Merck to Wipe Schistosomiasis off the face of Africa

By Esther Nakkazi

Ethiopia will receive around 13 million praziquantel tablets, treatment for schistosomiasis, in 2015.

Ethiopia is one of the most endemic countries for schistosomiasis in the world, says the World Health Organisation, with around 22 million people, or above 20 per cent of the entire population, needing treatment.

Merck (http://www.merckgroup.com), a leading company for innovative and top-quality, high-tech products in the pharmaceutical, chemical and life science sectors will donate the tablets.

The expanded Merck Praziquantel Donation Program will result in a financial commitment totaling around USD 23 million a year.

Merck is committed to the elimination of schistosomiasis, the parasitic worm disease, in Africa. At the beginning of 2012, it announced that it will fight schistosomiasis until the disease has been eliminated in Africa.

To reach this goal, the company will increase the annual donation of tablets up to 250 million in the medium term. The further scale-up of the program will allow the treatment of about 100 million children a year. Between 2011 and 2014, Merck’s annual donation has grown from 25 to about 75 million tablets.

"We have committed to continuing our efforts in Africa, in cooperation with WHO, until schistosomiasis is eliminated," said Frank Gotthardt, Head of Public Affairs at Merck and responsible for the Merck Praziquantel Donation Program.

According to a press release from APO, Gotthardt said that in order to fulfill this commitment, Merck will donate 100 million praziquantel tablets to African countries in 2015. Ethiopia will be one of the main beneficiaries of this donation.

The first meeting of the Global Schistosomiasis Alliance took place at the UN Conference Centre in Addis Ababa yesterday.

“This alliance will allow the different constituencies to engage in a coordinated approach to better address the challenges of meeting the elimination target”, commented Gotthardt.

The round table discussions and first global schistosomiasis meeting took place during the neglected tropical diseases week being hosted by the Ethiopian government from December 8 to 12.

The Merck Praziquantel Donation Program was launched in 2007. Since then, more than 200 million tablets have been supplied and over 54 million children have been treated.

It is also supporting awareness initiatives at African schools to explain the causes of schistosomiasis to children and teach them how to prevent the disease. Merck is also conducting research on a pediatric formulation of praziquantel for preschool children within the scope of a public-private partnership. So far, praziquantel tablets can only be administered to children over the age of six.

Join in for Universal Health Coverage

On Friday, 12 December, more than 500 organizations from over 100 countries will unite behind the first-ever Universal Health Coverage Day – representing an unprecedented worldwide coalition urging access to quality health care for all.

The Uganda government has already taken recent steps to introduce a national health insurance scheme as early as next year. But there is still much work to be done, to ensure that all Ugandans have access to affordable care.

This date, December 12, will also mark the two-year anniversary of the United Nation’s unanimous resolution endorsing universal health coverage. More than 1 billion people lack access to basic health care, and another 100 million fall into poverty trying to access it each year. 

The ongoing Ebola outbreak is only the most recent reminder of the desperate need to strengthen health systems for everyone, everywhere.

There is clear picture yet that universal health coverage is affordable and attainable. For instance Rwanda our neighbour has achieved it. Other countries as diverse as Brazil, Thailand, Mexico and Ghana are implementing steps toward universal health coverage, reducing the number of families facing catastrophic health care costs. In addition, about 24% of the growth in “full income” between 2000 and 2011 in low- and middle-income countries resulted from health improvements.

A report from the United Nations Secretary-General emphasized that universal health coverage is essential to ending extreme poverty and promoting sustainable growth for all. Once considered a pipe dream, universal health coverage, is an idea whose time has come.

Political talk does not lessen demand for Medical Male Circumcision in Uganda

By Esther Nakkazi

Uganda President Yoweri Museveni's negative talk about voluntary medical male circumcision (VMMC) is loud and clear, but Ugandans are not listening, as they continue to demand for the HIV intervention. 

In 2015, Uganda will carry out one million voluntary medical male circumcisions, if funding is available.  If that momentum is maintained, every year, all Ugandan men will undergo operation Abraham at some point. Then we shall have a circumcised nation, which is non muslim.

Museveni was a guest of honour in Fort portal at the World Aids Day (1st December 2014) and in his speech he undermined the importance of male circumcision as an HIV prevention intervention. He made comparisons between Bakonjo and Bagisu, tribes who have traditionally circumcised their men but still do not have the lowest HIV prevalence rates in the country. 

Museveni also mentioned that 'those who circumcise could die’.

Truth Tellers, who are a unified African voice speaking the truth of VMMC, as an HIV prevention intervention, say they want to win Museveni over, however, his talk has so far not lessened the demand and uptake of voluntary medical male circumcision.

