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All You Need to Know About HPV in the Developing WorldHuman 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

Gavi
The 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 Change-maker Organization

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 increase, the rate of disease will significantly decline.

Mikaela Frigillana

Photo: Flickr

Task Force for Global HealthBeginning 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 percent 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 cause by a virus which 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 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 the rural areas is due to the lack of vaccinations. There is low vaccination coverage of dogs, and 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 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 an 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

Bill Gates Epidemics

Bill Gates believes that the Ebola epidemic—which has killed 10,000 people around the world—might be minuscule in comparison to the impact of a future disease. If the world does not put a focus on diseases and prevention, Gates argues, the next virus that breaks out could affect even more people. “Next time we might not be so lucky,” Gates said at TED on March 15, 2015.

Gates  supported his TED speech with an opinion piece written for The New York Times and a paper written for The New England Journal of Medicine. Also supporting his argument was an African hospital simulation set up at the venue of his TED talk. Those who participated in the recreated experiment had to experience the difficulties of being a healthcare worker treating Ebola patients, including distributing “medicine” to “patients” in protective suits that proved hard to move around in.

Gates thinks that the fight against viral diseases should be like fighting a war, citing a time as a child when he considered nuclear weapons to be the biggest threat to the earth.  Now, he says, we need to “fight not missiles but microbes.”

“This should absolutely be a priority,” Gates said. “We need to get going because time is not on our side.” Gates says that the world’s governments should consider spending more money on disease prevention as an epidemic is “by far the most likely” thing that could kill more than 10 million people. It has happened before, with the 1918 Spanish flu killing 33.3 million people in just the duration of one year.

Gates has some ideas on preventing this from happening again, including “strengthening poor countries’ health systems” and “investing in disease surveillance.”

“To begin with, most poor countries, where a natural epidemic is most likely to start, have no systematic disease surveillance in place,” Gates points out in his New York Times op-ed piece. With the Ebola epidemic, he argues, “trained personnel should have flooded the affected countries within days. Instead it took months.” If the world does not learn from mistakes of the past, we could be in for a dangerous future.

Melissa Binns

Sources: Fortune,  NYT,  Recode

Photo: Panteres

Bill_and_Melinda_Gates
It has been 15 years since Bill and Melinda Gates started the Gates Foundation, and the couple has made a big bet for the next decade-and-a-half: the lives of people in poor countries will improve faster in the next 15 years than any other time in history.

The Gates’ annual letter was released on Wednesday, Jan. 21, 2015, on the foundation’s blog. The Gates’ are focusing on wiping out diseases, reducing poverty, and improving education. The letter is broken down into four sub-categories of the overall “bet.”

Child Deaths Will Be Cut In Half

The leading cause of death for children under 5 is disease. Unsanitary living conditions and a lack of vaccines kill one in 20 children, and the Gates hope to see a decrease by at least 50 percent by 2030. All countries will add vaccines for pneumonia, diarrhea, malaria and measles to their individual immunization programs. Better sanitation will also contribute to the decrease in disease. In addition to providing vaccinations, the Gates Foundation plans to help mothers adopt new practices, such as proper breastfeeding and skin-to-skin contact with newborns.

Africa Will Be Able to Feed Itself

Although seven out of 10 people in sub-Saharan Africa are farmers, many farms do not yield the benefits of their counterparts in the developed world. Many parts of Africa currently rely on food aid and imports from outside sources to feed their people. Innovations in farming can provide farmers with better fertilizers and a surplus in crops, allowing farmers to farm more food. As technology expands and becomes more easily available, communications with farmers in remote areas will become possible and business will increase. In the next 15 years, Africa will be able to export more than it receives in imports, creating a balanced economy.

Mobile Banking Will Transform Banking

Digital banking can give the poor easy access and control of their assets. Approximately 2.5 billion people don’t have access to cheap and easy financial services, and for many people, their savings is in the form of jewelry or livestock; it is very difficult to cover daily expenses. To be able to use a mobile phone to take care of finances makes it much easier to purchase and save money. Mobile banking is expected to expand and cover a wide range of financial services, such as interest-bearing savings accounts to credit and insurance.

