Creative messaging and sensitisation to kick Ebola out of Congo

By Esther Nakkazi

Officials in the Ministry of Health in the Democratic Republic of Congo have turned to sports to sensitize the public especially the youth about Ebola. This was after it was observed that young people were often the source of reluctance in the community and the first perpetrators of the destruction of sanitary materials.

The aim of the football tournament was to appease this youth, raise awareness about Ebola and invite them to take ownership of the Ebola response to end the epidemic, a statement from the Ministry of Health says.

To sensitize the public and particularly the youth, the coordination of the Ebola response organized a football tournament in Beni and Butembo in order to build trust with the youth of both cities. The last phases of the football tournament 'Ebola Pas Chez Moi' started on Monday, December 17, 2018, with the final and the small final of Butembo. 

After two weeks of strong emotions, it was the 'Racing Club of Kivu' (RCK) team that won the title of tournament champion in Butembo after having imposed on penalties against the team 'Jeunesse Sportive de Butembo '(JSB). The RCK will face Beni's championship team in the Grand Final of the tournament and attempt to win the Cup of Hope this Thursday, December 20, 2018.

Throughout the tournament, many awareness activities were organized including community animators who animated the games with messages and awareness songs. After being trained on the disease and the means of prevention, the young players themselves became involved in raising public awareness by recording prevention messages that were also broadcast by local radio stations. 

A special prize was awarded to the player of the tournament voted the best sensitizer of the competition. Handwashing and temperature sensing devices were installed at the entrance to all stadiums. 

In addition, on the sidelines of the Butembo final, experts from the different pillars of the Ebola response were set up in stands and answered all the public's questions about the epidemic.
Meanwhile, vaccination has continued wide-belt vaccination (or ring plus) in Otomaber (in Komanda Health Zone) and Aloya (in Mabalako Health Zone). Continued immunization of primary care providers in the Goma Health Zone.

The ministry records show that since vaccination began on 8 August 2018, 48,048 people have been vaccinated, including 19,017 in Beni, 8,619 in Katwa, 5,077 in Mabalako, 4,974 in Butembo, 2,208 in Kalunguta, 1,663 in Mandima, 824 in Komanda, 791 in Vuhovi, 750 to Masereka, 700 to Lubero, 670 to Oicha, 607 to Kyondo, 599 to Mutwanga, 434 to Bunia, 355 to Tchomia, 344 to Musienene, 257 to Goma, 70 to Biena, 63 to Alimbongo, 13 to Karisimbi and 13 to Kisangani.

ends

Research says nine of ten Africans are unqualified for the Jobs they apply for

Research conducted by the ROAM or Ringier One Africa Media (www.ROAM.Africa) Group shows that many Africans who apply for a job are not qualified in the first place

Close to 90% of applicants that apply to a job position are objectively not a match to the role advertised. This is caused less by a shortage of jobs, but a fundamental misunderstanding of job requirements, both from employers and candidates.

This has been uncovered by research conducted by ROAM, who is encompassing the market-leading job portals in West Africa (Jobberman) and East Africa (Brightermonday), as well as Executive Recruitment and HR Solutions firm The African Talent Company. The company has analysed data sets from more than 12 million users, as well as from more than 100,000 employers, across Nigeria and Kenya active in the last two years.

Matthew Page, ROAM Head of Jobs, on the background of the research: “We have recently conducted a data review and were shocked by this huge gap. Our initial hypothesis was that this is due to a shortage of jobs, gaps in the labour markets, and desperation."

"However digging deeper into our database, our analysis found that many candidates were indeed qualified for other available jobs, but did not necessarily apply for these. African employers and our clients indeed face a challenge in hiring the right people,” he said.

The company’s research further brought to light that an average job listing receives about 140 - 160 applications. This showcases that there are huge hiring efforts involved in the application and recruitment process, even before the interview. 

This is both on the candidate side, to launch this large number of wrong applications, as well as from the employer, to identify the 10% of right candidates, amidst a large number of unqualified requests.

“Hiring the right competency upfront typically returns 3x productivity for the employer. It also minimises the onboarding time required to get an employee up to speed. That is why we have launched smart employer products in the last months. These facilitate a smooth hiring experience for employers, through tech-enabled shortlisting and matching products that identify the best candidate for the best position”, adds Matthew Page.

Clemens Weitz, CEO of ROAM elaborates on the potential for economic growth: “Our research clearly shows that the education of the African job market has a long way to go - both on the seeker and employer side. Solving this challenge will unlock tremendous latent economic potential."

"Imagine an efficient economy, where all employees sit in the job that is a perfect, natural fit for their individual nature. Productivity and satisfaction would skyrocket. AI and machine learning have tremendous potential, and we plan to fundamentally solve this challenge in 2019,” he said

Press Release APO

Ebola Update

By Esther Nakkazi

According to the World Health Organisation concerns have been raised regarding the disproportionate number of women and children infected during this outbreak. 

To date, females accounted for 62% (280/450) of overall cases where sex was reported. Of all female cases, 83% (230/277) were aged ≥15 years. Of these women, at least 18 were pregnant, and an additional seven were breastfeeding or recently delivered at the time of infection. 

There have been 27 cases among infants less than one year of age, with 70% (19) of these being boys, and 21 fatalities (age-specific case fatality of 78%). There were also nine cases in infants aged less than one month. Children, less than 15 years of age accounted for 24% (106/447) of cases.

There are likely a multitude of factors contributing towards this disproportionate disease burden observed in women and children. These include exposure within formal and informal health facilities, involvement in traditional burial practices, transmission within family groups (including transmission between mothers caring for children), differences in health-seeking behavior, as well as the impact of ongoing conflict on the underlying population structure in affected areas. 

Among those with available information, commonly identified risk factors reported by cases include: having contact to a known case (224/320, 70%), having attended funerals (121/299, 40%) and having visited/admitted to a health facility before the onset of EVD (46/139, 33%). Of note, 46% of female cases (84/181) reported having attended funerals, in contrast to 31% of male cases (37/118).

ends

Traditional Healers fuelling Ebola spread

By Esther Nakkazi

In the past three weeks, a significant increase in Ebola cases has been observed in Butembo and Katwa with the main challenges in these areas related to the high density and mobility of the population in this major trading city of North Kivu, said Dr. Oly Ilunga Kalenga, the Minister of Health, Democratic Republic of Congo.

Another observed an unusual aspect of this epidemic is the role played by centers of traditional health practitioners in the transmission of the virus that a key factor in nosocomial infections. Nosocomial infection is an infection that is acquired in a hospital or other health care facility and is spread to the susceptible patient in the clinical setting by various means.

DRC ministry of health officials says a parallel consequence of these nosocomial infections is the contamination of a large number of healthcare providers. To date, 44 health workers have been infected (9% of the total number of cases), of whom 12 have died.

"Strengthening infection prevention and control measures in public, private and traditional health facilities is one of the priorities of the teams today," said Dr. Ilunga at a press conference in Kinshasa held Thursday, December 6, 2018.

Dr. IIunga also observed a reluctance by the community which is more violent than the reluctance usually observed during previous Ebola outbreaks.

"A minority of the population in these areas express their reluctance through the regular destruction of medical equipment and health centers as well as the physical attacks of health workers," he said.

Meanwhile, vaccination is still ongoing with more than 40,000 vaccinated people, and vaccination teams have averted more than 10,000 Ebola cases in 4 months or nearly half of the balance sheet of the epidemic in West Africa that lasted 2 years.

Since the beginning of vaccination on August 8, 2018, 41,226 people have been vaccinated, including 18,270 in Beni, 6,272 in Katwa, 4,578 in Mabalako, 3,556 in Butembo, 2,092 in Kalunguta, 1,663 in Mandima, 769 in Vuhovi, 750 in Masereka, 599 in Mutwanga, 521 in Oicha, 434 in Bunia, 409 in Komanda, 392 in Lubero, 355 in Tchomia, 274 in Musienene, 241 in Kyondo, and 51 in Alimbongo.

Continuation of vaccination of front-line providers in Lubero as a preventive measure in the context of the preparation of the health zone also continues.

Dr. Ilunga cautioned that the epidemic will last for several months and that the risk of spread will remain high until the epidemic is completely extinguished.

£28 million from UK government to support nutrition in Uganda

By Esther Nakkazi

The UK government has launched the Karamoja Nutrition Programme worth £28 million pounds which will improve the delivery of quality nutrition services across Karamoja.

84 percent of people in Karamoja are unable to afford a nutritious daily diet, 45 percent of households have limited access to food, and over half of all households do not have much diversity in their diet. 

Malnutrition, therefore, remains a major impediment to Karamoja’s development, undermining the health and economic prospects of the population. More than 1 in 3 children in Karamoja experience stunted development due to malnutrition.

The Karamoja Nutrition Programme, funded by UK aid and implemented by the United Nations Children’s Fund (UNICEF) and the United Nations World Food Programme, will strengthen the Government’s health system to ensure children and mothers across the region receive high-quality health and nutrition services and are better nourished.

