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. 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. Ukraine’s ‘Model’ TB Programme Destroyed by War, as Global TB Response Faces ‘Disastrous’ Funds Shortfall 22/03/2022 Kerry Cullinan & Elaine Ruth Fletcher Yana Terleeva, head of the Ukranian Ministry of Health’s TB programme Speaking in her car from an undisclosed location somewhere in war-torn Ukraine, Yana Teerleva, head of TB in the country’s Ministry of Health, lamented the destruction that she is witnessing every day in hospitals and clinics – including the shelling of three huge dispensaries where the country had stockpiled sufficient TB medications for the remainder of 2022. This month, Teerleva had been planning to implement an innovative new TB treatment regimen to further step up the national response to its drug resistant TB burden – which TB control officials in Geneva had praised as a model. “Instead we are dealing with the Russian invasion and discussing military hardware”, Teerleva said in a media briefing Tuesday, just ahead of World Tuberculosis Day, 24 March. Global TB experts are bemoaning the destruction of Ukraine’s innovative TB programme, which had made significant progress in addressing the country’s high burden of multi-drug resistant TB (MDR-TB) over the past 15 years. Meanwhile, with global TB funding well below needs, prospects of meeting the UN Sustainable Development Goal target for ending the TB epidemic by 2030 look increasingly dim, Lucica Ditui, executive director of the Geneva-based STOP TB Partnership, told Health Policy Watch in an interview. “This gives us very little chance of meeting the UN 2030 targets,” she said. Model programme now in ashes – literally Almost one-third of Ukraine’s TB cases are drug-resistant, and last year the country diagnosed and treated 24,000 people with TB, including almost 5,000 people with MDR-TB. But the Ukrainian government had been “extremely committed” to addressing TB over the past two to three years, paying for new drugs and diagnostics and building strong relationships with civil society organisations, Ditiu told Health Policy Watch. “The country did a lot to improve their health system. It is devastating to see these bombs destroying everything. These are losses that will take decades to regain.” A doctor shows Oleg Chutvatov, who was receiving TB treatment at the hospital in Kharkiv, an x-ray photo of his lungs in July 2021. The city is now under heavy attack from the Russian invasion. Over the past 15 years, Ukraine had significantly reduced its TB cases from over 127 cases per 100 000 people in 2005 to just 42.2 cases per 100 000 people in 2020. Just before the war, says Ditiui, “The country was paying for their own TB drugs as well as diagnostics – and they had secured enough to treat and diagnose everyone in need in Ukraine. “They were very keen to implement new tools like rapid molecular diagnosis, as well as new drugs. They had cohorts of people enrolled in studies for new TB treatments. Collaboration between public health officials, civil society and communities also was very good.” The gains in TB treatment were part of a broader health sector reform that had been underway, Ditiu added, saying: “What I am really upset about is that the country did a lot to improve their health system, their hospitals, to do health sector reform. To see these bombs destroying everything. These are losses that will take decades to regain.” “Ukraine was always at the forefront of the fight against tuberculosis,” Teleeva told the Stop TB briefing Tuesday. “We wanted Ukraine and the entire world to be free from the TB and for that, we have done everything possible.” However, she said that according to health ministry information, “more than 135 hospitals in Ukraine have been shelled by the Russian aggressors”, including “three huge regional anti-tuberculosis dispensaries” and the country’s health infrastructure “is not working”. WHO has confirmed some 60 attacks on hospitals and other health facilities. Appeal to combat stigma – among the war’s knock-on effects Both Ditiu and Teeleva stressed the need to focus now on countering the knock-on effects of the war – including how to treat internally displaced people, how to ensure people fleeing can continue their medications, and how to combat stigma that refugees elsewhere may encounter. “We worked to overcome the stigma discrimination of these people living with TB”, Teleeva said, of the pre-war period. She appealed to neighbouring countries that have a much lower burden of TB disease not to stigmatise Ukrainian refugees. “TB is very sensitive, and if we broadcast information about its uncontrolled spread, we will stigmatize people who are already stigmatized, for people who are already in a very difficult situation,” said Terleeva. Ditiu acknowledged that it’s very likely the war will lead to a higher level of TB cases -particularly inside Ukraine itself. “We’ll see an increase in TB, in drug-resistant TB and in mortality,” she predicted, “because people will be staying close together in shelters, in crowded places, with bad food and stress.” However, she said good tracking and surveillance by countries that receive refugees can help counter any spillover effect, beyond the borders. ‘Stupid war’ Romania’s Health Minister, Prof Alexandru Rafila Decrying the “stupid war”, Romania’s Health Minister, Professor Alexandru Rafila, told the briefing that his country was doing everything it could to assist the refugees that had fled across the 600km border with his country, including identifying and ensuring treatment for TB patients. As a country with a relatively high burden of TB itself, Romania has “a network of TB hospitals and TB ambulatory care centres where we can perform rapid diagnosis and treat Ukrainian patients if they are resistant or need to initiate treatment”, added Rafila. The Global Fund has also provided Romania with additional Gene Xpert rapid testing machines and TB medication to assist Ukranian patients, the health minister added. However, while Romania and Moldova had “some capacity” to deal with TB, Ditiu warned that Poland is in a different category – precisely because its own burden is quite low. “Poland is not a country with a lot of TB – so I’m not sure how well the network will be able to deal with it – even though the doctors certainly have a lot of knowledge”. In addition, prices of TB medication in both Romania and Poland are up to ten times higher than in Ukraine, as both countries are part of the European Union and pay EU prices for drugs that Ukraine was able to procure through the Global Fund, Ditiu added. “We are having a conversation with the Global Fund to see how we can lower the cost,” she added. TB civil society trying to locate patients Olya Klymenk, head of TB People Ukraine, a network of over 70 organisations, said that her organisation was doing its best to locate displaced patients who have fled their homes or their communities, and offer them humanitarian aid, including food. “We are trying to take care of the patients who are out of the hospital right now because we understand that, without social support, they will not have a good life,” said Klymenk. Teleeva stressed that in the emergency the primary need is to, “focus on ensuring patients know where to go and have a desire to continue treatment. “They have to be assured there is a reason to live, that they will go back to Ukraine, and they have to be healthy to help us rebuild. They need this optimism, to have this desire to live and continue living.” ‘Pathetic’ investment in TB Dr Lucica Ditiu, Executive Director of the Stop TB Partnership Meanwhile, Ditiu lamented that “investments in TB are pathetically low” – perhaps because 90% of the disease burden is in lower-income countries. “In 2020, we had $1.9 billion [in] domestic investments, which is very very, very little,” she said, referring to national governments’ own contributions to beating TB. In addition, “The Global Fund, which is a big donor for TB, gave around $800 million, which is completely insufficient.” Stop TB estimates that $19.6 billion per year will be needed over the next eight years for TB prevention and care, and $4 billion per year will be required for research and development (R&D) of the new diagnostics, medicines and vaccines needed to end TB. This represents about four times what is currently available for the TB response (in 2020, $5.3 billion was available for care and prevention and $0.9 billion for R&D). The year 2022 is critical for the global fight to end TB as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022. “We simply cannot continue to stand on the sidelines and watch while people around the world fall ill and die from a preventable and treatable disease,” said Ditiu. “We also cannot continue to accept what we accepted for years—every year having less than 40% of the funding need for the TB response. Now we are facing a disastrous funding shortfall, bigger than what we had expected. We not only need to step up efforts to meet targets set at the 2018 United Nations High Level Meeting on TB,” she said, referring to the UN pledge to accelerate progress toward the 2030 targets, “but the TB response must also recover from the devastating impacts of the COVID-19 pandemic.” Image Credits: The Global Fund / Evgeny Maloletka. ‘There is No Safe Place in Ukraine’ 21/03/2022 Kerry Cullinan Ukrainian child with his dog -displaced by war, in a refugee camp on the Moldova-Ukranian border There have been 52 attacks on Ukrainian health facilities in the past 25 days, more than two every day, according to the World Health Organization (WHO). Meanwhile, the health of fleeing refugees, their impact on the health services of neighbouring countries, and the fate of Ukraine’s tuberculosis patients are foremost on healthcare providers’ minds. “In less than a month, over three million people have left the country and nearly two million have been internally displaced,” said Jarno Habicht, WHO’s Representative in Ukraine. “This has happened faster than in any previous European crisis. There is no safe place in Ukraine right now, yet we need to ensure that health services are available.” “The military offensive continues, with a number of cities being entirely isolated – people are running out of food and water, and hospitals might not have electricity,” added Habicht, who has been head of the Ukraine office since 2018. “Worse still, we have seen many attacks on health workers and health facilities as well as patients. This is happening daily and is unacceptable. So, if you ask me how to describe it, every day things are getting worse, which means every day the health response is becoming more difficult.” Jarno Habicht, WHO’s Representative in Ukraine (centre) Banned cluster munitions According to Bonnie Docherty, a senior advisor for Human Rights Watch, Russian forces have “relied heavily” on cluster munitions, which are banned in most countries in the world, and explosive weapons with wide-area effects. Cluster munitions, large bombs that contain dozens or hundreds of smaller sub-munitions, were used to attack a hospital in Vuhledar on 24 February in which four civilians were killed, and 10 people including six healthcare workers were injured, wrote Docherty in the online security news outlet, Just Security, on Monday. Unexploded, the submunitions can lie dormant like landmines, exploding months and years later when picked up by children or farmers, she explains. However, artillery shells, mortars, rockets, missiles, and enhanced blast (thermobaric) weapons, and aerial bombs, have caused the bulk of the damage in Ukraine, adds Docherty. Concern for drug-resistant TB patients On the eve of World Tuberculosis Day on Thursday, WHO TB experts also expressed concern for Ukrainian TB patients, particularly those with drug-resistant TB. “Ukraine is one of the 18 high-priority countries in the WHO European region for TB and is on the global list for having a high burden of multidrug-resistant tuberculosis,” Dr Askar Yedilbayev, WHO Europe’s Regional TB advisor, told a media briefing on Monday. Dr Askar Yedilbayev “Before the war, Ukraine was one of the pioneering countries in response to TB and drug-resistant TB in the WHO European region,” he added. “However, destroyed health infrastructure, including limited access to TB treatment and public health services, is affecting the provision of essential tuberculosis services, causing significant delays in diagnosis of TB, affecting initiation of TB preventive treatment, and treatment of active TB and MDR TB,” he added. Shortly before the war, all TB medication had been distributed to regional warehouses and patients had been given one or two months’ supply of medicine, he added. But some of these warehouses had been damaged or were under threat of damage, and there was a need for the “emergency redistribution of procurement of medicines to ensure continuity of treatment”. In addition, as Ukraine’s neighbours did not have the same burden of TB disease, they were unlikely to have the medicine to treat large numbers of people with TB. Yedilbayev appealed for donations to the Global Fund and WHO Foundation to enable the delivery of health services to Ukrainians. Every second, a Ukrainian child becomes a refugee Every second, a Ukrainian child becomes a refugee, according to UNICEF and half of the over 3.5 million refugees estimated to have fled to neighbouring countries since 24 February are children under the age of 15. Almost two million refugees have fled to Poland, according to the WHO. “Refugees can be vulnerable to infectious diseases because of lack of health care, interrupted care in the country of origin, because of exposure to infectious infections and lack of care in transit, and if living conditions are poor in the destination country,” said Yedilbayev. Image Credits: UNICEF/UN0599222/Moldovan. As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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. 