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Noncommunicable Diseases
Noncommunicable diseases (NCDs) occur due to “genetic, physiological, environmental and behavioral factors.” They are not diseases you can get after touching or being in close contact with someone, but they occur after getting a communicable virus or illness that develops. Common NCDs are cardiovascular diseases, cancers and chronic respiratory diseases. In developing nations, NCDs cause 41 million deaths (74% of all deaths globally) per year. NCDs affect all people, but primarily those who have unhealthy diets, are physically inactive, smoke or excessively drink alcohol. The risks are higher in developing nations where unhealthy lifestyles such as high blood pressure, glucose, fat in the blood and obesity have become more prominent.

3 Deadliest Noncommunicable Diseases

  1. Cardiovascular Disease: This is the deadliest noncommunicable disease. Poor diet and a lack of physical activity are the leading causes of this disease. One can also inherit cardiovascular disease. This can lead to an increase in blood pressure, glucose and weight gain. When not treated, cardiovascular disease can progress into heart attacks and strokes, along with diseases that affect one’s arteries, and blood flow such as coronary artery disease and congenital heart disease.
  2. Cancer: According to the World Health Organization (WHO), people can avoid up to 50% of cancers with a healthier lifestyle, such as reducing their intake of tobacco and alcohol and getting immunizations for infections that could cause cancer. Cancer is the second deadliest noncommunicable disease, and lung, liver, stomach, colorectal, prostate, cervical and breast are the most common cancers.
  3. Chronic Respiratory Diseases: These diseases affect the airways and lungs, causing breathing difficulty. Besides inheriting, unhealthy lifestyle choices, such as smoking, also lead to chronic respiratory diseases. Environmental factors play a huge part too. Exposure to air pollution and poor air quality and ventilation can increase the chances of contracting a respiratory disease. Without proper treatment, people can develop more severe diseases such as cystic fibrosis, pulmonary hypotension, asthma and chronic obstructive pulmonary disease.

Looking Ahead

While people can treat these deadliest noncommunicable diseases, many developing nations cannot afford treatment and lack adequate professional health services. Noncommunicable diseases are long-lasting and can cause suffering with symptoms constantly worsening. According to WHO, every two seconds, a noncommunicable disease kills someone under the age of 70. Currently, 14 of 194 countries that NCDs affect are on target to reach “sustainable development goals” and decrease mortality rates by 2030, preventing nearly 30 million deaths. However, only 5% of outside support goes toward preventing and controlling NCDs, where they are often “overlooked and underfunded.”

To detect, screen and treat NCDs, professional health care services need a drastic improvement. The Sustainable Development Agenda for 2030 focuses on the role of governments and stakeholders in reducing and monitoring risk factors and building policies accordingly. For instance, many sectors, such as finance, education and agriculture, need improvement to prevent and control NCDs. In 2019, WHO extended the Global Action Plan from 2013 to 2030 and set nine global targets.

NCDs Around the World

According to the British Heart Foundation (BHF), 550 million people globally are reported to suffer from cardiovascular disease (CVD) as of 2019. Asia and Australasia account for 310 million of these cases, with Uzbekistan recording the highest mortality rate. WHO has a focused plan on all NCDs affecting Uzbekistan. As part of its cost-effective preventative measures, the government has tightened laws regarding the use of tobacco as well as salt and alcohol consumption. In addition, there are campaigns to encourage people to become more physically active. Screenings for CVD and diabetes will see an improvement as well as treatment for those who are high risk, new cases and ongoing cases.

In 2020, there were 18,094,716 cancer cases across the globe, with Denmark topping the list in terms of the number of cases. However, the highest mortality rates were in Mongolia. WHO’s 2020 to 2024 plan for decreasing cervical cancer has three primary targets: to vaccinate 90% of girls aged 15 against HPV, to screen 70% of women twice by 35 to 45 with 90% of treatment and support managing 90% of women who have invasive cervical cancer.

Possible Solutions

Globally, 545 million people suffered from a chronic respiratory disease in 2017, according to The Lancet Respiratory Medicine, which has seen an increase of 39.8% compared to 1990. COPD and asthma are the leading causes of mortality rates, especially in South Asia.

In order to diagnose NCDs, the fundamental factors require improvement first. For example, improving NCD data, research capacity and funding such as collaborating with other countries and organizations to produce better services, creating factually-correct strategies, and improving health technology. While there is no treatment-based plan, following SDG Target 3.4 could reduce one-third of premature deaths by 2030.

