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Preventing HIV in Kenya with an Injection

Preventing HIV in KenyaA new, injectable antiretroviral drug, cabotegravir (CAB LA), may have significant potential for preventing HIV among sub-Saharan African women. In November 2020, the World Health Organization (WHO) reported trial results of the HIV Prevention Trials Network Study (HPTN 084), testing the use and effectiveness of CAB LA in preventing HIV among more than 3,200 HIV-negative, sexually active women across east and southern Africa. This drug could significantly lower prevalence rates and help in preventing HIV in Kenya, which has one of the largest HIV/AIDS epidemics in the world.

Cabotegravir or CAB LA

CAB LA, a long-acting pre-exposure prophylaxis (PrEP) regimen, requires an injection only every eight weeks and has been shown to be 89% more effective in preventing HIV than taking a daily oral antiretroviral PrEP, a generic pill currently marketed as Truvada.

Kenya’s HIV Epidemic

The first case of HIV in Kenya appeared in 1984. By 1990, HIV was one of the leading causes of illness in the country. At its highest point, more than three million Kenyans lived with AIDS. Since then, the government of Kenya decreased the prevalence of HIV from its 10.5% peak in 1996 to 5.6% in 2012. By 2019, the prevalence rate was 4.5% in adults aged 15-49. However, certain vulnerable populations within Kenya are more at risk of getting HIV, such as women. Males have an estimated prevalence rate of 4.5% while the rate for females is 5.2%. Among youth aged between 15 and 24 years old, boys have a prevalence rate of 1.34% compared to girls at 2.61%.

The only option for preventing HIV in Kenya is a daily PrEP pill called Truvada. The government of Kenya first approved oral PrEP for country-wide distribution in 2015, and since 2017, has scaled up the distribution throughout Kenya. However, of the 1.5 million Kenyans living with HIV, only 26,098 (1.7%) are currently on PrEP.

Though 72% of the population had been tested for HIV, only 70% had been tested more than once. Frequent testing, at least once a year if sexually active or at least every six months if part of a particularly vulnerable population, is vital to giving care and treatment for at-risk groups.

The Potential of CAB LA for Preventing HIV in Kenya

  1. The HPTN study reported that CAB LA is nine times more effective in preventing HIV in Kenya than the Truvada pill, the current form of PrEP. The PrEP pill is only effective if taken daily and is not a standalone prevention method for other STIs or unplanned pregnancies. The new drug also does not require other forms of protection, such as condoms.
  2. This drug gives vulnerable populations more HIV options for preventing HIV in Kenya. Vulnerable populations include sex workers, men who have sex with men, people who inject drugs, youth and women. These vulnerable populations face stigma, which affects their ability to access PrEP pills. Because the injection is needed only once every two months, the increased discretion and ease of the infrequent injection may increase its use and thus increase the protection of those who need it.
  3. Discretion in use of the drug may be able to reach more women specifically. In combination with the stigma attached to HIV, women in Kenya face discrimination in terms of access to education, employment and healthcare. As a result, men often dominate sexual relationships, with women not always able to practice safer sex, even when they know they should. For example, in 2014, 35% of adult women (aged 15-49) who were or had been married had experienced spousal violence and 14% had experienced sexual violence. Women in Kenya find it especially difficult to take a daily pill, which significantly reduces the effectiveness of the medicine. Only 68% of Kenyan women have access to antiretroviral pills.

Though not yet approved by the U.S. Food and Drug Administration (FDA), the developer of the drug, ViiV Healthcare, expects cabotegravir to be ready for the market by early 2021.

– Charlotte Ehlers
Photo: Flickr

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Addressing Migrant and Refugee Health

Addressing migrant and Refugee HealthAt the end of 2019, there were 79.5 million recorded forcibly displaced people in the world, with 26 million labeled as refugees. Roughly 68% of those displaced come from just five countries, which means that resources can be scarce for many of these people and their physical and mental health may become less of a priority in lieu of other needs. More focus needs to go toward addressing migrant and refugee health in order to protect the well-being of one of the most vulnerable populations.

7 Facts About Migrant and Refugee Health

  1. The Immigrant, Refugee and Migrant Health Branch (IRMH) is a branch of the Division of Global Migration and Quarantine that works to improve the health and well-being of refugees. The IRMH also provides guidelines for disease prevention and tracks cases around the globe in migrant populations. The organization has three teams and five programs that work both in the U.S. and around the world to combat infectious diseases.

