Health Issues in Africa

Health Issues in Africa

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Ebola makes a comeback in Côte d’Ivoire

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Created by GC microbiologist Cynthia Goldsmith, this colourised transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion. Image credit: CDC/Cynthia Goldsmith, Public domain, via Wikimedia Commons

The Ebola virus arrested headlines earlier this year following an outbreak in the Democratic Republic of the Congo. Now, it’s back in the news with Côte d’Ivoire detecting its first case in more than 25 years.

The country’s Ministry of Health confirmed the news, after samples collected from an individual who had arrived from Guinea. This marks the first case of Ebola in Côte d’Ivoire since 1994. The individual in question – an eighteen-year-old girl – travelled to Côte d’Ivoire from Guinea, arriving in the country’s economic capital and largest city Abidjan on August 12th. The Pasteur Institute (Institut Pasteur) confirmed the case, with the patient receiving treatment in hospital. 

That the case was detected in a capital city is of concern, as World Health Organization (WHO) Regional Director for Africa Dr Matshidiso Moeti pointed out. “It is of immense concern that this outbreak has been declared in Abidjan, a metropolis of more than four million people,” she said. Nonetheless, she emphasised that “much of the world’s expertise in tackling Ebola is here on the continent and Côte d’Ivoire can tap into this experience and bring the response to full speed. The country is one of the six that WHO has supported recently to beef up their Ebola readiness and this quick diagnosis shows preparedness is paying off.”

The DRC experienced an outbreak of the Ebola virus earlier this year in its North Kivu province – its fourth in three years and twelfth overall. The outbreak was declared over on May 3rd, with WHO Director-General Dr Tedros Adhanom Ghebreyesus affirming the WHO’s commitment to “helping national and local authorities, and the people of North Kivu, [to] prevent the return of this deadly virus and to promote the overall health and well-being of all at-risk communities.” The outbreak witnessed eleven confirmed cases, one probable case, and six fatalities. 

A situation map of the Ebola virus epidemic in West Africa in 2014-16, as of November 30th, 2014. Notably, Côte d’Ivoire did not experience cases despite being a neighbouring country of Guinea, Liberia, and Sierra Leone which all experienced widespread transmission. Image credit: Mikael Häggström. Also updated by BrianGroen. Esperanto version included in separate layer by Piet-c., CC0, via Wikimedia Commons

Guinea also experienced an Ebola outbreak this year. “The Ministry of Health of the Republic of Guinea announced an outbreak of Ebola virus disease on 14 February 2021 after a cluster of cases was reported in the sub-prefecture of Gouécké, Nzérékoré Region,” the WHO said. “This was the first time the disease was reported in Guinea since the previous outbreak ended in 2016.” The outbreak was declared over on June 19th, following twelve confirmed cases and seven probable cases as well as twelve fatalities. 

Guinea was the epicentre of the 2014-16 Ebola outbreak in West Africa, which the WHO declared a public health emergency of international concern (PHEIC) on August 8th, 2014 – a designation which applies to “events with a risk of potential international spread or that require a coordinated international response” as the Centers for Disease Control and Prevention (CDC) explains. 

Widespread Ebola transmission occurred in Guinea, Liberia, and Sierra Leone. Italy, Mali, Nigeria, Senegal, Spain, the United Kingdom, and the United States also saw infections, with Italy, Mali, Nigeria, and the United States also experiencing instances of secondary infection. The WHO rescinded the PHEIC designation on March 29th, 2016. 

An infection control official teaches hygiene measures as part of Ebola control in Guinea. against Image credit: Lindsey Horton, CC BY 2.0 https://creativecommons.org/licenses/by/2.0, via Wikimedia Commons

It is as yet unclear as to whether the Côte d’Ivoire outbreak is linked to the outbreak in Guinea. Genome sequencing is underway as part of investigations into the origin of the new case and whether there is a link. In the interim, the WHO says it “is helping to coordinate cross-border Ebola response activities and 5000 Ebola vaccines doses which the organization helped secure to fight the outbreak in Guinea are now being transferred to Côte d’Ivoire, following an agreement between the ministries of health of Côte d’Ivoire and Guinea. An aircraft is departing Abidjan soon to collect the vaccines which will be used to vaccinate people at high risk, including health workers, first responders and contacts of confirmed cases. 

