Botswana is first country with severe HIV epidemic to reach key milestone in the elimination of mother-to-child HIV transmission

Brazzaville, Geneva, Nairobi – Botswana has become the first high-burden country to be certified for achieving an important milestone on the path to eliminating mother-to-child transmission of HIV by the World Health Organization (WHO).

High-burden HIV countries are defined as those with more than 2% of pregnant women living with the virus. Botswana has achieved the “silver tier” status, which moves it closer to eliminating mother-to-child HIV transmission. WHO awards this certification to countries which have brought the mother-to-child HIV transmission rate to under 5 %; provided antenatal care and antiretroviral treatment to more than 90 % of pregnant women; and achieved an HIV case rate of fewer than 500 per 100,000 live births.

“This is a huge accomplishment for a country that has one of the most severe HIV epidemics in the world – Botswana demonstrates that an AIDS-free generation is possible,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “This groundbreaking milestone is a big step forward in ending AIDS on the continent and shows how visionary political leadership aligned with public health priorities can save lives. I look forward to other African countries also reaching this goal.”

Globally, 15 countries have been certified for eliminating mother-to-child HIV transmission. None of them had an epidemic as large as Botswana. The country’s feat to date on its journey to elimination is the result of a national response strategy spanning two decades. In 1999 and facing an HIV prevalence rate as high as 30%, Botswana initiated an aggressive programme to prevent mother-to-child transmission.

“Botswana’s pathfinding accomplishment demonstrates the remarkable progress that can be achieved when the needs of mothers living with HIV and their children are prioritized,” said Winnie Byanyima, UNAIDS Executive Director. “Children are among the groups left furthest behind in the HIV response. Addressing this inequality and preventing new HIV infections in children is critical if we are to end AIDS. Political commitment, strong leadership and the hard work of dedicated health care workers and communities in Botswana have delivered impressive results.”

Women living with HIV who do not receive antiretroviral (ARV) medicine have a 15–45% chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding. That risk drops to less than 5% if treatment is given to both mothers and children throughout the stages when transmission can occur. Botswana quickly achieved national ARV coverage before going on to implement increasingly effective regimens, following WHO guidance.

In 2013, Botswana became one of the first countries in the world to implement the so-called ‘Option B+’, a plan for treating all pregnant and breastfeeding women living with HIV with a highly effective lifelong triple antiretroviral treatment regimen at the time of diagnosis.

Mohamed Fall, UNICEF Regional Director for Eastern and Southern Africa, asserted that the country’s progress could serve as an example for others.

“We applaud Botswana for this remarkable achievement, which serves as inspiration to other countries in Eastern and Southern Africa,” said Mr Fall. “The progress on prevention of mother to child transmission of HIV in this region is truly a public health success, with more than 1.7 million new infections in children averted since 2010. We look forward to congratulating other countries very soon and continuing the journey to full and sustained elimination over time.”

The global validation criteria and processes date to 2015, when UNAIDS, UNICEF, WHO and other partners created the Global Validation Advisory Committee to standardize the measurement of achievements for eliminating mother-to-child transmission of HIV and syphilis. In 2017 and in recognition of the achievements made by countries with a high burden of HIV that were demonstrating significant and sustained reductions in the mother-to-child transmission rate, new Path to Elimination criteria were introduced. The elimination agenda has broadened to a “triple elimination” of mother-to-child transmission of HIV, syphilis and hepatitis B.

Botswana is now updating its guidance regarding syphilis and will expand its elimination objectives moving forward.

Source: World Health Organization. Africa

World AIDS Day 2021: Confronting inequalities through concerted actions between the authorities, NGOs and civil society

Mauritius marked World AIDS Day 2021 on 01 December 2021 at the Yves Cantin community hospital, Black River under the theme “End inequalities. End AIDS. End pandemic”. This year’s theme is of utmost importance at a point in time where the COVID-19 pandemic has further widened inequalities among the world populations.

