Disability Inclusion in the National Strategic Plan for HIV/AIDS: A Review on the National Response of West African Countries.

Objectives: Persons with disabilities (PWD) often experience risks associated with HIV/AIDS including unmet needs and overlooked stigmatization. This could be attributed to certain misconceptions such as PWDs are asexual, and cannot enjoy sexual pleasure, among others. Therefore, this paper sought to investigate the extent of disability inclusion in recent National Strategic Plans (NSPs) for HIV/AIDS in West African countries. Methods: This study was a policy review of NSPs in 13 African countries. Relevant indicators in the UN Convention on the Rights of Persons with Disabilities and the UNAIDS International Guidelines on HIV and Human Rights were used. Six indicators (identification of people living with disability (PLWD) as a key population, the inclusion of principles related to PWD within the NSPs on HIV/AIDS, protecting the rights of PWD, recognition of PWD as a vulnerable population at higher risk of HIV and in need of special protection, providing HIV-related support services for PWD and monitoring and evaluating the impact of HIV on PWD). Results: Findings from this study revealed that only 30% of West African countries recognized disability as an issue of concern. Also, 38.5% of these countries recognize the vulnerability of people with disabilities to HIV. However, only a few (7.6%) provided support in the context of special needs, monitoring, and surveillance specifically for persons with disabilities. Conclusion: Most of the West African NSPs are outdated and due for renewal. Therefore, it is necessary to integrate the needs of persons with disabilities within the context of HIV/AIDS in the NSPs. More importantly, support and services should also be prioritized among the vulnerable groups to optimize inclusion.

Interventions to reduce and prevent childhood obesity in low-income and middle-income countries: a systematic review and meta-analysis.

BACKGROUND: 70% of children with obesity and overweight live in low-income and middle-income countries. Several interventions have been done to reduce the prevalence of childhood obesity and prevent incident cases. Hence, we did a systematic review and meta-analysis to determine the effectiveness of these interventions in reducing and preventing childhood obesity. METHODS: We conducted a search for randomised controlled trials and quantitative non-randomised studies published on MEDLINE, Embase, Web of Science, and PsycINFO databases between Jan 1, 2010, and Nov 1, 2022. We included interventional studies on the prevention and control of obesity in children up to age 12 years in low-income and middle-income countries. Quality appraisal was performed using Cochrane's risk-of-bias tools. We did three-level random-effects meta-analyses and explored the heterogeneity of studies included. We excluded critical risk-of-bias studies from primary analyses. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation. FINDINGS: The search generated 12 104 studies, of which eight studies were included involving 5734 children. Six studies were based on obesity prevention, most of which targeted behavioural changes with a focus on counselling and diet, and a significant reduction in BMI was observed (standardised mean difference 2·04 [95% CI 1·01-3·08]; p<0·001). In contrast, only two studies focused on the control of childhood obesity; the overall effect of the interventions in these studies was not significant (p=0·38). The combined studies of prevention and control had a significant overall effect, with study-specific estimates ranging between 0·23 and 3·10, albeit with a high statistical heterogeneity (I2>75%). INTERPRETATION: Preventive interventions, such as behavioural change and diet modification, are more effective than control interventions in reducing and preventing childhood obesity. FUNDING: None.

The reemergence of the human monkeypox: strengthening Africa's epidemic preparedness and response system.

The reemergence of the monkeypox (MPX) virus poses a serious threat to global health security. While the first human case was reported in Democratic Republic of Congo in 1970, a recent outbreak of this disease in May 2022 has gone 'viral,' spreading to most continents and occurring in nonendemic countries. Outside Africa, there have been reports of cases of MPX in countries such as Singapore in May 2019, Israel in September 2018, UK in September 2018, among others which have been traced back to importation of infected wild rodents from Africa. The Centers for Disease Control and Prevention (CDC) recommends that the standard laboratory facility to carry out MPX tests is Biosafety Containment Level (BSL)-2 working standards if the laboratory staff has taken smallpox vaccine within the last 3 years and BSL-3 working standards if the laboratory staff has not taken the smallpox vaccine. However, African countries have a shortage of BSL laboratories. Hence, there is a need to improve the integrated surveillance of the MPX virus, strengthen diagnostic capacity, capacity building of health workforce, public education programs, fund research, and development, among others. Leveraging a 'One Health' approach will offer fresh insight into the human-animal-environment interface and boost the understanding on the possibility and mechanisms of spillback and reverse zoonosis as well as disease severity and risk factors for severe disease as well as its epidemiology in various subpopulations. Not leaving Africa behind in the prevention, diagnosis, and management of MPX is important to stopping the spread and reemergence of this virus.

"Watching my family being killed by terrorists made me really depressed": Mental health experiences, challenges and needed support of young internally displaced persons in northern Nigeria.