  2. Refugees are affected by illness and health issues through transit and in their host communities. Most refugees are likely to be in good health in general, according to the CDC, but migrating tends to be a social determinant in refugee health. Health inequities are increased by conditions such as restrictive policies, economic hardship and anti-migrant views. Poor living conditions and changes in lifestyle also play a role.

  3. Refugee health profiles are compiled through multiple organizations to provide information about important cultural and health factors pertaining to specific regions. Refugees from different areas often have very different health concerns. For example, anemia and diabetes are priority conditions in Syrian refugees but parasitic infections and malaria are the focus for Congolese migrants.

  4. About one-third of migrants and refugees experience high rates of depression, anxiety and post-traumatic stress disorders. Mental health is a vital part of all refugee health programs and the priority for youth mental health programming is especially necessary. Forced displacement is traumatic and while there is likely a reduction of high anxiety or depression levels over time after resettlement, some cases can last for years.

  5. Healthcare is often restricted based on legal status within refugee populations. The 1946 Constitution of the World Health Organization articulated that the right to health is an essential component of human rights but many people are limited to claiming this right. Activists for refugee health along with many NGOs call for universal health care and protection for migrant populations.

  6. Important needs in refugee health include the quality and cost of disease screenings. HIV, hepatitis, schistosomiasis and strongyloidiasis are diseases that are prevalent among vulnerable refugee and migrant populations. However, ease and quality of medical screenings are not guaranteed in many centers or camps.

  7. Mothers and children face many barriers due to their unique needs and few refugee health care providers are able to properly address them. There is an increased need for reproductive health services and many of the barriers provide more difficulty than aid to many women. These include language, costs and general stigma.

Prioritizing Vulnerable Populations

The U.N. Refugee Agency (UNHCR) is well known for its work to safeguard the rights and well-being of people who have been forced to flee. Refugee International is another organization that advocates for the rights and protection of displaced people around the world. Awareness of refugee health facts and concerns enables organizations to take a direct stance on improving conditions and procedures. With the growing number of refugees around the world today, addressing migrant and refugee health must be prioritized in order to better protect these vulnerable populations.

– Savannah Gardner
Photo: Flickr

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Online Human Trafficking During COVID-19

human trafficking during COVID-19The United Nations has warned of a recent increase in human trafficking taking place through social media. According to the Committee on the Elimination of Discrimination against Women (CEDAW) perpetrators are approaching victims on social media and messaging platforms. Experts correlate this surge of online human trafficking with the lockdowns governments have implemented to combat COVID-19 that has left millions of people jobless and struggling to survive.

The Human Trafficking Crisis

Human trafficking has long posed a threat to the safety and well-being of the world’s most vulnerable populations. The U.N. has stated that between 2017 and 2018, approximately 75,000 trafficking victims were identified in 110 countries. During this period, 70% of victims were female, 77% of whom were then trafficked for sexual exploitation and 14% for forced labor.

There are several factors that make a person more vulnerable to human trafficking. The most pressing factor, however, is financial struggles or poverty.

Online Human Trafficking and COVID-19

Human trafficking is on the rise as millions are made desperate by the economic consequences of COVID-19. People employed in informal sectors have been particularly impacted by layoffs, while earlier this year migrant workers were left stranded far from home when borders closed and travel bans were implemented. According to the World Bank, the COVID-19 pandemic will result in global extreme poverty increasing for the first time in two decades, pushing as many as 150 million people into poverty by 2021.

The impact, however, will be felt the hardest by females. As a result of the pandemic, 47 million more women and girls will be pushed into extreme poverty. Estimates even predict that globally, for every 100 men living in poverty in 2030, there could be as many as 121 women.

Besides  COVID-19’s economic consequences, traffickers have also benefited from the fact that people are spending more time online during lockdowns. While traffickers have usually operated with a great deal of impunity, the internet allows for easier access to vulnerable populations as well as the benefits of anonymity and false identities.

Addressing Human Trafficking During COVID-19

Human trafficking is a global problem but despite the scale of the threat and the advantages that perpetrators have during COVID-19, governments can take action to protect vulnerable groups, especially women and girls.