“WHO staff based in Côte d’Ivoire are supporting the investigation into the case. In addition, a multidisciplinary team of WHO experts covering all key response areas will be deployed rapidly to the field. They will help with ramping up infection prevention and control of health facilities, diagnostics, contact tracing, treatment and reaching out to communities to ensure they take a key role in the response.” Earlier this year, the International Coordinating Group (ICG) on Vaccine Provision, which includes the World Health Organization (WHO), UNICEF, the International Federation of Red Cross and Red Crescent Societies (IFRC), and Médecins Sans Frontières (MSF, or Doctors Without Border), announced a global Ebola vaccine stockpile to enable countries affected by outbreaks to vaccinate their populations in a timely manner should the need arise.

The Ebola virus is rare, but deadly. Symptoms include fever, aches, fatigue, a sore throat, loss of appetite, gastrointestinal issues, and unexplained bleeding or bruising. Preventative measures include vaccination, avoiding contact with bodily fluids of those who are sick or items which they have had contact with, and avoiding contact with the meat and bodily fluids of animals which are known vectors for the Ebola virus such as bats, forest antelopes, and nonhuman primates (such as monkeys and chimpanzees).

How a Malawi Village is Fighting Malaria and Saving Lives

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Malawi had nearly 7 million malaria cases last year, more than a third of the population, with 2,500 lives lost to the mosquito-borne disease. However, one village – Mwikala village in Machinga district – has become a model for how to eradicate malaria and in June was honoured as the first-ever to have zero malaria cases for a whole year. In June of this year, Malawi’s president, Lazarus Chakwera, honoured the village’s chief for reducing malaria infection and for recording zero cases since 2017. The village chief augmented the campaign by creating laws requiring villagers to use mosquito nets.

Mosquito Net for Protection against Malaria

“I have introduced the bylaws to prevent people from abusing mosquito nets,” said Yasin Mustapha, a senior chief for Mwikala village. “Some people would sell the free mosquito nets to fishermen. So, anyone disobeying the bylaws would pay a fine of $6. I use the money (to) buy a mosquito net, and I give it to those who don’t have (one).”

The village is fighting malaria and saving lives

For years, health experts and global health partners have been trying to help Malawi eliminate malaria. But after being on the list of the country’s top ten most affected districts for over 30 years, the numbers have plateaued. In 2012, a new plan, including a very powerful tool – applying high-volume insecticide-treated mosquito nets – seemed to be working. However, a drop in aid from the global health community meant that these nets weren’t being used on the scale to close the gap. And then in 2016, the country’s new president, Peter Mutharika, appeared to cut the budget for fighting malaria and the international NGOs funding efforts were threatened with suspension.

Why Malawi?

Malawi has an average of 24 malaria cases and deaths per every 100,000 people. Making a real difference Mwikala is a village of fewer than 3,000 people. Ninety per cent of the community lives in homes without a solid roof, the majority built of mud and sticks. And for the most part, malaria was a fact of life. “Everyone had it,” remembers Rejoice Ngolongoliwa, a local health worker who is also a grandmother of seven and a mother of five. “Especially during the rainy season, when the water from the hills comes into our villages, we had to be careful. When the mosquitoes came, that was when we began to get sick.

What makes this village so successful?

The village is small, but its inhabitants take pride in how their living conditions are so different from those of the rest of the country. “It’s a blessing to live here. We have good sanitation, food and water, everything is okay and we are friendly with each other. The ward councillor helps us in the village,” 50-year-old resident Sakhina Sango says. Sango is among those in Mwikala that know how to protect themselves against the disease and does everything she can to keep mosquitoes away. And they do this using very simple and cheap measures. “We can also use leafy branches and a few sticks to cover the windows in our houses,” she says, proudly. “They are effective in controlling mosquitoes.

