SDG 3: Ensure healthy lives and promote wellbeing for all at all ages

The SDGs, otherwise known as the Global Goals, build on the Millennium Development Goals (MDGs), eight anti-poverty targets that the world committed to achieving by 2015. The new Global Goals, and the broader sustainablity agenda, go much further than the MDGs, addressing the root causes of poverty and the universal need for development that works for all people.

SDG 3 focuses primarily on the promotion of health and well-being at all ages.
Ensuring healthy lives and promoting the well-being for all at all ages is essential to sustainable development. Significant strides have been made in increasing life expectancy and reducing some of the common killers associated with child and maternal mortality.

Major progress has been made on increasing access to clean water and sanitation, reducing malaria, tuberculosis, polio and the spread of HIV/AIDS.
However, many more efforts are needed to fully eradicate a wide range of diseases and address many different persistent and emerging health issues.

According to the World Health Organization (WHO) the goals within the SDG 3 otherwise known as Health targets for SDG 3 include:

3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births.

3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births.

3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.

3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.

3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents.

3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.

3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.

3.a Strengthen the implementation of the WHO Framework Convention on Tobacco Control in all countries, as appropriate.

3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all.

3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States.

3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

Eating more fruits, vegetables can boost psychological well-being

Fruit and vegetables are important components of a healthy diet, and their sufficient daily consumption could help prevent major diseases, such as cardiovascular diseases and certain cancers. Approximately 16.0 million (1.0%) disability adjusted life years (DALYs, a measure of the potential life lost due to premature mortality and the years of productive life lost due to disability) and 1.7 million (2.8%) of deaths worldwide are attributable to low fruit and vegetable consumption.

Fruits and vegetables are a pivotal part of a healthful diet, but their benefits are not limited to physical health. New research finds that increasing fruit and vegetable consumption may improve psychological well-being in as little as two weeks.

Study leader Dr. Tamlin Conner, of the Department of Psychology at the University of Otago in New Zealand, and colleagues found that young adults who were given extra fruits and vegetables each day for 14 days ate more of the produce and experienced a boost in motivation and vitality.

The researchers reported their findings in the journal PLOS One.

A recently published WHO/FAO report recommends a minimum of 400g of fruit and vegetables per day (excluding potatoes and other starchy tubers) for the prevention of chronic diseases such as heart disease, cancer, diabetes and obesity, as well as for the prevention and alleviation of several micronutrient deficiencies, especially in less developed countries.

Keno Ekpokpobe
Public Health Researcher

Ovulation and how to calculate it

What is ovulation?

Ovulation is the release of the ripe egg (ovum) from the ovary. The egg is released when the cavity surrounding the follicle breaks open in response to a hormonal signal.
Ovulation occurs around 14 or 15 days from the first day of the woman's last menstrual cycle. When ovulation occurs, the ovum moves into the Fallopian tube and becomes available for fertilization.

Tracking your ovulation

Work out the length of your average menstrual cycle.
Day one is the first day of the menstrual period and the last day is the day before the next period begins.
Ovulation happens about two weeks before the next expected period.
So if your average menstrual cycle is 28 days, you ovulate around day 14.

Remember the ‘fertile window’ is the six days leading up to and including ovulation.

The three days leading up to and including ovulation are the most fertile. Depending on your cycle length the most fertile days in the cycle varies:

If you have 28 days between periods ovulation typically happens on day 14, and the most fertile days are days 12, 13, and 14.

If you have longer cycles, say 35 days between periods, ovulation happens on day 21 and the most fertile days are days 19, 20, and 21.

If you have shorter cycles, say 21 days between periods, ovulation happens on day 7 and the most fertile days are days 5, 6, and 7.

Keno Ekpokpobe
Public Health Researcher

Benefits of Exclusive Breastfeeding

Exclusive breastfeeding is defined as when a nursing mother feeds her infant only breastmilk, no water, or food for the first six (6) months of life.

The first milk produced after birth is called colostrum. This is synthesized during the end of pregnancy and 3-5 days of postpartum. It is very high in protein and low in fat and carbohydrates, and contains immunoglobulins.
This help the baby have a first bowel movement and prevent jaundice. It contains antibodies to protect the newborn against disease.

The breast milk is rich in nutrients and anti-bodies and contains the right quantities of fat, sugar, water and protein. These nutrients are major pre-requisites to the health and survival of the baby. When a child is exclusively breast fed, their immune system is strengthened, enabling the child to withstand life-threatening illnesses like pneumonia and diarrhoea amongst other infections.

Breast milk is the ideal food for the healthy growth and development of infants; breastfeeding is also an integral part of the reproductive process with important implications for the health of mothers.

The World Health Organization (WHO) estimates that around 220,000 children could be saved every year with exclusive breastfeeding.
Infants breast fed within the first hour of birth are three times more likely to survive than those who have their first breast milk after a day.

Exclusive breastfeeding should be given from birth up to 6 months and continued breastfeeding is recommended with appropriate complementary food until the child is weaned. The only exceptions are rehydration salts and syrups that contain medicine.
WHO recommends that infants start receiving complementary foods at six months (180 days) of age in addition to breast milk.

