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No Evidence That Shekau Received €5m Foreign Fund From An NGO

Boko Haram Terrorists

Fact-checkers at HumAngle online newspaper have described a news report published on Opera News that Abubakar Shekau’s faction of Boko Haram was in disarray after it received a donation of five mIllion euros from an “unidentified” international non-governmental organisation as false.

The publication claimed that senior members of the group have also turned against each other over how the fund should be shared within the group.

The story claimed that a military source said “Shekau is getting blind as such only the very close ones of his aides have access to him. The issue of €5m is causing serious disaffection in their camps.

“Shekau has been receiving such funding in the past and he was never able to build his terror infrastructure beyond what is currently being dismantled. Our commanders are not concerned that he is still defrauding those sponsoring him, if there is any concern it is that we should be able to capture him before his own fighters kill him,” the military source said as claimed by the news report.

Boko Haram Terrorists

But according to HumAngle newspaper, the Director of Nigerian Army Public Relations, Sagir Musa, when contacted to verify the claim said he was not aware of either the “verified intelligence reports” or the claim that Shekau received five million euros foreign fund through an NGO in the North-East.

The newspaper also said it searched autogist.com, the blog that the news was attributed to but could not find the story published on the blog.

“Fact-checkers at HumAngle contacted the Director of Nigerian Army Public Relations, Sagir Musa, to confirm the veracity of the claim and he said he was not aware of either the “verified intelligence reports” or the claim that Shekau received five million euros foreign fund through an NGO in the North-East.

“We searched autogist.com, the blog that the news was attributed to but could not find the story published on the blog. Also, no reliable medium reporting terrorism published the story. Other conflict and insurgency reporters were contacted by HumAngle but none was aware of the “verified intelligence report”.

“As the name of the NGO was not disclosed, it became difficult to trace its operation history.

“However, Nigeria’s military had suspended several NGOs from operating in the North-East following allegations of collaborating with the terrorist organisation. But no NGO has ever been charged to court by the authorities and the suspended NGOs were later allowed to resume operations in the region.

“Scholars and experts on Boko Haram have suggested different methods of terrorism financing, from state sponsorship to external support by other terror groups like ISIS and Alqa’eda. But Shekau’s faction of Boko Haram relies on self-funding streams through fishing, farming, crowdfunding, extortion, taxation, raids and ransom taking to finance its operations,” the newspaper published.

Quoting a report on Boko Haram sources of funding, it continued, “Much of Boko Haram’s funds are transported through human cash couriers, which are able to move rather easily between the porous borders of Nigeria, Niger, Cameroon and Chad… very little evidence of either Gulf or other foreign funding exists,” a report on Boko Haram sources of funding concluded.

“Due to the strict surveillance of monetary operations to avoid terrorist financing in Nigeria, financial regulations have forced Boko Haram to avoid remittances of funds online. Such a huge amount is not possible to be transferred without its being intercepted by international and local intelligence platforms.”

The newspaper further said Nigeria Financial Intelligence Unit follows any suspicious transaction with the aim of curbing terrorism financing.

“It collates information of all beneficiaries of humanitarian assistance to avert financing of terrorism through covert operations, thus making it impossible for any NGO to follow “previous channels and beneficiaries’ templates” of funding terrorism as claimed by the report.

“Humanitarian organisations work hand in hand with EFFC Department of Special Control against Money Laundering (SCUML) to checkmate their activities to curb terrorism financing, according to Abdurrashid Ibrahim a worker at the financial unit of an NGO in the North-East.

“Any transaction from five million naira must pass through a special control unit against money laundering (SCUML) clearance process be it for individual or corporate organisation,” he said.

Furthermore, there is no evidence that an NGO was allowed to operate after the military discovered that “Shekau has been receiving such funding in the past” as claimed by the news.

According to HumAngle findings, Abubakar Shekau does not operate or rely on an advisory council (Shura).

He is reported to be ruthless and brutal to any opposition within the group, making it unlikely for any Boko Haram commander to disagree with the leader.

Boko Haram

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May 9, 2020
My Uncle Died Of Coronavirus Symptoms, His Wife Now Sick But NCDC Failed To Respond, Kano Resident Says

A resident of Kano State has accused the Nigeria Centre for Disease Control of ignoring calls made to their lines since she lost her uncle, who was exhibiting COVID-19 symptoms on Thursday night.

