Geneva Health Forum – Unique Platform for Dialogue in the World’s Global Health Hub 25/03/2022 Elaine Ruth Fletcher Pierre Strauss The Swiss Confederation has been a key financial backer of the Geneva Health Forum since its early days. As the GHF prepares for its 2022 edition, 3-5 May, Pierre Strauss, health attaché to the Permanent Mission of Switzerland to the United Nations, spoke with Health Policy Watch about the evolution of the Forum and its relevance to the “International Geneva’’ landscape. Health Policy Watch: Given the situation we have now in Ukraine and the increasing polarization we see between Russia, China and the Western world – which could lead to fall out in other big meetings Geneva will be hosting, such as the World Health Assembly, what can you say about the Geneva Health Forum. Does this forum offer opportunities for more bridge-building? Pierre Strauss: The forum is not a political platform. The forum makes the link between scientific practices at country level, researchers, practitioners and the Geneva ecosystem. So as dramatic as the situation is in Ukraine right now and notwithstanding the worldwide consequences of the war, the issue here is really health, global health. If there are initiatives that can be taken from it to alleviate medical needs in specific countries, including Ukraine, certainly this is very positive. But this is not the objective of the forum. HPW: What’s your vision for the GHF’s outcomes? Strauss: A. For us, as the Swiss Mission to the UN in Geneva, Geneva is a “Center of Excellence” when it comes to global health, and so the Forum is a unique platform for people to come and discuss, share experience, when it comes to health. So we see the forum as a place with convening power, which brings together various stakeholders of the Geneva ecosystem and beyond. We see this as a very important tool, not only to make the link between the researchers, but between the researchers and the international organizations – because this is what makes Geneva unique. We have an extremely rich ecosystem of organizations, such as: the University of Geneva, the Graduate Institute, the HUG, WHO, as well as other international organizations and health-focused NGOs, so I think the Forum offers this unique perspective and opportunity to link the two worlds. HPW: Do you have a vision for future developments? What kind of new ideas or new energies would you like to see developed in the Geneva Health Forum in the coming years? Strauss: I should emphasize that the Federal Department of Foreign Affairs is supporting the Forum financially, but we are not part of the organizers. We are supporting the event because we think it has a role to play in the international Geneva. We think the current Forum has been extremely successful to date, in taking concrete research from the field and sharing it with practitioners – to see how knowledge can be shared or approaches can be scaled up. Alongside that, I think there is a potential for the Forum to play more of a role in health diplomacy, making the link between recent research findings and the international organizations when it comes to policy – and how all of this fits into the health agenda here in Geneva. Geneva Health Forum 2020 discussion on NCDs. Increasingly the Forum is focusing on the broader global health agenda, alongside sharing clinical experiences. HPW: So it’s evolving into a kind of two-pronged effort, you could say? Strauss: Yes, the Forum is a place where you can learn about recent clinical research and medical research. But in terms of future directions, as shown with the Planetary Health approach, we can reinforce the link between the Forum, international organizations and the broader global health agenda of International Geneva. HPW: The Planetary Health and One-Health theme this year might be an example of that kind of evolving focus? Strauss: Yes, we can see that in the One Health, for instance, we see that there are actually a lot of discussions that are no longer only about clinical research, but about policy, as well. You know, like in Geneva, you have for instance, the discussion over the Pandemic Treaty. And you have questions aligning to biodiversity, for instance, and how, nowadays, we see that biodiversity has also an impact on health. So, if you look at the theme of the Forum this year, here, looking at One Health, which reflects the complexity of health risks, it is opening up new doors into issues of health diplomacy that the Forum can explore further in future editions. To Register for the Geneva Health Forum click here. See more about the themes and features of the Geneva Health Forum’s 2022 edition: https://healthpolicy-watch.news/geneva-health-forum-pandemic-planetary/ Image Credits: Geneva Health Forum. Minamata Convention: Parties Review Progress on Global Measures to Halt Mercury Poisoning 25/03/2022 Editorial team Delegates from most of the world’s nations met in Bali this week to review progress in tackling the worldwide problem of mercury poisoning from artisinal gold mining and other environmental sources as well as in the health care industry, in line with the 2013 Minamata Convention. The parties were meeting for the fourth time since the Convention entered into force in 2017. Expanding the list of mercury-containing products for phase-out and discussing thresholds for mercury waste emissions in air and water, were among topics being discusssed. In addition, convention parties were reviewing national plans for the reduction and eventual elimination – of mercury in artisanal and small-scale gold mining (ASGM), which poses particularly grave health hazards for women and children working in the sector. In January 2022, WHO published a review of some 60 countries’ implementation strategies for tackling mercury’s environemental health risks. So far some 129 WHO member states have become parties to the Convention. However, there was no evidence of health ministry participation in about half of the national reports – reflecting the lack of public health sector involvement in promoting awareness about the huge health risks of mercury poisoning. Artisanal gold mining is one such major source of exposure. An estimated 4-5 million women and children are employed in ASGM, where mercury is still widely used to extract gold from ore – even though cleaner and safer alternatives exist. Metals production, waste incineration, including products like batteries, and the burning of coal, which leads to farflung environmental mercury contamination of water sources and ultimately aquatic life, are other key sources of mercury exposures to humans as well as wildlife. Updated guidelines on the use of mercury in artisinal mining were expected to emerge from the meeting, along with an agreement on a timeline for eliminating mercury from dental products. The health sector is traditionally a major consumer of mercury products, including devices such as thermometers as well as for dental fillings. However, there has been a push to replace them with safer alternatives, under the guidance of the World Health Organization, which has supported implementation of the Minamata Convention since its adoption. Among the 60 national reports reviewed, 11 countries did not even indicate a role for health authorities in implementing the Convention, the WHO report found. Also, the health sector role, when acknowledged, was limited largely to phase out of mercury devices in healthcare settings without much attention to the need to raise awareness of mercury’s health impacts in the broader enviornment. That is despite the toxic human health impacts of environmental mercury exposures from occupational and wildlife food sources, largely fish and shellfish. These include serious, permanent neurological and developmental damage, as well as toixic effects on digestive and immune systems, as well as lungs, kidneys, skin and eyes, according to WHO. See Geneva Solutions review of the challenges in phasing out the use of mercury from artisanal mining. Image Credits: Global Environmental Facility (GEF), World Health Organization . Nkengasong’s PEPFAR Prospects and Hopes for Africa CDC 25/03/2022 Paul Adepoju Nkengasong recently appeared before the US Senate regarding his nomination The current Director of the Africa CDC is a vote away from leading PEPFAR. He unveils his vision for the US-led global HIV/AIDS response and future wishes for the Africa CDC. Dr John Nkengasong, Director of the Africa Centres for Disease Control and Prevention (Africa CDC) is on track to lead the United States President’s Emergency Plan for AIDS Relief (PEPFAR) as the Ambassador at Large and coordinator of US activities to combat HIV/AIDS globally. Although Nkengasong is yet to officially announce his exit plans for Africa CDC, he has already appeared before the United States Senate Committee on Foreign Relations to answer questions from senators ahead of a vote to confirm his nomination by President Joe Biden. He would fill a position that has been left vacant for two years – ever since Deborah Birx stepped away from the post to join President Donald Trump’s COVID-19 response team. The road ahead for Africa CDC Nkengasong at the Africa CDC briefing on Thursday, 24 March. If finally confirmed to lead PEPFAR, Nkengasong’s departure from the Africa CDC is expected to raise concerns about the future of the African Center – which rose to prominence under his guidance steering a steady course in the storms of the COVID pandemic – and only recently gained the status of an independent agency. Asked by Health Policy Watch about his pending PEPFAR appointment in a Thursday briefing, Nkengasong refrained from speculating on how his departure might affect the agency or who would replace him at its helm. But he said that the next agenda for Africa CDC is to leverage the gains of its COVID-19 response in strengthening its healthcare systems across the African Union’s 55 member states, and to be better positioned to fight future pandemics. “The continent has been extremely innovative in developing platforms that are continuously being used to fight this COVID pandemic but we need to focus our energy on developing them to fight other diseases,” he said. He noted that initiatives such as the African Medical Supplies Platform that was set up to fight COVID can now be expanded to fight other diseases in terms of commodities and supply chain management. “So I’m really pleased to see the initiatives that have come out of this continent [and] my greatest wish would be that these initiatives be sustained and developed further so that they can be used in managing other diseases, including future pandemics,” he told Health Policy Watch. Testimony before the US Senate PEPFAR has a long history of involvement in Africa, dating back to its inception in 2003. Africa HIV/AIDS programs have largely been the beneficiaries of PEPFAR investments exceeding over $100 billion. The plan claims it has saved 21 million lives, prevented millions of HIV infections, and is supporting several countries to achieve HIV epidemic control – all while significantly strengthening global health security. In Nkengasong’s opening testimony before the US Senate on Tuesday, March 15, 2022, the Cameroonian virologist said he will draw upon his three decades of experience with research and programmes public health and HIV to advance PEPFAR’s mission, assure its continued success, collaborate with partner governments and communities, and sustain the strong partnership it enjoys with the US Congress. “If confirmed, I would be stepping into this role at a critical moment when the world is confronted with dual global pandemics. We have seen how COVID-19 has affected some progress in our HIV efforts with devastating results. But we have also witnessed how the health systems and institutions built and strengthened by PEPFAR’s investments have been central to the COVID-19 response,” he told the senators. As Director of the Africa CDC, Nkengasong said he has seen how PEPFAR’s investments in health systems over the past 19 years have strengthened—and in some cases, established—the fundamental health infrastructure, laboratories, surveillance systems, and human resources for health in the countries where it helps serve. While noting that previous efforts around HIV prevention, treatment and control were premised upon building ‘vertical’ systems as semi-independent entities, almost from the ground up, the goal has now shifted. PEPFAR’s future efforts must now ensure that these HIV services and systems are well integrated into national health systems, sustainably financed, and resilient to prevent and respond to HIV/AIDS in the future, as well as other diseases. “For this to happen, it is my belief that we need to capitalize on the capacity and experience of those in the countries where we work, coming to the table with a deep respect for their perspectives and needs, taking account of their insights, their knowledge of local contexts, and their reservoirs of expertise. For such systems to be sustainable and keep infectious disease in check, we must act collectively to support the capabilities of local leaders and regional institutions and work in respectful partnership and accountability with them,” he said. A dual US-Cameroonian citizen A native of Cameroon, Nkengasong earned his undergraduate degree at the University of Yaounde, and later studied at graduate level at the Institute of Tropical Medicine Antwerp, at the encouragement of the famed Belgian-British microbiologist, Peter Piot. After completing his second master’s degree in medical sciences in Brussels, he joined the World Health Organization in 1993. In the mid-1990s, he moved to the United States where he spent a stint at the University of California at Berkeley, as a Fogarty International Center trainee, after joining the US Centers for Disease Control and Prevention. He then took over the leadership of the US CDC’s virology lab in Abijdjan, Ivory Coast. Nkengasong subsequently returned to the States and rose to the role of acting deputy principal director for the CDC’s Center for Global Health in Atlanta, Georgia – the state where he also holds US citizenship. In early 2017, he was appointed director of the newly-created African CDC. “In 2014, when Ebola hit West Africa, the heads of state met again and asked the African Union commission to accelerate the establishment of the Africa CDC,” Nkengasong recalled in a 2017 interview, published by the Fogarty International Center. “For all the human and economic destruction wrought by Ebola, it ended up being the catalyst that pushed African leaders to rapidly advance the concept that they nurtured in 2013 to bolster the continent’s public health response, and Africa’s continent-wide public health agency was launched in January 2017.” Hopefully, the COVID-19 pandemic can have a similar effect on promoting Africa CDC’s continued development – regardless of who remains at its helm. Looking Beyond New TB Vaccines to Shorter Courses of Treatment 24/03/2022 Paul Adepoju TB patient at Brooklyn Chest Hospital in Cape Town, South Africa The world remains fixated on getting new TB vaccines. But expanding the circle of progress on shorter TB regimes, and more early detection, may be more important to overcoming setbacks of the COVID pandemic, says one expert on World TB Day. IBADAN, Nigeria – The Government Chest Hospital in the city’s Jericho neighborhood is regarded as one of the top hubs for TB testing, treatment and care in Nigeria. Even though health workers at the facility try to encourage TB patients to sustain their course of treatment until the very end, they often see patients are unwilling to do so. “We have those that do not want people around them to know they have TB, so it’s difficult for them to meet all of their appointments. We also have those that live very far from here. They often start well but over time, as the symptoms clear, they default and drug resistance may arise,” a nursing officer at the hospital told Health Policy Watch. So the World TB Day 2022 announcement of an updated WHO guideline recommending a shorter four-month treatment course for children with “non-severe” TB was a much-heralded development in the TB space as further highlighted the existing research gaps in TB. The latest recommendation relied heavily on the findings of the University College London’s SHINE Study that was conducted in South Africa, Uganda, Zambia and India. Professor Diana Gibb of University College London In an interview with Health Policy Watch, the study’s principal investigator, Professor Diana Gibb of University College London noted that the focus of TB treatment research for both adults and children now is shorter treatment plans considering its effectiveness in preventing resistance. “That’s where the research of both adults and children is focused because you can give shorter treatment and people take it properly, you’re less likely to get drug resistance, which is of course a major issue in some parts of the world,” she told Health Policy Watch. Estimates for total number of people who died from any form of TB in 2020.On World TB Day, WHO Director General, Dr Tedros Adhanom Ghebreyesus, revealed that the spotlight is on the urgent need to invest in the fight against TB to achieve the commitments made by global leaders. “Tuberculosis kills more than 1.5 million people each year and affects millions more, with enormous impacts on families and communities. Ending this debilitating disease remains a priority for WHO,” he said. Better treatment with shorter courses With no new TB vaccines yet in site, shortening TB treatment duration is gradually becoming a more immediate goal considered to be within reach near-term, one which could provide the TB ecosystem opportunities to recoup the big setbacks seen in treatment coverage during the pandemic. Along with the new four-month course for children, other recent treatment gains have included a six-month regimen for TB meningitis instead of 12 months. Moreover, bedaquiline and delamanid, two of the newest TB medicines to treat drug resistant TB, are now recommended for use in children of all ages, making it possible for children with drug-resistant TB to receive all-oral treatment regimens regardless of their age. Currently, however, treatment regimens for adults still require a six month course. And with patients seeing improvements in the early days of the treatment, it remains difficult to ensure adherence to the end of the regimen. That, in turn, can pave the way for resurgence and even multi-drug resistant TB. Gibb, for one, is hopeful that new studies targeting adults with non-severe TB could also yield similarly shorter treatment courses in the near future – although this remains more challenging because adult TB diagnosis is still often delayed and their symptoms are more severe at the commencement of treatment. “I think if you get adults at an early stage, it may be beneficial,” she told Health Policy Watch. Progress on vaccine candidates Funding Needs for TB Program Implementation in USD One major feature of conversations during World TB Days since the COVID-19 pandemic in 2020 has been the stark comparisons between the fact that available TB vaccines remain limited to the century-old BCG vaccine, which is only partially effective and primarily targeted to children, in comparison with the tens of new COVID-19 vaccines that have become available just one year after the pandemic – with more in the pipeline. However, with the huge shortfall in TB investments seen to date – including investments in R&D, money is sorely needed to bring the most promising candidates to clinical trials and market. In a statement for this year’s World TB Day, the World Health Organization (WHO) called for the need to build on lessons learnt from COVID-19 research to catalyze investment accelerated development of new TB vaccines. An additional US$ 1.1 billion per year is needed specifically for TB research and development – aside from the $13 billion required for TB diagnostics, treatments and prevention – asks for which only one-third or less has actually been received. “Urgent investments are needed to develop and expand access to the most innovative services and tools to prevent, detect and treat TB that could save millions of lives each year, narrow inequities and avert huge economic losses,” said Ghebreyesus. “These investments offer huge returns for countries and donors, in averted health care costs and increased productivity.” Improving TB detection A patient in the waiting room of the Government Chest Hospital, Ibadan Nigeria. More funding, expanded short-course treatments and faster detection are critical to overcoming setbacks of