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The East African : April 21st 2014
The EastAfrican 28 OUTLOOK APRIL 19-25,2014 S CI E N C E WHO issues new hepatitis C guidelines They include ways to inc≥ease the numbe≥ of people being tested By CHRISTABEL LIGAMI Special Correspondent on the treatment of hepatitis C — a chronic infection that affects an estimated 130 million people globally. The new guidelines make key rec- T ommendations on how to increase the number of people screened for hepatitis C infection; advice on how to mitigate liver damage for those who are infected; and how to select and provide appropriate treatments for chronic hepatitis C infection. The WHO recommends a screen- ing test for those considered at high risk of infection followed by another for those who test positive, to establish whether they have chronic hepatitis C infection. Since alcohol can accelerate liver damage caused by hepatitis C, the WHO now advises that people with chronic hepatitis C infection receive an alcohol assessment. The organisation also recommends providing counselling to reduce alcohol intake for people with moderate or high alcohol use. The guidelines provide recom- mendations on existing treatments based on interferon injections as well as the new regimens that use only oral medicine, as doctors seek new ways to fight the disease that causes between 350,000 and 500,000 deaths annually. The 2014 recommendations al- so summarise interventions that should be made by policy makers and health care workers to prevent transmission of hepatitis C, including measures to assure the safety of medical procedures and injections in health care centres and among persons who inject drugs. Rates of new hepatitis C infections remain unacceptably high in many coun- he World Health Organisation has issued its first guidelines BRIEFS Ebola death toll in West Africa rises to 121 The World Health Organisation said the death toll from the Ebola outbreak in West Africa is up to at least 121. The WHO said health ministries in Guinea, Liberia and other affected countries have reported about 200 confirmed or suspected cases of the virus. The vast majority of the victims are in Guinea, where officials have reported 168 cases, including 108 deaths. Liberia reported 13 deaths from the disease. News reports said Gambian authorities have ordered airlines not to pick up passengers from affected countries. Fertility clinic in Kigali to offer IVF, egg freezing RECOMMENDATIONS Increase the number of people screened for hepatitis C infection Mitigate liver damage for those who are infected Select and provide appropriate treatments for chronic hepatitis C infection Screening test for those considered at high risk of infection People with chronic hepatitis C infection to receive an alcohol assessment Many people remain unaware — sometimes for decades — that they are infected with hepatitis C.” Andrew Ball, senior adviser for policy, strategy and equity in WHO’s HIV/ Aids department tries because of the reuse of injections and lack of screening of blood transfusions. “Many people remain unaware — sometimes for decades — that they are infected with hepatitis C,” said Andrew Ball, senior adviser for policy, strategy and equity in WHO’s HIV/Aids Department. “Greater The guidelines aim to reduce hepatitis C infections, caused by the reuse of injections and lack of screening of blood transfusions. Picture: File awareness of the risks associated with hepatitis C should lead to a demand for services and expansion of laboratory capacity and clinical services so that more people can be tested, treated and cured,” he added. The publication of the WHO guidelines for the screening, care and treatment of persons with hepatitis C infection comes at a time of increased availability of more effective and safer oral hepatitis medicine, and the promise of new medicine in the next few years. “The recommendations are based on a thorough review of the best and latest scientific evidence,” said Stefan Wiktor, who leads the WHO’s Global Hepatitis Programme. “They aim to help countries improve treatment and care for hepatitis and thereby reduce deaths from liver cancer and cirrhosis.” The WHO will be working with individual countries so that they can introduce the guidelines as part of their national treatment programmes. The organisation’s support will include assistance to make the new treatments available and affordable for all. It will also assess the quality of hepatitis laboratory tests and generic forms of hepatitis medicines. “The challenge is to ensure that everyone who needs these drugs can access them. Experience has shown that a multipronged strategy is required to improve access to treatment. The development of