Records from the Ministry of Health, show that in 2011, Uganda performed only 57, 132 safe male circumcisions and in 2013 there were 801, 678 procedures. In 2014 over 900,000 procedures have been done.

Dr. Barbara Marjorie Nanteza the Coordinator, AIDS Control Program, Ministry of Health, Uganda, believes that if funding is made available, Uganda will perform over 1,000,000 million medical male circumcisions in 2015.

Uganda has a population of 36 million people. Over 49 percent of these are male. If at least a million a circumcised, per year, then all Ugandan men will at some point undergo operation Abraham.

“Most Ugandans know the consequences of HIV/AIDS, so they seek for protection through SMC, which is so far the most effective and it is provided as an HIV prevention package,” said Dr. Nanteza. 

Truth Tellers, say they need to win Museveni over, even though some feel they have already talked themselves hoarse to both politicians and the public about its benefits.

Research backs it up too. It has shown that men who circumcise, reduce their risk of becoming infected with HIV heterosexually, by approximately 60 percent.

“We have done our best to provide evidence to all the people including all the top politicians plus our President all these years,” said Dr. Nanteza.

“We really need to do something to win the voice of the President of Uganda to promote VMMC, or at least stop him from campaigning against the service,” said Stephen Mugamba who works with Rakai Health Sciences Program.

Truth Tellers stand for accelerated roll out of VMMC for HIV prevention in Africa.

“It is unfortunate the President of Uganda is speaking against Male circumcision. I wish we had a way of looking at circumcision from a cultural angle,” said an official from Kydesa (Kenya Youth Education and Development support Association) Rainbow community.

“ Changing a community culture might be very challenging. It requires deeper evidence that focuses on benefits of foreskin and circumcision as an option for HIV prevention,” he said.

Truth Tellers, now want to target the First Lady, Janet Museveni to champion voluntary medical male circumcision in Uganda.

“The president may have his misgivings about the strategy, however, it is great that they are not affecting the demand for the service. However, targeted advocacy may help. The first lady may also be targeted as a champion and may get to the president-in the spirit of female involvement. This is if she believes," said Martin a Truth Teller about VMMC.

ends

World Most Endangered Antelope Population Grows

By Esther Nakkazi

Less than 240 Hirola, a type of antelope, are left in the world living along the Kenya-Somalia border. They are critically endangered and without immediate intervention they could go extinct, the first time a mammal would do so on mainland Africa in modern human history.

Hirolas are the last living representative of an evolutionary lineage that originated over three million years ago. They look like a child born to an impala and hartebeest, and have trademark white "spectacles."

In 2006, the Ishaqbini Hirola Community Conservancy was established by Northern Rangelands Trust (NRT), The Nature Conservancy, the Kenya Wildlife Service (KWS), and partners banded together to establish the Ishaqbini Community Conservancy, to protect critically endangered Hirola.

Its the only Hirola sanctuary on the planet. It has a predator-proof fence.

It is also very much a part of the community, who tell regaling stories of helicopters manoeuvring through bushes and the gentleness of captured Hirola during translocation.

One community member, ‘a magical elder' mimics the hyena with red eyes and holes in his ears and grows the tail of a hyena calling them in order to catch them.

"This is powerful and entrenching and shows that the sanctuary indisputably belongs to the community and the stories are beyond any ‘conservation awareness’ we can do ourselves," said Dr. Juliet King, Science Advisor, Northern Rangelands Trust.

A recent survey showed that in less than three years 34 Hirola have been born, bringing the number of antelope protected from poaching and predators in the sanctuary to 78.

“A lot of people may not view 34 births in three years as significant, but with fewer than 240 Hirola left in the world we’re talking about the difference between survival and extinction,” said Matthew Brown, Africa Deputy Director, The Nature Conservancy.

The predator-proof sanctuary was built and 48 Hirola were successfully trans-located into the sanctuary in August 2012. The trans location effort was deemed an overwhelming success (there were no Hirola deaths during or immediately after the trans location.

The Ishaqbini Hirola Community Conservancy where they live is home to Somali pastoralists who voluntarily established this dedicated area for Hirola, assisted with the trans location, and continue to play a crucial role. The people of Ishaqbini have been quietly conserving this landscape for centuries and regard the Hirola as a blessing says a press release.

Additionally, the other wild animals in the sanctuary like giraffes, zebras, kudu, gazelles, ostrich and many others are significantly multiplying. Elephants for the first time have made their way into the sanctuary, and there is now an elephant family of eight settled in their new secured habitat.

The project’s long-term goal is to release animals bred within the sanctuary back into the free-ranging population, ultimately building a viable population that is equipped to cope with natural levels of predation and competition.

Museveni's World Aids Day Message Missed the Science in HIV?

By Esther Nakkazi

President Yoweri Museveni was a guest of honour in Fort portal yesterday and his speech for the World Aids Day missed the science in HIV.

