According to a report to be released by UNICEF on Thursday (9/17/09), the number of children dying before the age of five has fallen below 9 million, the New York Times reports. This is the lowest that this rate has been since child mortality has been tracked, since about 1960. In 1990, 12.5 million children under the age of 5 died. In 2008, UNICEF is estimating that number to be 8.8 million.
Public health experts say that an increase in the distribution of vaccines, mosquito nets, and a rise in the number of women breast-feeding (which reduces the amount of contaminated water infants consume) has contributed to the decrease in child deaths. Malawi has experienced one of the largest drops in childhood mortality. Malawi’s success is owed in large part to their health workers. Over 10,000 high school-educated village health officials work in Malawi. With at least 10 weeks of training, they are able to diagnose illness, provide injections, and give out medicines. Not having to depend on doctors or nurses in rural villages makes a world of difference in the continued struggle to bring down child mortality rates.
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In related news, South Africa has launched an ambitious, 2-week program to vaccinate and provide vitamins to 3 million children across the country. The program, started on September 7th, was set up by Health Minister Dr. Aaron Motsoaledi. Temporary clinics have been set up and health workers are going door-to-door to visit various homes throughout the country. Dr. Motsoaledi is a welcome figure in South Africa, after years of health leaders who have denied the link between HIV and AIDS and the effectiveness of anti-AIDS drugs.
Private Equity Fund to Invest in Health Care
The International Finance Corporation (IFC, a member of the World Bank Group), the African Development Bank, the Bill and Melinda Gates Foundation, and a German development finance group DEG, have combined forces to create a new private equity firm that will specifically invest in the health care sector of Africa. The Health in Africa Fund will “invest in small- and medium- sized companies in sub-Saharan Africa … with the goal of helping low-income Africans gain access to affordable, high-quality health services.” [Full Article]
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UN Working to Improve Communications for Health Workers
The Economic and Social Council of the United Nations is supporting the expansion of the telecommunications available for health workers in West Africa. The World Health Organization’s program eHealth will promote communications between physicians for diagnostic purposes, while also creating ethical and legal policies surrounding the collection and storage of electronic health information. The Director General of Ghanaian health services, Dr. Elias Sory says, “If you get a doctor who is away in the village and has come across a case he or she thinks is beyond him or her, why cannot that doctor be able link up easily with a senior doctor in Korle Bu to get advice on it? So we are not there. But eHealth will get us there.” [Full Article]
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HIV/AIDS Progress
During a briefing at the World Economic Forum on Africa being held in Cape Town, U.N. Special Envoy for HIV and AIDS in Africa Elizabeth Mataka said that several African countries have successfully scaled up their HIV/AIDS prevention and treatment programs, reports The Lusaka Times. Mataka listed Zambia and Botswana as some of the countries in Africa that have cited significant gains in the fight against HIV/AIDS. [Full Article]
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.
The 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.)
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.
Sierra Leone , Comende village. Malaria has followed Amadu Sheriff through all the four years of his life. According to his mother, Amadu,Äôs recent infection is just the latest in a row. To Amadu and other children in Sierra Leone, access to medicine and bed nets are essential to prevent the disease from killing them.
As new diseases cause epidemics and public health emergencies worldwide (swine flu, avian flu, SARS), Africa continues to battle against malaria - one of the world’s oldest maladies. Symptoms of malaria were recorded in ancient Chinese medical writings dated to 2700 BC. While medicines and preventative measures are available, scientists and doctors struggle against the disease’s drug resistance. The mosquito-borne disease claims the life of over one million people worldwide. Most casualties are among young children in Africa.
The Centers for Disease Control and Prevention commemorated World Malaria Day on April 25th, directly on the heels of the announcement by researchers at the University of Glasgow that an electronic chip could serve as a new weapon in the fight against malaria. View video on chip, courtesy of the BBC
While the chip is still being discussed as a method for travelers to Africa to remain safe and disease-free, the public health implications for Africans are astounding. New pledges from US President Barack Obama to meet the United Nation’s goal to eradicate malaria by 2015 have encouraged many living in Africa, as well as public health specialists and doctors; technological advances in detection would only help in this fight.
Hendrik Chassé is the newest member of A Chance for Every Child’s Board of Directors. An avid traveler and CFA charterholder, Hendrik has also been elected as the organization’s Chief Financial Officer, replacing Colin Stewart, who has been elected President. Hendrik is committed to using his experiences, and the relationships he has cultivated by working in financial management, to further ACEC’s mission and to make a meaningful impact on the health and quality of life of children in Sierra Leone.
