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Boko Haram: 3.5 million in dire need of healthcare in the northeast – WHO

…Trains 80 health workers on early diseases detection in Borno

The World Health Organisation (WHO) has said that over 3.5 million people in north-eastern Nigeria are in dire need of healthcare assistance due to the Boko Haram crisis in the region.

The Acting Country Representative of WHO in Nigeria, Dr Rex Mpazanje, disclosed this yesterday at a training capacity for 80 health professionals in Borno State on Early Warning Alert and Response System (EWARS), especially in IDPs camps and other host communities of states of Borno, Adamawa, Yobe and Gombe in need of such assistance.

Dr. Rex added that, “one of the most immediate responses for WHO in this emergency is “that of setting up EWARS, to detect and facilitate rapid response to suspected disease outbreaks in internally displaced persons (IDPs) camps and host communities in Borno, Yobe, Adamawa and Gombe states,” Dr Mpazanje stated.

According to him, “WHO has so far trained 33 Disease Surveillance and Notification Officers (DSNOs) and assistant DSNOs, 50 Surveillance Officers and Camp Coordinators from targeted health facilities in Maiduguri, Borno State and will train more health personnel in other states”, he added.

The latest batch of health workers were trained in Monguno Local Government Area (LGA) on 27 September, 2016.

EWARS is a WHO disease surveillance, alert and response initiative for early detection and containment of disease outbreaks in humanitarian emergency areas. Its major objective is to strengthen and expand the existing national Integrated Disease Surveillance and Response (IDSR) system in an effort to reducing the number of cases and deaths due to epidemic-prone diseases and other health conditions.

While expressing the delight of the Borno State Government over the support of WHO in building capacity to health workers in detecting epidemics in the state, Borno State Commissioner for Health, Dr. Haruna Msheila, noted that the “State government welcomes WHO’s support to building capacity of its health personnel for early detection of epidemic-prone diseases, which will help to mount adequate public health control measures to reduce preventable morbidity and mortality.”

The Commissioner who spoke through the Executive Director, Borno Primary Health Care Development Agency (PHCDA), Dr Sule Mele stated that “we are grateful to WHO for this assistance which will greatly improve the capacity of our health system to detect and respond to any health threat and close any existing gaps.”

Some of the graduate trainees lauded the idea of the programme, describing it as apt, especially considering what the north east region has faced due to the Boko Haram crisis.

For over six (6) years, the north eastern part of Nigeria was bedevilled with insecurity that left most health facilities and infrastructure destroyed, with many health workers either killed or abducted by the insurgents, just as many have also relocated to safety zones. This trend has caused serious health and humanitarian challenges leaving millions at the risk of health hazards.

The Nation’s findings revealed that a total of 56 health facilities and 16 IDPs camps are at the moment being covered by EWARS in five (5) partially accessible local government areas (LGAs) of Maiduguri, Jere, Konduga, Mafa and Kaga with an approximated population of 1.2 million IDPs.

The EWARS combines mortality and morbidity surveillance for a total of 17 diseases/health events including all those in the existing national Integrated Disease Surveillance and Response weekly reporting of diseases such as cerebrospinal meningitis, measles and cholera, among others.

WHO will assist the State Ministry of Health to conduct an initial assessment of Health Resource Availability Monitoring System (HeRAMS) in all targeted health facilities in 16 LGAs. This will assist in establishing baseline indicators on the capacity of health facilities to deliver primary health care services to IDPs and host communities.

The results of the assessment will be used to guide the SMOH and partners to appropriately deploy scarce resources and technical support.

To ensure broad coverage including in hard-to-reach areas, WHO has further increased the EWARS coverage to Monguno LGA, where 15 health facility surveillance focal points were trained and the health facilities enrolled on the EWARS platform. These 15 health facilities include 12 IDPs camp clinics and three host community health facilities, including a secondary health facility (General Hospital Monguno). In addition, mobile phones and surveillance reporting tools were provided to ensure a smooth take-off of the project.

WHO is working with the Monguno LGA primary health care department and health sector partners to ensure timely verification of alerts and risk assessments originating from the EWARS. Health sector partners and WHO will continue to support the SMOH to ensure a sensitive surveillance system.

October 2, 2016
WHO vows to reduce malnutrition in North

The World Health Organisation (WHO) has promised to reduce malnutrition among children in the North.

Regional Director Dr. Rex Mpazanje spoke in Ibadan yesterday at a conference: “Public Health in Africa and Sustainable Development Goals”, organised by the African Federation of Public Health Association (AFPHA), in conjunction with Society for Public Health Professionals of Nigeria (SPHPN).

According to him, WHO is aware of the unfortunate development in the North, and is making moves to tackle them, especially temperature, security and other challenges militating against children.

He said WHO would partner international donors to assist on humanitarian materials.