In his message Museveni, encouraged adolescents and young children to abstain from sexual intercourse until they become of age to make informed decisions. He urged health educators to repackage HIV prevention information for young people. That was fine.

He also saluted the Uganda Aids Commission (UAC) headed by former Health Minister Dr. Christine Ondoa for their work; infection rates are down from 162,000 in 2011 to 137,000 in 2013; people living with HIV on life-long treatment are 680,000 people as of June 2014, out of a total of 1,400,000 Ugandans living with HIV; mother to child transmission new guidelines are now rolled out country wide.

And pointed out that inspite of these achievements, 350 new HIV infection still occur in Uganda daily!

He spoke about the challenges Uganda is facing to fight HIV pointing out that most infections are happening among most at risk populations including: Sex workers, fisher folk, Uniformed Personnel and Truckers.

But Activists say while the messages were appropriate and encouraging he missed the point. And  the science in HIV. According to Alice Kayongo-Mutebi the Regional Policy and Advocacy Manager- East/West Africa Bureau, AIDS Healthcare Foundation (AHF).

His messages strongly undermined the importance of circumcision as an HIV prevention method.

"He made comparisons between Bakonjo and Bagisu who have traditionally circumcised their men but still do not have the lowest prevalence rates in the country," said Kayongo. He mentioned that 'those who circumcise could die'. Yes they could but he needed to back it up with stats.

A study done in African countries including his own country, Uganda, showed that men who are circumcised reduce their risk of becoming infected heterosexually by approximately 60 percent.

Kayongo said Museveni also undermined the use of condoms as a prevention tool when he said 'Condoms should stop! If you do not trust someone, then do not have sexual intercourse with them'.

Many studies have indicated that consistent use of condoms results in 80 per cent reduction in HIV incidence. Consistent use is defined as using a condom for all acts of penetrative vaginal intercourse.

Kayongo also pointed out that Museveni while talking about most-at-risk population did not mention men who have sex with men (MSM) and transgender Ugandans who at the risk of HIV infections.

Although no study has been done yet to establish the HIV incidence among MSM and commercial sex workers in Uganda, they are known to be among the drivers of the HIV epidemic. The one that was being done got suspended at MUWRP.

Scientists have indicated that Uganda’s HIV incidence-new infections per year, can be reduced by 77 percent if the country targeted prevention in most at risk populations which includes MSM.

Apparently, Men who have sex with Men are a bigger danger because most of them also have sex with women and they could be married, especially in a hostile environment like Uganda.

Uganda’s HIV incidence can be averted if they focused more on most at risk populations for prevention said a researcher from the school of Public Health Makerere University, Joseph Matovu. “If they did at least 2 million infections could be stopped by 2025,” said Matovu.

"Telling from the issues mentioned above, some of the President’s remarks were really unfortunate!
We need to continue to highlight the importance of safe male circumcision and condom use as prevention tools," said Kayongo. 

"The President has probably not been adequately informed about the scientific evidence surrounding these two interventions," said Kayongo.

Flavia Kyomukama, an HIV activist said Museveni had earlier said that any young person who gets infected with HIV is committing 'treason'.

"I think it is unfortunate for a Head of state not to know his epidemic and continue to leave some sections of the society behind. No wonder, Uganda's annual new HIV transmission rate is still as high as 137,000," commented Kyomukama.
ends

Africa Data Challenge

The Planet Earth Institute (PEI) (http://www.planetearthinstitute.org.uk), an international NGO that works for the scientific independence of Africa, held its first-ever ‘Africa Data Challenge’, as part of their #ScienceAfrica UnConference, held at Impact HUB, Westminster on November 18.

The ‘Africa Data Challenge’ had parties pitch their ideas for projects that harness data for real, human impact in Africa. Innovators from around the world pitched their ideas for projects that can help translate and transmit the power of data to those on the continent.

In a press release prior to the challenge Dr Álvaro Sobrinho, Chairman of the Planet Earth Institute, said: “Data holds a huge amount of promise for scientific development in Africa, and for many different business sectors too, but we haven’t yet fully explored how it can be used at a local level to improve lives."

"As an NGO we are always looking for practical ways to support science and technology, and this Africa Data Challenge will help do just that – developing and incubating new ideas with real impact."

Projects were unlimited in scope and focus, but designed to have a practical, human application in the next 12 months. Contestants presented to a live panel of judges and the successful innovators will be rewarded with a cash prize of £7,000 and receive PEI’s support to roll out their project.

The ‘Africa Data Challenge’ forms part of the PEI’s second #ScienceAfrica UnConference, which is hosted by Rt Hon Lord Boateng and run in partnership with UN Economic Commission for Africa, the World Bank and the European Commission.