– Deanna Barratt
Photo: Flickr

Cholera Outbreak in Malawi
According to the World Health Organization (WHO), “cholera is an intestinal infection that ingesting the bacteria Vibrio cholera in contaminated food and water causes.” Inadequate sanitation and lack of safe drinking water is the most common way to contract cholera, which causes severe diarrhea, vomiting and dehydration. Although it is an easily treatable disease, it can be fatal without treatment for even a few hours. Displaced populations and overcrowded camps on top of a lack of safe water and medication lead to an increased risk of the spread of cholera. Beginning in March 2022, a cholera outbreak in Malawi infected about 6,056 people with 183 deaths as of the end of October.

The Current Situation

Since 1998, cholera has plagued Malawi, specifically in the southern regions where there is frequent flooding in the rainy season. The current outbreak is the “largest reported Cholera outbreak in Malawi in the past 10 years” and comes after tropical storm Ana in January 2022 and Cyclone Gombe in March 2022, WHO reports. These storms spurred flooding and displacement of an already susceptible population who now lack access to safe water and sanitation.

Over the holidays, the outbreak surged causing 19 deaths on New Year’s Eve and the closure of primary and secondary schools in the capital Lilongwe and the commercial hub Blantyre. In these two cities, one of the main sources of the outbreak is improper drainage systems, which leads to polluted water sources.

The current cholera outbreak in Malawi exacerbates the country’s existing hunger crisis. With around “5.4 million individuals facing hunger,” a lack of sufficient nutrients weakens people’s immunity and leaves them highly susceptible to a fatal case of cholera. Malawi is one of the poorest nations in the world with 70% living in the country on less than $1.25 a day. In addition, 80% of the country’s population is in agriculture, an industry that storms and flooding deeply affect.

Some of the most at-risk populations during the cholera outbreak in Malawi are pregnant women and mothers with young children as they experience an increased workload and extra risk of infection as primary caregivers. This also threatens the advancement of women and girls in education and economic empowerment as they focus first on survival.

Malawi’s Response & International Aid

In response to the cholera outbreak in Malawi, the Ministry of Health and WHO are conducting an emergency response that consists of “surveillance, social mobilization, treatment, water sanitation, hygiene and oral cholera vaccines,” WHO reports. A cholera response plan and national and district-level emergency operation centers are mobilized nationally. The most affected districts received cholera kits, IV fluids, antibiotics, protective equipment, diagnostic tests, tents and cholera beds.

CARE will distribute chlorine powder for water purification in affected communities as well as supply Oral Rehydration solutions.

On November 7, 2022, Lilongwe received 2.9 million doses of Oral Cholera Vaccine (OCV) for a single-dose reactive campaign to the current Cholera outbreak in Malawi. The OCV campaign targets “adults and children aged 1-year-old and above living in highly affected districts.” The second campaign will prioritize providing vaccines to 14 districts with a large number of cholera cases.

UNICEF joins WHO and the Government of Malawi to strengthen water treatment systems, train health care workers, distribute medical supplies, provide clinical care and raise awareness regarding cholera prevention methods and best hygiene practices. The Government of Malawi has also appealed to the public and private companies and organizations for aid and constructed new, clean water spots in affected areas. As of November 6, around 6,398 people have recovered from the disease, UNICEF reports.

While numbers from January 11, 2023, reported 3,415 new cholera cases, according to Nyasa Times.

– Arden Schraff
Photo: Flickr

Malawi Eliminated Trachoma
According to the World Health Organization (WHO), Malawi is among 15 countries that recently eliminated trachoma. Presently, trachoma is one of the 20 most dangerous neglected tropical diseases identified by WHO. The eradication of trachoma has been a 12-year process by the Malawi government and non-governmental organizations. Here are all the facts about how Malawi eliminated trachoma and the lessons from their success in global health.

The History of Trachoma and Malawi

During the last 20 years, people at risk of blindness from trachoma decreased from 1.5 billion to 125 million. However, trachoma remains a severe health problem for more than 35 countries throughout the poorest regions of Central and South America, Asia and Africa. Specifically, trachoma disease is most prevalent in Africa, representing 84% of the worldwide concentration.

In Malawi, trachoma became endemic during the 1980s. But the government ignored the disease until 2008 when WHO and Sightsavers implemented surveys in the country. Afterward, the government of Malawi noted that 7.6 million people could contract trachoma in 2015.

The Path to the Eradication of Trachoma in Malawi

In 1996, WHO created the Global Elimination of Trachoma by 2020. The plan defined the elimination of trachoma as less than 2% in adults ages 15 or older and only one case per 1,000 people. According to WHO, the project targeted children ages 1 to 9  years old to obtain less than 5% infection. Specifically, Malawi was among the key 25 African countries in the project for the elimination of trachoma.

