Africa adopts strategic plan to reduce malnutrition

A strategic plan to reduce the double burden of malnutrition in the African Region was recently adopted at the 69th Regional Committee meeting of the World Health Organization (WHO) for the African Region.

 The Regional Committee is the governing mechanism involving health ministers from all 47 Member States of the WHO African Region.

WHO Regional Director for Africa, Dr Matshidiso Moeti, said the plan outlines the urgent and accelerated action to take to meet the goal of ending hunger and all forms of malnutrition by 2030.

“The WHO Secretariat will be developing and implementing a resource mobilization plan, supporting research collaborations and mounting high-level advocacy for increased investment to reach 90% coverage of the 10 highest-impact nutrition interventions that must be taken to meet the malnutrition challenges in our region,” Moeti said.

The double burden of malnutrition is particularly prevalent in countries undergoing “nutrition transformation” in which undernutrition and overweight or obesity coexist, often because of the increasing consumption of cheap, processed foods that are high in energy, fat and salt content but low in nutrient quality.

This diet, which is common in Africa, fails to address chronic undernutrition and micronutrient deficiencies and contributes to increased obesity and diet-related non-communicable diseases.

The the strategic plan aims to strengthen evidence-based policies and national capacity and contains clear targets to be achieved by 2025. Priority interventions include reinforcing legislation and food safety standards, using fiscal measures to incentivize healthy food choices and integrating essential nutrition actions in health service delivery platforms.

The number of undernourished people in sub-Saharan Africa rose from 181 million in 2010 to almost 222 million in 2016. Among children, although the prevalence of stunting decreased from 38.3% in 2000 to 30.3% in 2017, the numbers affected increased from 50.6 million to 58.7 million due to population growth. The rate of wasting in 2017 was 7.1% or 13.8 million children, of whom 4 million were severely wasted.

 Overweight rates are also increasing. The number of children younger than 5 years who are overweight increased from 6.6 million in 2000 to 9.7 million in 2017. For children aged 5–19 years, obesity rates doubled between 2006 and 2016, while for adults, overweight and obesity increased from 28.4% in 2000 to 41.7% in 2016.

UNICEF seeks $70m to provide humanitarian assistance to 900,000 children in Venezuela

UNICEF is appealing for more than US$70 million to provide life-saving humanitarian assistance to 900,000 children across Venezuela through the end of the year. New funding in the coming weeks is essential for UNICEF and its partners to meet the critical humanitarian needs of children and families inside the country.

“Some 3.2 million children in Venezuela need humanitarian aid as conditions across the country continue to deteriorate,” said UNICEF Executive Director Henrietta Fore. 

“We are ramping up our work to help children and families who are struggling against food shortages and limited access to essential services like healthcare, safe water and education.”

At least 4.3 million people across Venezuela do not have access to safe drinking water; vaccine-preventable diseases including measles and diphtheria have re-emerged, while yellow fever and malaria are on the rise. An estimated 1.3 million children and adolescents need protection services, while over 1 million children are out of school.

In line with 2019 Humanitarian Response Plan (HRP) for Venezuela launched by the United Nations and its partners, UNICEF’s priorities for the remainder of the year include: Providing 800,000 people with access to safe drinking water; Continuing to rehabilitate the vaccine cold chain; Vaccinating more than 1,200,000 children under 5 years against measles and ensuring treatment for 7,000 children under 5 years suffering from severe or moderate malnutrition.

Others include distributing education materials to 680,000 children aged 4-18 years; reaching 216,000 children with psychosocial and protection support; and providing over 170,000 pregnant women and newborn babies with health assistance.

These efforts build on UNICEF’s existing programmatic reach which has increased steadily over the past year to meet the growing needs of the most vulnerable children. Since 2018, UNICEF has shipped nearly 200 tons of basic health, nutrition, education, water, and sanitation relief supplies to Venezuela.

Ebola spreads in DR Congo as insecurity persists

CONGOLESE authorities have confirmed a new case of Ebola in the remote, militia-controlled province of Walikale, hundreds of kilometres from previous cases near the border with Uganda and Rwanda. 

