Measles Mortality Reduction and Pre- Elimination in the African Region,

Size: px
Start display at page:

Download "Measles Mortality Reduction and Pre- Elimination in the African Region,"

Transcription

1 SUPPLEMENT ARTICLE Measles Mortality Reduction and Pre- Elimination in the African Region, Balcha G. Masresha, 1 Amadou Fall, 2 Messeret Eshetu, 3 Steve Sosler, 4 Mary Alleman, 2 James L. Goodson, 5 Reggis Katsande, 1 and Deogratias Nshimirimana 1 1 Immunisation and Vaccines Development Programme, Regional Office for Africa, World Health Organization, Brazzaville, The Republic of the Congo; 2 Immunisation and Vaccines Development Programme, West Africa Inter-Country Support Team, World Health Organization, Ouagadougou, Burkina Faso; 3 Immunisation and Vaccines Development Programme, East and South Africa Inter-Country Support Team, World Health Organization, Harare, Zimbabwe; 4 Immunisation and Vaccines Development Programme, Central Africa Inter-Country Support Team, World Health Organization, Libreville, Gabon; and 5 Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia Introduction. In 2001, countries in the African region adopted the measles-associated mortality reduction strategy recommended by the World Health Organization and the United Nations Children s Fund. With support from partners, these strategies were implemented during Methods. To assess implementation, estimates of the first dose of measles vaccination through routine services (MCVI) and reported coverage for measles supplemental immunization activities (SIAs) were reviewed. Measles surveillance data were analyzed. Results. During , regional MCV1 coverage increased from 56% to 69%, and.425 million children received measles vaccination through 125 SIAs. Measles case-based surveillance was established in 40 of 46 countries; the remaining 6 have aggregated case reporting. From 2001 through 2008, reported measles cases decreased by 92%, from 492,116 to 37,010; however, in 2009, cases increased to 83,625. Conclusions. The implementation of the recommended strategies led to a marked decrease in measles cases in the region; however, the outbreaks occurring since 2008 indicate suboptimal vaccination coverage. To achieve high MCV1 coverage, provide a second dose through either periodic SIAs or routine services, and to ensure further progress toward attaining the regional measles pre-elimination goal by 2012, a renewed commitment from implementing partners and donors is needed. Measles vaccination was introduced in Africa during the 1960s through mass campaigns as part of the Smallpox Eradication and Measles Control Programme [1, 2]. In 1978, the Expanded Programme on Immunization was established in the region and facilitated introduction of the first dose of measles-containing vaccine (MCV1) for infants,1 year of age through routine health services [3]; all 46 countries in the World Health Organization (WHO) African region (AFRO) provide routine measles vaccination [4]. In 1988, 12 of the 46 countries in the region had R75% MCV1 coverage according to the WHO and United Potential conflicts of interest: none reported. Correspondence: Balcha G. Masresha, MD, Regional Office for Africa, World Health Organization, Immunisation and Vaccines Development Programme, Boite Postale 6, Brazzaville, The Republic of the Congo (masreshab@zw.afro.who.int). The Journal of Infectious Diseases 2011;204:S198 S204 Ó The Author Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please journals.permissions@oup.com (print)/ (online)/2011/204s1-0025$14.00 DOI: /infdis/jir116 Nations Children s Fund (UNICEF) estimates [5]. In 1994, MCV1 coverage was estimated to be R75% in 16 countries; 10 of the 16 were in the WHO AFRO southern subregion [5]. In this subregion, 7 countries, Botswana, Lesotho,Malawi,Namibia,SouthAfrica,Swaziland,and Zimbabwe, each sustained 80% national MCV1 coverage for R3 years and experienced a dramatic decrease in measles incidence [6, 7]. In 1996, these countries embarked on a measles elimination initiative based on the strategy that had been used to achieve measles elimination in the region of the Americas and included (1) attaining high MCV1 coverage through routine health services, (2) providing a second opportunity for measles vaccination through supplemental immunization activities (SIAs), (3) laboratory-supported measles case-based surveillance, and (4) improved case management [6, 7, 8]. After implementation of these strategies in the 7 southern African countries, reported measles cases and deaths decreased further [7]. S198 d JID 2011:204 (Suppl 1) d Masresha et al