The programme supports all District Local Governments in Karamoja to develop the skills of nutritionists and health workers; improve the treatment of severe acute malnutrition in hospitals and health centres; generate evidence to improve the design of nutrition services; procure and manage quality nutrition supplies; and provide more effective nutrition leadership and coordination across all Government departments and partners.

“Working to strengthen the Government’s health system, with strong district leadership and engagement, presents an opportunity for Karamoja to address its malnutrition challenge,” said Francesca Stidston, the Head of Office for the Department for International Development (DFID) in Uganda.
 

"This programme is timely in that it will help to ensure that children access higher quality nutrition services, which are essential to their survival and healthy development,” said Dr. Doreen Mulenga, UNICEF’s Representative in Uganda.

The programme will support: over 100,000 malnourished children under the age of 5 with a community based supplementary feeding programme; nearly 15,000 severely malnourished children with specialized treatment in hospitals and health centres; 140,000 children to receive Vitamin A supplements and deworming medication twice a year; and around 70,000 pregnant or breastfeeding women with iron folic acid supplements to treat anemia.

At the launch, the leadership from Karamoja’s eight districts - Abim, Amudat, Kaabong, Kotido, Moroto, Napak, Nakapiripirit and Nabilatuk - as well as leaders from the Ministry of Karamoja Affairs, committed to ensure that all pillars of the programme are fully integrated within the health sector and are effectively planned and budgeted for after the programme ends in three years.

“The Karamoja Nutrition Programme is a continuation of the Government of Uganda and development partners’ march to end child stunting in Uganda,” said WFP’s Country Director El-Khidir Daloum.

“We are outraged by the level of stunting in Karamoja, which remains unacceptably high. Ending stunting is mission possible,” Daloum said.

While child stunting has reduced by roughly one percent every year in Karamoja since 2006, 35 percent of all children under the age of 5 in Karamoja are still stunted.

The Karamoja Nutrition Programme compliments other programmes in Karamoja, such as the Karamoja Resilience Support Unit supported by USAID, Irish Aid, and UK aid and GIZ’s programme to improve the reliability of water supply and sanitation in selected health centers, which collectively contribute to a comprehensive multi-sectoral nutrition response to all people across Karamoja.

Urgent Research for Development Action Plan required to Combat ArmyWorm

By Esther Nakkazi

A more coordinated research-for-development (R4D) action plan is urgently needed to ensure that effective and affordable solutions reach smallholder farmers in sub-Saharan Africa so they can sustainably combat the voracious fall armyworm an international conference heard.

The international conference held from Oct. 29 to 31 at the African Union Commission in Addis Ababa, Ethiopia was also aimed at drawing a science-based roadmap to combat the fall armyworm.

“We must look at the big picture to design safer, accessible, effective and sustainable solutions against fall armyworm,” said Martin Kropff, director general of the International Maize and Wheat Improvement Center (CIMMYT).

“Fall armyworm has been the fastest pest to expand across the continent,” said Eyasu Abraha, Ethiopia’s State Minister for agriculture development.

African leaders consider the invasive fall armyworm “a big threat for African food security,” said Amira Elfadil, African Union Commissioner for Social Affairs, at the opening of the conference.

Since the initial shock in 2016, various stakeholders - farmers, researchers, extension officers, agribusinesses, governments, and donors have reacted quickly to fight the invasive pest in various ways.

They have used pesticides, agroecological approaches and new seeds but still the situation is far from under control. African farmers have as well lost millions of dollars in earnings due to the loss of crops to the fall armyworm.

The rapid increase of the pesticide market in Africa has led to the circulation of plenty of banned or counterfeit products, some very toxic, said Steven Haggblade, a professor in the Department of Agricultural, Food, and Resource Economics at Michigan State University, USA. Besides, most farmers are also often not well trained in the use of such chemicals and do not protect themselves during application, he said.

On the other hand, pesticide use also has many negative trade-offs, said Paul Jepson, a professor of environmental and molecular toxicology in the College of Agricultural Sciences at Oregon State University.

Natural enemies like parasitic wasps are also often far more vulnerable to pesticides than fall armyworm larvae, which are hard to reach and hide in the maize whorls for instance.

Since it was first detected in Nigeria and São Tomé, the moth has spread across more than 40 African countries where it has found an ideal environment, with diverse agro-ecologies and a warmer climate all year round amplifying its persistent threat. It has also been seen in India since July 2018.

Entomologists are trying to fill a knowledge gap in how the fall armyworm behaves and migrates throughout Africa. What is known is that it has a host range of more than 80 plant species, including maize, can cause total crop losses, and at advanced larval development, stages can be difficult to control even with synthetic pesticides.

The female fall armyworm can lay up to a thousand eggs at a time and produce multiple generations very quickly without pause in tropical environments. The moth can fly 100 km (62 miles) a night, and some moth populations have even been reported to fly distances of up to 1,600 kilometers in 30 hours, according to experts.

During the conference, experts debated intensely on the technical gaps and the best ways to combat the pest through an integrated pest management strategy, including how to scout the caterpillar in the crop field, establish monitoring and surveillance systems, pest control innovations and appropriate policy support to accelerate the introduction of relevant innovations.

They also heard the many collaborative initiatives, including national task forces and expert working groups, which have informed the current state of knowledge but were cautioned about the many still existing knowledge and technology gaps.

“The cost of not collaborating is pretty severe,” said Regina Eddy, who leads the Fall Armyworm Task Force at the USAID Bureau for Food Security. “The real gamechanger will be that all experts agree on a common and concrete research-for-development agenda and how to organize ourselves to implement it effectively.”

The conference was jointly coordinated by CIMMY and hosted by the Fall Armyworm R4D International Consortium which recommended that common methodologies and research protocols be developed to ensure data from various studies across the continent are better used and compared. For instance, this would look at how best could the true impacts of the fall armyworm on food and seed security, public health and environment be measured?

Conference participants also agreed to work on defining economic and action thresholds for fall armyworm interventions, to ensure better recommendations to the farming communities and that advice must include the use of environmentally safer pesticides, low-cost agronomic practices and landscape management and fall armyworm-resistant varieties, among other integrated pest management tools.
ends

Scientists find solution to Banana Wilt Disease

International Institute of Tropical Agriculture (IITA)
Scientists have announced progress in the search for banana varieties that are resistant to the lethal bacterial banana wilt disease.

The discovery was by a team led by Prof Rony Swennen, Head of banana breeding; Dr. George Mahuku, a senior Plant Pathologist for Eastern, Southern, and Central Africa; and Dr. Valentine Nakato, a Plant Pathologist, was reported in the Plant Pathology Journal. (https://doi.org/10.1111/ppa.12945).

The team systematically screened all the banana collection at IITA, Uganda, and identified 13 other sources of resistance next to M. balbisiana. Most importantly, Nakato identified several diploids derived from Musa acuminata—another wild banana—and which are already part of the existing highland breeding program of IITA and NARO (National Agricultural Research Organisation, Uganda).

“This debunks the notion that all banana varieties are susceptible to the disease and opens the possibility of breeding resistant varieties,” said scientists from the International Institute of Tropical Agriculture (IITA) who lead the team.

Banana wilt disease causes premature ripening and rotting of the fruits, wilting, and eventually, the death of the plant. It has drastically affected the highland cooking banana in East and Central Africa (ECA) and the food and income of millions of farmers.

The IITA scientists say until now, the scientific world believed that all banana varieties in the region, except for a wild-seeded banana called Musa balbisiana, were susceptible to the disease, which originated from Ethiopia and has now invaded all banana growing areas in the highlands of eastern and central Africa.

The disease is caused by Xanthomonas campestris pv. musacearum bacteria and its symptoms include yellowing and wilting of leaves, a cream to pale yellow bacteria-laded oozing when the plant is cut, shriveling of the male bud, premature ripening, internal discoloration of fruits, and finally death of infected plants.

Transmission is fast and mainly through contaminated tools, insect vectors, and planting material. Therefore, major investments by national programs, donors, and scientists have been geared towards rigorous monitoring of banana fields, removal of diseased plants, and decontaminating farm tools.

“This discovery is very important for the millions of smallholder banana farmers in the region as one of the most effective ways to control any disease is developing resistant varieties,” says Nakato, based in IITA, Uganda.

Bananas are an indispensable part of life in the region providing up to one-fifth of the total calorie consumption per capita. The average daily per capita energy from banana consumption in ECA is 147 kcal: 15 times the global average and 6 times the African average.

The region has over 50% of its permanent cropped area under banana; this is around half of the total area under banana cultivation across Africa. ECA countries (Burundi, DR Congo, Kenya, Rwanda, Tanzania, and Uganda) produce annually 21 million tons of banana with a value of US$4.3 billion.

“The findings of this study are very significant for the banana breeding community and we will redouble our efforts in developing banana varieties with resistance to the disease,” says Swennen.

