Though HIV prevalence in Nepal has dropped from 0.45 percent in 2005 to 0.3 percent in 2012, “[p]oor understanding of antiretroviral therapy (ART) amongst health officials, clinicians and patients in Nepal could undermine [those] gains … and threaten future progress in lowering the number of new infections,” PlusNews reports. The news service interviews several Nepalese HIV/AIDS specialists about the importance of patients’ adherence to ART, how difficult travel to clinics can inhibit patients from returning for medication refills or counseling, and how “[p]olicies that neglect the comprehensive nutritional, financial, educational, and pharmaceutical needs of people living with HIV/AIDS amount to treatment illiteracy at the policy level.” PlusNews writes, “Observers fear the positive results from national HIV efforts could be diluted if tensions over the administration of HIV programs continue, and adherence issues hamper implementation” (4/17).
Health Workforce & Capacity
Number Of People Worldwide With Dementia Expected To Triple By 2050; Caregivers Need Support, Report Says
The number of people living with dementia is expected to double to 65.7 million by 2030 and more than triple by 2050, with “the [current estimated] cost of treating and caring for those with the condition at $604 billion a year,” according to a report released Wednesday by the WHO and Alzheimer’s Disease International, Agence France-Presse reports (4/11). “Dementia affects people in all countries, with more than half (58 percent) living in low- and middle-income countries,” and “[b]y 2050, this is likely to rise to more than 70 percent,” according to a WHO press release.
The Associated Press/Huffington Post reports on how communications engineers are joining the fight against AIDS in Africa, highlighting a project in Mozambique that brings wireless printers equipped with cell phone technology to remote villages. “Getting AIDS test results from labs to remote villages once took weeks in Mozambique, with the information sent by courier along the impoverished country’s terrible roads. The delay could mean death,” the news agency writes, adding, “Now, communications engineers have adapted office printers and cell-phone technology to wirelessly and immediately relay test results.”
“In many parts of India, teenagers and housewives are now donning the garb of health volunteers and convincing pregnant women to deliver in hospitals, and not at homes,” the Times of India reports, and profiles Lata Ravikar, “one of the many ordinary women who are leading a silent revolution in urban slums and villages across the country.” The news service writes, “The invisible hand of these women” — called didis — “has already improved maternal and child health indicators, according to a Bill & Melinda Gates Foundation-funded initiative that has tracked their impact in two states,” noting, “In Maharashtra, for instance, the proportion of hospital deliveries has gone up from 78 percent to 88 percent in four years in the communities where these workers have been active.”
Legislation In Congress Is ‘Good Start’ To Raising Awareness Of, Preventing Attacks On Medical Workers
Attacks, kidnappings, and the murders of health care workers in the uprisings taking place across the Arab world violate principles held in the Geneva Conventions and international human rights treaties, Richard Sollom, deputy director of Physicians for Human Rights, writes in this Global Post opinion piece. “Recently I briefed the U.S. Congress on eight proximate causes — which I describe below — for the recent rise in such abuses across the Arab world,” he says. The eight causes include the unaccountability of military forces; medical workers have first-hand knowledge of the extent and responsible party of attacks; health care workers sometimes are viewed as “helping the enemy” and are attacked out of retribution; “perceived political activism”; “discrimination based on religious identity”; and “[o]f course error is a possible cause for violations of medical neutrality,” he notes.
“A network of global health research training institutions will increasingly focus on the rising levels of chronic diseases in developing countries, the National Institutes of Health Fogarty International Center announced on Wednesday,” CQ HealthBeat reports (Bristol, 4/4). NIH will award “about $20.3 million … over the next five years to support 400 early-career health scientists on nearly year-long research fellowships in 27 low- and middle-income countries,” according to a press release from the Fogarty International Center. “Program trainees will study the traditional global health problems such as HIV/AIDS, tuberculosis, malaria and maternal and child health, and will address the chronic non-communicable diseases that cause a majority of deaths in developing countries, such as cancer, cardiovascular disease and diabetes,” the press release states (4/4).
Health workers with Medical Teams International, a medical non-governmental organization, “say they are overwhelmed” by high demand at five health clinics in two southwestern Ugandan refugee centers, PlusNews reports. The refugees, “many of whom came from conflict-prone areas of the Democratic Republic of Congo (DRC),” and local residents are in need of HIV and tuberculosis (TB) prevention information, and care and treatment services, according to the news service. “Uganda suffers from a chronic shortage of health workers — less than half of the vacant health positions are filled — but the recent influx of refugees fleeing violence in neighboring DRC has put even more pressure on [the region’s] health services,” PlusNews writes. Physicians, who see 30 to 50 patients daily and often work double shifts, say gaps in the supplies of antiretroviral (ARV) and TB drugs poses concern, as does trying to follow-up with patients who may not return for visits, the news service notes (3/29).
Instability and insecurity in some West and Central African nations are threatening the success of a 20-country polio vaccination campaign, which aims to immunize 111.1 million children against the disease, IRIN reports. Ongoing insurgent attacks threaten the campaign in Nigeria, the region’s only polio-endemic country and home to 57.7 million of the children targeted, the news service notes. Parts of Mali, Niger, and Chad also pose security problems for health care workers trying to access children in remote or disputed areas, according to IRIN. “Human error and weak health systems also play an important role in sub-optimal immunization reach,” the news service writes, noting so far, “only Ghana, Cape Verde, Burkina Faso, Gambia, and Togo have achieved the required 90 percent coverage, according to UNICEF” (3/23).
Al Jazeera examines maternal mortality worldwide, saying, “If the situation continues at its current rate, the world will not meet” the U.N. Millennium Development Goal “to reduce maternal mortality by 75 percent between 1990 and 2015.” Though the estimated number of women who die of maternal mortality has dropped from 546,000 in 1990 to 340,000 today, a woman’s lifetime risk of dying during or following pregnancy in developing countries “is still high at one in 31,” compared with one in 4,300 in developed countries, the news agency reports. “Attaining zero maternal death would require greater community involvement and commitment” and increased access to contraceptives and skilled birth attendants, according to experts, Al Jazeera notes (Arjunpuri, 3/19).
PlusNews examines the challenges and concerns surrounding Zimbabwe’s plan to conduct a door-to-door HIV testing campaign, which has not yet begun but “is already being met with skepticism by activists who feel this is not a priority for the country, especially with global HIV/AIDS funding on the decline.” National AIDS officials say the country’s “AIDS levy — a three percent tax on income — has become a promising source of funding”; in 2010, $20.5 million was collected, with most of that going to purchase antiretroviral drugs (ARVs), PlusNews notes. Of the estimated 1.2 million people living with HIV in Zimbabwe, 347,000 access ARVs through a national program, and another 600,000 people “urgently” need them, according to the news service.