Témoignages

New Ebola Case in Sierra Leone: WHO continues to stress risk of more flare-ups

2016-01-14T20:00:00Z

A new case of Ebola has been confirmed in Sierra Leone, reflecting the ongoing risk of new flare-ups of the virus in affected countries.

The Sierra Leone government acted rapidly to respond to this new case. Through the country's new emergency operations centre, a joint team of local authorities, WHO and partners are investigating the origin of the case, identifying contacts and initiating control measures to prevent further transmission.

The World Health Organization stressed in a statement yesterday (14 January), that Guinea, Liberia and Sierra Leone remain at high risk of additional small outbreaks of Ebola in the coming months due to the virus persisting in survivors after recovery.

“We are now at a critical period in the Ebola epidemic as we move from managing cases and patients to managing the residual risk of new infections,” said Dr Bruce Aylward, WHO's Special Representative for the Ebola Response, yesterday. “We still anticipate more flare-ups and must be prepared for them.”

Sierra Leone is still in a 90-day period of enhanced surveillance following the declaration on 7 November 2015 of the end of Ebola transmission in the country. This period is designed to ensure no hidden chains of transmission have been missed and to detect any new flare-ups of the disease.

Ebola : West Africa is at zero, but new flare-ups are likely to occur

2016-01-13T20:00:00Z

Today the World Health Organization (WHO) declares the end of the most recent outbreak of Ebola virus disease in Liberia and says all known chains of transmission have been stopped in West Africa. But the Organization says the job is not over, more flare-ups are expected and that strong surveillance and response systems will be critical in the months to come.

Photo : Samwar Fallah/IRIN

Liberia was first declared free of Ebola transmission in May 2015, but the virus was re-introduced twice since then, with the latest flare-up in November. Today's announcement comes 42 days (two 21-day incubation cycles of the virus) after the last confirmed patient in Liberia tested negative for the disease two times.

“WHO commends Liberia's government and people on their effective response to this recent re-emergence of Ebola,” says Dr Alex Gasasira, WHO Representative in Liberia. “The rapid cessation of the flare-up is a concrete demonstration of the government's strengthened capacity to manage disease outbreaks. WHO will continue to support Liberia in its effort to prevent, detect and respond to suspected cases.”

This date marks the first time since the start of the epidemic two years ago that all three of the hardest-hit countries—Guinea, Liberia and Sierra Leone—have reported zero cases for at least 42 days. Sierra Leone was declared free of Ebola transmission on 7 November 2015 and Guinea on 29 December.
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“Detecting and breaking every chain of transmission has been a monumental achievement,” says Dr Margaret Chan, WHO Director-General. “So much was needed and so much was accomplished by national authorities, heroic health workers, civil society, local and international organizations and generous partners. But our work is not done and vigilance is necessary to prevent new outbreaks.”

The World Health Organization cautions that the three countries remain at high risk of additional small outbreaks of Ebola, like the most recent one in Liberia. To date, 10 such flare-ups have been identified that were not part of the original outbreak, and are likely the result of the virus persisting in survivors even after recovery. Evidence shows that the virus disappears relatively quickly from survivors, but can remain in the semen of a small number of male survivors for as long as one year, and in rare instances, be transmitted to intimate partners.

“We are now at a critical period in the Ebola epidemic as we move from managing cases and patients to managing the residual risk of new infections,” says Dr Bruce Aylward, WHO's Special Representative for the Ebola Response. “The risk of re-introduction of infection is diminishing as the virus gradually clears from the survivor population, but we still anticipate more flare-ups and must be prepared for them. A massive effort is underway to ensure robust prevention, surveillance and response capacity across all three countries by the end of March.”

WHO and partners are working with the Governments of Guinea, Liberia and Sierra Leone to help ensure that survivors have access to medical and psychosocial care and screening for persistent virus, as well as counselling and education to help them reintegrate into family and community life, reduce stigma and minimize the risk of Ebola virus transmission.

The Ebola epidemic claimed the lives of more than11,300 people and infected over 28,500. The disease wrought devastation to families, communities and the health and economic systems of all three countries.