2 In 2001, a global goal was set by the WHO member states to reduce estimated measles-associated mortality by 50% by 2005, compared with the 1999 estimate; this goal was also adopted by the WHO African region [9]. Implementation of the recommended strategies led to an estimated 60% reduction in measlesassociated mortality worldwide and an estimated 75% reduction in Africa by 2005 [10]. After this remarkable progress, in 2006, the African region adopted a goal, outlined by WHO, UNICEF, and partners in the Global Immunization Vision and Strategy (GIVS) for , to achieve 90% measles-associated mortality reduction by 2010, compared with the estimate for 2000 [11, 12]. By 2008 in the African region, reported measles cases decreased by 93% and estimated measles mortality decreased by 92%, compared with 2000 [13]. In May 2008, the African regional measles technical advisory group (TAG) reviewed the progress in measles control and made recommendations related to (1) securing funds for implementation of the GIVS, (2) improving vaccine procurement and management, and (3) strengthening routine vaccination service delivery and the collection and use of measles surveillance data [14]. In addition, the TAG established new measles disease reduction targets and defined a pre-elimination goal to reduce measles-associated mortality by.98% by 2012, compared with the 2000 estimate, and to reduce the annual measles incidence to,5 cases per million population in all countries by To achieve these goals, benchmarks for vaccination coverage achieved through routine services and SIAs and surveillance performance indicators were established. The TAG recommendations and preelimination goal were adopted by the African Regional Task Force for Immunization at the end of 2008 [15]. This report summarizes progress toward implementation of measles control strategies in the African region during A review of vaccination coverage through routine services and SIAs, recent outbreaks, and progress toward strengthening measles case-based surveillance was conducted. In addition, this report outlines the challenges faced by efforts to sustain the achievements and to make further progress toward the measles pre-elimination goal in Africa. REGIONAL STRATEGIES AND METHODS The WHO and UNICEF recommended strategies for measlesassociated mortality reduction include providing MCV1 at or shortly after 9 months of age through routine services and a second dose of measles vaccine through either routine services (MCV2) or SIAs [16]. Ten percent to fifteen percent of children vaccinated at 9 months of age do not experience seroconversion [17]. During SIAs, vaccination is provided to children in the target age group irrespective of previous vaccination, and special efforts are made to reach children who do not routinely access health services [18]. The recommended SIA strategy includes an initial nationwide catch-up campaign targeting children 9 months to 14 years of age and periodic nationwide follow-up SIAs targeting children 9 months to 4 years of age [16]. Followup SIAs are conducted every 3 4 years; the frequency is based on the measles epidemiology and estimates of the number of individuals susceptible to measles [16]. Measles vaccination is provided using standard safe injection practices, including the use of auto-disable syringes and safety boxes for disposal of materials [18]. Field trainings are conducted to ensure safe injection practices and appropriate management of adverse events after vaccination. Routine Vaccination Services In Africa, routine vaccination services are provided during scheduled sessions at health facilities, by mobile teams, or during periodic outreach vaccination service delivery sessions. The number of doses administered is tallied and reported monthly to a central administrative level, where they are aggregated to calculate national administrative vaccination coverage. National administrative coverage is reported annually using the WHO/ UNICEF Joint Reporting Form (JRF) [19]. WHO and UNICEF, in collaboration with national Ministries of Health, generate vaccination coverage estimates based on the reported national administrative coverage, available surveys, and results from independent coverage verification [20]. To prevent measles epidemics, it is estimated that population immunity needs to be maintained at. 93% 95% in all districts [16]. In measles-associated mortality reduction settings, achieving and maintaining R90% MCV1 coverage nationally and R80% in each district is recommended; in countries with a regional measles elimination goal, R95% coverage with 2 doses in every district is recommended [16]. In 2008, the African regional measles TAG recommended that countries consider the introduction of MCV2 through routine services when the following 2 criteria are met: (1) national level MCV1 coverage of.80% is maintained for at least 3 consecutive years based on the WHO and UNICEF estimates and (2) the annual target is achieved for at least 1 of the 2 primary measles surveillance indicators for at least 2 consecutive years [14]. The 2 primary surveillance indicators are the proportion of districts reporting R1 suspected measles case with a blood specimen collected (target, R80% annually) and the national annualized rate of nonmeasles febrile rash illness (target,.2 cases per 100,000 population) [14]. After the introduction of MCV2, continued implementation of follow-up SIAs every 3 4 years is recommended until R90% MCV1 and MCV2 coverage nationally are achieved and sustained for at least 2 years and the 2 primary measles surveillance performance indicators are met and sustained for at least 2 years [14]. Supplemental Immunization Activities SIAs are typically conducted as nationwide activities over a period of several days; however, some countries have conducted Measles Mortality Reduction in Africa d JID 2011:204 (Suppl 1) d S199