The resident, identified as @Nabeeylarh2, said the NCDC in Kano State had refused to move in to test or evacuate those, who might have been infected despite so many calls to their hotlines.

@Nabeeylarh2 said, “My uncle died last night of COVID-19 symptoms and his wife, my aunt, has been exhibiting symptoms as well. We have contacted NCDC since morning to come to her but we haven’t seen anyone.

“We did (called NCDC) they weren’t picking at first and when they finally did around 9pm they told us they would come but no one came. We called again around 4pm and they told us they would come but they don’t know when. We have been waiting ever since.

My uncle died last night of covid-19 symptoms and his wife my aunt has been exhibiting symptoms as well we have contacted @NCDCgov since morning to come to her but we haven’t seen anyone

— Nabeeylarh (@Nabeeylarh2) May 7, 2020

“Please, we need your help urgently @NCDCgov. My aunt is deteriorating every passing minute. Help needed urgently.”

Please we need your help urgently @NCDCgov my aunt is deteriorating every passing minute her name is Maryam this is her address Medile Kano. Tilba junction. Help needed urgently!!!!

— Nabeeylarh (@Nabeeylarh2) May 7, 2020

Kano has recorded over 300 cases in the past weeks, causing many deaths.

The state is the second highest hit state with 482 COVID-19 cases so far.

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May 9, 2020
Brain cells reach out to each other through miniature cages

Mouse neurons trapped inside cages grow long appendages to connect to each other. Trapping the cells allows us to precisely control their growth

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May 9, 2020
Can nudge theory really stop covid-19 by changing our behaviour?

Human behaviour is key to the spread of coronavirus, so government scientists are trying to control our decisions. Does it work, and what happens when they get it wrong?

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May 9, 2020
NRD opens all ID-related transactions by appointment during CMCO

PUTRAJAYA: The National Registration Department (NRD) has opened its offices nationwide to assist the public with pending identification document (ID) transaction on an appointment basis.

In a statement today, the NRD said most of its offices have been operating by appointment since the implementation of the Conditional Movement Control Order (CMCO) on May 4, except the offices located at urban transformation centres (UTC) and in the CMCO areas.

“This is in line with the government’s announcement. All transactions with the NRD can be done by appointment between 8.30 am and 4 pm. Customers can set their appointments by contacting any of the NRD Customer Service offices nationwide.

“This appointment-based service is being offered to ensure compliance of the Covid-19 preventive measures, especially in terms of social distancing,” the statement said.

The statement also said that the NRD will also follow the strict standard operating procedure (SOP) during the CMCO, including taking necessary details of customers and their body temperature, using hand sanitizer and sanitising the counters from time to time.

It said customers who have secured an appointment are not allowed to bring other people to keep them company during the appointment so as to ensure social distancing and minimise the number of people in the office at any one time.

For Mykad application involving 12-year-old applicants or a wedding ceremony which requires the attendance of more than one person, they will be advised to come in a minimal number.

“The public are advised not to walk in to the NRF office without an appointment as service can only be rendered if an appointment slot was vacated. If the transaction is not urgent and can be postponed, they are also advised to come after the MCO is lifted,” it said.

The government’s announcement that birth registration could be made within 90 days after the end of MCO period without any penalty is still in force, hence no need for the public to rush to register births.

Further information on the NRD services during the CMCO can be obtained at its website at www.jpn.gov.my or its official social media sites. –Bernama

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May 9, 2020
Socso’s PSP for Covid-19 screening : Only RT-PCR tests will do

KUALA LUMPUR: The Social Security Organisation will only accept the ‘Reverse Transcriptase-Polymerase Chain Reaction’ (RT-PCR) method for Covid-19 screening under its Program Saringan Prihatin (PSP) initiative and not the ‘Rapid Test Kit (RTK) Antibody’ methodology.

Socso said it was taking this measure based on the latest guidelines from the Health Ministry (KKM) on Covid-19 screening which only recognises RT-PCR as the methodology and the National Security Council’s decision on the same matter.

“Socso views the recommendation on the Covid-19 screening methodology for workers at high risk very seriously, The screening tests will be undertaken by the existing service providers and also others who will be appointed to enable more efficient delivery.

