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The World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyesus Friday announced that COVID-19 will no longer be categorized as a Public Health Emergency of International Concern (PHEIC).
This decision was made following a recommendation from the WHO Emergency Committee for COVID-19, which met every three months since the PHEIC was declared in early 2020.
The lifting of official PHEIC status is a sign of the progress made in the past year, getting most countries to a solid baseline of coverage, including with support from COVAX which has focused efforts on lower-income countries.
Global coverage with a primary series (two doses) of COVID-19 vaccine stands at 64% on average, and at 55% on average in the 92 lowest-income countries (compared to 28% at the beginning of 2022).
On average, the majority of healthcare workers and older adults across the world – among those at greatest risk – are protected with two doses, and are starting to receive boosters. The countries furthest behind have made remarkable progress.
However, Dr. Tedros Adhanom Ghebreyesus also noted that this news does not mean COVID-19 is “over as a global health threat.” Several PHEICs have not been related to pandemics, and several sustained epidemics or “pandemics” have not been assigned PHEIC status.
The WHO Director-General also stressed that the world must remain vigilant, as the virus continues to evolve. He urged countries to continue to monitor the situation closely, and to be prepared to take action if needed.
“The lifting of PHEIC status is a positive step, but it is important to remember that the COVID-19 pandemic is not over. We must continue to take precautions to protect ourselves and our communities, and to be prepared for future waves of the virus”, Dr. Tedros warned.
Ground-breaking success in the fight to reduce the toll of cigarettes in Sweden could provide major benefits for the rest of the world – and save the lives of millions of smokers here in Africa.
Sweden has begun celebrating its imminent status as the first developed nation in the world to become officially ‘smoke-free’. This is under guidelines that classify countries as smoke-free when the proportion of their population that smokes is less than 5%.1
Every country in the European Union has been working towards reaching this milestone by 2040. Most are on track to miss the target, but Sweden will smash it by a staggering 17 years. The Swedes have secured this historic achievement by developing a specific policy formula towards modern alternative nicotine products such as vapes and oral pouches for smokers.
They have made these products as accessible, acceptable, and affordable as possible to adult smokers. The results are remarkable; Fifty years ago, 49% of Swedish men were smoking regularly. In the last decade, smoking rates in Sweden halved and reached a record low of 5.6% in 2022. Soon, that figure will fall below the totemic 5%.2 3
How was this achieved?
For many years, Sweden was able to reduce its smoking rate slowly through education, tobacco
control measures, and the use of snus – smoke-free, oral tobacco. It was the introduction of modern tobacco-free alternatives – vaping in 2015, and next-generation oral nicotine pouches which followed in 2018 – that turbocharged their smoking decline.
In the last decade, smoking rates in Sweden have fallen by an astonishing 55%. The impact on public health in that country is evident.
Compared to the rest of the European Union, Sweden has 44% fewer tobacco-related deaths, a cancer rate that is 41% lower, and 38% fewer deaths attributable to any cancer. 4 Last month, global experts in tobacco harm reduction published a report showing that, if every other country in the EU followed Sweden’s example in its approach to tobacco harm reduction, up to 3.5 million early deaths in Europe would be prevented in just one decade.
So How can we achieve similar success in reducing Kenya’s smoking rates and enjoying the
the subsequent reduction in the burden on public health?
Here in Kenya, we are on course to miss our Health Ministry’s target of 9.7% smoking prevalence by 2025.6
Smoking rates remain stubbornly high at 13%( MoH 2022) overall – despite strict restrictions, which include the prohibition of smoking in public places and mandatory health warnings on packaging.
We must acknowledge that it is immensely difficult for smokers to quit their habit, even when they are desperate to do so. The Swedes recognized this and set about increasing the ability of adult smokers to switch to less harmful products.
Here, our policymakers maintain a ‘quit or die’ approach to tobacco control which is patently failing as it ignores the fact that alternative nicotine products are much less harmful than traditional tobacco products.
As part of this approach, the Kenyan Government classifies vapes and pouches as tobacco products and subjects them to the same high taxes and marketing restrictions that apply to far more harmful cigarettes.
