The World Health Organization (WHO) has reached out to 16 African nations to provide support for preparedness and response to a listeriosis outbreak that started in South Africa in 2017 but is now threatening other countries on the continent.
The 16 countries are Angola, Botswana, the Democratic Republic of the Congo, Ghana, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Nigeria, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe.
Nearly 200 South Africans have died since January 2017 as a result of contaminated ready-to-eat meat products that are widely consumed in South Africa and may also have been exported to two West African countries and 14 members of the South African Development Community (SADC)
South African health authorities recently declared the source of the outbreak as a factory in Polokwane, South Africa. This prompted a national and international recall of the food products. However, in light of the potentially long incubation period of listeriosis and the challenges relating to large scale nationwide recall processes, further cases are likely to occur.
Namibia has reported one confirmed case of listeriosis, a man who was admitted to hospital in early March. An investigation is ongoing to determine whether the case is connected to the outbreak in South Africa.
WHO’s Health Emergencies programme, the Global Outbreak alert and Response Network (GOARN) and the International Food Safety Authorities Network (INFOSAN) are working with the 16 priority countries to improve their ability to prepare for, detect and respond to potential outbreaks.
Immediate steps will include increasing awareness on listeriosis, enhancing active surveillance and laboratory diagnosis, ensuring readiness of Rapid Response Teams, and strengthening coordination and contingency planning. Experts have been deployed to South Africa, Lesotho and Swaziland to support these efforts.
“This outbreak is a wake up call for countries in the region to strengthen their national food safety and disease surveillance systems,” says Dr Matshidiso Moeti, WHO Regional Director for Africa.
The Ministry of Health in Uganda in mid-March, 2018 warned Ugandans against consuming imported meat products mainly imported from South Africa in a bid to avoid the spread of the disease to the Country. No case of Listeriosis has been reported in Uganda as of 22nd March, 2018.
The link between the contaminated products, the producing company and strains of Listeria isolated from the patients was made by the use of whole genome sequencing of isolated strains of the Listeria bacteria. WHO is supporting further genome sequencing to determine which cases are linked to this on-going outbreak.
In March, South Africa hosted a meeting of SADC health ministers to address regional preparedness and response to listeriosis. Ministers committed to regional collaboration, exchanging information and strengthening national food safety systems in line with international standards.
WHO does not currently recommend any trade related measures in relation to the current outbreak of listeriosis in South Africa, other than the recall of products identified as sources of infection.
Countries are encouraged to pay more attention to common foodborne pathogens such as Salmonella, Campylobacter, E.coli and Listeria, to notify WHO of listeriosis outbreaks in line with the International Health Regulations (2005), and to make use of WHO guidelines to strengthen surveillance of and response to the foodborne disease.
- Listeriosis is an infectious disease caused by the bacterium Listeria monocytogenes.
- Listeria monocytogenesare widely distributed in nature. They can be found in soil, water, vegetation and the faeces of some animals and can contaminate foods.
- High risk foods include deli meat and ready-to-eat meat products (such as cooked, cured and/or fermented meats and sausages), soft cheeses and cold smoked fishery products.
- Pregnant women, the elderly or individuals with a weakened immune system, such as people with immuno-compromised status due to HIV/AIDS, leukaemia, cancer, kidney transplant and steroid therapy, are at greatest risk of severe listeriosis and should avoid high risk foods.
- Listeriosis is a serious, but preventable and treatable disease.
Source: World Health Organisation
Additional Reporting by Cliff Abenaitwe
Seeing people smoking in a music video or a movie is a common scene not only in Uganda but globally. These scenes make smoking look fancy and this has far reaching consequences on the people especially the youth who look at musicians and movie stars as role models.
Health activists involved in tobacco control are concerned by this trend and want an end to it.
Andrew Kwizera, the Technical Resource Person in charge of the East African region for the Campaign for Tobacco Free Kids- a global Organisation on Tobacco Control says that many celebrities show scenes of smoking in music videos and films yet many are seen as role models to the youth. “Many young people who follow these stars have adopted smoking. This is setting a bad image to these innocent young people”, Kwizera observes adding that as a result of smoking, young people have been exposed to various tobacco related diseases which are hard and expensive to treat.
Statistics from the World Health Organization reveal that the average age of debutant smokers is 12-14 years globally.
According to Richard Baguma Tinkasimire, the coordinator Uganda Health Communication Alliance- one of the organizations at the forefront of tobacco control campaign in Uganda, young people are easily lured into smoking mainly by peer pressure and copying those they look at as role models. “Parents, leaders and celebrities must set a good example to the young generation and make children pick the best practices from them. Acts like smoking or tobacco consumption in any form should be discouraged”, he explains.
