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First ever State of the World’s Nursing report launched amid COVID19 pandemic

7 April 2020 – Nurses account for more than half of all the world’s health workers, providing vital services throughout the health system. Around the world they are demonstrating their compassion, bravery and courage as they respond to the COVID-19 pandemic, and never before has their value been more clearly demonstrated.

A new report, by WHO in partnership with the International Council of Nurses and Nursing Now, released today, reveals that, there are just under 28 million nurses worldwide. Between 2013 and 2018, nursing numbers increased by 4.7 million. But this still leaves a global shortfall of 5.9 million – with the greatest gaps found in countries in Africa, South East Asia and the WHO Eastern Mediterranean region as well as some parts of Latin America.

The State of the World’s Nursing 2020, provides an in-depth look at the largest component of the health workforce. Findings identify important gaps in the nursing workforce and priority areas for investment in nursing education, jobs, and leadership to strengthen nursing around the world and improve health for all.

Quotes:

“Nurses are the backbone of any health system. Today, many nurses find themselves on the frontline in the battle against Covid-19. This report is a stark reminder of the unique role they play, and a wakeup call to ensure they get the support they need to keep the world healthy.” Dr Tedros Adhanom Ghebreyesus, WHO Director General

“Politicians understand the cost of educating and maintaining a professional nursing workforce, but only now are many of them recognising their true value. Every penny invested in nursing raises the wellbeing of people and families in tangible ways that are clear for everyone to see. This report highlights the nursing contribution and confirms that investment in the nursing profession is a benefit to society, not a cost.” Annette Kennedy, ICN President

“This report places much-needed data and evidence behind calls to strengthen nursing leadership, advance nursing practice, and educate the nursing workforce for the future, said. The policy options reflect actions we believe all countries can take over the next ten years to ensure there are enough nurses in all countries, and that nurses use of the full extent of their education, training, and professional scope to enhance primary health care delivery and respond to health emergencies such as COVID-19. This must start with broad and intersectoral dialogue which positions the nursing evidence in the context of a country’s health system, health workforce, and health priorities.” Lord Nigel Crisp, Co-Chair of Nursing Now

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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
World TB Day 2020 Newsletter

Latest news and updates from WHO

Dear colleagues and friends,

World TB Day, this year, comes at a sobering time – as the world grapples with the COVID-19 pandemic. We stand in solidarity with those affected, those at the frontlines of the fight to combat COVID-19, as well as those who continue efforts to support
those ill with longstanding health problems like TB, HIV and other diseases. However, we cannot forget the millions and their families who battle TB every day and lose their lives to this ancient disease – which remains the world’s top
infectious killer.

As eloquently emphasized by WHO Director-General Dr Tedros Adhanom Ghebreyesus in his press briefing on COVID-19 yesterday, “I’d like to remind everyone that although COVID-19 is dominating the world’s attention-there is another respiratory
disease that is both preventable and treatable, but kills 1.5 million people every year – that disease is tuberculosis”

“It’s Time”, the focus for World TB Day this year is therefore on urgently accelerating the TB response to save lives and end suffering, even in times of crisis. This will be essential if we are to reach the targets and commitments made
by Heads of State at the 2018 UN High Level Meeting on TB.

We have made important strides against the TB epidemic to date.

We announced last year, that more people received life-saving treatment for tuberculosis in 2018 than ever before, largely due to improved detection and diagnosis. Globally, 7 million people were diagnosed and treated for TB – up from 6.4 million in 2017
– enabling the world to meet one of the milestones towards the United Nations political declaration targets on TB and the WHO Director-General Flagship Initiative Find.Treat.All End TB jointly with Stop TB Partnership and the Global Fund. This
has been a big win for the TB community.

WHO is working with countries to roll out important guidelines, including a comprehensive package on TB preventive treatment released today, and updated MDR TB guidelines to promote the use of all-oral regimens for patients with drug-resistant TB which
would be helpful – particularly at this point, when visiting health centers is a challenge. Furthermore, WHO has developed a note to guide and urge countries to ensure continuity of TB services during the COVID-19 pandemic.

We are strengthening our collaboration with civil society – more information is highlighted in the WHO Civil Society Taskforce Progress Review released today.

Youth mobilization is being ramped up through the WHO 1+1 Youth Initiative to end TB and the Global Youth Declaration to End TB. Multisectoral accountability is being promoted in countries through our framework and we have finalized a new global strategy
on TB research and innovation, that will be reviewed by the World Health Assembly.

Yet, the gains we have made are at risk – if there is any slackening of commitment and action, especially in times of crisis.

We are at a crossroads and we need to unite forces to take the path of success that will save lives and end suffering.

