MERRY CHRISTMAS AND HAPPY NEW YEAR FROM PASADA

MPH By DISTANCE LEARNING

Muhimbili University of Health and Allied Sciences (MUHAS) will work together with the Open University of Tanzania (OUT) in offering MPH by distance learning programme whereby OUT will provide teaching and learning facilities such as examination rooms and study centers, which are available in all regions of Tanzania. For more information about the course click here

Mwanza Research Methods Course

Highly experienced researchers from the Tanzania National Institute for Medical Research (NIMR) Mwanza Centre, Mwanza Intervention Trials Unit (MITU) and the London School of Hygiene & Tropical Medicine (LSHTM) will conduct this course. For more information click here

LHL International Newsletter Christmas 2016

Hello everyone,
LHL international has just released its Newsletter Christmas 2016 Issue. You can read it here

PASADA receives support from Dar Active Cyclists (DAC)

Today (20/12/2016) PASADA has received support from Dar es Salaam Active Cyclists.
This was given by the cyclists as their contribution to neediest in our community.
The support received included 14 children bicycles which were repaired and 10 new bicycles.
The bicycles were received by PASADA's Executive Director Mr. Simon Yohana who was very grateful for the support.
The bicycles will be used by PASADA children as part of play therapy and recreation while at PASADA clinics.

Dr. Daniel Magesa giving introductory remarks before the handing over of the bicycles

 Mr. Mathias Manyanya (2nd from left) from the Dar es Salaam Active Cyclists explaining something to PASADA's Executive Director, Mr. Simon Yohana

 Some of the children bicycles which were repaired and new ones donated by the Dar es Salaam Active Cyclists

University of Oslo;The International Summer School (ISS)

For those interested click on this link

WHO issues new guidance on HIV self-testing ahead of World AIDS Day

From the WHO Website
News release
29 November 2016 | GENEVA - In advance of World AIDS Day, WHO has released new guidelines on HIV self-testing to improve access to and uptake of HIV diagnosis.
According to a new WHO progress report lack of an HIV diagnosis is a major obstacle to implementing the Organization’s recommendation that everyone with HIV should be offered antiretroviral therapy (ART).
The report reveals that more than 18 million people with HIV are currently taking ART, and a similar number is still unable to access treatment, the majority of which are unaware of their HIV positive status. Today, 40% of all people with HIV (over 14 million) remain unaware of their status. Many of these are people at higher risk of HIV infection who often find it difficult to access existing testing services.
"Millions of people with HIV are still missing out on life-saving treatment, which can also prevent HIV transmission to others," said Dr Margaret Chan, WHO Director-General. "HIV self-testing should open the door for many more people to know their HIV status and find out how to get treatment and access prevention services."
HIV self-testing means people can use oral fluid or blood- finger-pricks to discover their status in a private and convenient setting. Results are ready within 20 minutes or less. Those with positive results are advised to seek confirmatory tests at health clinics. WHO recommends they receive information and links to counselling as well as rapid referral to prevention, treatment and care services.
HIV self-testing is a way to reach more people with undiagnosed HIV and represents a step forward to empower individuals, diagnose people earlier before they become sick, bring services closer to where people live, and create demand for HIV testing. This is particularly important for those people facing barriers to accessing existing services.
Between 2005 and 2015 the proportion of people with HIV learning of their status increased from 12% to 60% globally. This increase in HIV testing uptake worldwide has led to more than 80% of all people diagnosed with HIV receiving ART.

Who misses out on HIV testing?

HIV testing coverage remains low among various population groups. For example, global coverage rates for all HIV testing, prevention, and treatment are lower among men than women.
Men account for only 30% of people who have tested for HIV. As a result, men with HIV are less likely to be diagnosed and put on antiretroviral treatment and are more likely to die of HIV-related causes than women.
But some women miss out too. Adolescent girls and young women in East and Southern Africa experience infection rates up to eight times higher than among their male peers. Fewer than one in every five girls (15–19 years of age) are aware of their HIV status.
Testing also remains low among "key populations" and their partners - particularly men who have sex with men, sex workers, transgender people, people who inject drugs, and people in prisons - who comprise approximately 44% of the 1.9 million new adult HIV infections that occur each year.
Up to 70 % of partners of people with HIV are also HIV positive. Many of those partners are not currently getting tested. The new WHO guidelines recommend ways to help HIV positive people notify their partners about their status, and also encourage them to get tested.
"By offering HIV self-testing, we can empower people to find out their own HIV status and also to notify their partners and encourage them to get tested as well," said Dr Gottfried Hirnschall, Director of WHO’s Department of HIV. "This should lead to more people knowing their status and being able to act upon it. Self-testing will be particularly relevant for those people who may find it difficult to access testing in clinical settings and might prefer self-testing as their method of choice."
Self-testing has been shown to nearly double the frequency of HIV testing among men who have sex with men, and recent studies in Kenya found that male partners of pregnant women had twice the uptake of HIV testing when offered self-testing compared with standard testing.
Twenty three countries currently have national policies that support HIV self-testing. Many other countries are developing policies, but wide-scale implementation of HIV self-testing remains limited. WHO supports free distribution of HIV self-test kits and other approaches that allow self-test kits to be bought at affordable prices. WHO is also working to reduce costs further to increase access. The new guidance aims to help countries scale up implementation.
WHO is supporting three countries in southern Africa which have started large scale implementation of self-testing through the UNITAID-funded STAR project and many more countries are considering this innovative approach to reaching those who are being left behind.