Tracking attacks on health workers - Don't let them go unnoticed

2015-12-07T20:01:00Z

In the early hours of 3 October, rockets slammed into a Médecins Sans Frontières (MSF) hospital in Kunduz, Afghanistan, killing at least 14 health workers and injuring 37. An MSF clinic in the southern Yemen city of Taiz was bombed on 2 December, injuring 9 people, including 2 MSF staff. Since 2012, almost 60% of hospitals in Syria have been partially or completely destroyed, and more than half of the country's health workers have fled or been killed.

From Ukraine to Afghanistan, healthcare workers are in the line of fire. In 2014 alone, 603 health workers were killed and 958 injured in such attacks in 32 countries, according to data compiled by the WHO from a range of sources.

The attacks and deaths are tragic enough, but the loss of health workers, services and facilities results in less care for people, compounding the suffering caused by conflicts and other emergencies.

“Protecting health care workers is one of the most pressing responsibilities of the international community,” said Jim Campbell, director of WHO's Health Workforce department. “Without health workers, there is no health care.”

Until now, data on attacks against health workers has been piecemeal and there has been no standard way of reporting them.

A new tracking system

To address that need WHO developed a new system for collecting data that is being tested in Central African Republic, Syrian Arab Republic and West Bank and Gaza Strip. It will be available for use early next year. But the project doesn't only aim to collect data. It also plans to use the information to identify patterns and find ways to avoid attacks or mitigate their consequences.

“Every time a doctor is too afraid to come to work, or a hospital is bombed, or supplies are looted, it impedes access to health care,” said Erin Kenney, who manages the WHO project that has developed the new system.

In Pakistan, where 32 health care workers and other personnel involved in polio eradication have been killed since 2012, there have been fewer incidents since vaccinators switched from four-day campaigns to one-day campaigns, and studied the safest times to dispatch vaccinators.

“It's being clever about the way we do things,” Kenney said. “We're negotiating access routes so we can get people in and out, evacuate hospitals, and pre-position supplies so hospitals can be resilient.”

Protecting health workers

Attacks on hospitals and clinics in conflict situations are just one of the threats health workers face. During West Africa's Ebola epidemic, a team of 8 people trying to raise awareness about the outbreak were killed in Guinea amid a climate of fear and suspicion. More than 400 health workers lost their lives after becoming infected while treating Ebola patients.

The WHO's first global report on attacks against health will be published next year.

In December 2014, the United Nations General Assembly agreed to strengthen international efforts to ensure the safety of health personnel and to collect data on threats and attacks against health workers. A WHO report calling for measures to improve security for workers and health-care for patients is being presented to the assembly this month.

WHO has also developed a global strategy to help countries address health workforce challenges as they progress towards universal health coverage. In fragile states and countries in chronic emergencies, the strategy calls for additional protection of health workers from violence and harm.

From MDGs to SDGs, WHO launches new report

2015-12-07T20:00:00Z

The World Health Organization (WHO) today launched a new comprehensive analysis of global health trends since 2000 and an assessment of the challenges for the next 15 years.

Health in 2015: from MDGs to SDGs identifies the key drivers of progress in health under the United Nations Millennium Development Goals (MDGs). It lays out actions that countries and the international community should prioritize to achieve the new Sustainable Development Goals (SDGs), which come into effect on 1 January 2016.

The 17 SDGs are broader and more ambitious than the MDGs, presenting an agenda that is relevant to all people in all countries to ensure that "no one is left behind". The new agenda requires that all three dimensions of sustainable development – economic, social and environmental – are addressed in an integrated manner.

Almost all the SDGs are directly related to health or will contribute to health indirectly. One goal (SDG3) specifically sets out to “Ensure healthy lives and promote well-being for all at all ages.” Its 13 targets build on progress made on the MDGs and reflect a new focus on noncommunicable diseases and the achievement of universal health coverage.

"Universal health coverage cuts across all of the health-related goals," says Dr Marie-Paule Kieny, Assistant Director-General of Health Systems and Innovation at WHO. "It is the linchpin of development in health and reflects the SDGs' strong focus on equity and reaching the poorest, most disadvantaged people everywhere."

Although the health MDGs missed a number of global targets, the overall results were impressive. The past 15 years witnessed major declines in child and maternal mortality and progress in the fight against HIV, TB and malaria in developing countries.