“All 17 sustainable development goals are fashioned to serve as mechanisms to implement public health, which entails collaboration among all health elements.

“It is, therefore, compulsory for all and sundry to look at public health from its holistic sense to enhance economic development, and the 17 development goals are meant to tackle challenges beyond individual persons,” Mpazanje said.

Keynote speaker Prof. Adetokunbo Lucas said countries must take health important as the driver to their economic development.

He added that countries should learn from Cuba’s dedication to solving its health challenges.

Lucas emphasised the essence of research in global health, saying global spending on health research was $56 billion per year, 10 per cent of which is devoted to world health problems.

September 7, 2016
WHO confirms another polio case in Nigeria

Nigeria has reported its third polio case in the northeastern state of Borno, the World Health Organization (WHO) said Monday, warning more cases could appear in a major health setback.

Two other polio cases were reported in August.

Nigeria was on track to be certified free of the virus next year.

“A third child has been paralyzed by wild poliovirus type one (WPV1) in Borno state,” WHO said in a statement.

“It’s all linked to the same outbreak,” WHO said, adding: “detection of new cases is not unexpected and can be anticipated, particularly as disease surveillance is being strengthened including by conducting retrospective case searches.”

The three cases appear to come from the same strain of the disease circulating in the northeast for years, said Stephanie Mucznik, spokesperson for Rotary International, which is working with the Nigerian government to eradicate polio.

Mucznik said the latest case concerned a two-year-old boy suffering from the onset of paralysis on August 6 in the Monguno area.

“Genetic sequencing of the isolated viruses suggests they are most closely linked to WPV1 last detected in Borno in 2011, indicating the strain has been circulating without detection since that time,” Mucznik said.

Polio is a highly infectious viral disease which mainly affects young children and can result in permanent paralysis. There is no cure and it can only be prevented through immunisation.

Nigeria’s outbreak response, which includes a large immunisation campaign, is expected to continue until November and includes the neighbouring areas of Chad, Cameroon and Niger.

Nigerian Health Minister Isaac Adewole warned in August that the affected areas “have had their health facilities destroyed by insurgents” and “accessibility was a barrier to service provision.”

Since taking up arms in 2009, Boko Haram Islamist militants have captured swathes of territory in the northeast, cutting off health services for millions of people.

In the past year, the Nigerian military has recorded a series of successes against Boko Haram.

But the northeast has been devastated by the fighting, with the United Nations estimating that this year seven million people are in need of humanitarian assistance.

September 6, 2016
WHO confirms Nigeria’s third polio case

The World Health Organization (WHO) has confirmed a third case of polio in Nigeria, Rotary Club said Monday.

According to a Rotary report, a crippled toddler found in an area newly liberated from Boko Haram militants was confirmed as the latest case.

Nigeria had gone two years without recording any case of polio and was to be certified polio free next year before the recent development.

WHO warned that more cases are expected to be discovered in these areas, stressing that “it is an indicator that Nigeria’s war on polio cannot be won until it overcomes the insurgency by extremists who are violently opposed to western medicine.”

The United Nations Children’s Fund has warned that about one million children are in areas too dangerous to access.

Rotary is part of a new emergency immunization drive that vaccinated more than 1.5 million children last week in Borno, where WHO has said the virus has been circulating undetected for five years and where Boko Haram began its uprising in 2009.

The campaign is expected to spread across the country, with a plan to reach 25 million children before the end of the year.

September 5, 2016
Fidson Healthcare to open N9b WHO factory

•Govt urged to prioritise drug manufacturing

Fidson Healthcare Plc at the weekend took select journalists on a tour of its newly completed World Health Organisation (WHO)-standard manufacturing factory with a call on the government to prioritise domestic manufacturing of drugs.

Glistering in the daylight sun of Ota, Ogun State, the new plant, arguably the largest pharmaceutical manufacturing facility in Africa, is one of the few that had been shortlisted for WHO certification in Nigeria. The new plant is equipped to produce six distinct product lines-tablets, capsules, oral liquids, creams and ointments, dry powder and intravenous infusions to meet Nigeria and regional medicine needs.

Operations, Fidson Healthcare Plc Director, Mr Abiola Adebayo, who led the tour, said the factory had gulped N9 billion, with the funding generated through debts and internally generated revenue.

He said the plant was completed about eight months ago, but it could not start operations immediately because of issues of foreign exchange (forex), which has impeded raw materials sourcing.

He urged the government to treat medicine as part of national security by implementing policies that will encourage the growth and sustainable development of Nigerian domestic pharmaceutical industry.

According to him, the government should ensure a stable operating environment that would encourage long-term investments in the healthcare sector while also prioritising local manufacturers in its healthcare policies and transactions.