In an appeal to social media and messaging companies, CEDAW recommended that safety controls be set up to reduce the risk of exposing women and girls to trafficking and sexual exploitation. CEDAW has called upon online platforms to use data, artificial intelligence and analytics to identify possible patterns that could lead to trafficking. It also urges platforms to “put in place the appropriate governance structure and procedures which will allow them to be reactive in their response and provide the relevant level of information to the concerned authorities.”

CEDAW also urged governments to resolve the underlying issues that allow human trafficking to flourish. These issues include sex-based discrimination, economic insecurity, conflict and unsafe conditions for migrants and displaced people.

In addition, the United Nations has urged national governments to ensure that services for trafficking victims and survivors stay open during lockdowns and that the rights of migrant and informal workers are protected by labor laws. Finally, investments in programs for women’s economic empowerment are encouraged as a means of mitigating the disproportionate economic impacts on females. With the appropriate measures in place, human trafficking during COVID-19 can be prevented.

– Angie Grigsby
Photo: Flickr

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Life in US-Mexico Border Camps

border campsThe United States’ Migrant Protection Protocols (MPP) program, better known as “Remain in Mexico,” is a policy that requires those seeking asylum within the United States entering from the southern border to wait outside of the United States in Mexico while their cases are reviewed by immigration judges. Since its implementation in January 2016, this policy has led to the build-up of camps of asylum seekers around Mexico. These U.S.-Mexico border camps are ridden with crime, disease and other dangers.

Rampant Crime in US-Mexico Border Camps

The NGO, Human Rights First, has reported more than 1,314 cases of rape, kidnapping, murder, torture and other violent crimes against migrants forced to return to Mexico. Of those cases, 318 have been kidnappings or attempted kidnappings of children. Rampant police corruption in border cities means nothing is done to protect migrants. Crimes including extortion, assault and sexual harassment have all been reported against members of the Mexican police. These reports come from individual interviews held by Human Rights First in order to determine the scale of crime within migrant camps. Given that about 55,000 individuals have been returned to Mexico as part of the Migrant Protection Protocols program, the organization believes that those 1,314 cases are only the tip of the iceberg when it comes to violent crime in U.S.-Mexico border camps.

The Dangers of Mexican Regions

The United States Department of State periodically releases travel advisories on countries and regions throughout the world to warn citizens of dangers they may face when traveling there. This includes the Mexican state of Tamaulipas, Matamoros, a hotspot for gathering migrants awaiting entrance into the United States. Thousands of migrants, returned to Mexico by immigration officials to await their trials, live in tented border camps in a place that the United States considers dangerous. This has led to scrutiny by organizations such as the American Civil Liberties Union (ACLU) for endangering asylum seekers by sending them to places that the United States admits are dangerous.

Vulnerable Populations in Camps

Despite the fact that vulnerable populations are supposed to be exempt from the “Remain in Mexico” program, many individuals that should not have been sent back have shown up in U.S.-Mexico Border camps. The period from the programs start through June 2019 saw 13 pregnant women and 4,780 children sent to await their trials in Mexico according to Human Rights Watch. Human Rights Watch also reports that people genuinely afraid of returning to Mexico, including kidnapping and assault victims, have been denied exemption from the Migrant Protection Protocols program and were sent back across the border anyway. Human Rights Watch, the ACLU, Human Rights First and others, have all found that people including the disabled, the young, the sick and members of the LGBTQ+ community, have all been sent back to Mexico despite qualifying for an exemption from the policy.

Unsanitary Conditions Spread Disease

The unsanitary conditions along the U.S.-Mexico border have led to diseases spreading among migrants. Reportedly, there is little clean water and migrants often bathe in the Rio Grande River, which is known for containing E. coli, other bacteria and human feces. Few cases of COVID-19 have been officially recorded. However, with border camps’ proximity to COVID-19 hotspots both in the U.S. and Mexico, there is likely an abundance of unknown cases.

NGOs Assist Migrants

Immigration to the United States has basically come to a complete standstill as the border between the two countries has remained closed throughout the course of the pandemic. Because of this, NGOs have gone into border camps in order to assist those in need. The UNHRC has set up hand-washing stations and isolation areas in some migrant camps. It has also provided cash relief to migrants who have lost jobs due to the pandemic. Other organizations like Global Response Management and  Doctors Without Borders have provided medical assistance by building medical centers, distributing PPE and providing medical treatment for those infected with COVID-19.