Pinga, where the case was reported, is 150 km north-west of Goma, a town affected by the Ebola epidemic and further from the epidemic epicentre in Butembo and Beni. 

The health ministry confirmed the third case in South Kivu region, more than 700 km south of the first case.

Persistent insecurity and unrest are hampering the response in Beni. 

On 19 August 2019, a protest took place in Beni, Butembo and Oicha in response to recent attacks by armed groups on civilians causing temporary suspension of Ebola response activities. 

Operations resumed on 20 August 2019, with extra caution. The suspension of Ebola response activities often results in an increase in case numbers and in cases spreading to new areas in the following weeks.

In the past week, 57 new confirmed Ebola virus disease cases with an additional 46 deaths were reported from 18 health zones in three affected provinces. 

In the 21 days from 29 July through 18 August 2019, 65 health areas in 18 health zones reported new cases, representing 10 percent of the 665 health areas in North Kivu, South Kivu and Ituri provinces. During this period, a total of 215 confirmed cases were reported, with the majority coming from the health zones of Beni.

Cases  detected in two new health zones this past week include Mwenga Health Zone in South Kivu and Pinga Health Zone in North Kivu. In Mwenga, three confirmed cases have been reported thus far after two individuals (mother and child) had contact with a confirmed case in Beni before travelling south. 

The third confirmed case was a co-patient in a community health facility where the first cases initially sought care. In Pinga, one confirmed case has been reported and investigations are ongoing to identify epidemiological links between this individual and outbreak-affected areas. Rapid response teams were quickly deployed to scale up surveillance and response operations in both areas.

Ebola drugs increase survival rates

Two of four drugs in a clinical trial have been found to significantly increase survival rates for Ebola victims, says the US National Institutes of Health.

The study began in November 2018 in the Democratic Republic of Congo, but its current phase will now be stopped and all future patients switched over to the two treatments that have shown positive results, the US National Institutes of Health said in a statement.

“The preliminary results in 499 study participants indicated that individuals receiving REGN-EB3 or mAb114 had a greater chance of survival compared to participants in the other two arms.”

Patients receiving the two drugs that are being discontinued, Zmapp and remdesivir, will now have the option at the discretion of their treating physician to receive the treatments that have been shown to work.

Final analysis of the data is expected in late September or early October, after which the complete results would be submitted for publication in peer-reviewed medical literature.

The NIH, Democratic Republic of Congo health authorities and the World Health Organization hailed the “extraordinary team of individuals who have worked under extremely difficult conditions to carry out this study,” as well as the patients and their families.

“It is through this type of rapidly implemented, rigorous research that we can quickly and definitively identify the best treatments and incorporate them into the Ebola outbreak response,” they said.

Jeremy Farrar, Director of Britain’s Wellcome Trust research charity, said the development would “undoubtedly save lives,” adding: “Thanks to this trial, we are starting to understand which treatments to offer to patients in this and future outbreaks.

“The more we learn about these two treatments, and how they can complement the public health response, including contact tracing and vaccination, the closer we can get to turning Ebola from a terrifying disease to one that is preventable and treatable.”

No less than 1,888 people have died in eastern Democratic Republic of Congo since Ebola broke out there in August last year. A total of 2816 cases (2722 confirmed and 94 probable), including 833 survivors, and patients still under care have been recorded.

The virus is transmitted to people from wild animals, then spreads among humans through direct contact with the blood or other secretions of infected people or with surfaces contaminated with their fluids, according to the World Health Organization.

Thermostable TB vaccine on the horizon

Dr. Aswin Doekhie with a vial of ensilicated protein

A promising TB vaccine can be protected from heat damage with Ensilication - a technique developed at the University of Bath. The method prevents crucial vaccine components from going bad outside of refrigeration, giving hope for the development of a thermally stable vaccine that can be reliably delivered to remote areas around the world.

A new TB vaccine is urgently needed to withstand ‘cold chain’ challenges, especially as up to 50 percent of vaccine doses are discarded before use due to exposure to suboptimal temperatures. Thermostable vaccines are priority research to the World Health Organisation’s Global Vaccine Action Plan 2011-2020.

