Here are 8 cases Bill Gates makes for global health re­cov­ery

Business Day (Nigeria) - - NEWS - TEMITAYO AYETOTO

The health sec­tor is no doubt the hard­est hit by the coro­n­avirus cri­sis. It has shaken weak foun­da­tions of health sys­tems across the world and ex­posed the weak­nesses of even the best hos­pi­tals at weath­er­ing a storm.

As Bill and Melinda Gates Foun­da­tion puts it, the dam­age done is clear but health struc­tures across the world must take ac­tions that mat­ter in the next few months.

Ac­cord­ing to the 2020 Goal­keep­ers re­port, “Progress is pos­si­ble but not in­evitable.” Con­se­quently, the Foun­da­tion has made a case for ac­tions to be taken in the fol­low­ing key ar­eas of health in­di­ca­tors.

Ma­ter­nal mor­tal­ity

In­di­rectly, Covid-19 will cause more women than men to suf­fer and die, largely be­cause the pan­demic has dis­rupted health care be­fore, dur­ing, and im­me­di­ately af­ter child­birth.

Pre­ventable, treat­able com­pli­ca­tions such as se­vere bleed­ing, in­fec­tion, and high blood pres­sure cause the vast ma­jor­ity of ma­ter­nal deaths. Many health care work­ers, who used to man­age these emer­gen­cies, in­clud­ing ex­pe­ri­enced nurse-mid­wives, are be­ing di­verted to Covid-19 wards.

Mean­while, preg­nant women and new moth­ers must weigh the ben­e­fits of vis­it­ing a clinic—where they may not have re­ceived high-qual­ity care in the past, against the risk of ex­po­sure to Covid-19. Some are de­cid­ing to de­liver at home or skip new born care vis­its as a re­sult. Ex­pert ma­ter­nal care is the def­i­ni­tion of an es­sen­tial ser­vice. Un­like some other ser­vices, it can­not be safely post­poned and caught up later. A preg­nant woman is preg­nant now and de­liv­ers her baby when she de­liv­ers. It is im­per­a­tive that health sys­tems have all the re­sources they need to en­sure that she can do so safely and with dig­nity.

Un­der-5 mor­tal­ity

Cur­rent data sug­gest that chil­dren are less likely to have se­vere dis­ease from coro­n­avirus in­fec­tion than older adults. How­ever, as cov­er­age for rou­tine im­mu­ni­sa­tions de­creases and case man­age­ment for pneu­mo­nia and di­ar­rhoea have been in­ter­rupted due to the pan­demic, chil­dren are in­creas­ingly vul­ner­a­ble.

Mod­els pre­dict that acute mal­nu­tri­tion will in­crease dra­mat­i­cally, which will make it harder for chil­dren to fight off in­fec­tious dis­eases.

These con­se­quences of the pan­demic em­pha­sise the need to fig­ure out how to pre­vent se­condary and ter­tiary crises. Yet even now, life­sav­ing in­no­va­tion con­tin­ues. Vac­cines ex­ist to pro­tect against many causes of pneu­mo­nia, the lead­ing in­fec­tious killer of young chil­dren. But they can be ex­pen­sive—they ac­count for about half the bud­get of Gavi, the Vac­cine Al­liance. Sev­eral months ago, how­ever, the World Health Or­gan­i­sa­tion pre­qual­i­fied a new pneumo

strug­gling to main­tain ser­vices. nia vac­cine that costs only One in­no­va­tion that seems $6 for a three-dose reg­i­men to be help­ing is multi-month in­stead of $9. And thanks to dis­pens­ing—a sim­ple ap­proach in­creased in­vest­ment due to that helps peo­ple fit treat­ment Covid-19, more health care into their lives and keeps them fa­cil­i­ties are pro­vid­ing ac­cess out of over­bur­dened clin­ics. to oxy­gen to treat res­pi­ra­tory Even af­ter Covid-19 is un­der con­di­tions; this will help save con­trol, this will be a more ef­fec­the lives of many chil­dren in­tive, ef­fi­cient way to dis­pense fected Art.with­p­neu­mo­nia.

HIV

Cur­rent ev­i­dence shows that peo­ple liv­ing with HIV are at in­creased risk of death due to Covid-19. But the in­di­rect ef­fects of the pan­demic are also wor­ry­ing.

Dis­rup­tions to health ser­vices could mean peo­ple do not get an­tiretro­vi­ral ther­apy (ART), which would re­sult in more deaths and more in­fec­tions (be­cause vi­ral loads are higher in un­treated pa­tients, they are more likely to trans­mit to oth­ers). So far, this worst-case sce­nario has not hap­pened, although some coun­tries are

Tu­ber­cu­lo­sis

Be­fore Covid-19, there were al­ready 3 mil­lion “miss­ing cases” of TB: peo­ple with ac­tive TB who did not know it and were pass­ing the dis­ease to oth­ers while go­ing un­treated them­selves. Now, that num­ber will grow even larger as peo­ple ei­ther can­not go to health fa­cil­i­ties for di­ag­no­sis or choose not to go to avoid the pos­si­bil­ity of ex­po­sure to Covid-19.

For sim­i­lar rea­sons, peo­ple who know they have TB may not go in for treat­ment. Our fear is that this ex­panded pool of un­di­ag­nosed in­fec­tions will

lead to a long-term in­crease in the num­ber of TB cases around the world. As they come out of Covid-19, coun­tries are go­ing to have to make case-find­ing and fund­ing for TB a ma­jor pri­or­ity.

Malaria

Malaria is un­for­giv­ing: As long as it ex­ists, it will kill the most vul­ner­a­ble and take ad­van­tage of emer­gen­cies. That is why the Gates Foun­da­tion’s malaria strat­egy is geared to­ward erad­i­cat­ing the dis­ease. Even un­der or­di­nary cir­cum­stances, both the malaria par­a­site and the mos­qui­toes that trans­mit it develop re­sis­tance to the drugs and in­sec­ti­cides used to fight them.

“We in­vest in mod­el­ling and surveil­lance tech­nolo­gies de­signed to help coun­tries tai­lor strate­gies for de­ploy­ing malaria tools so that they drive down on­go­ing, high-level trans­mis­sion as much as pos­si­ble,” the Foun­da­tion stated, not­ing that these same tools are also crit­i­cal for epi­demic pre­pared­ness and re­sponse.

Fam­ily plan­ning

Be­fore Covid-19, there was good news about this indi­ca­tor. In West Africa, for in­stance, where progress had been slow, the num­ber of women us­ing con­tra­cep­tives more than dou­bled be­tween 2011 and 2020.

One so­lu­tion is to shift to­ward a model of self-care that equips women and fam­i­lies with the ex­per­tise, tools, and con­fi­dence to plan with­out hav­ing to rely on the health care sys­tem. This can in­clude spe­cific in­ter­ven­tions like self­in­jectable con­tra­cep­tives or plat­forms like telemedici­ne, but it is broader than that. Self­care is deeply rooted in women’s needs and can pro­mote ac­cess to fam­ily plan­ning and other es­sen­tial health ser­vices. Univer­sal health cov­er­age

The Univer­sal Health Cov­er­age (UHC) Ef­fec­tive Cov­er­age In­dex pro­duced by IHME in­cludes 23 in­di­ca­tors that, to­gether, are a short­cut for think­ing about whether peo­ple in a coun­try have ac­cess to es­sen­tial health ser­vices.

A breach of pro­to­col for pub­lic gath­er­ings at the burial cer­e­mony of late Emir of Zaz­zau, Shehu Idris.

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