the WHO guidelines is a key step in this process,” said Peter Beyer, senior advisor for the Essential Medicines and Health Products Department at WHO. There are five main hepatitis vi- ruses, referred to as types A, B, C, D and E. Hepatitis B and C have the greatest public health impact because they cause chronic infections that can progress to cirrhosis and liver cancer. Hepatitis A and E, which spread through unsafe water and contaminated food, have the potential to cause outbreaks in certain regions. The hepatitis C virus is most commonly transmitted through exposure to contaminated blood. Global fight against t≥opical diseases ≥eceives $120m By CHRISTABEL LIGAMI Special Correspondent ABOUT $120 million has been committed by a group of partners towards fighting 10 neglected tropical diseases (NTDs) common in places with limited access to clean water and sanitation, including $50 million from the Children’s Investment Fund Foundation (CIFF). In addition, the World Bank Group, which has long played a crucial role in fighting onchocerciasis (river blindness), is committing $120 million toward the goal of NTD control and elimination in low-income countries in Africa, including funding for school-based deworming efforts. The Bill and Melinda Gates Foundation is in- vesting $50 million towards mitigating transmission and drug resistance. NTD diseases like trachoma; human African trypanosomiasis (or sleeping sickness); lymphatic filariasis; onchocerciasis (river blindness); soil-transmitted helminths; schistosomiasis and visceral leishmaniasis, put one in six people worldwide at risk of falling sick and becoming disabled or disfigured. Ancient causes of human misery “The tremendous progress we have seen over the past two years is proof of the power of partnerships and the generosity of companies that made commitments under the London Declaration,” said Margaret Chan, director-general of the WHO. “Together with the governments of endemic countries, we are fast approaching the goal of controlling or eliminating many of these ancient causes of human misery. “This is a pro-poor initiative that is improving the lives of more than a billion people” Every new dollar invested in NTD programme implementation helps deliver up to $10 in donated drugs. Endemic countries have significantly in- creased demand for treatments in the past two years, thanks to drug donations from pharmaceutical companies that have removed drug supply as a barrier for a number of NTDs. In 2012, more than 5.5 million school-aged children and more than 11.5 million individuals needed preventive chemotherapy for schistosomiasis. In November 2011, Kenya became the first African country to launch an integrated, multiyear national NTD master plan, intended to maximise the efficiency of NTD control efforts. In addition, 194 member states at the 2013 World Health Assembly passed a resolution to hold themselves accountable and take ownership of NTD programmes. This has catalysed momentum and crucial resources against NTDs. Aid workers measure children for undernourishment in Yida, Unity State, South Sudan. Pic: AFP Global Fund target special groups with $1.7m The Global Fund for Eastern and Southern Africa has developed a new funding model that will ensure the participation of women and adolescents in the fight against HIV/Aids, tuberculosis and malaria. The $1.7 million fund will focus on micro-epidemics (girls and women, men having sex with men, migrant workers and prisoners). However countries applying for assistance from the Global Fund will now be allocated funds based on the burden of disease in their country. Rwandans may not have to travel abroad to get fertility-related care following the opening of a fertility clinic in Kigali at a cost of $350,000. It will initially offer services like in vitro fertilisation (IVF) — a procedure that enables an egg to be fertilised by a sperm in the laboratory — HIV sperm washing; intra-uterine insemination; egg freezing and storage. According to Justin Mfizi, the country co-ordinator of the Kigali IVF and Fertility Clinic, plans are underway to partner with local health insurance firms to enable low-income earners to access the services. 50,000 South Sudan children could die Up to 50,000 undernourished children below the age of five are likely to die in war-torn South Sudan unless they receive urgent treatment, the UN Children’s Fund has warned. Nearly 250,000 children will suffer severe acute malnutrition by the end of the year if more is not done now to tackle hunger. According to Unicef, more than 3.7 million people in South Sudan are at a high risk of food insecurity, with many already forced to eat wild “famine foods” like bulbs and grass.
April 14th 2014
April 28th 2014