I was especially heartened today, to see the TB community coming together like never before. We all took our events to the virtual realm due to COVID-19 lockdowns. The WHO Online Talk Show held this afternoon, had a powerful line up of speakers that included,
TB survivors and advocates, civil society, high level government representatives, heads of agencies, researchers and partners. As of this evening we have surpassed 10,000 views on YouTube. I also participated in townhalls organized by Stop TB Partnership.
Our joint efforts have indeed ensured a continuing spotlight on those affected by TB, and clearly shows that no matter what the barrier, we can surpass it if we work together.

I am proud to stand shoulder-to-shoulder with you all virtually – and recommit to champion End TB efforts till we reach the finish line.

It’s time to deliver on our promises and ensure no one is left behind.

It’s time to End TB!

Dr Tereza Kasaeva
Director
Global TB Programme
World Health Organization

World TB Day Talk Show

In the backdrop of the global battle against COVID-19, WHO organized a special online talk show to mark World TB Day 2020. The talk show had a powerful line up of speakers from among TB survivors and advocates, civil society, high-level government representatives,
heads of agencies, researchers and partners. The video was streamed live on WHO’s Youtube channel crossing over 10,000 views in a few hours. Watch the talk show video

Spotlight on TB Preventive Treatment

New WHO recommendations to prevent tuberculosis aim to save millions of lives

24 March 2020 News release

Geneva – New World Health Organization (WHO) guidance will help countries accelerate efforts to stop people with tuberculosis (TB) infection becoming sick with TB by giving them preventive treatment. A quarter of the world‘s population
is estimated to be infected with TB bacteria. These people are neither sick nor contagious. However, they are at greater risk of developing TB disease, especially those with weakened immunity. Offering them TB preventive treatment will not only protect
them from becoming sick but also cut down on the risk of transmission in the community. Read more

The full package is available below and at our World TB Day Campaign Page

WHO Civil Society Taskforce on TB: Progress Review

The WHO Civil Society Taskforce provides a platform for meaningful engagement of civil society, building on the commitment of the Director-General, with emphasis on harnessing the untapped potential in engagement with civil society and affected communities
al all levels. To mark World TB Day 2020, the Task Force has released a Progress Review highlighting key achievements since its formation in 2018.

Access link here

WHO eTB guidelines: A digital platform to promote adolopment of TB recommendations

WHO Global TB Programme / McMaster University

The WHO Global Tuberculosis (TB) Programme, in collaboration with McMaster University, Canada, is developing a smart platform to improve access to and use of all WHO recommendations on TB prevention and care. The WHO eTB guidelines platform will facilitate
the adoption, adaptation and implementation (“adolopment”) by countries of recommendations across the continuum of care. This digital platform will provide a variety of users – TB programme managers, healthcare workers including
nurses, researchers, patients and affected communities – with easy access to all essential information about WHO-s current policy guidance on TB.

The first set of recommendations on TB preventive treatment were released on this new platform on World TB Day.

WHO eTB guidelines platform

Infographic

TB and COVID-19

24 March 2020 News release

Geneva – As the world comes together to tackle the COVID-19 pandemic, it is important to ensure that essential health services and operations are continued to protect the lives of people with TB and other diseases or health conditions. Health services,
including national programmes to combat TB, need to be actively engaged in ensuring an effective and rapid response to COVID-19 while ensuring that TB services are maintained. Read more

Let’s never forget: It’s time to end TB

Ksenia Schenina

Ksenia Schenina

24 March 2020 Photo story

On World TB Day 2020, the theme – “Its time” – stresses the urgency to end the TB epidemic. TB survivor and advocate, Ksenia Schenina, talks about her struggle with the disease, the persistence of stigma and the role that remembrance can play
in fighting it. Through her TB memorial project, she aims to remember those who passed away from this terrible and ancient disease. “We do it to show what kind of people they were – what kind of things they liked, what kind of music
they listened to and what their favorite movies were; if they liked fishing or dreamt of a flight to space,” she says. Read more

Commentary

To end TB, we must invest in research and innovation

24 March 2020 Commentary

If the world is to get anywhere near ending TB, a disease that killed more than 1.5 million people in 2018, something significant needs to change.

TB remains the world’s leading infectious killer and yet, in the last 50 years, only three new drugs and regimes have been developed to combat the disease. “What we need is more research and more tools in the pipeline; better diagnostics,
more effective vaccines, and safer, shorter drug regimes,” explains Dr Tereza Kasaeva, Director of the World Health Organization Global Tuberculosis Programme. Read more

Emily: A Day in the Life of a TB Nurse

Maria Emily C. Ballesteros

Watch this story of Emily, a nurse managing the tuberculosis (TB) program of the City Health Office in Tuguegarao City. Her dream for Tuguegarao is to one day see zero TB cases and that no one dies from this infectious disease. Nurses and healthcare workers
play a critical role in TB prevention and care. It’s time to invest in them to improve healthcare for all. We thank all the nurses, midwives and healthcare workers working to #EndTB! Watch the video