For more information please contact:

Tunga Namjilsuren
WHO Department of HIV, Global Hepatitis Programme
Telephone: +41 22 791 1073
Mobile: +41 79 203 3176
Email: namjilsurent@who.int
Gregory Härtl
Coordinator, Department of Communications
Mobile: +41 79 500 6552
Telephone: +41 22 791 4458
Email: hartlg@who.int

Violence against women

From WHO Website

Intimate partner and sexual violence against women

Fact sheet
Updated November 2016

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Key facts:

• Violence against women - particularly intimate partner violence and sexual violence - are major public health problems and violations of women's human rights.
• Global estimates published by WHO indicate that about 1 in 3 (35%) women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.
• Most of this violence is intimate partner violence. Worldwide, almost one third (30%) of women who have been in a relationship report that they have experienced some form of physical and/or sexual violence by their intimate partner in their lifetime.
• Globally, as many as 38% of murders of women are committed by a male intimate partner.
• Violence can negatively affect women’s physical, mental, sexual and reproductive health, and may increase vulnerability to HIV.
• Factors associated with increased risk of perpetration of violence include low education, child maltreatment or exposure to violence in the family, harmful use of alcohol, attitudes accepting of violence and gender inequality.
• Factors associated with increased risk of experiencing intimate partner and sexual violence include low education, exposure to violence between parents, abuse during childhood, attitudes accepting violence and gender inequality.
• There is evidence from high-income settings that school-based programmes may be effective in preventing relationship violence (or dating violence) among young people.
• In low-income settings, strategies to increase women’s economic and social empowerment, such as microfinance combined with gender equality training and community-based initiatives that address gender inequality and relationship skills, have shown some effectiveness in reducing intimate partner violence.
• Situations of conflict, post conflict and displacement may exacerbate existing violence, such as by intimate partners, and present additional forms of violence against women.

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Introduction

The United Nations defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life."
Intimate partner violence refers to behaviour by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviours.
Sexual violence is "any sexual act, attempt to obtain a sexual act, or other act directed against a person’s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object."

Scope of the problem

Population-level surveys based on reports from victims provide the most accurate estimates of the prevalence of intimate partner violence and sexual violence in non-conflict settings. The "WHO Multi-country study on women’s health and domestic violence against women" (2005) in 10 mainly low- and middle-income countries found that, among women aged 15-49:

• between 15% of women in Japan and 71% of women in Ethiopia reported physical and/or sexual violence by an intimate partner in their lifetime;
• between 0.3–11.5% of women reported sexual violence by someone other than a partner since the age of 15 years;
• the first sexual experience for many women was reported as forced – 17% of women in rural Tanzania, 24% in rural Peru, and 30% in rural Bangladesh reported that their first sexual experience was forced.

A 2013 analysis conduct by WHO with the London School of Hygiene and Tropical Medicine and the Medical Research Council, based on existing data from over 80 countries, found that worldwide, almost one third (30%) of all women who have been in a relationship have experienced physical and/or sexual violence by their intimate partner. The prevalence estimates range from 23.2% in high-income countries and 24.6% in the Western Pacific region to 37% in the WHO Eastern Mediterranean region, and 37.7% in the South-East Asia region. Furthermore, globally as many as 38% of all murders of women are committed by intimate partners. In addition to intimate partner violence, globally 7% of women report having been sexually assaulted by someone other than a partner, although data for this is more limited.
Intimate partner and sexual violence are mostly perpetrated by men against women. Child sexual abuse affects both boys and girls. International studies reveal that approximately 20% of women and 5–10% of men report being victims of sexual violence as children. Violence among young people, including dating violence, is also a major problem.

Risk factors

Factors associated with intimate partner and sexual violence occur at individual, family, community and wider society levels. Some factors are associated with being a perpetrator of violence, some are associated with experiencing violence and some are associated with both.
Risk factors for both intimate partner and sexual violence include:

• lower levels of education (perpetration of sexual violence and experience of sexual violence);
• exposure to child maltreatment (perpetration and experience);
• witnessing family violence (perpetration and experience);
• antisocial personality disorder (perpetration);
• harmful use of alcohol (perpetration and experience);
• having multiple partners or suspected by their partners of infidelity (perpetration); and
• attitudes that are accepting of violence and gender inequality (perpetration and experience).