3 the SIAs in phases covering different geographical areas during periods of 2 4 years because of large populations, expansive geography, or resource constraints [18]. During SIAs, vaccination is provided through permanent health facilities, temporary vaccination posts, and mobile teams. SIA administrative coverage at the subnational and national level is calculated by tallying the numbers of administered doses and dividing by the target population. Target population (denominator) figures are often projections from old census data and are prone to inaccuracy. Post-SIA coverage surveys are recommended to validate the administrative vaccination coverage achieved during the SIA [18]. SIA coverage of.95% in all districts is recommended by the African regional measles TAG [14]. Measles Surveillance Measles surveillance in Africa is conducted nationally through 2 surveillance systems: (1) integrated disease surveillance (IDS) and (2) measles case-based surveillance [21]. In the IDS system, clinically diagnosed measles cases are recorded with information on age and vaccination status in health facility registers. The registry data are tallied each month on a summary form and transmitted to the district level; the data are aggregated and reported to the national level and submitted to the WHO attheendoftheyearwithuseofthewho/unicefjrf[19,21]. Measles case-based surveillance, in accordance with WHO regional guidelines, was started in each country during the year after implementation of the initial catch-up SIA [21]. Measles case-based surveillance was integrated into existing acute flaccid paralysis (AFP) surveillance systems for polio detection. For measles case-based surveillance, each suspected case is investigated. The suspected measles case definition is generalized maculopapular rash and fever plus one of the following: cough, coryza (runny nose), or conjunctivitis [21]. For each suspected measles case, an individual case investigation form is completed and a blood specimen collected and sent to the national laboratory for testing for measles-specific immunoglobulin M (IgM) antibody [21]. A laboratory-confirmed case of measles is defined as a suspected case with serological confirmation of measles-specific IgM antibody in a person who had not received measles vaccination within 30 days before the specimen collection [21]. A measles-associated death in the case-based surveillance system is defined as any death from illness in a confirmed case of measles within 1 month after the onset of rash [21]. National measles laboratories in Africa are supported by regional reference laboratories in Côte d Ivoire, South Africa, and Uganda for quality control, virus isolation, and genotyping of specimens collected during outbreaks. The national laboratories undergo annual accreditation to ensure standard implementation according to WHO guidelines [21]. The WHO African regional measles surveillance guidelines define a suspected measles outbreak as the occurrence of R5 reported suspected measles cases in a health facility or district in 1 month, and a confirmed outbreak of measles is defined as R3 laboratory-confirmed measles cases in a health facility or district in 1 month [21]. After an outbreak has been confirmed as measles, laboratory confirmation of cases and individual case investigations are discontinued; subsequent suspected cases are confirmed by epidemiological linkage and are reported, with information on age and vaccination status, in line-list format [21]. In the context of an outbreak, an epidemiologically linked case is one without a blood specimen collected and is linked in person, place, and time to a laboratory-confirmed case. WHO guidelines for outbreak response recommend action based on the epidemiological features of the outbreak [22]. Case-based surveillance data are compiled at the national level into a computerized database that is shared monthly with WHO AFRO. WHO AFRO monitors case-based surveillance performance indicators, including (1) the proportion of districts reporting R1 suspected measles case for which a blood specimen was collected (annual target, R80%) and (2) the annualized rate of nonmeasles febrile rash illness (annual target,.2 cases/ 100,000 population) [23]. The rate of nonmeasles febrile rash illness was introduced to the surveillance system in 2007 to monitor its sensitivity [23]. Case Management Appropriate management of clinical measles cases, including vitamin A supplementation, is essential for reducing morbidity and mortality. It is recommended that all children with measles infection receive 2 doses of vitamin A and that all patients are provided with supportive treatment, including fluids and antipyretics [22]. Antibiotics are only recommended for cases complicated by otitis media or pneumonia [22]. RESULTS Routine Vaccination According to WHO/UNICEF estimates, MCV1 coverage for infants 1 year of age in the African region increased from 56% in 2001 to 69% in 2009 (Figure 1). In 2009, of the 46 countries in the region, estimated MCV1 coverage was,60% in 6 (Chad, Equatorial Guinea, Gabon, Guinea, Mauritania, and Nigeria), 60% 79% in 23, 80% 89% in 4, and R90% in 13 [5]. Of the 6 countries that provided MCV2 through routine services in 2009, reported MCV2 coverage was 70% for Lesotho; R85% for Mauritius, the Seychelles, and South Africa; and not reported by Algeria and Swaziland. In 2009, the countries that were eligible for introduction of MCV2 after the attainment of the criteria established by the regional measles TAG were Ghana, Eritrea, Malawi, São Tomé and Principe, and Zambia; introduction of MCV2 in these countries awaits securing of funding from the GAVI Alliance [14]. S200 d JID 2011:204 (Suppl 1) d Masresha et al

