Tuesday, 1 September 2020

01 September 2020


COVID 19 AND GLOBAL HEALTH
     Malaria kills and 90 percent of these deaths occur in Africa.  Delay in treatment can cause death in just days, especially for children.  Each year in March, rains start falling in Uganda and bring mosquitoes and malaria.  At the Catholic Hospital in Kitgum Uganda, consultation and treatment for malaria costs the equivalent of US$3.75.  That requires three days of work at the basic wage.  Prevention with insecticide treated nets has been disrupted as distribution has been stopped by travel restrictions for the Covid pandemic. Annual malaria deaths had been dropping in recent years but,  according to Dr. Pedro L. Alonso, director of the World Health Organization’s global malaria program, “Covid-19 risks derailing all our efforts and taking us back to where we were 20 years ago.”    
     At the same time the rains brought malaria to Uganda, the Covid pandemic also began.  Because of past experience with Ebola, Uganda confronted the pandemic with effective public health measures.  However, the economy is devastated by lockdowns and now the biggest problem with accessing treatment for malaria is lack of money.  Fr. Dave Schwinghamer, MM works in Kitgum and reports that those without money purchase malaria medicines from less reputable sources for $0.25 or go without treatment until they become very sick.

     This pandemic has also affected people living with HIV.  Recent reporting shows this group has not become as sick with Covid as initially feared.  They quickly followed public health guidelines having learned from past experience with the HIV pandemic.  Experts wonder if the treatment for HIV offers some protection against the Covid virus and research is studying this.1 However, 25% of people with HIV can’t access the medicines they need each day and some have been sharing their drugs to stretch out their supplies.  These drugs are usually distributed on a monthly basis and need to be taken properly to prevent the virus from developing drug resistance.  Some countries, such as the Philippines, are considering dispensing medications for three to six months intervals to avoid this problem.   80% of HIV drugs are produced by eight Indian companies and some fear that these companies will increase the cost of their product or will switch to producing more lucrative drugs used to treat Covid.

     But perhaps the pandemic will most severely affect TB which kills 1.5 million people worldwide annually. TB is also spread from person to person through respiratory droplets.  Lockdowns in the small, cramped living quarters of Brazilian favelas and informal settlements in Nairobi will allow one person to spread the bacterium to 15 other people on average.  The World Health Organization (WHO) has received information from 121 countries reporting a decrease in the number of patients attending TB clinics.  A test called GeneExpert is regularly used to diagnose TB.  It can also amplify the genetic material of the Covid virus. So, some clinics are now only using it to look for the Covid virus rather than both organisms.  Companies, such as Cepheid in California, have switched from manufacturing TB tests to Covid tests because of financial gain.  When diagnosis of TB is delayed, transmission continues unabated.  When treatment is disrupted, TB resistance also develops and multidrug resistant (MDR) TB is increasing.  In June, the WHO changed the treatment program for MDR TB from 20 months of injections to ten months of pills, hoping that patients will better access the treatment they need.2

     Social determinants will negatively impact the health and lives of many, especially young girls.  In Kenya, schools have been closed for the remainder of 2020 and students will need to repeat the year.  The number of teen age pregnancies is increasing because girls are defiled at home, usually by men known to them.  In Tanzania these pregnant girls will never be allowed to return to public school.4 Lockdowns reduce access to immunizations and other public health measures to prevent disease.  They also impoverish people who live on the small incomes they generate daily from small businesses.  Food becomes scarce in both quality and quantity. 

     An effective and safe vaccine will be key to managing the pandemic and alleviating these knock-on effects.  The WHO plans to set terms for a new pact entitled COVAX Global Vaccines Facility by August 31, 2020. It aims to avoid ‘vaccine nationalism’ by providing Covid vaccine distribution worldwide, targeting health care workers and those most at risk. Vaccines will be delivered to 20% of the populations of member nations as soon as vaccines become available. 

     The United States has yet to provide leadership and funding for these global strategies.  On July 9, 2020 32 Senators signed a bipartisan letter to Senate leadership calling for “emergency funding for Covid 19 (that) includes a robust coordinated and sufficiently resourced international response.” To date this legislation languishes in Congress.  Dr. Tedros Ghebrejesus, chief of the WHO advises, “For the world to recover faster, it has to recover together, because it’s a globalized world: the economies are intertwined. Part of the world or a few countries cannot be a safe haven and recover.” 
The U.S. Congress would do well to speed up its response.

Faith in action: Urge Congress to provide foreign aid for COVID-19 recovery: https://bit.ly/MOGCaidCOVID


      Let's end on a VERY happy note.  On 26th August the WHO announced that wild virus polio has been eradicated from the continent of Africa!!!  I was privileged to work on this campaign in Sudan and Kenya.  Only two countries in the world, Afghanistan and Pakistan, still harbor the virus.


PEACE OF THE SEASON OF CREATION TO YOU

1st September - 4th October

It is the practice of Maryknoll Lay Missioners in Kenya 
to pray and work for peace on the first of each month.



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