IITA and NARO have developed superior high-yielding matoke hybrids dubbed NARITA and now those NARITA, which was developed with the resistant banana varieties, will be screened for bacterial wilt resistance and become part of future breeding schemes to develop bacterial wilt resistant matoke varieties.

Other partners in the study included the University of Pretoria, South Africa, and Centre of the Region Haná for Biotechnological and Agricultural Research, Institute of Experimental Botany, Academy of Sciences of the Czech Republic.

Confirmed Ebola case near Ugandan Border

By Esther Nakkazi

The Ministry of Health in Uganda has confirmed a new case confirmed case of Ebola in DRC, in Kasenyi village, situated near the shores of Lake Albert on the DRC side of the border, in Ituri Province.

"The patient died on the 19th of September 2018, at Tchomia General Hospital which is quite close to Uganda," a ministry of Health press statement released on 23rd September says. However, it confirms that there is no confirmed case of Ebola in Uganda yet.

The patient who died was a contact between two previously confirmed cases (her mother and sister), thus a high-risk contact. She got lost to follow up when she moved to Kasenyi, later became very sick, and was admitted in Tchomia General Hospital where she later died.

A sample was taken from her and results released on the 21st September 2018 confirmed that it was positive for Ebola according to the WHO which says a team from Beni is currently on the ground to conduct an investigation of this case, identify and list all contacts for follow up, and initiate a response.

"We understand that there are population movements across the Lake Albert to Uganda hence a high risk of spread of the disease to Uganda. The Ministry of Health and Partners are supporting the districts bordering DRC to heighten preparedness and readiness to handle any Ebola case that might come into Uganda," says the Ministry of Health in Uganda.

STARS Project to access a Continuum of Care enables delivery of healthy babies

By Esther Nakkazi

Twenty-three-year-old Edisa Nanteza is heavily pregnant and beyond the 9 months, she is already at term. She has also had some signs like lower back pain, a bloody vaginal discharge to show that the child is about to pop out.

Nanteza delivered her two older children aged 5 and 3 years at the Traditional Birth Attendant (TBA) and without her ever attending antenatal clinics. But for this third delivery, she is willing to change and deliver from a health facility.

She has learned a lot from the village health worker, Jacent Nakasujja, who aggressively monitors her and she evidently sees mothers with healthy babies in her community that have been born in health facilities.

Nakasujja works with the Grand Challenges Canada funded Stars project as a Community Health worker also called Village Health Team (VHT) in Uganda.

The Stars project on Reproductive, Maternal, New-born and Child health is implemented in Kibaale and Hoima district in midwestern Uganda by Malaria Consortium and is funded by Grand Challenges Canada.

“For the first two deliveries, I lost a lot of blood. The TBA put salt on the umbilical cord of the second baby and it developed a nasty infection,” says Nanteza for the reasons she wants to switch and deliver from a health facility.

What has also jerked Nanteza to go and have this child delivered under the watchful eyes of a skilled health worker are the constant SMS reminders she and her husband Ronald Kyeyune receive on their phones.

As a result of these reminders, she has her ‘delivery bag’ ready to go with all the necessities required for giving birth in case of an emergency.

The SMS are sent out reminding community members about different activities and to remind pregnant women and their husbands about attending antenatal visits. They particularly target men because their response is key in decision making for the health of their families.

Some of Nanteza’s profound fears about delivering from a health facility have been allayed by the VHT. She had a conversation with friends who narrated rude health workers and harrowing tales of survival.

The Malaria Consortium Stars project has trained the midwives and other health workers on how to handle clients at health facilities. “These days they are friendly and disciplined,” Nakasujja assures and that puts Nanteza in warm and caring hands.

Nanteza has also heard from another friend, Jackie Kabaseke, that she got all the services at the health facility with no hassle. “My friend told me when she gave birth the baby was immunized the next day and she spent only two days at the health facility and got discharged,” says Nanteza.

Her friend has only been back to the hospital to treat intense backache pains for which she was given painkillers and to have her bouncing baby immunised.

“During my pregnancy the village health worker visited my home and told me that I have to have four check-ups (antenatal) before birth, deliver in a health facility, maintain good hygiene, sleep under a mosquito net and eat a balanced diet and more so eat green vegetables so I planted them around my home,” says Nanteza’s friend.

She was educated about safety steps during pregnancy like attending at least four antenatal visits at 3, 4,6, 8 months and educated about the importance of antenatal, postnatal care, immunization, prevention of malaria during pregnancy and HIV prevention.

Many women suffer life-altering injuries and die during childbirth or their newborns fail to survive because basic issues that are inexpensive are not adhered to, important information is not passed on and there are no constant reminders or someone to check up on them.

Some luckily give birth without incident but for those who get seriously injured or never come home with their babies the situation can be better with an improved continuum of care from the community to the health facility.

Nanteza has heeded to what she has learned from the VHT who has been aggressively monitoring her and her friend’s good advice - to deliver from a health facility - because there are benefits for both mother and newborn. So this third child will be her first.

It was during one of her routine visits that Nakasujja found Nanteza still at home even though she already had all the labor signs at play. She immediately told her the urgency of going to the health facility with not a minute to waste. The two of them in tow picked up her already packed a delivery bag and traveled the long distance to Nyamarwa Health Centre III.

It is certainly with the VHTs intervention that Nanteza has ended up at the health facility and not the TBA to deliver this third child, says Stella Bakeera-Ssali, the project officer Stars project, Malaria Consortium.

The long line winding with pregnant women waiting to be attended to by Sister Jane Namakula, an enrolled midwife at Nyamarwa Health Centre III had to accommodate Nanteza. But she was lucky, Nakasujja was at her side and explained the urgency of the situation which gave her priority access.

“We have to detain her and monitor her because she is already at term,” says Sister Namakula. “We also can't let her go back home because she lives far away from the health facility and that could be another excuse for not delivering her baby from here,” says Namakula.

As the VHT leaves the health facility she is sure to check on a happy mother with a healthy newborn because she is in well-trained hands of the health worker.

ends
This Story was facilitated by the STARS project of the Malaria Consortium Uganda

Fellowship boosts Pediatric Hematology-Oncology specialists in East Africa

By Esther Nakkazi

The East African Pediatric Hematology and Oncology Fellowship Training Program at Makerere University College of Health Sciences has graduated its first class of graduates building on the critical mass of pediatric hematology-oncology specialists to independently provide effective, evidence-based pediatric cancer and hematology care in the African setting.

The four physicians who graduated are all pediatricians physicians; Ruth Namazzi, MB ChB, MMed, Barnabas Atwiine, MB ChB, MMed., Fadhil Geriga, MB ChB, MMed. and Dr. Philip Kasirye, MB ChB, MMed. 

“By training physicians through the fellowship program, we are increasing the number of pediatric hematology-oncology specialists who will be practicing in East Africa. This will improve the overall survival for children with cancer and blood diseases in the region," said Dr. David G. Poplack, Director of Global Hematology-Oncology Pediatric Excellence or HOPE and Associate Director of Texas Children’s Cancer and Hematology Centers.

The East Africa Pediatric Hematology and Oncology Fellowship Training Program is part of the comprehensive Global HOPE initiative, which launched in February 2017, a two-year fellowship program. 

“This first class of graduates of the fellowship program represents an exponential increase in the number of pediatric oncologists in East Africa and by extension a huge increase in the number of children diagnosed with cancer who may now receive high-quality treatment and the chance of recovery,” said John Damonti, President of the Bristol-Myers Squibb Foundation. 

“We are proud to support the creation of a sustainable, highly qualified team of oncology and hematology healthcare providers in southern and east Africa, to help change the health outcomes for children,” said Damonti.

In sub-Saharan Africa, about 90% of pediatric patients with cancer die while 80 percent of children with cancer survive in the USA. The most common types of childhood cancers in Africa are blood cancers, including leukemia and lymphoma.

Although most childhood cancers are treatable up until this point, the main reason for the staggering death rate across Africa has been due to an inadequate healthcare infrastructure and a significant lack of expert physicians and other healthcare workers trained to treat children with cancer and blood disorders. 

With the ambitious efforts of Global HOPE to build medical capacity to diagnose and treat pediatric blood disorders and cancer in Africa, the impact is already evident in the higher numbers of children receiving care in Uganda, Botswana and Malawi.

The East Africa Pediatric Hematology and Oncology Fellowship Training Program is the result of cooperation and commitment between some of the most eminent institutions in Africa and on the world-stage in cancer care, medical education, health policy, and pediatric hematology and oncology.

Its a partnership between the Ministry of Health of the Republic of Uganda, Makerere University College of Health Sciences, East African Community, Uganda Cancer Institute, Baylor College of Medicine Children’s Foundation- Uganda, Mulago National Referral Hospital, the Bristol-Myers Squibb Foundation and the Texas Children’s Cancer and Hematology Centers and Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children’s Hospital (BIPAI). 

Atwiine, during his Fellowship, led to the development of a new combination chemotherapy approach to treating children with Burkitt lymphoma in Africa; and championed the widespread use of hydroxyurea to control sickle cell disease in children. He will return to Mbarara to head the children’s cancer service and to initiate a pediatric hematology service.