“This screening is compulsory for foreign workers in the construction sector or those working in red zones only,” Socso said in a statement here today.

Prior to this, Socso had announced that under its PSP initiative on testing for Covid-19 on workers of companies operating during the Movement Control Order (MCO) period would entail two phases namely RT-PCR followed by the RTK Antibody.

Socso will be providing more information at its Portal Prihatin Perkeso at https://prihatin.perkeso.gov.my. –Bernama

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May 9, 2020
Free psychological help extended to May 15

GEORGE TOWN: The free psychological first aid offered by Wawasan Open University (WOU) in partnership with the International College of Clinical Hypnotherapy Practitioners (ICCHP) Asia will now be extended until May 15 owing to the overwhelming response received.

The aid comes in view of the mental challenges that the people, especially families, are experiencing during the movement control order (MCO), which has now entered its 52nd day.

A total of 223 people had reached out for help in relation to the Covid- 19 pandemic from April 1 to 25.

The programme is scheduled to continue past the anticipated relaxation of the MCO to handle post-traumatic stress from the prolonged lockdown.

The team from ICCHP Asia assisted callers with tips and skills to better manage their challenging emotions.

Although the free psychological service was set up mainly for the frontliners, there were many calls from the people due to various losses and the restrictions, WOU said in a statement.

Suicidal cases were referred to the team’s on-call psychiatrists for clinical assessment, advanced help and close monitoring.

The team helped to calm distressed callers and enabled them to better cope with the current uncertainties and make informed decisions.

Where practical assistance was needed, they worked with the Members of Parliament in the areas concerned to provide urgent assistance, such as medical emergencies, ambulance services and food aid.

Sixteen professionals from ICCHP Asia, including six psychiatrists, are offering support over the telephone.

All conversations are private and confidential.

Students who are doing complete online learning remotely from their homes or elsewhere are also encouraged to call in if they are feeling stressed during the MCO period.

Feel free to call ICCHP Asia from 9am to 9pm daily from now until May 15 as per below, or email icchpcovid19@gmail.com to arrange a convenient time to chat: 0124447032 / 0169271240/ 0124856404 (9am-12pm);

0123021262 / 0124080675/ 0123741558 (12pm-3pm);

0174777746 / 0124736830 / 0164979876 (3pm-6pm);

0122212906 / 0195645868 / 0124252962 (6pm-9pm)

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May 9, 2020
Statement on the third meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of coronavirus disease (COVID-19)
The third meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19), took place on Thursday, 30 April 2020, from 12:00 to 17:45 Geneva
time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference. Membership of the Emergency Committee was expanded
to reflect the nature of the pandemic and the need to include additional areas of expertise.

The Director-General welcomed the Committee, thanked them for their commitment to enhancing global public health, and provided an overview of the major achievements in the COVID-19 response since the last Emergency Committee meeting on 30 January 2020.
Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities.

The Ethics Officer from CRE provided the members and advisers with an overview of the WHO Declaration of Interest process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests
of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and
the work of the committee. Only those committee members and advisers who were not considered to have any perceived or direct conflict of interest participated in the meeting.

The Secretariat turned the meeting over to the Chair, Professor Houssin. He also welcomed the Committee and reviewed the objectives and agenda of the meeting.

The WHO Regional Emergency Directors and the Executive Director of the WHO Health Emergencies Programme (WHE) provided regional and the global situation overview. After ensuing discussion, the Committee unanimously agreed that the outbreak still constitutes
a public health emergency of international concern (PHEIC) and offered advice to the Director-General.

The Director-General declared that the outbreak of COVID-19 continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.