Background: Over 3.9 million people have been displaced in Nigeria as a result of the over one-decade-long Boko Haram insurgency and about 2.1 million of this population are internally displaced within the country. Young internally displaced persons (IDPs) are at higher risk of mental illness such as depression, anxiety, post-traumatic stress disorder (PTSD) among others, however, there are sparse studies on this population. Therefore, this study explored the mental health experiences, challenges, and needed support for young internally displaced persons in Durumi and New Kuchingoro Internally Displaced Persons Camps in Nigeria. Methods: This qualitative study was conducted among young IDPs in Durumi and New Kuchingoro IDP camps in Northern Nigeria. Fourteen (14) focus group discussions comprising 89 participants and 30 in-depth interviews with 30 participants were conducted with young IDPs. The interviews were in Hausa and Pidgin English, audio-recorded, transcribed, translated into English, and applied thematic analysis was done using MAXQDA Analytics Pro 2020. Results: A total of 89 participants consisting of 47 males and 42 females participated in the FGDs and IDIs. Five key themes emerged from the FGDs and IDI: (1) knowledge about mental health, (2) mental Health Experiences, (3) coping strategies, (4) availability of mental health and other health Support, and (5) needed support. Young IDPs had fair knowledge about mental healthcare. Participants reported their experience before displacement as being peaceful with members of the family together in a good environment while they experienced stress, trauma, shock, sadness, and symptoms of anxiety, depression, and PTSD during and post displacement. Personal coping strategies such as listening to music, engaging in sports, reading books, farming, and other economic activities were reported by participants. Participants reported the absence of structured and specialized mental health support in the IDP camps and solicited mental health, physical health, economic and educational support. Conclusion: Young IDPs had negative experiences that led to symptoms of mental health disorders such as depression, anxiety disorders, PTSD among others with little or no access to quality mental healthcare. Hence, they require specialized and structured mental health support to lead healthy and productive lives. Policy and programs aimed at increasing access to mental health information and services for forced migrants are recommended.

Safeguarding people living in vulnerable conditions in the COVID-19 era through universal health coverage and social protection.

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities. The world is at a never more crucial moment, requiring collaboration and cooperation from all sectors to mitigate the inequality gaps and improve people's health and wellbeing with universal health coverage and social protection, in addition to implementation of the health in all policies approach.

Lessons from the coronavirus disease 2019 (COVID-19) pandemic response in China, Italy, and the U.S.: a guide for Africa and low- and middle-income countries.

Africa can be "left behind" after other advanced continents recover from the coronavirus disease 2019 (COVID-19) pandemic as reflected by the global pandemic of HIV/AIDS. In this paper, we summarize potentially adaptable, effective and innovative strategies from China, Italy, and the U.S. The purpose is to help African countries with weaker healthcare systems better respond to the COVID-19 pandemic. China, being the first to report COVID-19 infection swiftly swung into anti-epidemic actions by the use of innovative risk communication and epidemic containment strategies. Italy and U.S., the next rapidly hit countries after China, however, experienced sustained infections and deaths due to delayed and ineffective response. Many African countries responded poorly to the COVID-19 pandemic as evidenced by the limited capacity for public health surveillance, poor leadership, low education and socioeconomic status, among others. Experience from China, Italy and U.S. suggests that a better response to the COVID-19 pandemic in Africa needs a strong public health leadership, proactive strategies, innovative risk communication about the pandemic, massive tests and isolation, and scaling-up community engagement. Lastly, African countries must collaborate with other countries to facilitate real-time information and experience exchange with other countries to avoid being left behind.

COVID-19: Learning from the HIV/AIDS pandemic response in Africa.

About 74.9 million persons were infected during the human immunodeficiency virus/acquired immunodeficiency syndrome HIV/AIDS global pandemic with nearly half of them succumbing to the disease. In 2018 alone, Africa recorded over 400,000 AIDS-related deaths which is more than half of the global total. This reflects years of inequality in the global pandemic response. Also, the international response to AIDS in the early years was very slow, with a global programme only developed 6 years into the pandemic. Many African countries still lack pandemic preparedness plans to handle a global pandemic. Thus, this paper highlights the important lessons that can be learnt from the response to the AIDS pandemic and recommends how they can be applied during the coronavirus disease 2019 (COVID-19) pandemic. Some of the important lessons include: HIV reversed the previous success recorded in health systems of developing countries; the antiretroviral drug development process was prolonged and required long term commitment; and primary healthcare was crucial in preventing and controlling the disease. These lessons can be utilised in the fight against COVID-19 pandemic. It is recommended that: there should be solidarity among the nations of the world to fight COVID-19; health authorities should be proactive in curbing misinformation; and interventions should prioritise human rights and focus on vulnerable communities. HIV treatment services should not be discontinued as it is still an ongoing pandemic. A balance needs to be achieved in combating both pandemics as discontinuation of HIV treatment during the coronavirus pandemic could result in more than 500,000 deaths.

Global fund: Analyzing 10 Years of bridging health inequalities.

The Global Fund is a non-profit organization founded by Bill Gates, Melinda Gates, Kofi Annan, Amir Attaran, and Jeffrey Sachs on the 28th January, 2002. Each year, about US$ 4 billion is invested to support programs and organizations led by local experts in various communities towards developing strategies and ways in which these three (HIV/AIDS, Malaria and Tuberculosis) diseases could be fought. The Global Fund has supported various innovative strategies used in tackling these infectious diseases. It is also worthy of note that 38 million lives have been saved through the Global Funds Partnership resulting in a 50% decline in mortality rate caused by tuberculosis, AIDS and Malaria in these reached countries. However, the Global Fund is not without its challenges as there has been lack of fund commitment from the G8 countries who instituted the idea in the first place. Another limitation being experienced is the poor risk management that has resulted in discrepancies of over US$4 million discovered in the Global Fund grants received by Nigeria as of 2016. This study discusses the current state of the Global Fund and suggests recommendations to policymakers that could be instrumental in strengthening health systems and achieving increased impact.