As part of the efforts to promote a smoking free generation, health activists in Uganda have adopted the use of musicians and other celebrities in the tobacco control campaigns.
Sophie Gombya- a household name in Uganda’s music industry is one of the Tobacco control ambassadors. “It’s true we have a big following, we have power to influence behavior directly or indirectly. As musicians and celebrities must be aware that what we do and show impacts on our followers.
We must therefore be mindful not to encourage bad habits like smoking among the people especially the youth who follow and adore us”, the vibrant Gombya explains.
Apart from Gombya, the Tobacco control fraternity has also used people like the Uganda National Netball Team- the ‘She Cranes’ to rally people against Tobacco- a move that Baguma says is paying off.
The Legal Framework
Uganda is a signatory of to the Framework Convention on Tobacco Control. Article 13 (4a) prohibits all forms of tobacco advertising, promotion and sponsorship that promote tobacco product by any means that are false, misleading, or deceptive or likely to create an erroneous impression about its characteristics, health effects, hazards or emissions.
Uganda’s Tobacco Control Act of 2015 also bans promotion and advertising of tobacco products, open display of tobacco products and selling of tobacco products to minors among others.
Whether showing of smoking scenes in movies and music videos is deliberate to lure people into this act, it is a clear breach of the law and the reality is- it ought to stop.
According to Kokulinda Lutgard, the head of Tanzania Tobacco Control Alliance, musicians and other celebrities have a huge impact on their following and can play a great role in Tobacco control but also everyone has a character to play in this campaign.
The Global Tobacco Burden
According to health experts, Tobacco use is one of the main risk factors for a number of chronic diseases, including cancer, lung diseases, and cardiovascular diseases.
The World Health Organisation (WHO) statistics show that Tobacco kills more than 7 million people each year worldwide with more than 6 million of those deaths as a result of direct tobacco use while around 890 000 are the result of non-smokers being exposed to second-hand smoke.
The most worrying fact is that nearly 80 percent of the world’s more than 1 billion smokers live in low- and middle-income countries where the burden of tobacco-related illness and death is heaviest and alarming.
Over the years, significant strides have been made in Tobacco Control but this is more in developed countries than in the developing world.
A 2017 report by WHO on “Monitoring tobacco use and prevention policies” reveal that more countries have implemented tobacco control policies, ranging from graphic pack warnings and advertising bans to no smoking areas. About 4.7 billion people – 63 percent of the world’s population are covered by at least one comprehensive tobacco control measure, which has quadrupled since 2007 when only 1 billion people and 15 percent of the world’s population were covered.
Uganda has an estimated 1.3 Million smokers- according to the Global Adult Tobacco Survey (GATS) report of 2013 with each smoker spending an average of 20, 730 Shillings (about 6 USD) on manufactured cigarettes per month.
Blood pressure and fluid retention improve in those counseled by dietitians, small study shows
Encouraging people with kidney disease to reduce their salt intake may help improve blood pressure and cut excess fluid retention, at least for a while, a new study suggests.
Study participants lowered their systolic blood pressure (the top number)
by almost 11 points, on average, on a salt-restricted diet versus their usual diet. They also flushed out a liter of water (about one-quart) from their bodies, on average, by slashing salt in their diets, researchers said.
Having high blood pressure and retaining excess salt and water in the body stresses the heart and blood vessels, explained lead author Dr. Rajiv Saran of the University of Michigan.
For kidney disease patients, high blood pressure (or “hypertension”) and excess fluid in the body can be a toxic combination. “They die predominantly of cardiovascular disease,” said Saran, a professor of internal medicine and epidemiology in the nephrology division.
Yet doctors rarely have time or make time to counsel each patient about salt-restricted diets, he said.
Saran and co-investigators wondered whether having trained dietitians talk to patients with chronic kidney disease by phone or in person about ways to lower daily sodium intake would make a difference. Read More
Low back pain affects millions of people in the United States, and the condition is one of the most common reasons for people missing work. New guidelines from the American College of Physicians recommend noninvasive ways of treating nonradicular low back pain.
The American Chiropractic Association (ACA)
report that approximately 31 million U.S. individuals experience low back pain at one point during their lives. The ACA also note that low back pain is the leading cause of disability across the world, as well as one of the most popular reasons why people miss work.
The condition accounts for a large proportion of all doctor visits in the U.S., and almost 25 percent of the entire adult population in the U.S. has experienced at least one day of low back pain in the past 3 months.
