Category: Medical & Health

Kano, 9 September, 2021 – On 25 August 2021, African countries marked one-year anniversary of Polio certification. Programme managers, health workers and polio survivors in Nigeria also celebrated the wild polio- free status in the country.

The victory notwithstanding, the fight against other forms of the poliovirus is not over. Cases of vaccine-derived polio caused by low and infrequent immunization are still being recorded in Nigeria, with the northwest accounting for more than 55% of the total cases in the country highlighting the need for continued vigilance to nip a possible outbreak in the bud.

The Kano State Commissioner for Health, Dr Aminu Ibrahim Tsanyawa says, “The circulating vaccine derived polio Virus type -2 outbreak indicates the importance of continuing to receive Routine Immunization (RI) that is available in our health facilities, in order to reduce the risk of polio. That is why, expeditious action must be taken to strengthen our children’s immunity, to prevent further spread of the disease in our state and the country as a whole”.

Following the report in late 2020 of cases of vaccine-derived polio virus (cVDPV) disease in the northwestern states (Jigawa, Kano, Kaduna, Katsina, Kebbi, Sokoto and Zamfara), health authorities there are unrelenting in their actions to vaccinate all children under five years (10,637,566); the age at which the vaccine-derived polio disease is likely to set in.

“We continue to do this work because it is important for the children’s future,” says 26-year-old Amina Ibrahim, a vaccinator in Sokoto who works in communities despite the COVID-19 pandemic. “What we do is make sure we wash our hands, wear our face masks and maintain two-meters physical distance as we go from house to house.”

Addressing menace of cVDPV

First discovered in Madagascar in 2001, circulating vaccine-derived polio often occurs when a child who has been vaccinated with the oral polio vaccine (OPV) and who is in a poor sewage area passes stool or urine. The weakened live virus present in the urine or stool could find its way into the systems of other under-immunised kids through contaminated water or food and mutate, becoming infectious and causing life-long paralysis and in some cases, death.

Circulating vaccine-derived polio is rare but it poses risks to children everywhere because of its highly infectious nature. Nigeria has been experiencing outbreaks since 2018. The disease is fought in the same way wild polio is: with vaccines that provide the most important protection for children.

To halt the emergence of more cases of the disease, Northwest zone authorities are pushing massive statewide vaccination campaign. With a population of 53,187,831 (2021 projected), the zone is targeting about almost 11 million children during outbreak response vaccination exercises.

While the oral polio vaccine was used to protect against wild poliovirus in Nigeria, vaccine-derived polio disease is warded off with the novel oral polio vaccine (nOPV2). The World Health Organization (WHO) recommends regular immunization, at least twice for children, to reduce risks of infection. House to house team members administer two drops of the vaccine to produce a stronger immune response, according to the WHO.

Maintaining vigilance

Health authorities in all the seven states are also intensifying surveillance with the help of community informants to identify and isolate possible cases of vaccine-derived polio disease in the various local government areas.

Supported substantially by WHO, health officers regularly monitor the environment as well, examining stool and sewer samples in at-risk communities to monitor virus activity, a method that proved useful in finding and isolating wild poliovirus cases in the past years.

The surveillance and vaccination efforts are crucial for the northwest of mostly farmers and cattle herders. In the zone, the state’s geography makes it an easy target for infections. In the NWZ, four states share borders with Niger Republic which recorded cVDPV in 2020. The borders in the West African region are widely known to be porous and polioviruses are themselves highly infectious. In 2008, cases of wild polio spread from Nigeria to countries as far as Yemen.

Parents and caregivers mobilized for vaccination

The thoughts of life-time paralysis have made Sokoto parents especially eager to see their kids protected with vaccines. While years back parents saw many cases of children affected by polio growing up, the difference is clear now, with fewer children having to go through the pain of paralysis. Nigeria’s polio successes, hyped by traditional institutions, also boosted confidence in vaccines, a significant feat in a population that is often wary of medical services seen as foreign.

“In the North West Zone, traditional institutions have a renewed commitment to support WHO in tackling the upsurge of cVDP2 through improved community sensitization to achieve optimal routine immunization coverage across the zone”, says Dr Jalal Saleh, WHO Zonal Coordinator.

Ladidi Mohammed, a 16-year-old mother in Kazaure LGA Jigawa state says, “I allowed my child to be vaccinated because I believe my child will be protected from diseases of Polio, measles, Meningitis and other childhood diseases. Our traditional leader always sensitizes us on the importance of vaccination and I thank government for ensuring that our children are vaccinated and prevented from getting infected.”