The effects of trachoma were especially life-threatening for millions of children in Malawi and caused financial instability for their families. However, between 2013 and 2015, the Malawi Ministry of Health mapped and targeted 25 districts most at risk of developing trachoma. The Malawi Ministry of Health used the Global Trachoma Mapping Project guidelines to establish the most endemic districts, which totaled about 9 million people. There were six districts, as the Malawi Ministry of Health reported, but none had surgery services. Lastly, in the Mchinji district, the disease prevalence was 21.3% for children ages 1 to 9 years old.

The Solution

In 2022, the Malawi Ministry of Health eliminated trachoma through SAFE, a strategy that WHO recommended. Furthermore, the Sightsavers organization and the Queen Elizabeth Diamond Jubilee Trust partly organized and funded the strategy. The SAFE strategy includes surgery to stop eyelashes from scrapping the eye, antibiotics, facial cleanliness and environmental improvements, according to Uniting to Combat NTDs.

As a result, trained local surgeons treated more than 6,000 cases of trachoma and volunteers distributed more than 22 million drug treatments that Pfizer donated. They supported more than 250 schools to improve hygiene and sanitation in their community. Lastly, Malawi is one of the first countries to adopt the Kigali Declaration on neglected tropical diseases, strengthening their political commitment to eradicate the disease.

A Victory for the People

The eradication of trachoma represents a victory for the people and government of Malawi. However, many lives did not survive in time along the path to find the solution. Still, the complete elimination of the disease represents the effectiveness of collaboration among international efforts.

The Malawi Ministry of Health, WHO, nonprofit organizations and the willingness to adopt the SAFE strategy demonstrate the value of continual support for these international organizations by high-income countries and individuals.

– Andres Valencia
Photo: Flickr

Poverty in Ukraine
Russia’s invasion of Ukraine began in February 2022 and has resulted in thousands of deaths and casualties on both sides. The attacks left 8 million people displaced in Ukraine by May 2022 and 7.8 million Ukrainians fleeing the country as of November 2022. With more than 250 days of the invasion, Ukrainians are likely to live with a blackout until at least March 2022, the EU will give a further £2.2 billion to help with the reconstruction of the country and the Word Health Organization (WHO) warned that Ukraine’s health system is “facing its darkest days in the war so far.” All of the factors have undoubtedly increased the poverty rate in Ukraine to 25% and future estimates it could be rising to 55% or more by the end of 2023.

Increase in Poverty

The damage that the war inflicted on infrastructure and the economy has obviously increased Ukraine’s poverty. The unemployment rate has increased and is currently at 35% and over months some workers have seen their incomes reduced by as much as 50%. World Bank Eastern Europe Regional Country Director Arup Banerji stated that “As winter really starts biting, certainly by December or January, there may be another internal wave of migration, of internally displaced persons.” As a result of the displacement of more people from their houses and fewer jobs available, the poverty rate in Ukraine will worsen as Russia’s invasion continues.

COVID-19

The WHO and Ukraine’s Ministry of Health announced that 22% of people in the country are struggling to access essential health care and COVID-19 spreading with 23,000 new cases reported since October 2022. With a low vaccination rate minus booster, millions of Ukrainians are not immune to it which has therefore led to an increase in cases. UNICEF delivered 2.3 million doses of the vaccine through the U.S. government for distribution in 23 regions of Ukraine. Recently, the Biden administration wrote a letter to Congress requesting $38 billion to help Ukraine with efforts, with $9 billion going towards COVID-19 vaccine access and long-term research.

Infrastructure Damage

Within recent weeks, Russian missiles and drones have struck 40% of Ukraine’s energy infrastructure that have created blackouts across the country. Eighty percent of Kyiv residents have been deprived of water and 350,000 homes have lost all power. The World Bank believes that Ukraine needs $349 billion to reconstruct the country. The process of cleaning and clearing explosive remains of war will need $11 billion in the next two years and $62 billion in the next 10 years. Other costs such as the rebuilding of roads, schools and hospitals will need more funding and could take away from the government supporting residents then lead others into poverty, increasing the rate after the ending of the invasion.

Solutions

Ukraine has received military assistance from other countries, the U.S. is the largest provider having committed $19.3 billion since the start of the Biden Administration. The Disaster Emergency Committee has helped 248,000 people in six months with food aid and opened 200 centers for displaced people. Similarly, the British Red Cross launched its appeal and described how it would use people’s donations. For example, £20 “could provide five blankets to families taking shelter.” Since its launch, the organization has helped 5 million people with emergency relief and 8 million with access to clean water.

