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Fight Disease in the DRC
With 80 million hectares of arable land and over 1,100 precious metals and minerals, the Democratic Republic of the Congo has quickly established itself as a large exporter in the lucrative diamond industry. Despite this, the DRC ranks 176th out of 189 nations on the UN’s Human Development Index and over 60 percent of the 77 million DRC residents live on less than $2 a day. Internal and external war, coupled with political inefficacy and economic exploitation, has hindered the country’s ability to combat poverty and improve health outcomes. Listed below are some of the most deadly diseases that are currently affecting individuals in the DRC and the different strategies that governments and NGOs have taken to fight disease in the DRC.

3 Deadly Diseases Currently Affecting Individuals in the DRC

  1. Malaria

The DRC has the second-highest number of malaria cases in the world, reporting 15.3 million of the WHO-estimated 219 million malaria cases in 2017. Of the more than 400 Congolese children that die every day, almost half of them die due to malaria, with 19 percent of fatalities under 5 years attributed to the disease. However, some are making to reduce malaria’s negative impact.  For example, the distribution of nearly 40 million insecticide-treated mosquito nets, or ITNs, has helped lower the incidence rate by 40 percent since 2010, with a 34 percent decrease in the mortality rate for children under 5. The DRC government procured and distributed the nets with international partners such as the Department for International Development, Global Fund and World Bank. In addition, the President’s Malaria Initiative, a program implemented in 2005 by President Bush and carried out by USAID, has distributed more than 17 million nets. UNICEF has also been a major contributor in the efforts to fight malaria and recently distributed 3 million ITNs in the DRC’s Kasaï Province. However, the country requires more work, as malaria remains its most frequent cause of death.

  1. HIV/AIDS

Among its efforts to fight disease in the DRC, the country has made significant progress recently in its fight against HIV/AIDS. As a cause of death, it has decreased significantly since 2007, and since 2010, there are 39 percent fewer total HIV infections.

This particular case illuminates the potential positive impact of American foreign aid. The DRC Ministry of Health started a partnership with the CDC in 2002, combining efforts to fight HIV/AIDS. PEPFAR, signed into U.S. law in 2003 to combat AIDS worldwide, has invested over $512 million since 2004, which has helped to fund antiretroviral treatment for 159,776 people. In 2017, it funded the provision of HIV testing services for 1.2 million people.

The country is also addressing mother-to-child transmissions. In the DRC, approximately 15 to 20 percent of mothers with HIV pass the virus onto their child. The strategy to end mother-to-child transmissions involves expanding coverage for HIV-positive pregnant women, diagnosing infants with HIV earlier and preventing new infections via antiretroviral drug treatment. UNAID, The Global Fund and the DRC Ministry of Health have undertaken significant work to accomplish these objectives and their efforts have resulted in the coverage of 70 percent of HIV-positive pregnant women.  However, much work remains to cover the remaining 30 percent of pregnant HIV-positive women.

Overall, there is still a lot of necessary work to undergo in the fight against HIV/AIDS in the DRC and around the world.  In total, UNAIDS estimated that HIV/AIDS was the cause of 17,000 deaths in the DRC in 2018.  While this is a decrease from previous years, it shows that the DRC still has a long way to go in order to fully control the spread of the disease.  Additionally, there must be more global funding. The U.N. announced on July 2019 that annual global funding for fighting HIV/AIDS decreased in 2018 by almost $1 billion.

  1. Ebola

Since 2018, the DRC has undergone one of the world’s largest Ebola outbreaks. On July 17, 2019, WHO declared the outbreak an international health emergency. Since August 2018, more than 2,500 cases have occurred, with over 1,800 deaths.

However, the country is making efforts to prevent the transmission and spread of Ebola in the DRC.  Recently, more than 110,000 Congolese received an experimental Ebola vaccine from Merck & Co. The vaccine is called rVSV-ZEBOV, and studies have shown the vaccine to have a 97.5 percent efficacy rate.  This vaccine provides hope that people will be able to control Ebola breakouts in the near future.