The United States Migrant Protection Protocols, or the “Remain in Mexico” policy, has without a doubt led to an increase in concerns for the health and safety of people along the U.S.-Mexico border. Now, with the COVID-19 pandemic bringing the already slow asylum process to a standstill, poverty and disease has spread throughout these camps. However, NGOs like the UNHRC have been stepping up and providing assistance to those most in need.

– Aidan Sun
Photo: Flickr

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Amber Heard Is Helping Syrian Refugees

Amber HeardAmber Heard is a model and actress who has dedicated her career to being more than just a “pretty face.” She is best known for her roles in Zombieland (2009), The Stepfather (2009) and The Danish Girl (2015). Heard was also featured in The Justice League (2017) as Mera, a role which she will be reprising in the upcoming Aquaman film.

The actress has always been a strong advocate for the importance of charity work and helping those who are in need. Now, through a lot of time and dedication, Amber Heard is helping Syrian refugees that need medical attention by partnering with The Syrian American Medical Society (SAMS).

The Syrian American Medical Society

SAMS is an organization that provides medical relief to Syrian refugees by working on the front lines. The non-governmental organization (NGO) prides itself on being one of the most active and trusted organizations on the ground in Syria. Its main goal is to provide medical care to every patient who needs it.

SAMS is dedicated to providing these medical services all while promoting medical education in Syria with the assistance of hard-working humanitarians from around the globe. Its vision is to strengthen the medical community for Syria’s future. In 2017 alone, SAMS worked to provide more than 3.5 million health services to vulnerable populations, serving patients regardless of religious affiliation, race, ethnicity or political affiliation.

SAMS primarily operates in Syria, Jordan, Lebanon and Turkey where it has provided support to 110 medical facilities and over 3,000 personnel. Now, its programs are quickly expanding to other countries that are facing extreme poverty. For example, in 2016, it launched SAMS Global Response (SGR) to address the medical needs of vulnerable populations in Greece.

In 2017, SAMS expanded its operation to Egypt and Bangladesh where it set up to meet the increasing medical needs of those who have no access to health care. SAMS does what is called “medical missions” where it brings in skilled health professionals from around the world to provide life-saving care free of charge.    

SAMS is a leader for advocacy and works closely with policymakers both within the United States and on the global level. It advocates increasing political action to help end the crisis in Syria and allow for the voices of its workers on the ground who continue to risk their safety to save the lives of the vulnerable. It advocates for:

  • Protection of medical facilities, healthcare workers and civilians
  • Provisions for access to trapped civilians
  • Increasing involvement of NGOs in decision-making
  • Support for both Syrian refugees and host communities

Amber Heard Is Helping Syrian Refugees

SAMS asked Amber Heard to join its crew on a medical mission to help assist with the 660,000 displaced Syrians in a camp. “My biggest takeaway from this trip is the indelible mark left on my soul after spending a week on the ground here…” Heard spent a week in Jordan with SAMS to visit one of the largest camps for Syrian refugees, which also doubles as a rehabilitation center for those who have been injured.  

Amber Heard is helping Syrian refugees by starting a fundraising campaign. During her trip to Jordan, Heard met a 12-year-old girl named Weam, who is in desperate need of medical assistance. She suffers from a disease called thalassemia, which means she needs blood transfusions every 20 days. This is an expense her family simply cannot afford. Weam had been receiving treatments from an NGO; unfortunately, due to budget cuts, the treatment had to stop. There are 12 more children that have to live with this disease who also need help.  

Amber Heard is helping Syrian refugees by partnering with SAMS to offer a trip to the Aquaman premiere as well as a meet and greet with Heard and her co-star Jason Momoa. The money raised will be used to help treat the 12 children suffering from thalassemia in Jordan.

Amber Heard is using her influence to raise awareness of the important work being done by SAMS. With her fundraiser, 12 children will get the blood transfusions they need to fight thalassemia. Medical attention for Syrian refugees is an important cause, and thanks to people like Amber Heard and organization like SAMS, some of the suffering that these refugees are experiencing can be lessened.

– Olivia Hodges

Photo: Flickr