September 2020 - WACI Health

GFAN Africa

September 29, 2020 byWACI Health Secretariat

To Defeat COVID-19 and Save Lives, We Must Invest Additional Resources for Health

2020 has taken each one of us aback. COVID-19 struck and disrupted health, school, businesses, travel, play, prayer, and livelihoods. We have had to make decisions that affect our health in a way only seen and done in health facilities. While going out to the shop, we have to wear a mask and sanitize and the body temperature had better be right. COVID-19 has reminded us basic facts – that we must first secure our health and then we can deal with other facets of our lives. Public health is a pre-requisite to social, economic and political stability.

Gradually, and gladly so, the lockdown measures are easing. One major move to ease the lockdown is the announcement by the Cabinet Secretary of Education Prof. George Magoha on the re-opening of schools. Great news indeed. There are health risks related to schools being closed. For some children, schools are nutrition centers that also offer psychosocial support. For some girls, being out of school can mean greater risk of sexual exploitation, early pregnancy, forced marriage and HIV infection. The longer a girl is out of school, the less likely that she will return. Education, like health, narrows inequalities, is a driver for sustainable development, breaks down cycles of poverty and opens up a world of possibilities.

As COVID-19 fades away, the aftermath will remain with us for years to come as intensive efforts to find therapeutics, treatment and a vaccine continue. When Kenya was put in lock down, access to healthcare services dwindled. People were afraid of going to health facilities when they fell ill for fear of having COVID-19 and for fear of related stigma. This has resulted in the possibility of increased incidence of other killer diseases such as HIV, TB and malaria presenting fresh and unprecedented health challenges.

A modelling report by the Stop TB Partnership indicates that as a result of the COVID-19 pandemic, global TB incidence and deaths in 2021 would increase to levels last seen in between 2013 and 2016 respectively – implying a setback of at least 5 to 8 years in the fight against TB.

We must see the fight against COVID-19 and other diseases such as HIV, TB and malaria as one fight. Measures to mitigate the impact of COVID-19 on HIV, TB and malaria should involve a combination of intensive community engagement and maintaining awareness of the importance of services to defeat the three diseases while emerging from the COVID-19 response. Programs must identify and address gender inequalities in their design and response. One approach is to meaningfully engage women, supporting primary healthcare services needed to reduce child and maternal mortality; and supporting caregivers, who are mostly women, caring for those who fall ill from COVID-19 or other causes. Gender barriers to health must be removed.

Further, as we tackle COVID-19, health advocates, partners and our Government must ensure that the response to COVID-19 includes lessons learned from the fight against HIV, TB and malaria. Human rights be protected; stigma and discrimination must be addressed. The available COVID-19 resources be shared equitably. When treatment and a vaccine is found, it should be available to everyone, one everywhere for free. So that no one is left behind.

Lastly, COVID-19 will not be the last pandemic. The next pandemic must find Kenya better prepared, ready with strong and resilient health systems with a strong focus on primary healthcare founded on strong community health systems. A rights-based, equitable, people-centered system that is conscious of other factors that affect health and wellbeing such as climate change, food and housing.

To achieve these successes, I urge the Government to invest additional domestic resources for health to build back better for a healthier future for all Kenyans. That health is one of the pillars of the Big 4 agenda is a sign of President Kenyatta’s commitment to health. Health is an investment in human capital and a key factor to the development of our country.

I urge for efficient, effective and affordable healthcare for every Kenyan, wherever they are.

Maurine Murenga is the Executive Director of Lean On Me Foundation

September 28, 2020 byWACI Health Secretariat

Cecilia Senoo: To defeat Covid-19, protect progress against HIV, TB and Malaria and save lives, we must unite to fight

Covid-19 struck and disrupted health, school, businesses, travel, play, prayer, and livelihoods. We have had to make decisions that affect our health in a way only seen and done in health facilities. While going out to the shop, we have to wear a mask and sanitize and the body temperature had better be right.

Covid-19 has reminded us of basic facts – that we must first secure our health to be able to deal with other facets of our lives. Public health is a pre-requisite to social, economic and political stability. That leads me to emphasize that investing in population-based services for preventing, detecting and responding to disease is needed for development.

Government must increase investments in health

When countries including Ghana were put in lockdown, access to healthcare services dwindled. People were afraid of going to health facilities when they fell ill for fear of having Covid-19 Stigma.