Ensilication

Ensilication “shrink-wraps” vaccine proteins in position using layers of silica that build up into a cage around the molecules – so they don’t unravel when exposed to temperatures that would usually break them down. The proteins are held in place until ready to be removed from the silica cage and delivered.

The research team from the Departments of Biology & Biochemistry and Chemistry first demonstrated that the TB antigen ag85b and a vaccine fused with the adjuvant protein Sbi are sensitive to breaking down outside of refrigerated temperatures. They then showed that these vaccine components were protected from heat damage when ensilicated and kept on a shelf at room temperature for long periods of time without loss of structure and function.

This is the first time that ensilication has been used to improve the thermal stability of proteins in a vaccine setting, after proof-of-principle work using model proteins.

The results are a big step forward not only in developing thermally-stable TB vaccines, but in showing that ensilication could be used for many different kinds of vaccines.

“A new TB vaccine is really urgently needed to supplement or replace the existing BCG vaccine and reduce the number of TB cases and deaths – particularly as drug-resistant TB infections remain high,” said Lead author Prof Jean van Den Elsen.

First author Ayla Wahid, added: “To make the vaccine as effective as possible it needs to be thermally-stable, or in other words not spoil outside of a fridge, which is why we’re really encouraged by these results. Cold-chain storage leads to a lot of wastage and expense which could be avoided by ensilication.”

Dr. Asel Sarbaeva, who invented ensilication, added: “Our results reveal the potential of ensilication in storing and transporting life-saving vaccines at ambient temperatures globally – in particular to remote areas of developing countries where disease rates are often highest.

“With up to 50 percent of vaccines being thrown away, and refrigeration raising vaccine costs by up to 80 percent, this is a major global health challenge that we need to overcome. By demonstrating for the first time that ensilication works to protect vaccine-relevant proteins from breaking down outside a fridge, we’re a big step closer to achieving this goal.”

OPEN DEFECATION: Nigeria leads Africa, trails India

With 47 million persons defecating in the open, Nigeria  the worst open defecation country in Africa and second in the world after India.

The 2018 WASH National Outcome Routine Mapping, (WASH NORM) Survey, says 75 million Nigerians use unimproved toilets while only 1 in 4 Nigerians have access to basic toilets.

The survey conducted by the National Bureau of Statistics, NBS, Federal Ministry of Water Resources and the United Nations Children's Fund, UNICEF, also reveals that Nigeria loses N455 billion ($ 1.3 billion) annually due to poor sanitation.

Five other African countries rank among the worst 10 where open defecation is prevalent. They include Ethiopia (3rd), Niger (7th), Sudan (8th), Chad (9th) and Mozambique (10th). Other countries in the worst 10 are Indonesia (4th), Pakistan (5th), and China (6th).

Further,  the survey revealed that 90 percent of the 122, 000 Nigerians, including 87,000 children ged under 5, who die each year from diarrhoea, is directly attributable to lack of Water and Sanitation and Hygiene.

Remarking on the report, UNICEF’s Chief of Water Sanitation and Hygiene, WASH, Zaid Jurji, said Nigeria's losses constitute 1 percent of her GDP.

"Open defecation costs Nigeria over US$ 1 billion a year (the GDP of Gambia)", Jurji noted.

Nigeria has remained on the list of top five open defecation countries in the world for 15 years, moving from 5th in 2003 to 2nd in 2015.

The UNICEF chief said Nigeria could achieve economic gains up to N359.1 billion (US$ 1.026 billion) annually from the N455 billion it loses due to lack of sanitation.

In 2012, the World Health Organisation, WHO and UNICEF  reported that Nigeria was among 10 countries that accounted for almost three-quarters of the people who practice open defecation. From the report, India ranks 1st with 626 million, Indonesia 63 million, Pakistan 40 million, Ethiopia 38 million, Nigeria 34 million, Sudan 19 million, Nepal 15 million, China 14 million, Niger -12 million, Burkina Faso -9.7 million, Mozambique  9.5 million and Cambodia 8.6 million.

There is the need for the country to prioritize sanitation on the federal and state government agenda and declare a state of emergency in the sector.

