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Tag: 2017

Don’t pay electricity bills if you’re not metered – FG

Acting President Yemi Osinbajo through the Nigerian Electricity Regulatory Commission, NERC, has ordered electricity consumers that are yet to be provided with prepaid meters as from March 1, to stop paying electricity bills presented by Distribution Companies, DISCOs, on the basis of estimated billing methodology.

The commission also assured the consumers of continued power supply, as they also ordered the DISCOs not to disconnect any such customer that refuses to pay the bill.

They in turn, advised such customers to report to the commission if disconnected.

NERC in a statement on its website at the weekend, said in line with its mandate of protecting the rights of customers, NERC had in June 2016 after consultation with the operators, directed DISCOs to conclude metering of all customers before November 30, 2016.

NERC added that the sanction was sequel to the expiration of the initial directives by NERC and the moratorium period given to DISCOs to meter consumers.

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The statement reads in part: “A directive was issued to distribution companies by the Commission in June 2016 for all MD customers to be metered by 30 November 2016.

“The Commission received appeals on compliance deadline from distribution companies prior to the expiration of the 30 November 2016 deadline. The deadline was extended to 1 March 2017 after consideration of appeals received from distribution companies.

“Upon due consideration of facts above and the expiration of the compliance deadline granted to distribution companies on the metering of MD customers; the Commission hereby directs as follows;

“1. Any MD customer that was not metered by 1 March 2017 shall not pay any electricity bill presented by a distribution company on the basis of estimated billing methodology and these customers are advised to report this to the Commission.[xyz-ihs snippet=”adsense-468b60″]

“2. No distribution company shall disconnect any MD customer that was not metered by 1 March 2017 on the basis of the customer’s refusal to pay a bill issued after the compliance deadline on the basis of estimated billing methodology.

“3. Any MD customer that was not metered by 1 March 2017 should notify the Commission directly on:

Nigerian Electricity Regulatory Commission
Adamawa Plaza
Plot 1099 First Avenue
Off Shehu Shagari Way
Central Business District, Abuja, the statement concluded.

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April 18, 2022
Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

Indonesia recently completed the last of its annual large-scale treatment for lymphatic filariasis (also known as elephantiasis or Penyakit Kaki Gajah) in Malaka District located in its southernmost province, East Nusa Tenggara. Unprecedented
progress by the National Lymphatic Filariasis Elimination Programme has strongly placed the country on the path to achieving the elimination of lymphatic filariasis as a public health problem.

“We reached an estimated number of 40.7 million people living in the 118 high-risk districts during this month-long treatment campaign in October 2019” said Dr Anung Sugihantono, who recently retired as Director General of Diseases
Prevention and Control, Ministry of Health Indonesia. “Single doses of diethylcarbamazine citrate and albendazole facilitated by WHO were delivered to all eligible populations.”

In 2010, an estimated 125 million Indonesians were still at risk of the disease and required treatment.

But things changed considerably in 2015 when Indonesia mounted an annual national campaign to resolutely address transmission of the disease and to tackle the morbidity and disability associated with it. The results were apparent as early as 2017, with
remarkable progress.

In Indonesia, LF is considered a significant public health concern. In 2009, risk mapping identified a population of 124.5 million people needing treatment for LF. The country initiated a national level LF elimination campaign in 2015, addressing both
disease prevention and management.

“In 2017 and in just two years we managed to achieve 100% geographical coverage of all people requiring treatment” said Dr Sugihantono. “It meant achieving more than 78% epidemiological coverage – much higher than the generally recommended 65% to stop transmission.”

Transmission of lymphatic filariasis can be stopped through large-scale treatment (or mass drug administration – MDA) of entire at- risk communities with recommended medicines once a year. These medicines kill the microfilariae in an infected patient’s
blood preventing mosquitoes to transmit¹ the disease to others. Through mass treatment, the aim is to reduce the reservoir of microfilariae in the blood to a level insufficient to maintain transmission by the mosquito vector.

This strategy to interrupt transmission is the corner-stone of the World Health Organization’s (WHO) Global Program to Eliminate Lymphatic Filariasis (GPELF). Indonesia has been using the GPELF’s strategy since 2002 using a district or city
as its implementation unit.

In 2005, it listed the elimination of LF as a national priority for controlling infectious diseases and the medicines it has been using in large-scale treatment programmes are diethylcarbamazine citrate (DEC) and albendazole² which are
largely distributed by volunteer community health workers³.

“Community health volunteers are themselves members of the community and know how to reach people effectively to improve compliance” said Dr. Stefanus Bria Seran, the Regent of Malaka District, one of LF endemic district in Indonesia. “Besides ensuring every single person ingests the medicine given to them, these community workers help in disseminating information well before a large-scale treatment campaign and also assist in reporting activities related to each treatment campaign”.

Indonesia’s efforts to eliminate lymphatic filariasis began in the 1970s but faced numerous challenges including programme coordination in the many inhabited islands, conducting information, education and awareness programmes, lack of capacity and
insufficient medicines.