It becomes essential that we counsel, encourage and support mothers to initiate exclusive breastfeeding. Governments, family members especially husbands and community health workers all have a role to play in the survival of newborns through the uptake of exclusive breast feeding.

Keno Ekpokpobe
Public Health Researcher

What is Polio?

What Is Polio?

Polio, or poliomyelitis, is a crippling and potentially deadly infectious disease. It is caused by the poliovirus. The virus spreads from person to person and can invade an infected person’s brain and spinal cord, causing paralysis (can’t move parts of the body).

Two types of vaccine protect against polio: oral poliovirus vaccine (OPV) and inactivated poliovirus vaccine (IPV) (given as an injection in the leg or arm, depending on the patient’s age).

Symptoms

Most people who get infected with poliovirus (about 72 out of 100) will not have any visible symptoms.

About 1 out of 4 people with poliovirus infection will have flu-like symptoms that may include—

*Sore throat
*Fever
*Tiredness
*Nausea
*Headache
*Stomach pain

These symptoms usually last 2 to 5 days then go away on their own.

A smaller proportion of people with poliovirus infection will develop other more serious symptoms that affect the brain and spinal cord:

Paresthesia (feeling of pins and needles in the legs)
Meningitis (infection of the covering of the spinal cord and/or brain) occurs in about 1 out of 25 people with poliovirus infection
Paralysis (can’t move parts of the body) or weakness in the arms, legs, or both, occurs in about 1 out of 200 people with poliovirus infection

Paralysis is the most severe symptom associated with polio because it can lead to permanent disability and death. Between 2 and 10 out of 100 people who have paralysis from poliovirus infection die because the virus affects the muscles that help them breathe.

Even children who seem to fully recover can develop new muscle pain, weakness, or paralysis as adults, 15 to 40 years later. This is called post-polio syndrome.

Note that “poliomyelitis” (or “polio” for short) is defined as the paralytic disease. So only people with the paralytic infection are considered to have the disease.

Transmission

Poliovirus only infects humans. It is very contagious and spreads through person-to-person contact. The virus lives in an infected person’s throat and intestines. It enters the body through the mouth and spreads through contact with the feces (poop) of an infected person and, though less common, through droplets from a sneeze or cough. You can get infected with poliovirus if you have faeces on your hands and you touch your mouth. Also, you can get infected if you put in your mouth objects like toys that are contaminated with faeces.

An infected person may spread the virus to others immediately before and about 1 to 2 weeks after symptoms appear. The virus can live in an infected person’s feces for many weeks. It can contaminate food and water in unsanitary conditions.

People who don’t have symptoms can still pass the virus to others and make them sick.

Prevention

Polio vaccine protects children by preparing their bodies to fight the polio virus. Almost all children (99 children out of 100) who get all the recommended doses of vaccine will be protected from polio.

There are two types of vaccine that can prevent polio: inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV). Only IPV has been used in the United States since 2000; OPV is still used throughout much of the world.

Keno Ekpokpobe
Public Health Researcher

Monkeypox disease: What you need to know

Key facts

*Monkeypox is a rare disease that occurs primarily in remote parts of Central and West Africa, near tropical rainforests.
*The monkeypox virus can cause a fatal illness in humans and, although it is similar to human smallpox which has been eradicated, it is much milder.
*The monkeypox virus is transmitted to people from various wild animals but has limited secondary spread through human-to-human transmission.
*Typically, case fatality in monkeypox outbreaks has been between 1% and 10%, with most deaths occurring in younger age groups.
*There is no treatment or vaccine available although prior smallpox vaccination was highly effective in preventing monkeypox as well.

Monkeypox is a rare viral zoonosis (a virus transmitted to humans from animals) with symptoms in humans similar to those seen in the past in smallpox patients, although less severe. Smallpox was eradicated in 1980.However, monkeypox still occurs sporadically in some parts of Africa.

Monkeypox is a member of the Orthopoxvirus genus in the family Poxviridae.

The virus was first identified in the State Serum Institute in Copenhagen, Denmark, in 1958 during an investigation into a pox-like disease among monkeys.

Outbreaks

Human monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo (then known as Zaire) in a 9 year old boy in a region where smallpox had been eliminated in 1968. Since then, the majority of cases have been reported in rural, rainforest regions of the Congo Basin and western Africa, particularly in the Democratic Republic of Congo, where it is considered to be endemic. In 1996-97, a major outbreak occurred in the Democratic Republic of Congo.

In the spring of 2003, monkeypox cases were confirmed in the Midwest of the United States of America, marking the first reported occurrence of the disease outside of the African continent. Most of the patients had had close contact with pet prairie dogs.

In 2005, a monkeypox outbreak occurred in Unity, Sudan and sporadic cases have been reported from other parts of Africa. In 2009, an outreach campaign among refugees from the Democratic Republic of Congo into the Republic of Congo identified and confirmed two cases of monkeypox. Between August and October 2016, a monkeypox outbreak in the Central African Republic was contained with 26 cases and two deaths.