Factors specifically associated with intimate partner violence include:

• past history of violence;
• marital discord and dissatisfaction;
• difficulties in communicating between partners.

Factors specifically associated with sexual violence perpetration include:

• beliefs in family honour and sexual purity
• ideologies of male sexual entitlement and
• weak legal sanctions for sexual violence.

The unequal position of women relative to men and the normative use of violence to resolve conflict are strongly associated with both intimate partner violence and non-partner sexual violence.

Health consequences

Intimate partner and sexual violence have serious short- and long-term physical, mental, sexual and reproductive health problems for survivors and for their children, and lead to high social and economic costs.

• Violence against women can have fatal outcomes like homicide or suicide.
• It can lead to injuries, with 42% of women who experience intimate partner violence reporting an injury as a consequence of this violence.
• Intimate partner violence and sexual violence can lead to unintended pregnancies, induced abortions, gynaecological problems, and sexually transmitted infections, including HIV. The 2013 analysis found that women who had been physically or sexually abused were 1.5 times more likely to have a sexually transmitted infection and, in some regions, HIV, compared to women who had not experienced partner violence. They are also twice as likely to have an abortion.
• Intimate partner violence in pregnancy also increases the likelihood of miscarriage, stillbirth, pre-term delivery and low birth weight babies.
• These forms of violence can lead to depression, post-traumatic stress and other anxiety disorders, sleep difficulties, eating disorders, and suicide attempts. The same study found that women who have experienced intimate partner violence were almost twice as likely to experience depression and problem drinking. The rate was even higher for women who had experienced non partner sexual violence.
• Health effects can also include headaches, back pain, abdominal pain, fibromyalgia, gastrointestinal disorders, limited mobility and poor overall health.
• Sexual violence, particularly during childhood, can lead to increased smoking, drug and alcohol misuse, and risky sexual behaviours in later life. It is also associated with perpetration of violence (for males) and being a victim of violence (for females).

Impact on children

• Children who grow up in families where there is violence may suffer a range of behavioural and emotional disturbances. These can also be associated with perpetrating or experiencing violence later in life.
• Intimate partner violence has also been associated with higher rates of infant and child mortality and morbidity (e.g. diarrhoeal disease, malnutrition).

Social and economic costs

The social and economic costs of intimate partner and sexual violence are enormous and have ripple effects throughout society. Women may suffer isolation, inability to work, loss of wages, lack of participation in regular activities and limited ability to care for themselves and their children.

Prevention and response

There are a growing number of well-designed studies looking at the effectiveness of prevention and response programmes. More resources are needed to strengthen the prevention of and response to intimate partner and sexual violence, including primary prevention, i.e. stopping it from happening in the first place.
Regarding primary prevention, there is some evidence from high-income countries that school-based programmes to prevent violence within dating relationships have shown effectiveness. However, these have yet to be assessed for use in resource-poor settings. Several other primary prevention strategies: those that combine economic empowerment of women with gender equality training; that promote communication and relationship skills within couples and communities; that reduce access to, and harmful use of alcohol; and that change cultural gender norms, have shown some promise but need to be evaluated further.
To achieve lasting change, it is important to enact legislation and develop policies that:

• address discrimination against women;
• promote gender equality;
• support women; and
• help to move towards more peaceful cultural norms.

An appropriate response from the health sector can play an important role in the prevention of violence. Sensitization and education of health and other service providers is therefore another important strategy. To address fully the consequences of violence and the needs of victims/survivors requires a multi-sectoral response.

WHO response

WHO, in collaboration with partners, is:

• Building the evidence base on the size and nature of violence against women in different settings and supporting countries' efforts to document and measure this violence and its consequences, including improving the methods for measuring violence against women in the context of SDG monitoring. This is central to understanding the magnitude and nature of the problem at a global level and to initiating action in countries.
• Strengthening research and research capacity to assess interventions to address partner violence.
• Undertaking interventions research to test and identify effective health sector interventions to address violence against women.
• Developing technical guidance for evidence-based intimate partner and sexual violence prevention and for strengthening the health sector responses to such violence.
• Disseminating information and supporting national efforts to advance women's health and rights and the prevention of and response to violence against women.
• Supporting countries’ to strengthen the health sector response to violence against women, including the implementation of WHO tools and guidelines.
• Collaborating with international agencies and organizations to reduce and eliminate violence globally.