Looking Ahead

The poverty rate in Ukraine has worsened significantly as it faces the impact of war. The country will need a complete rebuild that could cost more than $500 billion and leaves people in life-altering situations without homes and jobs. Russia’s invasion does not have an end date, it will continue to damage the economy and more importantly ruin the lives of Ukrainians.

– Mohamed Hassan
Photo: Flickr

About MeaslesMeasles is a communicable disease caused by a virus. Persian physician and scholar Abū Bakr Muhammad Zakariyyā Rāzī discovered the disease in the ninth century but it became a global term in the 16th century. In 1757, measles-infected blood was transmitted to healthy donors where Scottish doctor Francis Home discovered that a highly infectious bacterium causes measles. Measles only become a nationally recognized disease in the United States in 1912, when there were 6,000 deaths annually. To this day, measles is considered to be one of the world’s deadliest diseases, especially in developing nations, despite treatment efforts. Here are three facts about measles.

3 Facts About Measles

  1. In 2022, the creator of the measles vaccine Samuel L. Katz passed away at the age of 95. Before the development of the vaccine, almost every child had measles by the age of 15 and nearly 4 million people were infected every year. Five hundred people died from measles each year, there were 48,000 hospitalizations and 1,000 people had swelling of the brain due to the infection, according to the Centers for Disease Control and Prevention (CDC). In 1956, there was a disease breakout at a school in Boston, Massachusetts, where John F. Enders and Dr. Thomas C. Peebles collected blood samples from infected students and isolated the disease within David Edmonton’s blood. In 1963, they developed Edmonton’s virus into a vaccine and it officially received a license in the United States, where Maurice Hilleman and his research team further improved it in 1968.
  2. Before the vaccine, there was an epidemic every two to three years that caused around 2.6 million deaths each year worldwide, according to the World Health Organization (WHO). Even after the vaccine, in 2018, 140,000 people died from measles, most of which were children under 5. Unvaccinated children, pregnant women and non-immune people are most at risk of getting measles, though it is particularly common in developing nations, such as countries in Africa and Asia. In addition, more than 95% of deaths happen in low-income households and countries with underdeveloped health services, WHO reports. Once one has measles, there is no anti-treatment available. However, vitamin A can reduce the complications and risk of death from measles after taking two doses a day apart. The vaccine is a routine procedure in the U.S. and costs $1 per vaccine. However, many developing nations cannot afford the vaccine. This has led to 19.2 million infants not receiving a single dose in 2018. Around 6 million of these infants were from India, Nigeria and Pakistan, where the number of cases is significantly rising.
  3. According to the WHO, measles spreads through coughing, sneezing and being in close contact with infected patients. It can stay airborne and on infected surfaces for as long as two hours and can infect people four days before and after a rash occurs. The first symptoms of measles show 10 to 12 days after exposure to the virus, lasting for four to seven days. It initially has cold-like symptoms, such as a runny nose, cough, red and watery eyes and a fever. Patients also develop small white spots on their cheeks. This develops into a rash after 14 days, which could last for six days. Without treatment, complications could occur, such as blindness, brain swelling, diarrhea, dehydration and ear and respiratory infections. Though, complications occur more in malnourished children with a lack of vitamin A or those who have weak immune systems from other diseases.

Looking Ahead

In 2010, the World Health Assembly stated three targets to eradicate measles by 2015. First, to enable more first-dose vaccines during routine coverage to more than 90%. Second, to reduce case numbers to less than five cases per million annually. Third, to reduce measles-related deaths by at least 95%. Furthermore, in 2012, the World Health Assembly supported the Global Vaccine Action Plan of “eliminating measles in four WHO regions by 2015 and five regions by 2020,” the WHO reports. These goals were successful and as of 2018, mortality rates had decreased by 73% with the development of the vaccine coverage. The Measles and Rubella Initiative, founded in 2001 and the Gavi Vaccine Alliance also supported this by preventing 23.2 million deaths, where most of the deaths would have been in Africa and the countries that the Gavi Alliance support.

– Deanna Barratt
Photo: Flickr

Counterfeit Pain Relief in Côte d'IvoireCôte d’Ivoire — the world’s largest cocoa producer has beautiful landscapes that attract thousands of yearly visitors. It is also a breeding ground for the distribution of counterfeit and illicit drugs. Though the use of counterfeit medicines carries many risks, many Ivorians still seek them out. The growing need for counterfeit pain relief in Côte d’Ivoire has resulted in the expansion of a new sector dominated by adolescents and those in need of a different form of relief.