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. Ukraine’s ‘Model’ TB Programme Destroyed by War, as Global TB Response Faces ‘Disastrous’ Funds Shortfall 22/03/2022 Kerry Cullinan & Elaine Ruth Fletcher Yana Terleeva, head of the Ukranian Ministry of Health’s TB programme Speaking in her car from an undisclosed location somewhere in war-torn Ukraine, Yana Teerleva, head of TB in the country’s Ministry of Health, lamented the destruction that she is witnessing every day in hospitals and clinics – including the shelling of three huge dispensaries where the country had stockpiled sufficient TB medications for the remainder of 2022. This month, Teerleva had been planning to implement an innovative new TB treatment regimen to further step up the national response to its drug resistant TB burden – which TB control officials in Geneva had praised as a model. “Instead we are dealing with the Russian invasion and discussing military hardware”, Teerleva said in a media briefing Tuesday, just ahead of World Tuberculosis Day, 24 March. Global TB experts are bemoaning the destruction of Ukraine’s innovative TB programme, which had made significant progress in addressing the country’s high burden of multi-drug resistant TB (MDR-TB) over the past 15 years. Meanwhile, with global TB funding well below needs, prospects of meeting the UN Sustainable Development Goal target for ending the TB epidemic by 2030 look increasingly dim, Lucica Ditui, executive director of the Geneva-based STOP TB Partnership, told Health Policy Watch in an interview. “This gives us very little chance of meeting the UN 2030 targets,” she said. Model programme now in ashes – literally Almost one-third of Ukraine’s TB cases are drug-resistant, and last year the country diagnosed and treated 24,000 people with TB, including almost 5,000 people with MDR-TB. But the Ukrainian government had been “extremely committed” to addressing TB over the past two to three years, paying for new drugs and diagnostics and building strong relationships with civil society organisations, Ditiu told Health Policy Watch. “The country did a lot to improve their health system. It is devastating to see these bombs destroying everything. These are losses that will take decades to regain.” A doctor shows Oleg Chutvatov, who was receiving TB treatment at the hospital in Kharkiv, an x-ray photo of his lungs in July 2021. The city is now under heavy attack from the Russian invasion. Over the past 15 years, Ukraine had significantly reduced its TB cases from over 127 cases per 100 000 people in 2005 to just 42.2 cases per 100 000 people in 2020. Just before the war, says Ditiui, “The country was paying for their own TB drugs as well as diagnostics – and they had secured enough to treat and diagnose everyone in need in Ukraine. “They were very keen to implement new tools like rapid molecular diagnosis, as well as new drugs. They had cohorts of people enrolled in studies for new TB treatments. Collaboration between public health officials, civil society and communities also was very good.” The gains in TB treatment were part of a broader health sector reform that had been underway, Ditiu added, saying: “What I am really upset about is that the country did a lot to improve their health system, their hospitals, to do health sector reform. To see these bombs destroying everything. These are losses that will take decades to regain.” “Ukraine was always at the forefront of the fight against tuberculosis,” Teleeva told the Stop TB briefing Tuesday. “We wanted Ukraine and the entire world to be free from the TB and for that, we have done everything possible.” However, she said that according to health ministry information, “more than 135 hospitals in Ukraine have been shelled by the Russian aggressors”, including “three huge regional anti-tuberculosis dispensaries” and the country’s health infrastructure “is not working”. WHO has confirmed some 60 attacks on hospitals and other health facilities. Appeal to combat stigma – among the war’s knock-on effects Both Ditiu and Teeleva stressed the need to focus now on countering the knock-on effects of the war – including how to treat internally displaced people, how to ensure people fleeing can continue their medications, and how to combat stigma that refugees elsewhere may encounter. “We worked to overcome the stigma discrimination of these people living with TB”, Teleeva said, of the pre-war period. She appealed to neighbouring countries that have a much lower burden of TB disease not to stigmatise Ukrainian refugees. “TB is very sensitive, and if we broadcast information about its uncontrolled spread, we will stigmatize people who are already stigmatized, for people who are already in a very difficult situation,” said Terleeva. Ditiu acknowledged that it’s very likely the war will lead to a higher level of TB cases -particularly inside Ukraine itself. “We’ll see an increase in TB, in drug-resistant TB and in mortality,” she predicted, “because people will be staying close together in shelters, in crowded places, with bad food and stress.” However, she said good tracking and surveillance by countries that receive refugees can help counter any spillover effect, beyond the borders. ‘Stupid war’ Romania’s Health Minister, Prof Alexandru Rafila Decrying the “stupid war”, Romania’s Health Minister, Professor Alexandru Rafila, told the briefing that his country was doing everything it could to assist the refugees that had fled across the 600km border with his country, including identifying and ensuring treatment for TB patients. As a country with a relatively high burden of TB itself, Romania has “a network of TB hospitals and TB ambulatory care centres where we can perform rapid diagnosis and treat Ukrainian patients if they are resistant or need to initiate treatment”, added Rafila. The Global Fund has also provided Romania with additional Gene Xpert rapid testing machines and TB medication to assist Ukranian patients, the health minister added. However, while Romania and Moldova had “some capacity” to deal with TB, Ditiu warned that Poland is in a different category – precisely because its own burden is quite low. “Poland is not a country with a lot of TB – so I’m not sure how well the network will be able to deal with it – even though the doctors certainly have a lot of knowledge”. In addition, prices of TB medication in both Romania and Poland are up to ten times higher than in Ukraine, as both countries are part of the European Union and pay EU prices for drugs that Ukraine was able to procure through the Global Fund, Ditiu added. “We are having a conversation with the Global Fund to see how we can lower the cost,” she added. TB civil society trying to locate patients Olya Klymenk, head of TB People Ukraine, a network of over 70 organisations, said that her organisation was doing its best to locate displaced patients who have fled their homes or their communities, and offer them humanitarian aid, including food. “We are trying to take care of the patients who are out of the hospital right now because we understand that, without social support, they will not have a good life,” said Klymenk. Teleeva stressed that in the emergency the primary need is to, “focus on ensuring patients know where to go and have a desire to continue treatment. “They have to be assured there is a reason to live, that they will go back to Ukraine, and they have to be healthy to help us rebuild. They need this optimism, to have this desire to live and continue living.” ‘Pathetic’ investment in TB Dr Lucica Ditiu, Executive Director of the Stop TB Partnership Meanwhile, Ditiu lamented that “investments in TB are pathetically low” – perhaps because 90% of the disease burden is in lower-income countries. “In 2020, we had $1.9 billion [in] domestic investments, which is very very, very little,” she said, referring to national governments’ own contributions to beating TB. In addition, “The Global Fund, which is a big donor for TB, gave around $800 million, which is completely insufficient.” Stop TB estimates that $19.6 billion per year will be needed over the next eight years for TB prevention and care, and $4 billion per year will be required for research and development (R&D) of the new diagnostics, medicines and vaccines needed to end TB. This represents about four times what is currently available for the TB response (in 2020, $5.3 billion was available for care and prevention and $0.9 billion for R&D). The year 2022 is critical for the global fight to end TB as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022. “We simply cannot continue to stand on the sidelines and watch while people around the world fall ill and die from a preventable and treatable disease,” said Ditiu. “We also cannot continue to accept what we accepted for years—every year having less than 40% of the funding need for the TB response. Now we are facing a disastrous funding shortfall, bigger than what we had expected. We not only need to step up efforts to meet targets set at the 2018 United Nations High Level Meeting on TB,” she said, referring to the UN pledge to accelerate progress toward the 2030 targets, “but the TB response must also recover from the devastating impacts of the COVID-19 pandemic.” Image Credits: The Global Fund / Evgeny Maloletka. ‘There is No Safe Place in Ukraine’ 21/03/2022 Kerry Cullinan Ukrainian child with his dog -displaced by war, in a refugee camp on the Moldova-Ukranian border There have been 52 attacks on Ukrainian health facilities in the past 25 days, more than two every day, according to the World Health Organization (WHO). Meanwhile, the health of fleeing refugees, their impact on the health services of neighbouring countries, and the fate of Ukraine’s tuberculosis patients are foremost on healthcare providers’ minds. “In less than a month, over three million people have left the country and nearly two million have been internally displaced,” said Jarno Habicht, WHO’s Representative in Ukraine. “This has happened faster than in any previous European crisis. There is no safe place in Ukraine right now, yet we need to ensure that health services are available.” “The military offensive continues, with a number of cities being entirely isolated – people are running out of food and water, and hospitals might not have electricity,” added Habicht, who has been head of the Ukraine office since 2018. “Worse still, we have seen many attacks on health workers and health facilities as well as patients. This is happening daily and is unacceptable. So, if you ask me how to describe it, every day things are getting worse, which means every day the health response is becoming more difficult.” Jarno Habicht, WHO’s Representative in Ukraine (centre) Banned cluster munitions According to Bonnie Docherty, a senior advisor for Human Rights Watch, Russian forces have “relied heavily” on cluster munitions, which are banned in most countries in the world, and explosive weapons with wide-area effects. Cluster munitions, large bombs that contain dozens or hundreds of smaller sub-munitions, were used to attack a hospital in Vuhledar on 24 February in which four civilians were killed, and 10 people including six healthcare workers were injured, wrote Docherty in the online security news outlet, Just Security, on Monday. Unexploded, the submunitions can lie dormant like landmines, exploding months and years later when picked up by children or farmers, she explains. However, artillery