But despite the vaccination push, health workers say they face hurdles in reaching some populations, leading to low vaccination coverage, especially with the impact of Covid 19 disease lockdown.

Residual challenges

Parts of the NWZ are insecure due to activities of bandits, armed groups, for one and another, rumours around vaccines, with one rumour saying they cause infertility in children. It is also challenging to reach nomadic cattle herding groups who make up a significant population in Nigeria’s north.

Crucially, because of inadequate education, many do not believe in the need to be vaccinated after polio has been declared eradicated and are shunning ongoing vaccinations against both wild and vaccine-derived polio.

These factors have resulted in Nigeria recording 201 outbreaks of vaccine-derived polio between 2018 and 2021 alone. Authorities declared a state of emergency on routine immunization in 2017, created state and local emergency routine immunization coordination centers and directed more state resources towards delivering vaccines.

“There has been a resurgence of vaccine-derived poliovirus over the years because there’s a significant proportion of under-immunized children,” says Dr Walter Kazadi Mulombo, WHO Nigeria Country Representative. “WHO will continue to support the country with experienced personnel in conducting effective immunization drives particularly in the outbreak areas”.

Despite the challenges, health workers continue to deliver vaccines and hop door to door and are helping parents understand the benefits of vaccines. Nomad trails are tracked with geo-information mapping systems so that vaccinators always know where families are. In communities with poor health infrastructure, state authorities and WHO are supplying drugs for minor ailments to build trust. And there is a productive collaboration with security agencies and local security groups that is helping health workers deliver vaccines safely to conflict-affected communities.

Source: World Health Organization. Africa

Brazzaville – Weekly COVID-19 cases in Africa fell by more than 20%—the sharpest seven-day decline in two months – as the third wave pandemic tapers off. However, the rate of deceleration is slower than the previous waves owing to the impact of more transmissible variants.

The continent recorded more than 165 000 cases in the week ending on 5 September—23% lower than the week before, yet still higher than the weekly cases recorded at the peak of the first wave.

The more contagious Delta variant that partly fuelled the third wave has been dominant in several countries that experienced COVID-19 surge. In southern Africa, for instance, where more than 4000 COVID-19 genome sequencing data was produced in August, the Delta variant was detected in over 70% of samples from Botswana, Malawi and South Africa, and in over 90% from Zimbabwe.

“While COVID-19 cases have declined appreciably, the downward trend is frustratingly slow due to the lingering effects of the more infectious Delta variant,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “We are spearheading critical work and supporting countries in scaling up pathogen surveillance through genome sequencing to detect and respond effectively to COVID-19 variants.”

In collaboration with the South African National Bioinformatics Institute, WHO is at the forefront of the efforts to set up the Regional Centre of Excellence for Genomic Surveillance and Bioinformatics in Cape Town. The centre will support 14 countries before being expanded to serve more countries. Last year, WHO and partners established a COVID-19 sequencing laboratory network in Africa which has to date produced nearly 40 000 sequencing data.

“The continent lags far behind the rest of the world when it comes to sequencing, with only 1% of over 3 million COVID-19 sequences conducted worldwide occurring in Africa,” said Dr Moeti. “The third wave has shown us how variants can hijack the efforts to tame the pandemic. Countries must step up surveillance because without genomic information, variants can spread undetected. You can’t fix what you don’t measure.”

WHO has also recently provided financial support to countries including Eswatini, Sao Tome and Principe and Senegal to reinforce genomic surveillance. To date, the dominant Delta variant has been detected in 31 African countries, while the Alpha and Beta variants have respectively been identified in 44 and 39 countries.

The C.1.2 variant initially identified in South Africa has so far been detected in 130 cases in 10 countries globally, including five in Africa. Although the variant has exhibited concerning mutations, there is no evidence that it is more transmissible or may affect vaccine efficacy, but more research is needed.

As Africa’s third COVID-19 pandemic wave eases off, vaccine shipments to the continent continue to grow, with around 5.5 million doses received through COVAX in the first week of September. However, only around 3% of the continent’s population is fully vaccinated.

“To ultimately tip the scales against this pandemic, our best efforts to reduce transmission through public health measures must be met by a significant step-up in vaccine supplies and vaccinations,” Dr Moeti said.

