed 7.02. 40.8 percent of children surveyed had no measles vaccination, 45.1 percent received a single dose and only 12.1 percent received a second dose.
  6. Along with other standard, up-to-date vaccinations, measles vaccines are required by the CDC for all travelers visiting Bulgaria. This measure is to protect not only the traveler but also vulnerable Bulgarians. It also helps ensure that measles does not make its way to other countries.
  7. Bulgarians are required to notify health officials if they have measles. The Regional Inspection for Prevention and Control of Public Health (RIPCPH) and the National Center for Infectious and Parasitic Diseases (NCIPD) are then notified. The sooner individuals report cases, the sooner national health organizations can prevent outbreaks. Health officials also proactively study the demographics of measles patients to figure out where the disease came from and other risk factors.

Though Bulgaria’s recent measles outbreaks are distressing, the country has worked hard to protect as many people as possible. Additional efforts are aimed towards preparedness for the possibility of future outbreaks of measles in Bulgaria. With an increase in vaccines and a focus on the disease by medical professionals, Bulgaria will be able to keep measles under control.

– Alyson Kaufman
Photo: Pexels

Health Crisis in Venezuela

The extreme shortage of medicine and medical supplies in Venezuela has forced many people to seek refuge in neighboring countries in the hopes of getting the medical care that they need. More than three million Venezuelans have fled the country and the number continues to rise. With the continued lack of aid and action from the government, Venezuela’s health crisis shows no signs of disappearing. These are six facts about the health crisis in Venezuela.

6 Facts About the Health Care Crisis in Venezuela

  1. Because of the lack of available vaccinations, preventable diseases such as measles and diphtheria are spreading throughout the country. The Center for Disease Control and Prevention reported that diphtheria had not been reported in Venezuela for 24 years until 2016. Measles had not been seen since 2007. Unfortunately, these diseases are once again affecting the citizens of Venezuela. As of 2018, there have been 2,170 suspected cases of diphtheria with 1,249 being confirmed. There have been reports of 287 deaths due to this preventable disease. Out of the 7,524 cases of measles that had been suspected between 2017 and 2018, 6,252 were confirmed. At least 75 people have died from measles as of 2019. The toll of these diseases could have been prevented if the people of Venezuela had the vaccinations that they needed.
  2. In 2018, the Joint United Nations Programme on HIV/AIDS and the Venezuelan Ministry of Health noted that new cases of HIV had increased by 24 percent. Between 2010 and 2016, deaths due to AIDS increased by 38 percent. In addition, around “87 percent of the 79,000 registered individuals living with HIV” do have antiretroviral treatment because of the shortage of medicine in the country.
  3. Cases of malaria have increased by 76 percent. There were 240,613 reported cases of malaria in 2016 in Venezuela. In 2017, that number increased to 406,000 cases, the largest increase worldwide. WHO estimated 280 deaths due to the disease in 2016. Venezuelans fleeing the country to Colombia and Brazil are taking the disease with them and escalating the spread. The United Nations agency is urging those countries who are hosting Venezuelan refugees “to provide free screening and treatment regardless of their legal status to avoid further spread.” Because so many Venezuelans are fleeing, these diseases are reaching neighboring countries as well. The re-introduction of measles in Manaus, Brazil resulted in 1,631 cases as of November 2018.
  4. Expecting mothers are unable to receive the prenatal medication they need. Many are forced to have unsafe labors. According to a 2017 report by the Venezuelan Ministry of Health, infant mortality has increased by 30 percent and maternal mortality has increased by 65 percent.
  5. Although these neighboring countries are trying their best to provide aid to the people of Venezuela, their healthcare systems are also taking a toll. Many HIV-positive immigrants have reached Brazil only to find that local hospitals were already overwhelmed with AIDS patients dying from infection. Colombia is currently hosting the largest number of Venezuelan immigrants with an estimated one million as of November 2018. Public hospitals are struggling to accommodate refugee health care needs such as vaccinations and emergency services.
  6. The current government of Venezuela has not publicly recognized the crisis among its people, and therefore they are not allowing international relief agencies to enter the country. In Colombia, a huge supply of medicine and supplies from the United States waits to cross the border. Unfortunately, the current president of Venezuela won’t allow the supplies into the country. Colombia has organized many events to help raise money to aid their Venezuelan neighbors. A relief concert called Venezuela Aid Live was held in Colombia on February 22, 2019, to support and bring awareness to the crisis in Venezuela. In four days, the organization was able to raise almost $2.4 million. They plan to do the same next year to continue bringing awareness and aid to the people of Venezuela.