Key ingredients for success included a doubling in global funding for health, the creation of new funding mechanisms and partnerships, and the critical role of civil society in tackling diseases such as HIV/AIDS. Research investments led to the scale-up in all countries of new interventions such as antiretroviral therapy for HIV treatment and insecticide-treated bednets to prevent malaria.

The WHO report presents the latest data and in-depth analysis for the key areas outlined in the health SDGs:

reproductive, maternal, newborn, child and adolescent health
infectious diseases including HIV, tuberculosis, malaria, hepatitis and neglected tropical diseases
noncommunicable diseases (NCDs) including heart disease, cancer and diabetes
mental health and substance use including narcotics and harmful use of alcohol
injuries and violence
universal health coverage

"Snapshots" on 34 different health topics outline trends, achievements made, reasons for success, challenges and strategic priorities for improving health in the different areas. These "snapshots" range from air pollution to hepatitis to road traffic injuries.

In this report, WHO also explores how health contributes to and benefits from the other 16 SDGs and examines the implications of emerging issues such as technological and environmental change on global health.

The SDG health-related targets closely reflect the main priorities in WHO's programme of work for 2014-2019; many of these targets have already been agreed by Member States in the World Health Assembly. For example, the global voluntary targets for the prevention and control of noncommunicable diseases set in 2013 are closely linked to SDG Target 3.4, to reduce premature NCD mortality by one third by 2030. The WHO governing bodies will have a critical role in follow-up and review of implementation of the health-related SDGs.

"One of the biggest challenges will be measuring progress across a staggering number of targets, particularly with the lack of health data in developing countries," says Dr Kieny. The SDG monitoring requires regular, high-quality data, for example on the causes of death, from all population groups so that we know where we need to target resources."

WHO is working with partners to establish a Health Data Collaborative in early 2016 that aims to support countries to build better health data systems. An early product of this global collaboration is the WHO Global Reference List of 100 Core Indicators, published earlier this year, which is already being used to guide work in many countries.

"As the global agency with the mandate to cover the whole health agenda, WHO will take a leading role in supporting countries to set their own national targets and strategies, advising on best-buy interventions, defining research priorities and monitoring progress in achieving the health-related SDGs," says Dr Kieny.

In 2016, WHO will publish the first in a series of annual reports on the SDGs to set the baseline and measure progress towards achieving the goals over the next 15 years.

Accelerate expansion of antiretroviral therapy to all people living with HIV: WHO

2015-11-29T20:00:00Z

On World AIDS Day the World Health Organization (WHO) emphasizes that expanding antiretroviral therapy to all people living with HIV is key to ending the AIDS epidemic within a generation.

“The Millennium Development Goal of reversing the HIV epidemic was reached ahead of the 2015 deadline - an incredible achievement that testifies to the power of national action and international solidarity," declared WHO Director General Margaret Chan.

Expansion of antiretroviral therapy (ART) has resulted in a stark reduction of AIDS-related deaths. At the same time, increasingly effective prevention efforts have reduced numbers of new HIV infections. Since the epidemic's peak in 2004, the number of - deaths has fallen by 42% with some 7.8 million lives being saved over the last 15 years, according to a new WHO report. The number of new infections has fallen by 35% since the turn of the century.

Over the last 15 years, scale-up of ART has been most dramatic in the Africa Region where now more than 11 million people are receiving HIV treatment, up from 11 000 at the turn of the century. People living with HIV in Africa are now more likely to receive treatment than people living in most other parts of the world. Globally, in June 2015 close to 16 million people out of a total of 37 million people living with HIV were taking ART.

Doubling access to testing and antiretroviral therapy

At the UN General Assembly in September, world leaders endorsed a new set of Sustainable Development Goals and milestones, including a call for ending the AIDS epidemic by 2030. Reducing the number of new infections by 75% and doubling the number of people on ART by 2020 are the first milestones towards achieving this goal.

Trial results published earlier this year have confirmed that people living with HIV who begin antiretroviral therapy soon after acquiring the virus – before the virus has weakened their immune systems - are more likely to stay healthy and less likely to transmit the virus to their partners. Those findings led WHO in September to recommend that everyone living with HIV be offered treatment.

In the effort to help countries implement the “treat all” recommendation, WHO is now presenting an additional set of recommendations on how to expand ART to all – in a rapid, focused, and efficient manner.