Dr Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Professor Alan Christoffels, Director of the South African National Bioinformatics Institute, and Dr Christian Happi, Professor of Molecular Biology and Genomics and Director at the African Centre of Excellence for Genomics of Infectious Diseases at Redeemer’s University in Nigeria.

Also on hand to respond to questions were Dr Nicksy Gumede-Moeletsi, Regional Virologist, WHO Regional Office for Africa, Dr Richard Mihigo, Coordinator, Immunization and Vaccines Development Programme, WHO Regional Office for Africa, and Dr Thierno Balde, Regional COVID-19 Deputy Incident Manager, WHO Regional Office for Africa.

Source: World Health Organization. Africa

Midway the Korea International Cooperation Agency (KOICA)-funded project on “Making Health Systems Resilient to Public Health Emergencies with Quality Services and Emergency Preparedness and Response,” KOICA, WHO, Ministry of Health (MOH), and National Public Health Institute of Liberia (NPHIL) along with stakeholders have undertaken a midterm review (MTR) of the project implementation from September 2-3, 2021 at the Corina Hotel in Monrovia, Liberia. The MTR analyzed key lessons learned and best practices through the project implementation and assessed emerging challenges as well as collated recommendations from key stakeholders to streamline the project, improve results and ultimately ensure the achievement of the project outcomes and further inform the next phase of the project implementation in Liberia (2021-2023).

Held under strict adherence to COVID-19 protocol, the both virtual and in-person meeting brought together fifty (50) key stakeholders from eleven (11) healthcare facilities in the three (03) project counties, national and international levels (including KOICA-Nigeria Office, WHO-Headquarters) and other partner organizations.

Speaking during the opening of the MTR Workshop, Hon. A. Vaifee Tulay, Deputy Health Minister for Policy Planning, Monitoring and Evaluation and Research on behalf of the Honorable Minister of Health for Liberia, Dr. Wilhelmina Jallah, acknowledged the efforts of partners, especially WHO and the Korean Government for their support to Liberia health sector in enhancing quality healthcare service delivery during outbreaks and non-outbreak situations. “It is midway into the project implementation and new realities, like COVID-19 outbreak and re-emergence of EVD and Marburg threats have emerged. This is the reason why we need to revisit the dashboard to identify what went well, what did not go well and why, and how we can redesign the project or prioritize activities to respond to the current needs of the Country,” Minister Tulay said.

Dr. Zabulon Yoti, WHO Acting Country Representative applauded the collaboration and commitment of the MOH, NPHIL, relevant institutions and partners towards building a resilient health system in Liberia. “The importance of resilient health systems to tackle and withstand public health emergencies like COVID-19, while providing quality routine health services, cannot be overstated” Dr. Yoti said. He reiterated WHO’s commitment for continued partnership with the MOH, donors, KOICA, and partners in this endeavor.

For his part, Dr. Sohel Saikat, the overall KOICA Project Lead expressed satisfaction that the collaboration with KOICA has brought WHO’s expertise in health systems, global health security agenda, as well as disease/life course under one platform. He said for too long we have seen emergencies and health systems working parallel or in silos, isolated from one another and now responding to COVID-19, there is more like this and other challenges with us and ahead. “Strong and resilient health systems – equipped with and prepared for emergency – are our best line of defense. This reduces the risks of small events turning into emergencies,” Dr. Sohel highlighted. He then applauded the Korean Government for the partnership that KOICA and WHO continue to demonstrate in addressing the many challenges confronting the health systems of Liberia, Ethiopia and other countries alike.

Since its inception in Liberia (April 2019), the KOICA-funded HRS project continues to adopt a collaborative, participatory and multisectoral approaches to ensure close engagement with the project teams, government counterparts, donor, beneficiaries, and other key stakeholders in achieving several milestones in line with national priorities and the overall project objectives.

To this end, the review team believes that if the recommendations from the gaps identified: i) knowledge sharing and benchmarking of best practices ii) monitoring and tracking of health service quality and resilience indicators iii) roll out the training package for Health Service quality and resilience iv) Launching and application of the Health System Simulation (SimEx) package v) Institutionalization of health service quality and resilience into pre- and in-service training programs and vii) adaptation and roll out of technical guidance for health service resilience e.g. Health Service Continuity Planning are implemented, it is likely that the milestones of the KOICA funded project will be achieved by 2023. The stakeholders also called on WHO and KOICA to roll out the project in other health facilities, considering its impacts; and pledged to take measures to ensure sustainability and continuity of the interventions.