Furthermore, the situation in Indonesia is unusual than in many other countries endemic for lymphatic filariasis as the country is endemic for all three species of thread-like filarial worms – Brugia malayi, Brugia timori, and Wuchereria bancrofti –
that cause the disease. Most of the infections in Indonesia, however, are caused by B. malayi.

In the past, some of the factors that prevented access to the medicines (DEC and albendazole) were social stigmatization linked to the disease, the vast geography of the territory and challenges in reaching remote populations.

With an estimated population of 242 million, Indonesia is the world’s largest island nation and consists of approximately 17,000 islands, of which 5,000–6,000 are inhabited. It is the fourth most populated nation behind China, India, and the United
States.

Indonesia is endemic for many other neglected tropical diseases and an estimated 110 million Indonesians are believed to suffer from at least one neglected tropical disease (NTD), including lymphatic filariasis and soil-transmitted helminth infections.
Leptospirosis (not classified as NTD) is also widespread.

Indonesia is the only country of WHO’s South East Asia Region with endemic schistosomiasis. Like many other countries of the Region, it also faces recurrent threats of dengue outbreaks.

Global progress

The world has made significant progress towards the elimination of lymphatic filariasis as a public health problem.

Sixteen countries⁴ and one territory are now acknowledged by WHO to have achieved elimination of lymphatic filariasis as a public health problem.

Seven additional countries have successfully implemented recommended strategies, stopped large-scale treatment and are under surveillance to demonstrate that elimination has been achieved.

The disease

Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

Infection involves asymptomatic, acute, and chronic conditions. Most infections are asymptomatic, showing no external signs while contributing to transmission of the parasite. Although asymptomatic, these infections still cause damage to the lymphatic
system and the kidneys and alter the body’s immune system.

When lymphatic filariasis develops into chronic conditions it leads to lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling). Involvement of breasts and genital organs are common.

Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.

¹Lymphatic filariasis is transmitted by different types of mosquitoes – e.g the Culex mosquito which widespread across urban and semi-urban areas; Anopheles, mainly found in rural areas; and, Aedes, mainly
in endemic islands in the Pacific.

²In 2017, WHO recommended an alternative three drug treatment to accelerate the global elimination of lymphatic filariasis. The treatment, known as IDA, involves a combination of ivermectin, diethylcarbamazine citrate and albendazole.
It is recommended annually in settings where its use is expected to have the greatest impact.

³Community health workers, also called ‘cadres’, are volunteers who form part of the communities they serve and work with local
communities to educate families. Their contribution in promoting health has been significant in the country.

⁴Cambodia, The Cook Islands, Egypt, Kiribati, Maldives, Marshall Islands, Niue, Palau, Sri Lanka, Thailand, Togo, Tonga, Vanuatu, Viet Nam, Wallis and Futuna, and Yemen

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May 9, 2020
New GDO country profiles available

Countries across the six WHO regions are participating in the Global Dementia Observatory (GDO), a data and knowledge exchange platform. The GDO provides easy access to country-level key dementia data and functions as the monitoring mechanism of the Global dementia action plan on the public health response to dementia 2017-2025.

GDO country profiles offer a baseline summary of countries’ progress on dementia actions outlined in the global dementia action plan. They provide an easy read snapshot of the more comprehensive data submitted by Member States across three key domains related to dementia: policies, service delivery, and information and research. GDO country profiles can be used to inform policy, service planning and health and social care systems decisions for dementia. Additional country profiles will be added as data becomes available.

View GDO country profiles

Access the GDO

Read the GDO Reference Guide

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https://www.who.int/news-room/detail/28-04-2020-GDO-country-profiles

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May 9, 2020
Maternal infections in health facilities

A clearer picture of the global impact

New research from the Global Maternal Sepsis Study (GLOSS), a major WHO/HRP initiative, shows that infection has a much larger impact on global maternal mortality and morbidity than previously thought.

The
results from GLOSS, published in The Lancet Global Health, are the first to provide data on frequency of maternal infections and
sepsis across the pregnancy and post-pregnancy period, in a large number of health facilities around the world.

Around 11 women per 1000 live births had an infection which resulted in or contributed to what is known as a severe maternal outcome – either they died or nearly died – during their hospitalization.

Urgent improvement is needed to manage this life-threatening risk faced by all pregnant and recently pregnant women, wherever they are in the world.

What is maternal sepsis and how does it lead to maternal death?

Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, child-birth, post-abortion or the postpartum period.

The latest global estimates place sepsis due to obstetric infections as the third most common cause of maternal mortality. However, this only includes infections as a direct result of pregnancy, such as endometritis or post-caesarean wound infections.

Few
previous studies include post-abortion infections. Neither do they address indirect infections such as respiratory and meningitis, which are aggravated by pregnancy but not directly caused by it.

A better understanding of maternal infection

GLOSS was a massive facility-based data collection effort led by WHO, accompanied by a ‘STOP SEPSIS!’ campaign to increase awareness among healthcare providers.

The study gathered data on women who were admitted with suspected or confirmed infection during pregnancy or post-pregnancy over a one-week period in 2017. More than 2800 women participated in the study in 52 countries.