While there have been attempts to fight disease in the DRC in recent years, such as malaria, HIV/AIDS and Ebola, each disease remains a major issue. In the coming years, the country must continue its efforts.

– Drew Mekhail
Photo: Flickr

Poverty-Related Diseases

Every day, billions of individuals around the world suffer from diseases. To make matters worse, many of these individuals are mired in poverty with limited access to health care services. Reducing the negative impact that these diseases have on individuals in poverty starts with identifying which diseases are affecting the most people. Listed below are three diseases that are closely linked with individuals in poverty.

Top 3 Poverty-Related Diseases

  1. Tuberculosis
    Tuberculosis, or TB, is a disease that stems from the presence of bacteria in someone’s lungs. It is common in many poorer, more urban areas because it can spread quickly when individuals are in close contact with each other. TB killed over 1.5 million people in 2018 and infected 10 million individuals in total. The disease takes advantage of individuals who have weakened immune systems, which can happen to individuals who are malnourished or who are suffering from other diseases simultaneously. When an individual in poverty is diagnosed with TB, their options are limited. Treating TB is costly and many people cannot afford treatment. However, not all hope is lost. Organizations like the TB Alliance aim to produce more affordable TB treatment for individuals in poverty. The TB Alliance has already helped many individuals and is working to expand its operations in the coming years.
  2. Malaria
    Malaria is a parasitic disease that is spread by the Anopheles mosquito. It accounts for roughly 435,000 deaths per year (affecting roughly 219 million people) and disproportionally affects individuals under the age of 5 (children under 5 accounted for over 60 percent of malaria deaths in 2017). One NGO that is leading the fight against Malaria is the Bill and Melinda Gates Foundation. They have partnered with the U.S. Government, the WHO and NGOs like the Global Fund to help protect individuals around the world from malaria-transmitting mosquitos. So far, their work has been beneficial, as the number of malaria cases has been reduced by half since 2000. However, there is still much work to be done, as malaria remains a deadly disease that negatively affects millions.
  3. HIV/AIDS
    HIV is a virus that is transmitted through the exchange of bodily fluids. It affects nearly 37 million people worldwide every year, 62 percent of whom live in sub-Saharan Africa. HIV/AIDS (HIV is the virus that leads to AIDS) is common in countries where the population either does not have the knowledge or resources to practice safe sex. HIV can also spread in areas with poor sanitation, as individuals who use previously used needles can become infected with the virus. Many governments and NGOs around the world are doing good work to help stop the spread of HIV/AIDs. For example, in 2003, the U.S. Government launched The United States President’s Emergency Plan for AIDS Relief (PEPFAR) Initiative. The goal of this initiative was to address the global HIV/AIDS issue by helping those who already have the condition as well as by spearheading prevention efforts. Since the program was implemented, the results have been positive- the program is widely credited with having saved millions of lives over the last 16 years.

Each of these diseases negatively affects millions of individuals around the globe on a daily basis. Yet there is reason for optimism — continued work done by NGO’s such as the Bill and Melinda Gates Foundation, TB Alliance and The Global Fund, as well as efforts from governments to improve the current situation, will lead to a better future, hopefully, one where individuals no longer suffer from there poverty-related diseases.

– Chelsea Wolfe
Photo: Flickr

Oral Rehydration TherapyDiarrhea is both preventable and treatable, yet 1.6 million children die a year from diarrheal disease. Survivors are more susceptible to malnutrition, stunted growth and learning disabilities. In direct relation to poor sanitation, inadequate access to clean water and limited education, diarrhea has a particularly devastating impact in impoverished areas.

Background

Children in impoverished countries are diagnosed with dehydrating diarrhea approximately four times per year. Most cases of diarrheal diseases can be prevented with proper hygiene, sanitation and access to clean water. However, when prevention efforts fail, oral rehydration therapy has proven to be an effective treatment option for diarrhea.

Treatment

Oral rehydration therapy (ORT) uses available fluids such as breastmilk or rice water mixed with salt to rehydrate the ill. Oral rehydration solutions or ORS is a specific way of delivering ORT. Discovered in the 1970s, ORS is a mixture of sugar, salt and water that can be made at home to replenish electrolytes. In 2001, a new version of ORS, with reduced sodium and glucose, was packaged and distributed in powdered form.