This flies in the face of scientific evidence. Vapes and pouches do not burn tobacco, thereby dramatically reducing exposure to disease-causing chemicals. Global research shows that tobacco-free nicotine products are about 95% less harmful than cigarettes.
For this reason, we believe that alternative nicotine products should be regulated uniquely within a framework that recognizes their potential to reduce the health burden associated with traditional tobacco products.
The ‘Swedish Model’ is an example of tobacco harm reduction being used to drive down smoking rates and dramatically reduce smoking-related diseases.
To beat smoking like Sweden, we urge our politicians to support harm reduction strategies and make smoke-free alternatives more affordable than cigarettes, thereby removing barriers to switching. Similarly, health professionals and smokers should be educated in the science involved, so that they can make informed choices.
Kenya can – and should – benefit from Sweden’s successful switch to smoke-free status. Our policymakers must simply apply the same evidence-based solutions that have already started to save millions of lives.
The Ministry of Health is collaborating with County governments to incentivize nearly 90,000 community health workers serving in the existing primary healthcare networks nationwide. In an attempt to address malnutrition as an essential component of primary healthcare.
Dr. Josephine Mburu, Principal Secretary of the State Department for Public Health and Professional Standards pointed out the essence of this during the official opening of the 4th National Nutrition Symposium on April 12, 2023, at the Safaripark Hotel in Nairobi.
Where she revealed that the Ministry of Health is committed to achieving Universal Health Coverage (UHC) and is revamping primary healthcare as the engine for UHC including strengthening the primary healthcare networks and community health structures.
“In order to achieve UHC, the Ministry of Health acknowledges the need for adequate healthcare financing and optimal human resources for health for primary healthcare,” said the PS.
Further, Dr. Mburu noted that addressing malnutrition is crucial for not only ensuring the quality of life for all citizens but also contributing to significant economic growth. According to the 2016 Kenya Nutrition Investment Framework, every dollar invested in nutrition would yield 22 dollars (Ksh 2750) in returns.
According to the PS, it’s vital to collaborate between line ministries, development partners, civil society organizations, faith-based organizations, and private sectors who have contributed to nutrition improvement in the country.
“I look forward to receiving the key outcomes of the symposium, including recommendations on cost-effective best practices for optimal nutrition outcomes, local solutions for addressing persistent acute malnutrition, and evidence-based interventions for addressing all forms of malnutrition, including undernutrition, hidden hunger, overweight, and obesity,” she stated.
Ghana becomes the first country to approve a second malaria vaccine, R21/Matrix-M™. This is a significant development in the fight against malaria, which is a major killer of children in Africa.
The vaccine is developed by the University of Oxford and manufactured and scaled up by the Serum Institute of India (SII).
It has been approved for use in children aged 5 to 36 months, the age group at highest risk of death from malaria. R21 has a three-dose primary series with a fourth (booster) dose a year later.
The approval of R21 comes alongside the RTS,S vaccine, which was prequalified by the World Health Organization (WHO) in 2022 following a recommendation for its wider use in 2021.
These two vaccines offer a new way to protect children from malaria and could save millions of lives.
Gavi, the Vaccine Alliance, is ready to provide funding for R21 and to support its adoption alongside RTS,S. Gavi has already approved funding for a malaria vaccine programme and is ready to support countries to introduce the vaccine. Gavi is also working with partners to support the production of the vaccine in Africa.
The approval of R21 is a major step forward in the fight against malaria. It offers a new way to protect children from this deadly disease and could save millions of lives.
Uber and Uber Eats have teamed up with Vitality Health International (VHI), a health insurer, to incentivize healthy behavior among members of the Vitality program in Kenya.
The partnership comes after VHI launched a suite of new insurance products and additional reward partners in the Kenyan market on 1st March 2023.
Vitality Health International, a South African health insurer, launched in Kenya in January 2022 with the goal of encouraging people to lead healthier lifestyles and decrease their long-term health risks. The company’s shared-value model rewards people for healthier behaviour, which brings down the insurance risk and contributes towards a healthier society over time.
