Refugees International: Articles: Combating HIV/AIDS, Malaria & Other Diseases

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Combating HIV/AIDS, Malaria & Other Diseases

Sierra Leone 2001: HIV Positive Woman
08/23/2005

UN Millennium Development Goal #6

Disease remains a tremendous obstacle to sustained development and genuine improvement in global welfare. Every thirty seconds, a child dies of malaria. Every eleven seconds, a person dies of AIDS. And every second of every day, a mother, a father or a child is newly infected with tuberculosis. Illness, morbidity and death diminish household labor potential and agricultural production, threaten the safety and well-being of the community, deflate the economy and undermine social and political security. The burden of HIV/AIDS, malaria, tuberculosis and other preventable diseases helps to perpetuate the devastating cycle of impoverishment, vulnerability and destitution that plagues poor and underdeveloped countries today.

The Sixth Goal

The sixth goal of the UN Millennium Challenge is thus to combat HIV/AIDS, malaria and other diseases.

To Combat HIV/AIDS

Target: Halt and Begin To Reverse the Spread of HIV/AIDS

In the last year, an estimated three million people died of AIDS – eight thousand deaths every day. Another five million became newly infected with HIV – more than thirteen thousand new victims every day. Globally, more than 39 million men, women and children are infected, and there appears to be no end in sight. Despite unprecedented global attention and public awareness, the epidemic continues to spread, devastating the young and impoverished disproportionately as it undermines global social and economic stability. For children and dependents, the burden weighs most heavily. More than two million children are now infected with the deadly virus and fifteen million have been left destitute and orphaned in its wake.

In order to halt and begin reversing the spread of HIV and AIDS, the UN Taskforce on HIV/AIDS clarified two quantitative benchmarks to measure progress: a reduction in prevalence among youth to 5% in the most affected countries and by 50% elsewhere by the year 2015, as well as guaranteeing equitable and sustained access to antiretroviral therapy to at least 75% of those in need by 2015. Preventing new infections and minimizing the spread of HIV are the only means to accomplish these goals. Thus, scientifically-proven prevention measures must constitute the basis of all targeted efforts, including: comprehensive sexuality and reproductive health education for all children and young adults; campaigns promoting safe sex; universal access to voluntary testing and counseling services, prenatal screening and access to antiretroviral drugs in order to prevent mother-to-child transmission; and increased distribution and accessibility to condoms and contraceptives. To address regional disparities in disease transmission, additional measures are often appropriate in targeting vulnerable populations. Needle exchange and opiate substitution services for drug users are proven to reduce disease transmission and would effectively limit new infections throughout China and Southeast Asia, Russia, Ukraine, India and regions of Central and South America. Health education, counseling and condom distribution to commercial sex workers would similarly address the needs of this high-risk population.

Beyond prevention, medical treatment and improved nutrition are critical to sustain the lives of the 39 million currently infected with HIV/AIDS. An estimated two billion people lack access to even basic health services, due in part to shortages in skilled health workers, economic barriers to treatment, physical limitations of inadequate infrastructure, and the general deficiency of social and public health spending throughout the developing world. Only 8% of all pregnant mothers have access to services that would prevent mother-to-child transmission of the virus; and of this small number globally with access to antiretroviral therapy, it is rarely the poor or most in need.

To Combat Malaria and Other Diseases

Target: Halt and Begin to Reverse the Spread of Malaria and Other Major Diseases

Beyond AIDS, malaria and tuberculosis constitute a majority of the global disease burden. More than half of the world’s population is exposed to malaria and more than one-third is infected with the tuberculosis bacterium. Malaria alone afflicts between 300 and 500 million people every year with severe illness and kills one million annually. Not surprisingly, children and pregnant women are acutely vulnerable to the disease. Among children that survive malaria, brain damage and mental impairment is common. For pregnant mothers, anemia and labor complications, low birth weight and perinatal mortality often result. Tuberculosis kills an additional two million annually and infects an estimated nine million every year. Easily spread in crowded spaces through airborne pathogens in a sneeze or cough, it thrives on the weakened immune systems of the poor, malnourished, elderly and ill. 95% of those suffering from tuberculosis live in developing countries.

To halt and reverse the spread of malaria, a series of interventions are recommended, including: improved housing standards; mass distribution of insecticide-treated bed nets; DDT and pyrethroids for residual spraying; increased public awareness and malaria prevention education; improved monitoring, epidemic forecasting and transmission modeling; increased funding to provide early diagnosis and comprehensive treatment for the afflicted; as well as targeted programming to provide preventive treatment to pregnant women.

To halt and begin reversing the spread of tuberculosis, the Taskforce recommends: investing in the development of new drugs, diagnostic measures and vaccines to address multi-strain resistant tuberculosis; ensuring adequate and consistent tuberculosis treatment with sputum smear microscopy, short-course chemotherapy and the full course of medication for all infected; and establishing collaborative efforts to screen and treat HIV-related tuberculosis. In order to address these concurrent health crises, it is critical to invest in improvements to the institutional and service delivery capacity of national health systems throughout the developing world. Until there exists near universal access to health information, vaccinations and preventive healthcare, and adequate screening and treatment for infectious and non-communicable disease, progress in reversing the spread of HIV/AIDS, malaria, tuberculosis and other diseases will remain remote.

The Displaced and Stateless Populations

Refugees, the internally displaced and stateless populations are generally unable to access basic health services or social assistance, these populations are highly susceptible to disease transmission and affliction. Without adequate nutrition or clean water, shelter or sanitation, the displaced and destitute thus suffer disproportionately.

Refugee and internally displaced women and girls fleeing persecution are often without protection from sexual violence and rape, resulting in the violent spread of HIV and sexually transmitted disease to these innocent populations in war and conflict. Afflicted with the virus, displaced and stateless mothers are unable to access antiretroviral therapies that would block transmission of HIV to their nursing infants. With limited health programming available in refugee and displacement camps, as well as within stateless communities, screening and surveillance measures to track the spread of disease remain woefully inadequate. Lacking access to even the most fundamental of prevention tools – such as insecticide treated bed nets and condoms – disease continues to spread within these vulnerable populations.

The achievement of the sixth Millennium Development Goal will thus be more likely if the following actions are taken to address the needs of displaced and stateless persons:

Beyond expanding and improving the quality and coverage of primary health systems, governments and international donors increase investments in public health in order to remove user fees for primary healthcare, increase the number and quality of trained health workers, and increase access to health and disease prevention information.
International humanitarian organizations, UN agencies and local NGOs improve health programming and target disease transmission in refugee and displacement camps, communities hosting displaced populations, as well as within stateless communities by distributing treated bed nets and insecticide, condoms, and information on disease transmission in conjunction with voluntary screenings for HIV and tuberculosis.
International humanitarian organizations and national governments scale-up security and protection services to refugees, displaced and stateless populations in order to minimize the spread of HIV and sexually transmitted disease associated with conflict, rape and gender-based violence.