Transmission

Infection of index cases results from direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. In Africa human infections have been documented through the handling of infected monkeys, Gambian giant rats and squirrels, with rodents being the major reservoir of the virus. Eating inadequately cooked meat of infected animals is a possible risk factor.

Secondary, or human-to-human, transmission can result from close contact with infected respiratory tract secretions, skin lesions of an infected person or objects recently contaminated by patient fluids or lesion materials. Transmission occurs primarily via droplet respiratory particles usually requiring prolonged face-to-face contact, which puts household members of active cases at greater risk of infection. Transmission can also occur by inoculation or via the placenta (congenital monkeypox). There is no evidence, to date, that person-to-person transmission alone can sustain monkeypox infections in the human population.

In recent animal studies of the prairie dog-human monkeypox model, two distinct clades of the virus were identified – the Congo Basin and the West African clades – with the former found to be more virulent.

Signs and symptoms

The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 16 days but can range from 5 to 21 days.

The infection can be divided into two periods:

the invasion period (0-5 days) characterized by fever, intense headache, lymphadenopathy (swelling of the lymph node), back pain, myalgia (muscle ache) and an intense asthenia (lack of energy);the skin eruption period (within 1-3 days after appearance of fever) where the various stages of the rash appears, often beginning on the face and then spreading elsewhere on the body. The face (in 95% of cases), and palms of the hands and soles of the feet (75%) are most affected. Evolution of the rash from maculopapules (lesions with a flat bases) to vesicles (small fluid-filled blisters), pustules, followed by crusts occurs in approximately 10 days. Three weeks might be necessary before the complete disappearance of the crusts.

The number of the lesions varies from a few to several thousand, affecting oral mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (eyelid) (20%), as well as the cornea (eyeball).

Some patients develop severe lymphadenopathy (swollen lymph nodes) before the appearance of the rash, which is a distinctive feature of monkeypox compared to other similar diseases.

Monkeypox is usually a self-limited disease with the symptoms lasting from 14 to 21 days. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications.

People living in or near the forested areas may have indirect or low-level exposure to infected animals, possibly leading to subclinical (asymptomatic) infection.

The case fatality has varied widely between epidemics but has been less than 10% in documented events, mostly among young children. In general, younger age-groups appear to be more susceptible to monkeypox.

Diagnosis

The differential diagnoses that must be considered include other rash illnesses, such as, smallpox, chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies. Lymphadenopathy during the prodromal stage of illness can be a clinical feature to distinguish it from smallpox.

Monkeypox can only be diagnosed definitively in the laboratory where the virus can be identified by a number of different tests:

enzyme-linked immunosorbent assay (ELISA)antigen detection testspolymerase chain reaction (PCR) assayvirus isolation by cell culture

Treatment and vaccine

There are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled. Vaccination against smallpox has been proven to be 85% effective in preventing monkeypox in the past but the vaccine is no longer available to the general public after it was discontinued following global smallpox eradication. Nevertheless, prior smallpox vaccination will likely result in a milder disease course.

Natural host of monkeypox virus

In Africa, monkeypox infection has been found in many animal species: rope squirrels, tree squirrels, Gambian rats, striped mice, dormice and primates. Doubts persist on the natural history of the virus and further studies are needed to identify the exact reservoir of the monkeypox virus and how it is maintained in nature.

In the USA, the virus is thought to have been transmitted from African animals to a number of susceptible non-African species (like prairie dogs) with which they were co-housed.

Prevention

Preventing monkeypox expansion through restrictions on animal trade

Restricting or banning the movement of small African mammals and monkeys may be effective in slowing the expansion of the virus outside Africa.

Captive animals should not be inoculated against smallpox. Instead, potentially infected animals should be isolated from other animals and placed into immediate quarantine. Any animals that might have come into contact with an infected animal should be quarantined, handled with standard precautions and observed for monkeypox symptoms for 30 days.

Reducing the risk of infection in people

During human monkeypox outbreaks, close contact with other patients is the most significant risk factor for monkeypox virus infection. In the absence of specific treatment or vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus. Surveillance measures and rapid identification of new cases is critical for outbreak containment.

Public health educational messages should focus on the following risks:

Reducing the risk of human-to-human transmission. Close physical contact with monkeypox infected people should be avoided. Gloves and protective equipment should be worn when taking care of ill people. Regular hand washing should be carried out after caring for or visiting sick people.Reducing the risk of animal-to-human transmission. Efforts to prevent transmission in endemic regions should focus on thoroughly cooking all animal products (blood, meat) before eating. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues, and during slaughtering procedures.

Controlling infection in health-care settings

Health-care workers caring for patients with suspected or confirmed monkeypox virus infection, or handling specimens from them, should implement standard infection control precautions.

Healthcare workers and those treating or exposed to patients with monkeypox or their samples should consider being immunized against smallpox via their national health authorities. Older smallpox vaccines should not be administered to people with comprised immune systems.

Samples taken from people and animals with suspected monkeypox virus infection should be handled by trained staff working in suitably equipped laboratories.