He said in spite of the National Drug Policy that stipulates that 70 per cent of the drugs purchased by the government should be from the local industry, many local manufacturers are still not receiving the support of the government, a situation that is compounded by non-payment for supplies by the government.

He called for a review of the present regulatory environment and regional agreements with a view to protecting the local pharmaceutical manufacturing industry, noting that the ECOWAS Common External Tariff (CET) as it is now, places Nigerian domestic manufacturing in jeopardy.

According to him, the major issue with the current CET implementation on medicines is the reduction of import duty tariff on finished pharmaceutical products to zero per cent compared with five to 20 per cent duty on raw and packaging materials respectively, thus encouraging importation to the detriment of local manufacturing.

He said government can protect the local industry by invoking the Import Adjustment Tax of the CET while working on a medium to long-term review of the agreement, adding that Nigeria constitutes 72 per cent of local pharmaceutical industry in the ECOWAS region.

“We need to take a stand to ensure local pharmaceuticals survive,” Adebayo said.

Noting that the company had to provide its own infrastructure such as power, water and road in addition to numerous community development initiatives, Adebayo said government should consider the state of Nigerian infrastructure to support domestic manufacturers, who see the operation of Nigerian pharmaceutical industry as a patriotic duty.

“We need to be protected, we need to be patronised, we need to be paid, we have the quality and we have the same global standards,” Adebayo said.

July 18, 2016
WHO faces vaccine shortage amidst acute yellow fever outbreak in Africa

Faced with the worst yellow fever outbreak in parts of Africa in decades and running low on vaccine, the World Health Organisation plans to use only fractional doses of the vaccine in some areas when it launches an emergency immunisation campaign in July.

Health experts hope that by using smaller doses they can stretch the limited vaccine supply and slow the spread of the virus. Even in smaller doses — 1/5th the normal dose, in the upcoming campaign — the vaccine still provides full immunity for at least 12 months, health officials say.

WHO spokeswoman Sarah Cumberland said in an email that fractional dosing is being considered at this stage only for Kinshasa, the Congolese capital that is home to more than 10 million people.

“The outbreak is still in early stages and it could be an effective way of containing spread with the vaccine doses available,” Cumberland said. “Logistical considerations, such as obtaining suitable syringes and training health workers in this method, mean that dose-fractioning may be easier to implement in an urban setting.”

The other areas targeted are a 47- to 62-mile belt spanning the border between the Democratic Republic of Congo and Angola, where the disease first emerged in December, and high-risk inland areas associated with local mining areas and big markets that attract large migrant populations and movement of people to and from Angola, the WHO said.

“If we don’t respond fast, this has the potential to be a big outbreak with the risk of international spread,” Cumberland said. “The focus is on getting this under control as fast as possible.”

The use of fractional dosing is significant because such a tactic “should only be used in response to an emergency situation in which current vaccine supply is insufficient,” Cumberland said. This would mark the first time that fractional dosing has been used to combat yellow fever, she said.

Daniel Lucey, an immunologist at the Georgetown University’s O’Neill Institute for National and Global Health Law, said the move “underscores the severity of the situation … and it doesn’t bode well for what is a potentially worse situation that we’re going to be in, in future.”

Angola reported 3,294 suspected cases and 347 deaths from the virus, according to the WHO’s latest statistics , while Congo had 1,106 suspected cases and 75 deaths.

Distribution of the vaccine would focus on “districts where there is high movement of people and intense trade activities, particularly the northern border districts of Angola and targeted border districts in neighboring countries,” the WHO said in a recent statement. The aim is to create an immunity wall.

Already yellow fever cases linked to the Angola outbreak have been reported in China, Kenya and Congo, the WHO said.

The disease is transmitted by Aedes aegypti mosquitoes, which also carry dengue fever and the Zika virus, and causes high temperatures, jaundice, bleeding and eventually shock and multiple organ-failure in patients with severe infection. It can be fatal.

There is no cure for yellow fever, making prevention critical. But providing treatment for those in areas currently affected by the disease has been challenging because of the lack of the vaccine.

The global stockpile of 6 million doses has been depleted three times since the start of the outbreak in December, Cumberland said. Angola has received 15 million vaccines, 3 million doses have gone to Congo and 800,000 to Uganda, which is experiencing a bout of yellow fever unrelated to the cases in Angola.

Although the stockpile has been replenished to 5 million doses, demand could quickly outstrip supply, Cumberland said.

She said yellow fever has the potential to spread fast in urban settings, particularly when breeding conditions are favorable for the mosquito.

Meanwhile, the medical humanitarian group Doctors without Borders has been undertaking mass vaccination and mosquito control efforts in certain affected areas of the Democratic Republic of Congo and providing diagnoses and treatment of patients in Angola.

July 1, 2016
WHO confirms Zika virus in Africa

The Zika virus blamed for neurological disorders and birth abnormalities in Brazil has been confirmed to be circulating in Africa for the first.

