Month: March 2023

This Weekly Bulletin focuses on public health emergencies occurring in the WHO African region. This week’s articles cover:

Cholera in the WHO African Region

Marburg in Equatorial Guinea

Diptheria in Nigeria

Mpox in Africa

For each of these events, a brief description, followed by public health measures implemented and an interpretation of the situation is provided.

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have been controlled and closed.

Major issues and challenges include:

The WHO African Region is experiencing a rise in cholera cases and geographical spread, amid a global surge. This is occurring in the context of other emergencies including the cyclones and heavy rains, competing priorities and stretched resources. To date, 11 countries have reported cholera cases or outbreaks in the region. While the outbreak is slowing down in some countries like Nigeria and Cameroon, Malawi is still reporting high numbers, albeit with a decline in cases and deaths in the past two weeks. Notably the outbreak in Mozambique is trending upwards.

The burden of cholera could get worse unless member states and implementing partners boost efforts to control and prevent outbreaks.

Health authorities in Equatorial Guinea officially declared its first ever confirmed outbreak of Marburg Virus Disease (MVD) on 13 February 2023. The declaration came following a confirmation of the disease by real-time amplification after reverse transcription (qRT-qPCR) testing of one blood sample at Pasteur Institute of Dakar in Senegal on 12 February 2023. Efforts are underway with the support from WHO and other government partners to put in place the required emergency response activities to help the country cope with this outbreak and quickly contain its public health impact.

Thirteen newly confirmed mpox cases and death were reported in Africa in the past week. The cases were reported from the Central Africa Republic and Nigeria, which previously reported mpox cases before the outbreak in 2022. Sufficient human resources and infrastructure for genomic sequencing and bioinformatics are essential to eradicate the mpox outbreak in Africa.

Source: World Health Organization

American Cindy McCain will take over as executive director of the United Nations World Food Program when current director David Beasley steps down next month.

“Ms. McCain, a champion for human rights, has a long history of giving a voice to the voiceless through her humanitarian and philanthropic work,” said U.N. Secretary-General Antonio Guterres and Food and Agriculture Organization (FAO) Director-General Qu Dongyu in a statement announcing the appointment.

McCain is a prominent Republican Party member who is currently U.S. ambassador to United Nations agencies in Rome, which include the FAO, the WFP, and the International Fund for Agricultural Development.

She has been active in U.S. politics for decades as the wife of Arizona Senator John McCain, who died of brain cancer in August 2018. Since then, she has forged her own political profile, including backing Democrat Joe Biden in his presidential bid against then-incumbent Republican president Donald Trump in 2020.

Biden appointed McCain to the Rome post in November 2021. Typically, the White House is involved in nominating the U.S. candidate to head the WFP, which is often a U.S.-held post.

McCain has worked in philanthropy, starting the American Voluntary Medical Team in 1988, which provides emergency medical and surgical care to poor children across the world. She has also traveled in her personal capacity on behalf of the WFP, visiting mother and child feeding programs in Cambodia, Sierra Leone, Chad and the Democratic Republic of the Congo.

Mammoth challenges

McCain, 68, takes over the agency at a time of unprecedented global need. The WFP says 349 million people across 79 countries are acutely food insecure. The agency is attempting to raise $23 billion this year to reach almost 150 million people worldwide.

In 2022, the WFP reached 160 million people with humanitarian assistance.

“McCain takes over as head of the World Food Program at a moment when the world confronts the most serious food security crisis in modern history and this leadership role has never been more important,” the president of the WFP’s executive board, Polish Ambassador Artur Andrzej Pollok, said in a statement. “We wish her well and can assure her she will have the full support of the Executive Board.”

U.S. Secretary of State Antony Blinken offered his congratulations and said Washington is “deeply invested” in the WFP’s continuing success.

“I am confident that she will bring renewed energy, optimism, and success to the World Food Program,” Blinken said of McCain.