shells, mortars, rockets, missiles, and enhanced blast (thermobaric) weapons, and aerial bombs, have caused the bulk of the damage in Ukraine, adds Docherty. Concern for drug-resistant TB patients On the eve of World Tuberculosis Day on Thursday, WHO TB experts also expressed concern for Ukrainian TB patients, particularly those with drug-resistant TB. “Ukraine is one of the 18 high-priority countries in the WHO European region for TB and is on the global list for having a high burden of multidrug-resistant tuberculosis,” Dr Askar Yedilbayev, WHO Europe’s Regional TB advisor, told a media briefing on Monday. Dr Askar Yedilbayev “Before the war, Ukraine was one of the pioneering countries in response to TB and drug-resistant TB in the WHO European region,” he added. “However, destroyed health infrastructure, including limited access to TB treatment and public health services, is affecting the provision of essential tuberculosis services, causing significant delays in diagnosis of TB, affecting initiation of TB preventive treatment, and treatment of active TB and MDR TB,” he added. Shortly before the war, all TB medication had been distributed to regional warehouses and patients had been given one or two months’ supply of medicine, he added. But some of these warehouses had been damaged or were under threat of damage, and there was a need for the “emergency redistribution of procurement of medicines to ensure continuity of treatment”. In addition, as Ukraine’s neighbours did not have the same burden of TB disease, they were unlikely to have the medicine to treat large numbers of people with TB. Yedilbayev appealed for donations to the Global Fund and WHO Foundation to enable the delivery of health services to Ukrainians. Every second, a Ukrainian child becomes a refugee Every second, a Ukrainian child becomes a refugee, according to UNICEF and half of the over 3.5 million refugees estimated to have fled to neighbouring countries since 24 February are children under the age of 15. Almost two million refugees have fled to Poland, according to the WHO. “Refugees can be vulnerable to infectious diseases because of lack of health care, interrupted care in the country of origin, because of exposure to infectious infections and lack of care in transit, and if living conditions are poor in the destination country,” said Yedilbayev. Image Credits: UNICEF/UN0599222/Moldovan. As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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. 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. Ukraine’s ‘Model’ TB Programme Destroyed by War, as Global TB Response Faces ‘Disastrous’ Funds Shortfall 22/03/2022 Kerry Cullinan & Elaine Ruth Fletcher Yana Terleeva, head of the Ukranian Ministry of Health’s TB programme Speaking in her car from an undisclosed location somewhere in war-torn Ukraine, Yana Teerleva, head of TB in the country’s Ministry of Health, lamented the destruction that she is witnessing every day in hospitals and clinics – including the shelling of three huge dispensaries where the country had stockpiled sufficient TB medications for the remainder of 2022. This month, Teerleva had been planning to implement an innovative new TB treatment regimen to further step up the national response to its drug resistant TB burden – which TB control officials in Geneva had praised as a model. “Instead we are dealing with the Russian invasion and discussing military hardware”, Teerleva said in a media briefing Tuesday, just ahead of World Tuberculosis Day, 24 March. Global TB experts are bemoaning the destruction of Ukraine’s innovative TB programme, which had made significant progress in addressing the country’s high burden of multi-drug resistant TB (MDR-TB) over the past 15 years. Meanwhile, with global TB funding well below needs, prospects of meeting the UN Sustainable Development Goal target for ending the TB epidemic by 2030 look increasingly dim, Lucica Ditui, executive director of the Geneva-based STOP TB Partnership, told Health Policy Watch in an interview. “This gives us very little chance of meeting the UN 2030 targets,” she said. Model programme now in ashes – literally Almost one-third of Ukraine’s TB cases are drug-resistant, and last year the country diagnosed and treated 24,000 people with TB, including almost 5,000 people with MDR-TB. But the Ukrainian government had been “extremely committed” to addressing TB over the past two to three years, paying for new drugs and diagnostics and building strong relationships with civil society organisations, Ditiu told Health Policy Watch. “The country did a lot to improve their health system. It is devastating to see these bombs destroying everything. These are losses that will take decades to regain.” A doctor shows Oleg Chutvatov, who was receiving TB treatment at the hospital in Kharkiv, an x-ray photo of his lungs in July 2021. The city is now under heavy attack from the Russian invasion. Over the past 15 years, Ukraine had significantly reduced its TB cases from over 127 cases per 100 000 people in 2005 to just 42.2 cases per 100 000 people in 2020. Just before the war, says Ditiui, “The country was paying for their own TB drugs as well as diagnostics – and they had secured enough to treat and diagnose everyone in need in Ukraine. “They were very keen to implement new tools like rapid molecular diagnosis, as well as new drugs. They had cohorts of people enrolled in studies for new TB treatments. Collaboration between public health officials, civil society and communities also was very good.” The gains in TB treatment were part of a broader health sector reform that had been underway, Ditiu added, saying: “What I am really upset about is that the country did a lot to improve their health system, their hospitals, to do health sector reform. To see these bombs destroying everything. These are losses that will take decades to regain.” “Ukraine was always at the forefront of the fight against tuberculosis,” Teleeva told the Stop TB briefing Tuesday. “We wanted Ukraine and the entire world to be free from the TB and for that, we have done everything possible.” However, she said that according to health ministry information, “more than 135 hospitals in Ukraine have been shelled by the Russian aggressors”, including “three huge regional anti-tuberculosis dispensaries” and the country’s health infrastructure “is not working”. WHO has confirmed some 60 attacks on hospitals and other health facilities. Appeal to combat stigma – among the war’s knock-on effects Both Ditiu and Teeleva stressed the need to focus now on countering the knock-on effects of the war – including how to treat internally displaced people, how to ensure people fleeing can continue their medications, and how to combat stigma that refugees elsewhere may encounter. “We worked to overcome the stigma discrimination of these people living with TB”, Teleeva said, of the pre-war period. She appealed to neighbouring countries that have a much lower burden of TB disease not to stigmatise Ukrainian refugees. “TB is very sensitive, and if we broadcast information about its uncontrolled spread, we will stigmatize people who are already stigmatized, for people who are already in a very difficult situation,” said Terleeva. Ditiu acknowledged that it’s very likely the war will lead to a higher level of TB cases -particularly inside Ukraine itself. “We’ll see an increase in TB, in drug-resistant TB and in mortality,” she predicted, “because people will be staying close together in shelters, in crowded places, with bad food and stress.” However, she said good tracking and surveillance by countries that receive refugees can help counter any spillover effect, beyond the borders. ‘Stupid war’ Romania’s Health Minister, Prof Alexandru Rafila Decrying the “stupid war”, Romania’s Health Minister, Professor Alexandru Rafila, told the briefing that his country was doing everything it could to assist the refugees that had fled across the 600km border with his country, including identifying and ensuring treatment for TB patients. As a country with a relatively high burden of TB itself, Romania has “a network of TB hospitals and TB ambulatory care centres where we can perform rapid diagnosis and treat Ukrainian patients if they are resistant or need to initiate treatment”, added Rafila. The Global Fund has also provided Romania with additional Gene Xpert rapid testing machines and TB medication to assist Ukranian patients, the health minister added. However, while Romania and Moldova had “some capacity” to deal with TB, Ditiu warned that Poland is in a different category – precisely because its own burden is quite low. “Poland is not a country with a lot of TB – so I’m not sure how well the network will be able to deal with it – even though the doctors certainly have a lot of knowledge”. In addition, prices of TB medication in both Romania and Poland are up to ten times higher than in Ukraine, as both countries are part of the European Union and pay EU prices for drugs that Ukraine was able to procure through the Global Fund, Ditiu added. “We are having a conversation with the Global Fund to see how we can lower the cost,” she added. TB civil society trying to locate patients Olya Klymenk, head of TB People Ukraine, a network of over 70 organisations, said that her organisation was doing its best to locate displaced patients who have fled their homes or their communities, and offer them humanitarian aid, including food. “We are trying to take care of the patients who are out of the hospital right now because we understand that, without social support, they will not have a good life,” said Klymenk. Teleeva stressed that in the emergency the primary need is to, “focus on ensuring patients know where to go and have a desire to continue treatment. “They have to be assured there is a reason to live, that they will go back to Ukraine, and they have to be healthy to help us rebuild. They need this optimism, to have this desire to live and continue living.” ‘Pathetic’ investment in TB Dr Lucica Ditiu, Executive Director of the Stop TB Partnership Meanwhile, Ditiu lamented that “investments in TB are pathetically low” – perhaps because 90% of the disease burden is in lower-income countries. “In 2020, we had $1.9 billion [in] domestic investments, which is very very, very little,” she said, referring to national governments’ own contributions to beating TB. In addition, “The Global Fund, which is a big donor for TB, gave around $800 million, which is completely insufficient.” Stop TB estimates that $19.6 billion per year will be needed over the next eight years for TB prevention and care, and $4 billion per year will be required for research and development (R&D) of the new diagnostics, medicines and vaccines needed to end TB. This represents about four times what is currently available for the TB response (in 2020, $5.3 billion was available for care and prevention and $0.9 billion for R&D). The year 2022 is critical for the global fight to end TB as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022. “We simply cannot continue to stand on the sidelines and watch while people around the world fall ill and die from a preventable and treatable disease,” said Ditiu. “We also cannot continue to accept what we accepted for years—every year having less than 40% of the funding need for the TB response. Now we are facing a disastrous funding shortfall, bigger than what we had expected. We not only need to step up efforts to meet targets set at the 2018 United Nations High Level Meeting on TB,” she said, referring to the UN pledge to accelerate progress toward the 2030 targets, “but the TB response must also recover from the devastating impacts of the COVID-19 pandemic.” Image Credits: The Global Fund / Evgeny Maloletka. ‘There is No Safe Place in Ukraine’ 21/03/2022 Kerry Cullinan Ukrainian child with his dog -displaced by war, in a refugee camp on the Moldova-Ukranian border There have been 52 attacks on Ukrainian health facilities in the past 25 days, more than two every day, according to the World Health Organization (WHO). Meanwhile, the health of fleeing refugees, their impact on the health services of neighbouring countries, and the fate of Ukraine’s tuberculosis patients are foremost on healthcare providers’ minds. “In less than a month, over three million people have left the country and nearly two million have been internally displaced,” said Jarno Habicht, WHO’s Representative in Ukraine. “This has happened faster than in any previous European crisis. There is no safe place in Ukraine right now, yet we need to ensure that health services are available.” “The military offensive continues, with a number of cities being entirely isolated – people are running out of food and