There was fear of catching Covid-19 at the health facility. This has resulted in the possibility of increased incidence of other diseases such as HIV, TB and malaria presenting fresh and unprecedented health challenges.

HIV, TB and malaria services were largely disrupted during the lockdown. A modelling report by the Stop TB Partnership indicates that as a result, global TB incidence and deaths in 2021 would increase to levels last seen in between 2013 and 2016 respectively – implying a setback of at least 5 to 8 years in the fight against TB, due to the Covid-19 pandemic.

A report by UNAIDS posits that the HIV response could be set back further, by 10 years or more, where Covid-19 has caused severe disruptions. Malaria prevention programmes were interrupted such as in the delayed distribution of mosquito nets.

Schools have been closed for months and gladly, they are gradually re-opening. For out-of-school girls, this can mean a greater risk of sexual exploitation, early pregnancy, forced marriage and HIV infection. The longer a girl is out of school, the less likely that she will return. The level of risk is enormous.

Countries must then focus on how best to accelerate the restoration of services, to bring the disease burden under control.

Measures to mitigate the impact of Covid-19 on HIV, TB and malaria should involve a combination of intensive community engagement and maintaining awareness of the importance of services to defeat the three diseases while emerging from the Covid-19 response. Programs must identify and address gender inequalities in their design and response.

One approach is to meaningfully engage women, supporting primary healthcare services needed to reduce child and maternal mortality; and supporting caregivers, who are mostly women, caring for those who fall ill from Covid-19 or other causes. Gender barriers to health must be removed.

Further, as we tackle Covid-19, health advocates, partners and governments must ensure that the response to Covid-19 includes strategies and lessons learned from the fight against HIV, TB and malaria and resources are allocated towards this.

Human rights must be protected; stigma and discrimination must be addressed. The available Covid-19 resources must ensure equitable access to screening, testing and treatment. When treatment and a vaccine is found, it should be available to everyone, one everywhere for free. So that no one is left behind.

This calls for a solid global collaboration to acceleratethe development, production and equitable access to new Covid-19 technologies.

Lastly, Covid-19 will not be the last pandemic. The next pandemic must find us better prepared, ready with strong and resilient health systems with a strong focus on primary healthcare founded on strong community health systems. A rights-based, equitable, people-centred system that is conscious of other factors that affect health and wellbeing such as climate change, food and housing.

To achieve these successes, the government of Ghana must invest additional domestic resources for health to build back better for a healthier and safer future. The government must consider health as an investment in human capital in the realization that health is a key factor in the development of our country.

We unite to fight and the beat continues for efficient, effective and affordable healthcare for everyone, everywhere.

Source: https://www.myjoyonline.com/opinion/cecilia-senoo-to-defeat-covid-19-protect-progress-against-hiv-tb-and-malaria-and-save-lives-we-must-unite-to-fight/

Cecilia Senoo is the Executive Director, Hope for Future Generations
and Focal Person-GFAN-Africa

Article WACI Health News

September 16, 2020 byWACI Health Secretariat

Breastfeeding pegged on reduced maternal mortality

The World Breastfeeding Week, which runs from August 1 to 7, annually aims at focusing attention on the need to mothers to breastfeed their infants exclusively for the first six months of life.

This year’s theme was’ Support breastfeeding for a healthier planet’.

Unfortunately, unacceptably high number of women do not enjoy this privilege of breastfeeding their children because they never make it out of the delivery room alive.

Excessive bleeding or post-partum haemorrhage during or after child birth is the single highest killer of mothers in Africa.

According to the World Health Organisation (WHO) at least 295,000 women died during birth in 2017.

MATERNAL DEATHS

Sub-Saharan Africa alone accounts for roughly two-third (196,000) of these global maternal deaths. This in itself is unacceptably high.

Mothers need to stay alive to provide their children with the best possible start in life – breastfeeding.

Breastfeeding delivers health, nutritional and emotional benefits for children and it forms part of a sustainable food system. Unfortunately, this is not a possibility for mothers who lose their lives while delivering their babies.

WHO, based on extensive new evidence, issued two recommendations for prevention and treatment of bleeding in women and included two new medicines in the WHO model list of essential medicines in 2019.

If these recommendations are implemented, they will contribute to the reduction in maternal mortality especially in low and middle income countries.

BLOOD LOSS

Administration of an eﬀective uterotonic (these are drugs that help the uterus to contract and helps reduce blood loss during child birth) immediately after the birth of the baby has been shown to prevent PPH caused by the uterus failing to contract and is recommended by the WHO for all births.