Updates and messages

New research tool supports scale-up of digital technologies to End TB

24 March 2020 TDR news item

National anti-tuberculosis efforts are increasingly involving digital technologies, such as mobile applications to support treatment adherence and electronic surveillance systems that enable real-time monitoring of a country’s TB situation. Read more

World TB Day 2020: It’s Time for solidarity

24 March 2020 HIV/TB news item

At this unique time in history when the world is grappling with the COVID-19 pandemic, the WHO Department of Global HIV, Hepatitis and STI Programmes stands in solidarity with governments and communities as they seek to maintain health services
and continue to address the needs of patients suffering from HIV and tuberculosis (TB). Read more

New, shorter treatment to prevent TB to be rolled out in five high TB burden countries

24 March 2020 news item

Three-month regimen expected to prevent TB in those at highest risk of developing the disease, including people living with HIV and children under the age of five
Today, the Aurum Institute and its partners, as part of the IMPAACT4TB project, announced that five high-burden TB countries will roll out a new, shorter drug regimen (known as 3HP) to prevent TB. The announcement comes as countries around the world mark World TB Day, which takes place every year on March 24th. Countries that will initially provide the new regimen with funding from Unitaid, U.S. PEPFAR and the Global Fund include Cambodia, Ethiopia, Kenya, Malawi, South Africa and Zimbabwe. More than 120,000 patient courses of 3HP will be delivered by the project to 12 countries in 2020. An additional 1 million patient courses are expected to reach low- and middle-income countries by the end of the year, through the combined support of Unitaid, Global Fund, the Stop TB Partnership’s Global Drug Facility (GDF) and PEPFAR. Read more

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March 31, 2020
Schistosomiasis elimination: refocusing on snail control to sustain progress
Substantial progress has been made during the past decade to prevent and control schistosomiasis (also known as bilharziasis) globally. The disease affects more than 230 million people, mostly in sub-Saharan Africa.

Progress is mainly due to large-scale periodic treatment of affected populations with praziquantel, the only medicine recommended by the World Health Organization (WHO) against all forms of schistosomiasis. Regular treatment cures mild symptoms and prevents
progression to severe, chronic disease.

“Through progressive scale-up of periodic large-scale treatment
to control morbidity in many endemic countries, we are closer to
achieving the minimum target of 75% global coverage of all school‐aged
children,” said Dr Amadou Garba Djirmay, who leads WHO’s global schistosomiasis control programme. “But
if we want to achieve elimination, we must go a step further to
introduce snail control in hot spots and in areas targeting elimination.
This is bound to increase impact and accelerate progress towards
interruption of transmission.”

Expansion of treatment is largely supported by donated praziquantel from Merck KGaA of up to 250 million tablets annually. In 2018, almost 78 million children were treated, representing 63% of all school‐aged children eligible for treatment.

Transmission: role of snails

Schistosomiasis is an acute, chronic parasitic disease caused by infection with trematode worms of the genus Schistosoma. It is prevalent in tropical and subtropical areas, especially in poor, rural communities that have little or no access to
safe drinking‐water and basic sanitation. Infection is transmitted when people suffering from schistosomiasis contaminate freshwater sources when evacuating urine and faeces containing the parasite’s eggs.

Once an egg comes into contact with fresh water, it releases miracidia (hatchlings) which enter a snail and produce hundreds of cercariae (larvae) daily. The cercariae enter the human body on contact with the skin and develop into adult worms.

Besides treatment with praziquantel, eliminating snail hosts and improving sanitation are important methods for sustainable prevention of the disease. Dam and irrigation projects are known to be potential sites for outbreaks of the disease. Snail management,
often achieved through mollusciciding, can help to reduce transmission by eliminating these intermediate snail hosts.

Vector control

In 2017, the World Health Assembly – WHO’s decision making body – adopted resolution WHA70.16 on the Global Vector Control
Response, calling on Member States to develop or adapt national vector control strategies and operational plans. The strategy aims to reduce by at least 40% the incidence of vector borne diseases, including schistosomiasis, by 2025.

In response, WHO is reinforcing snail control as part of its strategic approach to achieve the target of eliminating schistosomiasis as a public health problem and, ultimately, the goal of elimination of transmission. Snail control will complement mass
treatment campaigns and sustain the public health impact of this core intervention.

To facilitate implementation of snail control, in 2019 WHO published on specific, standardized procedures and criteria for efficacy
testing and evaluation and in 2017 a manual on the use of molluscicides in the field. WHO is also planning to strengthen capacities
of health staff in medical malacology in order to reinforce snail control activities in countries.

In the past, molluscicides (particularly niclosamide¹ based products) were widely used in schistosomiasis control programmes. For example, in China programmes largely relied on snail control for over 30 years to overcome the disease as a public
health problem. In other parts of the world, however, snail control programmes were gradually discontinued and competencies faded away.