Geriga conducted research that demonstrated the high incidence of muscle cancers of the face that were previously often misdiagnosed as lymph node cancers. He will spearhead the development of a world-class muscle and kidney cancer care and research program at The East Africa Center of Excellence in Oncology at Uganda Cancer Institute, under the mentorship of world experts from Texas Children’s Hospital.

Kasirye, during his Fellowship, oversaw gigantic improvements in the care of children with Sickle Cell Disease at Mulago and formulation of nationwide guidelines of care for which he received an award of excellence from the Ministry of Health. He was requested to lead the Pediatric Cancer and Blood Diseases program of excellence at Kamuzu Central Hospital in Lilongwe, Malawi before returning to Mulago Hospital.

Namazzi led the upgrading of leukemia and kidney cancer treatment protocols that resulted in major improvements in the survival of children with these cancers. She also served as the Chief Fellow for the last two years. She will focus on research in cancerous and non-cancerous blood diseases and will co-direct the East Africa Pediatric Hematology and Oncology Fellowship.

At the graduation ceremony, Dr. Poplack was awarded an Honorary Doctor of Science, DSc. (Honoris Causa) from Makerere University for his academic contribution in the field of science. Under his leadership for the last 25 years, Texas Children’s Cancer and Hematology Centers established itself as an internationally-recognized leader in the treatment and research of pediatric cancer and blood disorders. 

With a desire to expand care to areas of the world with limited resources, Poplack and his team have worked over the last decade to provide care to children in sub-Saharan Africa. With the inception of Global HOPE, access to care will only continue to increase with this training of pediatric hematology-oncology physicians through the fellowship program.

The Global HOPE was developed to create an innovative pediatric hematology-oncology treatment network in southern and East Africa and will build long-term capacity to treat and dramatically improve the prognosis of thousands of children with cancer and blood disorders.

The initiative will train an estimated 4,800 health care professionals from Botswana, Uganda, Malawi and other African countries, including doctors and nurses specializing in pediatric hematology-oncology and social workers. 

The program estimates that over 5,000 children will receive care in the first five years. Modeled on the work of the Bristol-Myers Squibb Foundation, BIPAI and the Governments of Botswana, Uganda, and Malawi, which created the largest pediatric HIV treatment network in the world, leveraging existing experience, infrastructure, and public/private partnerships created through the initiative. 

Since 2003, the Bristol-Myers Squibb Foundation and BIPAI have trained 52,000 healthcare professionals and currently provide care for nearly 300,000 children with HIV and their families in sub-Saharan Africa, lowering the mortality rate for these children to 1.2 percent. 

The Bristol-Myers Squibb Foundation is committing $50 million over five years to fund the training of healthcare providers as well as clinical infrastructure and operations. BIPAI will raise an additional $50 million for the initiative.

ends

Uganda's Cipla announces share price for IPO

By Esther Nakkazi

Cipla Quality Chemical Industries Limited (CiplaQCIL), a leading pharmaceutical manufacturing company in sub-Saharan Africa have announced their opening of the Initial Public Offer (IPO) starting Tuesday, August through Friday 24 August 2018 as part of their growth strategy.

CiplaQCIL is a joint venture between India-based Cipla and Uganda's Quality Chemicals Ltd (QCL).

"This will encourage and enable Ugandans to share in our success story after being under private ownership for over 13 years," said Emmanuel Katongole the Executive Chairman of CiplaQCIL. 

The company aims to raise $45 million from its issued shares that are going for 256.5 shillings per share on the Uganda Securities Exchange (USE).

"Interested investors can contact the authorised selling agents and members of the (USE) or visit any branch of Standard Chartered Bank to participate in the CiplaQCIL IPO," said Joseph Kibuuka of Crested Capital, the Lead Sponsoring Stockbroker for the IPO.

"Our long-term vision at CiplaQCIL is to become a center of excellence in the manufacturing of quality and newer medicines that improve the quality of life," said Nevin Bradford the CEO of CiplaQCIL.  

Each of the shareholders will be selling a minority of their stakes to enable sufficient free float and liquidity. Cipla Group, represented through a subsidiary, will retain a majority stake.

The listing has received the relevant approvals required, and the Company will provide further details shortly. Renaissance Capital is acting as the lead transaction advisor and book runner and Crested Capital is the lead sponsoring stockbroker to the listing.

CiplaQCIL is a state-of-the-art pharmaceutical plant based in Kampala, Uganda and focused on the production of high-quality, WHO pre-qualified, life-saving medicines for the Sub-Saharan Africa (SSA) region. 

The Company’s products and pipeline target three major diseases that are widespread in Uganda and SSA and comprise anti- malarials, anti-retrovirals and Hepatitis B and C drugs. 

CiplaQCIL’s relevant products have been pre-qualified by the World Health Organization and approved by regulatory authorities in 19 countries, including Uganda, Kenya, Rwanda, Tanzania, Namibia, Ivory Coast, Zambia, Zimbabwe, Malawi, Namibia, Mozambique, Ghana, Ethiopia, Angola and South Sudan.

Rotavirus vaccine cuts infant diarrhoea deaths by a third in Malawi

Rotavirus vaccination reduced infant diarrhoea deaths by 34% in rural Malawi, a region with high levels of child deaths.

Rotavirus is the most common cause of diarrhoeal disease among infants and young children. Despite improvements in sanitation and case management, rotavirus still caused 215,000 child deaths in 2013, with 121,000 of these in Africa. 

In a study, led by scientists at the University of Liverpool, UCL, Johns Hopkins Bloomberg School of Public Health and partners in Malawi the findings revealed that children who received the rotavirus vaccine had a 34% lower risk of dying from diarrhoea, which is a similar impact to that observed in middle-income countries.

The major new study  provides the first population-level evidence from a low-income country that rotavirus vaccination saves lives.

The findings, published in The Lancet Global Health, add considerable weight to the World Health Organisation's (WHO) recommendation for rotavirus vaccine to be included in all national immunisation programmes.

Professor Nigel Cunliffe from the University of Liverpool’s Centre for Global Vaccine Research, one of the study leads, said: “Rotavirus remains a leading cause of severe diarrhoea and death among infants and young children in many countries in Africa and Asia. Our findings strongly advocate for the incorporation of rotavirus vaccine into the childhood immunisation programmes of countries with high rates of diarrhoea deaths, and support continued use in such countries where a vaccine has been introduced.”

With support from Gavi, the Vaccine Alliance, many countries in Africa with high death rates have added rotavirus vaccine to their routine immunisation programme over the past five years.

To determine the vaccine's impact on infant diarrhoea deaths, researchers carried out a large population-based birth cohort study of 48,672 infants in Malawi, which introduced a monovalent rotavirus vaccine in October 2012.

As low-income African countries often lack birth and death registries – a resource used for similar impact studies in middle-income countries - the investigators and their study team of more than 1,100 people visited the homes of infants in 1,832 villages over the course of four years to collect data, including the infants' vaccination status and whether they survived to age one.

“This is encouraging because children from the sub-Saharan African region account for more than half of global diarrhoea deaths, and with over 30 African countries thus far introducing rotavirus vaccine, the absolute impact on mortality is likely to be substantial,” said one of the report’s lead authors Dr Carina King, a senior research associate at UCL’s Institute for Global Health.

Co-lead author Dr Naor Bar-Zeev, Associate Professor of International Health at the International Vaccine Access Center of the Johns Hopkins Bloomberg School of Public Health, added: "We already knew that rotavirus vaccine reduces hospital admissions and is highly cost-effective in low-income countries with a high burden of diarrhoeal disease, and now we've been able to demonstrate that it saves lives.

“However not all countries are vaccinating against rotavirus yet, including some very populous countries. The key message of this paper is that to do the best for all our children and to help them survive, all countries should introduce rotavirus vaccination."

The researchers also found a direct link between the proportion of the population vaccinated and the reduction in mortality that achieved. Malawi had a strong immunisation programme and was very proactive in planning to introduce rotavirus vaccine, which made it possible to scale up coverage rapidly.

“Within about a year from vaccine introduction, we were able to reach up to 90% of the population. It is vitally important that rotavirus vaccines reach all children, especially the most vulnerable living in poorer settings where the impact of vaccination is greatest,” said one of the authors Dr. Charles Mwansambo, Chief of Health Services for Malawi.

The study received funding support from the Wellcome Trust and GlaxoSmithKline Biologicals.

The REDD+ tool hosted by the Center for International Forestry Research

The innovative REDD+ monitoring tool, International Database on REDD+ Projects and Programs Linking Economic, Carbon and Communities Data (ID-RECCO), is now hosted by the Center for International Forestry Research (CIFOR).

Launched in 2013, ID-RECCO highlights 467 subnational REDD+ initiatives from around the world. It includes 110 variables, such as carbon certification, sources of funding, and expected socio-economic and environmental impacts, in a format that can be used for research purposes and analysis.