Currently, most low and middle-income countries use oxytocin injection as the first line medicine for the prevention and treatment of PPH.

Oxytocin is a heat sensitive product that degrades when it is not kept refrigerated with temperatures of 2-8 °C (35-46 °F) throughout the supply chain, which can result in reduced effectiveness at the time of use, particularly in countries where reliable electricity and cold-chain may not be available.

Most countries in Africa use Oxytocin, a drug to stop bleeding during or after pregnancy, which requires cold chain. Many hospitals lack refrigeration facilities and also experience erratic power supply hence the efficacy of the drug becomes compromised. There are also many fake products in circulation.

COVID-19

Covid-19 has shown us that most of our health-care facilities are compromised in dealing with the pandemic be it human resource or equipment.

While most African countries have stepped up and working on strengthening their healthcare systems, we should not forget the fact that maternal mortality still remains high in this region and that there is a cost effective solution available especially in our resource stretched economies.

The 2018 recommendations issued by WHO for drugs that support the uterus to go back to ‘its setting” after delivery now includes heat stable carbetocin as an option for prevention of bleeding for all births by a skilled birth attendant.

This particular drug is heat stable and a new formulation which retains its effectiveness for at least 36 months when stored at temperatures up to 30 degrees Celsius.

TRAUMA PATIENTS

Another drug that has been in use for years in reducing blood loss during surgery for trauma patients – Tranexamic Acid – is also part of the recommendation. While it had previously not been a go-to drug for reducing bleeding during birth, WHO has now included in the 2019 list of essential medicines with an obstetric indication- treatment of Post-Partum Haemorrhage (PPH).

These medicines, some new but some not so new are much needed on a continent that should not be losing mothers when there are ways to prevent it. While these medicines have been included in the essential drugs list by WHO, most African countries are yet to include them on their country’s lists.

For mothers to continue breastfeeding, they need to stay alive after delivery. To achieve this, we need to include drugs that work and that can maintain their efficacy even in resource strapped areas to save the lives of mothers and to contribute to the reduction of maternal mortality.

Joyce Ng’ang’a is the Policy Advisor at WACI Health

GFAN Africa

September 16, 2020 byWACI Health Secretariat

The Global Fund in Ghana : Visit of the French Ambassador

On the occasion of the 6th Global Fund Replenishment Conference, held in Lyon (France) on October 10, 2019, the Ambassador of France to Ghana visited a facility that benefited from the Global Fund (Maamobi General Hospital), met with members of the Country Coordinating Mechanism (CCM) and beneficiaries. c128dca21ed80e4a5e3e909d125f59 4c74c

The French Ambassador, Anne Sophie AVE, went to the Maamobi General Hospital in Accra where she was welcomed by the Director, Dr. Dorcas ANFU OKINE and various care staff of the establishment as well as the CCM Chair, Ms. Cecilia SENOO. She was able to meet with the National Disease Control Programs (NACP), the National AIDS Control Program (NACP), the National Tuberculosis Program (NTP), and the National Disease Control Program (NTP). She also visited the maternity ward where she met pregnant women and young mothers receiving Global Fund-funded treatment.

She then met with members of the CCM as well as representatives of the Ministry of Health and the Ghana Health Service to discuss the modalities for strategic management and monitoring of grants.

The end of the morning was dedicated to a meeting with direct beneficiaries of the Global Fund. H.E. the Ambassador AVE was able to speak with Mrs. Comfort ASAMOAH-ADU, Executive Director of the WAPCAS (West African Program to Combat AIDS and STIs), the main recipient of the Global Fund. This sequence was an opportunity to discuss with different beneficiaries and affected communities about their backgrounds and the challenges they face.

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The Global Fund has several objectives: maximizing the impact of actions against HIV / AIDS, tuberculosis and malaria; building resilient and sustainable health systems; promotion and protection of human rights and gender equality and the mobilization of resources.

Since 2002, when it was created, more than $ 40 billion has been allocated to 140 countries to fight these three pandemics. By 2018, programs supported by the Global Fund to Fight HIV, Tuberculosis and Malaria have saved 32 million lives worldwide.
Ghana, the first recipient of a Global Fund grant, has received cumulative disbursements of US $ 817 million since 2002, including about US $ 110 million from France.