“Snail control is a crucial component of the global schistosomiasis elimination strategy,” said Dr Rajpal Yadav, Scientist, WHO Department of Control of Neglected Tropical Diseases. “It
is time we look for new snail control products that are cost–effective
and of low risk to humans and the environment. Some efforts are being
made to explore molluscicide compounds from plants, marine algae and
microorganisms.”

An integrated control strategy involving mass treatment with praziquantel, snail control and environmental modification, wider access to sanitation and safe water, economic and environmental development, health education and poverty-alleviation can greatly
contribute to sustainable control and elimination of schistosomiasis.

WHO’s new road map on neglected tropical diseases for 2021–2030, due to be launched later this year, advocates enhanced financial and political support to achieve the target of interruption of transmission. Additional research to address gaps,
develop tools and optimize the impact of existing programmes with snail control will complement the core strategic approach.

Schistosomiasis: forms of the disease

There are two major forms of schistosomiasis – intestinal and urogenital.

Intestinal schistosomiasis usually results in diarrhoea and blood in the stool; enlargement of the liver and of the spleen and portal hypertension are common in advanced cases.

Urogenital schistosomiasis is characterized by the presence of blood in the urine. Chronic infection results in fibrosis of the bladder and ureter that can evolve to hydronephrosis and create conditions for bladder cancer.

In women, urogenital schistosomiasis can cause vaginal bleeding, pain during sexual intercourse and nodules in the vulva, a condition now described as female genital schistosomiasis. In men, urogenital schistosomiasis can induce disease in the seminal
vesicles and prostate.

¹Limitations with the use of formulations based on niclosamide include restrictions on the usage of water immediately after application and temporary toxicity to non-target aquatic organisms including
fish, amphibians and invertebrates.
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March 27, 2020
WHO urges countries to ensure the continuity of malaria services in the context of the COVID-19 pandemic

The COVID-19 pandemic is testing the resilience of robust health systems around the world. Recognizing the heavy toll that malaria exacts on vulnerable populations in sub-Saharan Africa, as well as the region’s fragile health infrastructure, WHO underlines the critical importance of sustaining efforts to prevent, detect and treat malaria.

“As COVID-19 continues its rapid spread, WHO would like to send a clear message to malaria-affected countries in Africa,” said Dr Pedro Alonso, Director of the WHO Global Malaria Programme. “Do not scale back your planned malaria prevention, diagnostic and treatment activities. If someone living in a place with malaria develops a fever, he or she should seek diagnosis and care as soon as possible.”

Ensuring access to core malaria prevention measures is an important strategy for reducing the strain on health systems; these include vector control measures, such as insecticide-treated nets and indoor residual spraying, as well as chemoprevention for pregnant women and young children (intermittent preventive treatment in pregnancy, intermittent preventive treatment in infants and seasonal malaria chemoprevention). Additional special measures could ease the burden on health systems in the context of COVID-19, such as presumptive malaria treatment and mass drug administration.

Any interventions must consider the importance of both lowering malaria-related mortality and ensuring the safety of communities and health workers. WHO will provide guidance for countries to safely maintain essential health services in the context of the COVID-19 response.

About COVID-19

COVID-19 is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were unknown before the outbreak began in Wuhan, China, in December 2019. Essential information on the COVID-19 pandemic can be found in a dedicated WHO site.

About malaria

Malaria is a preventable and treatable disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. In 2018, there were an estimated 228 million cases of malaria worldwide and 405 000 malaria-related deaths. For more on malaria, visit: www.who.int/malaria

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March 26, 2020
Justice For Sambo Abdullahi, Victory For Whistleblowers In Nigeria By Chido Onumah and Godwin Onyeacholem

Whistleblowers are the first line of defence against corruption, crime and cover-ups, according to a 2019 paper by the All–Party Parliamentary Group (APPG) on whistleblowing in the UK.

For Sambo Abdullahi, head of internal audit at the Nigerian Bulk Electricity Trading (NBET) Plc, it has been one long tortuous journey. Over the past two years, he has been at the receiving end of the retaliation whistleblowers around the world, including in Nigeria, face for shining the light on malfeasance around them: denial of wages, job losses, expensive court cases, abuse, psychological trauma, blacklisting across their sector, and sometimes death.

Abdullahi has been denied his salary and other allowances since December 2017, threatened, blacklisted, arrested and sued. All of this for acting professionally and responding patriotically to the call of the Nigerian government asking citizens to join the fight against corruption by blowing the whistle on corrupt practices and other forms of wrongdoing in the country.

In two separate courts, in Ifo, Ogun State, and Okitipupa, Ondo State, where in a most brazen abuse of judicial process, Abdullahi was summoned to answer charges of defamation levelled against him by his boss, Dr. Marilyn Amobi, Managing Director of NBET, he easily walked through the doorway of victory. Both cases were struck out on account of Dr. Amobi’s lack of seriousness in prosecuting.

