‘Fragile’ Africa prepares for high risk of coronavirus spread

By Juliette Jabkhiro and Kate Kelland

DAKAR/LONDON (Reuters) – An isolation ward stands ready at a hospital in Khartoum, Sudan. Laboratories in Senegal and Madagascar have the testing equipment they need. Passengers arriving at airports in Gambia, Cameroon and Guinea are being screened for fever and other viral symptoms.

Africa’s Centres for Disease Control and Prevention says it has activated its emergency operation centre in the face of what global health officials say is a high risk the coronavirus disease epidemic that began in China will spread to its borders.

On a poor continent where healthcare capacity is limited, early detection of any outbreak will be crucial.

The fear is great that a spreading epidemic of coronavirus infections will be hard to contain in countries where health systems are already overburdened with cases of Ebola, measles, malaria and other deadly infectious diseases.

“The key point is to limit transmission from affected countries and the second point is to ensure that we have the capacity to isolate and also to provide appropriate treatment to people that may be infected,” said Michel Yao, emergency operations program manager at the World Health Organization’s regional office for Africa in Brazzaville, Congo.

The Democratic Republic of Congo is barring its citizens from flying to China. Burkina Faso has asked Chinese citizens to delay travelling to Burkina, and is warning that they face quarantine if they do. Kenya, Tanzania and Rwanda have all suspended flights to China.

“What we are emphasising to all countries is that they should at least have early detection,” Yao said.

“We know how fragile the health system is on the African continent and these systems are already overwhelmed by many ongoing disease outbreaks, so for us it is critical to detect earlier to that we can prevent the spread.”

John Nkengasong, Africa’s CDC director, told a briefing in the Ethiopian capital Addis Ababa this week that the activation of the emergency operation centre would create a single incident system to manage the outbreak across the continent.

The Africa CDC will also hold a training workshop in Senegal for 15 African countries on laboratory diagnosis, he said.

The continent has more than doubled the number of laboratories now equipped to diagnose the viral infection, this week adding facilities in Ghana, Madagascar and Nigeria and to established testing labs in South Africa and Sierra Leone.

“By the end of the week we expect that an additional 24 countries (in Africa) will receive the reagents needed to conduct the tests and will have the test running,” a spokeswoman for the WHO’s Africa Region told Reuters.

(Additional reporting by Giulia Paravicini in Addis Ababa, Benoit Nyemba in Kinshasa, Thiam Ndiaga in Ouagadougou, Josiane Kouagheu in Douala, Pap Saine in Banjul and Saliou Samb in Conakry. Writing and reporting by Kate Kelland; Editing by Pravin Char)

Number of hungry children in Africa’s Sahel hits 10-year high

Rural women who have carried their malnourished children for days across the Sahel desert in search of [food] rush into an emergency feeding center in the town of Guidan Roumdji, southern Niger, July 1, 2005. [Niger's severe food crisis could have been prevented if the United Nations had a reserve fund to jump-start humanitarian aid while appeals for money were considered, a senior U.N. official said on July 19. Some 3.6 million people are in need of food, among them 800,000 malnourished children. About 150,000 may die unless food arrives quickly in the impoverished West African nation of 13 million.] Picture taken July 1, 2005. - PBEAHUNYKGE

By Umberto Bacchi

LONDON (Thomson Reuters Foundation) – The number of hungry children in West Africa’s Sahel region reached a 10-year high in 2018 due to poor rains, conflict and high food prices, the United Nations said on Friday.

More than 1.3 million children under the age of five suffered from severe malnutrition this year in the six worst hit countries in the semi-arid belt below the Sahara – a 50 percent increase on 2017, said the U.N. children’s agency UNICEF.

“When children suffer from severe acute malnutrition, they are more vulnerable to illnesses such as malaria and waterborne diseases,” Marie-Pierre Poirier, UNICEF regional director for West and Central Africa said in a statement.

Hunger is a recurrent scourge in the region, whose growing population grapples with high poverty rates and periodic droughts, the agency said.