Despite Colombia’s struggle to accommodate refugees, the country is providing limited healthcare to Venezuelans who desperately need it. “In May 2017, the Colombian government declared that all public hospitals must provide free emergency” treatment for Venezuelan patients, which includes treatments for malaria and measles. Between 2017 and 2019, 29,000 pregnant women were able to safely deliver their babies in Colombia free of charge. This also means that their children will be getting free vaccinations plus a promise of healthcare due to their Colombia citizenship. Since 2017, Colombia has provided healthcare services to 340,000 Venezuelan immigrants.

Venezuela’s government officials still have a lot of work to do to help its own people, but thanks to countries like Colombia and Brazil, Venezuelans seeking medical treatment are able to get some assistance. Providing this healthcare, although straining, has made a difference to the three million Venezuelans who had no choice but to flee their country. Through this continued support and care, at least some of the health crisis in Venezuela can be alleviated.

Jannette Aguirre
Photo: Flickr

Life expectancy in Papua New Guinea

Papua New Guinea (PNG) is a country known for its natural beauty, from Mount Wilhelm, the highest mountain in the country, to the cuscus, a marsupial that roams its rainforests. When it comes to its people, the government has made strides to improve life expectancy with life expectancy at birth totaling 64 years as of 2017 compared to only 39 years in 1960. Still, life expectancy in Papua New Guinea falls far below the global average of 72 years.

Here is a look at the factors that influence life expectancy in the country as well as efforts to further improve longevity in PNG.

Country Cooperation Strategy

The World Health Organization (WHO) launched the Country Cooperation Strategy (CCS) in 2016 to improve health facilities and access to health care in a country that is mainly rural. The CCS aims to tackle many issues that are standing in the way of attaining sustainable health outcomes for PNG citizens:

  • User fees: User fees refer to the cost of medical services, drugs and entrance fees when seeing a health care provider. In countries where the majority of the population lives in poverty, user fees serve as barriers to health care services for those who may need it the most. One of the goals of the CCS is to eliminate these fees so that that the poor will have equal access to services that are essential for good health.
  • Vaccinations: Better access to vaccinations is another way the CCS plans to ensure that the life expectancy in Papua New Guinea increases. To that end, the country’s National Department of Health, in coordination with the WHO and UNICEF started a three-week campaign in June 2019 with the goal of vaccinating 1 million children against measles-rubella and polio. As Prime Minister Marape stressed in an address to parents at the launch: “We must make Papua New Guinea polio-free again.”
  • Newborn and Maternal Health: PNG has one of the highest mortality rates in the world. The main cause of mortality in mothers is exposure to infections and high blood pressure, which can interfere with kidney and liver function and also cause anemia. Infant mortality is mainly caused by infection and asphyxia. By providing more supervision during deliveries and by promoting community-based support through non-governmental organizations, the CCS plans to change this. Care for mothers and newborns will be addressed in the CCS with a focus on support for mothers before, during and after birth.
  • Health Care Providers: A lack of health care providers is a large problem affecting life expectancy in Papua New Guinea because there are not enough doctors to care for the sick people in the country. In 2009, there were only 330 doctors nationwide for a country of 8 million. The CCS plans to work with the government to increase access to education and create better facilities for learning for those who wish to pursue careers in the medical field, therefore increasing the number of doctors.

Other Factors Affecting Life Expectancy in PNG

  • Natural Disasters: PNG is in an area that is susceptible to natural disasters and the CCS plans on implementing new strategies for dealing with these kinds of events when they occur. After a 7.5 magnitude earthquake in PNG in 2018, the death toll was estimated to be 145 and about 270,000 people needed aid. Be it a volcanic eruption, earthquake or drought, the CCS wants to make sure that the people of PNG are ready for these disasters when they inevitably occur. More surveillance of these natural occurrences and emergency planning is necessary to make sure the country is secure in case of a natural disaster.