The UnConference brought together over 120 people passionate about and working in science, development and Africa for an interactive day of workshops and discussions.

Participants come from diverse sectors, including international policy makers, academics, students as well as the general public. The UnConference will also be live streamed on the PEI website and people are encouraged to use the #ScienceAfrica hashtag on Twitter to engage in a robust discussion about science, technology and innovation in Africa.

ends

Health Innovation: Automated Medical Equipment could save many lives

By Esther Nakkazi

Christine Nabbanja is a twenty-two year old, fourth year, biomedical engineering student at Makerere University. She is also part of a group of five innovative students, teamed up to offer global health solutions to the world.

Their innovation is an automatic switch for an electrical suction pump. Suctions are used to clear the airway of blood, saliva, vomit or other secretions so that a patient can breathe during respiratory failure or surgery.

In Uganda’s health systems, the problem is immense as they represent at least 25 percent of all failed equipment in hospitals. Although they can be switched off, when health workers are using them, they tend to forget and the system clogs, delaying the job at hand and threatening the life of the patient.

Others on the team were Brian Nkwanga Senabulya the team leader, Andrew Nyorigo, Patrick Ssonko and Engineer Johnes Obonguloch the Principal Investigator.

So the team of five came up with a solution, to add on an automatic switch to the suction pump, so that when the bottle fills with fluids, it automatically switches off, says Nabbanja who is attending the second Hack-a-thon at Mbarara University of Science and Technology 22-24 August 2014.

It was organised by the Consortium for Affordable Medical Technologies (CAMTech) Uganda and Mbarara University in partnership with Mass General Hospital’s Centre for Global Health. Other participating groups were the Massachusetts Institute of Technology (MIT), Harvard Medical School and Vellore Institute of Technology (VIT) in India.

It was my first time to attend a Hack-a-thon and I was really impressed. But I also ask what next?

Mbarara University 2014 Hack-a-thon cake

A Hack-a-thon enables teams made up of engineers, entrepreneurs, professors, clinicians to come up with innovations in just 24 hours that impact on global health to save millions of lives. What happens is teams pitch ideas to a group of judges. These are ideated and turned into prototypes and are again presented with business models that have the potential to transform health outcomes around the world.

To date, over 1,000 innovators have participated in CAM Tech hack-a-thons across Uganda, India and the United States and they have spawned many new technologies addressing different health problems.

Nabbanja and her team conceived the automated suction pump idea during the first Hack-a-thon held at Mbarara University last year. It won the second position and the first prototype has already been developed using the seed funding awarded to them.

The Pro-creation lab opened at Mbarara University 

Professor Fredrick Kayanja, the Vice Chancellor, Mbarara University says it is a practical innovation needed locally that could change hospitals and the way health workers work and save many lives.

He is also glad that it was hatched at a Hack-a-thon, which helps young people become better thinkers and emancipates fear from them.

For students ‘it changes the mindset about their education. People who did not think they were innovators become innovators,’ explains the director CAMTech, Elizabeth Bailey. And entrepreneurship skills are learnt because teams create viable business plans, she added.

“In this game, failure is totally acceptable. It also offers a neutral space where people do not fear failure,” says Bailey.

Kristian Olson the Medical Director of CAMTech, and Assistant Professor at Harvard Medical School says human resource is a limiting factor in resource limited settings.

Prof Kayanja and Prof Bangsberg

He explains that this is not a unique problem and agrees that the automated suction pump innovation by the students is a good idea. “Empowerment is transitional. The fact is that there is so much drive and to see that young people want to solve their own problems is intangible.”

Although the Hack-a-thons started only last year in Uganda and at Mbarara University, Dr. Data Santorino, a lecturer at Mbarara University and country director CAMTech says the idea is picking up.

At least 200 clinicians, engineers, entrepreneurs and end users participated in 2014 up from 150 last year, 29 from 23 projects were presented and at least 70 pitches of innovative ideas were made to judges by individual students.

More university students are attending and more local companies are getting interested to sponsor the event, says Santorino as he promotes strategic partnerships to improve global health. "Innovation is not a one person affair. As African innovators we need partnerships that support our weak areas. There is so much we can contribute to Global Health.

“At a Hack-a-thon ideas are from the bottom to the top of the pyramid through a chain to commercialisation,” says Dr. David Bangsberg, the Director at Mass General Hospital (MGH)’s Centre for Global Health. His challenge is to find more cooperate partners to pick them up and commercialise them.

“My dream is to see an ecosystem where an innovator can take an idea, find the right expertise to ideate it, test it, move it with small seed capital, scale it with cooperate sponsorship,” says Bangsberg.

But that is not all. “With technology it is different,” says Nabbanja. “When an innovation comes from Uganda, even us Ugandan we do not trust it. It is as if it should have the face of a white person to be trusted.”

ends