This year the problem was particularly acute across Burkina Faso, Chad, Mali, Mauritania, Niger and Senegal, it added.

An estimated 6 million people did not have enough to eat across the region during the lean season, according to the U.N. food agency (FAO).

Pastoralist communities were among the worst hit because poor rains meant there was not enough vegetation for grazing, said Coumba Sow, the FAO’s regional coordinator for resilience.

The Sahel has only one growing season and if it goes poorly due to climate shocks or conflict people must survive on whatever they have until the next one.

Global warming exacerbates the problem by making rainfall more erratic, said Sow, adding the rains were late and suffered a prolonged break, causing many farmers to lose half their seeds.

U.N. agencies and local governments were currently evaluating production levels for the new season, she said.

“We still hope that we will be able to get some good results in harvest, but it is too early to say,” she told the Thomson Reuters Foundation.

(Reporting by Umberto Bacchi @UmbertoBacchi, Editing by Claire Cozens. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s and LGBT+ rights, human trafficking, property rights, and climate change. Visit http://news.trust.org)

Infant mortality and malaria soar in Venezuela, according to government data

Pregnant women lay on beds without sheets during their labour at a maternity hospital in Maracaibo, Venezuela June 19, 2015. REUTERS/Isaac Urrutia

By Alexandra Ulmer

CARACAS (Reuters) – Venezuela’s infant mortality rose 30 percent last year, maternal mortality shot up 65 percent and cases of malaria jumped 76 percent, according to government data, sharp increases reflecting how the country’s deep economic crisis has hammered at citizens’ health.

The statistics, issued on the ministry’s website after nearly two years of data silence from President Nicolas Maduro’s leftist government, also showed a jump in illnesses such as diphtheria and Zika. It was not immediately clear when the ministry posted the data, although local media reported on the statistics on Tuesday.

Recession and currency controls in the oil-exporting South American nation have slashed both local production and imports of foreign goods, and Venezuelans are facing shortages of everything from rice to vaccines. The opposition has organized weeks of protests against Maduro, accusing him of dictatorial rule and calling for elections.

In the health sector, doctors have emigrated in droves and patients have to settle for second-rate treatment or none at all. A leading pharmaceutical association has said roughly 85 percent of medicines are running short. Venezuelans often barter medicine, post pleas on social media, travel to neighboring countries if they can afford it, or line up for hours at pharmacies.

The Health Ministry had stopped releasing figures after July 2015, amid a wider data blackout. It was not clear why it published this latest batch of data.

Its statistics for 2016 showed infant mortality, or death of children aged 0-1, climbed 30.12 percent to 11,466 cases last year. The report cited neonatal sepsis, pneumonia, respiratory distress syndrome, and prematurity as the main causes.

Hospitals often lack basic equipment like incubators, and pregnant women are struggling to eat well, including taking folic acid, factors that can affect a baby’s health.

(To read the story on Venezuelan women seeking sterilizations as crisis sours child-rearing, click http://www.reuters.com/article/us-venezuela-sterilizations-idUSKCN10E1NK)

Maternal mortality, or death while pregnant or within 42 days of the end of a pregnancy, was also up, rising 65.79 percent to 756 deaths, the report said.

The Health Ministry did not respond to a request for further information. Maduro’s government says a coup-mongering elite is hoarding medicines to stoke unrest.

‘TURMOIL’

While Venezuelans are acutely aware of the country’s health issues, the ministry’s statistics bulletin shocked some in the medical community.

“The striking part is turmoil in almost all the categories that this bulletin addresses, with particularly significant increases in the infant and maternal health categories,” said Dr. Julio Castro, an infectious disease specialist and an outspoken critic of the government’s health policies.

Doctors say the health bulletins, meant to be released weekly, should be published in a timely fashion to alert medical practitioners to national trends and threats.

Venezuela, for instance, had controlled diphtheria, a bacterial infection that is fatal in 5 to 10 percent of cases, in the 1990s. Doctors last year sounded the alarm that it had returned, but the government initially said there were no proven cases and admonished those seeking to spread “panic.”

