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A diverse look at global health issues.

Africa’s next big health challenge: non-communicable diseases

Though HIV/AIDS gets more attention, an increase in deaths from heart disease and diabetes threatens the continent's economic and social development.
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From left: Dr. Raj Panjabi, associate physician at Harvard Medical School moderates a panel on Monday, August 4, 2014, on non-communicable diseases as part of an ongoing conference in Washington DC on US-Africa investment. The panel brought together government officers and private investors from US and Africa. (Indrani Basu/GlobalPost)

WASHINGTON — Facing inadequate health care resources in their home country, each year more than 7,000 Kenyans seek treatment for non-communicable diseases (NCDs) like cancer and cardiovascular disease outside their nation’s borders in European and Asian countries.

“Some of them die on the way to these countries,” said James Macharia, Kenya’s Cabinet Secretary for Health, before a crowd of government officers and entrepreneurs from US and Africa in Washington on Monday. “Others die on the way back.”

NCDs are a growing problem in Kenya and across the African continent. For every death due to HIV in 2005, cardiovascular disease killed five others in Africa. By 2015, chronic diseases will account for a quarter of deaths in Africa, according to the World Health Organization. And by 2020, the largest increases in NCD deaths will occur in Africa, by far surpassing any of the developed countries, the WHO estimates. The global health body predicts that if this trend continues in Africa, NCDs alone will kill far more people than deaths due to communicable and nutritional diseases put together.

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Mobile health unproven but not without potential in South Africa

Proponents say working in the relatively new field of mHealth is "like flying and building a plane at the same time"
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The 'Vodacom' tower in Johannesburg, South Africa, reminds onlookers of the importance the telecommunications sector plays in this nation of 53 million citizens, where there are more mobile SIM cards then there are people. July 2014. (Sara Jerving/GlobalPost)

JOHANNESBURG, South Africa – Towering over downtown Johannesburg is a huge cylindrical skyscraper, a red banner at its crown with one word printed in white, ‘Vodacom’—the name of the largest telecommunications company in South Africa. The tower reminds onlookers of the importance the telecommunications sector plays in this nation of 53 million citizens, where there are more active mobile SIM cards then there are people.

The dominance of mobile technology is hard to miss in South Africa. The country has one of the highest mobile subscriber penetrations in sub-Saharan Africa. Advertisements for companies like Vodacom litter the airwaves and online. In a city like Johannesburg, there are few residents who aren’t connected to the rest of the world through a cellphone. 

For South Africans, having a cellphone means more than just socializing. It also means having a portal to access information and connect with health services.

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Here's what you need to know about #AIDS2014

Highlights from this year's 20th International AIDS conference, themed 'Stepping up the Pace' against HIV, via Storify.

Two advances may pave new ways for combating malaria

GlaxoSmithKline has applied to license the world’s first malaria vaccine and researchers in Tanzania have developed a new model for testing malaria drugs in Africa.
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South Sudanese suffering from malaria rest in the MSF (Doctors Without Borders) tent near the temporary camp for internally displaced persons in Mingkaman, South Sudan, on February 5, 2014. Around 90 percent of all malaria deaths occur in sub-Saharan Africa. (Fabio Bucciarelli/AFP/Getty Images)

The UK-based pharmaceutical company GlaxoSmithKline made waves last week with the announcement that it was seeking regulatory approval for the world’s first-ever malaria vaccine. GSK hopes that its vaccine, called ‘RTS,S,’ will prevent millions of malaria cases each year.

Meanwhile, researchers in Tanzania said this week they have made strides in developing an important research tool that they hope will significantly contribute to developing anti-malarial drugs and vaccines suited to the African population.

Both recent advents in the field of malarial research hold promise in tackling one of the world’s deadliest diseases. But there’s still a long way to go before eradicating malaria, experts say.

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Cultural differences complicate Ebola treatment in West Africa

Distrust of Western medicine is fast becoming one of the biggest problems in dealing with the recent Ebola outbreak.
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A member of the Guinean Red Cross uses a megaphone to give information concerning the Ebola virus during an awareness campaign on April 11, 2014 in Conakry. Guinea has been hit by the most severe strain of the virus, known as Zaire Ebola, which has had a fatality rate of up to 90 percent in past outbreaks, and for which there is no vaccine, cure or even specific treatment. (CELLOU BINANI/AFP/Getty Images)

Since the deadliest Ebola outbreak to date began in West Africa earlier this year, more than 670 people have died, according to the World Health Organization (WHO). Two Americans are among those who have been infected with the deadly infectious virus.

Ebola, which spreads through blood, sweat or other bodily fluids, can kill up to 90 percent of its victims. But aid workers say that in the countries hardest hit by Ebola — Sierra Leone, Guinea and Liberia — hostility toward Western medical treatment is pushing the outbreak to escalate dramatically.

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Ignorance and denial are prolonging the AIDS crisis in tiny Lesotho, Africa

Commentary: Country has world’s second-highest rate of HIV infection, in spite of hundreds of million in international aid.
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Children run towards charity workers on February 23, 2013 in Morija, Lesotho. (Chris Jackson/Getty Images)

MASERU, Lesotho – Some rankings instill pride. Others instill shame, and should inspire every effort to get off that list.

Two years ago, in a report for GlobalPost, I described how tiny Lesotho, a landlocked country high in the mountains of southern Africa, achieved a first for the entire region: a peaceful handover of power from ruler to opposition.

Two years later, the Basotho people of Lesotho have quietly climbed the wrong list. UNAIDS, reporting the “hope that ending AIDS is possible,” now ranks Lesotho as suffering the world’s second-highest rate of HIV infection; at 23 percent, the tragedy has touched nearly every Basotho family.