GLOSS included healthcare facilities that care for women during pregnancy, childbirth or at the end of pregnancy, as well as facilities without maternity service but where women could be hospitalized during or after pregnancy, and data on infections
which are not usually recorded as maternal sepsis, including post-abortion and indirect infections.

The result is a more complete understanding of the frequency and impact of maternal infections in health facilities.

GLOSS calls attention not only to the wider range of risks faced by pregnant women but also to the long period of time during which they are at risk.

Putting global numbers on maternal infection and sepsis

Overall, around 70 pregnant or recently-pregnant women per 1000 live births were found to have a maternal infection needing hospital management.

Across the study, 11 women with either direct or indirect infection per 1000 live births developed a severe maternal outcome, but in low- and middle-income countries up to 15 women per 1000 births were affected.

Infections were the underlying cause of most of the deaths recorded during the study, primarily post-abortion infection and indirect infections. Infections were also present in about a third of deaths attributed to other causes, such as postpartum
haemorrhage.

This suggests that the contribution of infection to global maternal mortality and morbidity may be larger than current reports of maternal sepsis mortality suggest.

Preventing, identifying and treating maternal infection and sepsis

Some of the most common maternal infections found in the study, such as urinary tract infections, post-caesarean and post-abortion infections, are largely preventable and treatable.

GLOSS results suggest that current levels of monitoring and clinical care across health facilities are not enough to prevent, identify and treat levels of maternal infection effectively.

For instance, a complete set of vital signs was not reported for a third of the women in the study, on the day their infection was suspected or diagnosed. Delays in antimicrobial therapy were frequent.

GLOSS also shows marked differences across countries, with the highest burden in low- and middle-income countries, compared with high-income countries.

This may reflect the impact of broader health determinants in different country contexts. Challenges of overcrowding, limited access to water and sanitation and constraints to safe births by skilled birth attendants can reduce the ability of healthcare
providers to manage the frequency and outcome of maternal infections.

An opportunity to implement evidence-based practice

GLOSS gives healthcare providers, policy-makers, and the public at large an opportunity: to mobilise around these data improve evidence-based practice, and save lives.

WHO has produced a number of resources which can support timely action to prevent, diagnose and treat maternal infection, as well as activities such as the upcoming SAVE LIVES: Clean Your Hands campaign
on 5 May which celebrates the central role played by nurses and midwives in clean health care.

In addition, WHO will publish a global sepsis epidemiology report around the 73rd World Health Assembly (WHA) in May, as requested in the
2017
WHA Resolution on Improving the prevention, diagnosis and clinical managementof sepsis.

Understanding why and how infection affects women is essential for equipping healthcare providers with life-saving knowledge and enabling health care systems to bring down global maternal mortality and morbidity.

Related publications

WHO recommendations for prevention and treatment of maternal peripartum infections

WHO Clinical practice handbook for safe abortion

Global guidelines on the prevention of surgical site infection

WHO statement on maternal sepsis

World Health Assembly resolution on Improving the prevention, diagnosis and clinical management of sepsis

Health Topics

Antimicrobial resistance

Infection Prevention and Control

Water Sanitation Hygiene

Other links

Global Maternal Sepsis Study

SAVE LIVES: Clean Your Hands 5 May 2020

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https://www.who.int/news-room/detail/27-04-2020-maternal-infections-in-health-facilities

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May 9, 2020
INFOSAN Quarterly Summary, 2020 #1

Food safety incidents

During the first quarter of 2020, the INFOSAN Secretariat was involved in 38 food safety incidents involving 109 WHO Member States and 9 territories of WHO Member States. There were 25 incidents involving a biological hazard (Salmonella spp. [8], Listeria monocytogenes [5], Norovirus [3] Shiga-toxin producing Escherichia coli [2], Clostridium botulinum [2] Bacillus cereus [2], Cronobacter spp. [1], Shigella sonnei [1], unspecified biological hazard [1]), 6 involving an undeclared allergen (milk [3], peanut (1), egg [1], gluten [1]), 5 involving a physical hazard (undetermined foreign matter [2], glass [1], metal [1], plastic [1]), one involving a chemical/toxin hazard (histamine), and one linked to an unspecified hazard.

The food categories that were most commonly involved in the 38 incidents during the first quarter of 2020 involved fish and other seafood (8), herbs and spices (4), legumes and pulses (4), milk and dairy products (3), nuts and oilseeds (3), snacks, desserts and other foods (3), cereals and cereal-based products (2), composite food (2), fruit and fruit products (2), meat and meat products (2), vegetables and vegetable products (2), products of special nutritional use (1), and food for infants and small children (1). One incident involved an unknown food source.

During such international food safety incidents, the INFOSAN Secretariat relies on the swift action of national INFOSAN Emergency Contact Points to respond to requests for information. Rapid sharing of information through INFOSAN enables members to implement appropriate risk management measures to prevent illness in their respective countries.

Geographic scope

The outlined incidents involved Member States from all WHO regions: Europe (39), followed by the Americas (24), Africa (24), the Western Pacific (18), the Eastern Mediterranean (8) and South-East Asia (6).