  • Tuberculosis: Protection against epidemics is another issue affecting the life expectancy in Papua New Guinea, malaria and tuberculosis (TB) being two of the most pressing. In 2017, there were 27,935 cases of tuberculosis. The WHO plans to investigate the causes of outbreaks by identifying TB early on and reducing the transmission of the disease. The WHO also plans to strengthen training programs that deal with treating conditions like these.

– Joslin Hughson and Kim Thelwell
Photo: Pixabay

Hepatitis B in Sierra Leone

The Hepatitis B virus (HBV) is the leading cause of liver disease. An estimated 248 million people are infected with the virus worldwide. HBV contributes to 600 thousand liver disease-related deaths a year. It is most prevalent in the Western Pacific with 6.2 percent infection rate and African regions with 6.1 percent of the population are infected. Instances of Hepatitis B in Sierra Leone are high, so the government is working to improve access to vaccinations.

Hepatitis B in Sierra Leone

Sierra Leone suffers an especially high prevalence of Hepatitis B. An estimated 8 percent of the population is actively infected, and 6-11 percent of mothers risk passing the disease onto their children through birth. HBV is most often transmitted via childbirth. It can also be transmitted through exposure to infected blood. In highly endemic areas, this occurs most often before age five. Adults can become infected through exposure to any infected body fluids, including through sexual activity.

Typically, the older an individual is at the time of exposure, the less likely the disease is to become chronic. However, children under a year old are 80 to 90 percent likely to develop chronic HBV if exposed, 30 to 50 percent before age 5 and fewer than 5 percent in adults. There is no cure for the disease, which often manifests without symptoms at initial infection. However, those suffering from it can suppress the virus through life-long treatment.

However, the HBV vaccine is 98 to 100 percent effective and has been shown to significantly decrease a country’s HBV prevalence when systematically administered. Sierra Leone has made a push toward improving its national health through international efforts. Though it is limited in its own resources, the country has facilitated “free testing, treatment and counseling” provided through the help of international donors.

Efforts to Reduce Hepatitis B in Sierra Leone

In 2014, the African Regional Committee of the World Health Organization passed a resolution to reduce HBV prevalence in children under 5 years old by 2020 to less than 2 percent. In 2007, Sierra Leone introduced HBV in the vaccine to newborns at week 6, 10 and 14, but the WHO recommended birth dose was not being given.

Much of the efforts on studying hepatitis B in Sierra Leone have been focused on providing accurate information on its epidemiology. The Center for Disease Control conducted a survey measuring the frequency of mother-child transmission and the effectiveness of the current immunization program. Data recently collected on 3,158 households in three provinces of Sierra Leone. Over the course of six weeks, 551 samples of serum were collected

This information will be used to inform Sierra Leone’s Ministry of Health and Sanitation on the success rate of the vaccination campaign. It will show how well the WHO recommended birth-dose works in reducing Hepatitis B. The research also compares Sierra Leone’s mother-to-child infection rate with that of other African countries with similar strains of the virus. The information is expected to be released by the end of 2019.

Areas to Improve

There are still many areas to cover. While the country focuses on expanding the vaccination program, there have been little effort put towards the prevention of adult to adult transmission. Some studies have shown that many healthcare workers lack adequate knowledge of the disease. At least 77 percent of healthcare staff were unable to recognizing clinical symptoms following infection. These areas need to be addressed in order to effectively reduce tranmission of the virus.

Still, the country has made massive strides in improving its HIV and malaria treatments in the past. Now, it must focus treatment on Hepatitis B in Sierra Leone. Education and vaccinations are essential to reducing the spread of the disease.

Katie Hwang
Photo: Flickr

Ebola in the Democratic Republic of the Congo

In August of 2018 the Democratic Republic of Congo declared an Ebola outbreak. The first case of the virus erupted in the city of Goma, located on the border of Rwanda. As the tenth Ebola outbreak in Congo within 40 years, the virus became a public health concern for the over 1 million people that call Goma home. Goma also acts as a popular transit hub for many people crossing the border into Rwanda putting the population at a heightened risk for the disease to spread. The International Health Regulations Emergency Committee has met four times following this initial Ebola case.