The 2001 low-osmolality ORS reported decreases in stool volume and vomiting by 25 and 30 percent, respectively. Since the implementation of ORT in the 70s, it has saved 50 million lives at an individual cost of less than 30 cents per package. Further, supplementary zinc treatments have proven to reduce the duration and recurrence of diarrheal illness, and provide strong supplementation to oral rehydration solutions.

However, ORT use between 1992 and 2005 decreased in 23 developing countries because they had no knowledge nor access to oral rehydration solutions. The World Health Organization (WHO) estimates that ORT has the potential to save an additional 300,000 children’s lives each year with ORT and zinc supplementation, but, currently, only 42 percent of children in prioritized countries are receiving ORT treatment. Further, only 7 percent receive both ORS and zinc.

Even though oral rehydration solutions sell for only 25 cents, impoverished families living on less than $1 a day cannot afford these costs. Additionally, there are common misconceptions in poor, less educated, communities that those suffering from diarrhea should be restricted from the consumption of food and fluids including oral rehydration solutions.

Solution

The Global Maternal, Child Health Network and the American Public Health Association have worked together to create a strategy involving international policymakers and health organizations with four main components:

  1. They must appoint a U.S. agency within one year to assume the role of global “children’s champion.” Their job is to coordinate efforts among United States’ and international, public and private, organizations.
  2. The WHO and UNICEF must update their 2004 recommendation for diarrhea treatment to include new information about oral rehydration therapy and zinc. Additionally, they should provide training for local health providers, and fund maternal education and community case management programs.
  3. They must refocus efforts to improve health standards for children under five with a coordinated strategy across many organizations, so no children die from a preventable disease such as diarrhea.
  4. Funding for diarrhea treatment and prevention must be allocated under universal health coverage. Funding should include the co-packaging of zinc and ORS as home-based diarrheal treatment.

While prevention efforts such as improving hygiene and sanitation should remain a priority, it is not always possible to address the consequences of poverty. Approximately, 58 percent of diarrhea fatalities in low and middle-income countries is a result of poor sanitation and inadequate access to clean water. This problem cannot be fixed overnight, however, if provided to everyone, oral rehydration therapy is an affordable treatment that could prevent 93 percent of diarrhea deaths.

– Haley Myers
Photo: Flickr

Dementia in AfricaDementia is universally feared and stigmatized because it is mistakenly viewed as a gradual part of aging. There has been no research found to treat these symptoms, but there are ways to care for and uplift those in need to reduce the risk of dementia around the globe — including Africa.

5 Facts to Raise Awareness About Dementia in Africa

  1. Dementia is an umbrella term under which Alzheimer’s disease can fall. Dementia is categorized as a syndrome and does not have a definitive diagnosis. It is a group of symptoms that affect mental cognitive tasks such as memory and reasoning, Health Line reported. According to Health Line, as dementia progresses with age, it can have an impact on the ability to function independently, placing an emotional and financial burden on families.
  2. Dementia currently affects more than 47 million people worldwide. More than 75 million people are expected to be living with dementia by 2030. Dementia in Africa will rise over the next decades due to an aging population, an increase in noncommunicable diseases and the effects of the HIV pandemic. Even though there has been a reduction in HIV contractions, the disease still leaves its mark as a conduit for dementia. According to The Conversation, South Africa accounts for 17 percent of the global burden of HIV infection. HIV is linked with cognitive decline and leads to HIV-associated dementia (HAD). The Conversation stresses that health care and social care systems are a crucial step toward getting society involved and aware. The World Health Organization (WHO) had a conference in 2015 to discuss global action against dementia. The committee stated that raising generational awareness was essential for encouraging action from younger generations. There is a need to search for disease-modifying therapy, improve care and quality of life and reduce the risk of dementia in Africa.
  3. The WHO emphasized that people must embed a rights-based approach in all interventions. Specifically, the WHO’s committee illustrated the importance that people living with dementia deserve empowerment. The goal is to provide support to exercise their rights and have access to enhanced autonomy to reduce the risk of dementia in Africa. Margaret Chan, director-general at the WHO, offered her view on the conference and its goals.“I can think of no other disease where innovation, including breakthrough discoveries to develop a cure, is so badly needed,” Chan said.
  4. The First WHO Ministerial Conference on Global Action Against Dementia sought to promote a better understanding of dementia, raise public awareness and engagement, demand respect for the human rights of people living with dementia, reduce stigma and discrimination, and foster greater participation, social inclusion and integration. The approval of the WHO Global Action Plan on Dementia in May 2017 allowed Alzheimer’s Disease International to put greater pressure on governments to take the issue with urgency and reduce the risk of dementia in Africa. In the African continent, there is a need for new studies to evaluate dementia prevalence, incidence, mortality and to monitor changes over time. According to WYLD Network, these studies are crucial to emphasize to governments, local and international organizations the necessity to target health policies for older people and the development of strategies for dementia care in sub-Saharan Africa.
  5. As the WHO progresses toward awareness to reduce the risk of dementia in Africa, it instilled an international surveillance platform, the Global Dementia Observatory. The WHO established this for policy-makers and researchers to facilitate monitoring and sharing of information on dementia policies, service delivery, epidemiology and research.

