With cervical cancer cases rising across Sub-Saharan Africa, and 80 percent of women diagnosed too late to stop the cancer’s deadly spread, the World Health Organization (WHO) is recommending screening and vaccination programmes throughout the region.

“WHO is going to strongly advocate with donors and decision-makers to list cervical cancer as a public health priority…because with a vaccine we can save lives by preventing cervical cancer.” said Jean Gabriel Wango, head of family health at WHO in Ouagadougou.

The vaccine will help fight the Human Papilloma Virus (HPV), which if left untreated, can develop into cervical cancer.

A silent killer’s spread

"There is little investment in this disease and many of our women are unaware of it…so they die in silence,” said Sita Kaboré, president of Kimi, an association that runs cervical cancer screening campaigns in Burkina Faso.

A cancer physician at the UK-based Oxford University, David Kerr, says by 2020, 70 percent of the 15 million new cases of cancer diagnosed every year will be contracted in the developing world.

Cervical cancer is the most common tumour for African women, according to WHO. In Uganda, 80 percent of female cancer survivors suffer from cervical cancer, says Dan Murokora, a Uganda-based gynecologist.

But weak record keeping has hampered governments’ efforts to find out the disease’s morbidity rates; WHO advises governments to focus on record keeping in developing their prevention plans.

Screening

Cervical cancer is largely preventable but women need to be screened every three to five years to halt the deadly disease, according to Charlemagne Ouédraogo, a Ouagadougou-based gynecologist.

But in Sub-Saharan Africa, which lacks diagnostic equipment and national prevention programmes, only 5 percent of women are regularly screened for cervical cancer, according to WHO’s Boureima Hama Sambo, relegating most cases to late-stage, hard-to-cure diagnoses.

WHO is urging health ministries to make the HPV vaccine available in their national health plans to all 10 to 13-year- old girls in order to prevent the disease.

Reducing vaccine costs

The vaccine’s three doses cost a total of US$300, in a region where the average annual salary is about US$550, according to the UN Children’s Fund, UNICEF.

The Geneva-based Global Alliance for Vaccines and Immunization is expected to negotiate with pharmaceutical companies to bring the price down, while the UN, Program for Adaptation of Technologies in Health (PATH), and World Bank have pledged to help with costs so patients only pay US$45 for the vaccine.

Hurdling the cost barrier

For some of Africa’s health officials, this price reduction is key to their governments’ participation. "It is a good idea to integrate the HPV vaccine into programmes, but it remains too expensive. WHO and its partners need to assist countries to buy the vaccine first." says gynecologist Caroline Leite from Cape Verde.

WHO’s Sambo dismisses these cost concerns, and says the vaccine should be widely available soon. “We think that there is an expression of political will and we think that very soon we’ll be able to roll out the vaccine for these populations,” he concluded.

IRIN 

The Ivorian Ministry of Health has confirmed 19 people have been infected with yellow fever since May, while the World Health Organisation (WHO) warns Cote d’Ivoire is at an “elevated” risk of yellow fever epidemics.

“Since the beginning of May, Abidjan has been threatened with a yellow fever epidemic,” confirmed Felix Bledi Touin, a senior health official. “Three cases have been found in the [Abidjan suburbs] Treichville and Cocody. At this stage, 19 cases have been confirmed and 1,500 people have been vaccinated,” he said.

Yellow fever is spread by mosquitoes. Epidemics touch on average 20 percent of people in affected areas, half of whom may die, according to the WHO. There is no cure for people already diagnosed with the fever, but a vaccination can prevent infection.

WHO vaccinated 26,000 people against yellow fever in February 2006 in Bouna, in the east of the country. A vaccination campaign was also conducted in the capital, Abidjan, in 2001.

The Ivorian government and WHO have announced another vaccination campaign for this year targeting almost two million people in Abidjan.

“Despite a large vaccination campaign conducted in 2001, the rate of coverage is still only around 60 percent,” the WHO said in a statement.

The early symptoms of yellow fever are similar to malaria, making it hard to recognise, experts say. After experiencing fevers, sore muscles, and nausea, an infected person may relapse into jaundice, bleeding from the eyes, nose and mouth. Resulting kidney failure can lead to death.

Yellow fever is on the rise again in Africa, although an effective vaccine has been available for 60 years.

IRIN 

“[Health researchers] are currently collecting information so as to identify the factors explaining the recurrence of the epidemic in districts where populations have been vaccinated”, Ousmane Badolo, head of the epidemiologic surveillance department at the ministry of health, told IRIN.

Vaccination campaigns target people between 2 to 30 years old; according to the ministry of health, 80 to 90 percent of the victims of meningitis belong to that age group.

A total of 714 people have died since 1 January out of 7,184 cases.

Several different bacteria can cause meningitis which is an inflammation of the protective membranes covering the central nervous system. The Neisseria sero-group is one of the most important to watch because it often leads to epidemics, experts say.

Badolo, the epidemiologist, said that health research teams from the UN World Health Organization and US-based Centers for Disease Control and Prevention have come to Burkina Faso to investigate. “This is the first time that such research is being conducted,” Badolo said, adding that at this stage he could only guess why the vaccination programmes have not worked.