These recommendations include using innovative testing approaches such as community or self-testing to help increase the number of people who know their HIV status; starting treatment faster in those people who are diagnosed with HIV; bringing ART to the community; and allowing for greater intervals between clinic visits for people who have been stable on ART for some time. They also highlight the importance of improving access to viral load testing and new classes of antiretroviral drugs.

“WHO applauds governments, civil society, and organizations that have made availability of life-saving antiretroviral therapy possible in the most trying circumstances. The new recommendation to

expand ART to all people living with HIV is a call to further step up the pace,” said Dr Winnie Mpanju-Shumbusho, Assistant Director General at WHO.

Preventing new infections

Reducing the number of new HIV infections remains a major focus for the vision of ending AIDS. There is increasing concern about a slow down–or even reversal - in the decrease of new infections in some countries and among some of the most affected population groups. “We must deploy all means to strengthen the HIV prevention response. The health sector can and must play a central role,” added Dr Mpanju -Shumbusho

Already, over the last 5 years in Africa some 10 million men have undergone voluntary medical circumcision, a procedure that reduces their risk of acquiring HIV by 60%. New approaches to prevention are also emerging, including the use of antiretroviral drugs to help people at substantial risk from acquiring HIV. WHO now recommends this practice, called “pre-exposure prophylaxis,” or PrEP, as an additional option to augment comprehensive prevention for people at heightened risk of HIV infection. Other elements of this package include behaviour-change communication, the consistent use of male and female condoms and prevention programmes for key populations, including harm reduction for people who use drugs.

The same drugs that keep people living with HIV from becoming sick also prevent transmission of the virus from pregnant women to their infants. Among the 22 countries that account for 90% of new HIV infections, 8 have reduced new infections among children by more than 50% since 2009, based on 2013 data, and another 4 are close to that mark.

Ingredients of success

Some low- and middle-income countries have made remarkable progress towards universal access to HIV services: 12 countries have ensured that 60% or more of all people living with HIV are aware of their infection and receiving antiretroviral therapy. Key ingredients of the successful HIV response in these countries are national ownership, greater focus of HIV services to reach the most affected locations and populations based on good data, and simplification of prevention and treatment services.

“The sense of urgency that was the norm during the disease's most-destructive years must not be allowed to abate,” Dr Mpanju-Shumbusho said. “HIV remains a major health challenge - drawing sharp attention to health system weaknesses and gaps in universal health coverage. Addressing these issues will be critical to meeting the new global targets for AIDS.”

WHO statement on links between processed meat and colorectal cancer

2015-10-28T20:00:00Z

WHO has received a number of queries, expressions of concern and requests for clarification following the publication of a report from the International Agency for Research on Cancer (IARC) relating to processed meat and colorectal cancer.

IARC was established 50 years ago through a resolution of the World Health Assembly as a functionally independent cancer agency under the auspices of WHO. Its programme of work is approved and financed by its participating states.

IARC's review confirms the recommendation in WHO's 2002 Diet, nutrition and the prevention of chronic diseases report which advised people to moderate consumption of preserved meat to reduce the risk of cancer. The latest IARC review does not ask people to stop eating processed meats but indicates that reducing consumption of these products can reduce the risk of colorectal cancer.

WHO has a standing group of experts who regularly evaluate the links between diet and disease. Early next year they will meet to begin looking at the public health implications of the latest science and the place of processed meat and red meat within the context of an overall healthy diet.

New report identifies four ways to reduce health risks from climate pollutants

2015-10-21T20:00:00Z

A new World Health Organization report highlights the urgent need to reduce emissions of black carbon, ozone and methane - as well as carbon dioxide – which all contribute to climate change. Black carbon, ozone and methane – frequently described as short-lived climate pollutants (SLCPs) - not only produce a strong global warming effect, they contribute significantly to the more than 7 million premature deaths annually linked to air pollution.

The report, “Reducing global health risks through mitigation of short-lived climate pollutants”, produced in collaboration with the Climate and Clean Air Coalition to Reduce Short-Lived Climate Pollutants, reveals that interventions to cut SLCPs can reduce disease and death and contribute to food security, improve diets and increase physical activity.