Online Education

Smartphones and software will become more available to African families that can provide more access to education. In remote areas where schools are hours away or students must be of a certain age to attend, it is essential to provide education as early as possible. As more children are exposed to education earlier in life, they are set down a path that leads to success in all areas of life. Online education can be crucial in countries where gender gaps are wide and girls can’t go to school or start a business. Countries that stay behind in education will eventually be left behind.

Alaina Grote

Sources: CNN, NPR, Youtube
Photo: Computer Business Review

The World's First Hookworm Vaccine
One-third of children and women living below the World Bank’s poverty line are infected with hookworm today, which often causes moderate to severe anemia. Hookworm and other Neglected Tropical Diseases, or NTDs, disproportionately affect the poorer Islamic countries such as Indonesia, Bangladesh, Mali, Nigeria and others in North Africa and the Middle East.

Children and pregnant women are by far the most drastically affected by this disease. Children with long-standing blood loss from hookworm often experience sufficient mental and motor development delays. They can actually lose IQ points as well. These detrimental effects undoubtedly follow them into adulthood, making productivity more difficult.

The blood loss caused by hookworm may affect women in labor, making their chance of death much higher. Additionally, the baby is more likely to be born prematurely or with low birth weight. This makes those babies less likely to survive, contributing to the child mortality rate.

Additionally, the link between hookworms and anemia is a large concern because of its relation to disabilities. Anemia accounted for 8.8 percent of the total disability of the world in 2010. Today, children under 5 years old and women of all ages still hold the heaviest burden.

Fortunately, the Sabin Vaccine Institute’s Product Development Partnership is developing the world’s first hookworm vaccine for human use. The Sabin Institute was established in 2000 with funding from the Bill & Melinda Gates Foundation and is the only Product Development Partnership in the world working to develop a vaccine for human hookworm infections.

The institute is receiving support from the European Commission FP7 program and uniting professionals from around the world to build research. This global consortium has been coined HOOKVAC and includes members from the Netherlands, the United States, Belgium, England, Germany and Gabon. This project aims not only to perfect the manufacturing process of the vaccine, but also to increase and share research on NTDs.

The first clinical testing of the vaccine will take place in Sub-Saharan Africa once it is ready. Gabon’s Lamberene Research Centre will lead clinical testing in adults and children in Gabon, a region plagued with hookworm.

The vaccine is being called the “anti-poverty” vaccine due to its vast potential to lower child mortality rates, save mothers in labor and improve health conditions for agricultural workers, who are the backbone of many poorer economies.

The vaccine, as of now, is intended only for use in the poorest regions of the world, where hookworm thrives. This means that the product will likely not be sold commercially by pharmaceutical companies, but will remain in the nonprofit sector with HOOKVAC.

The project will hopefully conduct trials in the coming years and bring health relief to millions, while contributing to the united fight against global poverty.

– Cambria Arvizo

Sources: Huffington Post, Sabin Vaccine Institute, American Society of Hematology
Photo: The Guardian

Northern_Lebanon
As of May 27, 1,029,779 Syrian refugees were registered and residing in Lebanon, creating a challenging situation in an already unstable country. The Food and Agricultural Organization (FAO,) a United Nations entity that has been active in Lebanon since 1977, is addressing an aspect of food security in agriculture through an on-going livestock vaccination campaign that addresses the needs of Northern Lebanon’s poor and rural farmers.

Since the on-set of the Syrian crisis, the influx of refugees has put a significant strain on the agricultural sector which is working to provide food security to both local people and refugee families.

In addition to the increase in demand for food and decrease in production due to the pressure from the refugee influx, many farmers in the Bekaa Valley in Northern Lebanon have not had adequate access to veterinary services or necessary animal medicine, feed and fertilizer for their livestock.