Recall in several countries of frozen spring roll sheets from Singapore due to the presence of an undeclared allergen

In February 2020, the INFOSAN Secretariat was notified by the European Rapid Alert System for Food and Feed (RASFF) and INFOSAN colleagues in Australia of a recall in Australia and several European countries of frozen spring roll sheets due to the detection of an undeclared allergen (milk), imported from Singapore. In collaboration with RASFF, the INFOSAN Secretariat was informed that the implicated frozen spring roll sheets were distributed internationally to 46 Member States from four WHO regions and 4 territories in Europe and the Western Pacific. Moreover, through engagement with the INFOSAN Emergency Contact Point (ECP) in Singapore, the INFOSAN Secretariat also received details of further distribution of implicated products to additional WHO Member States from all WHO regions, taking the total number of Member States involved to 65. It was also reported that the products involved had been redistributed by some countries to Europe, the Americas and Africa. Consequently, several countries recalled the implicated products to relabel them and investigated the issue to identify illnesses related to the consumption of the implicated frozen spring roll sheets. No illnesses were reported to the INFOSAN Secretariat.

This incident has highlighted undeclared allergens as an important category of hazards that can result in a largescale international response to implement risk management measures and prevent illness. In addition, it exemplified efficient communication among INFOSAN members and the Secretariat.

Outbreak of Listeriosis in the United States of America linked to enoki mushrooms imported from the Republic of Korea

In March 2020, the INFOSAN Secretariat was made aware by the United States (US) Centers for Disease Control and Prevention (CDC) of an outbreak of Listeriosis in the US linked to the consumption of enoki mushrooms, imported from the Republic of Korea. In total, 36 cases including 4 deaths have been reported in the US. Following investigations in Canada, carried out in collaboration with the US, the INFOSAN Secretariat was informed of 6 cases of Listeriosis between 2017 and 2019 in Canada potentially related by whole genome sequencing (WGS) to the ongoing outbreak in the USA. In addition, food isolates (from enoki mushrooms from the Republic of Korea) genetically associated with the cluster of cases have been collected in 2019 by authorities in Canada. The WGS information pertaining to the cases and food isolates were shared on the INFOSAN Community Website to assist the identification of cases in other countries.

The INFOSAN Secretariat engaged the INFOSAN Emergency Contact Point (ECP) in the Republic of Korea to seek details on any further international distribution of the implicated enoki mushrooms. Investigations are ongoing.

News & activities

Food Sector and the COVID-19 outbreak

On 31 December 2019, WHO was alerted to several cases of pneumonia of unknown origin in the city of Wuhan, Hubei Province, China. The virus, a previously unknown coronavirus has been named SARS-CoV-2 and is the cause of the COVID-19 disease.

The WHO Epidemic Information Network (EPI-WIN) aims to share information tailored to specific sectors, including food and agriculture. The INFOSAN Secretariat has recently developed a guidance document for food businesses with regards to COVID-19 and food safety which is now available online. The guidance has also been disseminated through EPI-WIN and presented during two webinars.

Call for applicants: INFOSAN Train-the-Trainer Workshop

In February, the INFOSAN Secretariat issued a call for applications for the INFOSAN Train-the-Trainer workshop. With the constant growth of the network, and the increased need for training that this entails, the INFOSAN Secretariat, in collaboration with the Canadian Food Inspection Agency (CFIA), has announced this workshop which aims to increase the human resources available to train INFOSAN members on a range of INFOSAN-related topics, online or in-person. As a result, it is expected that the understanding of the roles and responsibilities of INFOSAN members will be improved, resulting in greater participation that will enhance speed and efficiency during the response to food safety emergencies at the global level. The INFOSAN Secretariat, together with CFIA, look forward to hosting this important workshop later this year.

Developing the new INFOSAN Community Website

The INFOSAN Community Website (ICW) continues to be an effective tool for the network to disseminate information during food safety emergencies. Over the past year, through the INFOSAN member survey, the Secretariat has gained a better understanding of how members use the ICW and how it can be improved to enhance information sharing. The information collected, together with the experience of members of the Secretariat, has provided numerous innovative ideas to guide the development of the new ICW. The Secretariat is pleased to announce that the competitive process to select the vendor that will develop the new INFOSAN Community Website has concluded and the work on the creation of the new ICW has begun.

Voice of an active network member

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https://www.who.int/news-room/detail/23-04-2020-infosan-quarterly-summary-2020-1

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May 9, 2020
Making available free paediatric medicine can accelerate elimination of congenital Chagas disease
The donation of an essential antiparasitic medicine can potentially accelerate the elimination of Chagas disease infection in children. A pediatric presentation of benznidazole with accurate dosage and will soon be made available freely to address
a long-standing gap in the treatment of congenital infections of Chagas disease.

The donation, by the Mundo Sano Foundation¹ and INSud Pharma² group to the World Health Organization (WHO), is expected to become effective soon.

“Making benznidazole freely available for the treatment of newborns and children until the age of 19 will be a game-changer in the fight against Chagas disease” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control
of Neglected Tropical Diseases. “This can save future generations from developing life-threatening and fatal complications and also boost up diagnosis and treatment contributing to congenital Chagas disease elimination.”