According to Emma Knox, CEO of Vitality Health International, the company’s health insurance model is highly relevant in the context of the changing landscape. Knox notes that Vitality’s parent company, Discovery, pioneered the Vitality Shared-value Insurance model in South Africa, building successful partnerships globally with leading insurers.
Vitality is a science-based behaviour-change program that has been proven through independent research to positively affect health outcomes. The program is embedded in the Vitality Health International health insurance model and combines data analytics with rewards and incentives to encourage people to make healthier choices.
Under the partnership, members of the Vitality program can earn rewards by completing personalized weekly goals, including physical activity and mental wellbeing targets. Members can redeem their rewards with a range of partners, including Safaricom, Jumia, Garmin, Uber, and Uber Eats.
Wangui Mbugua, General Manager at Uber Eats Kenya, said that the company is delighted to partner with Vitality Health International to provide Uber vouchers as rewards to members when they achieve their healthy lifestyle and physical activity goals. Members can enjoy up to 450 Kenyan shillings towards their next ride with Uber and 450 Kenyan shillings off their next order with Uber Eats.
Overall, the partnership aims to share value with everyone, with rewards and immediate value visible to the young and healthy who are physically active, take up preventive screening and make healthy lifestyle choices.
A new research paper assessing the characteristics of One Health Networks (OHNs) globally reveals that investment in OHNs has not been equitably distributed around the world and that engagement across sectors and with a diverse array of stakeholders is sorely lacking.
The study, recently published in The Lancet (February 2023) as part of a landmark four-paper series on One Health and Global Health Security, was written by ILRI graduate fellow Athman Mwatondo and co-authors Afifah Rahman-Shepherd and Osman Dar, among others.
Moving forward, the glaring gaps in existing OHNs leave the world vulnerable to global health threats and serve as a stark reminder of the urgent need to establish more egalitarian OHNs that help vulnerable communities worldwide address their most pressing health challenges.
The COVID-19 pandemic has seen an increased focus on the threat of emerging diseases at the human-animal-environment interface. One outcome of this is likely to be increased investment in OHNs, which the study’s authors defined as ‘an engagement between two or more discrete organizations or entities, with representation from at least two of the three broadly categorized One Health sectors (animal health, human health, and environmental and ecosystem health)’.
Unfortunately, prior investment in OHNs has not been equitably distributed. Based on a global identification and analysis of OHNs, the recent Lancet study reveals that more global-level OHNs are formed and headquartered in Europe than in any other region. This means that the governance and decision-making of global OHNs are done predominantly in high-income countries.
The study also found low diversity in stakeholder and sector representation when it comes to OHN collaborations and partnership structures. Most OHNs are primarily focused on emerging infections with pandemic potential and novel pathogens.
Other pressing, more locally relevant issues like endemic and neglected diseases often do not receive the same level of attention or investment. Many OHNs also have little involvement with stakeholders in the environment and ecosystem sectors, thereby limiting their ability to respond to health threats in diverse contexts.
Moreover, OHNs are less likely to engage local community members in the design and agenda-setting phases of implementation than other types of stakeholders such as academic institutions and government bodies.
The study’s findings highlight that many global OHNs are based on high-income hegemony and a global health framework built from colonial structures. This limits the effectiveness and sustainability of their efforts to address a wider range of global health threats that most of the world’s population confronts.
Moving forward, it is imperative that OHNs, particularly those with a global focus, establish governance structures that ensure inclusive and equitable partnerships and agenda-setting.
Fortunately, the current One Health landscape presents a significant opportunity to focus efforts and resources on areas that need them most. ‘With COVID-19, there is a lot of focus on this kind of work right now, so there will be many more partnerships on One Health going forward’, said Mwatondo. ‘The focus then should be on bringing more equity and creating better partnerships’.
To accomplish that goal, Mwatondo et al’s study should be used as a baseline to establish databases and repositories of OHNs worldwide. Then, by identifying deficits in their mandates and activities, we can improve One Health equity by targeting investments and creating new One Health partnerships in areas currently underserved by global OHNs. Doing so will benefit not just those in low-income countries, but people worldwide, as the next major global health threat could emerge from anywhere.