water, and hospitals might not have electricity,” added Habicht, who has been head of the Ukraine office since 2018. “Worse still, we have seen many attacks on health workers and health facilities as well as patients. This is happening daily and is unacceptable. So, if you ask me how to describe it, every day things are getting worse, which means every day the health response is becoming more difficult.” Jarno Habicht, WHO’s Representative in Ukraine (centre) Banned cluster munitions According to Bonnie Docherty, a senior advisor for Human Rights Watch, Russian forces have “relied heavily” on cluster munitions, which are banned in most countries in the world, and explosive weapons with wide-area effects. Cluster munitions, large bombs that contain dozens or hundreds of smaller sub-munitions, were used to attack a hospital in Vuhledar on 24 February in which four civilians were killed, and 10 people including six healthcare workers were injured, wrote Docherty in the online security news outlet, Just Security, on Monday. Unexploded, the submunitions can lie dormant like landmines, exploding months and years later when picked up by children or farmers, she explains. However, artillery shells, mortars, rockets, missiles, and enhanced blast (thermobaric) weapons, and aerial bombs, have caused the bulk of the damage in Ukraine, adds Docherty. Concern for drug-resistant TB patients On the eve of World Tuberculosis Day on Thursday, WHO TB experts also expressed concern for Ukrainian TB patients, particularly those with drug-resistant TB. “Ukraine is one of the 18 high-priority countries in the WHO European region for TB and is on the global list for having a high burden of multidrug-resistant tuberculosis,” Dr Askar Yedilbayev, WHO Europe’s Regional TB advisor, told a media briefing on Monday. Dr Askar Yedilbayev “Before the war, Ukraine was one of the pioneering countries in response to TB and drug-resistant TB in the WHO European region,” he added. “However, destroyed health infrastructure, including limited access to TB treatment and public health services, is affecting the provision of essential tuberculosis services, causing significant delays in diagnosis of TB, affecting initiation of TB preventive treatment, and treatment of active TB and MDR TB,” he added. Shortly before the war, all TB medication had been distributed to regional warehouses and patients had been given one or two months’ supply of medicine, he added. But some of these warehouses had been damaged or were under threat of damage, and there was a need for the “emergency redistribution of procurement of medicines to ensure continuity of treatment”. In addition, as Ukraine’s neighbours did not have the same burden of TB disease, they were unlikely to have the medicine to treat large numbers of people with TB. Yedilbayev appealed for donations to the Global Fund and WHO Foundation to enable the delivery of health services to Ukrainians. Every second, a Ukrainian child becomes a refugee Every second, a Ukrainian child becomes a refugee, according to UNICEF and half of the over 3.5 million refugees estimated to have fled to neighbouring countries since 24 February are children under the age of 15. Almost two million refugees have fled to Poland, according to the WHO. “Refugees can be vulnerable to infectious diseases because of lack of health care, interrupted care in the country of origin, because of exposure to infectious infections and lack of care in transit, and if living conditions are poor in the destination country,” said Yedilbayev. Image Credits: UNICEF/UN0599222/Moldovan. As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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. 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. Ukraine’s ‘Model’ TB Programme Destroyed by War, as Global TB Response Faces ‘Disastrous’ Funds Shortfall 22/03/2022 Kerry Cullinan & Elaine Ruth Fletcher Yana Terleeva, head of the Ukranian Ministry of Health’s TB programme Speaking in her car from an undisclosed location somewhere in war-torn Ukraine, Yana Teerleva, head of TB in the country’s Ministry of Health, lamented the destruction that she is witnessing every day in hospitals and clinics – including the shelling of three huge dispensaries where the country had stockpiled sufficient TB medications for the remainder of 2022. This month, Teerleva had been planning to implement an innovative new TB treatment regimen to further step up the national response to its drug resistant TB burden – which TB control officials in Geneva had praised as a model. “Instead we are dealing with the Russian invasion and discussing military hardware”, Teerleva said in a media briefing Tuesday, just ahead of World Tuberculosis Day, 24 March. Global TB experts are bemoaning the destruction of Ukraine’s innovative TB programme, which had made significant progress in addressing the country’s high burden of multi-drug resistant TB (MDR-TB) over the past 15 years. Meanwhile, with global TB funding well below needs, prospects of meeting the UN Sustainable Development Goal target for ending the TB epidemic by 2030 look increasingly dim, Lucica Ditui, executive director of the Geneva-based STOP TB Partnership, told Health Policy Watch in an interview. “This gives us very little chance of meeting the UN 2030 targets,” she said. Model programme now in ashes – literally Almost one-third of Ukraine’s TB cases are drug-resistant, and last year the country diagnosed and treated 24,000 people with TB, including almost 5,000 people with MDR-TB. But the Ukrainian government had been “extremely committed” to addressing TB over the past two to three years, paying for new drugs and diagnostics and building strong relationships with civil society organisations, Ditiu told Health Policy Watch. “The country did a lot to improve their health system. It is devastating to see these bombs destroying everything. These are losses that will take decades to regain.” A doctor shows Oleg Chutvatov, who was receiving TB treatment at the hospital in Kharkiv, an x-ray photo of his lungs in July 2021. The city is now under heavy attack from the Russian invasion. Over the past 15 years, Ukraine had significantly reduced its TB cases from over 127 cases per 100 000 people in 2005 to just 42.2 cases per 100 000 people in 2020. Just before the war, says Ditiui, “The country was paying for their own TB drugs as well as diagnostics – and they had secured enough to treat and diagnose everyone in need in Ukraine. “They were very keen to implement new tools like rapid molecular diagnosis, as well as new drugs. They had cohorts of people enrolled in studies for new TB treatments. Collaboration between public health officials, civil society and communities also was very good.” The gains in TB treatment were part of a broader health sector reform that had been underway, Ditiu added, saying: “What I am really upset about is that the country did a lot to improve their health system, their hospitals, to do health sector reform. To see these bombs destroying everything. These are losses that will take decades to regain.” “Ukraine was always at the forefront of the fight against tuberculosis,” Teleeva told the Stop TB briefing Tuesday. “We wanted Ukraine and the entire world to be free from the TB and for that, we have done everything possible.” However, she said that according to health ministry information, “more than 135 hospitals in Ukraine have been shelled by the Russian aggressors”, including “three huge regional anti-tuberculosis dispensaries” and the country’s health infrastructure “is not working”. WHO has confirmed some 60 attacks on hospitals and other health facilities. Appeal to combat stigma – among the war’s knock-on effects Both Ditiu and Teeleva stressed the need to focus now on countering the knock-on effects of the war – including how to treat internally displaced people, how to ensure people fleeing can continue their medications, and how to combat stigma that refugees elsewhere may encounter. “We worked to overcome the stigma discrimination of these people living with TB”, Teleeva said, of the pre-war period. She appealed to neighbouring countries that have a much lower burden of TB disease not to stigmatise Ukrainian refugees. “TB is very sensitive, and if we broadcast information about its uncontrolled spread, we will stigmatize people who are already stigmatized, for people who are already in a very difficult situation,” said Terleeva. Ditiu acknowledged that it’s very likely the war will lead to a higher level of TB cases -particularly inside Ukraine itself. “We’ll see an increase in TB, in drug-resistant TB and in mortality,” she predicted, “because people will be staying close together in shelters, in crowded places, with bad food and stress.” However, she said good tracking and surveillance by countries that receive refugees can help counter any spillover effect, beyond the borders. ‘Stupid war’ Romania’s Health Minister, Prof Alexandru Rafila Decrying the “stupid war”, Romania’s Health Minister, Professor Alexandru Rafila, told the briefing that his country was doing everything it could to assist the refugees that had fled across the 600km border with his country, including identifying and ensuring treatment for TB patients. As a country with a relatively high burden of TB itself, Romania has “a network of TB hospitals and TB ambulatory care centres where we can perform rapid diagnosis and treat Ukrainian patients if they are resistant or need to initiate treatment”, added Rafila. The Global Fund has also provided Romania with additional Gene Xpert rapid testing machines and TB medication to assist Ukranian patients, the health minister added. However, while Romania and Moldova had “some capacity” to deal with TB, Ditiu warned that Poland is in a different category – precisely because its own burden is quite low. “Poland is not a country with a lot of TB – so I’m not sure how well the network will be able to deal with it – even though the doctors certainly have a lot of knowledge”. In addition, prices of TB medication in both Romania and Poland are up to ten times higher than in Ukraine, as both countries are part of the European Union and pay EU prices for drugs that Ukraine was able to procure through the Global Fund, Ditiu added. “We are having a conversation with the Global Fund to see how we can lower the cost,” she added. TB civil society trying to locate patients Olya Klymenk, head of TB People Ukraine, a network of over 70 organisations, said that her organisation was doing its best to locate displaced patients who have fled their homes or their communities, and offer them humanitarian aid, including food. “We are trying to take care of the patients who are out of the hospital right now because we understand that, without social support, they will not have a good life,” said Klymenk. Teleeva stressed that in the emergency the primary need is to, “focus on ensuring patients know where to go and have a desire to continue treatment. “They have to be assured there is a reason to live, that they will go back to Ukraine, and they have to be healthy to help us rebuild. They need this optimism, to have this desire to live and continue living.” ‘Pathetic’ investment in TB Dr Lucica Ditiu, Executive Director of the Stop TB Partnership Meanwhile, Ditiu lamented that “investments in TB are pathetically low” – perhaps because 90% of the disease burden is in lower-income countries. “In 2020, we had $1.9 billion [in] domestic investments, which is very very, very little,” she said, referring to national governments’ own contributions to beating TB. In addition, “The Global Fund, which is a big donor for TB, gave around $800 million, which is completely insufficient.” Stop TB estimates that $19.6 billion per year will be needed over the next eight years for TB prevention and care, and $4 billion per year will be required for research and development (R&D) of the new diagnostics, medicines and vaccines needed to end TB. This represents about four times what is currently available for the TB response (in 2020, $5.3 billion was available for care and prevention and $0.9 billion for R&D). The year 2022 is critical for the global fight to end TB as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022. “We simply cannot continue to stand on the sidelines and watch while people around the world fall ill and die from a preventable and treatable disease,” said Ditiu. “We also cannot continue to accept what we accepted for years—every year having less than 40% of the funding need for the TB response. Now we are facing a disastrous funding shortfall, bigger than what we had expected. We not only need to step up efforts to meet targets set at the 2018 United Nations High Level Meeting