By Adedapo Adesanya
Nigeria and the World Health Organisation (WHO) are seeking to eliminate a severe and often lethal mouth disease, Noma.
Nigeria has developed and implemented the programme’s national action plan for Noma prevention and control in collaboration with WHO and other partners.
The Nigerian Ministry of Health has integrated Noma into its existing surveillance system and incorporated it into the curricula of all national and district health professional schools, while the country now commemorates an annual National Noma Day in November each year.
Funding from WHO, as well as Médecins Sans Frontières (MSF), has also helped the Ministry to scale up training of primary care workers, with 741 having received training on noma in 2021 and the first half of 2022.
On Thursday, WHO launched a new free and interactive online Noma course through OpenWHO, the first WHO platform to host unlimited users during health emergencies.
“This course will be a useful self-learning tool for health workers to increase their capacity to prevent, identify, treat and refer noma considering both public health and human rights aspects.
“Officers in charge of noma at the national and district level can also utilize the course material to train primary care workers,” says Yuka Makino, a technical officer for oral health at the WHO Regional Office for Africa.
In the absence of reliable epidemiological data, a 1998 World Health Organization (WHO) global estimation of 140,000 new cases yearly remains the most widely cited source on noma. The majority of these cases are found in sub-Saharan Africa in children between the ages of two and six.
Even for those who ultimately survive the disease, if not treated immediately, it takes mere days for them to be left with severe facial disfigurements that make it hard to eat, speak, see or breathe. In turn, this often leads to severe stigmatization within their communities and a range of accompanying human rights violations.
“We’ve had cases where when the patient presents to the hospital, the whole of the lower jaw is already gone, or the whole of their nostril pathway is gone,” says Dr Abubakar Abdullahi Bello, Chairman of the Medical Advisory Committee at Sokoto Noma Children’s Hospital.
“But if the cases present to the hospital early, then they don’t have such issues. That’s what we are advocating for. With early admission, we can also reduce the duration of the stay in the hospital and these patients will not require surgical intervention.”
Noma can be prevented by basic public health interventions such as improving nutrition and oral hygiene; controlling comorbidities such as measles, malaria and HIV infection; and improving access to routine vaccinations.
In recent years, Nigeria has sought to increase awareness of noma and scale up its response activities as part of a commitment to eliminate the debilitating disease. Since 2016, it has been among 10 priority countries to form part of the World Health Organization’s (WHO) African Regional Noma Control Programme.
WHO, Edo Intensify Response to Combat Monkeypox
By Adedapo Adesanya
The World Health Organisation (WHO) and the Edo State government have intensified a coordinated response to contain the spread of the Monkeypox disease.
So far, Nigeria has reported 357 suspected cases with 133 confirmed monkeypox cases from 25 states – Lagos, Adamawa, Delta, Rivers, Edo, Bayelsa, Nasarawa Plateau FCT, Ondo, Anambra Cross River, Kwara, Borno, Taraba, Oyo, Imo, Kano, Katsina, Gombe, Niger Ogun, Kogi, Bauchi, Akwa Ibom and Abia.
Meanwhile, eight persons have so far tested positive for monkeypox in Edo state, and all the people diagnosed with the disease have recovered.
The Director, Public Health, Edo State Ministry of Health, Dr Ojeifo Stephenson, said it has become imperative to warn the residents of the state about the health risks that the virus poses and reiterate the need to be cautious and adhere to preventive measures.
He said the state Ministry of Health with support from the World Health Organization (WHO) and partners, has ramped up surveillance, diagnostics and other activities to curb the spread of infectious diseases.
“We have stepped up surveillance including prompt investigation of suspected cases, facilitating documentation of contacts, contact tracing and monitoring, as well as developed and disseminated public health advisory to raise awareness about the disease among residents of the state,” he said.
Additionally, Dr Benson Okwara, who works at UBTH, said WHO has been an invaluable partner in the response to monkeypox diagnosis and treatment in the facility.
Dr Okwara has five years of experience in managing patients with monkeypox.
He lamented that the disease spreads within the communities because of the poor health-seeking behaviour and late presentation of the case to the hospital.
“However, with WHO’s coordination, there is an early response following notification of suspected/confirmed cases with detailed case investigations using the monkeypox case investigation form (CIF) to collect data on patient contacts.
“There is a need for continuous risk messaging to educate people about infectious diseases and the importance of seeking medical care early and at appropriate health facilities to prevent the spread of diseases,” he said.
Across Nigeria, the Nigeria Centre for Disease Control (NCDC), supported by WHO, has activated Monkeypox Emergency Operations Centre to strengthen in-country preparedness and contribute to the global response to the outbreak.
Furthermore, WHO is supporting the coordination of technical assistance and operational support of partners, including the national One-health risk surveillance and information sharing (NOHRSIS) group, to facilitate timely information exchange on all prioritized zoonotic diseases.
Monkeypox is a zoonotic disease endemic in Nigeria and some parts of Africa.
However, there has been sporadic spread to other countries as more than 16,000 cases of monkeypox have been reported across more than 70 countries so far this year, and the number of confirmed infections rose 77 per cent from late June through early July.