  1. A Widespread Disease: Congo’s ongoing Ebola outbreak is now the world’s second-largest. According to The World Health Organization (WHO), the virus has infected 2,512 people and killed 1,676. The largest Ebola outbreak on record took place in West Africa killing more than 11,300 people. WHO continues its efforts to stop the spread of the disease in Congo with its team of medical specialists. In the worst cases, death and uncontrollable bleeding have resulted from the viral hemorrhagic fevers of the disease.
  2. A Global Issue: On July 17, 2019 the World Health Organization (WHO) declared the Ebola outbreak in Congo a global health emergency. Following the first case of Ebola, intensive training for the prevention and control of the virus heightened for more than six months. News of a female traveller from Beni that contracted the virus, and then visited Uganda sparked growing concern in Uganda and Congo. Between June and July of 2019 an estimated 245 confirmed cases of Ebola were reported in the North Kivu and Ituri provinces of Congo. WHO makes the continuous effort to monitor the cases of those infected, as well as travel and trade measures in relation to the virus.
  3. Dangerous Territory: The Ebola response teams in the Democratic Republic of Congo face violent attacks. David Gressley, the United Nations’ secretary-general, became the deputy of the U.N. missions in Congo and witnessed it firsthand. Gressley requested a force of peacekeepers along with the health officials to assist him amid the attacks. The violent attacks often hinder the Ebola responders from treating people with the virus, and still no one knows the reasoning or people behind the attacks. The U.N. estimates that due to the attacks about 1,200 have been shot or slashed to death with machetes. One popular theory points to Congolese politicians orchestrating the attacks in order to undermine political rivals. On the other hand, the Congolese government blames the Mai Mai militia. Rumors continue to swirl that the U.N. responders fail to treat Ebola patients, and intentionally spread the virus which makes them even more susceptible to these attacks.
  4. Catching Ebola: Common diseases such as measles and malaria share initial symptoms of Ebola. Many medical specialists in Congo believe that to put a stop to this epidemic they first must isolate the disease. Most Ebola patients receive a diagnosis too late, and go through multiple health facilities before getting treatment. Response teams understand that controlling the transmission of Ebola, and catching the disease in its early stages has the potential to save an entire community.
  5. The Ebola Vaccination: More than 111,000 people have received the Ebola vaccination. Developed by Canadian scientists, the Ebola vaccine (also known as the rVSV-ZEBOV vaccine) consists of an animal virus that can wear a non-lethal Ebola virus protein, which results in the human immune system developing a pre-emotive defense to the disease. Health care professionals, and family members of Ebola patients are the majority of those vaccinated. Health care responders in Congo ensure that all the contacts of Ebola patients receive a vaccine to stop the epidemic. Reports show no deaths from individuals that developed Ebola symptoms more than 10 days after receiving the vaccination.
  6. Promoting a Disease-Free Environment: Medecins Sans Frontieres/Doctors Without Borders (MSF) promotes healthcare and community engagement in Congo. This organization sends teams to determine and assist the medical needs of populations in crisis with exclusion from healthcare. Among the Ebola outbreak in Congo, MSF continues to provide free healthcare for non-Ebola needs, such as malaria and urinary tract infections. First starting in the city Goma, the MSF has now shifted aid to the Ituri province to limit infections with sanitation activities, and provide access to clean water.

These six facts about the Ebola outbreak in Congo demonstrate global organization’s enthusiasm to assemble in times of crisis. Countless organizations continue to lend support to the Democratic Republic of Congo, and in due time the country will be at its best with a healthy population.

– Nia Coleman
Photo: Flickr

All You Need to Know About HPV in the Developing World
Human papillomaviruses (HPV) are DNA viruses that infect skin or mucosal cells. Depending on the severity of the infection, HPV can lead to either cervical cancer and other head and neck cancers or low-grade cervical tissue changes and genital warts. Virtually all cervical cancer cases result from a sexually transmitted infection with HPV.

