World Mobile plans to launch balloons across Africa to connect hundreds of millions of people

World Mobile, the first mobile network built on blockchain and run by the people has partnered with Altaeros, developers of the world’s first autonomous aerostats, to connect the unconnected. 

World Mobile and Altaeros have united to bring internet to unconnected areas in Africa,  leading to mass digital inclusion.  

Through this partnership, Altaeros and World Mobile will provide low-altitude aerostats (tethered balloon platforms) with a coverage area of approximately 8,000 km^2 each, forming part of World Mobile Dynamic Network. 

World Mobile plans to launch these balloons across Africa to connect hundreds of millions of people. Several aerostats will launch in Zanzibar anchoring the network and delivering connectivity near to 100% of the island. 

Each aerostat will connect hundreds of thousands of subscribers and each subscriber on the network will create a blockchain wallet. World Mobile will be deploying thousands of aerostats across the continent.

The aerostat system consists of a helium-filled envelope and stabilising fins. The unique 3-tethered architecture limits the aerostat's movement in the air (pitch, roll and yaw), which is essential in stabilizing telco coverage so connectivity doesn't drop in and out. 

The aerostat is attached to a movable mooring platform with built-in software that adjusts the balloon's position depending on wind conditions. The onboard communication system, using beam forming technology (a technique that focuses a wireless signal towards a specific receiving device) will allow 3G, 4G and 5G handsets to connect directly and will also connect WM AirNodes in the vicinity via traditional and alternative spectrums.

“We’re on a journey to bring modern infrastructure to billions of un-served and under-served people around the world. We’re driven by a belief that business and technical innovation are the keys to creating a positive, scalable impact. World Mobile is the perfect partner to work with to deliver our vision as they strive to connect the unconnected, everywhere,” says Altaeros CEO/CTO Ben Glass.

“World Mobile is on a mission to connect the unconnected and build the first mobile network powered and run by the people. Working with leading tech partners who share our values will make us stronger, says World Mobile Founder and CEO Micky Watkins.

World Mobile is the first mobile network powered and run by the people. Their fearless commitment to community, the environment, and technology will help them go where no telecom has gone before. 

By joining forces with their users, they’ll connect billions of unconnected people worldwide—allowing everyone the freedom to explore the world. 

Altaeros is on a mission is to help bring connectivity to those who need it most. Founded at MIT in 2010, Altaeros is focused on developing and deploying innovative real-world infrastructure solutions to bring affordable services anywhere needed, helping businesses and communities access the basic building blocks to allow for prosperity. 

Altaeros is headquartered in Somerville, MA.

Total Uganda: the French Supreme Court recognizes the jurisdiction of the civil court

Press Release

The Court of Cassation (French Supreme Court) issued its ruling on the case against the oil giant Total, led by six French and Ugandan civil society organizations (CSOs) - Friends of the Earth France, Survie, AFIEGO, CRED, NAPE and NAVODAThis is the first legal action based on the law on the duty of vigilance of transnational corporations. 

Putting an end to a nearly two years long procedural battle, the Supreme Court ruled in favor of the CSOs, rejecting the jurisdiction of the commercial courts (1). As the violations continue and intensify in Uganda and Tanzania, the case will now return to the civil court of first instance, which will finally examine it on the merits.

After a ruling by the Nanterre civil court in January 2020, which considered that this dispute fell under the jurisdiction of the commercial court, and which was upheld in December 2020 by the Versailles Court of Appeal (2), Friends of the Earth France, Survie and their four Ugandan partners had decided in early 2021 to file an appeal to the Supreme Court. 

On this question of jurisdiction they were supported by three other civil society organizations - ActionAid France, CCFD-Terre Solidaire, Collectif Éthique sur l'étiquette -, and one trade union - CFDT. For the claimants, today's ruling by the Court of Cassation, giving jurisdiction to the civil court, is an important victory. The Court ruled in favor of the civil society organizations by recognizing the "right to choose" (‘droit d’option’) that they enjoy as non-commercial claimants (3). 

By entrusting the case to the civil court, this decision makes it possible to fulfil the objectives of the law on duty of vigilance. The purpose of this law is to hold companies liable for the impacts of their activities on third parties, such as employees of subsidiaries, suppliers and subcontractors, local communities and the environment.