The crisis of corruption in NBET has been going on for almost three years and the government appears not to have any solution. The appointment of Dr Amobi as the second substantive MD/CEO of NBET signified doom not only for Abdullahi as head of internal audit but also for the entire staff of the company. The MD withheld Abdullahi’s salary and other emoluments just because he exercised the right to decline participation in her fraudulent activities and rejected an unwarranted deployment to a new department unilaterally created by the MD to continue to perpetrate fraud.

Abdullahi, a Fellow of the Institute of Chartered Accountants of Nigeria (ICAN), graduated in Accounting from a reputable university and has over two decades of experience. He acquired experiences from both the private and public sectors before joining NBET. He was the pioneer Head of Internal Audit of NBET in 2012; a position he held till 2016 when Dr Amobi joined the company.

Within one month of Dr. Amobi’s assumption of office, Abdullahi discovered the illegal over-payment of N2 billion to two generating plants, Omotosho Power Plc and Olorunsogo Power Plc, both of which have no Gas Supply Agreement (GSA) and Gas Transportation Agreement (GTA) as required by industry agreement. The implication of this fraudulent transaction is that electricity consumers on a monthly basis pay N2billion in excess of what they ought to have paid if this fraud is averted. It is on record that the very first month the fraud was detected, Dr Amobi assumed the role of internal auditor by signing off the payment vouchers.

Her defence for this unlawful violation was that the mandatory GSA and GTA had been waived. The questions for her are, who approved the waiver? Why was the waiver not extended to other thermal plants? And why did the waiver idea come only after the head of internal audit had uncovered the fraud?

Other transactions that made Abdullahi to incur the wrath of Dr. Amobi was his refusal to endorse other payment vouchers for illegal procurement of alcohol using taxpayers’ money, proposed monthly payment of N2.5million to one Engr. Achinaya (an ex-staff of both NEPA and PHCN) without procurement process, procurement of legal advisory services of Azinge & Azinge and Aelex law firms in gross violation of the Procurement Act, and payment for return flight ticket from London for Dr Amobi to resume work in NBET in violation of the NBET Board-approved benefit compensation packages just to mention a few.

As a retaliation against Abdullahi for doing his job professionally, which to Dr Amobi connotes standing in her way, she colluded with the Office of the Accountant General of the Federation to get rid of Abdullahi and his colleague Waziri Bintube. Both were removed from their duly appointed and NBET Board- approved functions as head of internal audit and Chief Finance Officer respectively. While Abdullahi’s salary was stopped, Bintube was sacked.

In response, the duo wrote a petition to the Ministry of Power in 2017. The ministerial committee report was released in March 2018 and vindicated them, while indicting Dr. Amobi. But despite the minister’s (Babatunde Fashola) directives that Abdullahi’s salary should be restored and Bintube reinstated immediately, and in fact that both workers should enjoy the rights of NBET staff, Dr. Amobi refused to comply with the directives.

Till date, she denies Abdullahi his salaries and Bintube has not been called back. Dr. Amobi heads a government agency supervised by a Ministry, but her insolent defiance of a Ministerial order is unprecedented in the history of public sector administration in Nigeria. And it is strange that this is happening under a government that claims to prioritize due process and accountability in the public sector.

As if the stoppage of salaries and sacking were not enough, Dr Amobi got Abdullahi and Bintube detained in the facility of the State Security Services (SSS) for more than twenty-four hours. Several directives by Babatunde Fashola, then Minister of Power, were rebuffed by Dr Amobi who insisted that as an appointee of President Muhammadu Buhari she would only take directives from the president.

While the issue of salary suspension remained unresolved in spite of interventions from the Ministry of Power, Office of the Secretary to the Government of the Federation and the office of the Vice President, among others, Abdullahi approached the National Industrial Court in December 2018, twelve months after the unlawful stoppage of his salaries, with Nigerian Bulk Electricity Trading Plc, Dr Marilyn Amobi (MD/CEO), Hon Minister of Power and the Ministry of Power as defendants.

On March 11, 2020, Abdullahi (the claimant) once again walked the path of victory with the court delivering judgement in his favour. According to Hon Justice O. O. Oyewumi, the act of the suspension of the claimant’s salaries from December 2017 till date was wrongful; the denial of the claimant’s 2017 and 2018 leave was wrongful; the 1st and 2nd defendants, contrary to its terms and conditions of service, withheld the claimant’s salary and other emoluments wrongfully. The judge ordered the payment of Abdullahi’s salaries and other allowances, noting, “All sums awarded in the judgement is to be paid within 30days of the judgement, failure upon which it attracts 21% interest thereon per annum.”

While the case lasted in court, the Economic and Financial Crimes Commission (EFCC), Independent Corrupt Practices and Other Related Offences Commission (ICPC), Auditor General of the Federation and the Bureau of Public Procurement all issued reports indicting Dr Amobi while recommending her immediate prosecution. Sadly, some higher powers are preventing this from happening.