The Dilemma

In sub-Saharan Africa, counterfeit drugs run rampant, but in Côte d’Ivoire, they run everything. Pharmacies produce only 30% of the drugs circulated in Côte d’Ivoire while the other 70% are counterfeits. Overall, about 42% of the world’s counterfeit drugs were found in Africa, a continent whose inhabitants are the most susceptible to poverty. Since 1998, Côte d’Ivoire’s percentage of counterfeit drug usage has increased by 50%, but the rate of health care availability has remained stagnant.
A 2020 World Bank report found that 33% of Ivorians did not live in close proximity to a hospital or clinic. In two regions, this percentage exceeded 50%. Health care specialists mainly work in major, more developed cities and government spending typically goes for the more developed parts of Côte d’Ivoire. Furthermore, many Ivorians do not have health insurance to aid payments towards their medical bills. As a result, they are at risk of adopting high health expenditures— 74% of it due to their overspending on medications, according to a World Bank report.

Availability

Non-branded or generic medications cost seven times higher than the international standard. Brand-named medications cost 18 more than the international guidelines, according to the same report. The quantity and variety of available medications differ depending on the sector. Just 32% of drugs essential to Côte d’Ivoire’s population made their way into the public sector while 57% of essential drugs are available to the private sector— one that comprises 80% of wealthy Ivorians.

Getting medications after obtaining prescriptions is a time-consuming process. At times, drugs are not readily available for patients. Sometimes, restocking and transferring to neighboring pharmacies can take a while. Consequently, patients will purchase counterfeit drugs from local street vendors as it is a more convenient alternative.
Over a two-year span, law enforcement seized almost 400 tonnes of counterfeit pain relief in Côte d’Ivoire and pharmacies suffered a $173 million loss that was later attributed to the presence of counterfeits. Authentic medications will run the average Ivorian 10,000 CFA or $15. For most, this is too much to pay. Ivorians typically bring in $200 a month.

A Cheaper Alternative

Unlike pharmacies, counterfeit drug markets are open around the clock. Due to the unregulated nature of the informal sector, people in need of medications can purchase any quantity of their desired drug, according to a 2021 research article. A patient in need of just a few pills of their prescription can buy medications individually instead of buying them in a pack like most pharmacies require, further lowering their expenses. However, there are some who take advantage of the cheapness of the drugs and the illegality of counterfeits, buying them to fulfill an addiction, according to the same article. Others buy from counterfeit drug markets because they can’t find traditional forms of medicines in pharmacies, due to cultural or religious reasons.

Many street vendors sell counterfeit pain relief in Côte d’Ivoire to relieve themselves of poverty. Among them are children and teens who function similarly to cashiers, negotiating prices with customers and finding drugs that match a given description.
Counterfeit drugs present buyers with what they perceive to be a cheap alternative with good enough quality. In reality, these drugs are adulterated. Meaning an active pharmaceutical ingredient is present, but is coupled with inferior substance(s). The most common replacement for starchy components found in drugs is flour with water being the substitute for liquid components. Or the counterfeits consist of entirely different substances.
Taking poorly made counterfeits result in the annual deaths of more than 100,000 people in Africa. The cultivation of counterfeit drug products has allowed their effects to go undetected and has started to show signs of the fostering of antimicrobial resistance, according to a WHO study.

Encouraging A New Côte d’Ivoire

Ten years ago Côte d’Ivoire’s government launched a new initiative that provided affordable health care to millions. Unfortunately, it ended up downsizing after government spending exceeded the allocated amount, limiting coverage to women and children under the age of 6.
But in recent years, Côte d’Ivoire began with a universal health coverage plan that is said to broaden the scope of health care and increase its accessibility. The plan includes financial reforms, medical assistance schemes, larger medicinal access and an increased budget to ensure that every Ivorian receives quality health care.
Meditect is a social enterprise that aims to put an end to counterfeit drugs by increasing access to ones of quality. The app tracks the medicine supply from the time it hits the pharmacy to the time it reaches the street, ensuring that the drugs in circulation are authentic and of good quality. It directs patients to a nearby pharmacy that presents them with the best financial and medical options.

Currently, Meditect is available in three francophone countries in West Africa, providing services to the Senegalese, Cameroonian and Ivorian people. Its goal is to expand this initiative to more countries until no African country is facing the issue of the presence of counterfeits.

