Conflict, forced relocation and climate change have disrupted the lives of millions of people around the world. In Ukraine, for example, a year of armed conflict has resulted in the displacement of more than 13 million people and the destruction of much of the nation’s infrastructure, including schools and universities. As a result, the education of many young Ukrainians has been interrupted, as has their ability to build their futures.
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The impact of the COVID-19 pandemic in the United States has been unlike anything most of us have seen in our lifetimes. Conditions such as stay-at-home orders, wearing masks in public and the highest unemployment rate since the Great Depression affect all of us in different ways.
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Digital communications and media are now part of everyday life for many people around the world. But while people have turned to smartphones for entertainment, socializing and commerce, the health community is still working to make services, outreach and treatment digitally accessible. Examining successful applications allows us to understand what approaches might be possible for digital health services. During the COVID-19 pandemic, it is more crucial than ever that digital health resources provide support for people to access from their homes.
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Around the world, more than 1.2 billion children are out of the classroom due to the COVID-19 pandemic. Living rooms have transformed into classrooms. Lesson plans have gone virtual. What are the challenges that parents, students and teachers are facing as they suddenly shift to remote learning? How have, and how will, the adaptations that school systems are making to continue operating during a pandemic shape education in Africa in the future?
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More than ever, American Indians and Alaska Natives face some of the greatest challenges in the United States. Resources — including food, housing, medical care and family support services — have been inaccessible or nonexistent for years. During the COVID-19 pandemic, those resources have become even scarcer. According to researchers at the Harvard Project on American Indian Economic Development, the COVID-19 crisis is “devastating tribes’ abilities to fund their governmental services and forcing tribes to make painful decisions to lay off employees, drop workers’ insurance coverage, deplete assets and/or take on more debt.” At the same time, some Native communities have experienced disproportionately high numbers of COVID-19 infections and deaths.
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While much progress has been made to end the HIV epidemic, not enough has been done to put the power of prevention directly in women’s hands. The dapivirine ring, a flexible silicone ring inserted monthly into the vagina, can change this. If approved by regulators, the ring would be the first discreet, long-acting HIV prevention tool available specifically for women. The ring would complement daily oral HIV pre-exposure prophylaxis (PrEP) as another biomedical tool in the fight against HIV.
Recent evidence suggests significant acceptability of and demand for vaginal rings as a drug-delivery platform among women who used the dapivirine ring during clinical trials — and also among policymakers and other stakeholders in countries with a high HIV burden. To better understand these perspectives, the OPTIONS Consortium interviewed policymakers, implementers and civil society leaders in seven sub-Saharan African countries about possibilities for introduction and scale-up of the dapivirine ring. An analysis of the interviews shows widespread enthusiasm for the ring as part of comprehensive HIV prevention programming.
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The increased pressure on public health systems to respond to the COVID-19 pandemic affects all routine health care, including the provision of essential HIV services. People living with HIV require regular access to treatment, but crowded public health facilities carry increased risk of exposure to COVID-19. Routine treatment sites also may be harder to reach because of stay-at-home orders, curfews and public transportation shutdowns. To maintain gains in HIV epidemic control, we must ensure that people needing antiretroviral therapy (ART) continue to receive medication uninterrupted.
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Although we cannot truly compare COVID-19 with HIV, there are similarities worth exploring. As the COVID-19 epidemiological data pours in, we have learned that communities of color are at heightened risk for hospitalization and death. With the reality that the economic fallout affects minority communities more than anyone else, it is clear the odds are against us yet again. We have seen this story play out throughout the course of the HIV epidemic, with LGBTQ, black and Latinx communities enduring the brunt of the disease’s burden. These health disparities are the result of structural inequities that our nation has not yet found the resolve to address. So, just as we did in the early days of HIV, we must arm ourselves with knowledge and a community-driven purpose to protect ourselves and those around us from COVID-19.
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While the COVID-19 pandemic has been difficult for everyone, imagine you are a young person just out of jail, on parole or dropped out of high school. You are determined to get a new start on your life, and you are focused on getting the education and workforce skills you need to move from surviving to thriving. You already have a steep hill to climb. And then, the pandemic hits and everything becomes more complicated.
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An enduring remnant of colonialism is the notion that global development challenges are confined to the poorer countries in the Global South. The profound human development challenges in countries with higher levels of material wealth are on full display as the United States struggles with its painful history and current reality of racial injustice against people of color. The disproportionate impact that COVID-19 is having on poor communities and people of color exposes the reality that global development challenges are indeed universal.
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COVID-19 shines a spotlight on inequality
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I started to shake with chills, my face became flushed, my temperature soared. The persistent dry coughing I had been experiencing, which I had ascribed to allergies, became intense and, at times, painful. It was Friday the 13th and my luck had turned. It all happened so quickly, as if a switch had been turned from off to on. It was less than two weeks from the first reported case of COVID-19 in New York City.