The data now shows diphtheria affected 324 people – up from no cases the previous year.

Diphtheria was once a major global cause of child death but is now increasingly rare thanks to immunizations, and its return showed how vulnerable the country is to health risks.

Reuters documented the case of a 9-year-old girl, Eliannys Vivas, who died of diphtheria earlier this year after being misdiagnosed with asthma, in part because there were no instruments to examine her throat, and shuttled around several run-down hospitals.

(For a story on “Venezuelan girl’s diphtheria death highlights country’s health crisis”, click http://www.reuters.com/article/us-venezuela-health-idUSKBN15P1DA)

There were also 240,613 cases of malaria last year, up 76.4 percent compared with 2015, with most cases of the mosquito-borne disease reported in the rough-and-tumble Bolivar state.

Cases of Zika rose to 59,348 from 71 in 2015, reflecting the spread of the mosquito-borne virus around Latin America last year. There was no data for likely Zika-linked microcephaly, where babies are born with small heads, although doctors say there have been at least several dozen cases.

(To read the story on “Amid government silence, Venezuela’s microcephaly babies struggle”, click http://www.reuters.com/article/us-health-zika-venezuela-idUSKBN12H1NY)

(Reporting by Alexandra Ulmer; Editing by Girish Gupta and Frances Kerry)

Six innovations scientists hope will end Malaria

An Anopheles stephensi mosquito obtains a blood meal from a human host through its pointed proboscis in this handout photo

By Katy Migiro

ARUSHA, Tanzania (Thomson Reuters Foundation) – After being abandoned as too ambitious in 1969, global plans to eliminate malaria are back on the agenda, with financial backing from the world’s richest couple, Bill and Melinda Gates, and U.S. President Barack Obama.

The Gateses aim to eradicate malaria by 2040 by doubling funding over the next decade to support the roll out of new products to tackle rising drug resistance against the disease.

Their goal of permanently ending transmission of the disease between humans and mosquitoes is more ambitious than the Sustainable Development Goal of ending epidemic levels of malaria by 2030.

They are also supporting a push to create the world’s first vaccine against a parasite.

Six innovations scientists are working on are:

* New insecticides: Mosquitoes are becoming resistant to insecticides used to spray inside homes and in bed nets.

“There is no current insecticide that doesn’t show insect-resistance at the moment,” said Jed Stone, a spokesman for the UK-based Innovative Vector Control Consortium (IVCC).

Indoor spraying of walls with insecticide — which was used to wipe out malaria in the United States in the 1940s — has fallen by 40 percent since 2012 due to resistance to older products and the high cost of newer ones.

The IVCC is developing three new insecticides for use in indoor sprays and bed nets that kill insecticide-resistant mosquitoes.

“The insecticides are virtually ready but it will take about five years to finally develop them,” Stone said, adding that this largely involves registration with regulators.

* A single-dose cure: A pill that would wipe out all parasites in the body could be available by 2019, the Gates Foundation says.

Human trials of one candidate are planned following successful tests on mice, published in 2015.

Existing drugs have to be taken for three days with the risk that people do not finish their medication, contributing to the development of drug-resistant malaria.

They also only kill parasites at the asexual-stage where they cause fever but not at the sexual-stage where they are picked up by mosquitoes in blood.

* Insecticide-treated wall liners: Scientists hope insecticide-treated wall liners, which look like wallpaper, will be more effective than spraying people’s homes with insecticide every three to eight months. The wall liners kill mosquitoes that rest on them and can last for three years.

Tanzania’s National Institute for Medical Research is testing wall liners in 6,000 homes to see if they protect people from malaria. Results will be published in 2017.

* Insecticide-embedded clothing: American soldiers have been wearing combat uniforms treated with permethrin, a synthetic insecticide, since 2010 to protect them against insect-borne diseases.

The U.S. government’s Walter Reed Army Institute of Research will test the effectiveness of treated combat uniforms and repellent creams in July on Tanzanian soldiers who often catch malaria when working at night as peacekeepers.