The future

In a large number of tropical diseases, eradication and prevention are key to not only protecting human health but restoring the ecosystems upon which our livelihoods depend. Cured, reduced, or limited geographic areas of disease with high rates of infection like malaria prove that there is much more to eradicating these diseases than simply killing parasites in the environment. A healthy ecosystem is necessary for human health and when malaria is cut off, the ecosystem becomes less habitable and makes it much harder for humans to live healthy, productive lives.

South Africa: Mine Dumps Increase Asthma Risk

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Studies in South Africa have revealed that living close to a mine or exposure to mine dust is a risk factor for asthma, as well as other respiratory and bronchial illnesses.

Mining is a major industry in South Africa, with materials such as gold and coal having helped to boost the country’s economy. However, there are some problems with the industry, among them, being the potential health hazards. In particular, mine dumps, when mines dump large amounts of crushed, sandy refuse, are a point of concern. Two studies by Vusumuzi Nkosi, Janine Wichmann, and Kuki Voyi published in 2014 and 2015 examined the effects mine dumps had on nearby communities and the prevalence of illnesses such as asthma, rhinoconjunctivitis, and respiratory diseases. One study looked at the health of adolescents, while the other examined the elderly.

Writing in The Conversation, Nkosi, Special Scientist in Public Health for the South African Medical Research Council, said that the researched showed “exposure to mine dust or living close to a mine is a risk factor for asthma.” It revealed that there was a higher prevalence of asthma symptoms in children compared to studies in cities such as Cape Town. Older people near mine dump sites were also more likely to show asthma symptoms compared to similar studies carried out in the US.

This issue is one that affects many in South Africa, with around 1.6 million people living on or next to mine dumps. These often poor and marginalized populations already face other issues in relation to poor health and access to healthcare. However, even taking other factors into account, the two studies still found a clear link between mine dumps and respiratory conditions. The growth of asthma rates in South Africa is putting pressure on the health system, making it imperative to look for solutions.

Nkosi suggests that the answer lies in long-term solutions for dust control. He says that research should be carried out to determine the determine and implement the best solutions. Previous attempts by mining companies to solve the problem have not been sufficient. For example, spraying mining dumps is often rendered useless when the water quickly dries up. Rehabilitating areas by growing grass, designed to catch the dust, only works until the dry season kills the grass. Nkosi offers the possibility of buffer zones between mining areas and settlements.

As populations close to mining areas continue to grow, asthma and other respiratory conditions could become a greater burden on the health system. It’s important to address this issue before it creates an even larger burden, contributing to that of non-communicable diseases in the country.

Asthma is not the only concern, either. Mine dump often contains toxic heavy metals and, in communities like those in Soweto, Johannesburg, it is killing plants and animals, as well as directly affecting people’s health. Both mining companies and the government need to take action to find solutions for the people living in these communities. However, some mining companies deny that there is a problem.

Nigeria: Using Technology to Improve Healthcare

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Technology is being employed all over the world to improve healthcare. In Nigeria, technology is being hailed as the answer to poor healthcare by experts. The Future of Health Summit was held by Philips Africa and Forbes Africa, designed to provide an event to discuss Nigerian and African investment in healthcare technology. A survey recently carried out by Royal Philips revealed that the expectations Nigerians hold of their healthcare system don’t line up with the care that they receive. Only 36 percent of Nigerians think that their healthcare needs are met by the current system, but experts at the Future of Health Summit think that technology can change that.

In particular, preventative care was highlighted as a major area that needs focus. Chief Executive Officer of Philips Africa, Jasper Westerink, said that a more sustainable healthcare system could be created with more work and investment put into preventative care. He said that “The results also reinforce the need for the national government to invest a significant percentage of its healthcare budget towards medical research, preventive care, acute care and general health education.”