Global tuberculosis report 2016

From the WHO Website;

WHO report warns global actions and investments to end tuberculosis epidemic are falling far short

 

New data published by WHO in its 2016 "Global Tuberculosis Report" show that countries need to move much faster to prevent, detect, and treat tuberculosis if they are to meet global targets. The report highlights inequalities among countries in access to cost-effective diagnosis and treatment, and signals the need for bold political commitment and increased funding.

To read the full report click here.

You can also read the WHO press release here

The APOPO-PASADA Collaboration Shining

The Second Durban Declaration Access Equity Rights - Now!

PASADA attended the just ended 21st International AIDS Conference which took place in Durban, South Africa from the 18th to 22nd of July 2016. The meeting Released the 2nd Durban Declaration as shown below;

The Second Durban Declaration Access Equity Rights - Now! There has been remarkable progress in our response to AIDS since the global HIV community last convened in Durban in 2000. Curbing the spread of HIV was the first step . Accelerating investment and action on robust human rights and social justice agenda is the next. Despite significant scientific advancements, we continue to encounter structural barriers that impede real world progress. Realizing the promise of scientific achievement requires a greater commitment to removing barriers between discovery and implementation. The 21st International AIDS Conference (AIDS 2016) must bring these pieces together – the key scientific advances needed to end the epidemic and the key structural barriers impeding progress – and secure greater political commitment including financial resources to get the job done.
Focusing on the five key scientific advances Ensure access to antiretroviral therapy for all people living with HIV The benefits of early and sustained antiretroviral therapy (ART) for the health of people living with HIV and treatment as prevention in the overall population are undeniable and broadly recognized. We must ensure that on diagnosis ART access for all people living with HIV becomes a reality despite resource constraints.   Scale up modern combination HIV prevention packages Pre-exposure prophylaxis (PrEP) and voluntary medical male circumcision are major breakthroughs in HIV prevention science. They should complement the benefits of universal ART and must remain a priority. Long-acting and more convenient prevention methods such as injectable PrEP should be further developed to become an integral part of today’s combination HIV prevention package.   Treat and manage co-infections and co-morbidities Morbidity and mortality in people living with HIV is increasingly driven by co-infections and co-morbidities. A range of new technologies and drug options have been developed which now need to be fully scaled up, notably, for hepatitis C and tuberculosis HIV co-infections. Non-communicable diseases like diabetes and hypertension are another important area of linkage requiring attention.   Amplify research efforts for a vaccine and a cure Preventive vaccine strategies and sustained HIV remission while off ART remain paramount to achieving definitive and economically-sustainable epidemic control. The recent progress in vaccine development and HIV cure research should be accelerated, driven by the necessary resources and motivation to consign AIDS to history. Optimize implementation research Implementation science should increasingly become the cornerstone for realising access, acceptability, uptake, and sustained adherence across the HIV cascade. This will include leveraging differentiated models of care and other innovative approaches to translate science into long-term, sustainable and equitable progress.		Addressing the five key structural barriers Focus on key populations within and across various HIV epidemic scenarios Key populations – men who have sex with men, transgender people, sex workers and people who inject drugs – are disproportionately affected by HIV and among these groups there has been a recent resurgence in HIV infections. National responses should create an enabling environment and increase their access to HIV services across the cascade – including for adolescent key populations.   Address gender inequality and empower young women and girls Socially-embedded inequalities render young women and girls – including transgender women - particularly vulnerable to HIV infection. We need a global plan for ending the epidemic among them that includes ensuring multi-sectoral policy and programmatic synergy and embraces sexual and reproductive health and rights.   Challenge laws, policies and practices that stigmatize and discriminate against people living with HIV and key populations It is long past time to amend and remove laws, policies and practices that inappropriately regulate (e.g. violation of sexual and reproductive rights), control (e.g. entry, stay and residence restrictions), punish (e.g. criminalization of HIV non-disclosure, exposure and transmission) and/or fail to protect (e.g. criminalization of homosexuality, sex work and drug use; lack of protection from violence) key populations and people living with HIV in many contexts.   Increase investment in civil society and community lead responses Civil society – as activists, advocates and service providers - has long been the backbone of the AIDS response, ensuring greater accountability and action from political leaders to address the epidemic. In many settings, these groups are under siege by restrictive laws and funding cuts. The global HIV community must stand in solidarity with civil society and reaffirm its place in the HIV response.   Enhance capacity of frontline healthcare workers Ensure that frontline healthcare workers have what they need to provide client-centred care through national roll out of quality pre- and in-service training. This should include addressing stigma and discrimination which is often considered one of the most significant barriers to accessing HIV services.
We, the undersigned, agree that the return of the conference to Durban this year will be a defining moment to establish a clear path toward guaranteeing that no one is left behind in the AIDS response. When we write the history of the epidemic, let it be that in Durban in 2016 we seized the opportunity to alter the course of this epidemic forever. Now, more than ever we must ensure Access Equity Rights – Now! For further information and signing the Declaration click here