the COVID pandemic. Improving TB diagnosis, especially among children is another attainable goal that needs to rank high on health system agendas, Gibb said. This can be done if public health systems channel the financial gains of shorter regimens and more affordable drugs towards improving TB testing. She also noted the need to improve TB treatment for other forms of TB, such as TB meningitis in children in which there is TB infection around the brain. Taken together, new point-of-care testing kits, early detection of latent TB, and related to that, the ability to predict the transition from latent to active TB cases offer a cascade of solutions that can enable earlier detection of disease, when less of the lung is affected. And that, in turn, will lead to options for shorter treatment duration over time, she said. Overcoming previous side effects and limitations Government Chest Hospital in Ibadan Nigeria – considered a top national hub for TB testing, treatment, and care in the country. One of the major concerns that plagued the adoption of new TB treatment recommendations is the concern of serious side effects ranging from deleterious impacts on cognitive functions to impairment of liver functions. While admitting that these were real concerns in the past, Gibb, however, noted that new regimens have been able to overcome the side effects barrier in addition to requiring fewer daily tablets, better tasting tablets, and doing away with injections. “Actually the children tolerate the medicine very well,” said Gibb. “And we are using new medicines, in which the drugs are taken all together in one pill, which then can be dissolved in a little bit of liquid. “So it’s not as bad as it used to be in the old days when you had to take them more often. And we no longer use injections for children to get them as it used to be part of the old TB treatment,” she added. Image Credits: USAID, Southern Africa/Flickr, STOP TB Partnership , Fatola Babafemi/Google Maps, Fatola Babafemi/Google Maps . WHO Urges Caution on Africa’s Rollback of COVID-19 Measures 24/03/2022 Paul Adepoju Dr Matshidiso Moeti, WHO Regional Director for Africa Even while other parts of the world see upticks, or in the case of Asia, huge spikes in COVID-19 cases, an increasing number of African countries are scaling back COVID-19 surveillance and quarantine measures – a trend that the World Health Organization finds worrisome in the continent that still has the lowest rates of vaccination in the world. Addressing a WHO AFRO press briefing, Dr Matshidiso Moeti, WHO Regional Director for Africa, urged countries in the region to proceed cautiously and consider the risks that new variants like the Omicron BA.2 that are wreaking havoc in Asia could spread to Africa, or other new variants could emerge. In August 2020, 23 out of 54 African countries were conducting comprehensive COVID surveillance, including contact tracing, she noted. But as of 15 March 2022, only 13 countries were conducting comprehensive surveillance, while 22 African countries are no longer carrying out any kind of contact tracing whatsoever. “It is a matter of concern that nearly half of all countries in Africa have stopped tracing the contacts of cases. This, along with robust testing, is the backbone of any pandemic response. Without this critical information, it is difficult to track the spread of the virus and identify new COVID-19 hotspots that may be caused by known or emerging variants,” Moeti said. Nigeria is one of the countries where such public health measures are being rolled back, conceded Dr Ifedayo Adetifa, the new Director General of Nigeria’s Centre for Disease Control (NCDC), at the same briefing. But he defended the policies as evidence-backed decisions that attempt to find the balance between ensuring that lives are protected and livelihoods are also able to continue. “We looked at the test positivity rates trend since December last year, and we also looked at the genomic surveillance data. We have seen a continued and stable downward trend of test positivity in the country,” Adetifa said. Need to speed up vaccination Dr Ifedayo Adetifa, Director General of Nigeria’s Centre for Disease Control (NCDC) In addition to ensuring that systems are in place to monitor infection trends and allow a swift response to new variants of concern, WHO also urged African countries to scale up vaccinations to increase so that more people are protected from future virus waves. Only about 15% of Africans, on average, have been fully vaccinated. According to COVID-19 vaccination data curated by Africa CDC, Africa has received over 750 million vaccine doses, to date, out of which about 490 million have been administered. In Nigeria where only 4.4% of the population are fully vaccinated, Adetifa noted that while vaccination is ongoing, it is proceeding slowly. “We obviously need to achieve high vaccination coverage, particularly for the high risk groups and we already see that even with the few cases that we have, a few serious cases, hospitalizations, and deaths that we have, most of these have and still continue to occur among the elderly, among those with comorbidities especially cardiovascular or endocrine diseases,” he added. 70% coverage goal is still important Dr John Nkengasong, Director of the Africa CDC Despite the existence of several other public health challenges, some of which are more lethal and are killing more people than COVID-19, Dr John Nkengasong, Director of the Africa Centres for Disease Control (CDC) told Health Policy Watch that it is still important for African countries to prioritize the 70% vaccination coverage goal. That would still be six months later than the stated WHO aim of reaching 70% by July 2022 – a goal which presently seems far out of reach in light of current vaccination rates. Asked about concerns being expressed privately by some African health officials that the huge investment required for COVID vaccination could divert resources from other, even bigger disease challenges that the continent faces, he said that countries shouldn’t have to face that choice. Instead, he said they should endeavor to respond to all public health challenges at the same time. “I think we should continue to strive to get to 70%. It is not either or; it’s not that we should deplete resources to only get the vaccination to 70% and then neglect HIV, TB and malaria. We should be tackling all of these diseases. Those are the challenges of our time. Each generation has their own challenges to deal with and we cannot walk away from the challenges of our time,” he concluded. Flu Jab Offers Little Protection this Year. Researchers: No Reason to Panic 23/03/2022 Maayan Hoffman A hospital health worker prepares a flu vaccine The flu shots that are being administered in the United States, as well as elsewhere in the northern hemisphere, are not reducing the risk of catching the dominant strain of the influenza virus (H3N2) that is circulating this year, the Centers for Disease Control and Prevention (CDC) in a March edition of its Morbidity and Mortality Weekly Report. But top doctors told Health Policy Watch there is no cause for alarm. Specifically, the efficacy of the formula at preventing mild or moderate cases of flu was estimated to be only around 16% this season, according to the interim CDC findings – meaning the risk of infection for a vaccinated person and unvaccinated person are almost equal – although vaccination can still protect much more against serious disease and death. In the northern hemisphere, flu season usually hits its peak between December and February, but it can last until May, and in some years, new strains can start circulating at the end of the season as well. “It is clearly disappointing in the sense that we would like to see it have a higher efficacy, but it is not surprising,” said Dr Edward Belongia, director of the Center for Clinical Epidemiology & Population Health at the Marshfield Clinic Research Institute, Wisconsin. In Europe, the United States and “across the world” the dominant influenza strain this year has been the AH3N2 virus – comprising some 93% of all influenza viruses detected by the European Centers for Disease Control. “We know flu vaccines in general do not work as well against H3N2 viruses [one of several influenza virus lineages circulating now] and there are variations from season to season. Some seasons we see quite a good match and, unfortunately, due to unpredictable variations in flu virus, sometimes we have a poor match.” This year, in particular, scientists understood that a mismatch was likely, explained Dr. Kawsar R. Talaat, an associate professor in the International Health Department at Johns Hopkins University. WHO’s Global Influenza Surveillance system Twice a year, in September and February, the World Health Organization and a global advisory group of experts examine circulating influenza strains picked up by the WHO Global Influenza Surveillance and Response System, which includes laboratories and research centers in 124 countries. Based on that assessment, WHO issues recommendations for the composition of flu vaccines for the following winter seasons in the southern and northern hemispheres respectively. But what this amounts to is basically a “guess what is going to be circulating the following winter based on what is circulating at the time,” Talaat said. In February 2022, for instance, the WHO expert group already issued recommendations for the viral composition of influenza vaccines for the next 2022-23 winter flu season in the northern hemisphere – based on what has been observed circulating over the past six months. In 2020-2021, however, the flu season in both northern and southern hemispheres was historically mild as a result of COVID restrictions, Talaat said. As a result, the February 2021 WHO recommendations for this year’s season in the global north were even more flawed than usual. “It is an inaccurate science already,” Talaat told Health Policy Watch. “To do it without an existing flu makes it even harder.” However, five years ago, even in the absence of COVID, there was a similarly mismatched season, Talaat pointed out. “We should not be alarmed by this and there is no reason to panic,” she said. And even with the lower efficacy of the flu shot, those at highest risk should still get the jab, she stressed. The CDC said so too, recommending the shot for anyone over six months so long as the virus is circulating. The agency report stressed that the vaccine could still prevent serious disease, hospitalization and death. “The same groups that are at risk for having severe COVID infection should get vaccinated because it could protect these individuals and keep hospitals from having to deal with both severe COVID and flu patients at the same time,” Belongia stressed. Is there anything that can be done? The long-term solution, he said, is to develop a universal flu vaccine that protects against all strains. A universal flu vaccine, according to the National Institute of Allergy and Infectious Diseases (NIAID) would provide “robust, long-lasting protection against multiple subtypes of flu, rather than a select few. Current WHO-recommended flu vaccines typically protect against three or four major flu strains. Such a vaccine would eliminate the need to update and administer the seasonal flu vaccine each year and could provide protection against newly emerging flu strains, potentially including those that could cause a flu pandemic.” It would be at least 75% effective for all age groups and protect against group I and II influenza A viruses. “That is somewhere down the road,” Belongia said. “It won’t happen in the next year or two, but it is a very active area of research.” Image Credits: Flickr. One Month After Russia’s Invasion, Half of Ukrainians are Refugees or Stuck in Conflict Zones – And Their Needs Are Growing 23/03/2022 Kerry Cullinan People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. A month after the start of Russia’s invasion of Ukraine, almost 10 million people have been displaced, 64 attacks on health facilities have been verified – and the situation is set to worsen. This was the grim assessment of World Health Organization (WHO) officials briefing the media on Wednesday. “Nearly a quarter of Ukraine’s population has now been forcibly displaced. The humanitarian situation continues to deteriorate in many parts of the country and is critical in the Mariupol and Bucha districts,” said WHO Director-General Dr Tedros Adhanom Ghebreysus. Meanwhile, Dr Mike Ryan, director of health emergencies, said that “a further massive scaling up of assistance within Ukraine” is going to be needed in the coming weeks. Around 3.5 million Ukrainians have left the country, 6.5 million are internally displaced while 12 million are in conflict zones, said Ryan. “So across a population of 44 million, half the population of Ukraine has either the left the country, has been displaced within the country or is in a direct conflict zone,” said Ryan. “I have never myself seen such complex needs and a crisis that has developed so fast,” added Ryan, castigating the aggressors in both Ukraine and Tigray for refusing to allow unfettered humanitarian access to those in need. The WHO has raised less than a quarter of the $57.5 million it estimates it needs to deliver assistance in Ukraine over the next few months. “The disruption to services and supplies throughout Ukraine is posing an extreme risk to people with cardiovascular disease, cancer, diabetes, HIV and TB, which are among the country’s leading causes of mortality,” said Tedros. Displacement, poor shelter, and overcrowded living conditions caused by the conflict are also increasing the risk of diseases such as measles, pneumonia, and polio as well as COVID-19, he added. Preparing for nuclear, chemical warfare Dr Ibrahima Socé Fall, WHO Assistant General Secretary for Emergency Response Dr Ibrahima Socé Fall, Assistant General Secretary for Emergency Response, said the WHO was in a bind because it did not know how to get medical supplies from its warehouses to health facilities. “The really high confirmed attacks on health care includes attacks on ambulances. So It is difficult even for very simple movement [such as] making sure that the medical supplies will reach the hospitals where it is needed,” said Socé Fall. Meanwhile, the WHO has been working with the International Atomic Energy Agency (IAEA) and Ukrainian officers to prepare for chemical, biological or nuclear hazards. “There is another obvious layer to this, which is the horrific potential that weapons could be used that are either chemical or nuclear in nature,” said Ryan. “We are part of the UN system for response to such incidents if they occur, and we’re ready to do so. But it’s unconscionable even to think that that would be the case.” COVID resurgence is driven by BA.2 Dr Maria van Kerkhove The more infectious Omicron BA.2 sub-lineage is sweeping the world, accounting for 86% of the sequences available from the last four weeks, said WHO COVID-19 lead Dr Maria van Kerkhove. There have been large COVID-19 outbreaks in Asia and a fresh wave of infections in Europe. “Several countries are now seeing their highest death rates since the beginning of the pandemic,” said Tedros. “This reflects the speed with which Omicron spreads and the heightened risk of deaths for those who are not vaccinated, especially older people. We all want to move on from the pandemic. But no matter how much we wish it away, this pandemic is not over.” However, Ryan said that while transmission has taken off again in many places – especially where rules had been relaxed. But countries with high levels of vaccination, especially amongst vulnerable people, were not seeing high rates of hospitalisation, and deaths. Ethiopia finally allows access to Tigray The Ethiopian government, which has maintained a siege of Tigray for almost 500 days, had finally agreed to allow the WHO to deliver 95 tonnes of medical supplies to the territory, said Tedros. “If we can deliver the supplies safely, they will help people in desperate need. But much more is needed. So far, only 4% of the needs for health supplies have been delivered to Tigray. That is insignificant,” said Tedros. “With dire shortages of fuel and food, people are starving to death. Actually, giving them food is more important than medicine. We continue to call on the Ethiopian and Eritrean governments to end the blockade.” Ryan added that the WHO had experienced “all kinds of bureaucratic restrictions in the past, including cancellations” in getting aid to Tigray. “t is the responsibility of all parties to facilitate the process of giving access, not to take away piecemeal small bits of a blockade and allow some aid to trickle in,” said Ryan. “This is about opening up unfettered access to millions of people who are in desperate need.” He added that the basic principles of humanitarian law were being forgotten in Tigray and Ukraine – which is to ensure access to populations who desperately need aid . Image Credits: People in Need, Sam Mednick/TNH. Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Minamata Convention: Parties Review Progress on Global Measures to Halt Mercury Poisoning 25/03/2022 Editorial team Delegates from most of the world’s nations met in Bali this week to review progress in tackling the worldwide problem of mercury poisoning from artisinal gold mining and other environmental sources as well as in the health care industry, in line with the 2013 Minamata Convention. The parties were meeting for the fourth time since the Convention entered into force in 2017. Expanding the list of mercury-containing products for phase-out and discussing thresholds for mercury waste emissions in air and water, were among topics being discusssed. In addition, convention parties were reviewing national plans for the reduction and eventual elimination – of mercury in artisanal and small-scale gold mining (ASGM), which poses particularly grave health hazards for women and children working in the sector. In January 2022, WHO published a review of some 60 countries’ implementation strategies for tackling mercury’s environemental health risks. So far some 129 WHO member states have become parties to the Convention. However, there was no evidence of health ministry participation in about half of the national reports – reflecting the lack of public health sector involvement in promoting awareness about the huge health risks of mercury poisoning. Artisanal gold mining is one such major source of exposure. An estimated 4-5 million women and children are employed in ASGM, where mercury is still widely used to extract gold from ore – even though cleaner and safer alternatives exist. Metals production, waste incineration, including products like batteries, and the burning of coal, which leads to farflung environmental mercury contamination of water sources and ultimately aquatic life, are other key sources of mercury exposures to humans as well as wildlife. Updated guidelines on the use of mercury in artisinal mining were expected to emerge from the meeting, along with an agreement on a timeline for eliminating mercury from dental products. The health sector is traditionally a major consumer of mercury products, including devices such as thermometers as well as for dental fillings. However, there has been a push to replace them with safer alternatives, under the guidance of the World Health Organization, which has supported implementation of the Minamata Convention since its adoption. Among the 60 national reports reviewed, 11 countries did not even indicate a role for health authorities in implementing the Convention, the WHO report found. Also, the health sector role, when acknowledged, was limited largely to phase out of mercury devices in healthcare settings without much attention to the need to raise awareness of mercury’s health impacts in the broader enviornment. That is despite the toxic human health impacts of environmental mercury exposures from occupational and wildlife food sources, largely fish and shellfish. These include serious, permanent neurological and developmental damage, as well as toixic effects on digestive and immune systems, as well as lungs, kidneys, skin and eyes, according to WHO. See Geneva Solutions review of the challenges in phasing out the use of mercury from artisanal mining. Image Credits: Global Environmental Facility (GEF), World Health Organization . Nkengasong’s PEPFAR Prospects and Hopes for Africa CDC 25/03/2022 Paul Adepoju Nkengasong recently appeared before the US Senate regarding his nomination The current Director of the Africa CDC is a vote away from leading PEPFAR. He unveils