Governance problems are commonly found in federal government agencies due to either lack of a Board or total collapse of the governance structure. The Director General of the Bureau of Public Enterprises, Alex Akoh, noted in a letter to the Minister of Finance, Budget and National Planning, Zainab Ahmed, dated January 7, 2020, that “for the past 14 months, no Board meeting of the company (NBET) was held, a situation which has serious consequences on the corporate governance of the company”. Truth is, no Board meeting of NBET has held since August 2018 when Professor Yemi Osinbajo, then Acting President, ratified the reconstitution of the NBET Board of Directors recommended by Kemi Adeosun, the immediate past Minister of Finance.

The governance collapse in NBET has entrusted the fate of about 80 million electricity consumers in Nigeria in the hands of Dr Amobi who sees herself as not only untouchable, but also a sort of “Alfa and Omega.” She formulates and executes policies at will, such as changing the company organogram whenever she sees any staff as standing in her way. The entire senior management has passed a vote of no confidence in Dr Amobi but despite this and other fraudulent activities traceable to her, no action was taken by the government to ameliorate the problem in the power sector and curb the continuous fraud being perpetrated in NBET.

The Minister of Power of Power Engr. Sale Mamman, in December 2019, made a daring move to respond to the situation by suspending Dr. Amobi from office indefinitely. But curiously, he was overruled by President Muhammadu Buhari in less than two weeks and Dr. Amobi was returned to office.

This forced the Minister to fire a letter dated January 8, 2020, to Boss Mustapha, Secretary to the Government of the Federation, detailing investigations by the ICPC, EFCC and the reports of the Auditor General of the Federation which implicated the NBET boss “for breach of due process in the award of contracts and several financial wrongdoings.” In that letter copied to President Buhari, the Minister reminded the SGF of “the additional baggage which the suspended MD carries in the light of the anti-corruption stance of the Federal Government.”

If this government wants to be seen as genuinely fighting corruption, the NBET case is a golden opportunity to faithfully demonstrate that conviction. Dr. Amobi has been indicted for corruption by government anti-corruption agencies. The place for her, therefore, is the courtroom, not a cushioned seat of a government agency.

Meanwhile, before Dr. Amobi’s prosecution, government should direct her to obey without delay the judgment of a court of competent jurisdiction in the suit filed by a whistleblower, Sambo Abdullahi, the head of internal audit of NBET.

In addition, government should realize that all whistleblowers deserve full and effective protection from all kinds of retaliation, without which its whistleblowing policy will not succeed as an instrument for reducing corruption in the country.

Onumah and Onyeacholem are with the African Centre for Media & Information Literacy (AFRICMIL)

Opinion

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March 26, 2020
World TB Day 2020: It’s Time for solidarity
At this unique time in history when the world is grappling with the COVID-19 pandemic, the WHO Department of Global HIV, Hepatitis and STI Programmes stands in solidarity with governments and communities as they seek to maintain health services
and continue to address the needs of patients suffering from HIV and tuberculosis (TB).

Despite being preventable and treatable, tuberculosis remains the world’s biggest infectious killer and the leading cause of death among people living with HIV (PLHIV), responsible for 32% of the 770 000 lives lost to HIV in 2018. People
living with HIV are far more vulnerable (nearly 20 times more) to TB infection than people without HIV and are three times more likely to die during TB treatment.

While there are proven interventions that reduce TB deaths – such as provision of TB preventive treatment, adoption of novel diagnostics for earlier TB diagnosis and linkage to treatment, and antiretroviral therapy (ART) – we are far behind
in scaling these up, and diagnostic and treatment gaps remain, with only half of estimated TB cases among PLHIV reaching care in 2018, only half of estimated PLHIV with TB receiving ART, and less than half of PLHIV new on ART initiating TB preventive
treatment in a subset of countries which reported globally.

On this World TB Day, WHO highlights two key interventions to reduce unnecessary TB deaths among PLHIV:
- (1) provision of TB preventive treatment for all eligible PLHIV; and
- (2) increased uptake of newer diagnostic tests such as the lateral flow urine lipoarabinomannan assay (TB-LAM.)
As the new Director for the Department of Global HIV, Hepatitis and STI Programmes, I support current efforts to continue and to take to scale TB activities. It’s Time for solidarity!

-Meg Doherty, Director Global HIV, hepatitis and STI Programmes, WHO

HIV programmes are encouraged to ensure that TB preventive treatment, including shorter WHO-recommended regimens, with updated guidance launched today, are provided to all eligible PLHIV as part of a routine package of care, including provision of ART, and that treatment completion is ensured.

In recent months, WHO has also released guidelines for use of a bedside urine TB-LAM test to accelerate earlier TB diagnosis, with significantly expanded eligibility criteria. As this test is “point of care” with the potential for earlier
TB diagnosis and treatment initiation, HIV programmes should consider these recommendations as they enhance strategies for TB diagnosis among PLHIV, including as part of a routine package of advanced HIV care.