DURBAN STATEMENT ON CHILDREN, ADOLESCENTS AND HIV

The The Coalition for Children Affected by AIDS and The Teresa Group hosted the just ended "Children and HIV" Symposium from the 15th to 16th of July, 2016 in Durban South Africa. This was an affiliated event of the 21st International AIDS Conference. The meeting released the following Statement  on Children and Adolescents regarding HIV;

DURBAN STATEMENT ON CHILDREN, ADOLESCENTS AND HIV

We, civil society organizations working on behalf of children and adolescents and their families, urge national governments to ensure the following five global targets1 are achieved as policies are set, resources allocated and programs designed to address HIV and AIDS in their respective countries:
3. HIV-sensitive Care, Support & Social Protection:
Commit to ensuring 75% of children, adolescents and their parents living with and affected by HIV
receive comprehensive care and support – including social and child protection.
Comprehensive care and support, including social and child protection, have been shown to
both improve adherence and retention for children and parents and to enable HIV-affected
children to achieve their developmental potential. New evidence also shows that comprehensive
social protection—providing some form of cash transfer in combination with care and support
interventions such as parental monitoring, teacher support, adolescent-friendly clinics and peer
group activities (sometimes known as “cash plus care”)—improves adolescent adherence and
reduces their risk behaviour.
4. Supporting Caregivers so Children and Adolescents can Thrive:
Commit to strengthening the capacity of families, the community-level child care workforce, and
the social welfare workforce, so that together they can meet the developmental needs of children
living with, and affected by HIV, from pregnancy, to early childhood, and into adolescence.
We recognize the critical roles that families and other caregivers play in caring for HIV-affected
children and adolescents – including fostering healthy growth and development. We must ensure
programming helps family caregivers to deal with stresses & support children at each stage of
development into adolescence. This requires scale-up of caregiver/parenting support programs,
integrated as part of health, education and social welfare systems.
5. Stigma Elimination:
Commit to ensuring that all children living with and affected by HIV are free from stigma and
discrimination due to their HIV status and/or that of their caregivers.
HIV-related stigma and discrimination cause severe psychological distress among children,
and can prevent access to education, treatment, and care. Children orphaned by HIV, and those
living with HIV positive caregivers, experience greater stigma and bullying than their peers. Other
groups of children being discriminated against include children of parents of key populations, key
population adolescents, and children and adolescents with disabilities. Governments must work
with all key stakeholders to ensure that safe and non-discriminatory environments are created in
health facilities, community organizations, educational settings and more broadly in society as a
whole.

30th Annual Joint Scientific Conference 2016

The National Institute for Medical Research announces that its 30^th Annual Joint Scientific Conference (AJSC) will be held at the Bank of Tanzania Conference Centre in Dar es Salaam, Tanzania from October 4-6, 2016. The goal of AJSC is to foster and facilitate communication and collaboration between scientists, trainers, policy makers, donors, students and the media. The conference will feature speakers discussing the latest research elucidating the need for innovative research to address the Sustainable Development Goals. For more details click here

WHO confirms antiretroviral therapy reduces the risk of life-threatening HIV-related infections

20 June 2016 - Adults and children with HIV who start antiretroviral therapy (ART) as early as possible reduce their risk of developing serious HIV-related infections, according to new findings published in the journal Clinical Infectious Diseases on 15 June 2016.

