Bad news: Cholera is back

Presented by March of Dimes: The ideas and innovators shaping health care
Sep 26, 2023 View in browser
 
Future Pulse

By Evan Peng, Carmen Paun, Daniel Payne and Erin Schumaker

Presented by

March of Dimes
WORLD VIEW

FILE - A woman carries her son, who has cholera, at Bwaila Hospital in Lilongwe central Malawi, on Jan. 11, 2023. Malawi’s cholera outbreak has now claimed more than 1,000 lives by Tuesday, Jan. 25, 2023 according to the country’s health minister, who warned that some cultural beliefs and hostility towards health workers are slowing down response efforts. (AP Photo/Thoko Chikondi, File)

A Malawian woman carries her son, infected with cholera, during an outbreak earlier this year. | AP

112 percent

The reported increase in cholera cases from 2021 to 2022, according to the World Health Organization

An old scourge is on the rise again: cholera.

That’s according to a new analysis from the World Health Organization.

The WHO received reports of more than 470,000 cholera cases in 2022, up from over 220,000 in 2021.

Of the 80 countries that sent data to the WHO for 2022, 44 reported cases, an increase from 35 in 2021.

Cholera causes diarrhea and spreads via contaminated food and water. It can be fatal: Reporting countries recorded more than 2,300 deaths in 2022.

Additionally, the outbreaks themselves were larger, with seven countries reporting more than 10,000 cases each.

The hardest hit were in central Africa: Nigeria, Malawi and the Democratic Republic of the Congo.

Why the rise? The WHO report points to a host of factors, from climate change and inadequate infrastructure to civil conflicts and population displacement.

In addition, the end of infection-prevention practices and public health resources related to Covid-19 has impacted other diseases, including cholera.

Looking ahead: Preliminary data for 2023 suggests that the upward trend continues, with 24 countries reporting ongoing outbreaks.

The surge also puts a strain on vaccination resources. Starting in October 2022, the International Coordinating Group on Vaccine Provision, which manages the cholera vaccine stockpile, has started using a single-dose regimen instead of the usual two doses.

While appealing for more funding from wealthy nations, the WHO has released $16.6 million from its Contingency Fund for Emergencies for cholera response in 2022 and 2023.

 

A message from March of Dimes:

According to March of Dimes’ new set of reports, “Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity,” more than 5.6 million women in counties with no or limited access to maternity care services. Access to care continues to decline with a 4 percent decrease in birthing hospitals in one year and, overall, the loss of 301 birthing units in the U.S. since March of Dimes began reporting in 2018.

 
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POLICY PUZZLE

Royce West and Ellen Rosenblum

Royce West and Ellen Rosenblum | Courtney Rohrbach/POLITICO

Progressives see a direct line between the war on drugs and mass incarceration, compelling them to push Democrats to legalize drugs, defund police and exercise prosecutorial discretion to alleviate the war’s costs, particularly for people of color.

But Democrats at a POLITICO forum on the opioid crisis said there’s a need to keep fighting the war, at least when it comes to drug dealers.

“It’s everywhere. No one can deny it. If you do, you’ve just got blinders on,” said Oregon Attorney General Ellen Rosenblum of the U.S drug problem.

Why it matters: The Centers for Disease Control and Prevention estimates that illegal drugs killed 110,000 people last year, mostly driven by illicit fentanyl.

Oregon voters in 2020 approved a referendum legalizing possession of small amounts of hard drugs. Since then, its largest city, Portland, has seen a significant increase in their use.

Lawmakers in cities and states nationwide are grappling with what to do about encampments where homeless people openly use drugs.

Getting tough: Texas state Sen. Royce West of Dallas defended a new state law that permits prosecutors to charge fentanyl dealers with murder and increases criminal penalties for the manufacturing or delivery of the drug.

“We've got to make certain that persons that deal with this issue understand that there are consequences,” West said.

Rosenblum said her office was “very strong on the interdiction of drugs, and very strong on prosecution” of dealers.

Even so: The Democrats see a middle ground that also targets drug users for treatment and prevention.

Rosenblum said Oregon’s decision to legalize possession of hard drugs was “good policy” that kept people out of jail. She urged more “wraparound services” to help people suffering from substance use disorder.

West is trying to convince his Texas colleagues to join most other states in decriminalizing fentanyl test strips that enable drug users to know what’s in the drugs they’re taking. Right now, Texas treats the strips as drug paraphernalia, but the CDC says the strips can help drug users avoid overdosing.

 

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A message from March of Dimes:

As the leader in the fight for the health of all moms and babies, March of Dimes released this set of reports to raise awareness and illustrate the actions needed to improve outcomes for moms and babies.

Policy solutions around telehealth can address the limited access to maternity care in the U.S., expanding accessibility and providing more options for healthcare delivery. Telehealth can replace or enhance in-person care and can save lives by providing high-quality care to women across the country.

March of Dimes has also long supported policies that improve access to quality health care, advance health equity initiatives, and improve research and surveillance, by demanding lawmakers prioritize #BlanketChange policies.

We all have a role to play in addressing maternal health challenges. Call on leaders at the federal level, to implement new policies that put the health of moms and babies at the forefront. Act today at https://p2a.co/ga3vxkl

 
CHECKUP

BOSSIER CITY, LA - JANUARY 29:  Pulmonologist Dr. Loyd Whitley (R) examines patient Robbie Roach, 72,  during an office visit January 29, 2003 in Bossier City, Louisiana. A portion of Roach's visit is paid for by Medicare, the federal taxpayer-financed health insurance program that covers nearly 40 million Americans. According to Dr. Whitley, reimbursement from the government for patients on Medicare is   being reduced as of March 1, 2003. President George W. Bush touted his plan to add a prescription drug benefit to Medicare in his State of the Union address last night.  (Photo by Mario Villafuerte/Getty Images)

Women are more likely to go to the doctor, one reason they face higher medical bills. | Getty Images

Employed women spend as much as $15.4 billion more a year than men on out-of-pocket health care costs, according to a new analysis by the consulting firm Deloitte.

The report found that female employees aged 19 to 64 average 18 percent, or $266, more in out-of-pocket health care costs annually compared to male employees — and that’s with pregnancy-related services excluded.

Why so? Partly because women seek more health care than men. But that accounts for only a little more than half of the difference.

One factor that can explain the gap, the report found, is that women more often obtain medical services that surpass the typical deductible, which translates to higher out-of-pocket payments.

However, the analysis also found that, even while spending more out-of-pocket, women derive less value for each premium dollar spent. In other words, men get more bang for their buck.

What can be done? According to Deloitte’s analysis, the value gap between men and women amounts to $1.34 billion. By using enhanced products that adjust cost sharing for certain services, the report says, the average employer offering coverage could bridge that gap at less than $12 per employee per year.

 

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