The fight against Polio has been boosted by a new grant from Rotary International- the largest group of committed volunteering men and women committed to serve and change the world.
Rotary has announced $35 million in grants to support the global effort to end polio, bringing the humanitarian service organization’s contribution to $140 million since January 2016.
Nearly half of the funds Rotary announced January 2017 ($16.15 million) will support the emergency response campaigns in Nigeria and the Lake Chad Basin (Chad, northern Cameroon, southern Niger and Central African Republic). Four cases of polio were detected in Nigeria in 2016, which had previously not seen a case since July 2014.
With these cases, funding is needed to support rapid response plans in Nigeria and surrounding countries to stop the outbreak.
While significant strides have been made against the paralyzing disease, with just 35 cases reported in 2016, polio remains a threat in hard-to-reach and underserved areas, and conflict zones. To sustain this progress, and protect all children from polio, experts say $1.5 billion is needed.
In addition to supporting the response in the Lake Chad Basin region, funding has been allocated to support polio eradication efforts in Afghanistan ($7.15 million), Pakistan ($4.2 million), Somalia ($4.64 million), and South Sudan ($2.19 million). A final grant in the amount of $666,845 will support technical assistance in UNICEF’s West and Central Africa Regional Office.
Rotary has contributed more than $1.6 billion, including matching funds from the Bill and Melinda Gates Foundation, and countless volunteer hours since launching its polio immunization program, PolioPlus, in 1985. In 1988, Rotary became a spearheading partner in the Global Polio Eradication Initiative with the World Health Organization (WHO), UNICEF, U.S. Centers for Disease Control and Prevention, and was later joined by the Bill & Melinda Gates Foundation. Since the initiative launched, the incidence of polio has plummeted by more than 99.9 percent, from about 350,000 cases a year to 35 confirmed in 2016, and no cases in 2017 so far.
What is Polio?
According to the World Health Organization (WHO), Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children.
The virus is transmitted by person-to-person spread mainly through the faecal-oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio, it can only be prevented by immunization.
Key Facts about Polio
- Polio (poliomyelitis) mainly affects children under 5 years of age.
- 1 in 200 infections leads to irreversible paralysis. Among those paralysed, 5% to 10% die when their breathing muscles become immobilized.
- Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases then, to 74 reported cases in 2015. The reduction is the result of the global effort to eradicate the disease.
- As long as a single child remains infected, children in all countries are at risk of contracting polio. Failure to eradicate polio from these last remaining strongholds could result in as many as 200,000 new cases every year, within 10 years, all over the world.
- In most countries, the global effort has expanded capacities to tackle other infectious diseases by building effective surveillance and immunization systems
Rotary brings together a global network of volunteer leaders dedicated to tackling the world’s most pressing humanitarian challenges. Rotary connects over 1.2 million members of more than 35,000 Rotary clubs in over 200 countries and geographical areas.
Joint news release WHO/UNICEF/GAVI Alliance/BMGF
18 April 2013 | Geneva – In advance of World Immunization Week, global experts are highlighting strategies to further advance progress on the Global Vaccine Action Plan that was endorsed by the World Health Assembly, 2012. Better supply and logistics systems are essential to reach the estimated 22 million children in developing countries who are still not protected from dangerous diseases with basic vaccines, according to a special immunization issue published today by Vaccine.
Articles in the special supplement also underline the need to improve understanding about the health benefits of immunization. World Immunization Week starts 20 April with its call to “Protect your world, get vaccinated” with a range of activities in some 180 countries to help immunize more children against preventable diseases.
“We have seen some major advances in the development and delivery of vaccines in the past few years,” said Dr Flavia Bustreo, Assistant Director-General at WHO. “But many countries still face obstacles in getting life-saving vaccines to every child who needs them.”
Many countries encounter serious challenges in vaccine supply and logistics, from inability to keep vaccines at the correct temperature, to record keeping which enables community health workers to ensure the right vaccines reach the children who need them.
