Saints Kitts e Nevis
GENEVA – The World Health Organization (WHO) is calling on countries and global health partners to step up the fight against malaria, a preventable and treatable disease that continues to claim hundreds of thousands of lives each year. A better targeting of interventions, new tools and increased funding are needed to change the global trajectory of the disease and reach internationally-agreed targets.
According to WHO‘s latest World Malaria Report, progress against malaria continues to plateau, particularly in high burden countries in Africa. Gaps in access to life-saving tools are undermining global efforts to curb the disease, and the COVID-19 pandemic is expected to set back the fight even further.
“It is time for leaders across Africa – and the world – to rise once again to the challenge of malaria, just as they did when they laid the foundation for the progress made since the beginning of this century,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “Through joint action, and a commitment to leaving no one behind, we can achieve our shared vision of a world free of malaria.”
In 2000, African leaders signed the landmark Abuja Declaration pledging to reduce malaria deaths on the continent by 50 percent over a 10-year period. Robust political commitment, together with innovations in new tools and a steep increase in funding catalysed an unprecedented period of success in global malaria control. According to the report, 1.5 billion malaria cases and 7.6 million deaths have been averted since 2000.
A plateau in progress
In 2019, the global tally of malaria cases was 229 million, an annual estimate that has remained virtually unchanged over the last four years. The disease claimed some 409,000 lives in 2019 compared to 411,000 in 2018.
As in past years, the African Region shouldered more than 90 percent of the overall disease burden. Since 2000, the region has reduced its malaria death toll by 44 percent, from an estimated 680,000 to 384,000 annually. However, progress has slowed in recent years, particularly in countries with a high burden of the disease.
A funding shortfall at both the international and domestic levels poses a significant threat to future gains. In 2019, total funding reached US $3 billion against a global target of $5.6 billion. Funding shortages have led to critical gaps in access to proven malaria control tools.
COVID-19 an added challenge
In 2020, COVID-19 emerged as an additional challenge to the provision of essential health services worldwide. According to the report, most malaria prevention campaigns were able to move forward this year without major delays. Ensuring access to malaria prevention – such as insecticide-treated nets and preventive medicines for children – has supported the COVID-19 response strategy by reducing the number of malaria infections and, in turn, easing the strain on health systems. WHO worked swiftly to provide countries with guidance to adapt their responses and ensure the safe delivery of malaria services during the pandemic.
However, WHO is concerned that even moderate disruptions in access to treatment could lead to a considerable loss of life. The report finds, for example, that a 10 percent disruption in access to effective antimalarial treatment in sub-Saharan Africa could lead to 19,000 additional deaths. Disruptions of 25 percent and 50 percent in the region could result in an additional 46 000 and 100,000 deaths, respectively.
“While Africa has shown the world what can be achieved if we stand together to end malaria as a public health threat, progress has stalled,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “COVID-19 threatens to further derail our efforts to overcome malaria, particularly treating people with the disease. Despite the devastating impact COVID-19 has had on African economies, international partners and countries need to do more to ensure that the resources are there to expand malaria programmes which are making such a difference in people’s lives.”
A key strategy to reignite progress is the “High burden to high impact” (HBHI) response, catalysed in 2018 by WHO and the RBM Partnership to End Malaria. The response is led by 11 countries – including 10 in sub-Saharan Africa – that account for approximately 70 percent of the world’s malaria burden.
Over the last two years, HBHI countries have been moving away from a “one-size-fits all” approach to malaria control – opting, instead, for tailored responses based on local data and intelligence. A recent analysis from Nigeria, for example, found that through an optimized mix of interventions, the country could avert tens of millions of additional cases and thousands of additional deaths by the year 2023, compared to a business-as-usual approach.
While it is too early to measure the impact of the HBHI approach, the report finds that deaths in the 11 countries were reduced from 263,000 to 226,000 between 2018 and 2019. India continued to make impressive gains, with reductions in cases and deaths of 18 percent and 20 percent, respectively, over the last two years. There was, however, a slight increase in the total number of cases among HBHI countries, from an estimated 155 million in 2018 to 156 million in 2019.