The virus is being transmitted from animals to humans.
Recently, WHO activated its highest alert level for the growing monkeypox outbreak, declaring the virus a public health emergency of international concern.
WHO to Help Nigeria Achieve NHIA Act 2022 Objectives
By Adedapo Adesanya
The World Health Organization (WHO) has expressed its desire to support Nigeria in operationalising the National Health Insurance Authority (NHIA) Act 2022 signed by President Muhammadu Buhari in May 2022.
WHO’s Country Representative (WR), Dr Walter Kazadi Mulombo, made this pledge during a high-level meeting with the Secretary to the Government of the Federation (SGF), Mr Boss Mustapha, the Director General, National Health Insurance Authority (NHIA), Professor Mohammed Sambo, and a team of WHO Health Financing Mission delegates from the WHO Geneva, Africa Regional Office, and Nigeria.
The first ever high-level WHO Health Financing Mission to Nigeria, led by Dr Joseph Kutzin, was scheduled to provide sustainable health financing support to the country towards Universal Health Coverage (UHC) and health security while undertaking targeted advocacy to accelerate operationalization of the NHIA Act including the Vulnerable Group Fund (VGF).
This is in line with WHO’s goal of ensuring that all individuals and communities receive the quality health services they need without suffering financial hardship.
Dr Mulombo said President Buhari’s signing of the NHIA Bill into law will make health insurance mandatory for all legal residents in Nigeria and expands coverage to over 83 million poor and vulnerable people.
He expressed the optimism that government will prioritize immediate appropriation of the Special Intervention Fund in the Act to establish the Vulnerable Group Fund.
“Indeed, the task of ensuring that all citizens have access to the quality healthcare they need without falling into poverty is a deliberate political decision to achieve the cardinal objectives of population coverage, service coverage, and financial protection. I have no doubts that in a large federal nation like Nigeria, this milestone of appropriating the Special Intervention Fund will be achieved in the 2023 fiscal year”, he said.
In his remarks, Mr Mustapha appreciated WHO as the foremost development partner to Nigeria on health and lauded WHO’s invaluable guidance, particularly on the COVID-19 pandemic.
“WHO has demonstrated that it is an organization that cares for and caters for the health needs of the people. On the NHIA, let me commend the DG for his tenacity and determination to have this Act come to fruition. I want to thank WHO and other partners who supported in the drafting of the Bill. This modest attempt has provided basic health insurance coverage to the vulnerable, and making it mandatory will go a long way in assisting our people to manage their income and remain at work in terms of the depressed economy we are witnessing”.
The SGF further expressed the government’s commitment to appropriate the Special Intervention Fund (SIF) in the 2023 national budget for the establishment of the Vulnerable Group Fund (VGF).
“No family in Nigeria has economically survived catering for any of their own suffering from cancer. The health of our people is therefore topmost on our priorities despite competing demands”, he stated.
Monkeypox: Russians Are Back With Cheap Health Publicity
By Kestér Kenn Klomegâh
With rising cases of the monkeypox virus, Russians are back seeking again cheap health publicity in Africa. Just as Foreign Minister Sergey Lavrov completed his four African-nation tours, Russia plans to send monkeypox test kits to Egypt, Uganda, Ethiopia and Congo.
Russian consumer health watchdog Rospotrebnadzor said in a media statement that Russian test systems to diagnose monkeypox would be provided to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July.
“Rospotrebnadzor is continuing to extend support to partner countries’ efforts to counter the spread of monkeypox. Test systems produced by Rospotrebnadzor’s Vector Research Center will be handed over to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July,” the press service said.
“Furthermore, Rospotrebnadzor specialists are arranging special workshops for colleagues from partner countries that deal with laboratory methods to diagnose monkeypox,” it said.
Rospotrebnadzor said earlier that the Vector Research Center had produced monkeypox test kits, and such testing is currently available in all Russian regions.
Monkeypox is a rare infectious disease, most common in remote parts of Central and West Africa. Its symptoms include nausea, fever, rash, itch and muscle pain.
On July 12, Rospotrebnadzor announced the first national case of monkeypox: the patient had returned from Portugal. His symptoms were mild and did not endanger the patient’s life. Rospotrebnadzor said that all his contacts had been promptly identified and were under medical monitoring. The threat of spread has been contained.
Faced with a surge in monkeypox cases, the World Health Organization (WHO) has already declared the outbreak of monkeypox as a global health emergency — the highest alarm it sounded. Monkeypox has affected over 15,800 people in 72 countries, according to a tally by the US Centers for Disease Control and Prevention (CDC) published on July 20.
WHO, however, warned against discrimination. “A failure to act will have grave consequences for global health,” Lawrence Gostin, the director of the WHO Collaborating Center on National and Global Health Law, said on Twitter.
Some experts have asked why Russians have not chosen African countries such as Nigeria, or regions such as Central and West Africa where the virus is currently spreading most. But have listed as priority countries that Sergey Lavrov visited on 24-27 July: Egypt, Ethiopia, Uganda and the Republic of the Congo.
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