While the commercial courts draw their legitimacy from their knowledge of the business world, cases brought under the duty of vigilance law relate to the protection of human rights and the planet, and cannot therefore be reduced to a purely commercial dispute.

Moreover, this decision is coherent with the provision recently adopted by French Parliament in a new, soon to be enacted procedural law, which gives jurisdiction to the Paris civil court for all cases based on the duty of vigilance law (4).

For Juliette Renaud, of Friends of the Earth France, "We are relieved by this decision of the Court of Cassation, which finally closes nearly two long years of procedural battle. However, we are very concerned about the impact of the delays this procedural issue has caused: in the meantime, according to our investigations, more than 100 000 people are still totally or partially deprived of their land and livelihoods in Uganda and Tanzania (5). Action is urgently needed, and we hope that the upcoming decision on the merits of the case will order Total to finally take concrete measures to stop these violations”.

For Thomas Bart of Survie, "This decision is a first victory in the long legal battle we have launched against this transnational corporation. We will finally be able to focus on the substance of the case. Despite repeated warnings from civil society, the project continues at full speed without any concern for the repression of people on the ground: our partners and community members who dare to raise their voices against this oil megaproject are subject to increasing intimidation, and arbitrary arrests are multiplying (6)”.

This ruling of the Court of Cassation sends back the case to the civil court of Nanterre, where a hearing, finally dealing with the merits of the case, should be held in the coming months.

REF :

1. (1)  The decision of the Court of Cassation  .

2. (2)  See our press release from December 10, 2020 : "Total Uganda case: the Versailles Court of Appeal remands the case to commercial court". To learn more about the previous steps of this lawsuit, read the briefing from Friends of the Earth France and Survie (October 2020): Total Uganda – A first lawsuit under the duty of vigilance law: An update.

3. (3)  According to the right to choose (‘droit d’option’), if the claimants are a non-commercial entity, as is the case for our organizations, they can choose to bring a dispute against a commercial entity before either the civil court or the commercial court. In November 2020, this principle was reaffirmed by the Court of Cassation in the "Uber" ruling (available here in French only), even in a case where the subject matter of the dispute has a direct link with the company’s internal management. This decision was relied upon by the Nanterre court in the "Total climate" case, also based on the law on the duty of vigilance.

4. (4)  See our press release from October 21, 2021: Attribution de la compétence à un tribunal judiciaire : les parlementaires sauvent l’esprit de la loi sur le devoir de vigilance !

5. (5)  See Friends of the Earth France and Survie report (October 2020): A nightmare named Total - An alarming rise in human rights violations in Uganda and Tanzania

6. (6)  See the news report by Le Monde, published on November 26, 2021: "En Ouganda, le pétrole de Total impose le silence et la peur" (In Uganda, Total's oil imposes silence and fear)

Tanzania kids edutainment 'Akili and Me' wins TZ 19 Million Prize

Ubongo, a Tanzania-based nonprofit social enterprise and Africa’s leading producer of kids’ edutainment, is this year’s winner of the prestigious Rotman Innovation of the Year Award, worth $10,000 Canadian dollars (approximately 19 million Tanzanian shillings)

Ubongo was recognized for its transformative innovation of offering evidence-based programming that improves developmental outcomes for children, while using broadcast technology to reach a wide breadth of children across Sub-Saharan Africa.

The accolade is presented annually by Grand Challenges Canada, a Canadian not-for-profit organization that invests in local innovations that address critical global health, humanitarian and Indigenous community challenges in Canada and low-resource countries.

Ubongo’s flagship Akili and Me programming is currently translated in nine languages. Since receiving Grand Challenges Canada support in 2018, more than 1.37 million children (pre-primary and primary school) across Tanzania, Kenya, Rwanda, Nigeria, Uganda and Ghana have benefitted from watching Akili and Me. 

The multimedia platform—the first in Africa to integrate resource caregivers and other stakeholders—is easily accessible through television, radio and mobile phones.