Meeting global malaria targets
This year’s report highlights key milestones and events that helped shape the global response to the disease in recent decades. Beginning in the 1990s, leaders of malaria-affected countries, scientists and other partners laid the groundwork for a renewed malaria response that contributed to one of the biggest returns on investment in global health.
According to the report, 21 countries eliminated malaria over the last two decades; of these, 10 countries were officially certified as malaria-free by WHO. In the face of the ongoing threat of antimalarial drug resistance, the six countries of the Greater Mekong subregion continue to make major gains towards their goal of malaria elimination by 2030.
But many countries with a high burden of malaria have been losing ground. According to WHO global projections, the 2020 target for reductions in malaria case incidence will be missed by 37 percent and the mortality reduction target will be missed by 22 percent.
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Victoria Knight–KHN News–With the holiday season now underway just as COVID-19 case rates in the US are increasing at a record-breaking pace, leading to dire warnings from public health experts.
The Centers for Disease Control and Prevention has issued cautions and updated guidelines related to family gatherings. Dr. Anthony Fauci, a White House coronavirus adviser and director of the National Institute of Allergy and Infectious Diseases, said in interviews that his kids won’t be coming home for Thanksgiving because of coronavirus risks.
“Relatives getting on a plane, being exposed in an airport,” he told CBS News. “And then walking in the door and saying ‘Happy Thanksgiving’ — that you have to be concerned about.”
Are Americans listening? Maybe not. Especially as airlines, reeling from major revenue blows since the pandemic took hold in March, tell passengers they can travel with peace of mind and sweeten the deal with special holiday fares.
The airlines argue more is now known about the virus and recent industry-sponsored studies show flying is just as safe as regular daily activities. They also tout policies such as mask mandates and enhanced cleaning to protect travelers from the coronavirus.
Time for a reality check.
Americans who do choose to fly will be subject to evolving COVID safety policies that vary by airline, a result of the continuing lack of a unified federal strategy. Under the Trump administration, government agencies such as the Federal Aviation Administration and the Centers for Disease Control and Prevention have failed to issue and enforce any national directives for air travel.
And, though President-elect Joe Biden has signaled he will take a more robust federal approach to addressing COVID-19, which may result in such actions, the Trump administration remains in charge during the upcoming holiday season.
Here’s what you need to know before you book.
Airlines Say It’s Safe to Fly During the Pandemic. Is it?
The airline industry pins its safety clearance to a study funded by its leading trade group, Airlines for America, and conducted by Harvard University researchers, as well as one headed by the Department of Defense, with assistance from United Airlines.
Both reports modeled disease transmission on a plane, assuming all individuals were masked and the airplane’s highly effective air filtration systems were working. The Harvard report concluded the risk of in-flight COVID-19 transmission was “below that of other routine activities during the pandemic, such as grocery shopping or eating out,” while the DOD study concluded an individual would need to, hypothetically, sit for 54 straight hours on an airplane to catch COVID-19 from another passenger.
But these studies’ assumptions have limitations.
Despite airlines ramped-up enforcement of mask-wearing, reports of noncompliance among passengers continue. Most airlines say passengers who outright refuse to wear masks will not only be refused boarding, but will also be putting their future travel privileges at risk.
Recent press reports indicate Delta has placed hundreds of these passengers on a no-fly list. Some passengers may still try to skirt around the rule by removing their mask to eat or drink for an extended time on the flight, and flight attendants may or may not feel they can stop them.
And though public health experts agree that airplanes do have highly effective filtration systems spaced throughout the cabin that filter and circulate the air every couple of minutes, if someone who unknowingly has COVID-19 takes off their mask to eat or drink, there is still time for viral particles to reach others seated nearby before they get sucked up by the filter.
Public health experts said comparing time on an airplane with time at the grocery store is apples and oranges.
Even if you wear a mask in both places, said Dr. Henry Wu, director of Emory TravelWell Center and associate professor of infectious diseases at Emory University School of Medicine, the duration of contact in both locales can be very different.
“If it’s a long flight and you are in that situation for several hours, then you are accumulating exposure over time. So, a one-hour flight is 1/10 the risk of a 10-hour flight,” said Wu. “Whereas most people don’t spend more than an hour in the grocery store.”