However, the former Minister of Water Resources, Suleiman Adamu, had warned that if India was able to exit from its number one position in the list of countries with poor sanitation and open defecation by the middle of 2019, it would be a "national shame" for Nigeria not to.

"Three years ago, only 40 percent of Indians were using toilets but now, 95 percent of Indians are practicing full sanitation practices.

52 ILLEGAL pharmacies sealed up in Lagos

A TOTAL of 52 pharmacies, patent medicine shops, and unlicensed premises have been sealed up by the Lagos State Taskforce on Counterfeit, Fake Drugs and Unwholesome Processed Foods.

The outlets located at Isolo, Egbeda, Ikotun, Bariga, and Somolu in Oshodi-Isolo, Alimosho and Somolu Local Government areas of Lagos were shut for offenses bordering on the illegal operation, amongst others.

 HealthNewsExtra gathered that the enforcement and compliance raid was carried out by the State Task force on Counterfeit, Fake Drugs and Unwholesome Processed Foods in collaboration with the National Agency for Food Drug Administration and Control (NAFDAC), Pharmacists’ Council of Nigeria (PCN), Pharmaceutical Society of Nigeria (PSN), Federal Taskforce on fake drugs and Police Officers from Environmental and Special Offences Unit (Task Force) of Lagos Police Command.

Permanent Secretary of the Lagos State Ministry of Health, Dr. Titilayo Goncalves, said the affected pharmacies and patent medicine shops were shut for operating without a license and engaging unqualified persons to operate the outlets and dispense drugs to unsuspecting citizens.

Other offenses include operating beyond scope through the sale of ethical products and displaying and storing drugs in an unconducive environment that compromises the potency and integrity of the drugs, rendering them ineffective.

 Goncalves said although registered, it was disheartening to note that quite a number of the pharmacies had no qualified pharmacists on duty and displayed expired drugs for sale to the public.

She added that some of the premises visited also engaged in illegal clinical practices such as patient admission and setting of intravenous infusions. 

Such practice is unacceptable, she noted even as she vowed that the State Government would do all necessary to enforce the law and sanction erring operators. 

 “The sealing of the affected pharmacies and patent medicine stores was in accordance with the provisions of Section C34 of the Counterfeit, Fake Drugs and Unwholesome Processed Foods Miscellaneous Provision Act of 1999, No. 25”, Goncalves said. 

 She said licensed patent medicine vendors are authorized to sell only drug products in their original packs in approved pack size as produced by the manufacturing companies. “The law prohibits dispensing and wholesaling of drugs by patent medicine vendors,” she said. 

Operation of the task force came on the heels of the war against fake drugs and illegal drug shops. Goncalves warned that activities of the State Task Force on Fake Drugs would be sustained, and intensified until operators in the sector adhere strictly to the provisions of the law on the operation of pharmacies and patent medicine shops, in order to safeguard the health of the citizenry. 

Director of Pharmaceutical Services in the Ministry, Dr. Moyosore Adejumo said  the State Government will not relent in its efforts to stop the inherent dangers associated with the operations from unlicensed pharmaceutical outlets and drug shops.

 Task Force through the Pharmaceutical Inspectorate Unit (PIU) of the Pharmaceutical Services Directorate has been re-energized to intensify the on-going war against fake, expired and substandard drugs being peddled by unlicensed and illegal premises.

 “This closure is thus part of the government’s renewed efforts to sanitize the drug distribution system and curb proliferation of fake drugs in the State,” Adejumo said.  

 An investigative meeting would be held with owners of the sealed premises to make further inquiries on the status of the sealed premises and to notify them of the procedures and appropriate conditions to be met for reopening in line with government regulations and payment of an administrative fee. 

 The enforcement and compliance raid by the State Taskforce on Counterfeit, Fake Drugs and Unwholesome Processed Foods was carried out in collaboration with the National Agency for Food Drug Administration and Control (NAFDAC), Pharmacists’ Council of Nigeria (PCN), Pharmaceutical Society of Nigeria (PSN), Federal Taskforce on fake drugs and the Police Officers from Environmental and Special Offences Unit (Task Force) of Lagos Police Command.