According to a study, exposure to Ubongo’s Akili and Me program for 30 minutes per day for a month led to significantly improved child development scores, compared to those in the control group, including counting (24%); English skills (12.5%); number recognition (11.7%); shape knowledge (9.7%); and drawing skills (8.2%).

The project aims to positively impact the development, learning and life trajectory of over 100 million kids in Africa by 2030.

The Rotman Innovation of the Year Award was created in honour of the late Joseph Rotman, Founding Chair of Grand Challenges Canada, and his family, in recognition of their unfailing support for global health innovation. The Award honours innovation that has had the largest sustainable increase in lives saved or lives improved over the past year.

Ubongo Co-Founder and Chief Executive Nisha Ligon, who leads a strong, women-led team said the prize money will help with their goal of adapting content to more languages and contexts; the organization is determined to broadcast programming across Africa. 

“We are so honoured to receive this award. GCC’s support over the past three years has enabled us to expand our reach into many new markets and languages to reach millions of more kids. They have challenged us to think critically and strategically about our growth and have been essential in enabling Ubongo’s success,” she said.

“My father’s firm belief was that business has a critical role to play in building a better society. His vision is well embodied in Ubongo’s exceptional approach: the coordinated application of science and entrepreneurialism for the benefit of children. The Rotman Family congratulates Ubongo on being named the second annual winner of the Award,”Janis Rotman, President of the Rotman Family Foundation.

“Ubongo has brought a science-backed Early Childhood Development model into homes of children, many of whom otherwise don’t have access to quality education, through fun, localised and multi-platform educational content," said Jocelyn Mackie, the Grand Challenges Canada Co-CEO.

"To date, we have proudly financed Ubongo for a total of 1 million Canadian dollars under our Saving Brains program (with funding provided by Global Affairs Canada). Leveraging the reach of broadcast media, Ubongo has the largest breadth of impact in our Saving Brains portfolio.” 

“This very unique and successful idea that uses media for child development is helping to change the lives of the next generation of Africans, especially girls, so that they can live healthier lives, realize their potential, and prepare for active involvement in their communities,"said Her Excellency Pamela O’Donnell, High Commissioner for Canada in Tanzania.

The Government of Canada is investing in organizations, like Grand Challenges Canada, that support innovative solutions to save and improve the lives of people in low- and middle-income countries. "More than ever, we need new, creative solutions to build a sustainable future that leaves no one behind,”said O’Donnell. 

Last year, the inaugural Rotman Innovation of the Year Award, created as part of Grand Challenges Canada’s 10th anniversary, went to Hewatele, a Kenyan-owned social enterprise with a mission to address the lack of access to medical grade oxygen for rural and regional healthcare facilities by producing, delivering and servicing an eco-friendly, low-cost, safe and reliable oxygen solution.

£500,000 Hydrogen Training Academy to fight against climate change

A revolutionary project based in Ballymena, has received more than half-a-million-pounds of funding (£511,000) from the UK Government’s Community Renewal Fund (CRF) to start a new Hydrogen Training Academy, which they say will help in the fight against climate change.

With hydrogen emerging as a leading sustainable energy solution, the first-of-its-kind project for Northern Ireland will enable and develop a dynamic, skilled workforce that can take full advantage of hydrogen and clean tech opportunities.

The Hydrogen Training Academy is one of 31 projects across Northern Ireland set to benefit from a total of £12million CRF funding – all focusing on skills, education, local business and employment.

Led by Mid and East Antrim Borough Council, the Academy will be driven by a public-private partnership that includes Queen’s University, Ulster University, the University of Birmingham, Northern Regional College and Belfast Metropolitan College.

A consortium of key industry players also involved already includes Wrightbus, Energia, Translink, Firmus and EPUK with opportunities for other partners to come on-board as the project develops.

Professor David Rooney, Dean of Internationalisation and Reputation in the Faculty of Engineering and Physical Science at Queen’s University, comments:

“With COP26 taking place, sustainability is very much at the forefront of all of our minds. At Queen’s, we have been prioritising this as an area of research for many years and our world class experts have been working on many initiatives in the fight against climate change.

“Working in partnership with other institutions we will continue to use our expertise to develop cutting edge research and technology to drive forward change. I am also pleased that we will play an integral role in training our future leaders and the next generation of experts in the hydrogen economy.”