The three-year agreement will make available 108 000 tablets of benznidazole³ – one of the two antiparasitic medicines against Chagas disease. Treatment⁴ with benznidazole in the early stages of infection can cure Chagas
disease, prevent or curb disease progression and prevent congenital transmission in pregnant women.

“We have now added the systematic detection and treatment of all newborns and children under 19 which was not part of our recent switch from control to elimination of congenital Chagas disease” said Dr Pedro Albajar
Vinas, Medical Officer, WHO Department of Control of Neglected Tropical Diseases. “In addition, screening of pregnant women at risk of infection who have not had past antiparasitic treatment provides an excellent opportunity for prevention of posterior transmission throughout pregnancy and birth.”

Each year, an estimated 15 000 children are born from infected mothers.

The agreement

The donation by Mundo Sano Foundation for the duration of the agreement comprises benznidazole:
- 105,000 tablets of 100mg
- 3,000 tablets of 12.5mg
Furthermore, the Foundation may donate funds to support activities associated with distribution of medicines and is ready to consider extending this agreement beyond the specified duration of three years.

The disease

Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite Trypanosoma cruzi (T. cruzi).

Although considerable progress has been achieved, particularly in reducing vector transmission and screening of blood and organ supply, reaching, diagnosing and providing healthcare for people most affected has been a challenge.

Currently, under-diagnosis of Chagas disease cases is as high as 90% and under-diagnosis of congenital and paediatric cases is believed not to be lower.

Globally, an estimated 6-7 million people are infected with T. cruzi.

The disease is found mainly in endemic areas of 21 continental Latin American countries⁵. But movement of people to urban areas and to other continents has expanded its transmission through non vectorial routes, such as blood transfusion,
congenital transmission, organ transplants and oral transmission through food contamination.

Considering that neglected tropical disease as a growing public health problem in many countries, the World Health Assembly – WHO’s decision-making body – decided in May 2019 to commemorate World Chagas Disease Day on 14 April.

The inaugural celebration happens this year.

¹Mundo Sano is a nonprofit international foundation working with the public and private sectors, academia, and other international organizations to provide solutions to the affected communities and generate scientific knowledge.
In 2012, it led a public-private consortium in 2012 to produce benznidazole in Argentina.

²Insud Pharma (formerly known as Chemo Group) specializes in research, development, manufacture, sale and marketing of active pharmaceutical ingredients and medicinal products for human and veterinary use.

³In 2017, the United States Food and Drug Administration (FDA) approved benznidazole for the treatment of children aged 2–12, making it the first treatment approved in the United States for Chagas disease.

⁴Nifurtimox is also 100% effective in curing Chagas disease if given soon after onset of infection, including cases of congenital infection. It is donated by Bayer who pledged more than 7.5 million tablets for the period 2012-2021.

⁵Argentina, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, and Venezuela
(Bolivarian Republic of).

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April 8, 2020
Nigeria’s Unhealthy Healthcare In Eye Of Coronavirus By Runcie C.W. Chidebe

Coronavirus (COVID-19) is right here to show us a lesson; I hope we be taught. Nigeria’s healthcare is unhealthy. But as an alternative of fixing it our rulers have been busy flying up and down to profit from different nation’s productive well being system. With Coronavirus, actuality is upon us. No extra operating abroad for medical trip. Our rulers can’t journey to the United Kingdom, United States of America or India anymore for medical care. These nations are additionally hanging on their final breath, battling to outlive the COVID-19 pandemic.

In 2017, President Muhammadu Buhari spent 103 days in London receiving medical therapy for an undisclosed sickness, spending taxpayers’ cash as an alternative of investing within the nation’s healthcare. Thousands of Nigerians died in the identical interval from totally different sicknesses. More than 3,000 girls died of breast most cancers, greater than 2,000 girls died of cervical most cancers and greater than 1,500 males died of prostate most cancers, in line with World Health Organization (WHO) figures on annual most cancers mortality.

I had hoped that on his return to Nigeria, President Buhari would declare a state of emergency within the nation’s well being sector. Painfully, nothing of such occurred. Nigeria’s funds allocation to healthcare has remained lower than 5% of the whole funds for the previous 5 years. Simply put, in 2020 the federal authorities budgeted N2,000 (£4.2) for every Nigerian with a complete of N427.Three billion as funds allocation to the well being sector whereas the United Kingdom budgeted £2,159.6 for every citizen with a complete well being funds of £143.4billion. It is similar dismal story within the states throughout Nigeria. Healthcare isn’t a precedence. In some states in Nigeria, a hospital is a 20-minute boat journey and an hour-long automobile journey. Because many poor Nigerians don’t personal boats, a girl in labour may bleed to loss of life earlier than she reaches the hospital.

On March 22, 2018, Bill Gates, founding father of Microsoft and the Bill & Melinda Gates Foundation, criticized Nigerian authorities’s poor funding of healthcare within the nation. In his phrases, “One in three children is chronically malnourished.” This tragedy has large implications for the economic system. According to the World Bank, addressing the stunting disaster in Nigeria would add virtually $30 billion to Nigeria’s GDP. It is painful that regardless of Mr. Gates assertion, nothing has modified. Nigeria has remained one of many nations on this planet with the worst healthcare system with over 60 deaths per 1000 stay births. Nigeria has one of many worst most cancers survival charges on this planet, with solely 2 to three most cancers radiotherapy machines working at any time and fewer than 70 oncologists for a inhabitants of over 200 million.