* A vaccine: This is a big one, given vaccines success in eliminating smallpox, polio and measles in many countries.

More than 30 malaria vaccines are under development.

The Mosquirix vaccine, discovered in 1987, is a decade ahead of other candidates but, to date, it only halves the number of bouts of malaria young children suffer.

The World Health Organization is seeking funding for a pilot program to administer Mosquirix to 400,000 to 800,000 African children. The results will be used to make a decision on whether to use the vaccine more widely.

* GM mosquitoes: Scientists have genetically modified (GM) mosquitoes by adding genes that block the development of the malaria parasite inside the insect and prevent it from being transmitted to people.

Scientists have also genetically modified mosquitoes to make them infertile, so that they die out. But many are cautious about the unforeseen consequences of this.

“When people imagine a malaria end game scenario, GM mosquito technology would be incredibly powerful because it doesn’t rely on a robust health system in order to go in and disrupt transmission of the parasite,” said Martin Edlund, chief executive of Malaria No More, referring to war-torn countries like South Sudan.

The International Center for Journalists and Malaria No More provided a travel grant for this report

(Reporting by Katy Migiro; Editing by Katie Nguyen; Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, trafficking, property rights and climate change. Visit http://news.trust.org to see more stories.)

Presidents, billionaires battle World’s deadliest creature

Workers look for holes in mosquito netting at the A to Z Textile Mills factory producing insecticide-treated bednets in Arusha, Tanzania

By Katy Migiro

ARUSHA, Tanzania (Thomson Reuters Foundation) – Jakaya Kikwete, the former president of Tanzania, recalled arriving at his cousin’s house to find the family arguing about taking their feverish teenage daughter to hospital.

“They were saying: ‘No, no, no, it’s not malaria’,” he said, describing how the family had sought advice from a traditional medicine man who said a jinni, or spirit, had invaded her body.

“They said: ‘If you take this girl to the hospital, if she gets an injection, then that jinni (spirit)… will… suck all her blood’,” Kikwete said.

Ignoring their protests, he took the girl to hospital but it was too late. She died from malaria.

Kikwete, who also lost his brother to malaria as a child, is committed to eradicating the disease, which killed an estimated 438,000 people globally in 2015 – making the mosquito, which transmits it, the world’s deadliest creature.

He and his wife even appear in television adverts, urging Tanzanians to prepare their bednets before they sleep.

“We are looking at 2040 as the most probable date for a malaria-free Africa,” Kikwete, who stepped down as president in November, told reporters at a recent dinner in Dar es Salaam.

“If we continue with the interventions that we have been doing here relentlessly, we should be able to get there.”

THE “E-WORD”

Global plans to eliminate malaria were abandoned in 1969 as the goal was seen as prohibitively complicated and expensive, despite success in eradicating the disease in the 1950s in parts of Europe, North America and the Caribbean.

The “e-word” has been revived in recent years, with support from the world’s richest couple Bill and Melinda Gates and U.S. President Barack Obama, who called malaria a “moral outrage”.

Bill Gates, who Kikwete describes as a “good friend”, aims to eradicate malaria by 2040 and has called for a doubling of funding by 2025.

His goal of permanently ending transmission of the disease between humans and mosquitoes is more ambitious than the Sustainable Development Goal of ending epidemic levels of malaria by 2030.

Spending on malaria, mostly by the United States, surged to $2.7 billion in 2015 from $130 million in 2000, while death rates in Africa have fallen by 66 per cent, according to the World Health Organization (WHO).

The most important investment was the roll out of one billion free bednets. Some 68 percent of malaria cases prevented since 2000 were stopped by these bednets, according to a study by the University of Oxford.

Money was also poured into improved diagnostic tests, better drugs, indoor spraying with insecticide and educating the public to use these tools – rather than blaming witchcraft or buying medication blindly over the counter every time they got a fever.