The Republican chairman of the U.S. House Foreign Affairs Committee, Michael McCaul, and the highest-ranking Democrat, Gregory Meeks, welcomed McCain’s appointment saying she is “an exceptionally qualified leader.”

“At a time when food insecurity and fuel costs are at an all-time high and there is soaring global hunger, the task of leading the World Food Program is more significant and consequential than ever,” they said in a joint statement.

Former leader warns against partisanship

The United States is the WFP’s largest contributor, providing about 40% of its budget or $7 billion in 2022, so McCain’s political clout will be an asset in securing funding.

But former U.S. ambassador Ertharin Cousin, who headed the WFP from 2012-2017 and is now CEO of the Chicago-based Food Systems for the Future, cautioned that McCain is serving as an international civil servant, not as member of the Republican Party.

“She must serve on a non-partisan basis in order to effectively support the work of the organization,” Cousin told VOA. “But having said that, of course, I am not naive that she will need to continue to work with both sides of the aisle in order to secure the commitment from the U.S. for the level of contribution that is required to meet the global food insecurity needs.”

Cousin also said it will be important for McCain to keep the organization fit for its purpose.

“You are stewards of taxpayers’ dollars from across the globe, and as a result you have a responsibility to make sure the organization remains the efficient behemoth that the world needs,” Cousin said.

Outgoing chief Beasley offered his congratulations on Twitter Wednesday, a day ahead of the official announcement.

Outgoing WFP leader praised

Beasley said in mid-December that he would be leaving in April. He has served as the food agency’s chief since 2017. In 2020, the World Food Program was awarded the Nobel Peace Prize “for its efforts to combat hunger, for its contribution to bettering conditions for peace in conflict-affected areas and for acting as a driving force in efforts to prevent the use of hunger as a weapon of war and conflict.”

Guterres and the FAO Director-General expressed deep appreciation for Beasley’s leadership.

“He has led WFP with a deep compassion for the world’s hungry and most vulnerable during what can only be described as unprecedented crises that severely impacted global food security,” Guterres and Qu said. “He has humanized for the world the women and children most affected by hunger and has used his powerful voice to bring awareness and substantial resources to one crisis after another.”

Beasley’s tenure has coincided with the COVID-19 pandemic, unprecedented droughts and floods in several developing countries, as well as a steady stream of conflicts, including Russia’s invasion last year of Ukraine.

Despite tremendous levels of fundraising, a number of the agency’s programs are hurting for cash and facing cutbacks as needs continue to rise.

Source: Voice of America

United Nations chief Antonio Guterres urged countries to agree a “robust and ambitious” treaty to protect the high seas, as time starts to run out for negotiators.

After 15 years of formal and informal talks, delegates have been meeting in New York since Feb 20 to discuss a text that aims to protect nearly half the planet.

It is the third “final” negotiating round in less than a year and is due to end Friday.

“Our ocean has been under pressure for decades. We can no longer ignore the ocean emergency,” Guterres said in a message read to negotiators.

“The impacts of climate change, biodiversity loss and pollution are being keenly felt around the globe, affecting our environment, our livelihoods and our lives,” the secretary-general added.

“In adopting a robust and ambitious agreement at this meeting, you can take an important step forward in countering these destructive trends and advancing ocean health for generations to come.”

The high seas begin at the border of countries’ exclusive economic zones, which extend up to 200 nautical miles (370 kilometers) from coastlines. They thus fall under the jurisdiction of no country.

While the high seas comprise more than 60 percent of the world’s oceans and nearly half the planet’s surface, they have long drawn far less attention than coastal waters and a few iconic species.

An updated draft text released last weekend is still full of parenthetical clauses and multiple options on some major issues that will determine the robustness of the final agreement.

Source: Nam News Network (NNN)

President Emmanuel Macron kicks off a tour of Central Africa on Wednesday in a diplomatic drive to test out a new “responsible relationship” with the continent as anti-French sentiment runs high in some former colonies.