Advice to WHO

Coordination, planning, and monitoring
- Continue to lead and coordinate the global response to the COVID-19 pandemic in collaboration with countries, the United Nations (UN), and other partners.
- Work with fragile states and vulnerable countries that require additional technical, logistical and commodity support.
- Establish mechanisms to compile lessons learned from country and partner experiences and WHO missions and share the best practices and updated recommendations.
- Provide further guidance to countries about adjusting public health measures, taking into account the different epidemiological situations of the pandemic.
- Promote the inclusion of all interested countries, including low- and middle-income countries from all regions, in the Solidarity clinical trials for therapeutics and vaccines.
- Continue efforts with partners to obtain equitable access to personal protective equipment, diagnostics, and biomedical equipment essential to the pandemic COVID-19 response.
- Continue to coordinate global expert networks in epidemiology, laboratory, vaccines, clinical care, infection prevention and control, social sciences, and operational research; modelling; and other technical support.
One Health
- Work with the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO), and countries to identify the zoonotic source of the virus and the route of introduction to the human population, including
  the possible role of intermediate hosts. This should be accomplished through efforts such as scientific and collaborative field missions, which will enable targeted interventions and a research agenda to reduce the risk of similar events.
- Work closely with OIE and FAO to provide guidance on how to prevent SARS-CoV-2 infections in animals and humans and prevent the establishment of new zoonotic reservoirs.
- Work with partner organizations and countries to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply.
Essential Health Services
- Support countries to assess and manage the unintended consequences of public health measures implemented to control the COVID-19 pandemic, including gender-based violence and child neglect.
- Support countries to monitor their ability to provide and strengthen essential health services throughout a likely extended COVID-19 response. This should include, but is not limited to, essential prevention for communicable diseases, particularly
  vaccination; services related to reproductive health, including care during pregnancy and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic
  diseases, including mental health conditions; continuity of critical inpatient therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic
  diagnostic imaging, laboratory services, and blood bank services.
- Support countries to address shortages of essential medicines and health products, personal protective equipment, and other medical supplies and to establish sustainable risk management practices to prevent future shortages.
Risk communication and community engagement
- Continue risk communications and community engagement activities through the WHO Information Network for Epidemics (EPI-WIN) and other platforms to counter rumours and misinformation.
- Continue to regularly communicate clear messages, guidance, and advice about the evolution of the COVID-19 pandemic, how to reduce transmission, and save lives.
- Work with partners and countries to articulate potential long-term consequences of COVID-19 pandemic, emphasizing the need for strengthened cross-sectoral preparedness, transparency and global coordination.
Surveillance
- Clarify the testing strategy, support countries to increase testing capacity, and aim to provide equitable access to diagnostic tests and supplies in light of market failures and global shortages.
- Continue to provide guidance on monitoring disease trends using Severe Acute Respiratory Infections (SARI) and Influenza Like Illness (ILI) surveillance systems in anticipation of the co-circulation of influenza viruses.
- Develop qualitative and quantitative indicators that countries can use to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
- Continue to support countries and partners by providing technical and operational guidance, training platforms, and tools such as Go.Data,to enhance case identification and contact tracing capacity, strengthen the public health workforce, and engage
  communities for contact tracing.
- Provide clear qualitative and quantitative indicators to monitor SARS-CoV-2 transmission to inform the adjustment of public health and social measures.
Travel and Trade
- Continue working with countries and partners to enable essential travel needed for pandemic response, humanitarian relief, repatriation, and cargo operations.
- Develop strategic guidance with partners for the gradual return to normal operations of passenger travel in a coordinated manner that provides appropriate protection when physical distancing is not feasible.
- Update recommendations on appropriate travel measures and analyze their effects on international transmission of COVID-19, with consideration of the balance between benefits and unintended consequences, including entry and exit screening, education
  of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
To all States Parties