The Stop TB Partnership today issued a positive World TB Day reset, ‘Yes! We Can End TB,’ to rally the international community to end tuberculosis (TB) by 2030. The Stop TB Partnership Board and partners convened for the first time during World TB Day in Varanasi, India—the country with the highest TB burden but also with high political commitment, ambition, hard work, and a robust plan to end TB. On the sidelines of the One World TB Summit, the board and partners embraced a post-pandemic call to action that will see new efforts, research, tools, and innovations put into practice.
“The theme of the G20 is a resolution for the shared future of the entire world,” said the Honorable Prime Minister Shri Narendra Modi at the One World TB Summit today. He underlined that it is realizing the resolutions of global good with the One World TB Summit.
“India’s efforts are a new model for the global war on TB. People’s participation in the fight against TB is India’s big contribution. India is now working on the target of ending TB by the year 2025. I would like that more and more countries get the benefit of all campaigns, innovations and modern technology of India,” added the Prime Minister.
During the Board meeting, a high-level advocacy platform will be announced by the Stop TB Partnership: the Coalition of Leaders to End TB. Constructed on the leadership of India’s Prime Minister Narendra Modi, the coalition will include Heads of State and Government that are champions of the TB response at national, regional and global levels. Among the leaders whose representatives are negotiating this coalition are President Joko Widodo of Indonesia, President Lula da Silva of Brazil, President Cyril Ramaphosa of South Africa, and the newly elected President of Nigeria, Bola Tinubu. The Coalition of Leaders will be formally launched during the United Nations (UN) General Assembly week in New York City in September 2023.
In 2022, several of the high TB burden countries—including Brazil, Nigeria, India and Indonesia—diligently increased the number of people diagnosed and enrolled on TB treatment, reaching and exceeding the numbers seen before the COVID-19 pandemic. According to preliminary data from the Stop TB Partnership, in 2022 the gap between the estimated number of people with TB and those diagnosed and treated was the lowest ever—with less than 3 million missing people with TB. This gap was 3.2 million in 2019, 4.3 million in 2020, and 4.2 million in 2021.
Despite this progress, last year, as the COVID-19 pandemic ebbed, TB regained its tragic title as the world’s biggest infectious disease killer due to setbacks in diagnosis and treatment over the past three years. This year is critical as the international community prepares for the next UN High Level Meeting (UNHLM) on TB taking place in September 2023, the second such event held at the UN General Assembly.
“With the world regaining strength as the COVID-19 pandemic wanes, ending TB as a global health threat is a critically important goal,” said Dr. Lucica Ditiu, executive director of the Stop TB Partnership. “We have new innovations now to help us save lives—new diagnostic tools, shorter, less toxic treatment regimens, and new digital tools—and when we add the political muscle that the UNHLM will gather to the many dedicated health care professionals already in the front lines, ending TB looks increasingly possible.”
At the first UNHLM in 2018, 15 Heads of State and Heads of Government joined 1,000 participants in pledging to increase efforts to end TB. While the COVID-19 pandemic upended many of these commitments, the upcoming UNHLM on TB has already seen momentum in bringing the world together to renew this important goal. In fact, experts, scientists, donors, medical workers and advocates worldwide are already making up the ground which was lost due to the COVID-19 pandemic and economic downturn.
“It is absolutely inspirational to see so many nations stepping forward with their own national plans to end TB,” said Austin Arinze Obiefuna, executive director of the Afro Global Alliance in Ghana and vice chair of the Stop TB Partnership Board. “TB is a disease that hits the poorest parts of the world hardest. It will not simply go away; instead we need all governments to join us in stopping this disease from wrecking people’s lives, their families and their livelihoods.”