The World Health Organisation (WHO) on Friday said this is confirmed after sequenced from a sample from Cape Verde.

Matshidiso Moeti, WHO Africa Director, said the findings are of concern because it is further proof that the outbreak is spreading beyond South America and is on the doorstep of Africa.

She said the information would help African countries to re-evaluate their level of risk and adapt and increase their levels of preparedness.

Moeti said she would not recommend strict travel restrictions to try to stop the spread of the disease.

May 20, 2016
WHO: 422m adults live with diabetes

The number of people living with diabetes has quadrupled since 1980 to 422 million adults, with most living in developing countries, a World Health Organisation (WHO) report said yesterday.

The report was presented by WHO’s Director-General Margaret Chan, ahead of the World Health Day today. It highlighted the need to step up prevention and treatment of diabetes.

The report documented the number of people living with diabetes with its prevalence growing in all regions of the world.

It said in 2014, 422 million adults had diabetes, compared with 108 million in 1980.

The epidemic of diabetes has major health and socio-economic impacts, especially in developing countries. Diabetes caused 1.5 million deaths in 2012.

According to the report, higher-than-optimal blood glucose caused additional 2.2 million deaths by increasing the risks of cardiovascular and other diseases.

“If we are to halt the rise in diabetes, we need to rethink our daily lives, to eat healthy, be active and avoid excessive weight gain.

“Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes,’’ Chan said.

The WHO called for expanding health-promoting environments to reduce diabetes risk factors, such as physical inactivity and unhealthy diets, and strengthening national capacities to help people with diabetes receive treatments.

April 7, 2016
422m adults live with diabetes – WHO

The number of people living with diabetes has almost quadrupled since 1980 to 422 million adults, with most living in developing countries, a World Health Organisation (WHO) report said on Wednesday.

The report was present by WHO Director-General, Margaret Chan, ahead of World Health Day on Thursday, and it highlighted the need to step up prevention and treatment of diabetes.

The report documented the number of people living with diabetes with its prevalence growing in all regions of the world.

It said that in 2014, 422 million adults had diabetes, compared with 108 million in 1980.
The epidemic of diabetes has major health and socio-economic impacts, especially in developing countries. Diabetes caused 1.5 million deaths in 2012.

According to the report, higher-than-optimal blood glucose caused an additional 2.2 million deaths by increasing the risks of cardiovascular and other diseases.

“If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives, to eat healthily, be physically active, and avoid excessive weight gain.

“Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes,’’ Chan said.

The organisation called for expanding health-promoting environments to reduce diabetes risk factors, like physical inactivity and unhealthy diets, and strengthening national capacities to help people with diabetes receive treatment.

April 6, 2016
Emergency response to Ebola underway in Liberia -WHO

The World Health Organisation (WHO) and Ministry of Health teams in Liberia and Guinea are investigating the origins of transmission in case of Ebola.

This came up as the epidemic flared-u after learning that a woman who died from Ebola in Liberia last week had recently travelled from Guinea with her three young children.

The UN health agency said in a statement that Liberian health authorities have reported that the woman arrived with her children on 21 March 2016, shortly after her husband died in Guinea from unknown causes.

She stayed with relatives in Monrovia, where she developed symptoms over the following week. She initially sought care in local clinics and died en route to a Monrovia hospital on March 21.

The statement said one of her boys had since tested positive for Ebola virus disease, bringing the number of cases in this flare-up to two.

He is being treated at an Ebola care facility in Monrovia.

Her two other children, plus her sister, are being closely observed by medical staff.

WHO said Liberian health authorities quickly reactivated the country’s emergency response mechanisms and with support from key partners, immediately set to work tracing, isolating and monitoring contacts of the confirmed cases.

That the experts would intensify infection prevention and disease control measures and stepping up community outreach.

Teams plan to initiate vaccination of contacts with the Ebola vaccine to prevent potential spread of the virus.

It said 84 contacts of the cases had been identified in Liberia as of Monday and had been placed under medical observation.
Affected households have been offered food, water, hygiene supplies and counseling.

These latest cases in Liberia mark the country’s third flare-up of Ebola virus disease since its original outbreak was declared over on 9 May 2015.

The previous flare-up in Liberia began in November 2015 and ended 14 January 2016.

Last week, WHO said the Ebola epidemic in West Africa no longer represented a Public Health Emergency of International Concern, asserting that Guinea, Liberia and Sierra now had the detection and response capacities to effectively manage small outbreaks when they occur.

While the risk of flare-ups is declining, WHO reiterated that more must be expected, largely due to virus persistence in some survivors.

Nearly 1,000 WHO specialists remain in the region ready to contribute to emergency response operations when needed, and in the meantime, working to recover and strengthen health systems in the three countries.

April 5, 2016