his vision for the US-led global HIV/AIDS response and future wishes for the Africa CDC. Dr John Nkengasong, Director of the Africa Centres for Disease Control and Prevention (Africa CDC) is on track to lead the United States President’s Emergency Plan for AIDS Relief (PEPFAR) as the Ambassador at Large and coordinator of US activities to combat HIV/AIDS globally. Although Nkengasong is yet to officially announce his exit plans for Africa CDC, he has already appeared before the United States Senate Committee on Foreign Relations to answer questions from senators ahead of a vote to confirm his nomination by President Joe Biden. He would fill a position that has been left vacant for two years – ever since Deborah Birx stepped away from the post to join President Donald Trump’s COVID-19 response team. The road ahead for Africa CDC Nkengasong at the Africa CDC briefing on Thursday, 24 March. If finally confirmed to lead PEPFAR, Nkengasong’s departure from the Africa CDC is expected to raise concerns about the future of the African Center – which rose to prominence under his guidance steering a steady course in the storms of the COVID pandemic – and only recently gained the status of an independent agency. Asked by Health Policy Watch about his pending PEPFAR appointment in a Thursday briefing, Nkengasong refrained from speculating on how his departure might affect the agency or who would replace him at its helm. But he said that the next agenda for Africa CDC is to leverage the gains of its COVID-19 response in strengthening its healthcare systems across the African Union’s 55 member states, and to be better positioned to fight future pandemics. “The continent has been extremely innovative in developing platforms that are continuously being used to fight this COVID pandemic but we need to focus our energy on developing them to fight other diseases,” he said. He noted that initiatives such as the African Medical Supplies Platform that was set up to fight COVID can now be expanded to fight other diseases in terms of commodities and supply chain management. “So I’m really pleased to see the initiatives that have come out of this continent [and] my greatest wish would be that these initiatives be sustained and developed further so that they can be used in managing other diseases, including future pandemics,” he told Health Policy Watch. Testimony before the US Senate PEPFAR has a long history of involvement in Africa, dating back to its inception in 2003. Africa HIV/AIDS programs have largely been the beneficiaries of PEPFAR investments exceeding over $100 billion. The plan claims it has saved 21 million lives, prevented millions of HIV infections, and is supporting several countries to achieve HIV epidemic control – all while significantly strengthening global health security. In Nkengasong’s opening testimony before the US Senate on Tuesday, March 15, 2022, the Cameroonian virologist said he will draw upon his three decades of experience with research and programmes public health and HIV to advance PEPFAR’s mission, assure its continued success, collaborate with partner governments and communities, and sustain the strong partnership it enjoys with the US Congress. “If confirmed, I would be stepping into this role at a critical moment when the world is confronted with dual global pandemics. We have seen how COVID-19 has affected some progress in our HIV efforts with devastating results. But we have also witnessed how the health systems and institutions built and strengthened by PEPFAR’s investments have been central to the COVID-19 response,” he told the senators. As Director of the Africa CDC, Nkengasong said he has seen how PEPFAR’s investments in health systems over the past 19 years have strengthened—and in some cases, established—the fundamental health infrastructure, laboratories, surveillance systems, and human resources for health in the countries where it helps serve. While noting that previous efforts around HIV prevention, treatment and control were premised upon building ‘vertical’ systems as semi-independent entities, almost from the ground up, the goal has now shifted. PEPFAR’s future efforts must now ensure that these HIV services and systems are well integrated into national health systems, sustainably financed, and resilient to prevent and respond to HIV/AIDS in the future, as well as other diseases. “For this to happen, it is my belief that we need to capitalize on the capacity and experience of those in the countries where we work, coming to the table with a deep respect for their perspectives and needs, taking account of their insights, their knowledge of local contexts, and their reservoirs of expertise. For such systems to be sustainable and keep infectious disease in check, we must act collectively to support the capabilities of local leaders and regional institutions and work in respectful partnership and accountability with them,” he said. A dual US-Cameroonian citizen A native of Cameroon, Nkengasong earned his undergraduate degree at the University of Yaounde, and later studied at graduate level at the Institute of Tropical Medicine Antwerp, at the encouragement of the famed Belgian-British microbiologist, Peter Piot. After completing his second master’s degree in medical sciences in Brussels, he joined the World Health Organization in 1993. In the mid-1990s, he moved to the United States where he spent a stint at the University of California at Berkeley, as a Fogarty International Center trainee, after joining the US Centers for Disease Control and Prevention. He then took over the leadership of the US CDC’s virology lab in Abijdjan, Ivory Coast. Nkengasong subsequently returned to the States and rose to the role of acting deputy principal director for the CDC’s Center for Global Health in Atlanta, Georgia – the state where he also holds US citizenship. In early 2017, he was appointed director of the newly-created African CDC. “In 2014, when Ebola hit West Africa, the heads of state met again and asked the African Union commission to accelerate the establishment of the Africa CDC,” Nkengasong recalled in a 2017 interview, published by the Fogarty International Center. “For all the human and economic destruction wrought by Ebola, it ended up being the catalyst that pushed African leaders to rapidly advance the concept that they nurtured in 2013 to bolster the continent’s public health response, and Africa’s continent-wide public health agency was launched in January 2017.” Hopefully, the COVID-19 pandemic can have a similar effect on promoting Africa CDC’s continued development – regardless of who remains at its helm. Looking Beyond New TB Vaccines to Shorter Courses of Treatment 24/03/2022 Paul Adepoju TB patient at Brooklyn Chest Hospital in Cape Town, South Africa The world remains fixated on getting new TB vaccines. But expanding the circle of progress on shorter TB regimes, and more early detection, may be more important to overcoming setbacks of the COVID pandemic, says one expert on World TB Day. IBADAN, Nigeria – The Government Chest Hospital in the city’s Jericho neighborhood is regarded as one of the top hubs for TB testing, treatment and care in Nigeria. Even though health workers at the facility try to encourage TB patients to sustain their course of treatment until the very end, they often see patients are unwilling to do so. “We have those that do not want people around them to know they have TB, so it’s difficult for them to meet all of their appointments. We also have those that live very far from here. They often start well but over time, as the symptoms clear, they default and drug resistance may arise,” a nursing officer at the hospital told Health Policy Watch. So the World TB Day 2022 announcement of an updated WHO guideline recommending a shorter four-month treatment course for children with “non-severe” TB was a much-heralded development in the TB space as further highlighted the existing research gaps in TB. The latest recommendation relied heavily on the findings of the University College London’s SHINE Study that was conducted in South Africa, Uganda, Zambia and India. Professor Diana Gibb of University College London In an interview with Health Policy Watch, the study’s principal investigator, Professor Diana Gibb of University College London noted that the focus of TB treatment research for both adults and children now is shorter treatment plans considering its effectiveness in preventing resistance. “That’s where the research of both adults and children is focused because you can give shorter treatment and people take it properly, you’re less likely to get drug resistance, which is of course a major issue in some parts of the world,” she told Health Policy Watch. Estimates for total number of people who died from any form of TB in 2020.On World TB Day, WHO Director General, Dr Tedros Adhanom Ghebreyesus, revealed that the spotlight is on the urgent need to invest in the fight against TB to achieve the commitments made by global leaders. “Tuberculosis kills more than 1.5 million people each year and affects millions more, with enormous impacts on families and communities. Ending this debilitating disease remains a priority for WHO,” he said. Better treatment with shorter courses With no new TB vaccines yet in site, shortening TB treatment duration is gradually becoming a more immediate goal considered to be within reach near-term, one which could provide the TB ecosystem opportunities to recoup the big setbacks seen in treatment coverage during the pandemic. Along with the new four-month course for children, other recent treatment gains have included a six-month regimen for TB meningitis instead of 12 months. Moreover, bedaquiline and delamanid, two of the newest TB medicines to treat drug resistant TB, are now recommended for use in children of all ages, making it possible for children with drug-resistant TB to receive all-oral treatment regimens regardless of their age. Currently, however, treatment regimens for adults still require a six month course. And with patients seeing improvements in the early days of the treatment, it remains difficult to ensure adherence to the end of the regimen. That, in turn, can pave the way for resurgence and even multi-drug resistant TB. Gibb, for one, is hopeful that new studies targeting adults with non-severe TB could also yield similarly shorter treatment courses in the near future – although this remains more challenging because adult TB diagnosis is still often delayed and their symptoms are more severe at the commencement of treatment. “I think if you get adults at an early stage, it may be beneficial,” she told Health Policy Watch. Progress on vaccine candidates Funding Needs for TB Program Implementation in USD One major feature of conversations during World TB Days since the COVID-19 pandemic in 2020 has been the stark comparisons between the fact that available TB vaccines remain limited to the century-old BCG vaccine, which is only partially effective and primarily targeted to children, in comparison with the tens of new COVID-19 vaccines that have become available just one year after the pandemic – with more in the pipeline. However, with the huge shortfall in TB investments seen to date – including investments in R&D, money is sorely needed to bring the most promising candidates to clinical trials and market. In a statement for this year’s World TB Day, the World Health Organization (WHO) called for the need to build on lessons learnt from COVID-19 research to catalyze investment accelerated development of new TB vaccines. An additional US$ 1.1 billion per year is needed specifically for TB research and development – aside from the $13 billion required for TB diagnostics, treatments and prevention – asks for which only one-third or less has actually been received. “Urgent investments are needed to develop and expand access to the most innovative services and tools to prevent, detect and treat TB that could save millions of lives each year, narrow inequities and avert huge economic losses,” said Ghebreyesus. “These investments offer huge returns for countries and donors, in averted health care costs and increased productivity.” Improving TB detection A patient in the waiting room of the Government Chest Hospital, Ibadan Nigeria. More funding, expanded short-course treatments and faster detection are critical to overcoming setbacks of the COVID pandemic. Improving TB diagnosis, especially among children is another attainable goal that needs to rank high on health system agendas, Gibb said. This can be done if public health systems channel the financial gains of shorter regimens and more affordable drugs towards improving TB testing. She also noted the need to improve TB treatment for other forms of TB, such as TB meningitis in children in which there is TB infection around the brain. Taken together, new point-of-care testing kits, early detection of latent TB, and related to that, the ability to predict the transition from latent to active TB cases offer a cascade of solutions that can enable earlier detection of disease, when less of the lung is affected. And that, in turn, will lead to options for shorter treatment duration over time, she said. Overcoming previous side effects and limitations Government Chest Hospital in Ibadan Nigeria – considered a top national hub for TB testing, treatment, and care in the country. One of the major concerns that plagued the adoption of new TB treatment recommendations is the concern of serious side effects ranging from deleterious impacts on cognitive functions to impairment of liver functions. While admitting that these were real concerns in the past, Gibb, however, noted that new regimens have been able to overcome the side effects barrier in addition to requiring fewer daily tablets, better tasting tablets, and doing away with injections. “Actually the children tolerate the medicine very well,” said Gibb. “And we are using new medicines, in which the drugs are taken all together in one pill, which then can be dissolved in a little bit of liquid. “So it’s not as bad as it used to be in the old days when you had to take them more often. And we no longer use injections for children to get them as it used to be part of the old TB treatment,” she added. Image Credits: USAID, Southern Africa/Flickr, STOP TB Partnership , Fatola Babafemi/Google Maps, Fatola Babafemi/Google Maps . WHO Urges Caution on Africa’s Rollback of COVID-19 Measures 24/03/2022 Paul Adepoju Dr Matshidiso Moeti, WHO Regional Director for Africa Even while other parts of the world see upticks, or in the case of Asia, huge spikes in COVID-19 cases, an increasing number of African countries are scaling back COVID-19 surveillance and quarantine measures – a trend that the World Health Organization finds worrisome in the continent that still has the lowest rates of vaccination in the world. Addressing a WHO AFRO press briefing, Dr Matshidiso Moeti, WHO Regional Director for Africa, urged countries in the region to proceed cautiously and consider the risks that new variants like the Omicron BA.2 that are wreaking havoc in Asia could spread to Africa, or other new variants could emerge. In August 2020, 23 out of 54 African countries were conducting comprehensive COVID surveillance, including contact tracing, she noted. But as of 15 March 2022, only 13 countries were conducting comprehensive surveillance, while 22 African countries are no longer carrying out any kind of contact tracing whatsoever. “It is a matter of concern that nearly half of all countries in Africa have stopped tracing the contacts of cases. This, along with robust testing, is the backbone of any pandemic response. Without this critical information, it is difficult to track the spread of the virus and identify new COVID-19 hotspots that may be caused by known or emerging variants,” Moeti said. Nigeria is one of the countries where such public health measures are being rolled back, conceded Dr Ifedayo Adetifa, the new Director General of Nigeria’s Centre for Disease Control (NCDC), at the same briefing. But he defended the policies as evidence-backed decisions that attempt to find the balance between ensuring that lives are protected and livelihoods are also able to continue. “We looked at the test positivity rates trend since December last year, and we also looked at the genomic surveillance data. We have seen a continued and stable downward trend of test positivity in the country,” Adetifa said. Need to speed up vaccination Dr Ifedayo Adetifa, Director General of Nigeria’s Centre for Disease Control (NCDC) In addition to ensuring that systems are in place to monitor infection trends and allow a swift response to new variants of concern, WHO also urged African countries to scale up vaccinations to increase so that more people are protected from future virus waves. Only about 15% of Africans, on average, have been fully vaccinated. According to COVID-19 vaccination data curated by Africa CDC, Africa has received over 750 million vaccine doses, to date, out of which about 490 million have been administered. In Nigeria where only 4.4% of the population are fully vaccinated, Adetifa noted that while vaccination is ongoing, it is proceeding slowly. “We obviously need to achieve high vaccination coverage, particularly for the high risk groups and we already see that even with the few cases that we have, a few serious cases, hospitalizations, and deaths that we have, most of these have and still continue to occur among the elderly, among those with comorbidities especially cardiovascular or endocrine diseases,” he added. 70% coverage goal is still important Dr John Nkengasong, Director of the Africa CDC Despite the existence of several other public health challenges, some of which are more lethal and are killing more people than COVID-19, Dr John Nkengasong, Director of the Africa Centres for Disease Control (CDC) told Health Policy Watch that it is still important for African countries to prioritize the 70% vaccination coverage goal. That would still be six months later than the stated WHO aim of reaching 70% by July 2022 – a goal which presently seems far out of reach in light of current vaccination rates. Asked about concerns being expressed privately by some African health officials that the huge investment required for COVID vaccination could divert resources from other, even bigger disease challenges that the continent faces, he said that countries shouldn’t have to face that choice. Instead, he said they should endeavor to respond to all public health challenges at the same time. “I think we should continue to strive to get to 70%. It is not either or; it’s not that we should deplete resources to only get the vaccination to 70% and then neglect HIV, TB and malaria. We should be tackling all of these diseases. Those are the challenges of our time. Each generation has their own challenges to deal with and we cannot walk away from the challenges of our time,” he concluded. Flu Jab Offers Little Protection this Year. Researchers: No Reason to Panic 23/03/2022 Maayan Hoffman A hospital health worker prepares a flu vaccine The flu shots that are being administered in the United States, as well as elsewhere in the northern hemisphere, are not reducing the risk of catching the dominant strain of the influenza virus (H3N2) that is circulating this year, the Centers for Disease Control and Prevention (CDC) in a March edition of its Morbidity and Mortality Weekly Report. But top doctors told Health Policy Watch there is no cause for alarm. Specifically, the efficacy of the formula at preventing mild or moderate cases of flu was estimated to be only around 16% this season, according to the interim CDC findings – meaning the risk of infection for a vaccinated person and unvaccinated person are almost equal – although vaccination can still protect much more against serious disease and death. In the northern hemisphere, flu season usually hits its peak between December and February, but it can last until May, and in some years, new strains can start circulating at the end of the season as well. “It is clearly disappointing in the sense that we would like to see it have a higher efficacy, but it is not surprising,” said Dr Edward Belongia, director of the Center for Clinical Epidemiology & Population Health at the Marshfield Clinic Research Institute, Wisconsin. In Europe, the United States and “across the world” the dominant influenza strain this year has been the AH3N2 virus – comprising some 93% of all influenza viruses detected by the European Centers for Disease Control. “We know flu vaccines in general do not work as well against H3N2 viruses [one of several influenza virus lineages circulating