Cervical Cancer and HPV in the Developing World

Globally, cervical cancer is known as the second most common cancer among women, with about 500,000 new cases being diagnosed annually. Of the total deaths that occur due to cervical cancer each year, more than 80 percent are concentrated in developing countries.

Immunization coupled with regular screenings and consistent treatments are the best strategies for reducing the burden of cervical cancer and HPV in the developing world. In resource-poor countries that lack adequate access to cancer screenings and treatment services, it is even more essential that younger girls be immunized before they are sexually active and are exposed to HPV.

The HPV Vaccine

The HPV vaccine protects against the strains that cause up to 90 percent of cervical cancer cases. It is typically available in most routine immunization programs of high-income countries. Historically, the major barriers to reducing the burden of cervical cancer and HPV in the developing world are due to the high costs of the HPV vaccines and the difficulty of reaching adolescent girls.

The GAVI Alliance–formally known as the Global Alliance for Vaccines and Immunization–is a partnership of national governments, the World Health Organization (WHO), the World Bank Group, the Bill and Melinda Gates Foundation, the vaccine industry and many public health institutions. GAVI provides technical and financial support for vaccines in countries that have a gross national income of less than $1,000 per capita and other poverty-stricken countries including China, India and Indonesia.

Thanks to the efforts of GAVI, the HPV vaccine is at a record low price and the poorest countries are able to access it for as little as $4.50 per dose. Additionally, the WHO decided to change the recommended dosage of the HPV vaccine from three to two doses, which helped facilitate the country rollout of the vaccine as well as significantly reducing costs.

The first HPV vaccine demonstration program took place in Kenya in 2013, and since then, 1,000,000 girls have been vaccinated. By the end of 2016, GAVI had initiated HPV vaccine demonstration programs in 23 countries, which is the first step toward introducing the vaccine to national immunization programs. So far, Honduras, Rwanda and Uganda have introduced the HPV vaccine into their national immunization programs.

Potential Roadblocks in the Push for the HPV Vaccine

Unfortunately, the transition from the demonstration programs to national introductions is taking longer than expected for some countries. Consequently, GAVI has developed a new approach to HPV vaccine support, which draws from the valuable lessons learned from previous demonstration programs.

Some of these lessons include:

  1. The fact that school-based delivery works very well when administering the vaccine to young girls. It is more cost effective to integrate HPV immunization efforts into routine immunizations at existing health clinics and schools.
  2. When promoting HPV vaccination programs and cervical cancer prevention, the facilitation of effective and factual communication within the community is particularly critical.
  3. GAVI has made tremendous progress in reducing the prevalence of HPV in the developing world through its vaccination initiatives. Eight GAVI-supported countries have integrated the HPV vaccine into their national vaccination programs and 30 countries have started a demonstration program.

However, despite the strong signs of interest from GAVI-eligible countries and the rapid and effective integration of the HPV vaccine, GAVI’s original goal of immunizing 40,000,000 girls by 2020 may be at risk due to supply constraints.

GAVI chief executive Dr. Seth Berkley stated, “Scaling up cervical cancer prevention and control strategies should not be delayed, as we have the tools to achieve this goal. With the right commitment from vaccine manufacturers as well as political support, strategic partnerships and investments, this particular battle to improve women’s health can be won.”

Thus far, GAVI has helped low-income countries access the HPV vaccine at affordable and sustainable prices. Dr. Berkley is confident that the organization is capable of meeting its goal. GAVI is dedicated to ensuring that its progress is maintained and that millions of girls in the poorest of countries are protected from the perils of HPV and cervical cancer.

– Lolontika Hoque
Photo: Flickr

GaviThe Global Alliance for Vaccines and Immunization (Gavi) is a global organization whose goal is to create equal access to vaccines for children living in the word’s poorest countries. Gavi’s new country portal makes it easier for countries to apply for, report on, renew support and keep track of collaboration to make vaccines work and protect people’s health.

Documents are accessible for updates at any time, proving convenient for managing and viewing the latest information with partners.

Gavi’s New Country Portal

Before the creation of Gavi’s new country portal, processing important information between certain health ministries, representatives and vaccine manufacturers could take up to 13 months. “With the Country Portal, we expect to improve this time by 25 percent by 2017. This means we can get life-saving vaccines to children faster,” explains David Nix, Gavi’s Chief Knowledge Officer.