The development of the academy began earlier this year with the formal procurement of a new state-of-the-art training pod to support the practical training through the Hydrogen Training Academy. The training pod is being built by BSH Limited and will be delivered early in 2022.

The Mayor of Mid and East Antrim, Councillor William McCaughey, commented: “As all eyes around the world turn to COP26 and the urgent focus on environmental sustainability continues to gather pace, news of this funding really is very timely and very welcome indeed.

“Mid and East Antrim is uniquely placed in Northern Ireland in terms of the key strengths and assets we boast in energy and cleantech that align with zero carbon targets. Through this revolutionary Hydrogen Training Academy, our Borough will continue to build upon its reputation as centre of excellence and the main focal point of the emerging Northern Ireland wide hydrogen economy.

“I commend Council’s Elected Members and officers who, in collaboration with our public and private sector partners, have invested a huge amount of time and effort in bringing the project to this stage. I very much look forward to seeing the plans come to fruition in the coming months and witnessing the longer-term economic impact the Academy will undoubtedly have in the coming years.”

Graham Whitehurst MBE, Chair of Mid and East Antrim’s Manufacturing Task Force, explained how the Academy will play a “critical role” in training and upskilling both existing employees and new trainees to a recognised professional competence standard required for the hydrogen sector.

“The Hydrogen Training Academy will deliver a range of crucial entry-level introductory training for industry across a number of sectors, including energy, transport, gas, manufacturing and engineering,” he said.

“This training will be delivered via a combination of online, classroom and practical training with initial focus on two key areas of hydrogen – hydrogen gas basics and safety and hydrogen production.”

According to Mr Whitehurst, an initial pilot phase at the Academy will see 30 participants take part in a ‘Train the Trainer’ course, delivered by academics from the University of Birmingham, who have already successfully delivered their ‘KnowHy Training’ to over 1,000 participants.

Queen’s University and Ulster University will collaborate to develop a Level 7 postgraduate certificate in Hydrogen Power. Northern Regional College and Belfast Metropolitan College will draw upon the learning from participation on the Train the Trainer Programme to develop and accredit two Level 3 courses for delivery to young people and employees across the hydrogen industry.

“This Hydrogen Training Academy has been developed using a unique partnership approach involving Council, Further Education, Higher Education and industry. Their contribution has been, and will remain, critical to the overall success of the project and the future commercialisation of activity for the clean growth sector in Northern Ireland,” said Mr Whitehurst.



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Africa’s death rates from COVID-19 infections are significantly higher in patients with diabetes

By World Health Organisation

Africa’s sharp increase in diabetes is clashing with the COVID-19 pandemic and poor access to vaccines. Africa’s death rates from COVID-19 infections are significantly higher in patients with diabetes, according to a preliminary analysis which the World Health Organization (WHO) presented today in advance of the World Diabetes Day on 14 November.

“COVID-19 is delivering a clear message: fighting the diabetes epidemic in Africa is in many ways as critical as the battle against the current pandemic,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

“The COVID-19 pandemic will eventually subside, but Africa is projected in the coming years to experience the highest increase in diabetes globally. We must act now to prevent new cases, vaccinate people who have this condition and, equally importantly, identify and support the millions of Africans unaware they are suffering from this silent killer.”

Diabetes impairs the body’s ability to produce or process insulin, a substance essential to counteracting a dangerous rise in blood sugar. The disease causes inflammation and poor blood circulation, both of which increase the risk of complications, including death, from COVID-19.

A recent WHO analysis evaluated data from 13 countries on underlying conditions or comorbidities in Africans who tested positive for COVID-19 revealed a 10.2% case fatality rate in patients with diabetes, compared with 2.5% for COVID-19 patients overall. 

The case fatality rate for people with diabetes was also twice as high as the fatality rate among patients suffering any comorbidity. In addition to people with diabetes, the three most frequent underlying conditions included patients with HIV and hypertension.

The countries contributing data to the analysis were Burkina Faso, Chad, Cote d’Ivoire, Democratic Republic of the Congo, Eswatini, Guinea, Namibia, Niger, Rwanda, Senegal, Seychelles, Sao Tome and Principe and Uganda.