now] and there are variations from season to season. Some seasons we see quite a good match and, unfortunately, due to unpredictable variations in flu virus, sometimes we have a poor match.” This year, in particular, scientists understood that a mismatch was likely, explained Dr. Kawsar R. Talaat, an associate professor in the International Health Department at Johns Hopkins University. WHO’s Global Influenza Surveillance system Twice a year, in September and February, the World Health Organization and a global advisory group of experts examine circulating influenza strains picked up by the WHO Global Influenza Surveillance and Response System, which includes laboratories and research centers in 124 countries. Based on that assessment, WHO issues recommendations for the composition of flu vaccines for the following winter seasons in the southern and northern hemispheres respectively. But what this amounts to is basically a “guess what is going to be circulating the following winter based on what is circulating at the time,” Talaat said. In February 2022, for instance, the WHO expert group already issued recommendations for the viral composition of influenza vaccines for the next 2022-23 winter flu season in the northern hemisphere – based on what has been observed circulating over the past six months. In 2020-2021, however, the flu season in both northern and southern hemispheres was historically mild as a result of COVID restrictions, Talaat said. As a result, the February 2021 WHO recommendations for this year’s season in the global north were even more flawed than usual. “It is an inaccurate science already,” Talaat told Health Policy Watch. “To do it without an existing flu makes it even harder.” However, five years ago, even in the absence of COVID, there was a similarly mismatched season, Talaat pointed out. “We should not be alarmed by this and there is no reason to panic,” she said. And even with the lower efficacy of the flu shot, those at highest risk should still get the jab, she stressed. The CDC said so too, recommending the shot for anyone over six months so long as the virus is circulating. The agency report stressed that the vaccine could still prevent serious disease, hospitalization and death. “The same groups that are at risk for having severe COVID infection should get vaccinated because it could protect these individuals and keep hospitals from having to deal with both severe COVID and flu patients at the same time,” Belongia stressed. Is there anything that can be done? The long-term solution, he said, is to develop a universal flu vaccine that protects against all strains. A universal flu vaccine, according to the National Institute of Allergy and Infectious Diseases (NIAID) would provide “robust, long-lasting protection against multiple subtypes of flu, rather than a select few. Current WHO-recommended flu vaccines typically protect against three or four major flu strains. Such a vaccine would eliminate the need to update and administer the seasonal flu vaccine each year and could provide protection against newly emerging flu strains, potentially including those that could cause a flu pandemic.” It would be at least 75% effective for all age groups and protect against group I and II influenza A viruses. “That is somewhere down the road,” Belongia said. “It won’t happen in the next year or two, but it is a very active area of research.” Image Credits: Flickr. One Month After Russia’s Invasion, Half of Ukrainians are Refugees or Stuck in Conflict Zones – And Their Needs Are Growing 23/03/2022 Kerry Cullinan People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. A month after the start of Russia’s invasion of Ukraine, almost 10 million people have been displaced, 64 attacks on health facilities have been verified – and the situation is set to worsen. This was the grim assessment of World Health Organization (WHO) officials briefing the media on Wednesday. “Nearly a quarter of Ukraine’s population has now been forcibly displaced. The humanitarian situation continues to deteriorate in many parts of the country and is critical in the Mariupol and Bucha districts,” said WHO Director-General Dr Tedros Adhanom Ghebreysus. Meanwhile, Dr Mike Ryan, director of health emergencies, said that “a further massive scaling up of assistance within Ukraine” is going to be needed in the coming weeks. Around 3.5 million Ukrainians have left the country, 6.5 million are internally displaced while 12 million are in conflict zones, said Ryan. “So across a population of 44 million, half the population of Ukraine has either the left the country, has been displaced within the country or is in a direct conflict zone,” said Ryan. “I have never myself seen such complex needs and a crisis that has developed so fast,” added Ryan, castigating the aggressors in both Ukraine and Tigray for refusing to allow unfettered humanitarian access to those in need. The WHO has raised less than a quarter of the $57.5 million it estimates it needs to deliver assistance in Ukraine over the next few months. “The disruption to services and supplies throughout Ukraine is posing an extreme risk to people with cardiovascular disease, cancer, diabetes, HIV and TB, which are among the country’s leading causes of mortality,” said Tedros. Displacement, poor shelter, and overcrowded living conditions caused by the conflict are also increasing the risk of diseases such as measles, pneumonia, and polio as well as COVID-19, he added. Preparing for nuclear, chemical warfare Dr Ibrahima Socé Fall, WHO Assistant General Secretary for Emergency Response Dr Ibrahima Socé Fall, Assistant General Secretary for Emergency Response, said the WHO was in a bind because it did not know how to get medical supplies from its warehouses to health facilities. “The really high confirmed attacks on health care includes attacks on ambulances. So It is difficult even for very simple movement [such as] making sure that the medical supplies will reach the hospitals where it is needed,” said Socé Fall. Meanwhile, the WHO has been working with the International Atomic Energy Agency (IAEA) and Ukrainian officers to prepare for chemical, biological or nuclear hazards. “There is another obvious layer to this, which is the horrific potential that weapons could be used that are either chemical or nuclear in nature,” said Ryan. “We are part of the UN system for response to such incidents if they occur, and we’re ready to do so. But it’s unconscionable even to think that that would be the case.” COVID resurgence is driven by BA.2 Dr Maria van Kerkhove The more infectious Omicron BA.2 sub-lineage is sweeping the world, accounting for 86% of the sequences available from the last four weeks, said WHO COVID-19 lead Dr Maria van Kerkhove. There have been large COVID-19 outbreaks in Asia and a fresh wave of infections in Europe. “Several countries are now seeing their highest death rates since the beginning of the pandemic,” said Tedros. “This reflects the speed with which Omicron spreads and the heightened risk of deaths for those who are not vaccinated, especially older people. We all want to move on from the pandemic. But no matter how much we wish it away, this pandemic is not over.” However, Ryan said that while transmission has taken off again in many places – especially where rules had been relaxed. But countries with high levels of vaccination, especially amongst vulnerable people, were not seeing high rates of hospitalisation, and deaths. Ethiopia finally allows access to Tigray The Ethiopian government, which has maintained a siege of Tigray for almost 500 days, had finally agreed to allow the WHO to deliver 95 tonnes of medical supplies to the territory, said Tedros. “If we can deliver the supplies safely, they will help people in desperate need. But much more is needed. So far, only 4% of the needs for health supplies have been delivered to Tigray. That is insignificant,” said Tedros. “With dire shortages of fuel and food, people are starving to death. Actually, giving them food is more important than medicine. We continue to call on the Ethiopian and Eritrean governments to end the blockade.” Ryan added that the WHO had experienced “all kinds of bureaucratic restrictions in the past, including cancellations” in getting aid to Tigray. “t is the responsibility of all parties to facilitate the process of giving access, not to take away piecemeal small bits of a blockade and allow some aid to trickle in,” said Ryan. “This is about opening up unfettered access to millions of people who are in desperate need.” He added that the basic principles of humanitarian law were being forgotten in Tigray and Ukraine – which is to ensure access to populations who desperately need aid . Image Credits: People in Need, Sam Mednick/TNH. Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Nkengasong’s PEPFAR Prospects and Hopes for Africa CDC 25/03/2022 Paul Adepoju Nkengasong recently appeared before the US Senate regarding his nomination The current Director of the Africa CDC is a vote away from leading PEPFAR. He unveils his vision for the US-led global HIV/AIDS response and future wishes for the Africa CDC. Dr John Nkengasong, Director of the Africa Centres for Disease Control and Prevention (Africa CDC) is on track to lead the United States President’s Emergency Plan for AIDS Relief (PEPFAR) as the Ambassador at Large and coordinator of US activities to combat HIV/AIDS globally. Although Nkengasong is yet to officially announce his exit plans for Africa CDC, he has already appeared before the United States Senate Committee on Foreign Relations to answer questions from senators ahead of a vote to confirm his nomination by President Joe Biden. He would fill a position that has been left vacant for two years – ever since Deborah Birx stepped away from the post to join President Donald Trump’s COVID-19 response team. The road ahead for Africa CDC Nkengasong at the Africa CDC briefing on Thursday, 24 March. If finally confirmed to lead PEPFAR, Nkengasong’s departure from the Africa CDC is expected to raise concerns about the future of the African Center – which rose to prominence under his guidance steering a steady course in the storms of the COVID pandemic – and only recently gained the status of an independent agency. Asked by Health Policy Watch about his pending PEPFAR appointment in a Thursday briefing, Nkengasong refrained from speculating on how his departure might affect the agency or who would replace him at its helm. But he said that the next agenda for Africa CDC is to leverage the gains of its COVID-19 response in strengthening its healthcare systems across the African Union’s 55 member states, and to be better positioned to fight future pandemics. “The continent has been extremely innovative in developing platforms that are continuously being used to fight this COVID pandemic but we need to focus our energy on developing them to fight other diseases,” he said. He noted that initiatives such as the African Medical Supplies Platform that was set up to fight COVID can now be expanded to fight other diseases in terms of commodities and supply chain management. “So I’m really pleased to see the initiatives that have come out of this continent [and] my greatest wish would be that these initiatives be sustained and developed further so that they can be used in managing other diseases, including future pandemics,” he told Health Policy Watch. Testimony before the US Senate PEPFAR has a long history of involvement in Africa, dating back to its inception in 2003. Africa HIV/AIDS programs have largely been the beneficiaries of PEPFAR investments exceeding over $100 billion. The plan claims it has saved 21 million lives, prevented millions of HIV infections, and is supporting several countries to achieve HIV epidemic control – all while significantly strengthening global health security. In Nkengasong’s opening testimony before the US Senate on Tuesday, March 15, 2022, the Cameroonian virologist said he will draw upon his three decades of experience with research and programmes public health and HIV to advance PEPFAR’s mission, assure its continued success, collaborate with partner governments and communities, and sustain the strong partnership it enjoys with the US Congress. “If confirmed, I would be stepping into this role at a critical moment when the world is confronted with dual global pandemics. We have seen how COVID-19 has affected some progress in our HIV efforts with devastating results. But we have also witnessed how the health systems and institutions built and strengthened by PEPFAR’s investments have been central to the COVID-19 response,” he told the senators. As Director of the Africa CDC, Nkengasong said he has seen how PEPFAR’s investments in health systems over the past 19 years have strengthened—and in some cases, established—the fundamental health infrastructure, laboratories, surveillance systems, and human resources for health in the countries where it helps serve. While noting that previous efforts around HIV prevention, treatment and control were premised upon building ‘vertical’ systems as semi-independent entities, almost from the ground up, the goal has now shifted. PEPFAR’s future efforts must now ensure that these HIV services and systems are well integrated into national health systems, sustainably financed, and resilient to prevent and respond to HIV/AIDS in the future, as well as other diseases. “For this to happen, it is my belief that we need to capitalize on the capacity and experience of those in the countries where we work, coming to the table with a deep respect for their perspectives and needs, taking account of their insights, their knowledge of local contexts, and their reservoirs of expertise. For such systems to be sustainable and keep infectious disease in check, we must act collectively to support the capabilities of local leaders and regional institutions and work in respectful partnership and accountability with them,” he said. A dual US-Cameroonian citizen A native of Cameroon, Nkengasong earned his undergraduate degree at the University of Yaounde, and later studied at graduate level at the Institute of Tropical Medicine Antwerp, at the encouragement of the famed Belgian-British microbiologist, Peter Piot. After completing his second master’s degree in medical sciences in Brussels, he joined the World Health Organization in 1993. In the mid-1990s, he moved to the United States where he spent a stint at the University of California at Berkeley, as a Fogarty International Center trainee, after joining the US Centers for Disease Control and Prevention. He then took over the leadership of the US CDC’s virology lab in Abijdjan, Ivory Coast. Nkengasong subsequently returned to the States and rose to the role of acting deputy principal director for the CDC’s Center for Global Health in Atlanta, Georgia – the state where he also holds US citizenship. In early 2017, he was appointed director of the newly-created African CDC. “In 2014, when Ebola hit West Africa, the heads of state met again and asked the African Union commission to accelerate the establishment of the Africa CDC,” Nkengasong recalled in a 2017 interview, published by the Fogarty International Center. “For all the human and economic destruction wrought by Ebola, it ended up being the catalyst that pushed African leaders to rapidly advance the concept that they nurtured in 2013 to bolster the continent’s public health response, and Africa’s continent-wide public health agency was launched in January 2017.” Hopefully, the COVID-19 pandemic can have a similar effect on promoting Africa CDC’s continued development – regardless of who remains at its helm. Looking Beyond New TB Vaccines to Shorter Courses of Treatment 24/03/2022 Paul Adepoju TB patient at Brooklyn Chest Hospital in Cape Town, South Africa The world remains fixated on getting new TB vaccines. But expanding the circle of progress on shorter TB regimes, and more early detection, may be more important to overcoming setbacks of the COVID pandemic, says one expert on World TB Day. IBADAN, Nigeria – The Government Chest Hospital in the city’s Jericho neighborhood is regarded as one of the top hubs for TB testing, treatment and care in Nigeria. Even though health workers at the facility try to encourage TB patients to sustain their course of treatment until the very end, they often see patients are unwilling to do so. “We have those that do not want people around them to know they have TB, so it’s difficult for them to meet all of their appointments. We also have those that live very far from here. They often start well but over time, as the symptoms clear, they default and drug resistance may arise,” a nursing officer at the hospital told Health Policy Watch. So the World TB Day 2022 announcement of an updated WHO guideline recommending a shorter four-month treatment course for children with “non-severe” TB was a much-heralded development in the TB space as further highlighted the existing research gaps in TB. The latest recommendation relied heavily on the findings of the University College London’s SHINE Study that was conducted in South Africa, Uganda, Zambia and India. Professor Diana Gibb of University College London In an interview with Health Policy Watch, the study’s principal investigator, Professor Diana Gibb of University College London noted that the focus of TB treatment research for both adults and children now is shorter treatment plans considering its effectiveness in preventing resistance. “That’s where the research of both adults and children is focused because you can give shorter treatment and people take it properly, you’re less likely to get drug resistance, which is of course a major issue in some parts of the world,” she told Health Policy Watch. Estimates for total number of people who died from any form of TB in 2020.On World TB Day, WHO Director General, Dr Tedros Adhanom Ghebreyesus, revealed that the spotlight is on the urgent need to invest in the fight against TB to achieve the commitments made by global leaders. “Tuberculosis kills more than 1.5 million people each year and affects millions more, with enormous impacts on families and communities. Ending this debilitating disease remains a priority for WHO,” he said. Better treatment with shorter courses With no new TB vaccines yet in site, shortening TB treatment duration is gradually becoming a more immediate goal considered to be within reach near-term, one which could provide the TB ecosystem opportunities to recoup the big setbacks seen in treatment coverage during the pandemic. Along with the new four-month course for children, other recent treatment gains have included a six-month regimen for TB meningitis instead of 12 months. Moreover, bedaquiline and delamanid, two of the newest TB medicines to treat drug resistant TB, are now recommended for use in children of all ages, making it possible for children with drug-resistant TB to receive all-oral treatment regimens regardless of their age. Currently, however, treatment regimens for adults still require a six month course. And with patients seeing improvements in the early days of the treatment, it remains difficult to ensure adherence to the end of the regimen. That, in turn, can pave the way for resurgence and even multi-drug resistant TB. Gibb, for one, is hopeful that new studies targeting adults with non-severe TB could also yield similarly shorter treatment courses in the near future – although this remains more challenging because adult TB diagnosis is still often delayed and their symptoms are more severe at the commencement of treatment. “I think if you get adults at an early stage, it may be beneficial,” she told Health Policy Watch. Progress on vaccine candidates Funding Needs for TB Program Implementation in USD One major feature of conversations during World TB Days since the COVID-19 pandemic in 2020 has been the stark comparisons between the fact that available TB vaccines remain limited to the century-old BCG vaccine, which is only partially effective and primarily targeted to children, in comparison with the tens of new COVID-19 vaccines that have become available just one year after the pandemic – with more in the pipeline. However, with the huge shortfall in TB investments seen to date – including investments in R&D, money is sorely needed to bring the most promising candidates to clinical trials and market. In a statement for this year’s World TB Day, the World Health Organization (WHO) called for the need to build on lessons learnt from COVID-19 research to catalyze investment accelerated development of new TB vaccines. An additional US$ 1.1 billion per year is needed specifically for TB research