ID-RECCO was the first tool to gather such a large amount of information on subnational REDD+ initiatives in a comprehensive way, and it continues to evolve.ID-RECCO is the first comprehensive database on REDD+ projects worldwide. It allows international comparison of very diverse types of projects, in various locations.

“CIFOR is very pleased to host the ID-RECCO database given our priority for understanding the progress and performance of REDD+ on the ground. We are committed to keeping the database updated and ensuring that it stays relevant for the broader tropical forests and climate community, ” says Amy Duchelle, senior scientist at CIFOR.

As Duchelle describes, the next big change to ID-RECCO will allow users to easily distinguish between local REDD+ projects and subnational jurisdictional programs. For REDD+ projects, CIFOR will validate the data through a survey with project implementers that will be conducted in upcoming months.

To expand the database to include subnational jurisdictional REDD+ programs, CIFOR will draw on new collaborative research with Earth Innovation Institute (EII) and the Governors’ Climate and Forests (GCF) Task Force.

ID-RECCO was created by Gabriela Simonet when she was based at the French Agricultural Research Centre for International Development (CIRAD) and Climate Economics Chair (CEC) with the founding partner the International Forestry Resources and Institutions (IFRI).

“ID-RECCO was born in the hands of Gabriela in CIRAD, pushed by her motivation to understand if REDD+ was going to fulfill the on-the-ground socio-economic and ecological impacts that stakeholders were advocating for," says Driss Ezzine-de-Blas, Researcher, CIRAD.

In that sense, it is a ground-breaking initiative and a unique dataset to reach such an understanding. It allows, for example, to extract simple statistics, like the number of hectares covered by REDD+, and understand the trends and types of REDD+ projects and initiatives.

Ezzine-de-Blas also notes that while the data can be used by researchers to match their expectations to the reality of REDD+, other stakeholders will also benefit by taking REDD+ more seriously and will have data-based evidence in hand to continue their work.

"Being frequently updated and open access, it then constitutes a unique tool that makes possible monitoring and impact evaluation of those initiatives, which will provide a better understanding of the conditions of success of REDD+ implementation," says Philippe Delacote, Researcher, Climate Economics chair.

ID-RECCO can be accessed at http://www.reddprojectsdatabase.org/

Communities Guard Health Rights if they Know How

By Esther Nakkazi

His only choice was to travel back home.

Geoffrey Bagenda, 40 years, had a combination of HIV and TB, and he wanted to go back to Namutumba, where he was born and raised.

He knew he was sick but suspected witchcraft which he battled to heal using all his life savings. His illness took a fierce hold on him. He could not walk. He would not eat. His family abandoned him. His own mother who lives in the same homestead never cared for him.

His family wished he could die and he did too.

He was abandoned in a small, dark room on the family land. Community members who always passed by Bagenda’s house because it is beside a narrow road on their way to a water source turned their noses up and speeded up to escape the horrible stench. They spoke in low tones about him as they did with others who suffer from HIV.

The community knew his mother and his other siblings very well. He worked at the central market in Kampala, carrying heavy 100-150 kilogram sacks of food that were brought in from the farms.

He should have been a strong man with a big body. But now his cheekbones were protruding, his eyes sunken and when he walked he had to hold onto his now too big trousers that were almost falling.

“I did not have anyone to help me out. My house was smelly. My appetite was gone. I was asking God to take me,” said Bagenda who came back to die where he was born. “I had a wife but.... She left. We had no children,” he said staring in space.

He could not have suspected the knock on his door. It persisted but he had no energy to call out for the visitor to open. Eventually, the door opened.

“A lady came in and asked me how I was doing. She promised to come back,” he narrated.

Hadijah Munabi heard the story about Bagenda at a community dialogue. She attends these because of her work. She was trained as a paralegal by the Uganda Network on Law, Ethics, and HIV/AIDS or UGANET. Munabi also has palliative care knowledge after being trained by the Palliative Care Association of Uganda (PCAU).

With support from TASO-Global Fund, the Uganda Network on Law, Ethics, and HIV or UGANET, is working in 18 districts of Uganda to engage duty bearers and stakeholders on how to respond to Gender-Based Violence through different interventions.

“When UGANET trained us they taught us to identify such cases because that is violence,” said Munabi who identified this case as emotional violence because Bagenda was discriminated and stigmatised. She was also trained on other forms of Gender-based violence, which is rampant in this community.

“UGANET has helped me advocate for human rights and helped us fight against stigma in our daily work plan,” said Munabi.

When she went back to Bagenda’s house the next day she had a bucket, gloves, antiseptic detergents and a broom. She cleaned the house and they talked about his health.

Although he told the UGANET team he thought it was witchcraft, Munabi said Bagenda actually knew his HIV status but had skipped taking his anti-HIV drugs for a long time, making the disease to take a fierce turn and unfortunately getting a co-infection with TB.

Her first instinct was to go and report the case to Susan Achen, a UGANET legal aid officer based in Namutumba town. They both rode back to Bagenda’s house to assess the situation and map a way forward.

“Madam Susan looked at me and asked how I was feeling. I told her I was in a terrible condition and didn't have anyone to care for me,” said Bagenda. Achen assured him that everything would be taken care of.

Indeed, the next day Munabi came with a boda-boda guy (motorcycle) and they took him to a health facility where he was given a TB and HIV test, which were both positive. However, the anti-HIV drugs at the facility were out of stock so Bagenda was promised to start medication on his second visit due two weeks later. He was started on TB drugs.

“UGANET acts as a link of patients of this nature to the facility. One of our roles is human rights and palliative care. Although our major role is to give legal advise it is difficult if the clients are in pain,” said Achen.

As a UGANET community paralegal, Munabi had to pick TB drugs for Bagenda, she took him some porridge, cleaned his house and asked after his health. She spent weeks on these tasks every other day making her way to his house and telling him the same thing; you will be fine but you have to take your drugs diligently.

From 29 kgs when he started treatment to 36 kgs and now 43 kgs Bagenda is gaining weight. His Tuberculosis is gone and he is not infectious anymore. He can wash his clothes and dig away the bush that had grown in-front of his front door step.

UGANET gives legal advice to people who suffer from violence; 
Achen also visited occasionally but the UGANET office where she is in charge provided the funds to facilitate Bagenda to go the health facility and Munobi to do her work.

UGANET in partnership with PCAU promotes the health rights of palliative care patients in communities. It may not be legal but Achen knows that this cannot be ignored and that is part of her job.

“Many palliative care patients have concerns with their children, estates and want to deal with the question of their property. We sit with them and help them write a will,” said Achen.

The after effect of this has been noticed by their health providers. They say these people are happier because in a way they have made peace that they might not be around much longer, explained Achen.

But integrating legal aid into palliative care has its challenges. Not many people think that palliative care patients have rights, that they have a right to be heard and make decisions themselves. Often times caretakers tend to influence them.

So the first step is to get rid of the pain because when caretakers control who comes in to see a patient who is confined to a bed or a house, they dictate to them what they can say, said Achen. At this point, the patients are unwell, tired and have no knowledge of what is going on.

Sited outside his clean house and his washed clothes drying on the wash-line, Bagenda has enough energy and appetite. “Now I can stand and sit outside my house. I eat and I feel better,” he said.

“Now the community knows that a sick person can have his health restored but he needs to be supported not abandoned,” says Munabi.

ends

This feature was produced by Esther Nakkazi for UGANET highlighting domestic violence and health rights

Listening into a Healthy Life

By Esther Nakkazi 

How radio links up with village health clubs to educate communicates on healthy living.

Haruna Amooti is a radio presenter at Life FM, a community radio station that broadcasts mainly in the local languages of Runyoro and Rutooro.

Once every week, for an hour, from 7.15 to 8.15 pm, Amooti at the Life FM studios in Fort Portal, presents a program to listeners in seven districts of Kyegegwa, Kyenjojo, Kasese, Ntoroko, Kamwenge, and Kabarole, the estimated reach of the radio.

The young man speaks fluent Rutooro and Lunyoro although his program is broadcast in Rutooro.
For the content that is broadcast on his program, Amooti attends a village health club meeting every month. 

In there, he records live voices of the proceedings of the meeting. Sometimes, Amooti visits the various projects that the clubs have put up which are all supported by the Malaria Consortium project in Uganda.

Some clubs have formed money-saving schemes or SACCOS where each member makes a monthly contribution and on a rotational basis and they lend to contributing members. Others have established development projects like piggery and poultry or started drama groups that perform songs and skits with health promotional messages.

“I listen to Amooti’s program every Wednesday. I never miss it. It teaches us about diseases and how to improve our incomes,” said Teopista Namalembeko, a member of the Kitalesa health club that has a piggery project with twelve pigs. It was after hearing Amooti’s program that she joined her village health club.

Amooti’s most memorable meetings were in clubs in which members united to form a SACCO and had financial independence or projects like Teopista’s Kitalesa Club.