– Dorothy Quanteh
Photo: Unsplash

AIDS in Children
In August 2022, numerous intergovernmental agencies, civil society movements and a dozen countries congregated in Montreal, Canada to establish the Global Alliance for Ending AIDS in Children by 2030. Recognizing that only 52% of children with HIV access treatment, the newly created alliance strives to guarantee that all children living with HIV can access treatment by the end of the decade. Specifically, by closing the treatment gap between children and adults living with HIV, the alliance aims to ensure that all youth deserve the chance to progress into adulthood unimpeded by HIV.

Tackling HIV Treatment Disparities

According to the U.N., one of the most significant issues affecting AIDS response is the disparity between treatment provided to adults versus children. While 76% of adults received anti-retroviral therapy (ART) in 2021—treatment designed to control HIV infection—only 52% of individuals ages 0-14 years accessed ART. Furthermore, only 55% of children ages 15-19 in 21 sub-Saharan countries were on treatment in 2021. Despite technological advancements in HIV testing, “800,000 children and adolescents living with HIV (0-14 years) are untreated,” and “another estimated 400,000 adolescents (15-19 years) many of whom were likely recently infected are not receiving treatment.”

In recognition of these devastating figures, the U.N. believes that the low prioritization of HIV treatment on a national scale is the root of this problem. Specifically, inadequate investment in treatment strategies and national plans to mitigate societal inequalities has exacerbated the discrimination targeting those living with HIV. Although numerous similar plans have been implemented in recent decades—such as the Global Plan towards the Elimination of New HIV Infections Among Children by 2015 and the Start Free Stay Free AIDS Free Partnership—previous movements primarily focused on raising awareness and fostering engagement among leaders.

The Formation of a Global Alliance

Hoping to expand HIV treatment to millions of youths across the world, the alliance prioritizes creating a sustainable framework for HIV prevention in the next 8 years. UNAIDS, UNICEF and WHO are primarily leading the Global Alliance for Ending AIDS in Children by 2030. Beyond U.N. agencies, the alliance consists of “civil society movements…national governments in the most affected countries, and international partners.” The 12 countries involved in the alliance include Angola, Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo (DRC), Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia and Zimbabwe.

The alliance’s mission is four-fold:

  1. “Close the treatment gap among breastfeeding adolescent girls and women living with HIV and optimize the continuity of treatment.
  2. Prevent and detect new HIV infections among pregnant and breastfeeding adolescent girls and women.
  3. Promote accessible testing, optimized treatment, and comprehensive care for infants, children, and adolescents exposed to and living with HIV.
  4. Address gender equality, and the social and structural barriers that hinder access to services.”

The Global Alliance for Ending AIDS in Children by 2030 seeks to foster a sense of unity within the international community. The alliance stresses how collaboration is the key to eradicating HIV; only by pooling resources, committing to global mobilization, and creating holistic solutions can the world prevent AIDS in children by the end of this decade.

A Promising Future

Going forward, the alliance will ensure that there is accessible treatment and care for children and adolescents living with HIV for at least the next eight years. According to a report published by UNAIDS, the alliance will promote leadership to execute plans on a national level, advance previous programs hoping to end AIDS, collaborate with global organizations to promote advocacy, ensure that governments have access to financing and advance accountability by fostering a sense of collective responsibility. As the Global Alliance for Ending AIDS in Children by 2030 continues to expand HIV treatment to millions of deprived children, the world will inevitably see a new generation devoid of stigma and discrimination surrounding HIV—a promising future that allows children to prosper as they venture into adulthood.

– Emma He
Photo: Flickr

Malaria in Chad
According to the Malaria Consortium, Chad has one of the highest mortality rates globally for children younger than 5. For every 1,000 children, 119 die before the age of 5. Malaria is a significant cause of death in Chad, especially among children. Pregnant women and children are the most susceptible to contracting malaria because of their fragile immune systems. Several measures aim to control malaria in Chad, especially among the most vulnerable groups.

Preventative Measures

The World Health Organization (WHO) recommends the use of insecticide-treated nets and antimalarial medication among the most vulnerable populations in endemic countries.

The Against Malaria Foundation (AMF) funds insecticide-treated nets for distribution to countries facing high malaria burdens. In March 2022, AMF agreed to distribute 6.8 million mosquito nets across all of Chad’s provinces from January 2023 to April 2023. The distribution of these nets could prevent up to 9,000 malaria-related deaths. AMF also estimates that the supply of nets will add $163 million to Chad’s GDP. In a country where the poverty rate stood at 42% in 2018, measures to reduce the nation’s economic burden are crucial.