While there is no cure for dementia, several plans like the Global Action Plan on Dementia pave the way for successful care of those developing dementia. Updated research to reduce the risk of dementia in Africa is essential to inform officials of the development and empowerment for the most vulnerable.

Carolina Chaves
Photo: Creative Commons

As conflicts in Libya move towards the capital, Tripoli, humanitarian organizations are working to help refugees in Tripoli. Thousands of residents in Tripoli are deserting their homes as the impending fighting poses safety concerns.

Since the toppling of Muammar Gaddafi’s regime in 2011, factions in Libya have battled for control of the country. The Libyan National Army (LNA), led by commander Khalifa Haftar is on the march to take territory from the internationally recognized government of Prime Minister Fayez al-Serraj. Now the LNA is moving closer to Tripoli, at times as close as seven miles south of the city.

The international community, such as the United Nations (U.N.), the U.S. government, and the European Union (EU) are concerned about Tripoli. In fact, these organizations are appealing for a ceasefire to avoid a bloody battle for the Libyan capital. The U.N. Secretary-General, Antonio Guterres, told reporters “We have a very dangerous situation and it is clear that we absolutely need to stop it.” U.N. workers have been meeting with faction members in an attempt to bring together a peace process that eventually results in elections.

Increasing Refugees in Tripoli

Meanwhile, refugees in Tripoli, many of whom were in detention centers, are moving away from the capital to safe zones. The U.N. High Commission on Refugees (UNHCR) has already relocated more than 150 refugees.

In general, Libya is a major transit point for refugees from Africa trying to relocate to Europe. As a result of the conflicts in Tripoli, migration to Europe is increasing, as displacement is also increasing. In total, the U.N. reports 6,000 displaced peoples from Tripoli.

Humanitarian Efforts Addressing Food Stability

The U.N. is increasing the humanitarian response to help refugees in Tripoli. So far, 58 families have been evacuated. Additionally, the U.N. has established 12 shelters across Tripoli. They are working with the municipalities to find spaces for additional facilities. They anticipate that as the frontline shifts, some shelters will end up inside the conflict zone.

Together, the U.N. and the World Food Program (WFP), has collected enough food supplies to sustain 80,000 people for two weeks. That being said, as part of the Rapid Response Mechanism (RRM), the WFP and other humanitarian partners are planning to distribute two-week dry rations to 100 displaced households.

Humanitarian Efforts Addressing Health

The U.N. has medical supplies stockpiled in four sites to provide treatment for up to 210,000 people. Six EMT teams are working across Libya to assist various hospitals. So far 15 civilian casualties have been recorded and verified by the U.N. A branch of the U.N., the U.N.’s Water Sanitation and Hygiene team (WASH) have hygiene kits stocked for up to 24,000 people.