COVID-19 is exposing the insensitivity of our leaders to issues that matter most to us. That Nigerians are disobeying the federal government’s security recommendation on COVID-19 is a transparent reflection of residents’ distrust for his or her leaders. Many Nigerians belief their non secular leaders greater than they belief our political leaders. Successive governments have failed the nation, and it doesn’t appear like factor will change anytime quickly.

Nigeria is a rustic the place our rulers make legal guidelines as we speak and break the identical legal guidelines tomorrow. The Nigeria Centre for Diseases Control (NCDC) adopted the World Health Organization (WHO) guideline and strongly inspired all Nigerians coming from sure nations to self-isolate and monitor themselves, as a method to comprise or to delay the unfold of COVID-19. The president’s Chief of Staff, Abba Kyari, returned from Germany and as an alternative of isolating himself he was leaping from one state to a different, attending occasions and conferences with totally different folks, breaching the federal government’s personal advice and inserting the lives of different Nigerians in danger!

Now that COVID-19 is in Nigeria we have to face it with all that we’ve. But can we? The Nigeria Centre for Disease Control (NCDC) is now the nation’s solely perceived hope. Many Nigerians have been calling NCDC scorching traces, criticizing NCDC for not testing sufficient folks. But we must always face the music and never the dancer. NCDC is crippled and never effectively outfitted to guard Nigerians from the illness.

In 2016, NCDC budgeted N3.7m for its recurrent and N248m for capital allocations. That is a complete of N251.7m. Out of this, solely N155m was launched to the centre. In the identical 12 months, 1,166 Nigerians died of Cerebrospinal Meningitis. In 2017, the NCDC had a funds of N1.5b. Only N782m was launched. In the identical 12 months, greater than 120 Nigerians contracted Monkeypox and 7 folks died from the illness. That identical 12 months, the Presidency budgeted N77m for Aso Rock lease, N1b for journeys and sitting allowances, and N94m for meals. In 2018, the NCDC had a funds of N1.9b. Only N654m was launched. In the identical 12 months, N7.2b was proposed for Presidential Air Fleet. N440m was proposed for necessary improve and set up of stay TV and web service within the presidential aircrafts, N375m for brand spanking new cabin administration, N418m for the touchdown gears. In whole, over N1b was budgeted for the presidential aircrafts which is used for medical tourism and frequent journeys overseas.

On November 12, 2018, the NCDC institution invoice was signed by President Muhammadu Buhari, because of the efforts of Senator Mao Ohuabunwa, the then Chair, Senate Committee on Primary Healthcare and Communicable Diseases. On this premise, the NCDC was empowered with a laws for its work in stopping and making ready for outbreaks of infectious illnesses. Interestingly, the NCDC acquired the worst funds in 2019, the 12 months following the passage of the NCDC Act. The Centre had a funds of N1.4b, however solely N224m was launched. In the identical 12 months, over 472 Nigerians have been identified with Lassa fever and over 110 folks died from this viral hemorrhagic fever. Clearly, NCDC can’t carry out magic. They need assistance. Nigeria is grossly under-testing for COVID-19, the laboratories usually are not sufficient, and NCDC and its affiliate businesses wouldn’t have sufficient manpower and sources.

Months in the past, being unwell evoked empathy; as we speak being unwell evokes concern. The concern of COVID-19? No! It is the concern of not gaining access to the care that you just want, the concern of absence of ventilators, the concern of a damaged well being system. It is the concern of loss of life. Our political leaders have stolen from the sick by corruption. Many Nigerian governors construct non-functional hospitals of their states. Usually, after the commissioning of those hospitals, all of the CT Scan, Magnetic Resonance Imaging (MRI) and different medical machines—a few of them faux—are returned to the place they have been bought or left to rot.

Hospitals in Nigeria are among the worst on this planet. Our educating hospitals at the moment are museums the place lower than 5% of medical trial and analysis is occurring due to poor laboratory. Medical tourism has due to this fact grow to be the norm. Dubai hospitals, Saudi Arabian hospitals, and so on., are promoting in Abuja and Lagos for Nigerian sufferers. They are recruiting Nigerian docs, together with consultants. Nigeria isn’t solely going through “brain drain,” we’re additionally going through “patient drain.” Our docs and nurses work within the worst situations. Hazard allowance for well being staff is about N5,000 whereas wardrobe allowance for members of the National Assembly runs into hundreds of thousands.

Now is the time for Nigeria to confront its healthcare disaster. The Nigerian authorities should settle for its failure. Our political leaders should brace as much as their duty and critically replicate on the issue their greed has delivered to Nigeria. This is the time to put money into a result-oriented healthcare system. Health is wealth because the saying goes. healthcare system is the muse of any nation.

If we survive COVID-19, we have to contemplate a legislation to limit all public officers from searching for medical care overseas. It could also be perceived as strict, however it can save future generations since we don’t know which pandemic would come subsequent and when.