The Malaria Consortium aims to improve health across Asia and African regions “through evidence-based programs that combat targeted diseases and promote universal health coverage,” its website says. The Malaria Consortium’s malaria prevention efforts involve the distribution of seasonal malaria chemoprevention (SMC) to protect vulnerable populations in endemic countries. This effective intervention involves “administering monthly doses of antimalarial drugs to children aged 3-59 months during the peak malaria transmission season.”

In May 2016, the Malaria Consortium established an office in N’Djamena, Chad’s capital city, and has led SMC initiatives since then. In 2021, the organization provided support for SMC interventions across 26 districts in Chad, with the aim of reaching about 1 million under-5 children.

Since 2000, the incidence of malaria in Chad has reduced from 267 per 1,000 vulnerable people to 206 in 2020, according to the World Bank. One can attribute the general decrease in numbers to increased treatment and prevention measures.

Malaria Vulnerability During Pregnancy

Contracting malaria during pregnancy poses risks to both the mother and child. “Pregnant women suffering from malaria are at increased risk of anemia and miscarriage and their babies are at risk of stillbirth, prematurity, intrauterine growth retardation and low birth weight,” says the Population Reference Bureau. Low birth weight is a significant cause of neonatal mortality. Experts from the U.S. Centers for Disease Control and Prevention estimate that malaria during pregnancy causes between 75,000 to 200,000 infant mortalities annually across the world. In 2020, the WHO Africa Region recorded that 34% of all pregnant mothers had malaria exposure.

To protect vulnerable pregnant women from malaria, the WHO recommends the use of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) as part of antenatal care. The use of insecticide-treated nets is also important to ensure the mother’s safety. However, sulfadoxine-pyrimethamine (SP), branded as Fansidar, has its limitations. It has reduced efficacy among women with HIV and SP-resistance is becoming more common.

Efforts from organizations have contributed to a reduced prevalence of malaria in Chad. Continued treatment efforts and preventative measures will ensure the most vulnerable populations are protected from malaria.

– Yv Maciel
Photo: Flickr

Link Between Poverty and Women's Health
In February 2022, U.N. Women reported that an estimated 388 million women and girls will experience “extreme poverty” globally in 2022 — roughly 16,000 more compared to men and boys. Women make up the majority of the world’s impoverished and also face several health risks that men are less vulnerable to. Understanding the link between poverty and women’s health is important in eradicating the life-threatening conditions that many women in developing countries face over the course of their lifetimes.

3 Health Risks Associated with Poverty

  1. Malnutrition. Lack of access to nutrient-rich food is one of the most life-threatening consequences of poverty and it tends to have long-term effects on productivity in adults and development in young children. When families do not have enough food to go around, women are typically the last to eat, consuming smaller amounts in order to feed growing children or spouses. Although women may typically need less food to survive, their bodies require the same amount of nutrients as adult men, meaning that “they need to [consume] more nutrient-rich foods.” Unfortunately, these foods are often prohibitively expensive, resulting in nutrient deficiencies. Nutrition is especially important during pregnancy and micronutrient malnutrition can result in complications like anemia and hemorrhage, endangering the lives of both mothers and children.
  2. Infectious disease. Poverty-related diseases (PRDs) are communicable diseases arising from poor sanitation, indoor air pollution, malnutrition and other conditions of poverty. These include HIV/AIDS, malaria, tuberculosis and respiratory infections like pneumonia. The World Health Organization (WHO) reports that, in comparison to males, poor women and girls face greater risks of exposure to HIV. HIV weakens their immune systems and makes them more vulnerable to other communicable diseases. There are several contributing factors to this imbalance, according to U.N. Women: unequal power relations with men, which make it hard for a woman to advocate for herself sexually; sexual assault and violence and lack of education or resources for women to protect themselves from the spread of STDs. Poverty can also push women to engage in unsafe transactional sexual behaviors in order to survive.
  3. Untreated illness. According to a 2008 study, developing countries tend to have poor healthcare infrastructure, making diagnostic and treatment services harder to access, especially for those living in rural areas with limited or expensive transport options. Marginalized women in developing countries often have what an AXA article describes as “limited control over their own lives.” A lack of autonomy and financial independence can put health care out of reach because women must depend on spouses or other male family members for access to services. Lack of education can also lead women to choose not to seek help for health issues, simply because they cannot identify the warning signs of poor health.