Malaria remains a leading cause of death in Ghana, but since 2006 significant progress has been made in reducing prevalence, incidence and mortality. Tuberculosis is treated successfully in 85% of cases, but screening coverage is still low, as is the case for HIV. HIV / AIDS remains a significant cause of death and prevalence is high among key populations (sex workers, men who have sex with men). New HIV infections do not decrease (19,100 cases / year in 2017), the number of people living with HIV is estimated at 320,000 in 2018.

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On October 10, 2019, France hosted the 6th Global Fund Replenishment Conference in Lyon, meeting the financial needs for the 2020-2022 periods with a financial target of $ 14 billion to help save $ 16 million lives and avoid 234 million new infections in 2030.

The States present at this Conference have met their commitments: the Fund has collected $ 14.02 billion in pledges, including $ 1.4 billion from France, which remains the second largest contributor to the Global Fund since its creation in 2002, after the United States.

Global Fund resources alone will not be sufficient and the Government of Ghana will undoubtedly need strengthen its efforts through increased health budgets to eradicate the 3 pandemics.

GFAN Africa Run4TB

September 11, 2020 byWACI Health Secretariat

To Defeat COVID-19, Protect Progress against HIV, TB and Malaria, and Save Lives, We Must Unite to Fight

On 3 September, GFAN Africa, CS4ME and the Africa Coalition on Tuberculosis organized a webinar titled Dialogue on the HIV, TB and Malaria Response Amid COVID-19. The webinar is one of the series of activities organized by GFAN Africa as part of the #TheBeatContinues campaign in efforts to defeat COVID-19 and mitigate its effects of the disease on HIV, TB and Malaria. In her remarks, Linda Mafu the head of Civil Society and Political Advocacy at the Global Fund noted that COVID-19 is a global emergency that requires a global response. She emphasized that in the spirit of UHC, no one should be left behind. She called for deep community engagement as communities are most affected by COVID-19; which has resulted in increased out of pocket spending leading to more poverty and increased vulnerability to HIV, TB and malaria

Maurine Murenga a community leader and a global health advocate noted that during crises, girls and women suffer the most. “When girls are out of school for long, as has been occasioned by COVID-19, they are less likely to go back. While in school, they are less likely to engage in sex and are less vulnerable to HIV”. She underscored the need for a gender sensitive approach to the COVID-19 response. In addition, she noted that economies have been weakened by COVID-19. She called for civil society creativity in advocacy for the allocation of increased domestic resources for health. “This year is tough in the fight against malaria. There have been difficulties and delays in distributing mosquito nets because of the COVID-19 disruption” noted Olivia Ngou the Executive Director of Impact Sante Afrique. She added that the situation is further complicated because communities are avoiding visiting health facilities when they have a fever. She emphasized the need for increased advocacy at community level to encourage communities to seek healthcare services when they have a fever or fall ill. She added that the protection of frontline healthcare workers is of utmost importance.

Here are the key messages from the webinar

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To defeat COVID-19 and safeguard the critical fight against HIV, TB & malaria, additional domestic and international funding is needed. We must measure success not just in reducing the death toll from COVID-19; but also in reducing the impact of the pandemic, including the knock-on effects on existing diseases. Without additional funding to fight COVID-19, countries will; be unable to deliver on their targets for lifesaving services for ongoing HIV, TB and malaria programs; be unable to purchase personal protective equipment (PPE) to protect their health workers, putting their lives at risk and contributing to ongoing transmission of the virus; and be unable to purchase additional COVID-19 tests or treatments that are critical to fighting the virus and saving lives.

To defeat COVID-19, the response must address gender barriers, stigma & discrimination, and protect human rights. The global response to COVID-19 must take lessons from the fight against HIV, TB and malaria. These include ensuring that the response protects human rights and address stigma and discrimination and removes gender and human rights barriers to health.

To defeat COVID-19, protect progress against HIV, TB and malaria, and save lives, we must unite to fight. Diseases do not respect borders. The COVID-19 pandemic makes it clear that our global health security is only as strong as the world’s weakest health system. Around the world, people are uniting to fight. Health workers, governments, businesses, technical agencies, advocates and individuals are working together to continue the fight against infectious diseases and save lives. The Global Fund, the largest multilateral investor in grants for health systems worldwide, has provided immediate funding of up to US$1 billion to help countries fight COVID-19, mitigate the impact on lifesaving HIV, TB and malaria programs, and prevent fragile health systems from being overwhelmed. As advocates across the Africa region we are uniting to fight.

We #UniteToFight HIV, TB, Malaria and COVID-19 to save lives and so #TheBeatContinues