Let’s give each Nigerian an area to stay and a not probability to die.

Runcie C.W. Chidebe is Executive Director, Project PINK BLUE. He is at the moment a Commonwealth Scholar on Transforming and Leading in Health Care at Birmingham City University, United Kingdom. He tweets @runciecwc

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April 4, 2020
Chagas disease: providing free paediatric medicine can enhance diagnosis and treatment
Documentation resulting in the donation of an important antiparasitic medicine for the treatment of Chagas illness to the World Health Organization (WHO) is within the ultimate stage of preparation.

A 3-year settlement, between the Mundo Sano Foundation¹ (Brazil) and WHO, is anticipated to make obtainable 108 000 tablets of the paediatric formulation of benznidazole² – a first-line medicine towards Chagas illness. Treatment³ with benznidazole within the early levels of an infection can treatment Chagas illness.

“Making benznidazole freely obtainable for the treatment of newborns till the age of 18 might be a game-changer within the battle towards Chagas illness” mentioned Dr Mwelece Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical
Diseases. “This is not going to solely save future generations from growing life-threatening and deadly issues however can even increase up diagnosis and treatment.”

Each yr, an estimated 15 000 youngsters are born from contaminated moms. A freely obtainable paediatric presentation of benznidazole with correct dosage is essentially anticipated to contribute to deal with congenital infections.

“Treating newborns and youngsters was the lacking hyperlink, as we transfer decisively to advocate for the mixing of diagnosis of an infection amongst pregnant ladies and women of child-bearing age into different surveillance programmes, together with HIV and syphilis” mentioned Dr Pedro Albajar Vinas, Medical Officer with WHO’s Department of Control of Neglected Tropical Diseases. “Diagnosing and treating ladies of this age group earlier than being pregnant can increase successfully stop congenital transmission.”

The settlement

The donation by Mundo Sano Foundation at some point of the settlement includes benznidazole:
- 105,000 tablets of 100mg
- 3,000 tablets of 12.5mg
Furthermore, the Foundation might donate funds of as much as US$100 000 at some point of the settlement to help actions related to distribution of medicines and conferences. The Foundation additionally makes provision for an extension of this settlement past
the required length of three years.

The illness

Chagas illness, often known as American trypanosomiasis, is a doubtlessly life-threatening sickness brought on by the protozoan parasite Trypanosoma cruzi (T. cruzi).

Although appreciable progress has been achieved, significantly in decreasing vector transmission and screening of blood and organ provide, reaching and diagnosing individuals most affected has been a problem.

Currently, under-diagnosis of Chagas illness instances is as excessive as 90% and under-diagnosis of congenital transmission is believed to be even greater.

Globally, an estimated 6-7 million individuals are contaminated with T. cruzi.

The illness is discovered primarily in endemic areas of 21 continental Latin American international locations⁴. But motion of individuals to city areas and to different continents has expanded its transmission by means of non vectorial routes, akin to blood transfusion, congenital
transmission, organ transplants and oral meals contamination.

Considering the illness as a rising public well being drawback in lots of international locations, the World Health Assembly – WHO’s decision-making physique – determined in May 2019 to commemorate World Chagas Disease Day on 14 April.

The inaugural celebration occurs this yr.

¹Mundo Sano is a nonprofit worldwide basis working with the general public and personal sectors, academia, and different worldwide organizations to supply options to the affected communities and generate scientific information. In 2012, it led a public-private consortium in 2012 to provide benznidazole in Argentina.

²In 2017, the United States Food and Drug Administration (FDA) accepted benznidazole for the treatment of kids aged 2–12, making it the primary treatment accepted within the United States for Chagas illness.

³ Nifurtimox can be 100% efficient in curing Chagas illness if given quickly after onset of an infection, together with instances of congenital an infection. It is donated by Bayer who pledged greater than 7.5 million tablets for the interval 2012-2021.

⁴ Argentina, Belize, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, French Guiana, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Suriname, Uruguay, and Venezuela
(Bolivarian Republic of).

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April 3, 2020
WHO to continue support for Chagas disease programme that promotes patient self-care
The World Health Organization (WHO) and the Catalan Ministry of Health say they’ll collectively support the dissemination of a programme that gives support to sufferers affected by Chagas disease to handle their very own well being and promote self-care.

The Catalonian ‘Expert Patient Programme on Chagas disease’ includes interplay and sharing of knowledge amongst individuals affected by the disease and is performed by an knowledgeable patient. The programme is taken into account to have completed very properly because it was first initiated in 2017.

“Over the previous few years we now have seen exceptional improve in consciousness and confidence amongst sufferers to pursue medical care and follow-up with physicians” stated Dr Pedro Albajar Vinas, who’s accountable for WHO’s Chagas disease programme. “When sufferers discuss to each other there may be higher deal with general perceptions of well being, life-style, bettering shallowness, self-care and particular person satisfaction.”