The rate of Lesotho’s HIV affliction hasn’t changed in a decade. The country, under a fragile coalition government, has become a case study for the limits of international development assistance, and a cautionary tale for what happens when a country is reluctant to tackle the real issues that plague ordinary people.

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Red Cross worker in Gaza: 'The psychological wounds are many'

Q&A: Maria Cecilia Goin describes the mounting difficulties in providing aid to civilians in Gaza.
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Civil Defense workers evacuate the body of a little girl killed during the ongoing Israeli military offensive on the Shejaiya neighborhood between Gaza City and the Israeli border, which has left more than 50 people dead in a blistering bombardment which began overnight, medics said on July 20, 2014. (Mohammed Abed/AFP/Getty Images)

More than 600 people have died in Gaza since a wave of new violence between Palestinians and Israelis erupted two weeks ago. The United Nations estimates that over three quarters of those dead in Gaza are civilians, with at least a hundred of them children. A hospital that was hit by Israeli shells on Monday, Al-Aqsa Hospital, claimed five more lives, and injured over 70 people.

The fighting in the region during the Islamic holy month of Ramadan has robbed people of basic utilities like water and electricity, and made many others homeless. Aid workers in Gaza told GlobalPost that more than 90,000 people are currently without any water supply, and 18-hour power cuts have become the norm. The bombing intensifies during night, according to one aid worker, terrifying locals who can barely sleep until there is a relative lull after sunrise. And hundreds of people have taken shelter in basements, schools and hospitals.

The International Committee of the Red Cross (ICRC) has been working in Gaza since the recent fighting began, providing medical and infrastructural support to local aid workers. GlobalPost spoke with ICRC’s spokesperson Maria Cecilia Goin, who is in Gaza, to learn more about the organization’s efforts.

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HIV pill: Progress or setback?

New WHO recommendation on prevention medicine highlights debate about how to end the virus for good.
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MELBOURNE, AUSTRALIA - JULY 20: (CHINA OUT) (L-R) President-Elect of the IAS Chris Beyrer, president of the IAS Francoise Barre-Sinoussi, UNAIDS Executive Director Michel Sidibe, executive Officer of Living Positive Victoria Brent Allan, Ayu Oktariani, professor Sharon Lewin and Michael Kirby attend a press conference during the 20th International AIDS Conference at The Melbourne Convention and Exhibition Centre on July 20, 2014 in Melbourne, Australia. At least six delegates travelling to the 20th International AIDS Conference were on board the Malaysia Airlines flight MH17 which was reportedly shot down over Eastern Ukraine. (ChinaFotoPress/AFP/Getty Images)

The World Health Organization’s new recommendation that men who have sex with men should consider taking preventive medicine to help avoid HIV infection has renewed debate in the global health community about the best way to combat the disease.

In a set of guidelines on HIV treatment, care and prevention released this month, the WHO announced for the first time that among men who have sex with men, PrEP – short for pre-exposure prophylaxis – “is recommended as an additional HIV prevention choice within a comprehensive HIV prevention package.” Such a package should include monthly HIV testing, counseling and condom use, according to the report, published just ahead of the 20th International AIDS Conference, which started July 20 in Melbourne.

The announcement met a mixed response, with some AIDS experts and advocates saying that the recommendation is a step forward in HIV prevention strategies. Critics argued, however, that encouraging the use of PrEP could result in a drop in condom use and reverse existing prevention and treatment efforts.

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UN reports 21.8 million infants weren't vaccinated in 2013

Reducing this figure will require improving vaccine transportation and storage and rethinking aid, health experts say.
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A Pakistani health worker administers the polio vaccine to a child during a vaccination campaign in Bannu on June 25, 2014. Pakistan launched a fresh polio vaccination drive in its restive tribal belt late last month, but officials warned that nearly 370,000 children are likely to miss out because of security problems. (A Majeed/AFP/Getty Images)

Nearly 22 million infants around the world were not vaccinated last year that should have been, according to a report released last week by the World Health Organization and UNICEF. The startling number underscores the need for innovations in vaccination storage and a critical re-think of existing vaccine aid programs, health advocates said.

Though more than 111 million infants were vaccinated last year, WHO estimates that figure accounts for only 84 percent of the world’s children – and in fact, some experts say the proportion could be even lower.

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Public-private collaboration paved way for new portable TB test

Tuberculosis experts say partnerships key to development of new diagnostics and drugs in the fight against TB.
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Dr. Jeffrey Cirillo, professor at the Texas A&M Health Science Center College of Medicine, holds up a prototype of TB REaD, the portable diagnostic device he and his colleagues invented. The device is in its final clinical trials and is set to hit the market in about 18 months. (Texas A&M Health Science Center/Courtesy)

A five-inch, battery-operated black box could be the future of tuberculosis diagnosis. The device, developed this year by a team of Texas doctors, can spot tiny amounts of TB bacteria in coughed-out sputum samples in less than half an hour. That’s a fraction of the time it takes to diagnose the disease using the most common methods today.

The device, to be marketed under the name TB REaD, is “designed to be really simple and require no technical experience,” said Jeffrey Cirillo, a professor at the Texas A&M Health Science Center College of Medicine who led the product’s development. “We want this to be able to be used anywhere.”

Cirillo’s work – supported by a partnership that includes the Foundation for Innovative New Diagnostics (FIND), the Wellcome Trust, the National Institutes of Health (NIH) and the Bill and Melinda Gates Foundation – is just one example of the kind of innovation made possible by collaborations among non-government organizations, private companies and government bodies in the fight against TB.

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