“Some members have been able to construct permanent houses and move out of grass thatched ones. While others have used this money from SACCOS to buy land or boost their businesses, which has improved their families’ finances and health,” said Amooti.

He said he was also impressed with the way some clubs use enforcement techniques to improve health. For instance, a village club head and the local community leaders after a meeting, chased away the tenants from rental houses until the landlord constructed a befitting toilet. !

In some instances, Amooti has hosted some of the village health club facilitators on his program. He asks them what they have done as individuals, or collectively as a club, how effective they have been, what more health interventions they need from the government, Malaria Consortium Uganda, the implementing agent, and from the community.

“When the community leaders and members hear their own speaking on the radio they get very excited. I think with good mobilization and partnership with district leaders this village health club concept can be very successful and be well replicated,” said Dr. Julius Bahinda, the Kyegegwa District Health Officer.

Lawrence Businge, the Kyegegwa District health educator has been hosted on the show a dozen times. He as well thinks this concept can be rolled out in every district in Uganda because it is ‘workable’.

In his appearances, he has come with designed health messages, which highlight the achievements of some of the clubs and further educates the communities about the three target diseases; malaria, diarrhea, and pneumonia. Sometimes they also discuss and promote government health programs.

“The radio talk shows amplify our messages because not all members can attend the club meetings,” said Businge. He says the clubs have created a positive impact, mostly they have united communities that can now work togather to take care of and control communicable diseases.

Sometimes, during the radio program, they select a disease like malaria and discuss it, how to control it, what are the danger signs that come with it and at the end of each program, 15 minutes to the end are reserved for in-callers.

“For the fifteen minutes, callers from the districts that do not have village health clubs always request that they want to start them too,” said Amooti. Directly they call and ask him ‘Can you ask that Malaria Consortium group start village health clubs here because we also face the same health problems?’

Other callers request that Amooti alerts Malaria Consortium to include more than the three diseases of malaria, pneumonia, and diarrhea that are currently being handled by the village health clubs. The matter may be considered.

But for now, to further motivate the village health club members, Life FM in partnership with Malaria Consortium Uganda is going to hold competitions later this month to get the club that has practiced the village health clubs' concept best and the best performing village health facilitator.

“That will be the model that we hope shall be replicated all over the country,” said Amooti thoughtfully. But for all he knows now, his radio program has improved listenership and people are always eager to stay tuned because the information broadcast touches their everyday health issues and economic life.

This article was done for Malaria Consortium Uganda in 2015

A fifth of adolescents are overweight or obese due to the double burden of malnutrition in Africa

A new study from the University of Warwick blames macro-level factors for the double burden of malnutrition among adolescents in developing countries. The study lists war, lack of democracy and urbanization among factors to blame.

The double burden of malnutrition refers to the coexistence of undernutrition along with overweight and obesity, or diet-related noncommunicable diseases such as type 2 diabetes.
The authors have examined studies of almost 130,000 adolescents and also found that a fifth are overweight or obese and more than 10 percent had stunted growth due to double malnutrition and two percent were classed as both stunted and overweight.

A total of 57 counties were examined including Algeria, Benin, Ghana, Mauritania, Republic of Mauritius, Sudan, Swaziland, and Uganda.

The study entitled The double burden of malnutrition among adolescents: analysis of data from the Global School‐Based Student Health and Health Behaviour in School‐Aged Children Surveys in 57 low‐income and middle‐income countries suggests that factors including war, lack of democracy, food insecurity, urbanisation and economic growth are to blame.

The study was published in the American Journal of Clinical Nutrition (AJCN) and was led by Dr. Rishi Caleyachetty, Assistant Professor, Warwick Medical School.

His team found that the burden of double malnutrition is shockingly common and the researchers are now calling on governments and NGOs to identify context-specific issues and design and implement policies and interventions to reduce adolescent malnutrition accordingly.

The study set out to quantify the magnitude of the double burden of malnutrition among adolescents and explain the varying burden of adolescent malnutrition across low- and middle-income countries (LMICs).

Adolescence is a period for growth and development, with higher nutritional demands placing adolescents at greater risk of malnutrition.

They used data from the Centers for Disease Control and Prevention/World Health Organisation (WHO) Global School-Based Student Health Survey and WHO Health Behaviour in School-Aged Children surveys done in 57 LMICs between 2003-2013, comprising 129,276 adolescents aged 12-15 years.

They examined the burden of stunting, thinness, overweight or obesity, and concurrent stunting and overweight or obesity. They then linked nutritional data to international databases including the World Bank, the Center for Systemic Peace, Uppsala Conflict Data Program, and the Food and Agriculture Organization (FAO).

They found that across the 57 LMICs, 10.2% of the adolescents were stunted and 5.5% were thin. The prevalence of overweight or obesity was much higher at more than a fifth of the adolescents (21.4%). The prevalence of concurrent stunting and overweight or obesity was 2.0%. Between 38.4%-58.7% of the variance in adolescent malnutrition was explained by macro-level contextual factors.

Dr Caleyachetty said: “The majority of adolescents live in LMICs but the global health community has largely neglected the health needs of this population. At the population level, macro-level contextual factors such as war, lack of democracy, food insecurity, urbanisation and economic growth partly explain the variation in the double burden of malnutrition among adolescents across LMICs.

“The global health community will have to adapt their traditional response to the double burden of malnutrition in order to provide optimal interventions for adolescents.”

Funding for new drugs endemic to Africa available

New funding that will be given through a call for proposals for the discovery of new drugs for diseases endemic to Africa over the next two years is now available.

The Drug Discovery funds is up to $100,000 per project to researchers in Africa to identify new drug candidates, particularly for malaria, tuberculosis and neglected tropical diseases.

The funding will also be used to create a network of drug discovery as well for development scientists that will initiate, develop, share, evaluate and disseminate best approaches and practices within the research community in Africa.

The African Academy of Sciences (AAS), University of Cape Town (UCT) Drug Discovery and Development Centre (H3D), Medicines for Malaria Venture (MMV) and the Bill & Melinda Gates Foundation have committed funding for the discovery of new drugs for diseases endemic to Africa over the next two years.

This is the third call for proposals administered by the AAS’ Grand Challenges Africa (GC Africa), a scheme implemented through the AAS and the NEPAD Agency’s Alliance for Accelerating Excellence in Science in Africa (AESA).

"This partnership will benefit Africa by developing the capacity and augmenting efforts to discover and develop drugs for diseases that are prevalent on the continent and are otherwise being affected by a market bias that has seen drug discovery efforts on the continent hampered," said the AESA / Director of Programmes Prof Tom Kariuki.

Africa represents 17% of the world’s population but bears a disproportionate 25% of the global disease burden with sub-Saharan Africa carrying 90% of the global cases of malaria while 2.5 million who fell ill with TB in Africa in 2016 represented a quarter of new TB cases in the world.
Drug resistance is also compounding the disease burden requiring for Africa to build capacity and step up drug discovery activities.

The new funding will be given to projects that identify new chemical entities with potential for drug development in diseases of local relevance for Africa and to expand institutions' drug discovery research capacity. 

Selected applicants will also benefit from a network of drug discovery scientists in Africa and across the globe, linking them to peers, mentors and providing them with access to resources and technologies

Prof Kelly Chibale - Founder and Director of Drug Discovery and Development Centre, H3D at the University of Cape Town, said: “The attractive aspect of this programme is that it focusses on highlighting and investing in those who are present on the continent. The partners involved are proactively seeking to identify and fund talented African-based scientists to succeed and not to merely survive.

This will result in an effective increase in the numbers of productive and contributing African drug discovery scientists as well as an increase in the quality and impact of drug discovery science generated in Africa by Africans.”

“Medicines for Malaria Venture (MMV) is proud to support the effort to identify new drug candidates for the big three diseases of malaria, tuberculosis and Neglected Tropical Diseases via this call for proposals,” said Dr. Timothy Wells, MMV’s Chief Scientific Officer.

“At MMV, our focus is on bringing forward the next-generation of medicines to help defeat malaria. Through these grants, together with our partners, we aim to support the next-generation of African scientists to get involved in this endeavor for malaria as well as other diseases.”

www.aasciences.ac.ke

Uganda introduces rotavirus into routine vaccination

Uganda has today launched a new rotavirus vaccine to protect under five-year-old children from diarrhea.

An estimated 10,637 children under five years of age die in Uganda each year due to rotavirus diarrhea. Diarrhea is among the top ten causes of morbidity in Uganda, with rotavirus being responsible for about 40% of all diarrheal cases.

The vaccine, which will be available for free in health facilities throughout the country, is the 11th vaccine to be added into the national schedule of the expanded programme on immunization in Uganda.

Rotavirus vaccine is safe and can be administered simultaneously with other routine infant vaccines. It is given orally and requires two doses at 6 and 10 weeks of age, with an interval of at least 4 weeks between doses.

“This vaccine will help save the lives of thousands of children in Uganda by combating severe diarrhea,” said Gavi Deputy CEO Anuradha Gupta.