Equally helpful, the portal is user-friendly with guidelines in English, French, Spanish and Russian, the main languages of Gavi-supported countries, making the application process for vaccines much more efficient.

There is great value in vaccination; regular vaccines protect people’s overall health, as well as their incomes and savings. Healthier communities play a large role in promoting economic growth, saving up to $6 billion on health treatment costs.

Children and Vaccination

Children who avoid getting sick do better in school because they are able to attend, understand concepts and perform well on assessments, all of which contribute to better employment in the future. It goes without saying that more often than not, preventing diseases is a lot easier than treating them and spares individuals any additional struggles.

In the past, the cost of vaccines and immunizations has been a hindrance to millions of children living in poorer countries. New life-saving vaccines failed to reach children in developing countries where they were needed the most.

In January 2000, the Bill & Melinda Gates Foundation’s $750 million five-year pledge funded Gavi as a new approach to the global problem. Gavi’s public-private partnership brings together UN agencies and governments to improve childhood immunization coverage and make vaccines more affordable globally.

An Organization Making Change

Gavi has already produced remarkable results. By 2015, the development model served 500 million additional children since its creation and prevented more than seven million deaths. Between 2016 and 2020, Gavi sets to extend care to an additional 300 million children.

Gavi’s new country portal and humanitarian approach have yielded effective methods for improving global health and providing assistance to the world’s poor. The hope is that as the number of vaccinated children increases, the rate of disease will significantly decline.

Mikaela Frigillana

Photo: Flickr

Task Force for Global Health

Beginning in 1984 as the Task Force for Child Survival, the Task Force for Global Health started as a leading secretariat for various international health organizations such as UNICEF, The Rockefeller Foundation, and the World Bank. The Task Force worked alongside these global health organizations to design and improve effective child and family wellness, healthcare and survival strategies.

Thirty years later, the Task Force for Global Health has grown into a global nonprofit organization for public health. According to Forbes Magazine, the Task Force is the fourth largest nonprofit in the U.S. Headquartered in Decatur, Georgia, and under the leadership of public health expert Dr. Mark Rosenberg since 1999, the organization stands as the biggest nonprofit in Georgia since its expansion in 2013.

The Task Force focuses on three major areas: improving the efficiency of public health systems and field epidemiology, providing accessible treatment of immunizations and vaccines and eradicating neglected tropical diseases.

However, despite the Task Force’s incredible reputation and longstanding credentials, it remains largely unknown to a majority of the world. In an interview conducted by Georgia Center for Nonprofits’ (GCN) quarterly magazine, Georgia Nonprofit NOW, Rosenberg explains that keeping the Task Force under wraps was not only an intentional but effective strategy.

Rosenberg told GCN, “From the beginning, we have always tried to build coalitions, but it’s not always easy to get organizations to work together. If you want a partnership to work, our founder Bill Foege taught us, you’ve got to shine the light on your partners, and not on yourselves. We focus attention on our partners, and as a result, we are not well known in Georgia.”

The Task Force’s decision to maintain a low-key profile has resulted in high effectivity, not only as a major collaborator to some of the world’s most well-known nonprofit organizations but also as a large scale mobilizer towards peace and health care reform.

The Task Force for Global Health has managed to cover an incredible amount of ground in improving healthcare and offering accessible vaccinations and treatments to approximately 495 million people in 149 countries. The organization provides support and professional level healthcare training programs in 43 countries around the world, which results in widespread, efficient and accessible health care globally. Having formed strong partnerships with private and public healthcare providers and programs worldwide, the Task Force for Global Health has and continues to succeed in bringing about incredible reform and is changing the lives of millions of people every day.

Jenna Salisbury

Rabies outbreaks in poor rural areas
Rabies occurs in more than 150 countries in the world. The disease is present on all continents with the exception of Antarctica. Each year, tens of thousands of people die from the infection it causes.

Most of the areas that are affected are in Asia and Africa and account for over 95% of human rabies deaths. The disease occurs mainly in remote rural communities. Rabies outbreaks are rampant among impoverished and vulnerable populations.