Both emerging and reemerging health emergencies have underscored the importance of quality health services with emergency preparedness in health system. This was observed in different public health events such as the 2014-15 Ebola virus disease (EVD) outbreak in Liberia and the COVID-19 pandemic. As part of Liberia’s recovery process after the 2014-15 EVD outbreak to ensure health system functionality to maintain routine and emergency related healthcare services and response, key integrated approaches were identified. However, the operationalizing those integrated approaches in county level institutions and services remained a challenge.

The KOICA funded five-year project (2018 – 2023) on making health services resilient for public health emergencies was approved for Liberia along with Ethiopia, with the aim to build and strengthen resilient health care services to improve emergency preparedness while providing quality routine health services. Nineteen (19) healthcare facilities (public and private) from three (03) counties were selected to pilot the HSR project in Liberia.

Source: World Health Organization. Africa

Kinshasa – The Democratic Republic of the Congo has declared an outbreak of meningitis in the north-eastern Tshopo Province where 261 suspected cases and 129 deaths—a high case fatality ratio of 50%—have been reported.

Confirmatory tests carried out by the Institut Pasteur in Paris detected Neisseria meningitidis – one of the most frequent types of bacterial meningitis with the potential to cause large epidemics.

The health authorities have deployed an initial emergency team, and with the support of the World Health Organization (WHO), efforts are underway to quickly ramp up the response. A crisis response committee has been set up in Banalia, the community affected by the outbreak, as well as in Kisangani, the capital of Tshopo, to accelerate the outbreak control efforts. WHO has provided medical supplies in Banalia and plans to deploy more experts and resources.

“Meningitis is a serious infection and a major public health challenge. We are moving fast, delivering medicines and deploying experts to support the government’s efforts to bring the outbreak under control in the shortest possible time,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

More than 100 patients are already receiving treatment at home and in health centres in Banalia. Meningitis is transmitted among people through droplets of respiratory or throat secretions from infected people. Close and prolonged contact or living in close quarters with an infected person facilitates the spread of the disease. Although people of all ages can catch the disease, it mainly affects babies, children and young people.

“We are scaling up control measures within the community and rapidly investigating suspected cases in surrounding localities to treat patients and curb potentially widespread infections,” said Dr Amédée Prosper Djiguimdé, WHO Representative in the Democratic Republic of the Congo.

More than 1.6 million people aged between 1 and 29 years were vaccinated in a massive campaign in 2016 in Tshopo, which lies in the African meningitis belt that runs across the continent from Senegal to Ethiopia and comprises 26 countries. The African meningitis belt is the most vulnerable globally to recurrent outbreaks.

Meningitis outbreaks have occurred in several provinces of the Democratic Republic of Congo in the past. In 2009, an outbreak in Kisangani infected 214 people and caused 15 deaths—a case fatality ratio of 8%.

Meningitis is potentially fatal and is a medical emergency. Admission for treatment is necessary and appropriate antibiotic treatment must be started as soon as possible. Over the years, major improvements have been made on vaccines, which are specific to the type of meningitis.

In November 2020, the World Health Assembly—the global health policy-setting body—approved a roadmap for a meningitis-free world by 2030, with three key objectives: elimination of bacterial meningitis, reduction of vaccine-preventable bacterial meningitis by 50% and deaths by 70%, as well as reduction of disability and improvement of quality of life after meningitis.

Source: World Health Organization. Africa

Luanda – Angola reported this Saturday 214 new cases, 10 deaths and the recoveries of 22 patients in the last 24 hours.

According to the daily bulletin, there are 121 new cases in Luanda, 29 in Huíla, 21 in Cuando Cubango, 15 in Huambo, 9 in Namibe, 7 in Bié, 3 in Lunda Sul, 3 in Zaire, 2 in Moxico, 1 in Bengo, 1 in Benguela, 1 in Cabinda and 1 in Cuanza Sul.

With ages ranging from 11 days to 103 years, the group consists of 109 males and 105 females.

Of the deaths, 4 were reported in Cuando Cubango, 4 in Huíla, 1 in Bié and 1 in Luanda.

Among those recovered, 13 lives in Huíla, 5 in Huambo, 3 in Cuando Cubango and 1 in Moxico.

In the last 24 hours, laboratories have processed 2008 blood samples.

