Ebola Outbreak Destroying Health Systems in West Africa

Posted December 3, 2014

The ongoing outbreak of Ebola has damaged the health systems of Liberia, Sierra Leone and Guinea, said the World Health Organization. From VoA:

Ebola has killed about 6,000 people. But WHO Coordinator of Health Systems, Dr. Gerard Schmets said the deaths of many more people suffering from malaria, chronic diseases and other illnesses probably can be linked to Ebola.

He said Ebola has damaged the delivery of general services in Guinea, Sierra Leone and Liberia. For example, he noted health workers who are caring for Ebola patients are no longer available to work in ordinary health care centers, disrupting important services such as vaccination programs.

“For example, pregnant women do not have access to the care they need. Pregnant women do not have access to health centers simply because the health centers are closed, because we do not have staff in these health centers anymore. In Guinea, for example, the general consultations and the hospitalization rates have dropped by 50 percent,” said Schmets.

Schmets noted that health systems in the three countries were very weak well before Ebola struck. For example, in pre-Ebola days Sierra Leone had 0.2 doctors per 10,000 inhabitants compared to 2.5 in the rest of Africa and 14 doctors per 10,000 inhabitants in the rest of the world.

He said the impact of the epidemic on already shaky health systems is huge and must be urgently addressed.

“We need clearly to focus on Ebola response. We need clearly to focus on rebuilding the general services, but we need also to focus on making the system resilient, to making the system stronger to resist the future epidemics or any disasters in the future,” said Schmets.

The World Health Organization is organizing a meeting next week in Geneva focused on building resilient health systems in Ebola affected countries. Major financial institutions including the World Bank and the African Development Bank will participate, as will ministers of health and finance from Liberia, Sierra Leone and Guinea.

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Global Health and Development Beat

An estimated 2.5 million adults in Kenya are regular users of tobacco; this is according to a study conducted by government. The Global Adults Tobacco survey shows 11.6 per cent of the adult population either smokes or uses smokeless tobacco.

The Treatment Action Campaign boycotted South Africa’s World AIDS Day proceedings for the second consecutive year as the group alleges that the millions of rands used to host this year’s event in the Free State would be better spent strengthening the health system.

People living with HIV/AIDS in conflict zones are victimised twice – first by the virus itself, and second by the breakdown of health services, which can make treatment impossible to come by, said MSF.

Hazel Tau talks to VOA about her decision in 2002 to reveal her status to the entire country by suing in South African court for access to cheaper AIDS drugs, which were then behind a high wall of patent protection. At the time, she was working as an HIV counselor and spending more than one-fifth of her pay on medication.

Brazil, Cameroon, Ethiopia, Gabon, the Gambia, Iran, Kiribati, Malaysia, Mauritania, Mauritius, Mexico, the Philippines and Uruguay are the latest in a growing list of countries to make great strides in combating undernourishment, said the UN Food and Agriculture Organization in honoring the 13 countries.

Lack of access to clean water and basic sanitation in southern Africa hampers the fight against HIV/AIDS by reducing the effectiveness of life-saving drugs. Access to clean water is essential for HIV-positive patients who receive ARV drugs, because they need 1.5 litres of water per day just to absorb the medicine, said a report published by WaterAid and SAfAIDS.

People with HIV are at higher risk of developing cancer and with more than six million people living with HIV in the country, South Africa faces the threat of an HIV-related cancer epidemic.

A year on from the introduction of a new female condom in Ethiopia, KC Team explores what impact it is having on the lives of young women, including sex workers.

The G20 nations, comprising the world’s largest economies, met in mid-November in Brisbane, Australia, and came up with an action plan on how to fight corruption. The plan is an outgrowth of what happened in 2010 when G20 leaders created the “Anti-Corruption Working Group” at a summit in Toronto.

In the 35-years of the AIDS epidemic, about 80-million people have become infected with HIV and nearly 40-million have died. But great progress has been made in recent years in preventing and treating the disease. UNAIDS – the Joint United Nations Program on HIV/AIDS – has set a goal of ending the epidemic by 2030. An advocacy group says a strategic plan and much funding are needed to achieve that goal.