An estimated 24 million people are living with diabetes in Africa in 2021 according to the International Diabetes Federation and the continent is expected to experience the highest increase in diabetes globally, with the number of Africans suffering from the disease predicted to rise to 55 million by 2045, an increase of 134% compared with 2021. 

Africa is the region with the highest number of people who do not know their diagnosis – an estimated 70% of people with diabetes do not know they have the disease.

“Health officials in Africa should take advantage of the growing availability of low-cost rapid diagnostic tests to routinely test patients in diabetes centres to ensure early detection and proper care,” said Dr Benido Impouma, Director, Communicable and Noncommunicable Diseases Cluster at WHO Regional Office for Africa. “These centres also can be key venues for vaccination.”

Since the early days of the pandemic, people with diabetes in countries around the world have been prioritized to receive COVID-19 vaccinations. Africa has faced challenges in this strategy.

Access to vaccines remains poor. Thus far, only 6.6% of the African population is fully vaccinated against COVID-19, compared with about 40% globally. Data from 37 countries indicates that since March 2021, over 6.5 million COVID-19 vaccine doses have gone to Africans with comorbidities, representing 14% of all doses administered so far. 

Efforts to prioritize people with comorbidities, like diabetes, are accelerating with about half of those 6.5 million doses administered in just the last couple of months. However, there is still a lot more work to be done to ensure people at high risk receive the vaccines they need.

“Nine months since COVID-19 vaccination campaigns began in Africa, we are still nowhere near where we need to be with protecting our most vulnerable,” Dr Moeti said. “There is an urgent need to step up vaccination and other key services to people at high risk, including those with diabetes.”

There are two main types of diabetes: type 1 caused by a condition early in life that damages the pancreas and impairs insulin production; and type 2—which is linked to poor diet, obesity and lack of exercise—where the body struggles to process insulin. 

About 90% of diabetes cases globally, and the vast majority in Africa, are type 2, with rising rates in Africa attributed to the same poor diets and sedentary lifestyles causing a surge in type 2 diabetes around the world. 

In addition to COVID-19 risks, diabetes can also increase risk of heart attack, stroke, kidney failure, lower limb amputation, visual impairment, blindness and nerve damage, including erectile dysfunction.

“All Africans at risk of diabetes must have access to testing,” Dr Moeti said. “We can also stop diabetes from claiming more lives by promoting healthy, affordable diets and regular exercise.”

During the COVID-19 pandemic, access to diabetes care has been severely disrupted in the African Region. Lockdowns to limit the spread of COVID-19, for example, have impeded access to health care and the basic elements of proper disease management, such as routine glucose monitoring and eating a healthy diet.

To improve equitable access to quality diabetes care, WHO launched the Global Diabetes Compact in April 2021. This builds on work in recent years to rollout the WHO Package of Essential Noncommunicable Disease (WHO PEN) interventions for primary health care in low-resource settings. 

So far 21 African countries have started using this package. Benin, Eritrea, Eswatini, Lesotho and Togo have achieved national expansion covering all primary health care facilities.

WHO held a virtual press conference facilitated by APO Group. Dr Impouma was joined by Professor Maïmouna Ndour Mbaye, Head of the Internal Medicine unit, Cheikh Anta Diop University of Dakar and Director, National Diabetes Centre, Senegal, and Mr Greg Tracz, Chief Executive Officer, Diabetes Africa.

Also on hand to respond to questions were Dr Phionah Atuhebwe, New Vaccines Introduction Officer, WHO Regional Office for Africa, Dr Thierno Balde, Regional COVID-19 Incident Manager, WHO Regional Office for Africa, and Dr Jean-Marie Dangou, Coordinator, Noncommunicable Diseases Programme, WHO Regional Office for Africa.



(END)

55 million Africans predicted to suffer from diabetes by 2045

By World Health Organisation

Africa is expected to experience the highest increase in diabetes globally. The number of people suffering from the disease is predicted to rise to 55 million by 2045—a 134% spike compared with 2021. 

At 70%, the continent also has the world’s highest number of people who do not know they have diabetes.