Coordination and Collaboration
- Support WHO leadership and continue to collaborate with WHO at all levels of the organization and with other countries to enable effective global COVID-19 pandemic preparedness and response.
- Participate in global solidarity efforts to enable access to essential supplies for all.
- Document and share lessons learned from efforts to control the pandemic, including the timing, pace, and sequencing of the application and lifting of public health measures.
Preparedness
- Strengthen preparedness for health emergencies, and build resilient health systems, incorporating lessons learned during different stages of the pandemic, and sharing experiences with other countries.
Surveillance
- Work with WHO and multisectoral partners to interrupt transmission by maintaining robust surveillance systems; enhancing capacities for case detection, testing, isolation of cases, contact tracing, quarantine of contacts, and rapid response; strengthening
  the public health workforce; and actively engaging communities for contact tracing, with a particular focus on high risk areas.
- In settings where testing a large proportion of suspected cases is not possible, monitor overall trends; undertake early detection through laboratory confirmation of a limited number of cases with a focus on health workers; and rapidly implement
  public health measures.
- Share with WHO all data necessary to conduct global risk assessments through data platforms, such as the Global Influenza Surveillance and Response System and the IHR mechanism. These data should include SARI and ILI where available.
- Use the WHO qualitative and quantitative indicators to assess and monitor SARS-CoV-2 transmission at all levels of public health response.
Additional Health Measures
- Avoid restrictions on international transport of food, medical and other essential supplies and permit the safe movement of essential personnel required for an effective pandemic response.
- Implement appropriate travel measures with consideration of their public health benefits, including entry and exit screening, education of travelers on responsible travel behaviour, case finding, contact tracing, isolation, and quarantine, by
  incorporating evidence on the potential role of pre-symptomatic and asymptomatic transmission.
- Implement and monitor case finding and contact tracing of travellers, using digital tools where appropriate.
- Continue to review travel and trade measures based on regular risk assessments, transmission patterns at origin and destination, cost-benefit analysis, evolution of the pandemic, and new knowledge of COVID-19.
- Engage in global efforts to respond to the challenges of COVID-19 in managing maritime vessels.
- Do not implement trade restrictions beyond those considered to be of public health importance in accordance with relevant international agreements.
- Continue to provide appropriate public health rationale to WHO for additional health measures in accordance with IHR.
Health Workers
- Prioritize the protection of the health workforce through access to training and provision of personal protective equipment, infection prevention and control measures, improved working conditions, application of WHO recommended testing strategies,
  and prevention of stigma and attacks on health workers.
Food Security
- Work with WHO and partners to strengthen the global food supply chain, protect food workers, properly manage food markets, and mitigate possible disruptions to the food supply, especially for vulnerable populations.
One Health
- Promote sound practices to manage risks of trade of live animals in food markets and regulate trade of exotic wildlife.
Risk Communications and Community Engagement
- Continue to engage communities to address rumours and misinformation and keep the public informed, with a focus on vulnerable populations.
Research and development
- Address research gaps such as: routes of transmission, including the role of asymptomatic and pre-symptomatic infection droplet, contact, fomite and aerosol transmission; and viral shedding; and animal source and intermediate hosts, in collaboration
  with partners.
- Continue to support and conduct COVID-19 research, in line with the WHO Research and Development Blueprint, and the road map for COVID-19 vaccines, diagnostics, and therapeutics.
- Continue sharing full genome sequences to increase global understanding of virus evolution and phylogenetics and their application to public health practices.
Essential Health Services
- Maintain essential health services throughout a likely extended COVID-19 response. This should include essential prevention for communicable diseases, particularly vaccination; services related to reproductive health, including care during pregnancy
  and childbirth; care of vulnerable populations, such as young infants and older adults; provision of medications and supplies for the ongoing management of chronic diseases, including mental health conditions; continuity of critical inpatient
  therapies; management of emergency health conditions and common acute presentations that require time-sensitive intervention; and auxiliary services, such as basic diagnostic imaging, laboratory services, and blood bank services.
- Continue to track and document the impact of COVID-19 on essential health services.
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May 9, 2020
Massive proportion of world’s population are living with herpes infection

Virus causing genital herpes may put millions of people at greater risk of infection with HIV

About half a billion people worldwide are living with genital herpes, and several billion have an oral herpes infection, new estimates show.

Authored by staff at the University of Bristol, World Health Organization (WHO), and Weill Cornell Medical College-Qatar, and published in the Bulletin of the World Health Organization,
the new study estimates the global infection prevalence and incidence of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in 2016.

“Herpes infection affects millions of people across the globe and can have far-reaching health effects. We need more investment and commitment to develop better treatment and prevention tools for this infection.” says Dr Sami Gottlieb, Medical
Officer at WHO and an author of the study.

Prevalence and incidence

An estimated 491.5 million people were living with HSV-2 infection in 2016, equivalent to 13.2% of the world’s population aged 15 to 49 years. HSV-2 is almost exclusively sexually transmitted, causing infection in the genital or anal area (genital
herpes).

An estimated 3.7 billion people had HSV-1 infection during the same year – around 66.6% of the world’s population aged 0 to 49. HSV-1 is mainly transmitted by oral to oral contact to cause infection in or around the mouth (oral herpes). However,
HSV-1 can also be transmitted to the genital area through oral-genital contact – during oral sex – to cause genital herpes. Most HSV-1 infections were oral; however, between 122 million to 192 million people were estimated to have genital
HSV-1 infection, depending on the assumptions used in the estimation model.