Gender-based Health Risks

Women also have unique health risks linked to their anatomy. Cervical cancer, for example, is “the most common type of cancer in developing countries.” Although it is preventable with testing, these countries typically lack the resources to adequately conduct testing. WHO reported that in 2020, 90% of global cervical cancer deaths occurred in low- and middle-income countries because of underfunding for testing and treatment services. Maternal mortality is also a persistent problem in developing nations, where access to emergency care is limited and skilled attendants are often not present during childbirth. Preventable maternal deaths are common, with approximately 295,000 women dying “during and following pregnancy and childbirth in 2017” alone.

Working Toward Solutions

The link between poverty and women’s health is strong, but social and financial changes could be significant in solving the problem. Empowering women can go a long way toward improving health outcomes. U.N. Women’s Gender Action Learning System (GALS) training in Kyrgyzstan seeks to do this by changing restrictive social norms.

The methodology encourages households to consider the power dynamics between family members and to recognize the burden of domestic tasks placed upon working women in an effort to create a more equal playing field between women and men.

This, coupled with media training for journalists that encourages them to be more sensitive to gender differences and issues, will pave the way for women to be better able to advocate for themselves in other areas through broad societal change.

Every Mother Counts

Considering the link between poverty and women’s health, funding for essential services could be instrumental in improving health outcomes for women. For example, Every Mother Counts is a non-governmental organization (NGO) that aims to improve health outcomes for women in developing nations. In Tanzania, the organization “support[s] the training of health workers, provision of lifesaving resources and community outreach and health education for women in rural settings.” Every Mother Counts has partnered with the Maasai Women Development Organization since 2017 to fulfill the specific needs of marginalized groups, such as Maasai women, in Tanzania. Every Mother Counts has improved the lives of more than 185,000 people in Tanzania.

Empowering women to make their own choices and funding essential services is crucial in reducing the impacts of poverty on women’s health. Because poverty and illness disproportionately impact women due to gender inequities, efforts to alleviate poverty and strengthen equality are vital.

– Abbi Powell
Photo: Flickr

Mental Health in Zimbabwe
The Friendship Bench has revolutionized the field of mental health in Zimbabwe and beyond. Due to its great localized success, 32 Friendship Benches have undergone installation around stadiums at the FIFA World Cup in Qatar.

Mental Health in Zimbabwe

Zimbabwe is a landlocked country in southern Africa, with 70% of the population living below the poverty line. This economic state has caused many struggles for the citizens, such as inadequate nutrition and the prevalence of diseases. Mental health is also a major issue, but many often neglect it. Legislation regarding mental health policy is outdated, and the World Health Organization (WHO) has reported that “There is a shortage of human resources for mental health in Zimbabwe, in part a result of the emigration of locally trained professionals due to economic instability.”

Mental health is an important issue for the citizens of any country. Therefore, mental health care and support are a necessary part of a nation’s health system. UNICEF Zimbabwe has called for more assistance for youth and adolescents in the wake of the COVID-19 pandemic. Still, the country lacks the resources to address the issue in its entirety. This challenge has required creative solutions from local NGOs, an example being the Friendship Bench Project.

The Birth of the Friendship Bench

Since 2006, the Friendship Bench has trained more than 600 mentors to offer support on benches in communities around Zimbabwe. These volunteers offer assistance using techniques based on cognitive behavioral therapy and are often from the communities in which they practice. This connection allows a deeper understanding of the struggles that community members face. Citizens engage in positive dialogue with these volunteers, usually in 45-minute segments. In the past 16 years, the project has extended to Malawi, Zanzibar and New York City. In the future, it plans to expand in order to offer more care for youth and adolescents.

Proven Success

In 2016, JAMA Network produced a clinical trial regarding the potential impact of the Friendship Benches and the care they provide. Results indicated that “the group from the Friendship Bench had a significant decrease in depressive symptoms, compared to the control group.” These impacts on mental health in Zimbabwe prove that projects like this may be effective in countries with poor mental health resources.

The 2022 FIFA World Cup

Due to the success of the Friendship Bench in Zimbabwe, several groups have worked together to install 32 benches at the 2022 FIFA World Cup in Qatar. They will be located around the different stadiums, and will each represent a different participating international team. Organizers hope that the benches will spark a conversation around the importance of mental health care and focus. The colorful details of these benches are an added feature to catch the attention of players and spectators to spread awareness in a creative and positive format.

The success of the Friendship Bench Project on mental health in Zimbabwe is clear, and its impacts internationally suggest a positive future for growth in mental health care, even in nations with limited resources.

– Hailey Dooley
Photo: Wikimedia Commons