Also, both studies analyzed only one aspect of a travel itinerary — risk on board the aircraft. Neither considered the related risks involved in air travel, such as getting to the airport or waiting in security lines. And public health experts say those activities pose opportunities for COVID exposure.
“Between when you arrive in the airport and you get into a plane seat, there is a lot of interaction that happens,” said Lisa Lee, a former CDC official and associate vice president for research and innovation at Virginia Tech.
And while Wu said he agrees that an airplane cabin is likely safer than other environments, with high rates of COVID-19 in communities across the U.S., “there is no doubt people are flying when they’re sick, whether they know it or not.”
Another data point touted by the airline industry has been that out of the estimated 1.2 billion people who have flown so far in 2020, only 44 cases of COVID-19 have been associated with air travel, according to data from the International Air Transport Association, a worldwide trade group.
But this number reflects only case reports published in the academic literature and isn’t likely capturing the true picture of how many COVID cases are associated with flights, experts said.
“It’s very difficult to prove, if you get sick after a trip, where exactly you got exposed,” said Wu.
The low count could also stem from systemic contact-tracing inconsistencies after a person with COVID-19 has traveled on a flight. In a recent case, a woman infected with the coronavirus died during a flight and fellow passengers weren’t notified of their exposure.
That may be due to the decentralized public health system the U.S. has in place, said Lee, the former CDC official, since contact tracing is done through state and local health departments. The CDC will step in to help with contact tracing only if there is interstate travel, which is likely during a flight — but, during the pandemic, the agency has “been less consistently effective than in the past,” said Lee.
“Let’s say there is a case of COVID on a flight. The question is, who is supposed to deal with that? The state that [the flight] started in? That it ended in? The CDC? It’s not clear,” said Lee.
Is Now the Time to Fly?
Most airlines have implemented safety measures beyond requiring masks, such as asking passengers to fill out health questionnaires, enhancing cleaning on planes, reducing interactions between crew members and passengers, and installing plexiglass stations and touchless check-in at service desks.
But many have also stepped back from other efforts, such as pledging to block middle seats. United relaxed its social distancing policy for allowing empty middle seats between customers at the end of May, though there were complaints from customers before then about flights being full. American Airlines stopped blocking middle seats in July.
Other airlines plan to fill seats after the Thanksgiving holiday, with Southwest stopping the practice of blocking middle seats starting Dec. 1, and JetBlue planning to increase capacity to 85% on Dec. 2. In January, Alaska Airlines plans to stop blocking middle seats and JetBlue will fly at full capacity. Delta announced this week that it will continue to block the middle seat until March 30.
This policy change is a result of airlines’ lack of cash on hand, said Robert Mann, an aviation analyst. It also reflects a rising demand from consumers who feel increasingly comfortable traveling again, especially as holiday gatherings beckon.
“It was easy to keep middle seats empty when there wasn’t much demand,” said Mann.
Now, they’re instead hoping that new COVID-era services will calm passengers’ fears.
American, United, Alaskan and Hawaiian, among others, offer some form of preflight COVID test for customers traveling to Hawaii or specific foreign destinations that also require a negative test or quarantine upon arrival. JetBlue recently partnered with a company to offer at-home COVID tests that give rapid results for those traveling to Aruba.
Airlines are likely to expand their preflight COVID testing options in the next couple of months. “This is the new dimension of airline competition,” said Mann.
But is it a new dimension of travel safety?
Emory’s Wu said there is certainly a risk of catching the coronavirus if you travel by plane, and travelers should have a higher threshold in making the decision to travel home for the holidays than they would in years past.
After all, COVID case rates are surging nationwide.
“I think the less folks crowding the airports, the less movement in general around the country, will help us control the epidemic,” said Wu. “We are worried things will get worse with the colder weather.”
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GEORGETOWN, Guyana–November 29th 2020–The Ministry of Foreign Affairs on Friday dispatched a letter to the Panamanian authorities urging them to honor their obligations to Guyana and to pay the $1.9 billion owed to rice millers.
This measure was taken as the Government continues to take urgent steps to retrieve the outstanding sums.