WHO/A. Kari

Two studies in adults and children, supported by the World Health Organization (WHO) and conducted in collaboration with Columbia University, the London School of Hygiene & Tropical Medicine and McGill University, are the first global systematic and comprehensive analyses of data on HIV-related opportunistic infections over a 20-year period in 3 global regions: Africa, Asia and Latin America. The 2 reviews compared the risk of serious HIV-related infections before and after starting ART, then estimated the global number of cases of infection that would have been prevented (using data from 2013), and the costs saved, if ART had been started earlier.
“Opportunistic and other infections are the major cause of death in adults and children with HIV,” said Dr Philippa Easterbrook from WHO’s Department of HIV. “There have been previous estimates on the impact of ART in reducing deaths and new HIV infections, but not on its impact on each of the serious infections to which people with HIV are vulnerable, especially in low-income settings. Knowing how common these infections are is really important for planning HIV health services in these countries, including procuring drugs and diagnostic tests.”
In 126 different studies based on almost half a million adult HIV patients, the most common infections were oral thrush, tuberculosis, shingles and bacterial pneumonia – each of which occurred in more than 5% of adults before ART. There was a major reduction in the risk of development of all infections for those on ART, by 57% to 91%, and this was greatest in the first year of treatment. It was estimated that earlier ART would have prevented at least 900 000 cases of life-threatening infections and saved around US$ 50 million in 2013.
In the second review – 88 studies based on 55 679 HIV-infected children – bacterial pneumonia and tuberculosis were the most common infections, each occurring in around 25% of children before ART. As with the adult studies, there was a reduction in risk for all infections for those on ART, but this was greatest (by more than 80%) for HIV-related diarrhoea, cerebral toxoplasmosis and tuberculosis, with a smaller impact on bacterial septicemia and pneumonia. It was estimated that earlier access to ART could have prevented at least 161 000 cases of serious infections in children, with a saving of around US$ 17 million in 2013.
“Compared to adults, there is always a relative lack of data on HIV-infected children to inform guidelines and practice, and the scale-up of ART in children has been much less successful,” said coauthor Dr Marie-Renée B-Lajoie from McGill University. “But our study shows that the effect of ART in reducing HIV-related infections in children is as dramatic as that seen in adults.”
Dr Andrea Low, coauthor from ICAP, Columbia University, commented that “the level of effect of ART on serious infections in adults in these low-income settings was even more striking than that observed in high-income countries”. However, she also noted that interpretation of regional variation in incidence and the effect of ART is limited, as there were significant gaps in data from some regions, such as Latin America.
Dr Gottfried Hirnschall, Director of WHO’s HIV Department, concluded: “We know that ART has a dramatic effect in reducing death rates as well as new HIV infections. These findings demonstrate that ART has the same effect in reducing the risk of serious HIV-relatedI nfections in adults and children – thus, further explaining the reduction in death rates. This reinforces the need to continually prioritize the expansion of access to ART. The new WHO guidelines recommend starting ART in all HIV-infected persons as soon as possible, regardless of the stage of infection.”

From the WHO Website

Habari (Hello) from the Motherland!

June 20, 2016 Jennifer LeBlanc Leave a Comment

A few months ago we introduced two Queen Elizabeth Scholars who are now in Tanzania for the summer. Matt Jalink (Intern) and Keisha Jefferies (Scholar) have sent us updates to share.

Habari (Hello) from the Motherland!

Keisha Jefferies is a Master’s of Nursing student at Dalhousie University

What an experience this has been thus far. Not only is this my first time in Tanzania, but it is also my first trip to the Motherland. I was unsure of what to expect in terms of the lifestyle, social norms and attitudes, but I am definitely adjusting, settling in nicely and loving every moment!
Since arriving in Dar, I have been learning Swahili (one of the National languages in Tanzania) and it is paying off in the sense that I am able to connect with many people and build relationships. I still have a long way to go before I can hold a decent conversation in Swahili, but people are certainly amused and supportive of my attempts!

Swahili Dar Language (SDL) School where I am learning Swahili.

I have also had the opportunity to volunteer with my host (who is a dietician, nutritionist and lifestyle coach) on a project currently underway with the World Food Program (WFP). The project is focused around increasing awareness about healthy living for staff by proving education on healthy food choices, baseline measurements such as blood pressure (BP), fast blood glucose (FBG), height, weight and body mass index (BMI) as well as sharing options for exercise/ physical activity. We had a few busy days of preparing, presenting, taking baseline measurements and interacting with the WFP staff. Currently, my host is completing the analysis and will soon roll out the intervention phase of the project.

WFP Staff/ project coordinators, Nurses from Muhimbili National Hospital (MNH), my host and volunteers.

In addition to learning Swahili and volunteering with the WFP project, I am also working on my own project and program requirements for my Masters! Needless to say, it has been a busy 6 weeks but I am finding time to make friends and enjoy the beautiful city of Dar es Salaam. I have met some wonderfully nice people throughout the city and at the university. I have been fortunate enough to have been invited to attend 3 Masters level lectures on Research Methods for the Midwifery and Critical Care students. This was an amazing experience. Not only I was also able to share ideas and learn from the students and faculty, I was able to sit in and provide feedback on thesis topic presentations.

Students from the Masters of Midwifery and Women’s Health program at Muhimbili University of Health and Allied Sciences (MUHAS) and myself enjoying the warm waters of the Indian Ocean.

Masters students and myself at Kipepeo Beach in Kigamboni.

I am looking forward to the many adventures, experiences and opportunities over the next 7 weeks!

