Milestones :: Perspectives

Milestones :: Perspectives

Guinea: Battling a Large-Scale Measles Epidemic
April 06, 2017 – MSF Press Release
Less than a year after the official end of the Ebola outbreak, the Guinean health system continues to struggle.

NEW YORK/CONAKRY, GUINEA, APRIL 7, 2017—The international medical humanitarian organization Doctors without Borders/Médecins Sans Frontières (MSF), along with the Guinean Ministry of Health (MoH), is launching today a large-scale measles vaccination campaign in Conakry. Since the beginning of the year there have been 3,468 confirmed cases and 14 deaths dues to measles in Guinea, with most cases in the Conakry and Nzérékoré districts.

Routine vaccination in Guinea was drastically reduced during the 2014-2015 Ebola epidemic, both because most resources and attention were geared towards the management of Ebola and, mainly, due to fear. People stayed away from health facilities, and vaccination activities were suspended because of infection risks, leaving thousands of young children unprotected against easily preventable diseases. A nation-wide vaccination campaign was organized by authorities one year ago for children who had missed or never received their vaccines. Despite this catch-up effort, a measles epidemic was declared on February 8, 2017.

“The fact that a new epidemic occurs barely a year after a massive vaccination campaign is a worrying sign of the weakness of health care in Guinea,” said Ibrahim Diallo, MSF’s representative in Guinea. “Major problems remain in the health system, undermining its capacity to prevent and respond to outbreaks effectively and timely.”

After the devastating Ebola epidemic that killed over 11,000 people and severely affected the health systems of the three most affected countries—Guinea, Sierra Leone, and Liberia—the World Health Organization (WHO) and leading public health experts insisted on the importance of rebuilding responsive health systems in the three countries and equipping and supporting them to better manage similar or new health crises.

According to the United Nations (UN) body in charge of Ebola response, only 18 percent of the funds disbursed to support the countries during the Ebola outbreak were meant for recovery. International donor commitments to strengthen health systems has focused on improving disease surveillance to assure early detection and response to outbreaks, such as Ebola. However, today, faced with a large outbreak of measles, MSF in Conakry and Alima in Nzérokoré district are currently the only non-governmental organizations providing support to the MoH for the vaccination campaign in the worst affected districts. WHO and UNICEF have pledged support to other affected districts across the country, though it is still under discussion.

“If Ebola was a wake-up call, since then the world seems to have fallen back asleep,” said Dr. Mit Philips, MSF’s health policy analyst. “As shown by this measles outbreak, the concrete impact of the promises of funding, support and training made during and after the Ebola crisis still remain to be felt by ordinary Guineans. The country is still facing today the same problems that it was facing then, largely alone, in spite of the international public commitments to build better and more responsive health systems.”

To contain the measles epidemic, MSF and the MoH in Conakry is mobilizing 126 teams of 13 people, spread out across 164 vaccination sites in the city of three million people. All children from six months up to 10 years old will be vaccinated over the next nine days. MSF also supports 30 health centers in Conakry to care for children suffering from mild cases of measles, as well as a hospital referral center for severe cases.

::::::

Socio-economic costs of Zika virus in Latin America and the Caribbean to reach $7-$18 billion over three years
The epidemic will have a long-term impact, disproportionately affecting the poorest and most vulnerable communities, and could contribute to widening inequalities in the region.

New York, 6 April 2017 – The socio-economic cost of the recent spread of the Zika virus in Latin America and the Caribbean will total an estimated US$7-18 billion between 2015 and 2017 according to an impact assessment launched today by the United Nations Development Programme (UNDP), in partnership with the International Federation of Red Cross and Red Crescent Societies (IFRC).

The new report, “A Socio-economic impact assessment of Zika virus in Latin America and the Caribbean: with a focus on Brazil, Colombia and Suriname” provides an up-to-date analysis of the socio-economic and human development implications of the epidemic.

With research on the Zika virus still on-going, there continues to be considerable uncertainty surrounding the spread and medical conditions associated with the virus. That said, the report clearly concludes that the Zika epidemic will have significant short and long-term impacts in the economic and socials spheres in the Americas.