Similarly, the World Health Organization (WHO) is providing field hospitals, ambulances, and medical supplies. Dr. Sayed Jaffar Hussain, the WHO representative in Libya, implored the global humanitarian community to help, saying, “We fear that prolonged conflict will lead to more casualties, drain the area’s limited supplies and further damage health infrastructure… We call on the international community to ensure adequate funding to support the current crisis.”

U.N.’s WASH is also working on the logistics of treating, storing and transporting water to different areas of Tripoli. Addressing these goals include utilizing collapsible water tanks, water trucks and purifying tablets. They are also working to negotiate with armed groups for the protection of water shipments, advocating that water should not be used as a weapon.

Humanitarian Efforts Addressing Safety

UNICEF is monitoring detention centers and providing child protection services. Additionally, the U.N.’s Population Fund (UNFPA) is providing safe spaces and psycho-social support to help prevent gender-based violence and provide treatment for victims.

In unison, the International Organization for Migration (IOM) is working with the U.N. to find places for displaced people. In addition, the IOM and the U.N. are helping some families set up private accommodations or relocate to family members.

The safety and well being of refugees in Tripoli are progressing, as the conflict rages closer to the Lybian capital. However, as the international humanitarian community recognizes Libya’s need for aid, they are working to prepare a multi-faceted response to help those in need.

– Peter S. Mayer
Photo: Flickr

Top 10 Facts About Living Conditions in Somalia
Somalia, located at the Horn of Africa, is a country with colorful and diverse traditions, but harsh conditions. Life is not only affected by the climate, but also the treacherous political environment. In this article, the top 10 facts about living conditions in Somalia are presented.

Top 10 Facts About Living Conditions in Somalia

  1. Somalia has four seasons, two rainy and two dry ones. These seasons are combined with some of the highest mean temperatures worldwide. These conditions make farming incredibly difficult, in fact, only 0.05 percent of the land is inhabited by permanent crops. Most agricultural employment takes place through livestock. Somalia is also a large exporter of bananas, sorghum, corn, coconuts and rice. However, without consistent trade, much of this has gone to waste and has created a famine.
  2. There is virtually no infrastructure in many parts of the country due to the ongoing civil war. This affects the ability of a community to access clean water. Only 34 percent of individuals have access to sanitation services and, because plumbing is uncommon in many rural areas, 50 percent of individuals in these areas practice open defecation. Currently, progress on this issue is created through building wells, as well as implementing community programs to improve sanitation. Mercy USA has built over 580 wells in order to improve water access in Somalia. The WASH program is implementing underground wells that are attached to solar-powered sanitation systems.
  3. Another one of the top 10 facts about living conditions in Somalia relates to clean water access and adequate health care facilities. In 2017, there were over 79,000 cases of acute watery diarrhea or cholera alone. Only 6 percent of Somali residents have access to antenatal doctor’s appointments. The transmission of infectious diseases is amplified by the nomadic tendencies of pastoral clans, and the presence of large refugee camps. The WHO and UNICEF have been able to decrease measles outbreaks by administering vaccines to over 45,000 children in these camps. Nearly 50 percent of children under the age of 1 have been vaccinated for this disease.
  4. Women and children face danger on a daily basis. Armed men often take sexually violent acts against women and girls without prosecution. Children are recruited and indoctrinated by the terrorist organization Al-Shabaab. Somalia is ranked as one of the worst five places to be a woman in the world due to the widespread practice of Sharia law and restriction of gender-based freedoms. There is also limited access to health care and the prevalence of human trafficking. The Somali federal government did implement an incredibly comprehensive Sexual Offences Bill in May 2018, the bill that criminalizes sexual offenses.
  5. According to the WHO, the average life expectancy of a Somali individual is 53 years. The average expectancy of an individual to live a healthy life is only 45 years. Due to a lack of access to health care services and adequate sanitation, most adults die of infectious disease. Upon birth, only 9 percent of women are attended by a health professional. Maternal, neonatal and nutritional deaths account for approximately 18,000 deaths across both genders.
  6. The federal government only controls part of the country and formal economic activity is limited to the urban areas. Businesses are scarce due to the probability of looting and high inflation. It is 137 percent more expensive to live in Mogadishu, country’s capital, than in Tokyo. The main income of the country is international trade, but constant civil discourse prohibits this sector from experiencing significant growth. The new Public Financial Management bill should increase the government’s revenue security and control of expenses.
  7. There are two seceded states in the north: Somaliland and Puntland created after the civil war. Constant border disputes between the three regions have created unrest and violence. Around 2.1 million individuals have been displaced by federal government evictions, random acts of violence and climatic conditions. Foreign aid has made efforts to provide assistance to displaced peoples, but Al-Shabaab placed sanction prohibiting humanitarian organizations.
  8. The split between Puntland, Somaliland and the Somali Republic causes constant border disputes. There is no judiciary system to solve these issues and these disputes devolve into violent attacks. The influx of pastoral clans and refugees into major cities and ports during the dry season cause looting and disease.
  9. The government provides exponentially less health assistance than nongovernmental organizations. Regions within WHO jurisdiction have nearly twice the utilization of health services than regions without it. Maternal and child mortality rates are also much lower in these areas. Less than 50 out of 1,000 children die versus approximately 150 out of 1,000 in regions without aid. The Somali federal government has increased spending on health care services and has had 88 percent of the population for tuberculosis tested in regions without organizations’ assistance.
  10. Around 2.1 million people have been displaced internally in refugee camps. The surrounding countries have placed sanctions on incoming peoples seeking asylum due to limited resources. Those seeking asylum are also unable to travel across the disputed borders of Somaliland and Puntland because of convoys along them. With large numbers of people moving around so sporadically, it is also hard to create a consistent source of nutrition.