Dr Bernadette Adeyileka-Tracz, Founder and Chief Operating Officer of Diabetes Africa, a non-profit organization working to improve the health of Africans living with diabetes, explains the challenges in diabetes prevention and care in the continent.

What are the challenges a person living with diabetes faces in Africa? 

 

The number one challenge for a person living with type 1 or type 2 diabetes in Africa is diagnosis: people living with diabetes may not know they have the condition until serious complications develop. That’s because “looking healthy” is not the same as “being healthy.” 

People with excess blood sugar, particularly in the case of type 2 diabetes, can live without experiencing complications for a long time. However, when these complications do manifest, they present huge problems to livelihoods and add to the burden of already-strained health systems. Blindness, amputation, heart emergencies are not light complications.

In many places across the continent, this challenge is compounded by a lack of testing facilities or training among health workers that would enable them to identify risks early on. The earlier Type 2 diabetes or pre-diabetes can be diagnosed and treated, the better for the person and for the community at large.

The cost and access to medication is of course an acute challenge in Africa. We can add that managing blood glucose levels requires testing blood sugar levels regularly, and this presents challenges on its own: people living with diabetes should receive adequate training on the topic, but also be able to afford it: how can we expect people to test regularly if they must choose between feeding their families and buying test strips?

Diagnosis and testing are the first of a series of cascading challenges. Experts often use what they call the “rule of halves” to describe them: of 100 people living with diabetes, only 50 of them will have been diagnosed. The rest will live with the condition and its consequences without being aware of it. Of the 50 that have been diagnosed, 25 will receive care. 

The others are unable to seek care, for personal or economic reasons. Finally, among the 25 who receive adequate care, only 12 or 13 will meet their targets in terms of readings or measurements. But in the end, only six of them will have a positive health outcome.

This shows the scale of the challenge in front of us. It’s also possible that in remote and rural areas in Africa a rule of thirds or a rule of fourths applies.

How has COVID-19 made their situation worse? 

 

COVID-19 has certainly increased risks for people living with diabetes. People living with diabetes are more likely to have more severe symptoms of COVID-19. Research is still ongoing, but anecdotal evidence coming from Africa tends to corroborate research done in the United Kingdom and in the United States of America. 

In the Democratic Republic of the Congo, for example, the analysis of a small sample of 215 people who died of COVID-19 showed that 30% of them had diabetes.

The public response to the pandemic has also had an impact on people living with diabetes. An initial reaction to the pandemic has been to encourage people to stay at home and reduce visits to the hospital. People living with diabetes also chose to stay at home for fear of catching the virus. With the pandemic stretching into 2021, this did not prove to be a sustainable solution.

The sudden global focus on health may have encouraged some people to control their diabetes better and make an extra effort, but in general, COVID-19 and its associated restrictions has meant that people became more sedentary, experienced stress and anxiety and had more difficulties keeping a healthy diet and controlling their diabetes.

Luckily, in most instances, hospitals and healthcare providers acknowledged these challenges and made a special effort to allow people living with chronic conditions to receive face-to-face care. Telemedicine has helped in countries where phone calls and video calls were a workable option, for example in Nigeria and Kenya. However, in other countries, such as Uganda for example, the cost and technical challenges of telemedicine were often prohibitive.

COVID-19 has also been the catalyst for positive changes. Civil society organizations have had an active role in encouraging governments to tackle non-communicable diseases like diabetes to lighten the burden on health systems. In Kenya, the Noncommunicable Diseases Alliance has been actively advocating for essential diabetes medicines to be covered by the National Health Insurance Fund.

 

How can countries innovate and manage diabetes in a low-resource setting? 

 

It’s difficult to look at diabetes in isolation and ask how we could do more with less. Adequate healthcare demands a basic level of resources and given their impact on the overall system, noncommunicable diseases such as diabetes remain largely underfunded.

This is regrettable because managing health in a low-resource setting would benefit from actions that reduce costly complications, such as early diagnosis and prevention of diabetes. People who stay in the hospital with COVID-19 often have comorbidities. Can we not address these comorbidities at the source?