EVERYTHING IS FREE

In the Tanzanian town of Arusha, overlooked by the dormant volcano Mount Meru, donor-funded bednets and free tests and medicines have made a significant impact.

In a country with a powerful faith in witchcraft and traditional medicine, health officials have worked hard to persuade people to adopt proven methods of preventing and treating the disease.

“There are very few cases of malaria nowadays,” said Pius Dallos, the officer in charge of Kijenge Dispensary, where women sat on wooden benches, cradling their babies.

“Previously… if you didn’t have money, you could die from malaria. But nowadays, everything is free.”

But donors’ ability to maintain – and increase – funding is by no means certain given sluggish global growth and uncertainties over U.S. funding under a new administration.

“The political will to go that final mile may be hard to sustain because it will remain expensive until the end,” Dyann Wirth, a tropical disease expert at Harvard T.H. Chan School of Public Health, told the Thomson Reuters Foundation.

“It’s a question of priority.”

It is unlikely that Africa, which accounted for nine out of 10 of the 214 million cases of malaria in 2015, according to the WHO, could foot the bill itself.

On the edge of Arusha, Africa’s largest bednet manufacturer, A to Z Textile Mills, has been the main source of 50 million free bednets given to Tanzanians between 2009 to 2016.

Giant, noisy warehouses produce insecticide-treated fibres which are woven into round and square blue bednets. Women in green T-shirts work in fast-moving pairs, folding and cutting panels ready for stitching.

Donor funding drives production of the much-needed nets, as many ordinary Tanzanians cannot afford them.

“Demand is not driven by the need (but) by the funding,” said factory director Kalpesh Shah, sitting in front of framed photographs of visits by celebrity campaigners like Bono and Will Smith on the boardroom wall.

Commercial customers account for less than one percent of sales, he said. The Gates-funded Global Fund To Fight HIV, Tuberculosis and Malaria is their main buyer, followed by the U.S. President’s Malaria Initiative.

“The question of sustainability is on everyone’s mind,” said Daniel Moore, acting mission director for the U.S. Agency for International Development (USAID) in Tanzania.

“Right now, we are carrying the load.”

RISK

The failure of the global eradication programme that began in the 1950s casts a shadow over the latest campaign.

As mosquitoes and parasites developed resistance to insecticides and drugs in the 1960s, malaria rebounded in countries like Sri Lanka where once it had been virtually eliminated.

Resistance is becoming a major problem again. But greater efforts are being made to invest in new products that will keep humans one step ahead of evolution.

New tools are also required to eliminate the parasite from ‘asymptomatic carriers’ – people with a few parasites in their blood who don’t fall sick but can act as reservoir and spread the disease when they get bitten again by mosquitoes.

As the number of malaria cases falls, it will become harder to maintain the momentum among donors, governments and ordinary people in endemic regions.

“Without the long term investment of funds and the political commitment to continue the fight, we risk wasting the entire investment,” said Wirth.

“We are going to go back to the situation where we are losing one million children a year in Africa.”

The International Center for Journalists and Malaria No More provided a travel grant for this report

(Reporting by Katy Migiro; Editing by Ros Russell; Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women’s rights, trafficking, property rights and climate change. Visit http://news.trust.org to see more stories.)

British Drug Maker To Market World’s First Malaria Vaccine

GlaxoSmithKline is seeking approval for the world’s first malaria vaccine.

Testing of the drug with African children showed it cut the number of malaria cases. The trial showed an approximate 25% decrease in cases among infants. Tests also showed that 18 months after vaccination, children up to age 5 had a 46% reduction in infections.

Worldwide, a child dies from malaria every 30 seconds. It is the leading cause of illness and death in the world. At least 800,000 people every year die from the mosquito-borne parasite.

“Malaria is not just one of the world’s biggest killers of children, it also burdens health systems, hinders children’s development and puts a brake on economic growth. An effective malaria vaccine would have an enormous impact on the developing world,” UK International Development Minister Lynne Featherstone told the BBC. “We welcome the scientific progress made by this research and look forward to seeing the full results in due course.”