Karibu Tanzania! (Welcome to Tanzania)

Matt Jalink is a Community Health and Epidemiology student at Dalhousie University

Karibu Tanzania! (Welcome to Tanzania). I’ve heard this phrase countless times since arriving in Dar es Salaam. Reminiscent of my last visit to the northern city Moshi, the friendliness Tanzanians have shown me is amazing. This hot, bustling metropolis is quickly becoming one of my favorite cities, and stretches out into dozens of districts each with its own subsection of wards. I reside in the city centre district in a quaint little hotel 10 minutes walk from the Indian Ocean. I catch the dala dala (minivan buses) to work every morning in a nearby district called Temeke. Commuting is an experience in itself with obscene driving, constant usage of the horn and doubling the van’s capacity limit giving the suspension a workout. Traffic jams are frequent, so at times hoping on a boda boda (motor cycle taxi) is needed to maneuver around the traffic.
Working as an epidemiology student at PASADA has been a fantastic learning experience. In a very self-directed role, I have been acting primarily as a consultant on a tuberculosis diagnostic test project. Applying the skills I have gained from my coursework to the workplace has been both rewarding and challenging. Participating in data collection in some of the slums of Dar es Salaam was an eye-opening experience despite thinking that I was mentally prepared. However most of my time has been spent assembling the data set and coding the dataset for analysis.

Pastoral Activities and Services for people with AIDS Dar es Salaam Archdiocese (PASADA).

The majority of my free time has been spent exploring the city and surrounding area. Bongoyo Island was a beautiful escape from the city. Watching the Africa Cup of Nations qualifying match between Tanzania and Egypt at the national stadium as an avid football (soccer) player and fan was an incredible atmosphere to be apart of.
Kwaheri! (Bye for now)

The Canadian Queen Elizabeth II Diamond Jubilee Scholarship Program (QES) aims to build a dynamic community of young global leaders in Canada and across the Commonwealth. Queen Elizabeth Scholars engage in projects both at home and abroad, encompassing international education, discovery and inquiry, and professional experiences. Queen Elizabeth Scholars undertake projects that provide meaningful learning experiences, with the potential to create lasting impact. Dalhousie University has teamed up with its partners in the Caribbean, Uganda and Tanzania to develop an international student mobility project, funded by QES, for current Dalhousie students and students in other Commonwealth countries looking to study at Dal. The Global Health Office manages the relationship between our partner associations and Dalhousie, collaborating with many units across campus, and within the QES network, to make these projects possible

 Copied from Dalhousie University Blog

Double burden of malnutrition

From WHO Website, May 2016

The double burden of malnutrition is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related noncommunicable diseases, within individuals, households and populations, and across the lifecourse.

In the context of a changing global nutrition landscape, influenced by economic and income growth, urbanization, demographic change and globalization, diet-related epidemiology has seen a significant shift in recent decades.

Burden

In 2014, more than 1.9 billion adults worldwide, 18 years and older, were overweight while 462 million were underweight. More than 600 million were obese. In the same year, 41 million children under the age of five were overweight or obese but 159 million were affected by stunting (low height-for-age). While 50 million children were affected by wasting (low weight-for-height). In low- and middle-income countries, almost five million children continue to die of undernutrition-related causes every year yet simultaneously these same populations now witness a rise in childhood overweight and obesity – increasing at a rate 30% faster than in richer nations.
This double burden of malnutrition can exist at the individual level – for example obesity with deficiency of one or various vitamins and minerals, or overweight in an adult who was stunted during childhood – at the household level – when a mother may be overweight or anaemic and a child or grandparent is underweight – and at the population level – where there is a prevalence of both undernutrition and overweight in the same community, nation or region.
Moreover, the relationship between undernutrition and overweight and obesity is more than a coexistence. Reflected in the epidemiology and supported by evidence, undernutrition early in life – and even in utero – may predispose to overweight and noncommunicable diseases such as diabetes and heart disease later in life. Overweight in mothers is also associated with overweight and obesity in their offspring. Rapid weight gain early in life may predispose to long-term weight excess. These are just some of the examples of biological mechanisms, which along with environmental and social influences, are increasingly understood as important drivers in the global burden of malnutrition across the lifecourse.

Opportunity

This double burden of malnutrition offers a unique and important opportunity for integrated action on malnutrition in all its forms. Addressing the double burden of malnutrition will be key to achieving the Sustainable Development Goals (in particular Goal 2 and Target 3.4) and the Commitments of the Rome Declaration on Nutrition, within the UN Decade of Action on Nutrition.

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Life expectancy increased by 5 years since 2000, but health inequalities persist

From the WHO website

Life expectancy increased by 5 years since 2000, but health inequalities persist

News Release

19 May 2016 | GENEVA - Dramatic gains in life expectancy have been made globally since 2000, but major inequalities persist within and among countries, according to this year’s “World Health Statistics: Monitoring Health for the SDGs”.
Life expectancy increased by 5 years between 2000 and 2015, the fastest increase since the 1960s. Those gains reverse declines during the 1990s, when life expectancy fell in Africa because of the AIDS epidemic and in Eastern Europe following the collapse of the Soviet Union. The increase was greatest in the African Region of WHO where life expectancy increased by 9.4 years to 60 years, driven mainly by improvements in child survival, progress in malaria control and expanded access to antiretrovirals for treatment of HIV.