Bekaa Valley, one of the poorest areas in Lebanon where agriculture generates around 80 percent of local gross domestic product (GDP), hosts around 60 percent of the UNHCR registered refugees. Since most of the low-income families rely heavily on livestock for food security, an outbreak in disease would not only risk the health of the livestock and people, but also their livelihood.

Due to the conflict and the 250-300 cattle and goats crossing from Syria into Lebanon each day, the FAO began a nationwide vaccination campaign targeting Transboundary Animal Diseases (TADs) such as foot & mouth disease, lumpy skin disease and ovine rinderpest. Beginning last summer and running through August 2014, it has been largely successful, reaching 70 percent of the livestock in Lebanon so far.

The program not only works to increase the number of sheep, goats and cattle vaccinated against important diseases, but also provides resources to ensure that livestock is adequately nourished and make sure farmers in communities that are hosting large refugee populations are still able to make a living.

As the on-going refugee crisis in Lebanon threatens to draw 170,000 more people into poverty by the end of 2014, it is important that investments continue to be made to promote agricultural growth, one of the most effective ways in reducing poverty. The FAO’s vaccination campaign is one step in securing the livelihoods of rural farmers in Northern Lebanon against potentially devastating livestock diseases.

– Andrea Blinkhorn

Sources: Daily Star, IRIN News, United Nations, UNHCR 1, UNHCR 2
Photo: Wallsave

shot@Life Provides Vaccinations for Impoverished Nations - BORGEN
The United Nations Foundation [email protected] aims to give everyone the shot they need to live a happy and healthy life.

The [email protected] campaign is almost exactly like it sounds. This campaign works with volunteers to provide much needed vaccinations to the extremely impoverished nations of the world through advocacy and donations.

[email protected] educates, connects and empowers the American people to support vaccines, and vaccinations are one of the most cost-effective ways to save the lives of children in developing countries.

The campaign is basically a national call to action for a worthy global cause. The foundation rallies the American public and members of Congress to help them understand the fact that together they can save a child’s life every 20 seconds just by expanding access to vaccines.

The global foundation encourages the American public to learn about, advocate for and donate to provide vaccines. [email protected] aims to noticeably decrease vaccine-preventable childhood deaths and give every child a shot at a healthy life within the next 10 years.

This campaign began in 1998 as a U.S. public charity by philanthropist Ted Turner. The [email protected] campaign was created in order to build upon the U.N. Foundation’s 13-year legacy in global vaccine efforts as a leading partner in the Measles Initiative and Global Polio Eradication Initiative.

The [email protected] campaign draws on their core abilities through advocacy, community-building and communications in order to raise awareness for their cause.

There are a few causes in which they already have seen excellent success: the campaigns Nothing But Nets and Girl Up.

The Nothing But Nets campaign is dedicated to providing insecticide treated mosquito nets to impoverished peoples in order to prevent the spread of malaria from mosquito bites.

The Girl Up campaign was started in order to provide aid to young girls in poverty-laden nations. This campaign utilizes the help of teenage leaders in order to raise awareness about how young girls are being treated around the world.

[email protected] is also partnered with some of the largest names in fundraising, nonprofits and charities. They have received partnerships from UNICEF, the Bill & Melinda Gates Foundation and The Lions Club, to name a few.

This U.N. Foundation is uniquely positioned with in-house expertise and leadership to successfully bring [email protected] to the awareness of an American audience.

The nonprofit also utilizes social media in participation with news companies and webpages to give a portion of its advertising revenue on each company’s behalf for each like or share an article or blog post receives.

Providing vaccinations to the world’s poor is another huge step in the process to end global poverty. Getting vaccinations mean children will not die from diseases that are preventable such as smallpox, measles, polio and tuberculosis.

More children living into adulthood could potentially slow the birthrates and stabilize the life-expectancy of the people living in African nations as well as extremely impoverished parts of India.

The [email protected] campaign is dedicated to providing peace of mind to all the nations of the world.

– Cara Morgan

Sources: CDC, GirlUp, HuffPost 1, HufFPost 2, NothingButNets, [email protected]
Photo: Children’s Futures