The HIV/AIDS national campaign was launched by the Minister of Health and Wellness, Dr Hon Kailesh Kumar Jagutpal in the presence of the WHO Representative, Dr Laurent Musango, the National HIV/AIDS Coordinator, Dr Mungala Devi Soyjauda, Mrs S. Kalasapatan-Chellen, Ag Deputy Permanent Secretary, Dr A. Dinassing, Director Public Health and other personalities.

Indeed, 40 years after the first HIV cases were reported, AIDS remains a major public health concern due to unequal access to care and the situation has worsened with the COVID-19 pandemic as people living with HIV appear to be at elevated risk for virus-related illness and death.

Dr Hon. K.K. Jagutpal inaugurated a new caravan in view of strengthening HIV Screening in the community before launching the National HIV/AIDS campaign. The campaign this year is focusing on HIV Screening and Counselling Day islandwide to allow the maximum number of persons to know their status. Other activities include intensive sensitization and awareness programmes on national television and radio, and to reach the adolescents and young adults, virtual HIV prevention sessions by psychologists are also planned while HIV testing and counselling in the community are being organized with the close collaboration of NGOs and the Health Ministry.

One remarkable public health success is the elimination of mother-to-child HIV transmission across the globe. Data submitted by countries are evaluated by WHO before certification of elimination of mother-to-child HIV transmission is issued. “In this regard, Mauritius needs to make more effort in the collection of the data on mother-to-child HIV transmission to be able to be evaluated for certification by WHO,” said Dr L. Musango.

The WHO Representative advocated for equal access to HIV prevention, testing, treatment and care, including COVID-19 vaccinations and services. The close collaboration between the Ministry of Health and Wellness and the local NGOs, namely Ailes liberté Espoir et Sollidarité (AILES) and Prevention Information et Lutte Contre le SIDA (PILS) was highly appreciated. To recall, NGOs have been playing a key role in the chain to ensure essential health services during the lockdown and curfew. This has enabled the home distribution of Anti Retro Viral medicine to those under treatment to prevent issues related to immunocompromised and increased vulnerability vis à vis COVID-19. Concerted actions can help to confront inequity and improve health.

Source: World Health Organization. Africa

South Africa Teenage Pregnancy Spikes During Pandemic

South Africa’s teenage pregnancy rate has jumped 60% amid the COVID-19 pandemic, an increase affecting the education of many young women and their hopes to escape the cycle of poverty.

When schoolgirls in South Africa become pregnant, only one-third return to class — a major factor contributing to socioeconomic disadvantage among youth.

Serena, who does not want her real name to be used, was 15 years old when she gave birth to a daughter.

“I didn’t know what to do. I was confused. I was scared. I was devastated,” she said. “Sometimes I can’t balance my life, my education, and the baby, but due to the support of my parents, I can do that.”

Serena’s experience as a teen mother was made more difficult by her parents’ initial rejection and being ostracized by the local community.

Her mother, Rebecca, said, “I was very upset, very upset and too emotional, but all in all, ‘Serena, this is not the end of the world, the main purpose is that you must … go to school, attend school regularly, respect your teachers as you respect your parents at home.'”

Eddie Kekana, a primary school principal in Johannesburg, says the education system should put a priority on sex education.

“My school is situated in an informal settlement, where there are serious social-economic factors leading to the high rate of teenage pregnancy,” he said. “COVID-19 also exacerbated the situation. We should actually start collaborating, and then take responsibility educating our young people about this particular kind of a problem.”

Implementation of sex education programs was abandoned in the face of resistance by many parents, says Mugwena Maluleke, the head of a South African teachers’ union.

“When it was supposed to be introduced, the sexuality education, the communities started to make a lot of arguments, so it had to be stopped and, therefore, the training didn’t take place,” Maluleke said. “The communities were not happy with that, and we are seeing the consequences of not having sexuality education; is the highest rate of teenage pregnancy.”

While many communities and parents opposed sex education in schools, some parents like Serena’s mother supported the programs.