“The world has made great strides in reducing the needless suffering and premature deaths that arise from preventable and treatable diseases,” said Dr Margaret Chan, Director-General of WHO. “But the gains have been uneven. Supporting countries to move towards universal health coverage based on strong primary care is the best thing we can do to make sure no-one is left behind.”
Global life expectancy for children born in 2015 was 71.4 years (73.8 years for females and 69.1 years for males), but an individual child’s outlook depends on where he or she is born. The report shows that newborns in 29 countries – all of them high-income -- have an average life expectancy of 80 years or more, while newborns in 22 others – all of them in sub-Saharan Africa -- have life expectancy of less than 60 years.
With an average lifespan of 86.8 years, women in Japan can expect to live the longest. Switzerland enjoys the longest average survival for men, at 81.3 years. People in Sierra Leone have the world’s lowest life-expectancy for both sexes: 50.8 years for women and 49.3 years for men.
Healthy life expectancy, a measure of the number of years of good health that a newborn in 2015 can expect, stands at 63.1 years globally (64.6 years for females and 61.5 years for males).

Targets of Sustainable Development Goals

This year’s “World Health Statistics” brings together the most recent data on the health-related targets within the Sustainable Development Goals (SDGs) adopted by the United Nations General Assembly in September 2015. The report highlights significant data gaps that will need to be filled in order to reliably track progress towards the health-related SDGs. For example, an estimated 53% of deaths globally aren’t registered, although several countries – including Brazil, China, the Islamic Republic of Iran, South Africa and Turkey – have made considerable progress in that area.

• World Health Statistics 2016: Monitoring health for the SDGs

While the Millennium Development Goals focused on a narrow set of disease-specific health targets for 2015, the SDGs look to 2030 and are far broader in scope. For example, the SDGs include a broad health goal, “Ensure healthy lives and promote well-being for all at all ages”, and call for achieving universal health coverage. This year’s “World Health Statistics” shows that many countries are still far from universal health coverage as measured by an index of access to 16 essential services, especially in the African and eastern Mediterranean regions. Furthermore, a significant number of people who use services face catastrophic health expenses, defined as out-of-pocket health costs that exceed 25% of total household spending.
The report includes data that illustrate inequalities in access to health services within countries –between a given country’s poorest residents and the national average for a set of reproductive, maternal and child health services. Among a limited number of countries with recent data, Swaziland, Costa Rica, Maldives, Thailand, Uzbekistan, Jordan and Mongolia lead their respective regions in having the most equal access to services for reproductive, maternal, newborn and child health.
The “World Health Statistics 2016” provides a comprehensive overview of the latest annual data in relation to the health-related targets in the SDGs, illustrating the scale of the challenge. Every year:

• 303 000 women die due to complications of pregnancy and childbirth;
• 5.9 million children die before their fifth birthday;
• 2 million people are newly infected with HIV, and there are 9.6 million new TB cases and 214 million malaria cases;
• 1.7 billion people need treatment for neglected tropical diseases;
• more than 10 million people die before the age of 70 due to cardiovascular diseases and cancer;
• 800 000 people commit suicide;
• 1.25 million people die from road traffic injuries;
• 4.3 million people die due to air pollution caused by cooking fuels;
• 3 million people die due to outdoor pollution; and
• 475 000 people are murdered, 80% of them men.

Addressing those challenges will not be achieved without tackling the risk factors that contribute to disease. Around the world today:

• 1.1 billion people smoke tobacco;
• 156 million children under 5 are stunted, and 42 million children under 5 are overweight;
• 1.8 billion people drink contaminated water, and 946 million people defecate in the open; and
• 3.1 billion people rely primarily on polluting fuels for cooking.

Note to editors

Published every year since 2005, WHO’s “World Health Statistics” is the definitive source of information on the health of the world’s people. It contains data from 194 countries on a range of mortality, disease and health system indicators, including life expectancy, illness and death from key diseases, health services and treatments, financial investment in health, and risk factors and behaviours that affect health.
WHO’s Global Health Observatory updates health statistics year round of more than 1000 health indicators. Members of the public can use it to find the latest health statistics on global, regional and country levels.

For more information, please contact:

Simeon Bennett
WHO Department of Communications
Mobile: +41 79 472 7429
Office: +41 22 791 4621
Email: simeonb@who.int

HRH The Crown Princess of Norway visiting Tanzania

HRH The Crown Princess of Norway visiting Tanzania

Research Methods Course in Sexual Reproductive Health, HIV and Gender-Based Violence