“Every day, these pollutants threaten the health of men, women and children,” says Dr Flavia Bustreo, Assistant Director-General at WHO. “For the first time, this report recommends actions that countries, health and environment ministries, and cities can take right now to reduce emissions, protect health and avoid illness and premature deaths, which often take the greatest toll on the most vulnerable.”

The report builds off a 2011 assessment by the UN Environment Programme and World Meteorological Organization that estimated that a global deployment of 16 SLCP reduction measures would prevent an average of 2.4 million premature deaths annually by 2030. New estimates could raise that to 3.5 million lives saved annually by 2030, and between 3 to 5 million lives per year by 2050. These latest projections take into account WHO's latest data on deaths linked to air pollution as well as some new SLCP measures.

"Quick action to reduce black carbon, methane and other ozone precursors are much needed now, " says Helena Molin Valdés, head of the UNEP-hosted CCAC. “We know that the sooner we start reducing these pollutants the sooner we will relieve the pressures on climate and human health.”

Top actions for health and climate benefits

WHO rated more than 20 available and affordable measures to mitigate short-lived climate pollutants, including vehicle emissions standards, capturing landfill gas, switching from fossil fuels to renewables, reducing food waste and improving household cooking fuels, to see which have the greatest potential to improve health, reduce SLCP emissions and prevent climate change.

Four interventions rated medium to high in all three categories:

Reducing vehicle emissions by implementing higher emissions and efficiency standards could reduce black carbon and other co-pollutants from fossil fuels, improve air quality and reduce the disease burden attributable to outdoor air pollution.

Policies and investments that prioritize dedicated rapid transit such as buses and trains and foster safe pedestrian and cycle networks can promote multiple benefits, including: safer active travel and reduced health risks from air and noise pollution, physical inactivity, and road traffic injuries.

Providing cleaner and more efficient stove and fuel alternatives to the approximately 2.8 billion low-income households worldwide dependent on primarily wood, dung and other solid fuels for heating and cooking, could reduce air pollution-related diseases and reduce the health risks and time invested in fuel-gathering.

Encouraging high and middle-income populations to increase their consumption of nutritious plant-based foods could reduce heart disease and some cancers, and slow methane emissions associated with some animal-sourced foods.

“The health benefits that may be obtained from these strategies are far larger than previously understood, and they can be enjoyed immediately and locally,” says Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health. “The environment and health sectors can now prioritize interventions to meet both of their goals—preventing climate change and ensuring good health.”

The way forward

The release of today's report is a significant step in WHO's ongoing work to prevent diseases and deaths related to air pollution – and towards achieving the new global health goal. Target 3.9 aims to “By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination.”

In May 2015, the World Health Assembly adopted a resolution to address the health impacts of air pollution, which stresses the need for strong cooperation between different sectors and integration of health concerns into national, regional and local air-pollution-related policies.

WHO is piloting a number of these approaches in the urban health initiative it is leading with CCAC, Norway and other partners. The initiative will be rolled out in 4 cities in 2016. As part of this initiative, cost benefit analysis of key interventions recommended here will be further assessed.

Evidence from previous WHO studies on healthy transport already suggest that shifts to mass transport and the introduction of safe walking and cycling networks are relatively inexpensive when compared with the loss of life and costs of treating people for air-pollution related illnesses, traffic injuries and diseases related to physical inactivity.

WHO supports European countries in managing health needs of refugee and migrant influxes

2015-09-13T20:00:00Z

In response to the growing numbers of refugees and migrants arriving in the European Region, WHO supports countries by offering medical supplies, assessing national preparedness to assist people in need, training personnel at points of entry in public health and migration matters, and providing information materials.

Senior government officials of the 53 Member States in the WHO European Region discussed the public health impact of large-scale migration during the 65th session of the Regional Committee for Europe in Vilnius, Lithuania. They called for continued involvement and support from WHO to respond adequately to the public health implications of large influxes of people by conducting additional assessments in countries and by providing policy advice on contingency planning, training of health personnel and delivery of supplies. It was decided that a high-level WHO conference would be organized as soon as possible to agree on a common public health approach to large-scale migration in the Region.

"As refugee and migration movements escalate and the migratory routes change, more European countries face this challenge," said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. "Today more than ever, this situation calls for a regional, comprehensive and systematic public health response. As refugees and migrants move, intercountry coordination must be strengthened across the European Region, as well as with the countries of origin and transit."