“It depends what kind of parents we are, but naturally I must be free with my daughters to speak about sex because it is very much important,” Rebecca said. “They must know everything about sex, even at school, no problem, we don’t have any problem about that.”

The controversy continues, but has gained new urgency with the latest increase in teen pregnancy.

Source: Voice of America

Strengthening management of childhood cancer in Zimbabwe

Bulawayo, Zimbabwe – Zimbabwe is making great strides in strengthening cancer management as part of the country’s efforts to make Non-Communicable Diseases (NCDs) services more accessible. With the growing number of NCDs and the impact COVID-19 has had on people with cancer and other NCDs, steps have been taken to come up with a comprehensive cancer strategy that looks at all aspects of cancer management in the country. In particular, the Government of Zimbabwe through the Ministry of Health and Child Care (MoHCC) has shown interest to be one of the focus countries for the World Health Organization (WHO) Global Initiative for Childhood Cancer (GICC) in the WHO AFRO region. This initiative by WHO enables the participating countries to access technical and financial support to strengthen the health systems and raise awareness on childhood cancers. The move is expected to improve the landscape of cancer management for children in Zimbabwe.

In this regard, a multi-stakeholder meeting was held in Bulawayo recently to discuss practical steps the country needs to take to be part of the initiative.

The WHO Global Initiative for Childhood Cancer was launched in 2018 on the sidelines of the UN General Assembly with the aim to increase cancer survival rates for children with cancer to at least 60 percent globally by 2030. Childhood cancers outcomes affect low to medium countries (LMICs) more where the survival rate is 20% compared to 80% in the developed countries. The low childhood cancer survival in LMIC is mainly due to lack awareness amongst both communities and health workers. This results in late presentation. Limited access to therapeutic care like chemotherapy which is expensive and radiotherapy due to breaking down equipment is another challenge which the initiative will try to address.

According to the National Cancer Registry, a total of 253 childhood cancers (age 0-14) of all races were registered in 2017. These comprised of 151 (59.7%) boys and 102 (40.3%) girls. Pediatric cancers accounted for 3.3% of all the cancers recorded in 2017.

The most common childhood cancers of all races recorded in 2017 according to the International Classification of Childhood Cancer (ICCC) were as follows: leukaemia (21%), retinoblastoma (14%), renal tumours (13%), lymphoma (10%), central nervous system (9%), soft tissue (9%), bone tumours (4%) and neuroblastoma (4%). Other unspecified malignant tumours accounted for 16% on the childhood cancers. The MoHCC confirms that childhood cancers are common and require the government and partners to step up the response in awareness and early screening;

“The figures we have been recording are too high and an intervention is needed to ensure that awareness is raised in communities. The GICC will be our starting point,” says Dr Justice Mudavanhu, MoHCC Deputy Director for Non-Communicable Diseases (NCDs).”

In most low- and middle-income countries like Zimbabwe premature deaths from childhood cancers can be reduced by strengthening early and accurate diagnosis. This can only be done by strengthening the primary health care workers. This is one of the objectives of the Global Initiative for childhood cancers.

The initiative is supported by partners among them St Jude Children’s Research Hospital in the United States, which is the first WHO Collaborating Centre for Childhood Cancer.

Other countries in the AFRO region which have already joined the initiative have benefited a lot in strengthening their health systems to identify childhood cancers early. These include Ghana, Senegal and Zambia.

Through this initiative, WHO will support governments to carry out a situational analysis on leadership and governance capacity of the country, the capacity to screen and early diagnose childhood cancers and the country’s capacity to manage common childhood cancers once diagnosed. WHO is providing technical support to MoHCC and continue to on the importance of improving outcomes for children. This can only be done by ensuring early and accurate diagnosis followed by effective treatment, the major components the initiative seeks to address.

“High mortality rates due to childhood cancers have been mainly due to delayed diagnosis or indeed misdiagnosis, difficulties in accessing care in our setting, there is also a high rate of abandonment of treatment due to financial and sociocultural burden that childhood cancer brings,” adds Dr Sharon Kapambwe, WHO African Region Technical Officer for Cancer.