on TB,” she said, referring to the UN pledge to accelerate progress toward the 2030 targets, “but the TB response must also recover from the devastating impacts of the COVID-19 pandemic.” Image Credits: The Global Fund / Evgeny Maloletka. ‘There is No Safe Place in Ukraine’ 21/03/2022 Kerry Cullinan Ukrainian child with his dog -displaced by war, in a refugee camp on the Moldova-Ukranian border There have been 52 attacks on Ukrainian health facilities in the past 25 days, more than two every day, according to the World Health Organization (WHO). Meanwhile, the health of fleeing refugees, their impact on the health services of neighbouring countries, and the fate of Ukraine’s tuberculosis patients are foremost on healthcare providers’ minds. “In less than a month, over three million people have left the country and nearly two million have been internally displaced,” said Jarno Habicht, WHO’s Representative in Ukraine. “This has happened faster than in any previous European crisis. There is no safe place in Ukraine right now, yet we need to ensure that health services are available.” “The military offensive continues, with a number of cities being entirely isolated – people are running out of food and water, and hospitals might not have electricity,” added Habicht, who has been head of the Ukraine office since 2018. “Worse still, we have seen many attacks on health workers and health facilities as well as patients. This is happening daily and is unacceptable. So, if you ask me how to describe it, every day things are getting worse, which means every day the health response is becoming more difficult.” Jarno Habicht, WHO’s Representative in Ukraine (centre) Banned cluster munitions According to Bonnie Docherty, a senior advisor for Human Rights Watch, Russian forces have “relied heavily” on cluster munitions, which are banned in most countries in the world, and explosive weapons with wide-area effects. Cluster munitions, large bombs that contain dozens or hundreds of smaller sub-munitions, were used to attack a hospital in Vuhledar on 24 February in which four civilians were killed, and 10 people including six healthcare workers were injured, wrote Docherty in the online security news outlet, Just Security, on Monday. Unexploded, the submunitions can lie dormant like landmines, exploding months and years later when picked up by children or farmers, she explains. However, artillery shells, mortars, rockets, missiles, and enhanced blast (thermobaric) weapons, and aerial bombs, have caused the bulk of the damage in Ukraine, adds Docherty. Concern for drug-resistant TB patients On the eve of World Tuberculosis Day on Thursday, WHO TB experts also expressed concern for Ukrainian TB patients, particularly those with drug-resistant TB. “Ukraine is one of the 18 high-priority countries in the WHO European region for TB and is on the global list for having a high burden of multidrug-resistant tuberculosis,” Dr Askar Yedilbayev, WHO Europe’s Regional TB advisor, told a media briefing on Monday. Dr Askar Yedilbayev “Before the war, Ukraine was one of the pioneering countries in response to TB and drug-resistant TB in the WHO European region,” he added. “However, destroyed health infrastructure, including limited access to TB treatment and public health services, is affecting the provision of essential tuberculosis services, causing significant delays in diagnosis of TB, affecting initiation of TB preventive treatment, and treatment of active TB and MDR TB,” he added. Shortly before the war, all TB medication had been distributed to regional warehouses and patients had been given one or two months’ supply of medicine, he added. But some of these warehouses had been damaged or were under threat of damage, and there was a need for the “emergency redistribution of procurement of medicines to ensure continuity of treatment”. In addition, as Ukraine’s neighbours did not have the same burden of TB disease, they were unlikely to have the medicine to treat large numbers of people with TB. Yedilbayev appealed for donations to the Global Fund and WHO Foundation to enable the delivery of health services to Ukrainians. Every second, a Ukrainian child becomes a refugee Every second, a Ukrainian child becomes a refugee, according to UNICEF and half of the over 3.5 million refugees estimated to have fled to neighbouring countries since 24 February are children under the age of 15. Almost two million refugees have fled to Poland, according to the WHO. “Refugees can be vulnerable to infectious diseases because of lack of health care, interrupted care in the country of origin, because of exposure to infectious infections and lack of care in transit, and if living conditions are poor in the destination country,” said Yedilbayev. Image Credits: UNICEF/UN0599222/Moldovan. As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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.
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. Ukraine’s ‘Model’ TB Programme Destroyed by War, as Global TB Response Faces ‘Disastrous’ Funds Shortfall 22/03/2022 Kerry Cullinan & Elaine Ruth Fletcher Yana Terleeva, head of the Ukranian Ministry of Health’s TB programme Speaking in her car from an undisclosed location somewhere in war-torn Ukraine, Yana Teerleva, head of TB in the country’s Ministry of Health, lamented the destruction that she is witnessing every day in hospitals and clinics – including the shelling of three huge dispensaries where the country had stockpiled sufficient TB medications for the remainder of 2022. This month, Teerleva had been planning to implement an innovative new TB treatment regimen to further step up the national response to its drug resistant TB burden – which TB control officials in Geneva had praised as a model. “Instead we are dealing with the Russian invasion and discussing military hardware”, Teerleva said in a media briefing Tuesday, just ahead of World Tuberculosis Day, 24 March. Global TB experts are bemoaning the destruction of Ukraine’s innovative TB programme, which had made significant progress in addressing the country’s high burden of multi-drug resistant TB (MDR-TB) over the past 15 years. Meanwhile, with global TB funding well below needs, prospects of meeting the UN Sustainable Development Goal target for ending the TB epidemic by 2030 look increasingly dim, Lucica Ditui, executive director of the Geneva-based STOP TB Partnership, told Health Policy Watch in an interview. “This gives us very little chance of meeting the UN 2030 targets,” she said. Model programme now in ashes – literally Almost one-third of Ukraine’s TB cases are drug-resistant, and last year the country diagnosed and treated 24,000 people with TB, including almost 5,000 people with MDR-TB. But the Ukrainian government had been “extremely committed” to addressing TB over the past two to three years, paying for new drugs and diagnostics and building strong relationships with civil society organisations, Ditiu told Health Policy Watch. “The country did a lot to improve their health system. It is devastating to see these bombs destroying everything. These are losses that will take decades to regain.” A doctor shows Oleg Chutvatov, who was receiving TB treatment at the hospital in Kharkiv, an x-ray photo of his lungs in July 2021. The city is now under heavy attack from the Russian invasion. Over the past 15 years, Ukraine had significantly reduced its TB cases from over 127 cases per 100 000 people in 2005 to just 42.2 cases per 100 000 people in 2020. Just before the war, says Ditiui, “The country was paying for their own TB drugs as well as diagnostics – and they had secured enough to treat and diagnose everyone in need in Ukraine. “They were very keen to implement new tools like rapid molecular diagnosis, as well as new drugs. They had cohorts of people enrolled in studies for new TB treatments. Collaboration between public health officials, civil society and communities also was very good.” The gains in TB treatment were part of a broader health sector reform that had been underway, Ditiu added, saying: “What I am really upset about is that the country did a lot to improve their health system, their hospitals, to do health sector reform. To see these bombs destroying everything. These are losses that will take decades to regain.” “Ukraine was always at the forefront of the fight against tuberculosis,” Teleeva told the Stop TB briefing Tuesday. “We wanted Ukraine and the entire world to be free from the TB and for that, we have done everything possible.” However, she said that according to health ministry information, “more than 135 hospitals in Ukraine have been shelled by the Russian aggressors”, including “three huge regional anti-tuberculosis dispensaries” and the country’s health infrastructure “is not working”. WHO has confirmed some 60 attacks on hospitals and other health facilities. Appeal to combat stigma – among the war’s knock-on effects Both Ditiu and Teeleva stressed the need to focus now on countering the knock-on effects of the war – including how to treat internally displaced people, how to ensure people fleeing can continue their medications, and how to combat stigma that refugees elsewhere may encounter. “We worked to overcome the stigma discrimination of these people living with TB”, Teleeva said, of the pre-war period. She appealed to neighbouring countries that have a much lower burden of TB disease not to stigmatise Ukrainian refugees. “TB is very sensitive, and if we broadcast information about its uncontrolled spread, we will stigmatize people who are already stigmatized, for people who are already in a very difficult situation,” said Terleeva. Ditiu acknowledged that it’s very likely the war will lead to a higher level of TB cases -particularly inside Ukraine itself. “We’ll see an increase in TB, in drug-resistant TB and in mortality,” she predicted, “because people will be staying close together in shelters, in crowded places, with bad food and stress.” However, she said good tracking and surveillance by countries that receive refugees can help counter any spillover effect, beyond the borders. ‘Stupid war’ Romania’s Health Minister, Prof Alexandru Rafila Decrying the “stupid war”, Romania’s Health Minister, Professor Alexandru Rafila, told the briefing that his country was doing everything it could to assist the refugees that had fled across the 600km border with his country, including identifying and ensuring treatment for TB patients. As a country with a relatively high burden of TB itself, Romania has “a network of TB hospitals and TB ambulatory care centres where we can perform rapid diagnosis and treat Ukrainian patients if they are resistant or need to initiate treatment”, added Rafila. The Global Fund has also provided Romania with additional Gene Xpert rapid testing machines and TB medication to assist Ukranian patients, the health minister added. However, while Romania and Moldova had “some capacity” to deal with TB, Ditiu warned that Poland is in a different category – precisely because its own burden is quite low. “Poland is not a country with a lot of TB – so I’m not sure how well the network will be able to deal with it – even though the doctors certainly have a lot of knowledge”. In addition, prices of TB medication in both Romania and Poland are up to ten times higher than in Ukraine, as both countries are part of the European Union and pay EU prices for drugs that Ukraine was able to procure through the Global Fund, Ditiu added. “We are having a conversation with the Global Fund to see how we can lower the cost,” she added. TB civil society trying to locate patients Olya Klymenk, head of TB People Ukraine, a network of over 70 organisations, said that her organisation was doing its best to locate displaced patients who have fled their homes or their communities, and offer them humanitarian aid, including food. “We are trying to take care of the patients who are out of the hospital right now because we understand that, without social support, they will not have a good life,” said Klymenk. Teleeva stressed that in the emergency the primary need is to, “focus on ensuring patients know where to go and have a desire to continue treatment. “They have to be assured there is a reason to live, that they will go back to Ukraine, and they have to be healthy to help us rebuild. They need this optimism, to have this desire to live and continue living.” ‘Pathetic’ investment in TB Dr Lucica Ditiu, Executive Director of the Stop TB Partnership Meanwhile, Ditiu lamented that “investments in TB are pathetically low” – perhaps because 90% of the disease burden is in lower-income countries. “In 2020, we had $1.9 billion [in] domestic investments, which is very very, very little,” she