Emergency Yellow Fever Vaccines Set to Run Out in 2010; Recent Outbreaks in Africa and Latin America Draw 6 Million Doses - from Reuters South Africa, May 26, 2009
Zimbabwe cholera cases to top 100,000 - from the Associated Press, May 26, 2009
New South African Health Minister Aaron Motsoaledi to launch an accelerated plan for preventing mother-to-child HIV transmission in an attempt to reduce the “war-like” infant mortality statistics. - article from The Times, May 25, 2009
“Pregnancy and childbirth kill more than 536,000 women a year, more than half of them in Africa, according to the World Health Organization.” - article from the NYTimes, May 23, 2009
“The U.S. Commitment to Global Health: Recommendations for the Public and Private Sectors”, from the Institute of Medicine of the National Academies Summary available here - May 20, 2009
Celebrating Relief from Fistula in the Ivory Coast
Global Health News, Articles, Blogs, and Video - Link Drop!
May 27th, 2009Global Financial Crisis Leads to Budget Cuts in Healthcare Throughout Africa
May 18th, 2009
Courtesy of UNICEF
According to a recent report from The World Bank entitled “Averting a Human Crisis During the Global Downturn” (pdf available here), millions of people that are currently undergoing medical intervention for HIV/AIDS with antiretroviral treatment (ART) are faced with the risk of their medicines being interrupted. As international organizations and African governments are experiencing budget cuts due to the financial crisis, the health community fears that increasing unemployment will lead to reduced food security. The resulting loss of quality of nutrition will continue to put pressure on already weak health systems.
Specifically, the World Bank reports that continuity of treatment could be threatened for around 70% of people currently on ART in eastern and southern Africa. The report also addresses commitments that may need to be cut from international aid organizations. According to NAM, a non-profit community based HIV information provider based in the UK, Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, TB and Malaria has announced a funding shortfall of $4 billion in 2010. Organizations like the South African Treatment Action Campaign are speaking out to advocate for greater health funding during the crisis, pointing out that “…The region of sub-Saharan Africa bears the greatest burden of disease, and has 68% of the world’s HIV-positive people but only 1% of the global expenditure on health, and 2% of the global health workforce.”
This financial struggle during the global crisis highlights an already alarming problem. In April 2001, the members of the Heads of State and Government of the Organisation of African Unity, met in Abuja, Nigeria, and created the Abuja Declaration, committing to set aside 15% of their national expenditure towards health, specifically to fight HIV/AIDS. According to Paula Akugizibwe, regional advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia, “”Very few countries have met this goal. The money is there. It’s all about prioritisation of resources. The situation is very frightening, because governments cut back on already insufficient HIV treatment and care programmes.” (Click here for full article and Akugizibwe’s comments.)
The World Bank’s report calls for “a combination of efficiency improvements, being selective in cutting of certain types of expenditures, and/or income support mechanisms can allow governments to maintain services that are critical to the most poor and vulnerable.” The report also lists the hazards of stopping treatment for those who are receiving it, including:
- Severe consequences for households (”children orphaned, loss of human capital, increased household poverty”), and the loss of experienced workers to the economy.
- Increased infectiousness of those who stop being treated.
- Diminished drug effectiveness, “requiring use of extremely costly second-line drugs and placing additional demands on health systems to monitor their use.”
Summary of the World Bank’s Key Policy Recommendations regarding HIV/AIDS
- A more rigorous and determined push for efficiency and cost-effectiveness helps countries better prioritize resource allocations across HIV/AIDS treatment and prevention programs.
- For countries with high reliance on external financing for AIDS programs, national authorities and their development partners should identify impending cash flow interruptions and provide bridge financing that, at the very least, prevents treatment interruptions.
- A simple early warning system can help track and minimize treatment interruptions, including better monitoring of drug supplies and use of key health services.
- For countries receiving emergency budget support, an appropriate base level of funding for HIV should be included as part of the social protection package.
Interesting links:
- May 18, 2009: South Africa’s Netcare seeing revenue growth as demand for private health care increases
- May 16, 2009: Op-Ed in the New York Times discussing the need to prioritize maternal health in Sierra Leone
- May 14, 2009: African Response to influenza A(H1N1)
May 11, 2009
DDT Use Discouraged in Africa and Asia Due to Health Effects
May 4th, 2009The health community continues to focus on malaria (see our recent post on new malaria detection technologies), as governments, health organizations, and non-profit organizations hope to eradicate this deadly disease. Almost 1 million people die from malaria every year, and the majority of deaths occur in children living in sub-Saharan Africa. DDT is the pesticide that is commonly used to target mosquitoes, which are the vector for the parasites that cause malaria.
Scientists at the National Institute of Environmental Sciences (NIEHS) have concluded that DDT “should be used with caution, only when needed, and when no other effective, safe and affordable alternatives are locally available.” The scientists also reported that the adverse health effects associated with DDT include genital birth defects, breast cancer, and diabetes. (See full article and research here.)
While most of the world banned DDT in the 1970s (in the US, DDT was banned in 1972), DDT continues to be used in Africa and Asia to curtail the spread of malaria. In 2006, the first President Bush created the President’s Malaria Initiative (PMI). The initiative, while producing marked results, includes a program called Indoor Residual Spraying, or IRS.
IRS is a routine anti-malarial program, used by many organizations. Because of this, DDT use is on the rise in Africa and Asia. Only one study has been conducted to study the effects on individuals living in areas where IRS is employed routinely. In this study, conducted in 2007, men in South Africa who were continually exposed to DDT were found to lower sperm counts, lower semen volume, and high levels of DDT in their blood. DDT is also known to accumulate in other bodily fluids, such as breast milk.
“DDT is now used in countries where many of the people are malnourished, extremely poor and possibly suffering from immune-compromising diseases such as AIDS, which may increase their susceptibility to chemical exposures,” said panel member Jonathan Chevrier, a University of California at Berkeley post-doctoral researcher in epidemiology and in environmental health sciences.
The authors of the study from NIEHS hope that the scientific community can find a suitable, and safer, pesticide to use in the war against malaria. In the meantime, we hope that DDT will be used as more sparingly in Africa and Asia, while other methods of prevention against the spread of malaria, such as bed nets and anti-malarial drugs, will be more readily available to those who need it the most.