Dr Kapambwe also confirmed WHO commitment to work with MoHCC and all stakeholders to ensure Zimbabwe is part of the initiative and implements the initiative successfully.

“WHO looks forward to working with the Zimbabwean government to come up with a sustainable childhood cancer programme that will improve chances of survival for children with cancer in the country and reduce their suffering.”

Source: World Health Organization. Africa

Fauci: Existing Coronavirus Vaccines Provide ‘Some’ Protection Against Omicron Variant

The top U.S. infectious disease expert said Tuesday that vaccinated Americans have “some degree of protection” against the new omicron variant of the coronavirus, but that scientists will not know for a few weeks how vaccines may need to be altered to best fight it.

Dr. Anthony Fauci, President Joe Biden’s top medical adviser, said at a White House coronavirus news briefing that the omicron “mutation profile is very different from other variants” of the coronavirus.

While he said the three existing vaccines used in the U.S. could prevent people who have been inoculated from getting seriously ill from the omicron variant, it “remains uncertain … speculative” whether they will fully work against people getting sick.

“We believe it is too soon to tell about the severity” of the omicron variant, he said. “We should have a much better idea in the next few weeks.”

To date, he said, 226 cases of the omicron variant have been identified in 20 countries across the globe, but none so far in the United States. Health officials, however, say they assume the variant eventually will spread to the United States.

“We are actively looking for the omicron variant in the U.S.,” said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

Stephane Bancel, chief executive of Moderna, which produces one of the vaccines used in the U.S., predicted in an interview with the Financial Times that existing vaccines would be much less effective in combating the omicron variant than the previous four variants of the coronavirus.

“There is no world, I think, where (the effectiveness) is the same level … we had with delta,” Bancel said, referring to the highly contagious variant that is the predominant strain throughout the U.S. and was first detected in India in late 2020.

His comments sent U.S. stock indexes tumbling, as investors feared the effect of the omicron variant on the world economy, in which many countries are still struggling from the coronavirus onslaught that started in early 2020.

Bancel said it could take months for pharmaceutical companies to manufacture effective new vaccines to deal with the specific molecular makeup of the omicron variant.

Dutch officials said Tuesday that they detected the omicron variant in tests almost two weeks ago, days earlier than when two flights from South Africa transported infected passengers to the Netherlands.

Walensky said 45 million adults are unvaccinated in the U.S., and millions more children, ages 5 to 18, are eligible to get shots, but their parents have yet to get them inoculated.

In addition, Jeffrey Zients, the White House COVID-19 response coordinator, said that 100 million vaccinated people in the U.S. are eligible for booster shots but have yet to get them.

He, too, said that vaccinations provide “some protection” against the omicron variant and that “boosters help that.”

“We want to make sure Americans are doing all they can to protect themselves,” he said.

Source: Voice of America

FAB reiterates basketball relaunching

Benguela – Basketball in Angola is being re-launched and needs the support of the whole society, the head of Angolan Basketball Federation (FAB) Moniz Silva said Saturday.

Speaking at the end of the first phase of the FIBA World Basketball Cup qualification Asia held in Angola’s coastal Benguela province, Moniz Silva underscored the new stage the Angolan basketball is going through that requires time and patience from the fans for the national team to return to conquer trophies in Africa again.

“The renewal process is gradual, there is a group of forty players with possibilities of being selected” he said.

The FAB official said he considers as normal the solo defeat the national team had in the qualifier since Angola had faced a much stronger team.

“Here we had only half of those who were in Rwanda and we knew the risk we were taking. In the next window we will be stronger”, Mr. Silva said, adding that besides the supply of material the training component is also one of the priorities of the federation for basketball to be widespread nationwide.

Source: Angola Press News Agency

National team finish sixth in FIBA World Cup qualifying point’s average

Benguela – Angola national basketball team ended the first phase of the FIBA World Cup in the sixth position with 209 points corresponding to an average 69.7 points per game.