It’s Time to urgently scale up TB preventive treatment and TB diagnosis and strengthen referral and linkages to TB treatment at HIV service delivery points in all countries and continue to scale-up ART among PLHIV with TB. This applies to all populations
at risk, including children, pregnant women and marginalized groups, to ensure no one is left behind.

WHO calls for continued collaboration in countries across health programmes for harmonized and integrated policies and service delivery, and engagement with communities and other sectors. Unless HIV programmes scale up interventions to close these
gaps in prevention, diagnosis and treatment both for TB and HIV, countries and their development partners will not meet our common target: a 75% reduction in TB deaths among PLHIV between 2010 and 2020. HIV mortality cannot be reduced without addressing
the leading cause: tuberculosis.

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March 25, 2020
Webcast excerpt: What was the reason for the 2018 market downturn?

In this excerpt of a recent webcast, Vanguard Chief Executive Officer Tim Buckley and Chief Investment Officer Greg Davis share their insights and perspectives on what’s in store for investors in 2019.

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March 24, 2020
New WHO recommendations to prevent tuberculosis aim to save millions of lives
Geneva – New World Health Organization (WHO) guidance will help countries accelerate efforts to stop people with tuberculosis (TB) infection becoming sick with TB by giving them preventive treatment.

A quarter of the world‘s population is estimated to be infected with TB bacteria. These people are neither sick nor contagious. However, they are at greater risk of developing TB disease, especially those with weakened immunity. Offering them TB
preventive treatment will not only protect them from becoming sick but also cut down on the risk of transmission in the community.

As we mark World TB Day 2020, the disease remains the world’s top infectious killer. In 2018, 10 million people fell ill with TB worldwide and 1.5 million people lost their lives to this disease.

“COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be,“ said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The world committed to end TB by 2030; improving prevention is key
to making this happen. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives”.

Dr Tedros highlighted the importance to continue efforts to tackle longstanding health problems, including TB during global outbreaks such as COVID-19. At the same time, programmes already in place to combat TB and other major infectious diseases
can be leveraged to make the response to COVID-19 more effective and rapid.

Although some progress has been made towards targets set at the UN high-level Meeting on TB in 2018, TB preventive treatment has been largely neglected. Global leaders committed to ensuring access to TB preventive treatment to at least 24 million contacts
of people with active TB and 6 million people living with HIV by 2022. To date only a fraction of that target has been reached, with countries putting less than 430,000 contacts and 1.8 million people on TB preventive treatment in 2018.

TB remains the top cause of death among people with HIV. TB preventive treatment works synergistically with antiretroviral therapy to prevent TB and save lives. Reinvigorated efforts by governments, health services, partners, donors and civil society
will be needed to increase access to TB preventive treatment to the levels targeted.

The new consolidated guidelines recommend a range of innovative approaches to scale up access to TB preventive treatment:
- WHO recommends a scale-up of TB preventive treatment among populations at highest risk including household contacts of TB patients, people living with HIV and other people at risk with lowered” immunity or living in crowded settings.
- WHO recommends an integration of TB preventive treatment services into ongoing case finding efforts for active TB. All household contacts of TB patients and people living with HIV are recommended to be screened
  for active TB. If active TB is ruled out, they should be initiated on TB preventive treatment.
- WHO recommends that either a tuberculin skin test or interferon-gamma release assay (IGRA) be used to test for TB infection. Both tests are helpful to find people more likely to benefit from TB preventive treatment
  but should not become a barrier to scale-up access. Testing for TB infection is not required before starting TB preventive treatment in people living with HIV, and children under 5 years who are contacts of people with active TB.
- WHO recommends new shorter options for preventive treatment in addition to the widely used 6 months of daily isoniazid. The shorter options that are now recommended range from a 1 month daily regimen of rifapentine plus isoniazid
  to 3 months weekly rifapentine plus isoniazid, 3 months daily rifampicin plus isoniazid, or 4 months of daily rifampicin alone.
“As people around the globe come together to commemorate World TB Day, WHO is calling on governments, affected communities, civil society organizations, health-care providers, donors, partners and the industry to unite forces and step up
the TB response – notably for TB preventive treatment – to ensure no one is left behind,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “The new WHO guidance shows the way forward for millions to rapidly
access new tools and shorter, safer options for preventive treatment. The time for action is now.”

TB preventive treatment is an affordable intervention that can prevent families from sliding into poverty and preserve the health and economy of whole communities. WHO anticipates that as new and safer drugs come onto the markets, and as prices
fall, it will become a highly-cost effective way to save millions of lives.