“Perhaps it is because of population displacement,” he said, “for instance in gold mining areas people are often coming and going.”

The health researchers will focus their work on the districts of Réo in the central west of the country, Boulsa in the central north, Titao in the north and in Sig-nonghin a district in the north of the capital Ouagadougou.

The populations in each of those four districts were vaccinated last year yet each has reached epidemic thresholds.

A total of five out of the country’s 55 districts have reached the epidemic threshold and 14 others are on alert.

Meanwhile, 3.5 million people have been vaccinated this year out of a population of 14 million. The government said it is in the process of procuring a million more vaccines with the help of UN Children’s Agency UNICEF.

People vaccinated against meningitis are supposed to have protection for three years but health officials have announced that meningitis epidemics have occurred in several areas where populations had recently been immunized.

“[Health researchers] are currently collecting information so as to identify the factors explaining the recurrence of the epidemic in districts where populations have been vaccinated”, Ousmane Badolo, head of the epidemiologic surveillance department at the ministry of health, told IRIN.

Vaccination campaigns target people between 2 to 30 years old; according to the ministry of health, 80 to 90 percent of the victims of meningitis belong to that age group.

A total of 714 people have died since 1 January out of 7,184 cases.

Several different bacteria can cause meningitis which is an inflammation of the protective membranes covering the central nervous system. The Neisseria sero-group is one of the most important to watch because it often leads to epidemics, experts say.

Badolo, the epidemiologist, said that health research teams from the UN World Health Organization and US-based Centers for Disease Control and Prevention have come to Burkina Faso to investigate. “This is the first time that such research is being conducted,” Badolo said, adding that at this stage he could only guess why the vaccination programmes have not worked.

“Perhaps it is because of population displacement,” he said, “for instance in gold mining areas people are often coming and going.”

The health researchers will focus their work on the districts of Réo in the central west of the country, Boulsa in the central north, Titao in the north and in Sig-nonghin a district in the north of the capital Ouagadougou.

The populations in each of those four districts were vaccinated last year yet each has reached epidemic thresholds.

A total of five out of the country’s 55 districts have reached the epidemic threshold and 14 others are on alert.

Meanwhile, 3.5 million people have been vaccinated this year out of a population of 14 million. The government said it is in the process of procuring a million more vaccines with the help of UN Children’s Agency UNICEF.

IRIN

Some 172 cases of meningitis have been reported in Cote d’Ivoire and 44 deaths since the beginning of January, but with only 400,000 vaccines available for the one million people at risk and health staff poorly prepared to deal with a meningitis epidemic, a wider crisis is feared.

Health staff are “not well-trained” in predicting and responding to meningitis outbreaks in Cote d’Ivoire, said Mamadou Guingaré, an epidemiologist at the World Health Organization’s Multidisease Control Centre in Burkina Faso, which means officials “do not know for certain” the full extent of the problem.

Only seven Ivorian health districts have reported meningitis cases, with many of the other 65 districts not reporting at all, despite 18 of them being known to be at risk, he said.

Epidemic levels have only been announced for the town of Tengréla in the north on the Mali border where 75,000 people have been vaccinated.

The towns Bouaké, Sakassou, Vavoua and Daoukro in the centre and centre-west of the country are on alert, according to Rémi Allah Kouadio the minister of health and hygiene.

Across the border in Burkina Faso, 255 people have died of the infection out of a total of 1,938 reported cases since the beginning of January.

Kouadio Aka Tanoh Bian from the World Health Organization said the WHO may have to call on emergency funding mechanisms such as the UN Central Emergency Response Fund, to buy more vaccines quickly for Cote d’Ivoire.

The WHO team in Cote d’Ivoire said it is supplying the government with 379,000 vaccine doses against two types of meningitis and has sent a request for 600,000 more for Cote d’Ivoire to the International Coordination Group for vaccine (ICG) on Vaccine Provision for Epidemic Meningitis Control which provides vaccines.

The meningitis bacterium, which usually reaches epidemic levels in the West Africa region between December and May, could be especially severe this year, forecasters have warned, as the region is heading toward the peak of a 10- to 12-year cycle of meningitis crises.

Sukuta Health Centre recently organised an open day vaccination programme aimed at saving lives. The programme was organised by the MRC unit in partnership with the Gambian Governments’ Department of State for Health.

Delivering his speech during the programme, the MRC unit Director Professor Tumani Corrah underscored the significance of centres in sub-Saharan Africa in researching the mechanisms of infectious diseases and the development of effective interventions. He added that health, and the conditions which promote it, are a common theme across the Millennium Development Goals. Technology, he said, has a key role to play in their attainment.

The MRC Director further explained that in 2002, the MRC in the UK established a partnership with The Gambia’s Department of State for Health in order to investigate how the immune systems of infants respond to vaccines and infections encountered in early life.

According to Professor Corrah, the MRC Sukuta field team works in close collaboration with the staff of the health centre. He went on to say that the Government’s extended programme of immunisation and the National Leprosy and TB Control Programme are fully informed and supportive of the research activities that are taking place.