“The introduction of rotavirus vaccine marks a key milestone in the country’s commitment to improving the health of all children and I’d like to commend the Government for its efforts to provide a bright future for Uganda’s next generation.”

Speaking at the launch of the vaccine in Buikwe, the Minister of Health, Honorable Dr. Jane Ruth Aceng, announced that Rotavirus vaccine is now available in Uganda. She appealed to Ugandans to take their children at 6 weeks and 10 weeks of age for rotavirus immunization to the nearest health facility.

“WHO emphasizes the use of Rotavirus vaccines to be part of a comprehensive strategy to control diarrhea diseases with the scaling up of both prevention and treatment packages,” said WHO Representative Dr. Yonas Tegegn Woldermariam.

The UNICEF Representative in Uganda, Dr. Doreen Mulenga, congratulated the Ministry of Health for making further progress in securing children’s health by introducing a rotavirus vaccine into its national immunization programme and said that vaccination is one of the best ways to protect children from serious childhood diseases.

The introduction of the rotavirus vaccine into the routine immunization schedule has been financed by Gavi, the Vaccine Alliance, with technical support from WHO and UNICEF.

Rotavirus infection is the leading cause of diarrhea in children under five and it is highly contagious. It poses an exception to typical diarrheal disease management rules.

While improved access to clean water and better sanitation and hygiene practices are vital to preventing most diarrheal diseases, they have done little to disrupt rotavirus infection. The virus may cause severe, dehydrating diarrhea in young children and, in untreated cases, lead to death.

Globally, according to the World Health Organization, an estimated 450,000 children under five years of age die each year from vaccine-preventable rotavirus infections.

Another sickle cell treatment option now available to Ugandans

By Esther Nakkazi

Today, 19th June is world sickle cell day and from this year hydroxyurea, arguably the most significant breakthrough in sickle cell treatment ever is now on the list of essential drugs in Uganda.

That means it is now more available in drug shops and that brings the price down to a third of the original price, to Ushs 3,000 per tablet from Ushs 10,000 although this does not necessarily mean its affordable and it is not yet available in public health facilities.

As well it does not mean that it will be prescribed to everybody who’s eligible as Ugandan doctors like elsewhere in the world may not necessarily want to prescribe hydroxyurea because it is given in the most maximum tolerated doses and requires continuous blood tests.

Hydroxyurea was approved for sickle cell treatment in 1998 by the FDA and was originally and it still is a cancer drug which increases healthy forms of oxygen-carrying hemoglobin, resulting in less organ damage and fewer pain crises, transfusions, and emergencies for sickle cell patients.

Specialists doctors who are supposed to treat sickle cell disease, hematologists, are hard to come by so most patients are seen by clinicians except for a few dedicated doctors like Prof. Christopher Ndugwa, a paediatrician now known to many as the ‘Uganda grandfather of sickle cell disease’. He has trained about 80 percent of the doctors who treat sickle cell disease in Uganda.

Sickle cell is a multi-organ disease. When patients get an attack they go through a vaso-occlusive crisis in which sickle-shaped red blood cells clog the vessels and cut off oxygen to joints and organs. The inadequate blood supply triggers excruciating pain, damages vital organs and causes a stroke.

Sickle cell disease has been declared a major public health problem for sub-Saharan Africa by the World Health Organization.

The intensity of the disease was unknown until a study was done which prompted action and institution of policy. Now after 20 years since its approval, the now called wonder drug to Ugandans is no longer scarce and here are some efforts that led to policy, treatment changes and action.

In 2014, the Ministry of Health carried out a survey to profile the sickle cell trait and sickle cell disease across Uganda. To date, Uganda is the only African country with current national prevalence data, which was also been published in a leading medical journal, the Lancet.

The survey found scary statistics; at 15,000 to 20,000 babies are born with sickle cell disease every year in Uganda and 80 percent of them die before their 5th birthday. It further documented a high sickle cell burden with a national trait average of 13.3 percent and a disease burden of 0.73 percent.

The research earned Uganda a reward. It was nominated to host the 6th International Symposium on Sickle Cell Disease (REDAC 2016). Mass screening, patient management, early testing, pre-marital counseling and sensitization campaigns were created.

On 16th March 2017, the Minister of Health, Dr. Jane Aceng presented a Ministerial Statement to parliament about the situation of sickle cell in Uganda. The shocked parliamentarians pledged to support it in terms of allocations of funds to the budget, creating awareness and policy.

They requested that equipment be available to screen at birth for sickle cells in all regional hospitals and a budget be allocated so that funding for sickle cell treatment is not left to donors as was the practice.

Aceng informed them that the Ministry of Health had in fact already set up a national programme to screen newborn babies and children below two years in high prevalence districts and a National Sickle Cell reference laboratory with the capacity to run 8,000 samples at ago was operational.

Aceng also appealed to the Buganda kingdom to collaborate with the Ministry and create awareness. The study showed that Buganda was one of the high burden regions with a prevalence of 20 percent and disease burden above 1.5 percent.

The Kingdom of Buganda agreed to provide support to which they accepted to use Sickle Cell Anaemia treatment drives as a theme in the Kabaka Birthday Run for the next three years.

As such the 2017 edition of the Kabaka’s birthday run launched by the Katikkiro of Buganda Charles Peter Mayiga, he equated the lack of awareness to the early HIV days. He said people referred to sicklers as 'offsprings of parents with bad blood or those that are cursed'. That year the funds from the birthday run went to support sickle cell.

More efforts continued like lobbying from civil society organizations like HEPS Uganda and now finally hydroxyurea is on the table in Uganda. However, elsewhere more treatment options are becoming available.

Endari, a nutritional supplement which has been shown to relax the stiff, sickle-shaped red blood cells of people with the disease is now the newest drug on the market. Another treatment option that still needs to go through clinical trials is CRISPR or gene editing therapy. This can be used to edit the sickle mutation in blood stem cells so they produce more fetal hemoglobin, which can reduce the severity of the disease.

It would be interesting to know if Ugandans would participate in the CRISPR sickle cell clinical trials if they got here. But all we know there is hope after all more treatment options are on the way.

Recombinants harsh to HIV vaccine development

By Esther Nakkazi

Today is World HIV vaccine day. As we celebrate the day, we have a lot of hope this time around more than ever.

For the first time in many years, four efficacy vaccine concepts are in phase III and could give us an HIV vaccine. But even if they do not it is a still a great leap forward.

“If they do not give us a vaccine they will at least give us information about how it works,” said Dr. Francis Kiweewa, the head of research and scientific affairs at Makerere University Walter Reeds Project (MUWRP).

Kiweewa said we shall get to know this important information just two to three years from today in either 2020 and 2021 and that is not far off. He was speaking to journalists at their monthly science cafe organized by Health Journalists Network in Uganda, HEJNU.

But that withstanding you could ask do we still need an HIV vaccine anyway? In some circles, the debate is could HIV be the first epidemic to be eliminated without a vaccine.

I guess you have heard of all the interventions these days, the condom, the antiretroviral therapy for both treatment and prevention, the vaginal ring that showed promising results and more to it scientists are busy in their laboratories cooking up new HIV prevention and therapeutic tools every day.

Dr. Kiweewa says despite these efforts we still need an HIV vaccine. "The numbers of new infections remain incredibly high," he says. For instance in Uganda 500 youth get infected with HIV every week. In South Africa, 5000 young women are infected with HIV every week.

Also, the high cost of treatment is unsustainable and ultimately a vaccine would be cheaper, reach many more people and let us not forget that ‘prevention is better than cure’.

Even if we get the HIV vaccine in the next two to three years, there is a possibility that it might not be suitable for us. And here is why an HIV vaccine might work elsewhere and not for Uganda or East Africans.

HIV has many sub-types, the East African region has two predominant subtypes A and D while southern Africa mostly has subtype C. The Uganda Virus Research Institute (UVRI) scientists did a research, sequencing the virus and found that 50% of the HIV virus in Uganda are recombinants of subtype A and D.

This means 50% of the estimated 1.3 million people who are infected with HIV in Uganda have a combination of subtype A and D or AD/DA. While it may not necessarily be more virulent scientists say it progresses faster.

“A vaccine has that challenge,” says Prof Pontiano Kaleebu, the director of MRC/UVRI and the London School of Tropical Medicine (LSHTM). It is for that reason and many others that the renowned professor thinks we are a forgotten lot. 

“They are forgetting us here where we have recombinants in east Africa,” said Kaleebu. In other words, the spread of recombinant forms of HIV could have implications for vaccines developed to guard against only certain sub-types and not others.

Not enough research is being done in the region, your governments are not investing enough money so that the scientists develop that vaccine that is suitable for you.  So keep the optimism but also be mindful of the future that we could walk away empty handed here where the HIV burden is highest.

ends.

WhatsApp groups with journalists and their sources should stop

By Esther Nakkazi

As we celebrate this years' World Press Freedom day, I say WhatsApp groups with journalists and their sources should stop.