Poverty and civil war are rampant issues that result in many consequences for Somalia. Humanitarian aid is the main source of help in improving living conditions for over 5.4 million people that are in desperate need. Between the assistance of these organizations and the growing effectiveness of the federal government, the people of Somalia may have a decent chance to live in a comfortable environment.

– Emily Triolet

Photo: Flickr

Effects of PovertyOf all the social issues faced by a developing country, poverty often feels especially overwhelming. Of the many factors working against the poor, the effects of poverty on the brain development of children is probably the most daunting yet.

Researchers have long suspected a correlation between a child’s behavior and cognitive abilities and their socio-economic status. This correlation becomes even more apparent among people living in extreme poverty. In a 2015 study published in Nature Neuroscience, a team led by neuroscientists Kimberly Noble from Columbia University in New York City and Elizabeth Sowell from Children’s Hospital Los Angeles, California, imaged the brains of 1,099 children, adolescents and young adults in several U.S. cities. Their findings revealed that children from the lowest income bracket of less than $25,000 had up to six percent less surface area than children from families making more than $150,000. Within the poorest families themselves, income inequalities of a few thousand dollars were associated with major differences in brain structure and cognitive skills.

Within countries that live on less than a dollar a day, researchers have found other developmental problems such as stunted growth and cognitive issues. In an unprecedented study conducted in 1960, a team of researchers began giving out nutritional supplements to young children in rural Guatemala. The study was aimed at collecting data to test the theory that providing enough supplements during a child’s formative years would help in reducing stunted growth. This theory was proved in the early 2000s, when the researchers returned to check on the children who had received the supplements in the first three years of their life. They found that not only did the children grow one to two centimeters more than the control group; they even scored higher in cognitive tests. This experiment proved the effects of poverty on the brain development of children.

In 2006, the World Health Organization (WHO) published a study into the heights and weights of children between birth and age five in Brazil, Ghana, India, Norway, Oman and the United States. The results showed that healthy children, regardless of their home countries, follow a very similar growth trajectory. Based on these results, the WHO established benchmarks for atypical growth. In countries like Bangladesh, India, Guatemala and Nigeria, over 40 percent of children meet the definition of stunted growth. In light of the growing awareness and consensus around effects of stunting, the WHO included the reduction in the number of children under five with stunted growth by 40 percent as one of its six global nutritional targets for 2025.