said, referring to national governments’ own contributions to beating TB. In addition, “The Global Fund, which is a big donor for TB, gave around $800 million, which is completely insufficient.” Stop TB estimates that $19.6 billion per year will be needed over the next eight years for TB prevention and care, and $4 billion per year will be required for research and development (R&D) of the new diagnostics, medicines and vaccines needed to end TB. This represents about four times what is currently available for the TB response (in 2020, $5.3 billion was available for care and prevention and $0.9 billion for R&D). The year 2022 is critical for the global fight to end TB as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022. “We simply cannot continue to stand on the sidelines and watch while people around the world fall ill and die from a preventable and treatable disease,” said Ditiu. “We also cannot continue to accept what we accepted for years—every year having less than 40% of the funding need for the TB response. Now we are facing a disastrous funding shortfall, bigger than what we had expected. We not only need to step up efforts to meet targets set at the 2018 United Nations High Level Meeting on TB,” she said, referring to the UN pledge to accelerate progress toward the 2030 targets, “but the TB response must also recover from the devastating impacts of the COVID-19 pandemic.” Image Credits: The Global Fund / Evgeny Maloletka. ‘There is No Safe Place in Ukraine’ 21/03/2022 Kerry Cullinan Ukrainian child with his dog -displaced by war, in a refugee camp on the Moldova-Ukranian border There have been 52 attacks on Ukrainian health facilities in the past 25 days, more than two every day, according to the World Health Organization (WHO). Meanwhile, the health of fleeing refugees, their impact on the health services of neighbouring countries, and the fate of Ukraine’s tuberculosis patients are foremost on healthcare providers’ minds. “In less than a month, over three million people have left the country and nearly two million have been internally displaced,” said Jarno Habicht, WHO’s Representative in Ukraine. “This has happened faster than in any previous European crisis. There is no safe place in Ukraine right now, yet we need to ensure that health services are available.” “The military offensive continues, with a number of cities being entirely isolated – people are running out of food and water, and hospitals might not have electricity,” added Habicht, who has been head of the Ukraine office since 2018. “Worse still, we have seen many attacks on health workers and health facilities as well as patients. This is happening daily and is unacceptable. So, if you ask me how to describe it, every day things are getting worse, which means every day the health response is becoming more difficult.” Jarno Habicht, WHO’s Representative in Ukraine (centre) Banned cluster munitions According to Bonnie Docherty, a senior advisor for Human Rights Watch, Russian forces have “relied heavily” on cluster munitions, which are banned in most countries in the world, and explosive weapons with wide-area effects. Cluster munitions, large bombs that contain dozens or hundreds of smaller sub-munitions, were used to attack a hospital in Vuhledar on 24 February in which four civilians were killed, and 10 people including six healthcare workers were injured, wrote Docherty in the online security news outlet, Just Security, on Monday. Unexploded, the submunitions can lie dormant like landmines, exploding months and years later when picked up by children or farmers, she explains. However, artillery shells, mortars, rockets, missiles, and enhanced blast (thermobaric) weapons, and aerial bombs, have caused the bulk of the damage in Ukraine, adds Docherty. Concern for drug-resistant TB patients On the eve of World Tuberculosis Day on Thursday, WHO TB experts also expressed concern for Ukrainian TB patients, particularly those with drug-resistant TB. “Ukraine is one of the 18 high-priority countries in the WHO European region for TB and is on the global list for having a high burden of multidrug-resistant tuberculosis,” Dr Askar Yedilbayev, WHO Europe’s Regional TB advisor, told a media briefing on Monday. Dr Askar Yedilbayev “Before the war, Ukraine was one of the pioneering countries in response to TB and drug-resistant TB in the WHO European region,” he added. “However, destroyed health infrastructure, including limited access to TB treatment and public health services, is affecting the provision of essential tuberculosis services, causing significant delays in diagnosis of TB, affecting initiation of TB preventive treatment, and treatment of active TB and MDR TB,” he added. Shortly before the war, all TB medication had been distributed to regional warehouses and patients had been given one or two months’ supply of medicine, he added. But some of these warehouses had been damaged or were under threat of damage, and there was a need for the “emergency redistribution of procurement of medicines to ensure continuity of treatment”. In addition, as Ukraine’s neighbours did not have the same burden of TB disease, they were unlikely to have the medicine to treat large numbers of people with TB. Yedilbayev appealed for donations to the Global Fund and WHO Foundation to enable the delivery of health services to Ukrainians. Every second, a Ukrainian child becomes a refugee Every second, a Ukrainian child becomes a refugee, according to UNICEF and half of the over 3.5 million refugees estimated to have fled to neighbouring countries since 24 February are children under the age of 15. Almost two million refugees have fled to Poland, according to the WHO. “Refugees can be vulnerable to infectious diseases because of lack of health care, interrupted care in the country of origin, because of exposure to infectious infections and lack of care in transit, and if living conditions are poor in the destination country,” said Yedilbayev. Image Credits: UNICEF/UN0599222/Moldovan. As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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.
Ukraine’s ‘Model’ TB Programme Destroyed by War, as Global TB Response Faces ‘Disastrous’ Funds Shortfall 22/03/2022 Kerry Cullinan & Elaine Ruth Fletcher Yana Terleeva, head of the Ukranian Ministry of Health’s TB programme Speaking in her car from an undisclosed location somewhere in war-torn Ukraine, Yana Teerleva, head of TB in the country’s Ministry of Health, lamented the destruction that she is witnessing every day in hospitals and clinics – including the shelling of three huge dispensaries where the country had stockpiled sufficient TB medications for the remainder of 2022. This month, Teerleva had been planning to implement an innovative new TB treatment regimen to further step up the national response to its drug resistant TB burden – which TB control officials in Geneva had praised as a model. “Instead we are dealing with the Russian invasion and discussing military hardware”, Teerleva said in a media briefing Tuesday, just ahead of World Tuberculosis Day, 24 March. Global TB experts are bemoaning the destruction of Ukraine’s innovative TB programme, which had made significant progress in addressing the country’s high burden of multi-drug resistant TB (MDR-TB) over the past 15 years. Meanwhile, with global TB funding well below needs, prospects of meeting the UN Sustainable Development Goal target for ending the TB epidemic by 2030 look increasingly dim, Lucica Ditui, executive director of the Geneva-based STOP TB Partnership, told Health Policy Watch in an interview. “This gives us very little chance of meeting the UN 2030 targets,” she said. Model programme now in ashes – literally Almost one-third of Ukraine’s TB cases are drug-resistant, and last year the country diagnosed and treated 24,000 people with TB, including almost 5,000 people with MDR-TB. But the Ukrainian government had been “extremely committed” to addressing TB over the past two to three years, paying for new drugs and diagnostics and building strong relationships with civil society organisations, Ditiu told Health Policy Watch. “The country did a lot to improve their health system. It is devastating to see these bombs destroying everything. These are losses that will take decades to regain.” A doctor shows Oleg Chutvatov, who was receiving TB treatment at the hospital in Kharkiv, an x-ray photo of his lungs in July 2021. The city is now under heavy attack from the Russian invasion. Over the past 15 years, Ukraine had significantly reduced its TB cases from over 127 cases per 100 000 people in 2005 to just 42.2 cases per 100 000 people in 2020. Just before the war, says Ditiui, “The country was paying for their own TB drugs as well as diagnostics – and they had secured enough to treat and diagnose everyone in need in Ukraine. “They were very keen to implement new tools like rapid molecular diagnosis, as well as new drugs. They had cohorts of people enrolled in studies for new TB treatments. Collaboration between public health officials, civil society and communities also was very good.” The gains in TB treatment were part of a broader health sector reform that had been underway, Ditiu added, saying: “What I am really upset about is that the country did a lot to improve their health system, their hospitals, to do health sector reform. To see these bombs destroying everything. These are losses that will take decades to regain.” “Ukraine was always at the forefront of the fight against tuberculosis,” Teleeva told the Stop TB briefing Tuesday. “We wanted Ukraine and the entire world to be free from the TB and for that, we have done everything possible.” However, she said that according to health ministry information, “more than 135 hospitals in Ukraine have been shelled by the Russian aggressors”, including “three huge regional anti-tuberculosis dispensaries” and the country’s health infrastructure “is not working”. WHO has confirmed some 60 attacks on hospitals and other health facilities. Appeal to combat stigma – among the war’s knock-on effects Both Ditiu and Teeleva stressed the need to focus now on countering the knock-on effects of the war – including how to treat internally displaced people, how to ensure people fleeing can continue their medications, and how to combat stigma that refugees elsewhere may encounter. “We worked to overcome the stigma discrimination of these people living with TB”, Teleeva said, of the pre-war period. She appealed to neighbouring countries that have a much lower burden of TB disease not to stigmatise Ukrainian refugees. “TB is very sensitive, and if we broadcast information about its uncontrolled spread, we will stigmatize people who are already stigmatized, for people who are already in a very difficult situation,” said Terleeva. Ditiu acknowledged that it’s very likely the war will lead to a higher level of TB cases -particularly inside Ukraine itself. “We’ll see an increase in TB, in drug-resistant TB and in mortality,” she predicted, “because people will be staying close together in shelters, in crowded places, with bad food and stress.” However, she said good tracking and surveillance by countries that receive refugees can help counter any spillover effect, beyond the borders. ‘Stupid war’ Romania’s Health Minister, Prof Alexandru Rafila Decrying the “stupid war”, Romania’s Health Minister, Professor Alexandru Rafila, told the briefing that his country was doing everything it could to assist the refugees that had fled across the 600km border with his country, including identifying and ensuring treatment for TB patients. As a country with a relatively high burden of TB itself, Romania has “a network of TB hospitals and TB ambulatory care centres where we can perform rapid diagnosis and treat Ukrainian patients if they are resistant or need to initiate treatment”, added Rafila. The Global Fund has also provided Romania with additional Gene Xpert rapid testing machines and TB medication to assist Ukranian patients, the health minister added. However, while Romania and Moldova had “some capacity” to deal with TB, Ditiu warned that Poland is in a different category – precisely because its own burden is quite low. “Poland is not a country with a lot of TB – so I’m not sure how well the network will be able to deal with it – even though the doctors certainly have a lot of knowledge”. In addition, prices of TB medication in both Romania and Poland are up to ten times higher than in Ukraine, as both countries are part of the European Union and pay EU prices for drugs that Ukraine was able to procure through the Global Fund, Ditiu added. “We are having a conversation with the Global Fund to see how we can lower the cost,” she added. TB