Inefficient health and delivery systems threaten access, availability, quality – and health outcomes. WHO, UNICEF, the GAVI Alliance, the Bill & Melinda Gates Foundation and the many other partners active in the Decade of Vaccines have drawn up new plans to strengthen immunization systems to:
- ensure that more vaccines are discovered and developed and that packaging is designed to meet the needs of developing countries – such as the MenAfriVac vaccine for Meningitis A in Africa which can be transported and stored for as long as four days without refrigeration;
- establish supply and logistics systems that support and sustain efficient and effective vaccine delivery – this can include, using ‘moving warehouses’ to distribute vaccines to remote health centres, and integrating the distribution of vaccines with other health commodities;
- Improve immunization information systems to show more accurately where the needs are – for example by using immunization registries, such as those used in Albania, Sri Lanka, and Uruguay. The registries track and follow individual children which makes it possible to trace and better understand who is not being vaccinated, and why;
- maintain a competent and motivated health workforce, through professionalizing supply chain positions improved training for staff and better management and supervision
- explore the use of mobile technology to strengthen communication and data capture across the supply chain, including stock management;
- allocate more resources to remote and marginalized groups, including specific programs to target nomadic and indigenous communities, such as the programs under way in Sudan.
There is also an urgent need to better communicate the health benefits provided by vaccines, and the dangers of not immunizing children. Immunization averts an estimated 2-3 million deaths every year, protecting children from diphtheria, measles, pertussis (better known as whooping cough), pneumonia, polio, rotavirus diarrhoea, rubella (or German measles) and tetanus.
“In some parts of the world, complacency about immunization has led to gaps in vaccination coverage,” said Geeta Rao Gupta, Deputy Executive Director, UNICEF. “When gaps occur, outbreaks follow.”
In other places, myths are circulating that vaccines do not work, or on the nature and frequency of side effects, which lead parents and caregivers to refuse to vaccinate their children.
“We need to help parents to better understand the benefits of immunization to ensure they reach all children, no matter where they live,” said Dr Seth Berkley, Chief Executive Officer of the GAVI Alliance. “Today vaccines protect the lives of hundreds of millions of children; but with our partners, we need to ensure that an additional quarter of a billion children are immunized by 2015,” he added.
Chris Elias, president of Global Development at the Bill & Melinda Gates Foundation, agrees. “We know that vaccines work to save lives and protect children for a lifetime. Strong immunization systems protect our gains against polio and provide a platform for new vaccines and primary health care.”
Nevertheless, in recent years, there have been resurgences of diphtheria, measles and rubella in developed and developing countries alike. For example, outbreaks of measles have occurred in France, Italy, Spain, the United Kingdom, and Pakistan.
World Immunization Week, with its call to “Protect your world, get vaccinated” is an opportunity to raise global awareness of the health benefits of vaccination. Governments, development partners, international organizations, manufacturers, health professionals, academia, civil society, communities and individuals come together in 180 countries to promote the goal of universal immunization coverage – and to overcome challenges to achieving it.
Different geographical regions emphasize different themes to adapt to their specific needs. In World Immunization Week 2013 the regional focus is as follows:
- Africa: Save lives, Prevent disabilities, Vaccinate!
- The Americas: Vaccination, a shared responsibility.
- Eastern Mediterranean: Stop measles now!
- Europe: Protect. Prevent. Immunize.
- South-East Asia: Intensification of routine immunization.
- Western Pacific: Finish the job – No more measles for anyone.
WHO, UNICEF, the GAVI Alliance, and the Bill & Melinda Gates Foundation are all committed to giving all children a healthy start to life by achieving the Decade of Vaccines vision via the Global Vaccines Action Plan launched in 2012. The Plan aims to deliver universal access to immunization by 2020.
WHO helps countries integrate immunization into national health policies and plans and thus increase access to existing vaccines. The Organization promotes new vaccines (such as the Human Papilloma Virus vaccine) and new initiatives such as the integrated plan to end preventable child deaths worldwide from pneumonia and diarrhoea by 2025. It works to ensure access to quality vaccines and immunization equipment, notably through the prequalification of vaccines and immunization equipment.
WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.
UNICEF works in more than 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.
In June 2012, the Governments of Ethiopia, India and the United States with UNICEF launched a global roadmap to end preventable deaths of children under the age of five. Since then, under the banner of Committing to Child Survival: A Promise Renewed, more than 170 countries have signed up and renewed their commitment to child survival.
The GAVI Alliance is a public-private partnership committed to saving children’s lives and protecting people’s health by increasing access to immunization in developing countries. The Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. GAVI uses innovative finance mechanisms, including co-financing by recipient countries, to secure sustainable funding and adequate supply of quality vaccines. Since 2000, GAVI has financed the immunization of an additional 370 million children and prevented more than 5.5 million premature deaths.
Bill & Melinda Gates Foundation
Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. In developing countries, it focuses on improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty. In the United States, it seeks to ensure that all people – especially those with the fewest resources – have access to the opportunities they need to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Jeff Raikes and Co-chair William H. Gates Sr., under the direction of Bill and Melinda Gates and Warren Buffett.
From World Health Organisation