NOTES FOR EDITORS:

WORK BY WHO AND PARTNERS

WHO works closely with Member States including the US Government and technical and funding partners such as UNITAID to enhance access to shorter TB preventive treatment regimens. UNITAID-supported projects such as IMPAACT4TB and Cap-TB projects
enabled by WHO with partners in Brazil, Cambodia, Cameroon, Côte d’Ivoire, Democratic Republic of Congo, Ethiopia, Ghana, India, Indonesia, Kenya, Lesotho, Malawi, Mozambique, South Africa, Uganda, United Republic of Tanzania and
Zimbabwe are leading the way. The new treatment options are also now more affordable, thanks to the significant price drop of rifapentine – a key drug – facilitated recently by UNITAID, the Global Fund to Fight AIDS, Tuberculosis and Malaria
and global biopharmaceutical company Sanofi, along with forthcoming arrangements underway with generic manufacturers.

MORE ABOUT THE GUIDELINES

The new consolidated WHO guidelines come with an operational handbook to help guide countries step-by-step as they take TB preventive treatment to scale. This includes guidance on how to prioritize and invest from demand creation for TB prevention
to supervision and monitoring of the programme.

The guidelines and operational handbook are also accompanied by an innovative mobile application – Prevent TB –to help health-care workers manage TB preventive treatment in their communities. Its online dashboard allows programme
managers to visualize and monitor data in real time. The application can be customized by countries to suit their specific settings and is currently being adopted in India and Philippines.

WORLD TB DAY

The new guidelines and tools are being released ahead of World TB Day. World TB Day is observed on March 24 each year to raise public awareness and understanding about the world’s deadliest infectious killer – TB and its devastating
health, social and economic impact on people around the world. Under the theme “It’s Time”, the spotlight this year is on urgently accelerating the TB response to save lives and end suffering.

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March 24, 2020
Dracunculiasis eradication: intensifying surveillance amid continued zero human cases in Ethiopia and Mali

A total of 54 human cases of dracunculiasis (guinea-worm disease) were reported to the World Health Organization (WHO) in 2019, with Chad reporting 48 out of the 54 cases.

In Chad, Ethiopia, Mali and South Sudan, trained volunteers are supporting surveillance and detection of infections in domestic dogs and cats. Surveillance has been heightened, as evidenced by the increase in reports of rumoured human cases which in 2019 peaked at 108 207 out of which 106 678 were investigated within 24 hours.

“We are working with the broader scientific community to understand the epidemiology of animal infections, mainly in dogs in Chad, where the highest number of human cases were reported in 2019,” said Dr Dieudonné Sankara, who leads WHO’s eradication and elimination team in the Department of Control of Neglected Tropical Diseases. “Interestingly, there have been no human cases in Ethiopia and Mali, and 4 human cases in South Sudan in 2019, compared with 10 in 2018.”

In Mali, the number of animals infected with Dracunculus medinensis (the guinea-worm) has decreased from 20 animals in 2018 to 8 dogs and 1 cat in 2019. However, insecurity remains a challenge to freely accessing some endemic areas in Mali.

Conversely, Chad reported 1935 infections in dogs and 46 in cats in 2019, an increase of 85% from 2018, and a 176% increase among humans.

Angola reported only 1 human case in 2019. Community-based surveillance is being reinforced mainly in Cunene Province where a case was reported in 2018.

In South Sudan, integrated surveillance activities have been carried out with the trachoma and onchocerciasis control programmes, in accordance with WHO’s recommendation that programmes collaborate, integrate and co-implement activities, whenever possible, to strengthen surveillance.

In order to strengthen cross-border surveillance, WHO led a mission to Cameroon in November 2019 to investigate circumstances around an “imported” case in the country’s Far North Region. Discussions were held with the health authorities to establish active surveillance in all villages in the area, including training for application of temephos.[1]

Also, in 2019, and with the support of trained field workers, vector control was intensified to larvicide ponds and water sources in more than 400 villages, compared with 72 villages in 2018.

In late 2019, WHO supported cross-border meetings with officials of national dracunculiasis eradication programmes from Mali, Burkina Faso and Côte d’Ivoire in West Africa; between Ethiopia and South Sudan in East Africa, and between Angola and Namibia in Southern Africa, to share experiences and plan joint surveillance activities across the borders to prevent transmission of the disease.

The disease

Dracunculiasis is a crippling parasitic disease caused by infection with D. medinensis, a long, thread-like worm. It is usually transmitted when people drink stagnant water contaminated with parasite-infected water fleas.

WHO works with Member States and in partnership with The Carter Center and the United Nations Children’s Fund to support efforts to eradicate the disease. WHO provides technical guidance, works with national programmes to coordinate surveillance in dracunculiasis-free areas, and monitors and reports on the progress achieved.

WHO is the only Organization mandated to certify countries as free of transmission of the disease following the recommendations of the International Commission for the Certification of Dracunculiasis Eradication.

Since 1995, WHO has certified a total of 199 countries, territories and areas, including 187 Member States, as free of dracunculiasis transmission.

[1] Temephos is a cyclopicide used to kill water fleas (cyclops) that carry the infective guinea-worm larvae.

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March 20, 2020