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Spotlight on PSI

In a post for The Hill blog, PSI ambassador Ashley Judd and Deb Derrick, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, share the lessons they learned from seeing the fight against AIDS on the frontlines. An excerpt:

In her role as Population Services International (PSI) ambassador, Ashley has traveled the world, meeting people like Kausar. A mother of two in Dharavi, India, Kausar was told by her doctor upon finding out she was HIV-positive, “There are drugs, but you cannot afford them, and you’ll be dead in ﬁve years anyway.” Rather than accept this fate, she decided to fight — literally. She slapped the doctor’s face, which landed her in front of a judge. Thankfully, she won the case and went on to continue fighting. She fought not only for herself — getting the necessary medications — but for her entire community, transforming her life and those of the people around her. Kausar now serves as a PSI peer educator. She has managed to not just survive, but to rise above circumstances many of us cannot imagine.

A trip to Zambia, and the opportunity to meet Isther, a young mother of three, had a similarly significant impact on Deb. During her first pregnancy, Isther and her husband tested for HIV and learned that they were both positive. Not that long ago, the story might have ended tragically. Instead, they started treatment, and Isther received services to prevent transmission to her child. Not only was her baby born HIV-negative, but two years later she gave birth to a healthy set of twins. Today, Isther and her family are healthy and happy, and all three children remain HIV-free.

Stories of hope like Kausar and Isther’s have taught us several critical lessons:

U.S. leadership has been instrumental in the fight against HIV/AIDS. The Global Fund, of which the United States is the largest donor, and the U.S. government’s President’s Emergency Plan for AIDS Relief (PEPFAR) account for roughly 80 percent of international assistance.

Partnerships are paramount. Financing is only part of the solution; it is technical partners — including PEPFAR, the UN family, and NGOs such as PSI — that implement lifesaving programs on the ground.

Defeating HIV/AIDS is a shared responsibility. In order to sustain momentum over the long term, an increasing level of support will need to come from domestic resources. Already, implementing countries’ financial contributions are growing. Over 80 countries increased their domestic investments in the HIV/AIDS response by more than 50 percent between 2006 and 2011, and several nations in sub-Saharan Africa are evaluating innovative financing mechanisms to help bridge the gap between available resources and existing need.

Women and girls are central to the solution. Globally, girls and young women 15 to 24 — for whom HIV/AIDS is the leading cause of death — are twice as likely to be at risk of infection as boys and young men in the same age group. This can be attributed to many factors, including unequal power in sexual relationships, gender-based violence, lack of economic control and poor access to health information and services.

Progress has been made. Global HIV/AIDS-related deaths have fallen 30 percent since their height in 2005. More than 9.7 million people in low- and middle-income countries now haveaccess to treatment and new infections among children have fallen by 52 percent since 2001.

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Buzzing in the Blogs

Some ideas on how to create a culture of effective philanthropy from Charlie Bresler, executive director of The Life You Can Save. An excerpt:

According to the “Money for Good” study, commissioned by the Hewlett Foundation, Aspen Network of Development Entrepreneurs, The Metanoia Fund, and the Rockefeller Foundation, only 35% of people do any research on the impact of their donations and of those, 75% do less than two hours. More upsetting is that only 16% of individuals surveyed report that their priority is the impact of their donations. So how do we reconcile the outpouring of humanitarian concern and aid during crises and the relative dormancy the rest of the time?

I suggest that there is a useful distinction to be made between “associational” giving and “optimal” giving. Understanding this distinction helps make sense of our behavior.

Most of our giving induces a “warm glow.” This giving is generally familial, personal, local, or at least domestic. While this giving does not produce “the most bang for the buck,” it fulfills us emotionally: we can see the impact of our gifts (or at least imagine the impact), right there in front of us.

Similarly, “crisis giving” occurs when the media brings a crisis into our lives in such a vivid way that it can grab us as if it is right in front of us. This effect does not persist or, unfortunately, generalize to other desperate situations that are ongoing among those living in extreme poverty.

“Optimal” giving, on the other hand, is when a donor wants to get the most “bang for the buck.” Since a dollar goes dramatically further in the developing world than in developed countries, and most extreme poverty and its effects are centered there, charities operating effectively in the developing world are best positioned to achieve optimal results.

At The Life You Can Save, we encourage donors to do two things: 1) move some “associational giving” to “optimal giving” in order to get the most impact for their dollars and 2) consider giving more overall, including taking an income-based pledge. For this Giving Season and the New Year ahead here’s a resolution worth considering: I will investigate the charities I donate to more thoroughly than I have in the past and give more generously to support the charities that deliver “bang for the buck.”

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