and development – aside from the $13 billion required for TB diagnostics, treatments and prevention – asks for which only one-third or less has actually been received. “Urgent investments are needed to develop and expand access to the most innovative services and tools to prevent, detect and treat TB that could save millions of lives each year, narrow inequities and avert huge economic losses,” said Ghebreyesus. “These investments offer huge returns for countries and donors, in averted health care costs and increased productivity.” Improving TB detection A patient in the waiting room of the Government Chest Hospital, Ibadan Nigeria. More funding, expanded short-course treatments and faster detection are critical to overcoming setbacks of the COVID pandemic. Improving TB diagnosis, especially among children is another attainable goal that needs to rank high on health system agendas, Gibb said. This can be done if public health systems channel the financial gains of shorter regimens and more affordable drugs towards improving TB testing. She also noted the need to improve TB treatment for other forms of TB, such as TB meningitis in children in which there is TB infection around the brain. Taken together, new point-of-care testing kits, early detection of latent TB, and related to that, the ability to predict the transition from latent to active TB cases offer a cascade of solutions that can enable earlier detection of disease, when less of the lung is affected. And that, in turn, will lead to options for shorter treatment duration over time, she said. Overcoming previous side effects and limitations Government Chest Hospital in Ibadan Nigeria – considered a top national hub for TB testing, treatment, and care in the country. One of the major concerns that plagued the adoption of new TB treatment recommendations is the concern of serious side effects ranging from deleterious impacts on cognitive functions to impairment of liver functions. While admitting that these were real concerns in the past, Gibb, however, noted that new regimens have been able to overcome the side effects barrier in addition to requiring fewer daily tablets, better tasting tablets, and doing away with injections. “Actually the children tolerate the medicine very well,” said Gibb. “And we are using new medicines, in which the drugs are taken all together in one pill, which then can be dissolved in a little bit of liquid. “So it’s not as bad as it used to be in the old days when you had to take them more often. And we no longer use injections for children to get them as it used to be part of the old TB treatment,” she added. Image Credits: USAID, Southern Africa/Flickr, STOP TB Partnership , Fatola Babafemi/Google Maps, Fatola Babafemi/Google Maps . WHO Urges Caution on Africa’s Rollback of COVID-19 Measures 24/03/2022 Paul Adepoju Dr Matshidiso Moeti, WHO Regional Director for Africa Even while other parts of the world see upticks, or in the case of Asia, huge spikes in COVID-19 cases, an increasing number of African countries are scaling back COVID-19 surveillance and quarantine measures – a trend that the World Health Organization finds worrisome in the continent that still has the lowest rates of vaccination in the world. Addressing a WHO AFRO press briefing, Dr Matshidiso Moeti, WHO Regional Director for Africa, urged countries in the region to proceed cautiously and consider the risks that new variants like the Omicron BA.2 that are wreaking havoc in Asia could spread to Africa, or other new variants could emerge. In August 2020, 23 out of 54 African countries were conducting comprehensive COVID surveillance, including contact tracing, she noted. But as of 15 March 2022, only 13 countries were conducting comprehensive surveillance, while 22 African countries are no longer carrying out any kind of contact tracing whatsoever. “It is a matter of concern that nearly half of all countries in Africa have stopped tracing the contacts of cases. This, along with robust testing, is the backbone of any pandemic response. Without this critical information, it is difficult to track the spread of the virus and identify new COVID-19 hotspots that may be caused by known or emerging variants,” Moeti said. Nigeria is one of the countries where such public health measures are being rolled back, conceded Dr Ifedayo Adetifa, the new Director General of Nigeria’s Centre for Disease Control (NCDC), at the same briefing. But he defended the policies as evidence-backed decisions that attempt to find the balance between ensuring that lives are protected and livelihoods are also able to continue. “We looked at the test positivity rates trend since December last year, and we also looked at the genomic surveillance data. We have seen a continued and stable downward trend of test positivity in the country,” Adetifa said. Need to speed up vaccination Dr Ifedayo Adetifa, Director General of Nigeria’s Centre for Disease Control (NCDC) In addition to ensuring that systems are in place to monitor infection trends and allow a swift response to new variants of concern, WHO also urged African countries to scale up vaccinations to increase so that more people are protected from future virus waves. Only about 15% of Africans, on average, have been fully vaccinated. According to COVID-19 vaccination data curated by Africa CDC, Africa has received over 750 million vaccine doses, to date, out of which about 490 million have been administered. In Nigeria where only 4.4% of the population are fully vaccinated, Adetifa noted that while vaccination is ongoing, it is proceeding slowly. “We obviously need to achieve high vaccination coverage, particularly for the high risk groups and we already see that even with the few cases that we have, a few serious cases, hospitalizations, and deaths that we have, most of these have and still continue to occur among the elderly, among those with comorbidities especially cardiovascular or endocrine diseases,” he added. 70% coverage goal is still important Dr John Nkengasong, Director of the Africa CDC Despite the existence of several other public health challenges, some of which are more lethal and are killing more people than COVID-19, Dr John Nkengasong, Director of the Africa Centres for Disease Control (CDC) told Health Policy Watch that it is still important for African countries to prioritize the 70% vaccination coverage goal. That would still be six months later than the stated WHO aim of reaching 70% by July 2022 – a goal which presently seems far out of reach in light of current vaccination rates. Asked about concerns being expressed privately by some African health officials that the huge investment required for COVID vaccination could divert resources from other, even bigger disease challenges that the continent faces, he said that countries shouldn’t have to face that choice. Instead, he said they should endeavor to respond to all public health challenges at the same time. “I think we should continue to strive to get to 70%. It is not either or; it’s not that we should deplete resources to only get the vaccination to 70% and then neglect HIV, TB and malaria. We should be tackling all of these diseases. Those are the challenges of our time. Each generation has their own challenges to deal with and we cannot walk away from the challenges of our time,” he concluded. Flu Jab Offers Little Protection this Year. Researchers: No Reason to Panic 23/03/2022 Maayan Hoffman A hospital health worker prepares a flu vaccine The flu shots that are being administered in the United States, as well as elsewhere in the northern hemisphere, are not reducing the risk of catching the dominant strain of the influenza virus (H3N2) that is circulating this year, the Centers for Disease Control and Prevention (CDC) in a March edition of its Morbidity and Mortality Weekly Report. But top doctors told Health Policy Watch there is no cause for alarm. Specifically, the efficacy of the formula at preventing mild or moderate cases of flu was estimated to be only around 16% this season, according to the interim CDC findings – meaning the risk of infection for a vaccinated person and unvaccinated person are almost equal – although vaccination can still protect much more against serious disease and death. In the northern hemisphere, flu season usually hits its peak between December and February, but it can last until May, and in some years, new strains can start circulating at the end of the season as well. “It is clearly disappointing in the sense that we would like to see it have a higher efficacy, but it is not surprising,” said Dr Edward Belongia, director of the Center for Clinical Epidemiology & Population Health at the Marshfield Clinic Research Institute, Wisconsin. In Europe, the United States and “across the world” the dominant influenza strain this year has been the AH3N2 virus – comprising some 93% of all influenza viruses detected by the European Centers for Disease Control. “We know flu vaccines in general do not work as well against H3N2 viruses [one of several influenza virus lineages circulating now] and there are variations from season to season. Some seasons we see quite a good match and, unfortunately, due to unpredictable variations in flu virus, sometimes we have a poor match.” This year, in particular, scientists understood that a mismatch was likely, explained Dr. Kawsar R. Talaat, an associate professor in the International Health Department at Johns Hopkins University. WHO’s Global Influenza Surveillance system Twice a year, in September and February, the World Health Organization and a global advisory group of experts examine circulating influenza strains picked up by the WHO Global Influenza Surveillance and Response System, which includes laboratories and research centers in 124 countries. Based on that assessment, WHO issues recommendations for the composition of flu vaccines for the following winter seasons in the southern and northern hemispheres respectively. But what this amounts to is basically a “guess what is going to be circulating the following winter based on what is circulating at the time,” Talaat said. In February 2022, for instance, the WHO expert group already issued recommendations for the viral composition of influenza vaccines for the next 2022-23 winter flu season in the northern hemisphere – based on what has been observed circulating over the past six months. In 2020-2021, however, the flu season in both northern and southern hemispheres was historically mild as a result of COVID restrictions, Talaat said. As a result, the February 2021 WHO recommendations for this year’s season in the global north were even more flawed than usual. “It is an inaccurate science already,” Talaat told Health Policy Watch. “To do it without an existing flu makes it even harder.” However, five years ago, even in the absence of COVID, there was a similarly mismatched season, Talaat pointed out. “We should not be alarmed by this and there is no reason to panic,” she said. And even with the lower efficacy of the flu shot, those at highest risk should still get the jab, she stressed. The CDC said so too, recommending the shot for anyone over six months so long as the virus is circulating. The agency report stressed that the vaccine could still prevent serious disease, hospitalization and death. “The same groups that are at risk for having severe COVID infection should get vaccinated because it could protect these individuals and keep hospitals from having to deal with both severe COVID and flu patients at the same time,” Belongia stressed. Is there anything that can be done? The long-term solution, he said, is to develop a universal flu vaccine that protects against all strains. A universal flu vaccine, according to the National Institute of Allergy and Infectious Diseases (NIAID) would provide “robust, long-lasting protection against multiple subtypes of flu, rather than a select few. Current WHO-recommended flu vaccines typically protect against three or four major flu strains. Such a vaccine would eliminate the need to update and administer the seasonal flu vaccine each year and could provide protection against newly emerging flu strains, potentially including those that could cause a flu pandemic.” It would be at least 75% effective for all age groups and protect against group I and II influenza A viruses. “That is somewhere down the road,” Belongia said. “It won’t happen in the next year or two, but it is a very active area of research.” Image Credits: Flickr. One Month After Russia’s Invasion, Half of Ukrainians are Refugees or Stuck in Conflict Zones – And Their Needs Are Growing 23/03/2022 Kerry Cullinan People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. A month after the start of Russia’s invasion of Ukraine, almost 10 million people have been displaced, 64 attacks on health facilities have been verified – and the situation is set to worsen. This was the grim assessment of World Health Organization (WHO) officials briefing the media on Wednesday. “Nearly a quarter of Ukraine’s population has now been forcibly displaced. The humanitarian situation continues to deteriorate in many parts of the country and is critical in the Mariupol and Bucha districts,” said WHO Director-General Dr Tedros Adhanom Ghebreysus. Meanwhile, Dr Mike Ryan, director of health emergencies, said that “a further massive scaling up of assistance within Ukraine” is going to be needed in the coming weeks. Around 3.5 million Ukrainians have left the country, 6.5 million are internally displaced while 12 million are in conflict zones, said Ryan. “So across a population of 44 million, half the population of Ukraine has either the left the country, has been displaced within the country or is in a direct conflict zone,” said Ryan. “I have never myself seen such complex needs and a crisis that has developed so fast,” added Ryan, castigating the aggressors in both Ukraine and Tigray for refusing to allow unfettered humanitarian access to those in need. The WHO has raised less than a quarter of the $57.5 million it estimates it needs to deliver assistance in Ukraine over the next few months. “The disruption to services and supplies throughout Ukraine is posing an extreme risk to people with cardiovascular disease, cancer, diabetes, HIV and TB, which are among the country’s leading causes of mortality,” said Tedros. Displacement, poor shelter, and overcrowded living conditions caused by the conflict are also increasing the risk of diseases such as measles, pneumonia, and polio as well as COVID-19, he added. Preparing for nuclear, chemical warfare Dr Ibrahima Socé Fall, WHO Assistant General Secretary for Emergency Response Dr Ibrahima Socé Fall, Assistant General Secretary for Emergency Response, said the WHO was in a bind because it did not know how to get medical supplies from its warehouses to health facilities. “The really high confirmed attacks on health care includes attacks on ambulances. So It is difficult even for very simple movement [such as] making sure that the medical supplies will reach the hospitals where it is needed,” said Socé Fall. Meanwhile, the WHO has been working with the International Atomic Energy Agency (IAEA) and Ukrainian officers to prepare for chemical, biological or nuclear hazards. “There is another obvious layer to this, which is the horrific potential that weapons could be used that are either chemical or nuclear in nature,” said Ryan. “We are part of the UN system for response to such incidents if they occur, and we’re ready to do so. But it’s unconscionable even to think that that would be the case.” COVID resurgence is driven by BA.2 Dr Maria van Kerkhove The more infectious Omicron BA.2 sub-lineage is sweeping the world, accounting for 86% of the sequences available from the last four weeks, said WHO COVID-19 lead Dr Maria van Kerkhove. There have been large COVID-19 outbreaks in Asia and a fresh wave of infections in Europe. “Several countries are now seeing their highest death rates since the beginning of the pandemic,” said Tedros. “This reflects the speed with which Omicron spreads and the heightened risk of deaths for those who are not vaccinated, especially older people. We all want to move on from the pandemic. But no matter how much we wish it away, this pandemic is not over.” However, Ryan said that while transmission has taken off again in many places – especially where rules had been relaxed. But countries with high levels of vaccination, especially amongst vulnerable people, were not seeing high rates of hospitalisation, and deaths. Ethiopia finally allows access to Tigray The Ethiopian government, which has maintained a siege of Tigray for almost 500 days, had finally agreed to allow the WHO to deliver 95 tonnes of medical supplies to the territory, said Tedros. “If we can deliver the supplies safely, they will help people in desperate need. But much more is needed. So far, only 4% of the needs for health supplies have been delivered to Tigray. That is insignificant,” said Tedros. “With dire shortages of fuel and food, people are starving to death. Actually, giving them food is more important than medicine. We continue to call on the Ethiopian and Eritrean governments to end the blockade.” Ryan added that the WHO had experienced “all kinds of bureaucratic restrictions in the past, including cancellations” in getting aid to Tigray. “t is the responsibility of all parties to facilitate the process of giving access, not to take away piecemeal small bits of a blockade and allow some aid to trickle in,” said Ryan. “This is about opening up unfettered access to millions of people who are in desperate need.” He added that the basic principles of humanitarian law were being forgotten in Tigray and Ukraine – which is to ensure access to populations who desperately need aid . Image Credits: People in Need, Sam Mednick/TNH. Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Looking Beyond New TB Vaccines to Shorter Courses of Treatment 24/03/2022 Paul Adepoju TB patient at Brooklyn Chest Hospital in Cape Town, South Africa The world remains fixated on getting new TB vaccines. But expanding the circle of progress on shorter TB regimes, and more early detection, may be more important to overcoming setbacks of the COVID pandemic, says one expert on World TB Day. IBADAN, Nigeria – The Government Chest Hospital in the city’s Jericho neighborhood is regarded as one of the top hubs for TB testing, treatment and care in Nigeria. Even though health workers at the facility try to encourage TB patients to sustain their course of treatment until the very end, they often see patients are unwilling to do so. “We have those that do not want people around them to know they have TB, so it’s difficult for them to meet all of their appointments. We also have those that live very far from here. They often start well but over time, as the symptoms clear, they default and drug resistance may arise,” a nursing officer at the hospital told Health Policy Watch. So the World TB Day 2022 announcement of an updated WHO guideline recommending a shorter four-month treatment course for children with “non-severe” TB was a much-heralded development in the TB space as further highlighted the existing research gaps in TB. The latest recommendation relied heavily on the findings of the University College London’s SHINE Study that was conducted in South Africa, Uganda, Zambia and India. Professor Diana Gibb of University College London In an interview with Health Policy Watch, the study’s principal investigator, Professor Diana Gibb of University College London noted that the focus of TB treatment research for both adults and children now is shorter treatment plans considering its effectiveness in preventing resistance. “That’s where the research of both adults and children is focused because you can give shorter treatment and people take it properly, you’re less likely to get drug resistance, which is of course a major issue in some parts of the world,” she told Health Policy Watch. Estimates for total number of people who died from any form of TB in 2020.On World TB Day, WHO Director General, Dr Tedros Adhanom Ghebreyesus, revealed that the spotlight is on the urgent need to invest in the fight against TB to achieve the commitments made by global leaders. “Tuberculosis kills more than 1.5 million people each year and affects millions more, with enormous impacts on families and communities. Ending this debilitating disease remains a priority for WHO,” he said. Better treatment with shorter courses With no new TB vaccines yet in site, shortening TB treatment duration is gradually becoming a more immediate goal considered to be within reach near-term, one which could provide the TB ecosystem opportunities to recoup the big setbacks seen in treatment coverage during the pandemic. Along with the new four-month course for children, other recent treatment gains have included a six-month regimen for TB meningitis instead of 12 months. Moreover, bedaquiline and delamanid, two of the newest TB medicines to treat drug resistant TB, are now recommended for use in children of all ages, making it possible for children with drug-resistant TB to receive all-oral treatment regimens regardless of their age. Currently, however, treatment regimens for adults still require a six month course. And with patients seeing improvements in the early days of the treatment, it remains difficult to ensure adherence to the end of the regimen. That, in turn, can pave the way for resurgence and even multi-drug resistant TB. Gibb, for one, is hopeful that new studies targeting adults with non-severe TB could also yield similarly shorter treatment courses in the near future – although this remains more challenging because adult TB diagnosis is still often delayed and their symptoms are more severe at the commencement of treatment. “I think if you get adults at an early stage, it may be beneficial,” she told Health Policy Watch. Progress on vaccine candidates Funding Needs for TB Program Implementation in USD One major feature of conversations during World TB Days since the COVID-19 pandemic in 2020 has been the stark comparisons between the fact that available TB vaccines remain limited to the century-old BCG vaccine, which is only partially effective and primarily targeted to children, in comparison with the tens of new COVID-19 vaccines that have become available just one year after the pandemic – with more in the pipeline. However, with the huge shortfall in TB investments seen to date – including investments in R&D, money is sorely needed to bring the most promising candidates to clinical trials and market. In a statement for this year’s World TB Day, the World Health Organization (WHO) called for the need to build on lessons learnt from COVID-19 research to catalyze investment accelerated development of new TB vaccines. An additional US$ 1.1 billion per year is needed specifically for TB research and development – aside from the $13 billion required for TB diagnostics, treatments and prevention – asks for which only one-third or less has actually been received. “Urgent investments are needed to develop and expand access to the most innovative services and tools to prevent, detect and treat TB that could save millions of lives each year, narrow inequities and avert huge economic losses,” said Ghebreyesus. “These investments offer huge returns for countries and donors, in averted health care costs and increased productivity.” Improving TB detection A patient in the waiting room of the Government Chest Hospital, Ibadan Nigeria. More funding, expanded short-course treatments and faster detection are critical to overcoming setbacks of the COVID pandemic. Improving TB diagnosis, especially among children is another attainable goal that needs to rank high on health system agendas, Gibb said. This can be done if public health systems channel the financial gains of shorter regimens and more affordable drugs towards improving TB testing. She also noted the need to improve TB treatment for other forms of TB, such as TB meningitis in children in which there is TB infection around the brain. Taken together, new point-of-care testing kits, early detection of latent TB, and related to that, the ability to predict the transition from latent to active TB cases offer a cascade of solutions that can enable earlier detection of disease, when less of the lung is affected. And that, in turn, will lead to options for shorter treatment duration over time, she said. Overcoming previous side effects and limitations Government Chest Hospital in Ibadan Nigeria – considered a top national hub for TB testing, treatment, and care in the country. One of the major concerns that plagued the adoption of new TB treatment recommendations is the concern of serious side effects ranging from deleterious impacts on cognitive functions to impairment of liver functions. While admitting that these were real concerns in the past, Gibb, however, noted that new regimens have been able to overcome the side effects barrier in addition to requiring fewer daily tablets, better tasting tablets, and doing away with injections. “Actually the children tolerate the medicine very well,” said Gibb. “And we are using new medicines, in which the drugs are taken all together in one pill, which then can be dissolved in a little bit of liquid. “So it’s not as bad as it used to be in the old days when you had to take them more often. And we no longer use injections for children to get them as it used to be part of the old TB treatment,” she added. Image Credits: USAID, Southern Africa/Flickr, STOP TB Partnership , Fatola Babafemi/Google Maps, Fatola Babafemi/Google Maps . WHO Urges Caution on Africa’s Rollback of COVID-19 Measures 24/03/2022 Paul Adepoju Dr Matshidiso Moeti, WHO Regional Director for Africa Even while other parts of the world see upticks, or in the case of Asia, huge spikes in COVID-19 cases, an increasing number of African countries are scaling back COVID-19 surveillance and quarantine measures – a trend that the World Health Organization finds worrisome in the continent that still has the lowest rates of vaccination in the world. Addressing a WHO AFRO press briefing, Dr Matshidiso Moeti, WHO Regional Director for Africa, urged countries in the region to proceed cautiously and consider the risks that new variants like the Omicron BA.2 that are wreaking havoc in Asia could spread to Africa, or other new variants could emerge. In August 2020, 23 out of 54 African countries were conducting comprehensive COVID surveillance, including contact tracing, she noted. But as of 15 March 2022, only 13 countries were conducting comprehensive surveillance, while 22 African countries are no longer carrying out any kind of contact tracing whatsoever. “It is a matter of concern that nearly half of all countries in Africa have stopped tracing the contacts of cases. This, along with robust testing, is the backbone of any pandemic response. Without this critical information, it is difficult to track the spread of the virus and identify new COVID-19 hotspots that may be caused by known or emerging variants,” Moeti said. Nigeria is one of the countries where such public health measures are being rolled back, conceded Dr Ifedayo Adetifa, the new Director General of Nigeria’s Centre for Disease Control (NCDC), at the same briefing. But he defended the policies as evidence-backed decisions that attempt to find the balance between ensuring that lives are protected and livelihoods are also able to continue. “We looked at the test positivity rates trend since December last year, and we also looked at the genomic surveillance data. We have seen a continued and stable downward trend of test positivity in the country,” Adetifa said. Need to speed up vaccination Dr Ifedayo Adetifa, Director General of Nigeria’s Centre for Disease Control (NCDC) In addition to ensuring that systems are in place to monitor infection trends and allow a swift response to new variants of concern, WHO also urged African countries to scale up vaccinations to increase so that more people are protected from future virus waves. Only about 15% of Africans, on average, have been fully vaccinated. According to COVID-19 vaccination data curated by Africa CDC, Africa has received over 750 million vaccine doses, to date, out of which about 490 million have been administered. In Nigeria where only 4.4% of the population are fully vaccinated, Adetifa noted that while vaccination is ongoing, it is proceeding slowly. “We obviously need to achieve high vaccination coverage, particularly for the high risk groups and we already see that even with the few cases that we have, a few serious cases, hospitalizations, and deaths that we have, most of these have and still continue to occur among the elderly, among those with comorbidities especially cardiovascular or endocrine diseases,” he added. 70% coverage goal is still important Dr John Nkengasong, Director of the Africa CDC Despite the existence of several other public health challenges, some of which are more lethal and are killing more people than COVID-19, Dr John Nkengasong, Director of the Africa Centres for Disease Control (CDC) told Health Policy Watch that it is still important for African countries to prioritize the 70% vaccination coverage goal. That would still be six months later than the stated WHO aim of reaching 70% by July 2022 – a goal which presently seems far out of reach in light of current vaccination rates. Asked about concerns being expressed privately by some African health officials that the huge investment required for COVID vaccination could divert resources from other, even bigger disease challenges that the continent faces, he said that countries shouldn’t have to face that choice. Instead, he said they should endeavor to respond to all public health challenges at the same time. “I think we should continue to strive to get to 70%. It is not either or; it’s not that we should deplete resources to only get the vaccination to 70% and then neglect HIV, TB and malaria. We should be tackling all of these diseases. Those are the challenges of our time. Each generation has their own challenges to deal with and we cannot walk away from the challenges of our time,” he concluded. Flu Jab Offers Little Protection this Year. Researchers: No Reason to Panic 23/03/2022 Maayan Hoffman A hospital health worker prepares a flu vaccine The flu shots that are being administered in the United States, as well as elsewhere in the northern hemisphere, are not reducing the risk of catching the dominant strain of the influenza virus (H3N2) that is circulating this year, the Centers for Disease Control and Prevention (CDC) in a March edition of its Morbidity and Mortality Weekly Report. But top doctors told Health Policy Watch there is no cause for alarm. Specifically, the efficacy of the formula at preventing mild or moderate cases of flu was estimated to be only around 16% this season, according to the interim CDC findings – meaning the risk of infection for a vaccinated person and unvaccinated person are almost equal – although vaccination can still protect much more against serious disease and death. In the northern hemisphere, flu season usually hits its peak between December and February, but it can last until May, and in some years, new strains can start circulating at the end of the season as well. “It is clearly disappointing in the sense that we would like to see it have a higher efficacy, but it is not surprising,” said Dr Edward Belongia, director of the Center for Clinical Epidemiology & Population Health at the Marshfield Clinic Research Institute, Wisconsin. In Europe, the United States and “across the world” the dominant influenza strain this year has been the AH3N2 virus – comprising some 93% of all influenza viruses detected by the European Centers for Disease Control. “We know flu vaccines in general do not work as well against H3N2 viruses [one of several influenza virus lineages circulating now] and there are variations from season to season. Some seasons we see quite a good match and, unfortunately, due to unpredictable variations in flu virus, sometimes we have a poor match.” This year, in particular, scientists understood that a mismatch was likely, explained Dr. Kawsar R. Talaat, an associate professor in the International Health Department at Johns Hopkins University. WHO’s Global Influenza Surveillance system Twice a year, in September and February, the World Health Organization and a global advisory group of experts examine circulating influenza strains picked up by the WHO Global Influenza Surveillance and Response System, which includes laboratories and research centers in 124 countries. Based on that assessment, WHO issues recommendations for the composition of flu vaccines for the following winter seasons in the southern and northern hemispheres respectively. But what this amounts to is basically a “guess what is going to be circulating the following winter based on what is circulating at the time,” Talaat said. In February 2022, for instance, the WHO expert group already issued recommendations for the viral composition of influenza vaccines for the next 2022-23 winter flu season in the northern hemisphere – based on what has been observed circulating over the past six months. In 2020-2021, however, the flu season in both northern and southern hemispheres was historically mild as a result of COVID restrictions, Talaat said. As a result, the February 2021 WHO recommendations for this year’s season in the global north were even more flawed than usual. “It is an inaccurate science already,” Talaat told Health Policy Watch. “To do it without an existing flu makes it even harder.” However, five years ago, even in the absence of COVID, there was a similarly mismatched season, Talaat pointed out. “We should not be alarmed by this and there is no reason to panic,” she said. And even with the lower efficacy of the flu shot, those at highest risk should still get the jab, she stressed. The CDC said so too, recommending the shot for anyone over six months so long as the virus is circulating. The agency report stressed that the vaccine could still prevent serious disease, hospitalization and death. “The same groups that are at risk for having severe COVID infection should get vaccinated because it could protect these individuals and keep hospitals from having to deal with both severe COVID and flu patients at the same time,” Belongia stressed. Is there anything that can be done? The long-term solution, he said, is to develop a universal flu vaccine that protects against all strains. A universal flu vaccine, according to the National Institute of Allergy and Infectious Diseases (NIAID) would provide “robust, long-lasting protection against multiple subtypes of flu, rather than a select few. Current WHO-recommended flu vaccines typically protect against three or four major flu strains. Such a vaccine would eliminate the need to update and administer the seasonal flu vaccine each year and could provide protection against newly emerging flu strains, potentially including those that could cause a flu pandemic.” It would be at least 75% effective for all age groups and protect against group I and II influenza A viruses. “That is somewhere down the road,” Belongia said. “It won’t happen in the next year or two, but it is a very active area of research.” Image Credits: Flickr. One Month After Russia’s Invasion, Half of Ukrainians are Refugees or Stuck in Conflict Zones – And Their Needs Are Growing 23/03/2022 Kerry Cullinan People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. A month after the start of Russia’s invasion of Ukraine, almost 10 million people have been displaced, 64 attacks on health facilities have been verified – and the situation is set to worsen. This was the grim assessment of World Health Organization (WHO) officials briefing the media on Wednesday. “Nearly a quarter of Ukraine’s population has now been forcibly displaced. The humanitarian situation continues to deteriorate in many parts of the country and is critical in the Mariupol and Bucha districts,” said WHO Director-General Dr Tedros Adhanom Ghebreysus. Meanwhile, Dr Mike Ryan, director of health emergencies, said that “a further massive scaling up of assistance within Ukraine” is going to be needed in the coming weeks. Around 3.5 million Ukrainians have left the country, 6.5 million are internally displaced while 12 million are in conflict zones, said Ryan. “So across a population of 44 million, half the population of Ukraine has either the left the country, has been displaced within the country or is in a direct conflict zone,” said Ryan. “I have never myself seen such complex needs and a crisis that has developed so fast,” added Ryan, castigating the aggressors in both Ukraine and Tigray for refusing to allow unfettered humanitarian access to those in need. The WHO has raised less than a quarter of the $57.5 million it estimates it needs to deliver assistance in Ukraine over the next few months. “The disruption to services and supplies throughout Ukraine is posing an extreme risk to people with cardiovascular disease, cancer, diabetes, HIV and TB, which are among the country’s leading causes of mortality,” said Tedros. Displacement, poor shelter, and overcrowded living conditions caused by the conflict are also increasing the risk of diseases such as measles, pneumonia, and polio as well as COVID-19, he added. Preparing for nuclear, chemical warfare Dr Ibrahima Socé Fall, WHO Assistant General Secretary for Emergency Response Dr Ibrahima Socé Fall, Assistant General Secretary for Emergency Response, said the WHO was in a bind because it did not know how to get medical supplies from its warehouses to health facilities. “The really high confirmed attacks on health care includes attacks on ambulances. So It is difficult even for very simple movement [such as] making sure that the medical supplies will reach the hospitals where it is needed,” said Socé Fall. Meanwhile, the WHO has been working with the International Atomic Energy Agency (IAEA) and Ukrainian officers to prepare for chemical, biological or nuclear hazards. “There is another obvious layer to this, which is the horrific potential that weapons could be used that are either chemical or nuclear in nature,” said Ryan. “We are part of the UN system for response to such incidents if they occur, and we’re ready to do so. But it’s unconscionable even to think that that would be the case.” COVID resurgence is driven by BA.2 Dr Maria van Kerkhove The more infectious Omicron BA.2 sub-lineage is sweeping the world, accounting for 86% of the sequences available from the last four weeks, said WHO COVID-19 lead Dr Maria van Kerkhove. There have been large COVID-19 outbreaks in Asia and a fresh wave of infections in Europe. “Several countries are now seeing their highest death rates since the beginning of the pandemic,” said Tedros. “This reflects the speed with which Omicron spreads and the heightened risk of deaths for those who are not vaccinated, especially older people. We all want to move on from the pandemic. But no matter how much we wish it away, this pandemic is not over.” However, Ryan said that while transmission has taken off again in many places – especially where rules had been relaxed. But countries with high levels of vaccination, especially amongst vulnerable people, were not seeing high rates of hospitalisation, and deaths. Ethiopia finally allows access to Tigray The Ethiopian government, which has maintained a siege of Tigray for almost 500 days, had finally agreed to allow the WHO to deliver 95 tonnes of medical supplies to the territory, said Tedros. “If we can deliver the supplies safely, they will help people in desperate need. But much more is needed. So far, only 4% of the needs for health supplies have been delivered to Tigray. That is insignificant,” said Tedros. “With dire shortages of fuel and food, people are starving to death. Actually, giving them food is more important than medicine. We continue to call on the Ethiopian and Eritrean governments to end the blockade.” Ryan added that the WHO had experienced “all kinds of bureaucratic restrictions in the past, including cancellations” in getting aid to Tigray. “t is the responsibility of all parties to facilitate the process of giving access, not to take away piecemeal small bits of a blockade and allow some aid to trickle in,” said Ryan. “This is about opening up unfettered access to millions of people who are in desperate need.” He added that the basic principles of humanitarian law were being forgotten in Tigray and Ukraine – which is to ensure access to populations who desperately need aid . Image Credits: People in Need, Sam Mednick/TNH. Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