New tools and investments
In the past few years, new tools to combat TB have cleared regulatory approvals and entered the marketplace. Multilateral institutions and development agencies are working to make these innovations more accessible and available to the countries and regions most in need. These innovations include:
- Rapid molecular tests that can identify TB and resistance patterns in the bacteria;
- Shorter treatment regiments, for drug-sensitive and drug-resistant infections;
- New digital tools, such as AI enabled ultraportable X-ray systems for screening for TB; and
- Vaccine candidates that have advanced to phase 3 clinical trials.
Globally, investments in TB research and development have started to climb, surpassing US$1 billion for the first time ever. Advocates look to the coming UNHLM to boost this momentum and help governments and funding institutions reach the US$2 billion goal pledged at the first UNHLM, and further increase to US$5 billion per annum as estimated by the Global Plan to End TB. And there is growing political momentum on commitment and ambition from countries like India, Indonesia, Nigeria and South Africa to step up action at a time when new data shows that every US$1 invested in TB yields US$46 in benefits.
“What we need is quite simple, given that TB kills 1.6 million people every year,” added Dr Ditiu. “We need increased political commitments from all high TB burden countries, and significantly more financing so that we can meet all the challenges and embark upon a much faster path to new vaccines. We know what it takes to end TB; we need to roll up our sleeves and make it happen.”
Strong commitments and actions by high TB burden countries
India, the country with the highest TB burden, has displayed a strong ambition to beat back the disease under the leadership of Prime Minister Modi and strategic planning and execution of the Minister of Health of India, Dr. Mansukh Mandaviya, and his team. In 2022, 2.4 million people with TB in India accessed diagnosis and treatment, which is the highest ever in any year and signals that India’s TB response has now fully recovered from the impacts of COVID-19.
“Under the Prime Minister’s TB Free India Campaign, launched in September 2022, nearly 1 million people with TB have received commitment from individuals in society who will support them through their treatment journey,” explained Suvanand Sahu, the deputy executive director of the Stop TB Partnership. “This initiative is unique in the world and is a great intervention for TB awareness, stigma elimination, community ownership and crowd funding.”
India has a unique real-time TB information system called NIKSHAY, which is also linked to direct cash transfers to TB patients. In the last five years, using this system, US$260 million has been disbursed to nearly 8 million people with TB to support their nutrition.
The ambitious call from the Prime Minister to end TB in India has driven innovations in the areas of digital tools, diagnostics, data systems, community engagement and logistics. Twenty-five of these innovations, developed in the last two years, will be presented at a session at the Stop TB Board meeting on March 15 in Varanasi, India. Ownership for implementation has been decentralized to state, district and village levels, with awards given to recognize states and districts who are making rapid progress towards ending TB. People who have gone through the experience of TB are being empowered and made “TB Champions” for their contributions to end TB in their community. Currently more than 30,000 TB Champions are supporting the TB response in India.
“India is providing models to fight TB. Trace, Test, Track, Treat and Technology is the strategy we are implementing to end TB in India by 2025. India is also producing 80% of TB medicines. India is determined to end TB by 2025…India is ready to work shoulder to shoulder with all other countries and ensure a better world for future generations,” added Prime Minister Modi.
Indonesia, with the world’s fourth largest burden of TB, also made significant progress in 2022. Almost three-quarters of the estimated TB caseload was diagnosed and treated, with the overall treatment success rate at 84%—the highest rates recorded for Indonesia. Key to the success of the National TB Program was the deployment of screening campaigns similar to what was used for COVID-19—pushed through thanks to the political commitment of President Widodo and Minister of Health Budi Gunadi Sadikin and his TB response team.
During the Board meeting, the Stop TB Partnership will also launch The Accountability Report of TB-affected Communities and Civil Society: Priorities to Close the Deadly Divide. This report follows up on the first ever global community report released in 2020, entitled A Deadly Divide: TB Commitments vs. TB Realities. The 2023 iteration was coordinated by the Affected Community and NGO Delegations to the STP Board and featured the mobilization of more than 1,000 civil society and affected community partners from over 90 countries. Their inputs are reflected throughout the report in over 30 country case studies and culminate in six calls to action that are required to end the TB epidemic.