Philips wants to raise awareness of how lifestyle factors can influence health. Using technology, they can encourage healthier lifestyle habits. Philips manufactures both hospital-grade technology and gadgets that can be used in the home, from smart toothbrushes to air filters.

Speaking to The Guardian, one of the issues that Westerink has highlighted is the importance of early detection. Screening for health problems using imaging solutions and early detection methods helps to prevent and manage illnesses and other issues. He has suggested that telehealth and remote health could play an important role, making health services more accessible to a wider range of people. This can be used in combination with artificial intelligence, which helps to reduce the need for medical professionals being present everywhere. He says that even people who aren’t medically trained can be taught to carry out scans and perform other tasks, and full-sized medical equipment isn’t necessary to do these things.

Speaking at the Future of Healthcare Summit, Westerink said, “We believe that sustainable healthcare development requires a system-wide approach, combining technology, capacity-building including training, service and maintenance, as well as long-term financing. To that end, we aim to expand access to quality and affordable healthcare across the country and compliment significant efforts to strengthen Nigeria’s growing health sector.”

Another issue raised at the event included the problem of brain drain from African countries – Nigeria’s smart, educated professionals in not just medicine but science, technology and other areas are choosing to find work elsewhere. One of the answers to this could lie in technology. Offering better access to technology, along with higher wages, better benefits and improved working environments could encourage Nigeria’s smartest to stay, instead of choosing to build their lives overseas.

Clare Omatseye, President of Healthcare Federation of Nigeria, said that “With technology being a major driver of change, especially today when patients are digitally empowered, healthcare solutions must be incorporated into everyday innovations and meet patients at their point of need.”

The Greatest Health Issue In Africa Today Is Not What You Would Expect

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If you pay attention to latest news stories, you might assume that the biggest issues for Africa are communicable diseases such as Ebola or yellow fever. While diseases like this are certainly a concern, it is worth pointing out that Africa is slowly but surely finding the solutions to these problems. Take Ebola for instance.

In May of 2018, the ninth outbreak of Ebola in the Congo seemed to be at risk of spreading to Mbandaka, a city with a population of 1.2 million. However, there has recently been promising updates in this area. For instance, experimental drugs are being used to treat the disease, including a vaccine known as rVSV-ZEBOV. This vaccine is being used to treat people with the condition in rural areas as well as cities. As such, there is hope for the future of treatments for communicable diseases in Africa.

So, if this isn’t the main problem that the continent is facing, what is? The answer lies in the current growth of noncommunicable diseases or NCDs.

The Thread Of NCDs

This includes cancer, cardiovascular disease, and diabetes. Recent reports reveal that NCDs are responsible for 50% of the deaths in many countries across Africa.

Indeed, by 2030 the World Health Organisation believes that the toll will be equal to the number of deaths caused by communicable diseases, malnutrition, and newborn deaths totalled. The WHO has also revealed that there are several key factors causing the growth of this issue in Africa. For instance, adoption of unhealthy lifestyles and a greater level of prosperity will have an impact with a recent report in the New York Times revealing that obesity could become a new epidemic in the continent. This is combined with the fact that an estimated two billion people across the world cannot get the medicines that they need.

Government Response

African governments are responding to the threat of NCDs in their countries, and one of the main ways that they are tackling this issue is with education. They are hoping that by providing the public with information about physical inactivity, high levels of drinking and even smoking that they can prevent the rise of some of these conditions.

However, the World Bank believes that treatment will still become an important aspect of expenditure for Africa in the next few years.

Ultimately, it is going to be important to ensure that the public can gain access for the treatment that will be necessary as these conditions continue to grow and develop. One of the issues with this is the cost. It is true that low government spending can lead to problems with the supply of drugs and medicine needed for noncommunicable diseases.

There are various solutions to this issue including value-based pricing. Introducing value-based pricing, the cost of treatment for health issues is determined by the impact that that particular treatment could have on the prosperity levels or even the economy of the country. This is just one of the potential solutions that should be explored when attempting to solve the growing problem of NCDs in the future.