Angolans just finished above Guinea (7th place) with 204 points, equivalent to 68.0 points average and Central Africa Republic in the 8th position with 183 points and 61.0 points average.

Nigeria finished at the top among the countries in the two groups (A and C) that competed in Angola southern Benguela province after reaching 238 points an average of 79.3, followed by Côte d’ Ivoire with 229 an average 76.3 per match and Uganda in third position with 212, average 70.2 points per match.

In Group A, Nigeria is in first position with 5 points, the same as Mali in second, Uganda is third with 4, while Cape Verde is fourth with 4 points.

In group C, Cote d`Ivoire was first with 6 points, followed by Angola with 5, Guinea with 4 and Central African Republic with 3.

Source: Angola Press News Agency

Government holds public consultation for projects to combat drought

Ondjiva – The Ministry of Energy and Water on Wednesday (01), in Cunene province, held the public consultation act of the structuring projects to combat drought in Curoca and Cahama municipalities.

The referred study is part of the Emergency Programme to Fight Drought in Cunene province, described in lots 7, 8 and 9.

The act will take place in Oncócua commune, Curoca municipal headquarters, 340 kilometres from Ondjiva city, under the guidance of the Minister of Energy and Water, João Baptista Borges.

It aims to make public and private entities, local civil society organisations, as well as people interested in the referred municipalities, aware of the projects under development and collect their impressions and recommendations in order to ensure the best solutions for the region.

The solutions to be presented include the construction of a dam on the Caculuvar River in the Cova do Leão section, 17 metres high with capacity to store 25 million m³ of water.

Also part of the programme is the construction of water supply systems for the Cahama and Otchinjau Communes from the Cova do Leão catchment.

Source: Angola Press News Agency

New Twitter CEO Steps From Behind the Scenes to High Profile

Newly named Twitter CEO Parag Agrawal has emerged from behind the scenes to take over one of Silicon Valley’s highest-profile and politically volatile jobs.

But his prior lack of name recognition, coupled with a solid technical background, appears to be what some big company backers were looking for to lead Twitter out of its current morass.

A 37-year-old immigrant from India, Agrawal comes from outside the ranks of celebrity CEOs, which include the man he’s replacing, Jack Dorsey, Facebook’s Mark Zuckerberg or SpaceX and Tesla’s Elon Musk. Those brand-name company founders and leaders have often been in the news — and on Twitter — for exploits beyond the day-to-day running of their companies.

Having served as Twitter’s chief technology officer for the past four years, Agrawal’s appointment was seen by Wall Street as a choice of someone who will focus on ushering Twitter into what’s widely seen as the internet’s next era — the metaverse.

Agrawal is a “‘safe’ pick who should be looked upon as favorably by investors,” wrote CFRA Research analyst Angelo Zino, who noted that Twitter shareholder Elliott Management Corp. had pressured Dorsey to step down.

Elliott released a statement Monday saying Agrawal and new board chairman Bret Taylor were the “right leaders for Twitter at this pivotal moment for the company.” Taylor is president and chief operating officer of the business software company Salesforce.

Agrawal joins a growing cadre of Indian American CEOs of large tech companies, including Sundar Pichai of Google parent Alphabet, Microsoft’s Satya Nadella and IBM’s Arvind Krishna.

He joined San Francisco-based Twitter in 2011, when it had just 1,000 employees, and has been its chief technical officer since 2017. At the end of last year, the company had a workforce of 5,500.

Agrawal previously worked at Microsoft, Yahoo and AT&T in research roles. At Twitter, he’s worked on machine learning, revenue and consumer engineering and helping with audience growth. He studied at Stanford and the Indian Institute of Technology, Bombay.

While Twitter has high-profile users like politicians and celebrities and is a favorite of journalists, its user base lags far behind old rivals like Facebook and YouTube and newer ones like TikTok. It has just over 200 million daily active users, a common industry metric.

