WHO stops short of declaring Ebola crisis a global health emergency

 The Ebola outbreak in the DRC still does not warrant the declaration of a global health emergency, the World Health Organization said Friday. This is a decision that is sure to trigger substantial debate as the virus continues to spread unabated, writes STAT, a publication that provides analysis of biotechnology and life sciences.

In the past two weeks, the case count has surged by double digits most days over the past two weeks — a far faster rate than earlier in the epidemic.

“The decision was made by WHO Director-General Tedros Adhanom Ghebreyesus on the basis of a recommendation by a committee of outside experts that has now concluded twice that the outbreak does not warrant an emergency declaration. Tedros said he accepted their advice. The panel’s chairman, Robert Steffen, said there was an explanation for the rising numbers, noting that the new cases are concentrated in or originating from Katwa and Butembo, where the outbreak response teams have had difficulty gaining the cooperation of the communities. “There was turmoil in these areas, which were just not accessible for a certain period of time.”

Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, disagreed with the call. “I do think it’s a mistake. I do think conditions have been met for declaring it. It’s at least as serious as public health emergencies of international concern that have been declared so in the past,” Inglesby told STAT. “And I think it’s a mistake because I think it could have drawn in more international attention, political will and support.”

april 15, 2019


Lancet: Global Health has forgotten the Arab world

In a 2014 Lancet Series on Health in the Arab World, Abbas El-Zein and colleagues wrote about “a choice between, on the one hand, regional cooperation and ecological integration for the sake of survival and, on the other hand, war, sectarian divisions, mistrust, and little hope in the future”. 5 years on, that choice has been made, writes Richard Horton, the current editor-in-chief of the Lancet in April 2019, referencing many Arab nations that have undergone upheaval: Iraq, Syria, Yemen, Libya, Egypt, and the occupied Palestinian territory.  The editorial notes that the health community, including international health institutions, has utterly failed to prioritise a region facing endemic conflict and conflagration.

The only health organisation with an exclusive mandate to address health in the Arab World is WHO's Regional Office for the Eastern Mediterranean (EMRO). Ten “key initiatives” for 2019 include creating an “Alliance for Health for All”, revitalising community-based programmes, and promoting patient safety.

“But these priorities and initiatives are pedestrian”, writes Horton. They do not match the urgency of multiple predicaments facing Arab countries. What can be done? Instead of waiting for governments to act, the health and medical research communities could do more to encourage collaborations with Arab nations. The Arab World is home to world-class universities—the American University of Beirut, Birzeit University, the University of Jordan, to name but a few. By forging bilateral educational, clinical, and research partnerships, possibilities for a transformational shift in opportunities for a new Arab generation are palpable. (We have seen these possibilities realised during 10 years of The Lancet Palestinian Health Alliance.) Arab countries are an illuminatingly rich arena for health action. The Qur'an underlines the importance of knowledge (20.114), reflection (45.13), and education (96.5). Scaling up programmes of scientific and professional exchange would justly honour these Qur'anic commitments”.

April 8, 2019


SUPERBUGS FLOURISH AT HEALTH FACILITIES

The Telegraph reports that one in four healthcare facilities around the world lack even basic access to water services. This exacerbates the spread of drug resistant superbugs.

In the first comprehensive review of access to water, sanitation and hygiene services (WASH) in healthcare centers, UNICEF and the World Health Organization (WHO) found that roughly two billion people use health facilities lacking basic water services globally – while almost 900 million people use centers with no water services at all. The report was published on 3 April 2019. “Water, sanitation and hygiene services in health facilities are the most basic requirements of infection prevention and control, and of quality care,” said António Guterres, United Nations Secretary-General. Poor sanitary conditions have been directly linked to rising rates of so-called superbugs, which develop when bacteria and other pathogens become resistant to antibiotics.

The WHO has listed antimicrobial resistance as one of its top threats to global health, and current estimates suggest that nearly 10 million people a year will die from untreatable superbugs by 2050 – a dramatic increase from the 700,000 deaths linked to antibiotic resistance in 2014. In clinics without adequate WASH facilities this is common, as antibiotics prevent and treat infectious diseases which could have been avoided with better hygiene practices. 

april 1 2019


Disease inevitable following cyclone in Southern Africa

Officials have warned that disease is threatening to aggravate the already dire conditions facing millions of survivors following the powerful tropical cyclone which ravaged southern Africa 10 days ago, reports Agence France Press.

Cyclone Idai smashed into Mozambique's coast unleashing hurricane-force wind and rain that flooded swathes of the poor country before battering eastern Zimbabwe. More than 700 people were killed across the two nations. Speaking at a briefing in Beira, 1,000 kilometres (620 miles) northeast of the Mozambique capital Maputo, Lands Minister Celso Correia said it iss now "inevitable that cases of cholera and malaria will arise".

The World Food Programme said Friday that the humanitarian disaster unfolding in Mozambique was on par with the situation in Yemen and Syria which are both in the grip of civil wars. "The government is already setting up a cholera treatment centre to mitigate cholera. We should not be frightened when cholera issues arise," added Correia, describing efforts to control the emerging humanitarian crisis.

March 25, 2019


Nigeria: “the end of HIV/Aids in sight”

President Muhammadu Buhari of Nigeria has said the trends reflected in the latest Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) report signal that the end of the disease is in sight in the country, reports African Daily Voice.