The addition of Hendrik to the ACEC family is a move to continue to incorporate individuals who are passionate about philanthropy and inspired to use their professional skills to advance health and education in the developing world. We are excited to be working with him as ACEC continues to affect change in Sierra Leone.
African Union (AU) Commissioner for Social Affairs, Biencé Gawana, insists that African countries should focus on promoting maternal, infant and child health and reporting on progress. During a summit on child and maternal health in Addis Ababa, Ethiopia, the members of the AU agreed to create a continent-wide campaign to stress the importance of child and maternal health. While Africa has some of the highest rates of maternal, infant, and child mortality, progress is being made. As information and communications technology and innovation continue to grow, health officials are certain that the improvements to maternal, infant and child health will be “paramount”. In addition, the AU has proposed a pharmaceuticals manufacturing plan, which will allow countries within Africa to produce their own drugs and medicines.
In the hope of reducing child and maternal mortality, which are key indicators of the health of any community, 60 nursing aides in Sierra Leone have recently been awarded certificates for passing a course specifically educating them in child mortality. While there is a lack of qualified health workers willing to work in health throughout Sierra Leone, the graduation of these 60 nursing aides shows that Sierra Leone has heeded the advice of the AU, and has taken steps to assure that infant, child, and maternal mortality decreases over time.
In 1997, Dr. Andre Briand noticed that the nutritional balance of proteins, lipids, and calories in a popular chocolate spread was similar to therapeutic meals used to treat children suffering from severe malnutrition. Two years later, Plumpy’Nut was born. (click here for transcript of an interview with Dr. Briand)
Dr. Briand, a French pediatrician, had been searching for a method to supply malnourished children with the nutritional equivalent of therapies recommended by the World Health Organization (WHO). While these suggested diets worked extremely well, it was impossible to reach a wide population of children because the special combination of meal powder, oil, sugar, vitamins and minerals required the use of clean drinking water to prepare (an ingredient often unavailable in villages throughout the world).
Plumpy’nut is a Ready-to-Use Therapeutic Food (RUTF) contained in individual packets, usually foil pouches. RUTF packets are administered to children regularly, and requires no addition of any materials, which reduces the risk of bacterial infection. Plumpy’nut is also convenient for home administration: allowing health workers to follow the progress of children receiving treatment, but also freeing space in normally overflowing treatment centers and hospitals. Plumpy’nut is also being produced in Africa, which reduces the cost of distribution and creates a sense of self-sufficiency and control among the populations that need food therapy the most.
Anderson Cooper interviewed Dr. Milton Tectonidis, a nutrition specialist with Doctors Without Borders for 60 Minutes. Dr. Tectonidis states, “It’s a revolution in nutritional affairs. … Now we have something. It is like an essential medicine.”
Recent developments in Sierra Leone highlight the lack of adequate healthcare in the region. According to the IRIN (Integrated Regional Information Networks), an editorially independent part of the UN Office for the Coordination of Humanitarian Affairs, clinics that were approved to open under the SLPP (Sierra Leone Peoples Party, defeated in 2007) have never been built. In the village of Charlotte, residents use wheelbarrows to cart those needing medical care to Regent, a neighboring village. The distance is approximately 9 kilometers (5.6 miles). The last medical care given to the residents of Charlotte consisted of a temporary clinic created by volunteer doctors in April 2008. These doctors distributed medicines and treatment before leaving.
As of 2004, the World Health Organization (WHO) estimated that Sierra Leone had 168 doctors in the entire country (far short of the 1 per 10,000 residents that WHO recommends). Sierra Leone falls at the very bottom of UNICEF’s recent report of The State of the World’s Children 2009, with respect to maternal and newborn health. However, UNICEF workers there remain hopeful that the health of Sierra Leonians is improving. According to Dr. Samuel Kargbo, of the Sierra Leone Health Ministry, health is a top priority for the government in 2009. The UK-based Department for International Development is slated to help develop the infrastructure necessary for improving health throughout the country. However, it has been acknowledged that money is not the only answer to the nation’s failing health. Systems, infrastructure, and medical personnel are necessary to execute government plans for rebuilding the war-torn country. Short and long-term sustainable goals are necessary, according to UNICEF, to dramatically reduce infant mortality.
Over the past few months, A Chance for Every Child has been busy working to launch its new-and-improved site. A very special thanks to Matt Thomas for redesigning everything from the ground up. Check out our new Donate page and our Tell-a-Friend feature. A lot of exciting things are in store for 2009, so remember to come back and read this blog for news, events and updates!