He will first stop in Gabon for an environmental summit, before heading to Angola then the Republic of Congo — also known as Congo-Brazzaville — and finally neighbouring Democratic Republic of Congo.

Macron’s trip comes as alarm grows in Paris over Russia’s rising influence in French-speaking African countries, alongside Chinese jockeying for position, which has been visible for some years.

In Gabon, he will attend the One Forest Summit on preserving forests worldwide, including along the vast Congo River basin.

Covering 1.62 million square kilometres, the forests of Central Africa represent the planet’s second-largest carbon sink after the Amazon.

They are also home to huge biodiversity including forest elephants and gorillas, and bear traces of the settlement of early humanity.

But they face threats such as poaching, deforestation for the oil palm and rubber industries, and illegal logging and mineral exploitation.

Macron in a speech on France’s Africa policy on Monday called for a “mutual and responsible relationship” with the continent of more than 50 countries, including on climate issues.

He reiterated a pledge to break with former post-colonial policies.

“To measure our influence through a number of military operations, to rest on exclusive privileged ties with certain leaders, or to consider that certain economic markets are rightfully ours because we were there before — these are things of the past,” he said.

Macron has insisted Africa is a priority of his second term, and in July he went to Cameroon, Benin and Guinea-Bissau.

After Gabon, he heads to the former Portuguese colony of Angola as part of a drive to enhance French ties with English- and Portuguese-speaking parts of Africa.

Stopping in Congo-Brazzaville, another former French colony, he will end his trip in the neighbouring Democratic Republic of Congo — ruled by Belgium during the colonial era — on Friday and Saturday.

Macron’s tour follows disruption in the Sahel region further north.

Paris has fallen out with new military authorities in former colonies Mali and Burkina Faso and withdrew its troops from both countries following years of helping them to battle jihadists.

France and its Western allies accuse Russian mercenary group Wagner, infamous for its activities in Syria and Ukraine, of being active in Mali and the Central African Republic, also once ruled by France.

Paris has also accused Russia of spreading disinformation to undermine French interests on the continent.

Macron on Monday said the military would reduce its footprint on the continent in the coming months, turning French outposts there into training academies or “partner” bases with more African forces.

More than 3,000 French soldiers are deployed in Senegal, Ivory Coast, Gabon and Djibouti, according to official figures. Another 3,000 are in the Sahel, including in Niger and Chad.

Source: Nam News Network

HIGHLIGHTS

Tropical Storm Freddy has led to significant rainfall in Mozambique in recent days, with river levels expected to continue to rise.

The number of people affected by Freddy has risen to 383,300 (226,000 in Madagascar and more than 163,300 in Mozambique), including nearly 47,000 who were temporarily displaced (37,700 in Madagascar and 9,268 in Mozambique).

At least 14 people have died following Freddy’s passage (7 in Madagascar and 7 in Mozambique).

Response to Tropical Cyclone Freddy is underway in both Madagascar and Mozambique.

SITUATION OVERVIEW

Tropical Storm Freddy made landfall in Vilankulo district, Inhambane province, of Mozambique on 24 February, where it has led to significant rainfall, with river levels expected to continue rising. Between 23 and 27 February, Dondo (Sofala Province) and Vilankulo (Inhambane Province) both received more than 500 millimetres (mm) of rainfall, while Massinga (Inhambane Province) and Beira (Sofala Province) both received more than 300mm. A further 300mm of rain are expected in Inhambane Province this week, according to Mozambican authorities, and the Global Flood Awareness System (GloFAS) indicates the potential for unprecedented flooding on the Changane River, particularly between Chibuto town and Xai-Xai in Gaza Province. In Zimbabwe, on the other hand, while flooding is still possible in south-eastern Zimbabwe, severe flooding is now unlikely, as Freddy did not extend as far inland as previously forecasted.