WHO Urges Caution on Africa’s Rollback of COVID-19 Measures 24/03/2022 Paul Adepoju Dr Matshidiso Moeti, WHO Regional Director for Africa Even while other parts of the world see upticks, or in the case of Asia, huge spikes in COVID-19 cases, an increasing number of African countries are scaling back COVID-19 surveillance and quarantine measures – a trend that the World Health Organization finds worrisome in the continent that still has the lowest rates of vaccination in the world. Addressing a WHO AFRO press briefing, Dr Matshidiso Moeti, WHO Regional Director for Africa, urged countries in the region to proceed cautiously and consider the risks that new variants like the Omicron BA.2 that are wreaking havoc in Asia could spread to Africa, or other new variants could emerge. In August 2020, 23 out of 54 African countries were conducting comprehensive COVID surveillance, including contact tracing, she noted. But as of 15 March 2022, only 13 countries were conducting comprehensive surveillance, while 22 African countries are no longer carrying out any kind of contact tracing whatsoever. “It is a matter of concern that nearly half of all countries in Africa have stopped tracing the contacts of cases. This, along with robust testing, is the backbone of any pandemic response. Without this critical information, it is difficult to track the spread of the virus and identify new COVID-19 hotspots that may be caused by known or emerging variants,” Moeti said. Nigeria is one of the countries where such public health measures are being rolled back, conceded Dr Ifedayo Adetifa, the new Director General of Nigeria’s Centre for Disease Control (NCDC), at the same briefing. But he defended the policies as evidence-backed decisions that attempt to find the balance between ensuring that lives are protected and livelihoods are also able to continue. “We looked at the test positivity rates trend since December last year, and we also looked at the genomic surveillance data. We have seen a continued and stable downward trend of test positivity in the country,” Adetifa said. Need to speed up vaccination Dr Ifedayo Adetifa, Director General of Nigeria’s Centre for Disease Control (NCDC) In addition to ensuring that systems are in place to monitor infection trends and allow a swift response to new variants of concern, WHO also urged African countries to scale up vaccinations to increase so that more people are protected from future virus waves. Only about 15% of Africans, on average, have been fully vaccinated. According to COVID-19 vaccination data curated by Africa CDC, Africa has received over 750 million vaccine doses, to date, out of which about 490 million have been administered. In Nigeria where only 4.4% of the population are fully vaccinated, Adetifa noted that while vaccination is ongoing, it is proceeding slowly. “We obviously need to achieve high vaccination coverage, particularly for the high risk groups and we already see that even with the few cases that we have, a few serious cases, hospitalizations, and deaths that we have, most of these have and still continue to occur among the elderly, among those with comorbidities especially cardiovascular or endocrine diseases,” he added. 70% coverage goal is still important Dr John Nkengasong, Director of the Africa CDC Despite the existence of several other public health challenges, some of which are more lethal and are killing more people than COVID-19, Dr John Nkengasong, Director of the Africa Centres for Disease Control (CDC) told Health Policy Watch that it is still important for African countries to prioritize the 70% vaccination coverage goal. That would still be six months later than the stated WHO aim of reaching 70% by July 2022 – a goal which presently seems far out of reach in light of current vaccination rates. Asked about concerns being expressed privately by some African health officials that the huge investment required for COVID vaccination could divert resources from other, even bigger disease challenges that the continent faces, he said that countries shouldn’t have to face that choice. Instead, he said they should endeavor to respond to all public health challenges at the same time. “I think we should continue to strive to get to 70%. It is not either or; it’s not that we should deplete resources to only get the vaccination to 70% and then neglect HIV, TB and malaria. We should be tackling all of these diseases. Those are the challenges of our time. Each generation has their own challenges to deal with and we cannot walk away from the challenges of our time,” he concluded. Flu Jab Offers Little Protection this Year. Researchers: No Reason to Panic 23/03/2022 Maayan Hoffman A hospital health worker prepares a flu vaccine The flu shots that are being administered in the United States, as well as elsewhere in the northern hemisphere, are not reducing the risk of catching the dominant strain of the influenza virus (H3N2) that is circulating this year, the Centers for Disease Control and Prevention (CDC) in a March edition of its Morbidity and Mortality Weekly Report. But top doctors told Health Policy Watch there is no cause for alarm. Specifically, the efficacy of the formula at preventing mild or moderate cases of flu was estimated to be only around 16% this season, according to the interim CDC findings – meaning the risk of infection for a vaccinated person and unvaccinated person are almost equal – although vaccination can still protect much more against serious disease and death. In the northern hemisphere, flu season usually hits its peak between December and February, but it can last until May, and in some years, new strains can start circulating at the end of the season as well. “It is clearly disappointing in the sense that we would like to see it have a higher efficacy, but it is not surprising,” said Dr Edward Belongia, director of the Center for Clinical Epidemiology & Population Health at the Marshfield Clinic Research Institute, Wisconsin. In Europe, the United States and “across the world” the dominant influenza strain this year has been the AH3N2 virus – comprising some 93% of all influenza viruses detected by the European Centers for Disease Control. “We know flu vaccines in general do not work as well against H3N2 viruses [one of several influenza virus lineages circulating now] and there are variations from season to season. Some seasons we see quite a good match and, unfortunately, due to unpredictable variations in flu virus, sometimes we have a poor match.” This year, in particular, scientists understood that a mismatch was likely, explained Dr. Kawsar R. Talaat, an associate professor in the International Health Department at Johns Hopkins University. WHO’s Global Influenza Surveillance system Twice a year, in September and February, the World Health Organization and a global advisory group of experts examine circulating influenza strains picked up by the WHO Global Influenza Surveillance and Response System, which includes laboratories and research centers in 124 countries. Based on that assessment, WHO issues recommendations for the composition of flu vaccines for the following winter seasons in the southern and northern hemispheres respectively. But what this amounts to is basically a “guess what is going to be circulating the following winter based on what is circulating at the time,” Talaat said. In February 2022, for instance, the WHO expert group already issued recommendations for the viral composition of influenza vaccines for the next 2022-23 winter flu season in the northern hemisphere – based on what has been observed circulating over the past six months. In 2020-2021, however, the flu season in both northern and southern hemispheres was historically mild as a result of COVID restrictions, Talaat said. As a result, the February 2021 WHO recommendations for this year’s season in the global north were even more flawed than usual. “It is an inaccurate science already,” Talaat told Health Policy Watch. “To do it without an existing flu makes it even harder.” However, five years ago, even in the absence of COVID, there was a similarly mismatched season, Talaat pointed out. “We should not be alarmed by this and there is no reason to panic,” she said. And even with the lower efficacy of the flu shot, those at highest risk should still get the jab, she stressed. The CDC said so too, recommending the shot for anyone over six months so long as the virus is circulating. The agency report stressed that the vaccine could still prevent serious disease, hospitalization and death. “The same groups that are at risk for having severe COVID infection should get vaccinated because it could protect these individuals and keep hospitals from having to deal with both severe COVID and flu patients at the same time,” Belongia stressed. Is there anything that can be done? The long-term solution, he said, is to develop a universal flu vaccine that protects against all strains. A universal flu vaccine, according to the National Institute of Allergy and Infectious Diseases (NIAID) would provide “robust, long-lasting protection against multiple subtypes of flu, rather than a select few. Current WHO-recommended flu vaccines typically protect against three or four major flu strains. Such a vaccine would eliminate the need to update and administer the seasonal flu vaccine each year and could provide protection against newly emerging flu strains, potentially including those that could cause a flu pandemic.” It would be at least 75% effective for all age groups and protect against group I and II influenza A viruses. “That is somewhere down the road,” Belongia said. “It won’t happen in the next year or two, but it is a very active area of research.” Image Credits: Flickr. One Month After Russia’s Invasion, Half of Ukrainians are Refugees or Stuck in Conflict Zones – And Their Needs Are Growing 23/03/2022 Kerry Cullinan People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. A month after the start of Russia’s invasion of Ukraine, almost 10 million people have been displaced, 64 attacks on health facilities have been verified – and the situation is set to worsen. This was the grim assessment of World Health Organization (WHO) officials briefing the media on Wednesday. “Nearly a quarter of Ukraine’s population has now been forcibly displaced. The humanitarian situation continues to deteriorate in many parts of the country and is critical in the Mariupol and Bucha districts,” said WHO Director-General Dr Tedros Adhanom Ghebreysus. Meanwhile, Dr Mike Ryan, director of health emergencies, said that “a further massive scaling up of assistance within Ukraine” is going to be needed in the coming weeks. Around 3.5 million Ukrainians have left the country, 6.5 million are internally displaced while 12 million are in conflict zones, said Ryan. “So across a population of 44 million, half the population of Ukraine has either the left the country, has been displaced within the country or is in a direct conflict zone,” said Ryan. “I have never myself seen such complex needs and a crisis that has developed so fast,” added Ryan, castigating the aggressors in both Ukraine and Tigray for refusing to allow unfettered humanitarian access to those in need. The WHO has raised less than a quarter of the $57.5 million it estimates it needs to deliver assistance in Ukraine over the next few months. “The disruption to services and supplies throughout Ukraine is posing an extreme risk to people with cardiovascular disease, cancer, diabetes, HIV and TB, which are among the country’s leading causes of mortality,” said Tedros. Displacement, poor shelter, and overcrowded living conditions caused by the conflict are also increasing the risk of diseases such as measles, pneumonia, and polio as well as COVID-19, he added. Preparing for nuclear, chemical warfare Dr Ibrahima Socé Fall, WHO Assistant General Secretary for Emergency Response Dr Ibrahima Socé Fall, Assistant General Secretary for Emergency Response, said the WHO was in a bind because it did not know how to get medical supplies from its warehouses to health facilities. “The really high confirmed attacks on health care includes attacks on ambulances. So It is difficult even for very simple movement [such as] making sure that the medical supplies will reach the hospitals where it is needed,” said Socé Fall. Meanwhile, the WHO has been working with the International Atomic Energy Agency (IAEA) and Ukrainian officers to prepare for chemical, biological or nuclear hazards. “There is another obvious layer to this, which is the horrific potential that weapons could be used that are either chemical or nuclear in nature,” said Ryan. “We are part of the UN system for response to such incidents if they occur, and we’re ready to do so. But it’s unconscionable even to think that that would be the case.” COVID resurgence is driven by BA.2 Dr Maria van Kerkhove The more infectious Omicron BA.2 sub-lineage is sweeping the world, accounting for 86% of the sequences available from the last four weeks, said WHO COVID-19 lead Dr Maria van Kerkhove. There have been large COVID-19 outbreaks in Asia and a fresh wave of infections in Europe. “Several countries are now seeing their highest death rates since the beginning of the pandemic,” said Tedros. “This reflects the speed with which Omicron spreads and the heightened risk of deaths for those who are not vaccinated, especially older people. We all want to move on from the pandemic. But no matter how much we wish it away, this pandemic is not over.” However, Ryan said that while transmission has taken off again in many places – especially where rules had been relaxed. But countries with high levels of vaccination, especially amongst vulnerable people, were not seeing high rates of hospitalisation, and deaths. Ethiopia finally allows access to Tigray The Ethiopian government, which has maintained a siege of Tigray for almost 500 days, had finally agreed to allow the WHO to deliver 95 tonnes of medical supplies to the territory, said Tedros. “If we can deliver the supplies safely, they will help people in desperate need. But much more is needed. So far, only 4% of the needs for health supplies have been delivered to Tigray. That is insignificant,” said Tedros. “With dire shortages of fuel and food, people are starving to death. Actually, giving them food is more important than medicine. We continue to call on the Ethiopian and Eritrean governments to end the blockade.” Ryan added that the WHO had experienced “all kinds of bureaucratic restrictions in the past, including cancellations” in getting aid to Tigray. “t is the responsibility of all parties to facilitate the process of giving access, not to take away piecemeal small bits of a blockade and allow some aid to trickle in,” said Ryan. “This is about opening up unfettered access to millions of people who are in desperate need.” He added that the basic principles of humanitarian law were being forgotten in Tigray and Ukraine – which is to ensure access to populations who desperately need aid . Image Credits: People in Need, Sam Mednick/TNH. Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Flu Jab Offers Little Protection this Year. Researchers: No Reason to Panic 23/03/2022 Maayan Hoffman A hospital health worker prepares a flu vaccine The flu shots that are being administered in the United States, as well as elsewhere in the northern hemisphere, are not reducing the risk of catching the dominant strain of the influenza virus (H3N2) that is circulating this year, the Centers for Disease Control and Prevention (CDC) in a March edition of its Morbidity and Mortality Weekly Report. But top doctors told Health Policy Watch there is no cause for alarm. Specifically, the efficacy of the formula at preventing mild or moderate cases of flu was estimated to be only around 16% this season, according to the interim CDC findings – meaning the risk of infection for a vaccinated person and unvaccinated person are almost equal – although vaccination can still protect much more against serious disease and death. In the northern hemisphere, flu season usually hits its peak between December and February, but it can last until May, and in some years, new strains can start circulating at the end of the season as well. “It is clearly disappointing in the sense that we would like to see it have a higher efficacy, but it is not surprising,” said Dr Edward Belongia, director of the Center for Clinical Epidemiology & Population Health at the Marshfield Clinic Research Institute, Wisconsin. In Europe, the United States and “across the world” the dominant influenza strain this year has been the AH3N2 virus – comprising some 93% of all influenza viruses detected by the European Centers for Disease Control. “We know flu vaccines in general do not work as well against H3N2 viruses [one of several influenza virus lineages circulating now] and there are variations from season to season. Some seasons we see quite a good match and, unfortunately, due to unpredictable variations in flu virus, sometimes we have a poor match.” This year, in particular, scientists understood that a mismatch was likely, explained Dr. Kawsar R. Talaat, an associate professor in the International Health Department at Johns Hopkins University. WHO’s Global Influenza Surveillance system Twice a year, in September and February, the World Health Organization and a global advisory group of experts examine circulating influenza strains picked up by the WHO Global Influenza Surveillance and Response System, which includes laboratories and research centers in 124 countries. Based on that assessment, WHO issues recommendations for the composition of flu vaccines for the following winter seasons in the southern and northern hemispheres respectively. But what this amounts to is basically a “guess what is going to be circulating the following winter based on what is circulating at the time,” Talaat said. In February 2022, for instance, the WHO expert group already issued recommendations for the viral composition of influenza vaccines for the next 2022-23 winter flu season in the northern hemisphere – based on what has been observed circulating over the past six months. In 2020-2021, however, the flu season in both northern and southern hemispheres was historically mild as a result of COVID restrictions, Talaat said. As a result, the February 2021 WHO recommendations for this year’s season in the global north were even more flawed than usual. “It is an inaccurate science already,” Talaat told Health Policy Watch. “To do it without an existing flu makes it even harder.” However, five years ago, even in the absence of COVID, there was a similarly mismatched season, Talaat pointed out. “We should not be alarmed by this and there is no reason to panic,” she said. And even with the lower efficacy of the flu shot, those at highest risk should still get the jab, she stressed. The CDC said so too, recommending the shot for anyone over six months so long as the virus is circulating. The agency report stressed that the vaccine could still prevent serious disease, hospitalization and death. “The same groups that are at risk for having severe COVID infection should get vaccinated because it could protect these individuals and keep hospitals from having to deal with both severe COVID and flu patients at the same time,” Belongia stressed. Is there anything that can be done? The long-term solution, he said, is to develop a universal flu vaccine that protects against all strains. A universal flu vaccine, according to the National Institute of Allergy and Infectious Diseases (NIAID) would provide “robust, long-lasting protection against multiple subtypes of flu, rather than a select few. Current WHO-recommended flu vaccines typically protect against three or four major flu strains. Such a vaccine would eliminate the need to update and administer the seasonal flu vaccine each year and could provide protection against newly emerging flu strains, potentially including those that could cause a flu pandemic.” It would be at least 75% effective for all age groups and protect against group I and II influenza A viruses. “That is somewhere down the road,” Belongia said. “It won’t happen in the next year or two, but it is a very active area of research.” Image Credits: Flickr. One Month After Russia’s Invasion, Half of Ukrainians are Refugees or Stuck in Conflict Zones – And Their Needs Are Growing 23/03/2022 Kerry Cullinan People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. A month after the start of Russia’s invasion of Ukraine, almost 10 million people have been displaced, 64 attacks on health facilities have been verified – and the situation is set to worsen. This was the grim assessment of World Health Organization (WHO) officials briefing the media on Wednesday. “Nearly a quarter of Ukraine’s population has now been forcibly displaced. The humanitarian situation continues to deteriorate in many parts of the country and is critical in the Mariupol and Bucha districts,” said WHO Director-General Dr Tedros Adhanom Ghebreysus. Meanwhile, Dr Mike Ryan, director of health emergencies, said that “a further massive scaling up of assistance within Ukraine” is going to be needed in the coming weeks. Around 3.5 million Ukrainians have left the country, 6.5 million are internally