In an interview with DPI on Friday, Minister of Agriculture, Hon. Zulfikar Mustapha said the Spanish-speaking country acknowledged the arrears and has since committed to paying the sum soon.Photo: Guyana Government Information Service. Minister Mustapha shows the letter that was sent to the Panamanian government about the money owed to the rice millers.
“They wanted the contract to continue in the new year. Since then to now, they have indicated that they will pay, but they are awaiting the end of this pandemic,” Minister Mustapha said. To follow up the letter, the Minister said he will be contacting Panama’s Minister of Agriculture in the new week, to fix a date for the money to be released.
Minister Mustapha also said the Government remains committed to recouping the sums and will continue to make representation for the rice industry. He said the matter could have been resolved a long time ago, had the previous administration shown “some interest” in the concerns of rice farmers.
Minister Mustapha has been engaging the Panamanian Government to ensure that the sum is paid in a timely manner since the PPP/C Government took office in August. The matter has been a priority for the Guyana Government and has been discussed at several Cabinet meetings. President Dr. Mohamed Irfaan Ali has also held talks with the Panamanian Government on the issue.
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KINGSTON, Jamaica–November 29th,2020–HIV/AIDS Officer at the United Nations Population Fund Sub-Regional Office for the Caribbean, Dr. Denise Chevannes, is urging interested parties to focus on adolescent pregnancy prevention, as one of the social and economic consequences of the COVID-19 pandemic.
She noted that COVID-19 has exacerbated the problem of adolescent pregnancy and has left more girls susceptible to teenage pregnancy.
Dr. Chevannes claimed that Jamaica has the third-highest adolescent pregnancy rate in Latin America and the Caribbean, adding that the closing schools is likely to make that situtation even worse.
“There is also a concern that the closure of schools will cause even more girls to drop out of schools and the interruption in schools is also likely to increase domestic responsibilities for girls and leads to a premature shift towards income generation,” she said.
“Moreover, outside of the protective environment provided by schools, many girls are more susceptible to adolescent pregnancy and gender-based violence,” Dr. Chevannes added.
She was speaking at the virtual staging of the Women’s Centre of Jamaica Foundation (WCJF) annual Pamela McNeil lecture on November 27, which was held under the theme ‘Adolescent Pregnancy: Reducing the Rate within the Context of the COVID-19 Pandemic’.
Dr. Chevannes also shared with the audience several impacts that the pandemic has had on the adolescent pregnancy.
Included among them are limited access to contraceptives and other family planning services which can result in an unplanned pregnancy and unsafe abortion; and limited access to age-appropriate comprehensive sexuality education due to the closure of schools and other vocational centers.
Other impacts include a lack of access to health facilities and services because of movement restrictions caused by COVID 19 or due to the fear of being exposed to COVID-19, as well as the diversion of clinical staff to deal with COVID-19 related health issues.
“In Jamaica, in particular where we have, as many as 20 percent of the population in adolescence, the health of this group of individuals has important implication for the health and well-being of the nation,” Dr. Chevannes said.
However, in addressing adolescent pregnancy she said it will not be a “one size fit all” approach.
The country, she said will have to design an intervention that takes into account the different categories of vulnerable groups that exist within the adolescent population, as well as their sexual orientation and gender identities.
Minister of State in the Ministry of Culture, Gender, Entertainment and Sport, the Hon. Alando Terrelonge is also urging young people not to surrender to social pressure to become parents early, or to have children by a certain age, to fit in with society’s expectations.
Instead, he is encouraging them to empower themselves and to ensure that they wait until they are mentally, financially, and emotionally ready to become a parent.
“We need our young men to understand that having a child at 18, 19 or 21 does not make you a man, what makes you a man is focusing on your education and putting yourself in a position where you can take care of a family and that is what makes you a woman as well,” Mr. Terrelonge said.
That’s what he said at the virtual staging of the Women’s Centre of Jamaica Foundation (WCJF) annual Pamela McNeil lecture on November 27, which was held under the theme ‘Adolescent Pregnancy: Reducing the Rate within the Context of the COVID-19 Pandemic’.