civil society trying to locate patients Olya Klymenk, head of TB People Ukraine, a network of over 70 organisations, said that her organisation was doing its best to locate displaced patients who have fled their homes or their communities, and offer them humanitarian aid, including food. “We are trying to take care of the patients who are out of the hospital right now because we understand that, without social support, they will not have a good life,” said Klymenk. Teleeva stressed that in the emergency the primary need is to, “focus on ensuring patients know where to go and have a desire to continue treatment. “They have to be assured there is a reason to live, that they will go back to Ukraine, and they have to be healthy to help us rebuild. They need this optimism, to have this desire to live and continue living.” ‘Pathetic’ investment in TB Dr Lucica Ditiu, Executive Director of the Stop TB Partnership Meanwhile, Ditiu lamented that “investments in TB are pathetically low” – perhaps because 90% of the disease burden is in lower-income countries. “In 2020, we had $1.9 billion [in] domestic investments, which is very very, very little,” she said, referring to national governments’ own contributions to beating TB. In addition, “The Global Fund, which is a big donor for TB, gave around $800 million, which is completely insufficient.” Stop TB estimates that $19.6 billion per year will be needed over the next eight years for TB prevention and care, and $4 billion per year will be required for research and development (R&D) of the new diagnostics, medicines and vaccines needed to end TB. This represents about four times what is currently available for the TB response (in 2020, $5.3 billion was available for care and prevention and $0.9 billion for R&D). The year 2022 is critical for the global fight to end TB as the world faces a fast-running countdown to reaching the 2018 United Nations High-Level Meeting (UNHLM) TB targets, which the international community agreed to meet by the end of December. All projections show that the world is not on course to meet the UNHLM treatment targets set for 2022. “We simply cannot continue to stand on the sidelines and watch while people around the world fall ill and die from a preventable and treatable disease,” said Ditiu. “We also cannot continue to accept what we accepted for years—every year having less than 40% of the funding need for the TB response. Now we are facing a disastrous funding shortfall, bigger than what we had expected. We not only need to step up efforts to meet targets set at the 2018 United Nations High Level Meeting on TB,” she said, referring to the UN pledge to accelerate progress toward the 2030 targets, “but the TB response must also recover from the devastating impacts of the COVID-19 pandemic.” Image Credits: The Global Fund / Evgeny Maloletka. ‘There is No Safe Place in Ukraine’ 21/03/2022 Kerry Cullinan Ukrainian child with his dog -displaced by war, in a refugee camp on the Moldova-Ukranian border There have been 52 attacks on Ukrainian health facilities in the past 25 days, more than two every day, according to the World Health Organization (WHO). Meanwhile, the health of fleeing refugees, their impact on the health services of neighbouring countries, and the fate of Ukraine’s tuberculosis patients are foremost on healthcare providers’ minds. “In less than a month, over three million people have left the country and nearly two million have been internally displaced,” said Jarno Habicht, WHO’s Representative in Ukraine. “This has happened faster than in any previous European crisis. There is no safe place in Ukraine right now, yet we need to ensure that health services are available.” “The military offensive continues, with a number of cities being entirely isolated – people are running out of food and water, and hospitals might not have electricity,” added Habicht, who has been head of the Ukraine office since 2018. “Worse still, we have seen many attacks on health workers and health facilities as well as patients. This is happening daily and is unacceptable. So, if you ask me how to describe it, every day things are getting worse, which means every day the health response is becoming more difficult.” Jarno Habicht, WHO’s Representative in Ukraine (centre) Banned cluster munitions According to Bonnie Docherty, a senior advisor for Human Rights Watch, Russian forces have “relied heavily” on cluster munitions, which are banned in most countries in the world, and explosive weapons with wide-area effects. Cluster munitions, large bombs that contain dozens or hundreds of smaller sub-munitions, were used to attack a hospital in Vuhledar on 24 February in which four civilians were killed, and 10 people including six healthcare workers were injured, wrote Docherty in the online security news outlet, Just Security, on Monday. Unexploded, the submunitions can lie dormant like landmines, exploding months and years later when picked up by children or farmers, she explains. However, artillery shells, mortars, rockets, missiles, and enhanced blast (thermobaric) weapons, and aerial bombs, have caused the bulk of the damage in Ukraine, adds Docherty. Concern for drug-resistant TB patients On the eve of World Tuberculosis Day on Thursday, WHO TB experts also expressed concern for Ukrainian TB patients, particularly those with drug-resistant TB. “Ukraine is one of the 18 high-priority countries in the WHO European region for TB and is on the global list for having a high burden of multidrug-resistant tuberculosis,” Dr Askar Yedilbayev, WHO Europe’s Regional TB advisor, told a media briefing on Monday. Dr Askar Yedilbayev “Before the war, Ukraine was one of the pioneering countries in response to TB and drug-resistant TB in the WHO European region,” he added. “However, destroyed health infrastructure, including limited access to TB treatment and public health services, is affecting the provision of essential tuberculosis services, causing significant delays in diagnosis of TB, affecting initiation of TB preventive treatment, and treatment of active TB and MDR TB,” he added. Shortly before the war, all TB medication had been distributed to regional warehouses and patients had been given one or two months’ supply of medicine, he added. But some of these warehouses had been damaged or were under threat of damage, and there was a need for the “emergency redistribution of procurement of medicines to ensure continuity of treatment”. In addition, as Ukraine’s neighbours did not have the same burden of TB disease, they were unlikely to have the medicine to treat large numbers of people with TB. Yedilbayev appealed for donations to the Global Fund and WHO Foundation to enable the delivery of health services to Ukrainians. Every second, a Ukrainian child becomes a refugee Every second, a Ukrainian child becomes a refugee, according to UNICEF and half of the over 3.5 million refugees estimated to have fled to neighbouring countries since 24 February are children under the age of 15. Almost two million refugees have fled to Poland, according to the WHO. “Refugees can be vulnerable to infectious diseases because of lack of health care, interrupted care in the country of origin, because of exposure to infectious infections and lack of care in transit, and if living conditions are poor in the destination country,” said Yedilbayev. Image Credits: UNICEF/UN0599222/Moldovan. As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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.
‘There is No Safe Place in Ukraine’ 21/03/2022 Kerry Cullinan Ukrainian child with his dog -displaced by war, in a refugee camp on the Moldova-Ukranian border There have been 52 attacks on Ukrainian health facilities in the past 25 days, more than two every day, according to the World Health Organization (WHO). Meanwhile, the health of fleeing refugees, their impact on the health services of neighbouring countries, and the fate of Ukraine’s tuberculosis patients are foremost on healthcare providers’ minds. “In less than a month, over three million people have left the country and nearly two million have been internally displaced,” said Jarno Habicht, WHO’s Representative in Ukraine. “This has happened faster than in any previous European crisis. There is no safe place in Ukraine right now, yet we need to ensure that health services are available.” “The military offensive continues, with a number of cities being entirely isolated – people are running out of food and water, and hospitals might not have electricity,” added Habicht, who has been head of the Ukraine office since 2018. “Worse still, we have seen many attacks on health workers and health facilities as well as patients. This is happening daily and is unacceptable. So, if you ask me how to describe it, every day things are getting worse, which means every day the health response is becoming more difficult.” Jarno Habicht, WHO’s Representative in Ukraine (centre) Banned cluster munitions According to Bonnie Docherty, a senior advisor for Human Rights Watch, Russian forces have “relied heavily” on cluster munitions, which are banned in most countries in the world, and explosive weapons with wide-area effects. Cluster munitions, large bombs that contain dozens or hundreds of smaller sub-munitions, were used to attack a hospital in Vuhledar on 24 February in which four civilians were killed, and 10 people including six healthcare workers were injured, wrote Docherty in the online security news outlet, Just Security, on Monday. Unexploded, the submunitions can lie dormant like landmines, exploding months and years later when picked up by children or farmers, she explains. However, artillery shells, mortars, rockets, missiles, and enhanced blast (thermobaric) weapons, and aerial bombs, have caused the bulk of the damage in Ukraine, adds Docherty. Concern for drug-resistant TB patients On the eve of World Tuberculosis Day on Thursday, WHO TB experts also expressed concern for Ukrainian TB patients, particularly those with drug-resistant TB. “Ukraine is one of the 18 high-priority countries in the WHO European region for TB and is on the global list for having a high burden of multidrug-resistant tuberculosis,” Dr Askar Yedilbayev, WHO Europe’s Regional TB advisor, told a media briefing on Monday. Dr Askar Yedilbayev “Before the war, Ukraine was one of the pioneering countries in response to TB and drug-resistant TB in the WHO European region,” he added. “However, destroyed health infrastructure, including limited access to TB treatment and public health services, is affecting the provision of essential tuberculosis services, causing significant delays in diagnosis of TB, affecting initiation of TB preventive treatment, and treatment of active TB and MDR TB,” he added. Shortly before the war, all TB medication had been distributed to regional warehouses and patients had been given one or two months’ supply of medicine, he added. But some of these warehouses had been damaged or were under threat of damage, and there was a need for the “emergency redistribution of procurement of medicines to ensure continuity of treatment”. In addition, as Ukraine’s neighbours did not have the same burden of TB disease, they were unlikely to have the medicine to treat large numbers of people with TB. Yedilbayev appealed for donations to the Global Fund and WHO Foundation to enable the delivery of health services to Ukrainians. Every second, a Ukrainian child becomes a refugee Every second, a Ukrainian child becomes a refugee, according to UNICEF and half of the over 3.5 million refugees estimated to have fled to neighbouring countries since 24 February are children under the age of 15. Almost two million refugees have fled to Poland, according to the WHO. “Refugees can be vulnerable to infectious diseases because of lack of health care, interrupted care in the country of origin, because of exposure to infectious infections and lack of care in transit, and if living conditions are poor in the destination country,” said Yedilbayev. Image Credits: UNICEF/UN0599222/Moldovan. As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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.