“Aside from tangible losses to GDP and to economies heavily dependent on tourism, and the stresses on health care systems, the long-term consequences of the Zika virus can undermine decades of social development, hard-earned health gains and slow progress towards the Sustainable Development Goals”, said Jessica Faieta, UN Assistant Secretary-General and UNDP Director for Latin America and the Caribbean…

::::::

Africa Centres for Diseases Control and Prevention launches new networks to fight health threats in Africa
Two new surveillance and laboratory networks will be built in all regions of Africa to accelerate outbreak detection, enhance disease intelligence and prevention, and combat antimicrobial resistance
Addis Ababa, 29 March 2017- African and international public health experts from governments, universities, and non-governmental organisations met from 27th to 29th March to coordinate prevention and response to disease threats in Africa through surveillance and laboratory networks. The recently launched Africa Centres for Disease Control and Prevention (Africa CDC) is committed to strengthening Africa’s disease intelligence, outbreak response, and prevention capacity through surveillance and laboratory networks. At the meeting, Africa CDC and partners established the Regional Integrated Surveillance and Laboratory Networks (Africa CDC RISLNET). These surveillance and laboratory networks will be established by Africa CDC’s five Regional Collaborating Centers (RCCs) in Egypt, Nigeria, Gabon, Zambia, and Kenya in collaboration with all available public health assets in their region, including universities, national public health institutes, private laboratories, centres of excellence, non-governmental organizations, and veterinary networks.

“This is the new spirit of practicing public health in Africa. We will be partnering effectively, collaborating closely, and using efficiently all public health assets in each region of Africa to improve detection and response,” said Dr. John Nkengasong, the Director of the Africa Centres of Disease Control and Prevention.

Africa CDC RISLNET will serve as the platform to implement Africa CDC’s 5 year strategic plan, which was endorsed by its Governing Board last week. Between 2017 and 2018, Africa CDC will support countries and regions to map existing surveillance and laboratory networks, including private laboratories.

Africa CDC is also committed to combating resistance to antibiotics, which are estimated to cause about 4 million deaths per year in Africa by 2050. To begin to address this severe threat, Africa CDC also launched the Antimicrobial Resistance Surveillance Network (Africa CDC AMRSNET). This new network will work closely with the World Health Organisation’s (WHO) Global Antimicrobial Resistance Surveillance Systems to strengthen capacity on the continent for surveillance, including through regional task-based and structured mentorship programmes.

Africa CDC will use proven models of medical education to build a community of practice to fight antimicrobial resistance, providing better care to more people where they live…

::::::

Featured Journal Content

BMC Public Health
http://bmcpublichealth.biomedcentral.com/articles
(Accessed 8 April 2017)
Research article
Improving immunization in Afghanistan: results from a cross-sectional community-based survey to assess routine immunization coverage
Raveesha R. Mugali, Farooq Mansoor, Sardar Parwiz, Fazil Ahmad, Najibullah Safi, Ariel Higgins-Steele and Sherin Varkey
BMC Public Health 2017 17:290
Published on: 4 April 2017
Abstract
Background
Despite progress in recent years, Afghanistan is lagging behind in realizing the full potential of immunization. The country is still endemic for polio transmission and measles outbreaks continue to occur. In spite of significant reductions over the past decade, the mortality rate of children under 5 years of age continues to remain high at 91 per 1000 live births.
Methods
The study was a descriptive community-based cross sectional household survey. The survey aimed to estimate the levels of immunization coverage at national and province levels. Specific objectives are to: establish valid baseline information to monitor progress of the immunization program; identify reasons why children are not immunized; and make recommendations to enhance access and quality of immunization services in Afghanistan. The survey was carried out in all 34 provinces of the country, with a sample of 6125 mothers of children aged 12–23 months.
Results
Nationally, 51% of children participating in the survey received all doses of each antigen irrespective of the recommended date of immunization or recommended interval between doses. About 31% of children were found to be partially vaccinated. Reasons for partial vaccination included: place to vaccinate child too far (23%), not aware of the need of vaccination (17%), no faith in vaccination (16%), mother was too busy (15%), and fear of side effects (11%).
Conclusion
The innovative mechanism of contracting out delivery of primary health care services in Afghanistan, including immunization, to non-governmental organizations is showing some positive results in quickly increasing coverage of essential interventions, including routine immunization. Much ground still needs to be covered with proper planning and management of resources in order to improve the immunization coverage in Afghanistan and increase survival and health status of its children.