In the treatment centers there are 199 people hospitalized, while 172 citizens are in institutional quarantine and 1,164 contacts of positive cases are under medical surveillance.

Angola has a total of 48,475 positive cases, with 1,258 deaths, 43,817 recoveries and 3,400 active. Of the active, 12 are critical, 29 serious, 112 moderate, 46 mild and 3201 asymptomatic.

Source: Angola Press News Agency

Brazzaville – Africa is set to miss the urgent global goal of vaccinating the most vulnerable 10% of every country’s population against COVID-19 by the end of September. Forty-two of Africa’s 54 nations—nearly 80%—are set to miss the target if the current pace of vaccine deliveries and vaccinations hold, new data from the World Health Organization (WHO) shows.

Nine African countries, including South Africa, Morocco and Tunisia, have already reached the global target set in May by the World Health Assembly, the world’s highest health policy-setting body. At the current pace, three more African countries are set to meet the target. Two more could meet it if they speed up vaccinations.

“With less than a month to go, this looming goal must concentrate minds in Africa and globally. Vaccine hoarding has held Africa back and we urgently need more vaccines, but as more doses arrive, African countries must zero in and drive forward precise plans to rapidly vaccinate the millions of people that still face a grave threat from COVID-19,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

Almost 21 million COVID-19 vaccines arrived in Africa via the COVAX Facility in August, an amount equal to the previous four months combined. With more vaccines expected from COVAX and the African Union by the end of September, we could see enough doses delivered to meet the 10% target.

While many African countries have sped up COVID-19 vaccinations as vaccine shipments ramped up in August, 26 countries have used less than half of their COVID-19 vaccines.

Over 143 million doses have been received in Africa in total and 39 million people—around just 3% of Africa’s population—are fully vaccinated. In comparison, 52% of people are fully vaccinated in the United States of America and 57% in the European Union.

“The inequity is deeply disturbing. Just 2% of the over five billion doses given globally have been administered in Africa. Yet recent rises in vaccine shipments and commitments shows that a fairer, more just global distribution of vaccines looks possible,” said Dr Moeti.

Countries must continue to address operational gaps and continually improve, adapt and refine their COVID-19 vaccination campaigns. Of the 30 countries that have submitted data to WHO on operational readiness, one in two have not conducted intra-action reviews, which are key to assessing and fine-tuning progress. One in three countries have not updated their National Vaccine Deployment Plans, which instruct all COVID-19 vaccination actions in each country.

WHO is providing tailored policy advice and technical guidance and support to African countries to help enhance their logistics, planning and monitoring capacities. WHO is also working to share valuable lessons and experiences between countries.

COVID-19 cases are declining slightly in Africa but remain stubbornly high. A rising number of new cases in Central, East and West Africa pushed case numbers up to nearly 215 000 in the week ending on 29 August. Twenty-five countries—over 45% of African countries—are reporting high or fast-rising case numbers. Over 5500 deaths were reported in the week ending on 29 August.

“ Although Africa’s third wave peaked in July, the decline in new cases is at a glacial pace — far slower than in previous waves. The pandemic is still raging in Africa and we must not let our guard down. Every hour 26 Africans die of COVID-19.”

The highly transmissible Delta variant has been found in 31 African countries. The Alpha variant has been detected in 44 countries and the Beta variant in 39.

The C.1.2 variant has been identified in 114 cases in South Africa. Single cases have been found in four other African countries, and very low case numbers have been reported internationally. While first reported to WHO in July, the prevalence of this new variant remains very low. To be identified as a variant of concern there must be evidence of an impact on transmissibility, severity or immunity. This is not the case for the C.1.2 variant, yet more data is required.

“We are closely monitoring the spread and evolution of all reported variants of COVID-19, including C.1.2. Mask wearing, physical distancing and regular hand washing will help keep you safe from all variants,” said Dr Moeti.

Dr Moeti spoke during a virtual press conference today facilitated by APO Group. She was joined by Dr Nicholas Crisp, Deputy Director General, National Health Insurance, Department of Health, South Africa, and Dr Assan Abdoul Nasser, Director of Immunizations, Ministry of Public Health, Population and Social Affairs, Niger.

Also on hand to respond to questions were Dr Richard Mihigo, Coordinator, Immunization and Vaccines Development Programme, WHO Regional Office for Africa, and Dr Thierno Balde, Regional COVID-19 Deputy Incident Manager, WHO Regional Office for Africa.

Source: World Health Organization. Africa