In 2015 alone, over 350 000 refugees and migrants have reached European countries, adding to the almost 2 million who have taken shelter in Turkey. According to the estimates of the Office of the United Nations High Commissioner for Refugees (UNHCR), 850 000 people are expected to seek refugee status in Europe this year and next.

In spite of a common perception, there is no systematic association between migration and the importation of infectious diseases. The risk for importation of exotic and rare infectious agents, such as Ebola, Marburg and Lassa viruses or Middle East respiratory syndrome coronavirus (MERS-CoV), into Europe by refugees or migrants is exceedingly low. For example, the 15 cases of MERS-CoV infection reported in the WHO European Region since 2012 were imported by travellers or tourists, not refugees or migrants. Not a single case of Ebola was imported into Europe by refugees or migrants.

The countries from where most of the refugees and migrants originate often have higher levels of immunization and therefore a lower incidence of vaccine-preventable diseases, such as measles, compared with a number of European countries.

"Our efforts must now focus on public health measures, including immunization for vaccine-preventable diseases when needed, emergency care for injuries, access to care during pregnancy and childbirth, children's access to medical care in case of fever or childhood diseases, medication and care for those who have chronic conditions, as well as psychosocial care," added Dr Zsuzsanna Jakab.

Joint assessment missions have been conducted with ministries of health in Bulgaria, Cyprus, Greece, Italy, Malta, Portugal, Serbia and Spain using the new WHO Toolkit for assessing health-system capacity to manage large influxes of migrants in the acute phase. WHO provides policy advice on contingency planning for the health sector in Italy and Malta.

WHO also ensures that countries have adequate medical supplies when needed, through the procurement of interagency health emergency kits containing essential medicines and equipment, each catering to the medical needs of a population of 10 000 for three months.

In the former Yugoslav Republic of Macedonia, WHO will provide training in September on managing the public health aspects of migration, including standard operating procedures, to health-care workers providing medical care for people arriving at entry points into the country.

Hosting close to 2 million refugees, Turkey has welcomed the largest influx of refugees in the world, according to UNHCR. WHO established a field presence in Gaziantep in October 2013 to scale up its capacity and to respond to the public health needs of refugees. In close collaboration with the Ministry of Health of Turkey and its partners, WHO continues to assess the needs of Syrian refugees, providing support through the capacity-building of Syrian medical staff, technical and financial assistance for outbreak response and immunization campaigns, the supply of medical equipment and drugs, and the dissemination of information material to refugees.

WHO providing emergency life-saving health services to internally displaced persons in South Sudan

2015-08-18T20:00:00Z

The World Health Organization (WHO) and partners are racing to cope with the health needs of thousands of internally displaced persons (IDPs) in northeastern South Sudan where fighting continues and the humanitarian situation remains dire.

More than 10 000 people have arrived to the Malakal protection-of-civilians (PoC) site since 1 August 2015 stemming from a month-long aid blockade to the region. The influx brings the total number of asylum seekers in the PoC to 46 567, with families crammed together with little or no access to safe water or sanitation.

“Malakal PoC is now a home for thousands of South Sudanese and overcrowding easily results in water contamination and diseases like dysentery, bloody diarrhoea, hepatitis E and cholera,” says Dr Allan Mpairwe, Head of Outbreaks and Disasters Management at WHO in South Sudan.

Given the vulnerability their situation, there is an urgent need to strengthen coordination mechanisms to scale up the health services, provision of water, sanitation and hygiene (WASH) services to prevent disease outbreaks.

“There is a serious need of health care services and access to clean drinking water and sanitation. WHO and health cluster partners are racing to ensure WASH supplies are available to prevent infections and the spread of diseases, especially in vulnerable populations like children, pregnant women and the disabled,” adds Dr Mpairwe.

Besides cholera and other water-borne diseases, malaria, measles and polio are other significant public health threats to IDPs. In response to the rapid influx, additional clinics and outreaches have been opened in order to improve access to prevention, screening and treatment of these serious threats. WHO has supported the health cluster partners to vaccinate over 37 000 IDPs with the oral cholera vaccine during the first round and the second round is expected to begin on 1 September 2015.