In Mozambique, more than 163,300 people had been affected by rainfall and flooding generated by Tropical Storm Freddy across southern and central Mozambique by 28 February, including 9,268 people who were taking shelter in 26 accommodation centres across Inhambane, Gaza, and Sofala, according to Government authorities. Over 27,811 houses were destroyed or damaged, including 13,760 partially destroyed, 1,621 totally destroyed and 12,430 flooded houses. Damage to public infrastructure and services has also been reported, with 408 classrooms destroyed, affecting nearly 20,700 pupils. Some 685 km of road has been damaged, while nearly 26,800 hectares of crops were affected.

In Madagascar, at least 226,000 people were affected by Freddy’s passage, of whom an estimated 148,000 are in need of humanitarian assistance, according to the findings of a multi-sectoral assessment carried out by the Government and humanitarian partners. The number of people displaced has increased to 37,700, and more than 28,800 houses have been destroyed or damaged. Following the cyclone’s passage, more than 1,600 classrooms have been destroyed or damaged (including 670 destroyed, 318 partially destroyed and 654 left roofless), leaving more than 70,200 students out of school. Some 16 community health centres and 2 hospitals were partially damaged, most of them in Vatovavy region, according to Government authorities.

Source: UN Office for the Coordination of Humanitarian Affairs

Maternal and Perinatal Death Surveillance and Response (MPDSR) is an established, sound and robust system for reviewing maternal deaths and establishing nationwide enquiries into deaths during pregnancy labour and puerperium. MPDSR is a system that measures and tracks all maternal and perinatal deaths in real time, helps to understand the underlying factors contributing to the deaths, and stimulates and guides actions to prevent future deaths. It is a form of continuous surveillance that links the health information system and quality improvement processes from local to national levels, permits routine identification, notification, quantification, and determination of causes of maternal and perinatal deaths, and is useful information to help respond with actions that will prevent future deaths (World Health Organization, 2021a). MPDSR also supports the delivery of quality maternal and newborn health care (World Health Organization, 2021b).

MPDSR has been identified by multiple global and regional bodies as a priority for ending preventable maternal and newborn deaths and stillbirths. The World Health Organization (WHO) released global technical guidelines on Maternal Death Surveillance and Response (MDSR) (World Health Organization, 2013) in 2013, and a perinatal death audit in 2016 (World Health Organization, 2016a). In 2020, WHO listed MPDSR among the essential interventions to mitigate the indirect effects of COVID-19 on maternal and perinatal outcomes (World Health Organization, 2020). Operational guidance and tools to support MPDSR implementation were released in September 2021 (World Health Organization, 2021c). Global priority for MPDSR has been demonstrated through inclusion in the United Nations Secretary-General’s Global Strategy for Women’s and Children’s Health in 2015 (Every Woman Every Child, 2015), and as part of the accountability milestone of the Ending Preventable Maternal Mortality (EPMM): A Renewed Focus for Improving Maternal and Newborn Health and Well-being in 2021 (World Health Organization and United Nations Children’s Fund, 2021). In Africa, institutionalizing MPDSR is one of the priorities of the African Union Commission’s action plan towards ending preventable maternal, newborn and child mortality in Africa since 2013 (United Nations Population Fund, 2013).

The joint United Nations (i.e. WHO, UNFPA and UNICEF) regional offices in East and Southern Africa (ESA) have been supporting countries and facilitating south-south learning to strengthen MPDSR in the region. As countries adapt and apply this guidance, implementation gaps and challenges remain in preventing successful MPDSR uptake (Kinney et al., 2021). The United Nations inter-agency partners started to monitor MPDSR in ESA through the standard biennial survey in 2014. A MPDSR regional status report for 2016 and 2018 have been produced and disseminated to enhance the quality and use of MPDSR. This report represents the status of MPDSR in 2021, and documents the progress made since 2016.

Source: United Nations Population Fund