displaced while 12 million are in conflict zones, said Ryan. “So across a population of 44 million, half the population of Ukraine has either the left the country, has been displaced within the country or is in a direct conflict zone,” said Ryan. “I have never myself seen such complex needs and a crisis that has developed so fast,” added Ryan, castigating the aggressors in both Ukraine and Tigray for refusing to allow unfettered humanitarian access to those in need. The WHO has raised less than a quarter of the $57.5 million it estimates it needs to deliver assistance in Ukraine over the next few months. “The disruption to services and supplies throughout Ukraine is posing an extreme risk to people with cardiovascular disease, cancer, diabetes, HIV and TB, which are among the country’s leading causes of mortality,” said Tedros. Displacement, poor shelter, and overcrowded living conditions caused by the conflict are also increasing the risk of diseases such as measles, pneumonia, and polio as well as COVID-19, he added. Preparing for nuclear, chemical warfare Dr Ibrahima Socé Fall, WHO Assistant General Secretary for Emergency Response Dr Ibrahima Socé Fall, Assistant General Secretary for Emergency Response, said the WHO was in a bind because it did not know how to get medical supplies from its warehouses to health facilities. “The really high confirmed attacks on health care includes attacks on ambulances. So It is difficult even for very simple movement [such as] making sure that the medical supplies will reach the hospitals where it is needed,” said Socé Fall. Meanwhile, the WHO has been working with the International Atomic Energy Agency (IAEA) and Ukrainian officers to prepare for chemical, biological or nuclear hazards. “There is another obvious layer to this, which is the horrific potential that weapons could be used that are either chemical or nuclear in nature,” said Ryan. “We are part of the UN system for response to such incidents if they occur, and we’re ready to do so. But it’s unconscionable even to think that that would be the case.” COVID resurgence is driven by BA.2 Dr Maria van Kerkhove The more infectious Omicron BA.2 sub-lineage is sweeping the world, accounting for 86% of the sequences available from the last four weeks, said WHO COVID-19 lead Dr Maria van Kerkhove. There have been large COVID-19 outbreaks in Asia and a fresh wave of infections in Europe. “Several countries are now seeing their highest death rates since the beginning of the pandemic,” said Tedros. “This reflects the speed with which Omicron spreads and the heightened risk of deaths for those who are not vaccinated, especially older people. We all want to move on from the pandemic. But no matter how much we wish it away, this pandemic is not over.” However, Ryan said that while transmission has taken off again in many places – especially where rules had been relaxed. But countries with high levels of vaccination, especially amongst vulnerable people, were not seeing high rates of hospitalisation, and deaths. Ethiopia finally allows access to Tigray The Ethiopian government, which has maintained a siege of Tigray for almost 500 days, had finally agreed to allow the WHO to deliver 95 tonnes of medical supplies to the territory, said Tedros. “If we can deliver the supplies safely, they will help people in desperate need. But much more is needed. So far, only 4% of the needs for health supplies have been delivered to Tigray. That is insignificant,” said Tedros. “With dire shortages of fuel and food, people are starving to death. Actually, giving them food is more important than medicine. We continue to call on the Ethiopian and Eritrean governments to end the blockade.” Ryan added that the WHO had experienced “all kinds of bureaucratic restrictions in the past, including cancellations” in getting aid to Tigray. “t is the responsibility of all parties to facilitate the process of giving access, not to take away piecemeal small bits of a blockade and allow some aid to trickle in,” said Ryan. “This is about opening up unfettered access to millions of people who are in desperate need.” He added that the basic principles of humanitarian law were being forgotten in Tigray and Ukraine – which is to ensure access to populations who desperately need aid . Image Credits: People in Need, Sam Mednick/TNH. Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
One Month After Russia’s Invasion, Half of Ukrainians are Refugees or Stuck in Conflict Zones – And Their Needs Are Growing 23/03/2022 Kerry Cullinan People at the railway station in Lviv wait in line for hours to board trains to leave Ukraine. A month after the start of Russia’s invasion of Ukraine, almost 10 million people have been displaced, 64 attacks on health facilities have been verified – and the situation is set to worsen. This was the grim assessment of World Health Organization (WHO) officials briefing the media on Wednesday. “Nearly a quarter of Ukraine’s population has now been forcibly displaced. The humanitarian situation continues to deteriorate in many parts of the country and is critical in the Mariupol and Bucha districts,” said WHO Director-General Dr Tedros Adhanom Ghebreysus. Meanwhile, Dr Mike Ryan, director of health emergencies, said that “a further massive scaling up of assistance within Ukraine” is going to be needed in the coming weeks. Around 3.5 million Ukrainians have left the country, 6.5 million are internally displaced while 12 million are in conflict zones, said Ryan. “So across a population of 44 million, half the population of Ukraine has either the left the country, has been displaced within the country or is in a direct conflict zone,” said Ryan. “I have never myself seen such complex needs and a crisis that has developed so fast,” added Ryan, castigating the aggressors in both Ukraine and Tigray for refusing to allow unfettered humanitarian access to those in need. The WHO has raised less than a quarter of the $57.5 million it estimates it needs to deliver assistance in Ukraine over the next few months. “The disruption to services and supplies throughout Ukraine is posing an extreme risk to people with cardiovascular disease, cancer, diabetes, HIV and TB, which are among the country’s leading causes of mortality,” said Tedros. Displacement, poor shelter, and overcrowded living conditions caused by the conflict are also increasing the risk of diseases such as measles, pneumonia, and polio as well as COVID-19, he added. Preparing for nuclear, chemical warfare Dr Ibrahima Socé Fall, WHO Assistant General Secretary for Emergency Response Dr Ibrahima Socé Fall, Assistant General Secretary for Emergency Response, said the WHO was in a bind because it did not know how to get medical supplies from its warehouses to health facilities. “The really high confirmed attacks on health care includes attacks on ambulances. So It is difficult even for very simple movement [such as] making sure that the medical supplies will reach the hospitals where it is needed,” said Socé Fall. Meanwhile, the WHO has been working with the International Atomic Energy Agency (IAEA) and Ukrainian officers to prepare for chemical, biological or nuclear hazards. “There is another obvious layer to this, which is the horrific potential that weapons could be used that are either chemical or nuclear in nature,” said Ryan. “We are part of the UN system for response to such incidents if they occur, and we’re ready to do so. But it’s unconscionable even to think that that would be the case.” COVID resurgence is driven by BA.2 Dr Maria van Kerkhove The more infectious Omicron BA.2 sub-lineage is sweeping the world, accounting for 86% of the sequences available from the last four weeks, said WHO COVID-19 lead Dr Maria van Kerkhove. There have been large COVID-19 outbreaks in Asia and a fresh wave of infections in Europe. “Several countries are now seeing their highest death rates since the beginning of the pandemic,” said Tedros. “This reflects the speed with which Omicron spreads and the heightened risk of deaths for those who are not vaccinated, especially older people. We all want to move on from the pandemic. But no matter how much we wish it away, this pandemic is not over.” However, Ryan said that while transmission has taken off again in many places – especially where rules had been relaxed. But countries with high levels of vaccination, especially amongst vulnerable people, were not seeing high rates of hospitalisation, and deaths. Ethiopia finally allows access to Tigray The Ethiopian government, which has maintained a siege of Tigray for almost 500 days, had finally agreed to allow the WHO to deliver 95 tonnes of medical supplies to the territory, said Tedros. “If we can deliver the supplies safely, they will help people in desperate need. But much more is needed. So far, only 4% of the needs for health supplies have been delivered to Tigray. That is insignificant,” said Tedros. “With dire shortages of fuel and food, people are starving to death. Actually, giving them food is more important than medicine. We continue to call on the Ethiopian and Eritrean governments to end the blockade.” Ryan added that the WHO had experienced “all kinds of bureaucratic restrictions in the past, including cancellations” in getting aid to Tigray. “t is the responsibility of all parties to facilitate the process of giving access, not to take away piecemeal small bits of a blockade and allow some aid to trickle in,” said Ryan. “This is about opening up unfettered access to millions of people who are in desperate need.” He added that the basic principles of humanitarian law were being forgotten in Tigray and Ukraine – which is to ensure access to populations who desperately need aid . Image Credits: People in Need, Sam Mednick/TNH. Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Over a Million People Could Die of Omicron in China 23/03/2022 Maayan Hoffman More than a million people could die of Omicron in China unless it takes action to boost its elderly population with a Western COVID-19 vaccine, according to a new analysis by Airfinity. Potential cumulative deaths in China The analysis shows that, although China vaccinated 80% of its population over the age of 60, Chinese people have low protection because its Sinovac and Sinopharm vaccines – used to inoculate the majority of citizens – have significantly lower efficacy and provide less protection against infection and death. In addition, only 40% of Chinese people have taken a booster shot, the report showed. Airfinity compared China to nearby Hong Kong, which has experienced one of the most devastating waves of infections and deaths caused by COVID-19 which has been attributed to low protection levels due to reliance on less efficacious Chinese vaccines and a lack of community immunity. “The death rate in Hong Kong is the highest in the world and much higher than Western countries have ever experienced, peaking at 37.6 daily deaths per million – more than double the United Kingdom’s peak in January 2021,” according to the report. The case fatality rate (CFR) is 20 times higher than in New Zealand, which also had a “zero COVID” policy and relied heavily on Chinese vaccines. “Should China have similar levels of protection, they too could experience a very high CFR,” writes Airfinity. Case fatality ratio over time for countries However, “most of these deaths can be prevented,” the team advised. “If China faced an Omicron wave with protection levels similar to New Zealand, our analysis shows deaths could be reduced to 45,000. China could bolster protection in its population by administering booster jabs with higher efficacy vaccines.” Airfinity said that there are enough alternative vaccines that could be redistributed immediately to jab 54% of China’s population and save their lives. Image Credits: Flickr, Airfinity. Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Eradicating polio would eradicate so much tragedy 23/03/2022 Matshidiso Moeti In response to the case of wild poliovirus in Malawi, health authorities have launched a Polio vaccination campaign in Malawi 2022 In the outskirts of Malawi’s capital, Lilongwe, just beyond where paved roads transition to dirt, an undiagnosed polio infection paralysed a three-year-old girl. From one day to the next, the child’s life was changed forever. Among Africa’s public health community, we had looked at our successes against wild poliovirus as a cause for optimism. In the 1990s, the disease paralysed more than 75,000 African children every year. But following extensive immunization campaigns, coupled with strong surveillance, the wild poliovirus was officially kicked out of sub-Saharan Africa just under two years ago. We went from 300,000 cases in 1985 to zero in 2020, just as the COVID-19 pandemic struck. In Malawi, there had been no case of wild poliovirus since 1992, and for many, the disease had become a distant memory. Polio is a viral infection that causes nerve damage and, in some cases, paralysis that can lead to permanent disability or even death. It is transmitted mostly through contaminated water or food, and its symptoms – fever, sore throat, headaches, pain in the arms and legs – are so generic that an active infection is often difficult to diagnose until paralysis strikes. While polio remains endemic to Afghanistan and Pakistan, with a few dozen cases identified every year in each country, it has been eradicated just about everywhere else. The Americas were declared polio-free in 1994; China, Australia, and the Western Pacific countries in 2000, Europe in 2002; and Southeast Asia in 2011. The last cases in Africa were in Nigeria, in 2016, in the north of the country where the horrors of armed conflict had upended immunization efforts. But over the past two years, the COVID-19 pandemic has disrupted efforts to combat vaccine-preventable diseases, including polio, in many other places. The four-month suspension of polio vaccination campaigns in more than 30 countries in 2020, coupled with related disruptions to essential immunization services, led to tens of millions of children missing polio vaccines, including the three-year-old girl in Malawi who is now paralysed for life. We know a lot about wild poliovirus now, enough to trace the case in Malawi to a strain of the virus originating in Pakistan. While this new detection does not affect the African region’s wild poliovirus-free certification status, it has set the world back in its efforts to eradicate the disease. And if transmission is not stopped within the next 12 months, the continent’s certification status would likely be revisited. This disease creates far too much devastation, on a personal and health system level, for us to allow that to happen. Health officials are vaccinating Malawian children in their homes to stop polio. Vaccination and surveillance efforts With support from international and local partners, governments in the region aim to vaccinate more than 23 million children in Malawi and its neighbours, Tanzania, Zambia, Mozambique, as well as Zimbabwe. The vaccine needs to be administered in multiple doses, so the logistics of reaching out to both urban and rural locations, with trained staff who carry sufficient numbers of doses, has to be well planned and executed. Luckily, we are benefiting from lessons learned from experiences in Syria and Somalia in recent years, where the polio programme quickly stopped the spread of imported wild poliovirus, despite challenges posed by ongoing conflict and insecurity. We can detect the presence of the virus, along with its genetic origins, through sampling urban sewers—and so we have launched surveillance efforts in Lilongwe and cities in neighbouring countries. We’ve also deployed healthcare workers to go door-to-door in Malawi, identifying families whose children have unexplained paralysis, and securing samples for testing to see if polio was the cause. It was no coincidence that the African Region achieved its wild polio-free status two years ago. This only happened because of the decades of commitment by governments, communities and partners, and we are now leveraging the wealth of experience and expertise we have built in the region to move quickly to bring this outbreak under control. The payoff is immense. Globally, eradication efforts have saved the lives of an estimated 180,000 people and spared an estimated 1.8 million children from disability. The economic benefit for ending polio have been projected at upwards of $50 billion by 2035, with the vast majority of these benefits accruing to low-income countries freed from having to handle such a terrible health threat. Eliminating polio is about more than an economic stimulus, of course. We do it because it is a source of suffering that we can remove from this world because every child paralysed by a polio infection is one child too many. Wild poliovirus cases around the world are at an all-time low, and we have a historic opportunity to stop the transmission of the virus for good. To achieve this, we need governments throughout Africa—especially the southern nations—to join these efforts, step up surveillance, vaccinate their children, and get back on track to wipe this virus off the planet. Dr Matshidiso Moeti is the World Health Organization (WHO) Regional Director for Africa. Image Credits: WHO Africa. UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
UN Appeals for Groundwater Protection as Large Tracts of Africa Battle Drought 23/03/2022 Kerry Cullinan A family feeds their cattle with straw plucked from the roof of their home in Adadle in the Somali region of Ethiopia. As global water experts meet at the World Water Forum in Senegal this week, large swathes of Africa are facing famine as severe droughts prevail in the Horn of Africa and large parts of southern Africa. “Harvests are ruined, livestock is dying and families are bearing the consequences of increasingly frequent climate extremes,” according to Michael Dunford, the UN World Food Programme’s Regional Director for Eastern Africa. The countries most affected are Somalia, Kenya, Djibouti and Ethiopia in the east, and Angola, Madagascar, Mozambique and Namibia in the south. The UN launched its World Water Development Report at the forum to coincide with World Water Day on Wednesday, appealing for better management of groundwater, which is usually stored in aquifers, many of which are vulnerable to climate change and human settlements. Aquifers are under threat in rapidly expanding low-income cities, including Dakar (Senegal) and Lusaka (Zambia), as well as informal communities reliant on on-site sanitation where “the increased frequency of extreme rainfall can amplify leaching of surface and near-surface contaminants”, warns the report. Low-storage, low-recharge aquifer systems in drylands, such as Bulawayo (Zimbabwe) and Ouagadougou(Burkina Faso), are also at risk, in situations where “alternative perennial water sources are limited or do not exist, and recharge is episodic so that even small reductions in recharge can lead to groundwater depletion”, the report warns. Water scarcity affects over 40% of the 🌍 population.And for every 1°C ⬆️ in global temperature, an additional 500 million people will face #waterscarcity.🔗 https://t.co/4WYuzYPgpM #WorldWaterDay💦 @WorldBankWater pic.twitter.com/k4lshprKoA — World Bank India (@WorldBankIndia) March 22, 2022 Lack of research Meanwhile, information about the impact of climate change on Africa is scarce, according to the Intergovernmental Panel on Climate Change latest (sixth) report on Impacts, Adaptation, and Vulnerability. “Many countries lack regularly reporting weather stations, and data access is often limited. From 1990–2019 research on Africa received just 3.8% of climate-related research funding globally: 78% of this funding went to EU and North American institutions and only 14.5% to African institutions,” notes the IPCC report in a special section on Africa. “Increased funding for African partners, and direct control of research design and resources can provide more actionable insights on climate risks and adaptation options in Africa.” To address this, the World Water Council and the Organisation for Economic Co-operation and Development (OECD) launched a new programme this week to produce new data, evidence and policy guidance on water security in Africa. “With 250 million Africans expected to live in water-stressed areas by 2030, and 60% of the population expected to live in cities by 2050, now is the time to get water policies right for sustainable development in Africa,” according to Jose Angel Gurria Trevino, OECD’s Secretary-General. Image Credits: Michael Tewelde / World food Programme. Posts navigation Older postsNewer posts