As Europe Moves to Improve Mental Health Services for Children, Experts Are Concerned About Men’s Mental State 21/03/2022 Kerry Cullinan Dr Hans Kluge Mental health practitioners worldwide are warning of a massive wave of pandemic-related mental health issues that many countries are ill-equipped to address. On Monday, the World Health Organization’s (WHO) Europe office and the government of Greece launched a new European programme to strengthen and improve the quality of mental health services for children and adolescents. WHO Europe Director Dr Hans Kluge told the launch that suicide was the leading cause of death in children and adolescents aged 10 to 19 living in low- and middle-income countries in the region and that over 4000 young people in this age group had killed themselves in 2015. 🔴Suicide is the leading cause of deathamong adolescents in low & middle income countries & 2nd in high income countries in the European Region Find guidance on how to approach child & adolescent #MentalHealth as a primary health care provider here👉 https://t.co/EUoragqO0q pic.twitter.com/AOvZRIY7HR — WHO/Europe (@WHO_Europe) March 21, 2022 “Ensuring that all children and adolescents in the region have access to quality mental health services is a moral imperative,” said Kluge, adding that this was as important as childhood vaccinations. The WHO Europe programme aims to work with member states to encourage them to share knowledge and expertise about how to boost the mental healthcare of children and adolescents, and to support member countries to develop their own strategies and frameworks. It will also “develop a package of tools to measure progress against evidence-based standards”, according to the regional office. Through this new programme, WHO/Europe will continue to help countries strengthen and improve #mentalhealth services for children and adolescents, as well as developing tools to measure progress pic.twitter.com/Fspx9hh2lN — WHO/Europe (@WHO_Europe) March 21, 2022 Mental health woes of COVID-19 COVID-19 has exacerbated mental health issues and, during the first year of the pandemic, there was a 25% increase in the global prevalence of anxiety and depression, according to a WHO brief published in early March. Approximately 140,000 children in the US have lost a parent or guardian to COVID, for example, and are likely to be struggling to come to terms with this loss. “One major explanation for the increase is the unprecedented stress caused by the social isolation resulting from the pandemic. Linked to this were constraints on people’s ability to work, seek support from loved ones and engage in their communities,” according to the WHO. “Loneliness, fear of infection, suffering and death for oneself and for loved ones, grief after bereavement and financial worries have also all been cited as stressors leading to anxiety and depression. Among health workers, exhaustion has been a major trigger for suicidal thinking,” it added. Calls to South Africa’s only mental health helpline, for example, have jumped exponentially during the pandemic – from around 400 to 600 calls a day before COVID-19 to over 2400 calls a day in 2021. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) that operates the helpline, said that his non-governmental organisation, which is wholly reliant on donations, had been struggling to keep up with demand. Psychologist Zamo Mbele, a board member of the South African Depression and Anxiety Group (SADAG) Male violence and mental health “One of the reasons we’ve seen an increase in our calls is because of COVID, but one of the other reasons is because people who would not previously access health are beginning to recognise that they need help,” said Mbele. He added that “toxic” manifestations of masculinity – seen in the country’s high levels of domestic violence, road rage and substance abuse – were indications that men, in particular, needed help. “It’s not as though men only recently starting to struggle with mental difficulties or emotional difficulties,” he added. “But they are just starting to see that the expression of their difficulties is no longer functional to them or to society. It’s no longer as socially acceptable to be violent in order to deal with your depression, or to have a big temper in order to deal irritability or anxiety – or to drink excessively or to spend copious amounts of hours at the gym. “Instead, we’re beginning to recognise that actually doing a lot of these things is masking a lot of symptoms.” https://twitter.com/SkosanaDr/status/1505834397391544323 Men and suicide In the vast majority of countries, men are far more likely to commit suicide than women, which mental health practitioners say is likely to be because men find it harder to ask for help. This is a worldwide trend, captured by the WHO’s Suicide Worldwide in 2019: Global Health Estimates. The report found that South Africa has the third-highest suicide rate on the African continent. Of the 13,774 suicides reported in South Africa, 10,681 were men in 2913 were women. Russia, South Korea, the US and Japan also have high suicide rates, particularly amongst men. However, while there has been an increase in suicidal thoughts during the pandemic, there has not been a global increase in actual suicides – with notable exceptions, such as Austria, and Japan (although there is very little information from LMICs). Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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.
Mass Polio Vaccination Drive to Administer More Than 80 Million Doses to Southern African Children in Five Countries 18/03/2022 Raisa Santos Polio vaccinate campaign to target children under 5 across five southern African countries. Malawi is launching a mass vaccination campaign against wild poliovirus type 1, which is to extend to 23 million children across five southern African countries, WHO said on Friday. The campaign, to kick off Sunday, follows Malawi’s declaration of a polio outbreak on 17 February – three months after the first polio virus case in 30 years was identified in a young child in Lilongwe. The case was the first in Africa since the region was certified free of indigenous wild poliovirus in 2020. WHO said that the region’s certification as wild polio-free remains unchanged, as the wild poliovirus strain identified had been “imported” from Pakistan. So far, no clear explanation of how the Asian virus strain may have infected an African child who had never traveled outside of the country, has been provided by WHO or Malawi health authorities. Nor has there been any explanation of why it took three months between the time the child was diagnosed and the outbreak was formally declared by WHO. But the breadth of the new campaign makes it clear the incident has been perceived as a major threat to Africa’s wild polio virus free status – with risks of subtle, silent transmission of the virus much more widely, via contaminated water and sewage, food, or human-to-human contact. Malawi has since set up an environmental surveillance system for poliovirus in 11 cities across four sites, including the Lilongwe District that encompasses the capital Lilongwe, where the initial, and so far only reported case, was detected, WHO said. Asked by Health Policy Watch whether traces of the wild polio virus had also been identified in sewage sources, through the environmental surveillance, WHO did not reply as of publication time. Targeting children across four countries – then Zimbabwe More than 80 million doses will be administered to more than 23 million children under 5 years in a four-round vaccination campaign in five southern African countries, WHO said. The first phase of the campaign, beginning this month, will target 9.4 million children across Malawi, Mozambique, Tanzania, and Zambia. Three subsequent rounds – with Zimbabwe joining the campaign- are set for April, June, and July, and aim to reach more than 23 million children with more than 80 million doses of the bivalent Oral Polio Vaccine recommended by the World Health Organization (WHO). “Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbours, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said WHO Regional Director for Africa Dr Matshidiso Moeti. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.” Single case of polio in Malawi linked to Pakistan strain Pakistan is one of two countries where polio remains endemic. Laboratory analysis has linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019. In addition to environmental surveillance, WHO has also been supporting the country to reinforce response measures including risk assessment, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations, and the government to end the outbreak. The WHO team is a part of a broader multi-partner Global Polio Eradication Initiative to support the country. In an unrelated event, a vaccine-directed case of polio was also identified in February by Israeli authorities in Jerusalem, also for the first time in 30 years. The infected child is part of an ultra-orthodox Jewish community in which vaccination rates hover at around 50% or less. A vaccination drive also was launched in the city. Polio, a viral disease with no cure, can invade the nervous system and can cause total paralysis within hours, particular among children under 5 years. The virus is transmitted from person to person, mainly through contamination by fecal matter or, less frequently, through contaminated water or food, and multiplies in the intestine. While there is no cure for polio, the disease can be prevented through administration of a vaccine. Image Credits: Sanofi Pastuer/Flickr, Sanofi Pastuer/Flickr. UN Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. 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 Environment Programme Joins WHO Alliance to Advance One Health Approach 18/03/2022 Editorial team Safer and more sustainable food systems – from production to sales in food markets is key to a One-Health Approach. UN Environment has joined a three-way alliance with the Food and Agriculture Organization, the World Animal Health Organization (OIE), and WHO to advance “One-Health” solutions to both ecosystem degradation and pandemic threats, leaders of the four agencies said on Friday. The statement followed a meeting this week of the Tripartite FAO, WHO and OIE partnership – which now has become a “Quadripartite”. “The One Health approach aims to sustainably balance and optimize the health of people, animals, ecosystems and the wider environment,” said WHO in a press release. “It mobilizes multiple sectors, disciplines and communities to work together to foster well-being and tackle threats to health and ecosystems. And it addresses the collective need for clean water, energy and air, safe and nutritious food, action on climate change, and contributing to sustainable development.” The work of the newly expanded alliance will be focused on a One Health Joint Plan of Action, which includes six main action tracks: enhancing countries’ capacity to strengthen health systems under a One Health approach; reducing the risks from emerging or resurfacing zoonotic epidemics and pandemics; controlling and eliminating endemic zoonotic, neglected tropical or vector-borne diseases; strengthening the assessment, management and communication of food safety risks; curbing the silent pandemic of antimicrobial resistance (AMR) and better integrating the environment into the One Health approach. Increased awareness of One Health As the world enters the third year of the COVID-19 pandemic, with an estimated cost of $8 to 16 trillion, there is increased awareness and broad recognition of the importance of One Health as a long-term, viable and sustainable approach. The G7, G20 and UN Food Systems Summit have all given a nod to the approach, along with the increased references by WHO and its partners. But the hard work of reforming food systems, from production to markets, as well as halting related deforestation and ecosystem destruction, are much more formidable challenges that the organisations have barely begun to face. Last year saw the Tripartite implement a number of initial initiatives, including on antimicrobial resistance, a One Health High-Level Expert Panel, and guidance on better management – but not the banning – of wild animal sales in markets – in the wake of the COVID pandemic, whose origins may have emerged from the capture, transport and slaughter of SARS-CoV2 infected wild animals at the Wuhan, China market. Plan implementation the key challenge “Now the challenge is implementation: how do we translate our work on the ground to support our Members? And how do we mobilize funding and financing mechanisms to support the Joint Plan for Action?” said FAO Director QU Dongyu, handing over the chair of the Secretariat to WHO. WHO Director-General Tedros Adhanom Ghebreyesus, said: “We need to build a more comprehensive and coordinated One Health governance structure at global level. We need a strong workforce, committed political will, and sustained financial investment. We need to develop a more proactive way of communicating and engaging across sectors, disciplines and communities to elicit the change we need.” (WHO) Image Credits: Michael Casmir/Pierce Mill Media. Posts navigation Older postsNewer posts