The programme additionally encourages self-responsibility and features as a part of the Chronic Disease Prevention and Care Programme of the Government of Catalonia. It is predicated on three key approaches:
- support supplied by sufferers and observing professionals to these in power part of the disease;
- promote interplay in teams by 9 fastidiously deliberate periods;
- consider efficiency of previous periods by questionnaires earlier than a brand new session begins.
Many individuals who attended the programme over time say they might suggest it to household and associates because it vastly helps to enhance information about disease.

Initiators of the programme are assured that the methodology used, and classes discovered can type a part of a broader technique to push for complete care for a disease that continues to be largely uncared for. For instance, regardless of the efforts of the previous decade, the worldwide detection fee for Chagas disease is lower than 10%.

Through this settlement, WHO will present support in facilitating the interpretation of supplies and paperwork in languages utilized in its Member States in addition to help within the improvement of any mobile-based software if the necessity arises. The Government of Catalonia will print and distribute for advocacy functions.

To promote international advocacy for the disease, the World Health Assembly – WHO’s decision-making physique – in 2019 adopted a call to have a good time World Chagas Disease Day on 14 April.

The disease

Chagas disease was as soon as confined to rural areas of Latin American international locations the place the primary route of transmission is vectorial transmission.

But over the previous many years, the disease has been more and more reported in lots of international locations exterior Latin America primarily due to motion of populations and migration.

According to WHO estimates, round 6-7 million individuals are contaminated with Trypanosoma cruzi – the protozoan parasite that causes Chagas disease.

Vectorial transmission happens when people are available in contact with the faeces or urine of triatomine bugs (referred to as ‘kissing bugs’, amongst many different native names).

These bugs – the vectors that carry the parasites – reside within the wall or roof cracks of properties – the place they disguise in the course of the day and lively at evening after they feed on human blood. They often chew an uncovered space of pores and skin such because the face (therefore its widespread identify ‘kissing bug’).

Right after a chew, the bug defecates/urinates shut to the chew space. The parasites enter the physique when the particular person instinctively reacts to the chew and smears the bug faeces or urine into the chew, the eyes, the mouth, or into any pores and skin break.

The parasite may also be transmitted by:
- consumption of meals contaminated with T. cruzi by, for instance, contact with faeces or urine of contaminated triatomine bugs or marsupials (this type of transmission sometimes causes outbreaks with extra extreme morbidity and better mortality – infecting teams of individuals concurrently with extra frequent instances of extreme disease and better variety of deaths);
- blood or blood product transfusion from contaminated donors;
- passage from an contaminated mom to her new child throughout being pregnant or childbirth;
- some organ transplants utilizing organs from contaminated donors; and
- laboratory accidents.
There is not any vaccine in opposition to Chagas disease. Domiciliary vectorial management and transfusional management, along with congenital transmission, stay the simplest strategies of stopping transmission in Latin America.

Chagas disease was named after Carlos Ribeiro Justiniano Chagas, a Brazilian doctor and researcher who found the disease in 1909.

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April 3, 2020
WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic

The COVID-19 pandemic is straining health systems worldwide. The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively.

Previous outbreaks have demonstrated that when health systems are overwhelmed, mortality from vaccine-preventable and other treatable conditions can also increase dramatically. During the 2014-2015 Ebola outbreak, the increased number of deaths caused
by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola
^[1,2].

“The best defense against any outbreak is a
strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus.
“COVID-19 is revealing how fragile many of the world’s health systems and
services are, forcing countries to make difficult choices on how to best meet
the needs of their people.”

To help countries navigate through these challenges, the World Health Organization (WHO) has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating
the risk of system collapse. This includes a set of targeted immediate actions that countries should consider at national, regional, and local level to reorganize and maintain access to high-quality essential health services for all.

Countries should identify essential services that will be prioritized in their efforts to maintain continuity of service delivery and make strategic shifts to ensure that increasingly limited resources provide maximum benefit for the population. They
also need to comply with the highest standard in precautions, especially in hygiene practices, and the provision of adequate supplies including personal protective equipment This requires robust planning and coordinated actions between governments
and health facilities and their managers.

Some examples of essential services include: routine vaccination; reproductive health services including care during pregnancy and childbirth; care of young infants and older adults; management of mental health conditions as well as noncommunicable diseases
and infectious diseases like HIV, malaria and TB; critical inpatient therapies; management of emergency health conditions; auxiliary services like basic diagnostic imaging, laboratory services, and blood bank services, among others.

Well-organized and prepared health systems can continue to provide equitable access to essential service delivery throughout an emergency, limiting direct mortality and avoiding increased indirect mortality.

The guidelines stress the importance of keeping up-to-date information. This requires frequent transparent communications with the public, and strong community engagements so the public can maintain trust in the system to safely meet their
essential needs and to control infection risk in health facilities. This will help ensure that people continue to seek care when appropriate, and adhere to public health advice.

1. Elston, J. W. T., Cartwright, C., Ndumbi, P., & Wright, J. (2017). The health impact of the 2014–15 Ebola outbreak. Public Health, 143, 60-70.

2. Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerging infectious diseases, 22(3), 433.

For interviews please contact: Tarik Jasarevic

To access the full guidance please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/maintaining-essential-health-services-and-systems

For further information and guidance on COVID-19 please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

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March 31, 2020