Dr. Corrah went on to explain that since 2002 some 1,300 children have been recruited into studies of infections and vaccines at the Sukuta Health Centre.

This has led to some breakthroughs in our understanding of the infant immune system. Among these is a better understanding of immunity to the chronic viral infections Epstein Barr Virus (EBV) and Cyto Megal Virus (CMV). The effects of malaria contracted during pregnancy by the mother, on a child in its early life are also better understood as a result of the research.

Other speakers included Chief of Kombo North Demba Sanyang and Sukuta Clinical service Dr. Jane Adefita. The closing remarks were delivered by Dr. Katie Flannagan. 

At least 44 (forty four) Red Cross volunteers were, over the weekend, prepared for a measles immunization campaign which will reach out to communities in Central River Region.

Speaking earlier the Red Cross Supervisor Mr Pa Musa Kijera pointed out that this program campaign will cover children from 6 to 59 months, adding that during the campaign they will also be giving vitamin A and de-worming tablets to children. Mr Kijera implored the participants to make best use of the knowledge and skill and to live up to expectations.

For his part the Regional Health Officer CRR Mr Karamba F. Keita asserted that vitamin A deficiency is a problem in many children, noting that vitamin A helps to reduce damage to tissues and aids the body in resisting infection. Mr Keita further stated that children from 6 months to 11 months will be given 100,000 IU blue capsules, while children from 12 months to 59 months will be given 200,000 IU red capsules.

He further elucidated that worms are parasites that live in human intestines, stating that de-worming will lead to the improvement of child health and well being. Mr Keita revealed that targeting about 34,979 children in the CRR and that vaccination trams will be going round to immunize the children.

He further called on the people of CRR to cooperate with the volunteers during the campaign; he commended the Red Cross crew for their active participation during the training.

Pastoralist children in the Horn of Africa face some of the greatest challenges and are among the most vulnerable in the world, according to a new report by the UN Children’s Fund (UNICEF).

The region, which covers parts of Eritrea, Ethiopia, Kenya and Somalia, has about 20 million pastoralists, including an estimated four million children.

They mostly live in water-scarce arid and semi-arid areas, characterised by poor road and communication infrastructure, few investments, limited educational opportunities and a lack of basic services.

"At least 90 percent of children below five years in Somalia [where 50-60 percent of the population are pastoralist] are not immunised against measles," Per Engebak, UNICEF regional director, said at the launch of The Pastoralist Child in Nairobi on 29 October.

In some areas of Eritrea, Engebak added, just 22 percent of the children have received measles vaccinations, while in Ethiopia there is only one doctor per 300,000 people.

Access to healthcare is also a major problem in pastoralist Kenya, with people travelling an average of 40 to 80km to reach a health facility, said the report. In the Afar region of Ethiopia, two hospitals, nine health centres and 587 health workers serve a population of 1.4 million.

Only 20 percent of children in these areas go to school. Joseph Kelong, a student from Kacheliba in the pastoralist Pokot area in northwestern Kenya, said there are only two secondary schools in the district and very few skilled teachers.

“Our education is affected by cattle rustling, clashes, water scarcity, lack of electricity and poverty,” he said. “The children in Nairobi [the capital] and Lokichoggio [in northwestern Kenya] should have equal standards of education.”

Malnutrition rates in children surpassed the UN World Health Organization’s emergency threshold rate of 15 percent after successive droughts and flooding in 2005 and 2006.

The report said that malnutrition ranged from 11 to 20 percent in Eritrea, and about 30 percent in several areas in Kenya and Somalia. Overall, by early 2006, at least four million children, 1.5 million of them under five years old were in need of emergency nutrition and health interventions.

The pastoralist way of life has faced difficulties for many years, with fixed borders interrupting migratory routes, rainfall diminishing, and growing pressures on fewer areas of pasture and water sources.

According to Engebak, the most serious effects of climate change are also likely to impact fragile areas like those in the Horn of Africa.

In the pastoralist districts of northeastern Kenya, the average distances to the nearest water points are 25-40km, while below four percent of people in nomadic/pastoralist areas of Somalia have access to safe water sources, the report said.
 
Despite the inherent challenges, these communities have continued to contribute to the economies of the region, Engebak said.

Ethiopia, which has the largest livestock population in Africa, relies on this as its second leading export earner after coffee. The camel population in Kenya is estimated to be worth 200 billion shillings (US$3 billion) with livestock production accounting for at least 10 percent of the gross domestic product.

The report recommends inclusive leadership, community involvement and budgetary reallocations, coordinated plans, policies and the role of nationl governments and international donors to improve the lives of pastoralists.

UNICEF’s report launch coincided with the start of Kenya Pastoralists' Week (KPW) - an annual advocacy event aimed at influencing policies affecting pastoralist communities.

According to the acting director of the Centre for Minority Rights Development (CEMIRIDE), Yobo Rutin, the pastoralist way of life is often seen as archaic and has suffered years of neglect from mainstream development.