To prevent malaria and other vector-borne disease, response actions have been undertaken to improve access to timely and appropriate care, interventions to interrupt community transmission and coordination of behaviour change communication. With the support from WHO and partners, stocks of artemisinin combination therapy (ACTs), malaria diagnostics, and other malaria case management supplies have been dispatched to Malakal and other deep front areas. The WHO immunization programme and vaccination teams are positioned to vaccinate all new arrivals in the PoC site against measles and polio.

Coupled with this situation, WHO and partners are also responding to a cholera outbreak which has affected more than 1600 people and resulted in 43 deaths (CFR 2.85%) from May to 15 August 2015 in South Sudan's Juba and Bor counties.

To help fund these life-saving initiatives, WHO has mobilized resources form the Common Humanitarian Fund (CHF) and the United Nations Central Emergency Response Fund (CERF) grant to meet the most critical needs. Funds are being allocated for outbreak response, case management of the common but potentially fatal illnesses, basic emergency obstetrics care services, strategically prepositioning of emergency medicines, life-saving surgical interventions and reducing the high burden of morbidity of malaria and other communicable diseases.

The WHO Representative's Office in South Sudan will continue to support the Ministry of Health and health cluster partners at the central and subnational level to strengthen health services to deliver effective, safe, quality interventions to those in need.

Africa risks large meningitis outbreak

2015-07-27T20:00:00Z

With Africa at risk of a large meningitis outbreak, an acute shortage of meningitis C-containing vaccine threatens to severely limit the world's ability to minimize the number of people affected, four international public health organizations warned today.

International Federation of Red Cross and Red Crescent Societies (IFRC), Médecins sans Frontières (MSF), The United Nations Children's Fund (UNICEF), and the World Health Organization (WHO) (the 4 organizations, which together constitute the International Coordinating Group for Vaccine Provision for Epidemic Meningitis Control - ICG) are therefore calling today on vaccine manufacturers to step up meningitis C-containing vaccine production by 5 million doses before the 2016 meningitis season starts in January.

“Meningitis tends to hit Africa in cycles. Cases of meningitis C have been rising since 2013, first in Nigeria in 2013 and 2014, and then in Niger in 2015. We have to be ready for a much larger number of cases during the 2016 meningitis season,” said Dr William Perea, Coordinator for Control of Epidemic Diseases Unit at WHO.

“We have had preliminary discussions with vaccine manufacturers and impressed upon them the need to produce a stockpile of 5 million doses of vaccine so as to be ready for flare-ups of the disease next year in Africa, but so far they haven't yet revised their production plans to meet demand,” said Dr Imran Mirza, Helath Specialist, Program Division, UNICEF.

While substantial progress has been made in recent years in protecting Africa from other main sub-types of meningitis with, for example, the introduction of the MenAfrVac vaccine against meningitis A in 2010, much work needs to be done to protect the African meningitis belt from meningitis C outbreaks.

“We have been working to reinforce detection and response systems, and are working to secure other sources of meningitis C vaccine in Cuba and Brazil, but the manufacturers have not yet submitted an application for WHO prequalification,” said Mr Alejandro Costa, ICG Secretariat. Until they do, we can only turn to those manufacturers who are already prequalified and have provided vaccine in the past. We need to get them to produce and provide vaccine, in the right quantity and at an affordable price.”

“In just the first six months of 2015, there have been 12,000 cases of meningitis C in Niger and Nigeria, and 800 deaths. At the same time, there has been a critical shortage of vaccine,” said Dr Myriam Henkens, International Medical Coordinator, MSF. “The campaigns consequently were limited to the critically affected age groups and areas, and even so, had to be delayed until vaccine supply became available and we believe next year will be worse. We need vaccine manufacturers to plan production of multivalent vaccine now to allow sufficient lead time and capacity to meet this demand.”

The ICG stresses that vaccination remains key to preventing meningitis. “Since the introduction of the meningitis A conjugate vaccine (MenAfriVac) in 2010 in 15 countries in Sub-Saharan Africa, the meningitis disease burden has been dramatically reduced. No epidemics of meningitis A have been reported in areas where the population has been vaccinated. We need now to do the same for meningitis C,” said Ms Amanda McClelland, Senior Officer, Emergency Health, IFRC.