Similar studies were conducted in Brazil, Peru, Jamaica, the Philippines, Kenya and Zimbabwe, all with the same conclusion. However, pediatric cognitive development is a complex multidimensional problem and not all stunted growth, which affects an estimated 160 million children worldwide, is connected to malnutrition. Malnutrition is one side of this multifaceted problem; poor sanitation, stressful home environments, exposure to industrial chemicals, lack of access to good education and income disparities are other possible factors.

It would not be an overstatement to say that all research points to an urgent need to address the problem of world poverty. Factors such as lack of education, poor hygiene, lack of pre-post-natal care, nutritional deficiency, exposure to chemicals and stressful childhood are some of the paralyzing issues faced by those in extreme poverty. The daunting effects of poverty on the brain development of children have already been proven by researchers and new research and studies are further fortifying what is already known. In essence, even as officials start to take action in providing adequate nutrition, research cannot be clearer in building the case for the urgent need to eliminate world poverty.

Jagriti Misra

Photo: Flickr

A large portion of the countries currently affected by hepatitis B and C are taking proactive approaches to eliminate the disease in their areas.

According to information from the World Health Organization (WHO), 28 countries representing approximately 70% of the global health burden are establishing hepatitis elimination committees. More than half of these countries have already committed funding for hepatitis responses.

Dr. Tedros Adhanom Ghebreyesus, the WHO Director-General, finds the commitment of these countries encouraging. “Identifying interventions that have a high impact is a key step towards eliminating this devastating disease. Many countries have succeeded in scaling-up the hepatitis B vaccination. Now we need to push harder to increase access to diagnosis and treatment,” Dr. Tedros said in a statement from the WHO.

Hepatitis (which means inflammation of the liver) is caused by toxins, certain drugs, diseases, heavy alcohol use and bacterial and viral infections. The disease is spread when blood or other bodily fluids enter the body of an uninfected person. Symptoms include jaundice (yellowing of the skin and eyes), fatigue, abdominal pain, swelling, chest pain, abdominal swelling, fever, and diarrhea.

The WHO report was released to coincide with World Hepatitis Day and is calling on countries to increase their commitment to end the disease. The current theme of World Hepatitis Day is Eliminate Hepatitis, focusing on increased awareness, diagnosis, universal vaccination and treatment.

Viral hepatitis affected 325 million people worldwide in 2015 and is responsible for 1.34 million deaths. The two main killer strains of hepatitis B and C affected 257 million and 71 million people respectively. WHO data shows that more than 86% of countries that were reviewed have already set national hepatitis elimination targets. More than 70% have begun to develop national hepatitis elimination programs by enabling access to effective prevention, diagnosis, treatment and care services.

Dr. Gottfried Himschall, WHO’s Director of the HIV Department and Global Hepatitis Program acknowledges that awareness of hepatitis is gaining momentum but also states that there are too many people living with hepatitis that don’t know they have the disease or cannot access treatment.

“For hepatitis elimination to become a reality, countries need to accelerate their efforts and increase investments in life-saving care. There is simply no reason why many millions of people still have not been tested for hepatitis and cannot access the treatment for which they are in dire need,” Dr. Himschall said in a statement from the WHO.

The World Hepatitis Summit in Sao Paulo, Brazil, organized jointly by the WHO, the World Hepatitis Alliance (WHA) and the government of Brazil, will bring together key players in hepatitis elimination. The summit will be held Nov. 1-3 and promises to be the largest global event to advance the viral hepatitis agenda.

Drew Hazzard

Photo: Flickr

HIV in SwazilandBy scaling up testing and treatment efforts in the past years, Swaziland has achieved big successes in the fight against the HIV epidemic. As a new study shows, more than 73 percent of adults living with HIV now have viral load suppression (VLS) and the rate of new infections with HIV in Swaziland has dropped by 44 percent since 2011.

With more than 27 percent of the adult population infected in 2016, Swaziland is the country with the highest HIV prevalence in the world. UNICEF reports that the epidemic’s effects are felt across all aspects of society: the high prevalence of the virus draws financial resources from other priority areas and burdens the country’s health system. It also affects capital accumulation and productivity negatively. Families and communities are disrupted by the virus and the number of orphans and vulnerable children has increased.