In the current era, WhatsApp groups are formed pretty much after every engagement and for any cause to exchange information, debate issues, network or even fundraise.

Some are just timely, they run for a short while and for a worthy cause. I particularly like the baby shower WhatsApp groups. We discuss everything from the sex of the baby to its gifts. On the D-day, we ‘surprise’ the mother.

After the baby shower is over, happy moments in pictures are shared, the group is deleted and we move on. It is interesting that some people forget about the whole issue and probably check on mother and born baby a year later!

While the exchange of ideas and debating issues via WhatsApp is very good and has changed the way audiences consume news, giving feedback and wider visibility through more eyeballs, I am afraid that WhatsApps groups with journalists and especially the people supposed to give them information is outright wrong.

Ethically it has never been a good idea for journalists to cozy up to the people they cover. I thought journalists are supposed to keep some professional distance? But now the opportunist and savvy public relations officers have mastered their WhatsApp game. Don't also forget that journalists can be lazy.

They set up their own groups, send minute to minute updates - these can even be a voice WhatsApp and by the end of the day all radio stations will be singing their story with the same voice quote like a song.

If the groups only kept the conversations to news discussions maybe it would make sense but the reality is that they move beyond that and engage in ‘lugambo’ and getting daily compliments or updating each on a minute by minute basis, because that is what WhatsApp almost does to us!

The defenders of these groups were journalists are bedding with their sources say these keep the journalists and the people who give them information in constant touch in this era of fast news and they are so much alike press conferences but only in virtual space.

I have been on WhatsApp groups where posts deepen not only to family issues but also to uncomfortable topics where the public relations or communications person will blame the journalist for bad publicity - however truthful the story may be and even pressurise the journalists to apologise or retract because their ‘bosses are angry’ and job security has been threatened. 

I guess it is okay to send a personal WhatsApp to the source but manipulation of a whole group to cover what they want and the way they want it is demeaning good journalism.

Until we understand that the two groups have completely different roles, only then will journalists stop bedding with public relations or communication officers in the same WhatsApp group.

Malawi’s six-year maize export ban increased consumption but made farmers poorer

By Esther Nakkazi

Malawi’s six-year maize export ban increased consumption by 6 percent, achieving its objective of increased food security, measured narrowly in terms of availability of maize at lower prices, according to a study by Karl Pauw et al.

But these gains come at a cost to the rural farm sector, which suffered a 0.2 percent decline in agricultural value-added and lower disposable income levels, especially among poor farmers. Malawi imposed an uninterrupted maize export ban from 2011/12 until the end of 2017.

The ban was instituted through the government regulation of international trade of so-called “strategic crops” through its Control of Goods Act (2015). In there, commodities listed in the act, such as maize, require an export license. So export bans are enforced by withholding licenses, which in practice means formal exports through recognized border posts are affected.

Our results show that policy-induced distortions in the form of export bans or export levies on agricultural commodities create disincentives for farmers to produce, rendering these policies self-defeating and unsustainable in the long run. Moreover, export restrictions can be welfare-reducing and welfare losses tend to be biased against poorer farm households says the study.

It says when short-term political motivations outweigh longer-term socio-economic considerations, adverse effects may be conveniently overlooked by policymakers.

"Our results also highlight a more general concern about uncertain and incoherent agricultural policy environments that prevail in so many Sub-Saharan African countries, namely that they perpetuate a subsistence farming culture rather than encouraging commercial crop cultivation," says the study.

"This has negative consequences for the supply of marketed foods and intermediate inputs required by agro-processing sectors. Ultimately this is inconsistent with the stated economic transformation ambitions of so many African countries, articulated in the case of Malawi in its second Malawi Growth and Development Strategy (MGDS II) as shifting its economy from being a “predominantly importing and consuming economy to a predominantly producing and exporting economy”

In the past decade, more than 30 countries, including virtually all the world’s top grain producers and several southern and eastern African countries have imposed grain export restrictions.

Given the political and socioeconomic importance of maize in Malawi, the export ban has always been a highly sensitive topic, and any advocacy on the matter was done discreetly.

More about this study can be found at https://www.sciencedirect.com/science/article/pii/S0305750X18301025

Suddenly, why am I among the generation to not end malaria?

By Esther Nakkazi

The world over, on this day, April 25, 2018, it is World Malaria Day. Today is also the tenth World Malaria day ever after a decade when it started being celebrated and maybe the saddest ever because malaria is on the rise again.

With not much time to waste we should know that the gains we sang about and thumped our chests over about conquering malaria for the past decade have reversed. In 2016, malaria cases rose for the first time in a decade and there were 216 million cases of malaria, 5 million more than the previous year.

There were also 445,000 deaths in 2016 as well human migration is continually importing the disease from high burden areas to lower burden areas. In some high burden countries, the annual number of deaths from malaria has increased. Those with the greatest burden of disease and death are those caught up in a humanitarian crisis where conflict remains the greatest challenge like Burundi, Chad, DR Congo and South Sudan.

Sadly, this treatable disease, malaria, still kills a child every two minutes.

I have not suffered from malaria in about five years and I think it is because I try to prevent it. I often spray my inside and outside my house twice a year. I sleep under a mosquito treated bed net and when I stay out of Uganda for long, I take my medication days before I return.

But it is not only me who has achieved some feat, some countries have even bigger gains. Egypt and Morocco have been malaria-free since 2000, and Algeria since 2016. Others are following suit, Botswana, Cape Verde, Comoros, South Africa and Swaziland, will most likely eliminate malaria by 2020.

Algeria, Comoros, Madagascar, the Gambia, Senegal, and Zimbabwe have also been honored this year by the African Leaders Malaria Alliance for leadership in scaling down malaria cases. In total forty-four countries are reporting less than 10,000 cases.

But even with my own prevention success and for the countries mentioned, malaria is back and with a vengeance. Suddenly, the target of reducing malaria cases by at least 90% by 2030 looks bleak.

Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO says the malaria fight is at crossroads. But he is hopeful this generation could be it but wants urgency.
“We could be the generation to end the disease for good. If we don’t seize the moment now, our hard-won gains will be lost,” says Dr. Ghebreyesus and cautions, "if we continue along this path, we will lose the gains for which we have fought so hard."

Anti-malaria campaigners say we have become complacent in dealing with malaria. Funding has also flatlined. However, if ONE of the actions to revitalize the fight against malaria is funding then we have hope after the London Malaria Summit.

The UK Prime Minister Theresa May and other Commonwealth leaders made a commitment to halve malaria burden across 53 member countries by 2023 in response to the London Malaria Summit.

There was renewed leadership and energy in the fight to end malaria or “Ready to Beat Malaria” and resource commitments - worth over £2.9bn ($4bn) - to catalyse progress towards beating malaria at a time when efforts to end the preventable disease have stalled.

In addition, the Multilateral Initiative on Malaria (MIM) conference in Dakar brought together scientists and researchers from across Africa to share the latest innovations in the fight against the disease.

Specifically, over the next five years, the Wellcome Trust committed more than £100 million to understand the parasite genome, designing more effective vaccines, developing new treatments, insecticides, and diagnostic tests, and tackling the emergence of a "super strain" of resistant malaria in Southeast Asia before it spreads to Africa. 

Zenysis Technologies has a software platform to help governments identify potential malaria outbreaks ahead of time and they committed in-kind technical support worth $6 million to other malaria-endemic countries in Africa and elsewhere.

Also, five crop protection companies, BASF, Bayer, Mitsui Chemicals, Sumitomo Chemical Company & Syngenta, launched ZERO by 40, a joint initiative supported by IVCC and the Bill & Melinda Gates Foundation, to accelerate development of innovative vector control tools and extend their commitments to help eradicate malaria by 2040.

Australia announced an investment of AUS $56.25 million from their Health Security Initiative to support the development of new resistance beating malaria prevention, diagnosis, and treatment tools 2018-22. They also committed up to AUS $700,000 to support the July 2018 Malaria World Congress in Melbourne and finance new Health Security Fellowships for professionals working in the Greater Mekong Sub-Region.

The Kingdom of Eswatini pledged to get rid of malaria by 2020 and to double domestic financing for indoor residual spraying and also committed to mobilize more domestic resources from the private sector.

Ghana agreed to be one of three countries to pilot the new malaria vaccine, RTS, S, and one of the first to introduce next-generation resistance beating insecticides for indoor residual spraying. RTS, S, the first approved malaria vaccine, will be used in the field starting later this year. The Gate Foundation is working with GSK and other partners to find ways to make RTS, S more durable.

Guyana committed to a targeted response, technology transfer and the need to introduce new tools to accelerate their efforts to defeat malaria. Kenya said it would ensure at least 80% of people living in malaria risk areas are using appropriate malaria preventive interventions and that all malaria cases are treated in accordance with the National Malaria Treatment Guidelines. 

While Malawi committed to reduce malaria incidence and deaths by at least 50% by 2022 and to eliminate malaria entirely from the country by 2028.

With all this renewed commitment and my own success am hoping that this generation does end malaria.