As CEO, Agrawal will have to step beyond the technical details and deal with the social and political issues Twitter and social media are struggling with. Those include misinformation, abuse and effects on mental health.

Agrawal got a fast introduction to life as CEO of a high-profile company that’s one of the central platforms for political speech online. Conservatives quickly unearthed a tweet he sent in 2010 that read “If they are not gonna make a distinction between muslims and extremists, then why should I distinguish between white people and racists.”

As some Twitter users pointed out, the 11-year-old tweet was quoting a segment on “The Daily Show,” which was referencing the firing of Juan Williams, who made a comment about being nervous about Muslims on an airplane.

Twitter did not immediately respond to a message for comment on the tweet.

Source: Voice of America

UN: Pandemic to Cost Global Tourism $2.0 Trillion in 2021

The coronavirus pandemic will cost the global tourism sector $2.0 trillion in lost revenue in 2021, the U.N.’s tourism body said Monday, calling the sector’s recovery “fragile” and “slow.”

The forecast from the Madrid-based World Tourism Organization comes as Europe is grappling with a surge in infections and as a new heavily mutated COVID-19 variant, dubbed Omicron, spreads across the globe.

International tourist arrivals will this year remain 70-75% below the 1.5 billion arrivals recorded in 2019 before the pandemic hit, a similar decline as in 2020, according to the body.

The global tourism sector already lost $2.0 trillion (1.78 trillion euros) in revenues last year due to the pandemic, according to the UNWTO, making it one of sectors hit hardest by the health crisis.

While the U.N. body charged with promoting tourism does not have an estimate for how the sector will perform next year, its medium-term outlook is not encouraging.

“Despite the recent improvements, uneven vaccination rates around the world and new Covid-19 strains” such as the Delta variant and Omicron “could impact the already slow and fragile recovery,” it said in a statement.

The introduction of fresh virus restrictions and lockdowns in several nations in recent weeks shows how “it’s a very unpredictable situation,” UNWTO head Zurab Pololikashvili told AFP.

“It’s a historical crisis in the tourism industry but again tourism has the power to recover quite fast,” he added ahead of the start of the WTO’s annual general assembly in Madrid on Tuesday.

“I really hope that 2022 will be much better than 2021.”

While international tourism has taken a hit from the outbreak of disease in the past, the coronavirus is unprecedented in its geographical spread.

In addition to virus-related travel restrictions, the sector is also grappling with the economic strain caused by the pandemic, the spike in oils prices and the disruption of supply chains, the UNWTO said.

Pololikashvili urged nations to harmonize their virus protocols and restrictions because tourists “are confused and they don’t know how to travel.”

International tourist arrivals “rebounded” during the summer season in the Northern Hemisphere thanks to increased travel confidence, rapid vaccination and the easing of entry restrictions in many nations, the UNWTO said.

“Despite the improvement in the third quarter, the pace of recovery remains uneven across world regions due to varying degrees of mobility restrictions, vaccination rates and traveller confidence,” it added.

Arrivals in some islands in the Caribbean and South Asia, and well as some destinations in southern Europe, came close to, or sometimes exceeded pre-pandemic levels in the third quarter.

Other countries, however, hardly saw any tourists at all, particularly in Asia and the Pacific, where arrivals were down 95% compared to 2019 as many destinations remained closed to non-essential travel.

A total of 46 destinations — 21% of all destinations worldwide — currently have their borders completely closed to tourists, according to the UNWTO.

A further 55 have their borders partially closed to foreign visitors, while just four nations have lifted all virus-related restrictions — Colombia, Costa Rica, Dominican Republic and Mexico.

The future of the travel sector will be in focus at the WTO annual general assembly, which will run until Friday.

The event — which brings together representatives from 159 members states of the U.N. body — was original scheduled to be held in Marrakesh.

But Morocco in late October decided not to host the event due to the rise in COVID-19 cases in many countries.

Before the pandemic, the tourism sector accounted for about 10% of the world’s gross domestic product and jobs.

Source: Voice of America