In the past years, prevention and treatment to fight the HIV epidemic were scaled up significantly in the small monarchy. The Swazi government received support for these efforts from the U.S. government President’s Emergency Plan for AIDS Relief program (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Swaziland’s strategy to contain the further spread of HIV is to dose patients with antiretroviral drugs (ARVs) immediately after they have tested positive, regardless of their health status.

ARVs drive down the HIV level in the blood, therefore reducing the risk of transmission of the virus. The concept of treatment-as-prevention aims to contain the further spread of the HI virus, and is “a major part of the solution to ending the HIV epidemic”, according to the World Health Organisation (WHO). The number of adults with HIV in Swaziland who have their viral load suppressed has doubled in the past five years and is now at more than 73 percent, according to the second Swaziland HIV Incidence Measurement Survey.

PEPFAR director Deborah Birx emphasizes that this method does not eliminate HIV in the country, but it can “contract the epidemic on our way to vaccine and a cure.”

The Swazi Ministry of Health has also developed a plan to encourage boys and men to get circumcised voluntarily. In the past years, an increased number of males opted for circumcision. According to the WHO, there is “compelling evidence” that circumcision lower the risk of female-to-male transmissions by 60 percent.

These up-scaled efforts to fight HIV in Swaziland have come to fruition: compared to 2011, the rate of new infections was cut by 44 percent.

In addition to these successes, the incidence survey also brings light to “key gaps that remain in reaching younger men and women with HIV services,” Birx said. People aged 15 to 24 are lagging behind older age groups; they were found to be less likely to know their status, and of those receiving treatment, a quarter did not suppress their infections.

Not only does the information from the survey offer an opportunity for the Swazi government to improve its efforts further and increase focus on the population groups with the greatest need, but it also adds important scientific evidence to the research about the treatment-as-prevention method.

Sibongile Ndlela-Simelane from the Ministry of Health said, in reaction to the study’s outcomes: “We are very encouraged by this progress. We understand that the battle is not over, and therefore we must maintain the momentum.”

Lena Riebl


Preventable diseases continue to claim thousands of lives each year in Africa, but leaders of state have taken a bold stand against this reality. An official pledge in January affirmed their commitment to realizing the goal of universal access to immunization by the year 2020.

African Union Commission Chairperson Nkosazana Dlamini-Zuma stated in a press release following the Addis Declaration on Immunization (ADI) summit: “With political support at the highest levels, we are closer than ever to ensuring that all children in Africa have an equal shot at a healthy and productive life.”

This announcement marks the continuation of ongoing efforts to provide immunizations to citizens of 40 separate countries by Gavi, the Vaccine Alliance. To date, Gavi has saved more than 4.5 million lives by providing vaccines.

“African leaders are making a sound economic investment in future generations,” Dr. Seth Berkley, the CEO of Gavi, said in response to the announcement.

Berkley’s comment is not figurative. According to a 2016 study by Johns Hopkins University, when factoring in quality of life and reduction in economic disease burdens, every one dollar invested by the U.S. in vaccination among the 94 poorest countries on Earth yields a staggering 44 dollars in returns. In those countries directly supported by Gavi, the figure rises even higher, to 48 dollars.

The extensive list of diseases prevented by such immunizations includes polio, whooping cough, tetanus, yellow fever, diarrhea, cervical cancers and the most deadly of all, measles. Due to its highly contagious nature, measles alone was the cause of nearly 40,000 deaths in Africa in 2013, based on a survey by the World Health Organization.

The African government is not alone in supporting immunization efforts for children. Africa United, a platform for raising awareness of global health issues, has enlisted star football athletes to provide public service adverts during this year’s Total Africa Cup of Nations tournament. “Football unites people from all across Africa and beyond,” stated Issa Hayatou, the President of the Confederation of African Football, the governing body of professional football for Africa. “Together we can help ensure millions of African children are immunized by 2020.”

Though great strides have been made during the past 15 years, approximately one in five young people in Africa still do not have access to vaccines that prevent these life-threatening diseases. This pledge may mark the first step in reducing that number to zero by providing universal access to immunization.

Dan Krajewski

Photo: Flickr