Mr. Terrelonge stressed that too much pressure is being placed on young people to engage in sexual activities at an early age and to become parents. He did not state exactly who is applying the pressure and what might be done about the problem.
“Certainly nobody is telling anybody that they can’t have six children [or] seven children. What we are saying is have the number that you can afford, not just financially but emotionally as well and in terms of your time,” he explained.
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FREEPORT, Bahamas–November 29th,2020–The Bahamas is fuming over a TV news report in Miami that suggested that the Bahamas was a Covid-19 hotspot, and recommended that citizens not travel to the Bahamas.
A Bahamas government press release said: “The Ministry of Foreign Affairs is aware of a Channel 10 Miami News broadcast on Tuesday, 24 November 2020, in which the broadcaster erroneously reported on hugely inflated figures for COVID-19 infections in The Bahamas, while at the same time referring to a US travel advisory that, inter alia, advised its citizens not to travel to The Bahamas.”
The reporter said that there were 7,460 COVID-19 cases reported in The Bahamas on Tuesday, when in fact the number for that day was 29. The 7,460-figure referred to in the broadcast was the total number of cases recorded in The Bahamas to that date.
To make matters even worse, the news story was repeated on several social media outlets and at least one local news station.
One report suggested that the Ministry took no action to correct this mistake made by Channel 10 and the Ministry’s leadership in Miami was called into question.
The Ministry said that the Bahamas Consul-General in Miami had, in fact, immediately and appropriately contacted Channel 10 to point out the error. Channel 10 subsequently made a retraction the same day. Furthermore, the Consul-General provided Channel 10 with the correct statistics for The Bahamas.
The correction is on the website of Channel 10 and states, “Editor’s note: An earlier version of this story erroneously stated that 7,460 cases of COVID-19 had been reported on Tuesday. That number is, in fact, the total number of cases that have been confirmed in the Bahamas to date. We regret this error.
“Unfortunately, as is usually the case in situations such as this, the correction gets very little publicity compared to the original incorrect reporting,” the press release continued.
The Ministry takes this opportunity to remind the general public of its press release of 23 November 2020, which provided the views of the Ministry on the US’s most recent travel advisory on The Bahamas. These travel advisories are normal and are done in accordance with US regulations. There is a US travel advisory on virtually every country the world.
The Ministry remains engaged with the US Government, as it is with other Governments, to promote national interests and provide information about The Bahamas that will result in the most favorable outcomes possible for the Government and people of The Bahamas.
Washington D.C., (PAHO) – Measures to control COVID-19 can be made more effective by targeting, embracing, and engaging informal workers, migrants and other populations in vulnerable situations, say experts at the Pan American Health Organization (PAHO).
Recommendations and guidance about those measures are detailed in a new PAHO publication “Guidelines for the application of non-pharmacological public health measures in populations in vulnerable situations in the context of COVID-19.”
The publication includes guidance on how to improve the effectiveness of non-pharmaceutical interventions (NPI) – such as school and business closures, confinement at home, restrictions on transportation, and others – by ensuring that everyone can adhere to them, especially those populations in vulnerable situations. Recommendations are made on identifying the groups most impacted by these interventions and their barriers to adherence, along with suggestions on how to adapt the interventions so populations are protected.
“The pandemic has shown that vulnerability goes beyond just individual and biological characteristics,” said Gerry Eijkemans, Chief of the Health Promotion and Social Determinants Unit at PAHO. “Rather, it´s determined by the social, economic, and political context. Informal workers, migrants, and people living in overcrowded conditions, have proven to be especially vulnerable during the pandemic.”
The 60-page publication notes that some interventions have had negative secondary effects on these population groups, many of whom were struggling even before COVID-19 hit. It calls on policy makers to address the unintended effects of interventions such as business closures that leave informal workers without pay.
Likewise, some of the public health recommendations – such as telling people to wash their hands frequently when they have little or no access to clean water and soap – have proven difficult for them.
“Inclusive social policies that are developed with the participation of the impacted communities will make it easier to mitigate the undesirable effects of some public health measures meant to combat COVID-19,” said Eijkemans.
“It is absolutely critical to make sure that leaders are always considering equity issues and the social determinants of health when considering how to deal with the pandemic.”
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