One of the greatest innovations in a low-resource setting would be to change mindsets: consider investing in keeping people healthy, rather than fixing problems. There will always be emergencies and costly operations that cannot be avoided. But diabetes need not be the cause of them.

This involves an effort to train healthcare professionals, inform and train people who may be at risk, sharing knowledge at a much greater scale, which is what Diabetes Africa aims to do. This would also entail working with commercial organizations, in particular in the food and beverage industry to label products and help people make informed decisions.

Study: Access to a simple breathing monitor could prevent 11,000 fatal anaesthetic accidents per year in sub-Saharan Africa

A study, the Global Capnography Project (GCAP), published 26 September 2018, in the journal Anaesthesia, clearly identified the need for middle and low-income countries to have access to a simple and life-saving method of monitoring a patient’s breathing, called capnography, in operating theatres and in intensive care units.

Capnography is an essential monitor for safe anaesthesia and is widely used in high-income countries as part of major improvements in the safety of anaesthesia care. 

The study called: ‘Global Capnography Project (GCAP): implementation of capnography in Malawi - an international anaesthesia quality improvement project’ and will be published in the journal Anaesthesia in September 2018 https://www.onlinelibrary.wiley.com/doi/10.1111/anae.14426 

A landmark study in 2011, the 4th National Audit Project (NAP4), further confirmed the importance of capnography both in the operating theatre and especially in the intensive care unit. Despite this, the device is hardly ever available in low-income countries.

The GCAP team set out to measure the availability of capnography and determine whether its introduction was feasible and could improve patient care in a low-income country. 

A pilot site was identified in Malawi and forty capnographs were donated by Medtronic to eight hospitals in the southern part of the country. In addition, thirty-two anaesthesia providers at these hospitals received a one-day capnography training course.

Prior to the pilot project, there was only one capnograph in the southern region of Malawi, across eight hospitals. During the six-month pilot, 699 episodes of monitoring with the capnographs were recorded and 90% of the anaesthesia providers trained believed that the use of capnography had saved lives. They reported that a minimum of 57 lives had been saved during the six months of use. 

Oesophageal intubation (accidently placing a tracheal tube in the patient’s oesophagus) and breathing circuit disconnections are two of the most important incidents in operating theatres and intensive care units that capnography monitoring can detect. Both of these can lead to significant patient harm and mortality if not identified early and corrected quickly.

During the six-month pilot, 44 oesophageal intubations were detected by capnography. From this, the GCAP team made an estimation that with a population of 7.5 million in Southern Malawi there is a rate of 11.7 oesophageal intubations per million population per year.

Assuming Southern Malawi is representative of sub-Saharan Africa as a whole (with a population of 1,022 million), the team then went on to estimate that over 11,000 oesophageal intubations could occur per year in the region.

These incidents pose a very significant patient safety risk that could be prevented by access to capnography. The GCAP team estimated that there are at least 70,000 operating theatres in the world
without Capnography.

Prof Ellen O’Sullivan from GCAP Team, said: “We believe that this is one of the most important projects in anaesthesia safety in the last decade. Our research clearly shows that lives are at risk in low-income countries due to an absence of a simple method of monitoring breathing, called capnography. 

This is despite international standards recommending its use. We are calling for the development of an international project to make global capnography to become a reality, so that like pulse oximetry, it can be included the World Health Organisation (WHO) surgical safety checklist to help improve patient safety worldwide All relevant organisations should consider taking this forward.”

 “These results show that capnography is desperately needed to help save patients’ lives in our operating theatres and ICUs. We found the equipment robust and easy to use. We plead with the international anaesthesia community to support the dissemination of the GCAP project throughout Malawi and other sub-Saharan African countries,”Dr Delia Mabedi from Zomba Hospital, Malawi commented.

"Medtronic is grateful for the opportunity to participate in the GCAP project that demonstrated the major clinical benefits of monitoring patients breathing with capnography. We look forward to working with the clinical community to address the global need for this technology and to keep patients safe worldwide,” said Vafa Jamali, senior vice president and president of Respiratory, Gastrointestinal and Informatics, which is part of the Minimally Invasive Therapies Group at Medtronic.

-Ends-
REF: https://www.onlinelibrary.wiley.com/doi/10.1111/anae.14426