Villgro Africa has been at the forefront of empowering entrepreneurs across Africa through seed funding and investments in the health sector. The Indian-based franchise is now celebrating its seven years of impacting change.
The incubator launched in Kenya in 2013, and Villgro rebranded to Villgro Africa in 2020 deciding to go continental. The aim is to support easy access to health care solutions, as they support entrepreneurs who have projects offering solutions.
Villgro Africa co-founder and CEO Wilfred Njagi noted that the firm is championing the betterment of healthcare in Kenya and Africa considering the challenges still faced in the sector which he indicates has been underserved countless times.
“Since its inception, Villgro Africa has enabled access to healthcare to those at the bottom of the pyramid. In the past seven years, Villgro has steadily invested seed funding in social enterprises with homegrown solutions that solve Africa’s healthcare and lifestyle dilemmas,” Njagi said.
In reference to the Abuja declaration, which called for 10% of GDP assigned to healthcare, Mr. Njagi cites the essence of healthcare’s role in mortality rates and life spans of the people.
He added that it’s ironic how Africa is regarded as the third world’s poorest but our health costs are the highest something, he insists, needs to change.
The firm recently launched “The Impact Report” which reveals Kenyan startups received the lion’s share of Villgro Africa’s investments accounting for $1.36 (Sh171 million) out of the $2.14 million (Sh269.6 million) committed since their inception,”
Mr. Njagi said that the most essential support is technical assistance which entails nurturing innovators with solutions to build and grow their businesses.
Villgro Africa co-founder and Chief Innovation Officer Robert Karanja in his opinion reiterated his sentiments saying that the issue about healthcare failures is the inability to teach and learn a knowledge economy that can assist academia link with innovation.
“We have reached a moment of urgency in developing solutions that bring down the cost of inventions. That is aimed at re-engineering our technology and building better, from scratch that solves problems at hand,” said Mr. Karanja Robert.
To make this a reality, Villgro Africa has set its eyes on launching an Incubator-Fund Platform in partnership with Jaza Rift Fund, with a target fund size of $30 million (Sh3.8 billion) to support startups graduating from the incubator.
Villgro Africa has supported various startups in the Kenyan and wide Africa region; from Kenya, Bena Care, a firm providing home-based care and Negus Med, an advanced wound care and theatre textiles distribution and manufacturing company where as Ghana has Cowtribe and Ethiopia’s Simbona Africa amongst others.
However, Mr. Karanja calls on lessening bureaucracy and regulations when it comes to matters dealing with healthcare research and steps aimed at advancing and growing the sector. He urged for more investment in the healthcare sector as it is a determinant of the productivity of the people and a major security investment for future generations.
The 71st Health Ministers Conference was held in Lesotho on the 8th and 9th of February 2023, and it was a gathering of some of the most influential voices in healthcare from Eastern and Southern Africa.
The conference was chaired by Dr. Nakhumicha Wafula, the Cabinet Secretary for Health of the Republic of Kenya, who expressed her delight and honor to take up the chair on behalf of her country.
In her opening remarks, Dr. Nakhumicha emphasized the importance of the Eastern and Southern Africa Health Community (ECSA-HC) and the need for cooperation among member states to improve health services and achieve the highest standards of health.
The 72ndHealth Ministers Conference will be held along the sidelines of the 76th World Health Assembly in Geneva
The COVID-19 pandemic has underlined the importance of collaboration and strong health systems, and Dr. Nakhumicha highlighted the measures taken by Kenya to strengthen its health systems in response to the pandemic.
The conference provided an opportunity for member states to come together, share their experiences, and work towards strengthening their health systems. The discussions and recommendations from the conference will be instrumental in improving health services in the Eastern and Southern Africa region.
Dr. Nakhumicha expressed her excitement to work with her fellow ministers and heads of delegations in addressing the challenges faced by ECSA-HC member states and positioning the community in the global health realm.
The conference was a success and marked an important step towards better health for all in Eastern and Southern Africa.
“The 72ndHealth Ministers Conference will be held along the sidelines of the 76th World Health Assembly in Geneva, and we look forward to continued progress towards better health for all in the region,” the CS said.