Because herpes is a lifelong infection, estimated prevalence increased with age; HSV-2 prevalence was also higher among women and in the WHO African Region.

Health and social impacts

Most people living with herpes, caused by either HSV-1 or 2, are unaware they have the infection.

When symptoms do occur however, oral herpes infection can lead to painful sores around the mouth (“cold sores”). Genital herpes infection can cause recurring, often painful, genital sores, often referred to as genital ulcer disease.

WHO and partners published a study in March 2020 estimating that around 5% of the world’s population (187 million people) suffered from at least one episode of herpes-related genital ulcer disease in 2016 (1). Most of these episodes were due to
HSV-2, which can recur frequently over many years.

Recurrent symptoms of genital herpes can lead to stigma and psychological distress, and can have an important impact on quality of life and sexual relationships. However, in time, most people with herpes adjust to living with the infection.

“Genital herpes is a substantial health concern worldwide – beyond the potential pain and discomfort suffered by people living with the infection, the associated social consequences can have a profound effect on sexual and reproductive health”
says Dr Ian Askew, Director of the Department of Sexual and Reproductive Health and Research at WHO.

Herpes and HIV

A strong association exists between HSV-2 infection and HIV infection. In 2019, WHO commissioned a modeling study to estimate how much HSV-2 infection might contribute to HIV incidence. The study estimated that almost 30% of new sexually acquired HIV
infections in 2016 worldwide were likely attributable to HSV-2 infection (2).

Evidence shows that people with HSV-2 infection are at least three times more likely to become infected with HIV, if exposed. HSV-2 leads to inflammation and small breaks in the genital and anal skin that can make it easier for HIV to cause infection.
In addition, people with both HIV and HSV-2 infection are more likely to spread HIV to others.

Women have higher biologic susceptibility to both HSV-2 and HIV. Women living in the WHO Africa Region have the highest HSV-2 prevalence and exposure to HIV – putting them at greatest risk of HIV infection, with negative implications for their health
and well-being.

For people living with HIV (or who are living with other conditions that compromise their immune systems) as well as HSV-2, the symptoms of herpes can be more severe and more frequent.

Neonatal herpes

Neonatal herpes can occur when an infant is exposed to HSV in the genital tract during delivery. This is a rare condition, occurring in an estimated 10 out of every 100,000 births globally, but can lead to lasting neurologic disability or death. The risk
for neonatal herpes is greatest when a mother acquires HSV infection for the first time in late pregnancy. Women who have genital herpes before they become pregnant are at very low risk of transmitting HSV to their infants.

No cure – better treatment and prevention needed

There is no cure for herpes. At present, antiviral medications, such as acyclovir, famciclovir, and valacyclovir, can help to reduce the severity and frequency of symptoms but cannot cure the infection.

As well as increasing awareness about HSV infection and its symptoms, improved access to antiviral medications and heightened HIV prevention efforts for those with genital HSV symptoms are needed globally.

In addition, development of better treatment and prevention interventions is needed, particularly HSV vaccines. WHO and partners are working to accelerate research to develop new strategies for prevention and control of HSV infections. Such research includes
the development of HSV vaccines and topical microbicides. Several candidate vaccines and microbicides are currently being studied.

“A vaccine against HSV infection would not only help to promote and protect the health and well-being of millions of people, particularly women, worldwide – it could also potentially have an impact on slowing the spread of HIV, if developed
and provided alongside other HIV prevention strategies” says Dr Meg Doherty, Director of the WHO Department of Global HIV, Hepatitis, and STI Programmes.

Related publications

WHO guidelines for the treatment of Genital Herpes Simplex Virus

WHO preferred product characteristics for herpes simplex virus vaccines

———————-

(1) Looker KJ, Johnston C, Welton NJ, et al. The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history modelling study. BMJ Glob Health. 2020;5(3):e001875. doi: 10.1136/bmjgh-2019- 001875.

(2) Looker KJ, Welton NJ, Sabin KM, et al.Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data. Lancet Infect Dis.2020;20(2):240-249. doi: 10.1016/S1473-3099(19)30470-0.

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May 9, 2020
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