Buhari said the availability of accurate and reliable HIV data for the country is crucial for planning effective health interventions to arrest the HIV epidemic and ultimately rid the country off this health threat. “The Nigeria AIDS Indicator and Impact Survey were designed to provide the data we need to plan adequately and consolidate on the progress towards the elimination of HIV in Nigeria.

The official HIV prevalence for persons aged 15-49 years in Nigeria is now 1.4 percent. An estimated 1.9 million Nigerians are now living with HIV with about one million persons on treatment.

March 19, 2019


Science inching forward with HIV “Cure” Research

World headlines from the Conference on Retroviruses and Opportunistic Infections (CROI) held in Seattle last week are that for the second time, a bone marrow transplant eliminates HIV from the blood of a patient. Given its complexity and cost, this method is not likely to be used on a large scale.

Researchers from University College London (UCL) reported the case of an HIV-positive man who, after receiving a bone marrow transplant, no longer showed any sign of the AIDS virus, 18 months after he had stopped taking antiretroviral therapy. Dubbed “the London patient”, the man’s “recovery” follows a similar route of that of “the Berlin patient”, Timothy Brown, whose case was reported 11 years ago. Both men had the same type of cancer and both had stem cell transplants, from donors with a rare genetic mutation that resists HIV infection.

Scientists have warned that this breakthrough should not be described as a cure or as healing, as it would give false hope. Michel Sidibé, executive director of UNAIDS did emphasize that HIV science was given a boost with this news. “It gives us great hope for the future that we could potentially end AIDS with science, through a vaccine or a cure. However, it also shows how far away we are from that point and of the absolute importance of continuing to focus HIV prevention and treatment efforts”, said Sidibé.

mar 11, 2018


Poorest countries in the world lag far behind in health spending 

Spending on health has increased around the world but lower income countries still lag behind, reports The Telegraph.  

The analysis of spending on health by all 194 member states of the World Health Organization has found that in 2016 the world spent $7.5 trillion (£5.75 trillion) on health, close to 10% of global gross domestic product (GDP). On average $1,000 was spent on health per person in 2016 but half of the world’s countries spent less than $350 per person. According to the analysis only 20 per cent of the world’s population live in high income countries but these countries account for almost 80 per cent of spending on health.

Over the period studied, as countries became richer their domestic spending on health increased and their reliance on aid decreased. Upper middle income countries saw the greatest increase in domestic spending: from $130 per person per year in 2000 to $270 in 2016. This was accompanied by a drop in external aid. The analysis found that nearly half of donor funds for health went to HIV/Aids (28% of all donor funds), malaria (14%) and tuberculosis (4%). The report found that the external funding for HIV/Aids does not show a clear relationship with national prevalence or income level, varying by as much as $700 per person in different countries. The report said this discrepancy warranted further research. 

feb 25, 2018


Safety concerns again affect Ebola response in DRC

International aid agency Médecins Sans Frontières (MSF) has suspended work in an area of Democratic Republic of Congo close to where authorities are fighting an outbreak of Ebola, after two local staff members were abducted by gunmen, reports The Telegraph.

"On the February 8, MSF lost contact with two colleagues following an incident that took place between Nyabiondo and Masisi, North-Kivu province," an MSF spokesperson said. "Following that incident, MSF decided to suspend partially its activities in the health zone of Masisi. The staff have since returned safely. "In order to ensure its team security, MSF reduced its staff on the field but continue to provide vital medical care in the General Hospital of Masisi."

All other MSF activities, including its work to control Ebola, in the vast North Kivu province will continue as normal. 

According to the latest WHO Ebola update, the volatile security situation in North Kivu “at times limits the implementation of response activities,” with the risk of the disease spreading regionally or nationally still very high. 

feb 19, 2019


Ebola vaccine used to contain the disease in DRC

The World Health Organisation (WHO) is confident that an experimental vaccine being used in DRC is playing a major role in controlling the spread of Ebola. Cases of Ebola haven’t increased at the same rates as was the case in 2014 in West Africa before the vaccine was introduced. The rollout of the rVSV-ZEBOV in the DRC has been done using the “ring vaccination” strategy, which involves vaccinating the first and second degree contacts of an infected individual. The “immediate” group didn’t contract Ebola while some individuals in the delayed group contracted the disease. This evidence gave the WHO hope that the vaccine could be 100% effective.

Yet, six months after the first case was diagnosed, the outbreak is still not contained and cases are being reported almost daily and occasionally spreading outwards, reports “The Conversation”. The challenge is to reach adequate numbers of vaccinated people in a country where many people are on the move because of political violence and even for those living in relative peace, the poor infrastructure is not favorable for effective vaccination.

Feb 11, 2019


UHC Day – what is it?

A year ago, the WHO declared 12th December International Universal Health Coverage Day. One year on, many people across the world still struggle to get to a clinic or cannot afford the care available there.

International Universal Health Coverage Day (UHC Day) on December 12th aims to mobilize stakeholders to call for stronger, more equitable health systems to achieve universal health coverage, leaving no one behind. It’s an annual rallying point for the growing global movement for Health for All, according to http://universalhealthcoverageday.org/

Citizen News Service in India reports that countries require a strong primary health care platform as the backbone of universal health coverage. “If we do not have UHC, we risk losing the gains made in fighting HIV infection, TB, malaria or any other disease control. We cannot afford not to strengthen UHC. In addition to UHC, we also need to scale up research and development of better tools to prevent infections such as HIV”.

Dec 12, 2018