| | | | |  | | By Carmen Paun and Daniel Payne | | | | | 
Rwandan master echocardiography trainer Nasson Nduwamungu (right) guides trainee Laetitia Thizalimana on the use of point-of-care echocardiography in Rwinkwavu, Rwanda. Training front-line providers improves access to lifesaving diagnostic tests at PEN-Plus clinics. | Gene F. Kwan/PIH | HELPING THE POOR WITH CHRONIC DISEASES — Health challenges in developing countries usually center around infectious diseases — a problem now made worse by a pandemic entering a third year. But among the world's poorest one billion residents — who live primarily in sub-Saharan Africa and South Asia — noncommunicable diseases and injuries kill nearly 800,000 people under age 40 each year, according to a 2020 Lancet report. This is more than those in the same age group who live in extreme poverty and die from HIV, tuberculosis, and maternal-related causes combined. The pandemic is likely to make things worse. While chronic conditions are typically associated with middle-aged people who have conditions like heart disease, in poor countries children and young adults are more affected by severe chronic illnesses: like sickle cell disease, type 1 diabetes and rheumatic heart disease, Gene Bukhman, the director of the Program on Global Noncommunicable Diseases and Social Medicine at Harvard Medical School, said. In Nigeria for example, 150,000 children are born each year with sickle cell disease, a group of inherited red blood cell disorders that can cause pain, infection, and stroke. Tens of thousands of them die before age 5, The New York Times reported. What's being done: Bukhman co-chairs the NCDI Poverty Network made up of 21 lower-income countries — including the Democratic Republic of Congo, Ethiopia, Haiti, Mozambique, and Nepal — that's trying to improve care locally for these severe diseases. One of the network's projects, the Package of Essential NCD Interventions-Plus (PEN-Plus), trains nurses at regional hospitals to provide specialist care usually available only at specialized hospitals in major cities. The aim is to expand the training nationally, following a program first implemented in Rwanda. Malawi, Liberia and Haiti are also scaling up with support from the international nonprofit Partners In Health. Closer health services. Ten more countries, including Sierra Leone, Kenya, Tanzania, Mozambique and Nepal, plus Chhattisgarh state in India are expected to set up training sites for the project this year. The aim is to decentralize care so people in remote areas have close access to health services. Having access to heart ultrasounds, for example, could help diagnose rheumatic heart disease, which can develop after untreated strep throat or scarlet fever infections. Many poor countries don't have the capacity to diagnose infections and treat them before they cause permanent damage, said Ana Mocumbi, the head of the noncommunicable diseases division at Mozambique's National Institute of Health, the country's CDC equivalent. She's also a co-chair of the NCDI Poverty Network. A matter of funding. With a bit more than $1 million over three years, Mozambique will train nurses at a rural hospital to manage cardiovascular and respiratory disease and severe and advanced high blood pressure in younger people, Mocumbi told Global Pulse. But much more funding is needed to address chronic diseases in poor countries, and less than 1 percent of global development assistance goes toward it, said Mocumbi. Thirty million dollars are needed a year by 2023 and $100 million by 2030, she said.
| | | WELCOME BACK TO GLOBAL PULSE, where your hosts agree with HHS Assistant Secretary for Global Affairs Loyce Pace that international work is not as glamorous when you have to be up in the middle of the night for meetings or, in our case, for interviews. Global Pulse is a team effort. Thanks to editors Eli Reyes and Barbara Van Tine. Follow us on Twitter: @_daniel_payne and @carmenpaun.
| | | | | 635 Million The number of children globally affected by classroom closures due to the Covid-19 pandemic, according to UNICEF. | | | | THE STATE OF THE PANDEMIC | | PANDEMIC ENDGAMES? NOT SO FAST — While the WHO's regional director in Europe was signaling optimism about the pandemic's coming months — even suggesting light at the end of a two-year tunnel — the WHO's director general was quick to add that the global situation is quite different. Hans Kluge, the WHO Europe director, told the AFP that "it's plausible that the region is moving towards a kind of pandemic endgame." Quick response. The next day, WHO Director General Tedros Adhanom warned that — globally — "it is dangerous to assume that Omicron will be the last variant, or that we are in the endgame." Kluge issued a new statement that day, saying it's too early to let down our guard. "The pandemic is far from over, but I am hopeful we can end the emergency phase in 2022," Kluge said in the statement. In a statement to Global Pulse, the WHO clarified the seemingly different messages about pandemic endgames, saying that Europe may be moving into a new phase of the pandemic but the global pandemic could be at a different point. "The Regional Director's statement yesterday concerns the European Region specifically," the spokesperson said. "And while he is hopeful we can end the emergency phase of the pandemic this year, he has also been crystal clear that the pandemic is far from over, certainly from a global perspective." Pandemic phases. Peter Hotez, professor of molecular virology at Baylor College of Medicine, underscored the unpredictability of future variants — and phases of the pandemic. "I think it's a bit reckless to talk about omicron as a game ender for this pandemic," he said in an email to Global Pulse. "Without vaccination, omicron virus induced immunity will not be durable, and until we vaccinate the world, new variants of concern will continue to emerge from unvaccinated low income and middle income countries."
| | | EU COUNTRIES LOOK TO SIMPLIFY TRAVEL WITH COVID CERTIFICATES — Travelers should be able to travel throughout the EU with proof of vaccination or recovery or a negative test, without having to face quarantine or additional testing measures under new nonbinding rules for travel, POLITICO's Carlo Martuscelli and Hanne Cokelaere report. Ministers backed the recommendations at a meeting of the General Affairs Council on Tuesday, confirming a report by POLITICO late last week. The aim is to "take into account the advantage of the individual situation of people, especially vaccinated people, and limit for them as much as possible travel restrictions in Europe," France's European Affairs Secretary, Clément Beaune, said ahead of the meeting. Travelers would be able to freely enter a country if they have had their first course of vaccination a maximum of 270 days prior, or have received a booster shot. This also applies to people who have recovered from Covid-19 in the last 180 days, and passengers who have had a PCR test 72 hours before arriving or an antigen test 24 hours before. One exception: Countries in the highest "dark red" category of the European Centre for Disease Prevention and Control's color-coded risk map won't qualify. Currently, most of the EU falls into this category. COVID SPURS EFFORTS TO CLEAN UP INDOOR AIR — Scientists have long warned that the air in homes, offices and public spaces — where people spend an estimated 90 percent of their time — can be more heavily polluted than the busiest city roads. But campaigners felt too little was being done to tackle the problem — that's changing thanks to the coronavirus, POLITICO's Antonia Zimmermann reports. Because Covid-19 is an airborne disease that spreads more easily in poorly ventilated rooms, people are increasingly conscious of indoor air quality, said Corinne Mandin, president of the International Society of Indoor Air Quality and Climate, a nongovernmental organization. Campaigners hope the focus on keeping people safe from Covid will bump the broader issue of indoor air quality higher up on the policy agenda in Brussels. "EU legislation covering indoor air quality is fragmented and we lack a comprehensive, integrated approach," said Javi López, a Spanish member of the European Parliament with the Socialists and Democrats, who is pushing for greater attention to indoor air pollution in an upcoming revision of EU air quality rules expected in the fall.
| | | Financial Times: COVAX is running out of money to pay for syringes and other supplies needed for vaccine donations, Gavi boss says. The New York Times: Rich countries lure health workers from poor nations to fight staff shortages. The Washington Post: Kiribati was once one of the world's last Covid-free places. Now it's under lockdown. Nature: Why scientists are racing to develop more Covid antivirals. | | | | Follow us | | | | |
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