Rabies is a zoonotic disease. It is caused by a virus that allows the disease to be transmitted to humans from animals. The disease may affect domestic and wild animals, known carriers include foxes, raccoons, skunks, jackals, mongooses and other wild carnivore host species. However, dogs are the primary sources of human rabies deaths. Rabies is spread to people through close contact with an infectious substance such as bites, saliva or scratches. Most people usually become infected after a deep bite or scratch by an infected animal. Upon the onset of the disease developing, the disease is nearly always fatal.

Prevalence in rural areas is due to the lack of vaccinations. There is low vaccination coverage of dogs, and an inability to finance the costs of vaccination for humans. Other factors include poor management of dogs, and in particular the free movement of dogs, which increases their risk of contracting rabies from wildlife.

In terms of policy, rabies is lacking policy formulations to combat rabies throughout developing countries. As a result of the poor level of political commitment and effort to control rabies, there is a lack of understanding of how rabies impacts public health and socioeconomic affairs.

Rabies is a vaccine-preventable viral disease. Each year over 14 million people receive a post-exposure vaccination to prevent the disease. This vaccination prevents hundreds of thousands of rabies deaths. Other strategies to control the disease consist of controlling the dog population, vaccinating domesticated animals and education about prevention to reduce the number of animal bites. After a bite, immediately cleaning the wound, and immunization within a few hours after contact with the animal can prevent the onset of rabies.

The World Health Organization promotes human rabies prevention through the elimination of rabies in dogs. Their target is for the elimination of human and dog rabies in all Latin American countries by 2015, and South-East Asia by 2020.

Erika Wright

Sources: Iowa State University, International Journal of Infectious Diseases, NIH, WHO
Photo: CNN

Vaccine
In developing nations across the globe, the challenges of distributing vaccines remain a huge roadblock in eradicating diseases that many other parts of the world have already eliminated. The lack of adequate medical centers, lack of access to clinics and lack of stock make vaccinations a tricky and almost impossible task to make universal. Amongst these challenges is the challenge of keeping the vaccines viable in often-harsh climates with a lack of adequate preservation technology available.

Vaccines, to maintain their viability and ensure proper vaccination, often need to be kept cold, a task that increases in difficulty with the combination of high temperatures and inadequate access to electricity. While scientists continue to work on creating cost-effective thermostable vaccines that would facilitate widespread distribution in areas where keeping the vials cold is a challenge, a study conducted by Devex reveals that there might be other options for the interim.

The study found that improving cold and supply chains is a more direct and cost-effective way to directly improve vaccine viability and thus more effective distribution, at least for right now. Devex has formulated a set of guidelines as follows:

1. Define the full range of thermostability of existing vaccines — By defining this range and making it easily accessible and viewable to people distributing the vaccines, they have clearer guidelines to focus on and can be more careful about making sure that the vaccines they administer have not been altered due to excessive change in temperature.

2. Set thermostability goals — This means that for newer vaccines being developed, a goal of heat stability or freeze protection can be incorporated into the development.

3. Focus on improving cold chain infrastructure and supply chain system design — This goal in particular is more of a short-term, direct impact step towards keeping system costs and coverage low and also towards setting a standard of thermostability for the future.

4. Keep monitoring for innovative technologies — For long-term progress in vaccine accessibility and effectiveness, this goal is immensely important. Technology is ever changing and new ideas should be frequently welcomed and tested to ensure that if there is a way to improve vaccine distribution, it is being done.

One of the advantages of these guidelines is that they are aimed at nearly every step of the process, from development to post-implementation monitoring. As companies and programs embrace these goals and incorporate them into their own plans of action, they are making progressive steps towards bridging public health inequities, particularly in vaccinations. While the World Health Organization has recently made tremendous strides in enacting governmental programs to ensure regular vaccination of children, even more progress can be made by targeting the distribution level of vaccination. The implementation of programs and continued technological innovation is a winning combination for achieving universal vaccination, but can also serve as a model for other public health initiatives.

Emma Dowd

Sources: Devex, Infection Control Today
Photo: City of Hope