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Hope Rises for Malaria, Ebola ‘Elimination’
Date Posted: 20/Jun/2019
There is renewed hope in the horizon that deadly diseases such as malaria and Ebola could be eliminated soon.
 
Besides the fact that a ‘deadlier’ disease such as smallpox has been eliminated globally, the World Health Organisation (WHO) has certified Paraguay, Algeria, Iran, Malaysia and Timor-Leste malaria-free.
 
Also, many other countries have made impressive strides in controlling and stamping out malaria.
 
In 2016, the WHO identified 21 malaria-endemic countries that could feasibly eliminate the disease by 2020. Together, these countries form the “E-2020 initiative” and are part of a concerted effort to drive indigenous malaria cases to zero within the 2020 timeline.
 
In 2018, Paraguay became the first E-2020 country to be certified by WHO as malaria-free, and this year Algeria was awarded the same status. Three other countries – the Islamic Republic of Iran, Malaysia and Timor-Leste – achieved zero indigenous cases of malaria in 2018. China and El Salvador, meanwhile, have been at zero since 2017, and Cabo Verde has been malaria-free since January 2018.
 
China is celebrating a major health achievement: the country has not recorded a single indigenous case of malaria since August 2016. This is a notable feat in a place where the disease has historically taken a huge toll. In the 1940s, there were an estimated 30 million cases of malaria and 300,000 deaths each year.
 
WHO’s Global technical strategy for malaria, adopted by the World Health Assembly in 2015, calls for the elimination of malaria in at least 10 countries by the end of next year.
 
WHO grants a certification of malaria elimination when a country has proven, beyond reasonable doubt, that the chain of indigenous transmission has been interrupted nationwide for at least the previous three consecutive years. In addition, a national surveillance system capable of rapidly detecting and responding to any malaria cases must be operational, together with an appropriate programme to prevent re-establishment of transmission. To date, 38 countries and territories having been certified malaria-free by WHO.
 
Once the WHO’s Malaria Elimination Certification Panel verifies that a country is malaria-free, however, countries cannot be complacent. Two years after Sri Lanka was certified free of malaria, an imported case from neighbouring India led to local transmission; Sri Lankan authorities quickly responded and prevented any further cases.
 
Malaysia faces significant challenges of the disease being brought in from returning Malaysians who work outside the country in professions that are at high risk of malaria, such as plantation workers and loggers. Many other countries have porous borders, including China and Myanmar, where every morning Chinese market sellers traverse the border into Myanmar, and children from Myanmar cross over for free schooling in China.
 
Also, a preliminary risk assessment conducted by the Nigeria Centre for Disease Control (NCDC) found that the overall risk of importation of Ebola Virus Disease to Nigeria from the Democratic Republic of the Congo (DRC) and Uganda is low.
 
Director, Prevention and Programmes’ Coordination, NCDC, Dr. Joshua Obasanya, told journalists, that the centre is monitoring the Ebola Virus Disease (EVD) outbreak in the DRC and recent cases in Uganda. Obasanya, in a statement, said the Nigeria Ebola Preparedness team, coordinated by the NCDC, has conducted a preliminary risk assessment following the recent confirmation of EVD in Kasese District of Uganda.
 
According to the NCDC, outbreaks of EVD are known to bear risk of international spread hence the rationale for continual evaluation of Nigeria’s potential risk amidst regional trade and flight route within the region. “Based on available data, the overall risk of importation of EVD to Nigeria remains low. This is also in line with the WHO’s risk assessment for Nigeria. There are no direct commercial flights and no known direct trade routes to Nigeria from Uganda. The current transmission pathway of the disease in Uganda is through unmanned land borders and further away from the capitals of both Uganda and Nigeria,” the Obasanya said.
 
The centre, however, said the Nigeria Ebola Preparedness Team has put in place several measures to ensure adequate preparedness.
 
The NCDC explained: “Our national Emergency Operations Centre (EOC), situated at the Incident Coordination Centre (ICC) in NCDC Abuja, is functional and currently in Alert Mode for EVD. Our team of national first responders are on standby and ready for deployment within 24 hours when the need arises. Public Health EOCs (PHEOCs) in States where major points of entry are located (Lagos, Kano, Abuja and Port Harcourt) are also on standby. We have improved point-of-entry screenings in major airports; the Port Health Services unit of the Federal Ministry of Health is on alert and has heightened screening measures at entry points at our ports.
 
“In addition to the above, designated treatment centres and isolation facilities have been identified. Nigeria currently has in-country capacity for the diagnosis of EVD within NCDC’s National Reference Laboratories. Our risk communications technical working group has developed an All Infectious Diseases Risk Communication Plan, and coordinates with a network of media houses and Health Educators in all States for prompt information dissemination. There are currently ongoing Infection Prevention Control (IPC) programs nationwide, including the development of new guidelines, as well as training packages for health care workers to mitigate transmission.”
 
To prevent the spread of Ebola, the NCDC advised members of the public to adhere to the following precautions:
•Wash your hands frequently using soap and water – use hand sanitizers when soap and water is not readily available
•Avoid direct handling of dead wild animals
•Avoid physical contact with anyone who has possible symptoms of an infection with an unknown diagnosis
•Make sure fruit and vegetables are properly washed and peeled before you eat them
 
The NCDC advised health care workers to ensure universal precautions at all times. This includes the use of personal protective equipment always when handling patients.
 
The NCDC said it is working closely with colleagues at the WHO Nigeria Country Office, who are in close contact with WHO African Region and Ministries of Health in Uganda and DR Congo, to determine the risk of spread to other African countries. Our multi-sectoral technical working group has heightened situational awareness on the ongoing outbreak in both countries.
 
NCDC said it remains fully committed and capable of protecting the health of all Nigerians from infectious disease outbreaks.
 
On June 11, 2019, the Ugandan Ministry of Health confirmed an outbreak of EVD in Kasese District, at the border with the Democratic Republic of the Congo. The index case was a five-year old boy who fell ill after a visit to Mabalako Health Zone in Democratic Republic of the Congo to attend the burial of his grand-father, a confirmed EVD case, who died in the community on 1st of June 2019. As at 12th June 2019, the Uganda Virus Research Institute (UVRI) has confirmed three (03) cases of EVD and one (01) death recorded. A total of eight contacts have been identified and are being closely monitored. As at 14th June 2019, ring vaccination for high-risk contacts and frontline healthcare workers is currently ongoing. The district taskforce on EVD, a national Emergency Operations Centre (EOC), the WHO Uganda Country Office and Partners are supporting the response in the country.

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