4 Figure 1. Number of measles cases reported and estimated percentage of children who received measles vaccine through routine services, , World Health Organization African Region. Cases of measles as reported to the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) through the Joint Reporting Form [24]. Vaccination coverage data are from WHO and UNICEF estimates [5]. Supplemental Immunization Activities Before 2000, 7 countries (Botswana, Lesotho, Malawi, Namibia, South Africa, Swaziland, and Zimbabwe) in the region completed a measles catch-up SIA. As of the end of 2009, catch-up SIAs and/or R1 follow-up SIAs had been conducted by all countries except Algeria, Mauritius, and the Seychelles (Table 1). During , a total of 425,336,965 children were vaccinated during a total of 125 measles SIAs in the region; of these, 236,417,893 (56%) were vaccinated during catch-up SIAs in 34 countries and 188,919,072 (44%) during follow-up SIAs in 41 countries (Table 1). Of the 125 SIAs during , SIA administrative coverage was,90% for 25, 90% 94% for 17, 95% 100% for 45,.100% for 35, and not available for 3. Eleven countries conducted the catch-up SIA in phases (Benin, Cameroon, Central African Republic, Chad, the Democratic Republic of the Congo, Ethiopia, Ghana, Niger, Nigeria, the United Republic of Tanzania, and Zambia); in general, the phases covered different geographical areas over various periods that ranged from 2 to 4 years. Measles SIAs have provided a platform for the integrated delivery of other essential child survival interventions, especially vitamin A supplementation, in many countries. In addition to vitamin A, other SIA-integrated interventions have included oral polio vaccine, yellow fever vaccine, tetanus toxoid vaccine for women of child bearing age, deworming tablets, insecticidetreated bed nets, and praziquantel in areas where schistosomiasis is endemic. During , 39 of 68 SIAs had at least 2 integrated interventions; since 2006, all except one included R1 integrated intervention. Measles Surveillance The annual number of measles cases reported through the WHO and UNICEF JRF in Africa decreased from.1 million during the early 1980s to 520,102 in 2000 (Figure 1). During , reported cases decreased from 492,116 cases to 37,010 cases, a 92% decrease and a historic low for Africa. However, in 2009, suspected cases increased to 83,625 among the 46 countries of the region. The number of countries with established measles case-based surveillance in accordance with the WHO African regional measles surveillance guidelines increased from 26 in 2004 to 40 in 2009 (Table 2). The annual number of confirmed measles cases in the region detected through case-based surveillance ranged from 2787 in 2004 to 14,445 in The regional annual incidence of confirmed measles ranged from 0.7 cases per 100,000 population in 2004 to 1.9 cases per 100,000 population in 2009 (Table 2). In 2009, of the 40 countries with case-based surveillance, 20 (50%) met the target of R80% of their districts reporting R1 suspected measles case accompanied by a blood specimen, 21 (53%) had a nonmeasles febrile rash illness rate of.2 cases per 100,000 population, and 14 (35%) met targets for both of these main measles case-based surveillance performance indicators (Table 2). Measles Outbreaks During , large measles outbreaks occurred in Angola, Burkina Faso, the Democratic Republic of the Congo, Ethiopia, Mali, Namibia, and South Africa, with the number of reported cases ranging from 3511 in Ethiopia in 2008 to 54,118 in Burkina Measles Mortality Reduction in Africa d JID 2011:204 (Suppl 1) d S201

5 Table 1. Measles Supplementary Immunization Activities by Country, 2009, World Health Organization African Region SIA Target Children vaccinated in target Country Year Type Age group Area No. % Angola 2009 Follow-up 9 59 months Nationwide 3,469, Botswana 2009 Follow-up 9 59 months Nationwide 187, Burundi 2009 Follow-up 9 59 months Nationwide 1,321, Cameroon 2009 Follow-up 9 59 months Nationwide 3,315, Cape Verde 2009 Follow-up months Nationwide 47, Chad 2009 Follow-up 6 59 months Nationwide 1,782, DR Congo 2009 Follow-up 6 59 months Sub-national 2,412, Equatorial Guinea 2009 Follow-up 9 59 months Nationwide 70, Eritrea 2009 Follow-up 9 59 months Nationwide 285, Ethiopia 2009 Follow-up 9 59 months Sub-national 266, Guinea 2009 Follow-up 9 59 months Nationwide 1,977, Guinea-Bissau 2009 Follow-up 6 59 months Nationwide 208, Kenya 2009 Follow-up 9 59 months Nationwide 5,525, Namibia 2009 Follow-up 9 59 months Nationwide 298, Rwanda 2009 Follow-up 9 59 months Nationwide 1,350, Sierra Leone 2009 Follow-up 9 59 months Nationwide 829, Swaziland 2009 Follow-up 9 47 months Nationwide 91, Uganda 2009 Follow-up 9 47 months Nationwide 4,894, Zimbabwe 2009 Follow-up 9 59 months Nationwide 1,408, Total 29,743,062 NOTE. A complete list of measles supplementary immunization activities (SIAs) by country, , conducted in the World Health Organization African Region can be found in the Supplementary Data, available online. Faso in 2009, according to a combination of IDS and case-based surveillance data. During these outbreaks, case-reporting through the case-based surveillance system was incomplete; therefore, epidemiologic analyses and incidence figures from the case-based data did not fully represent all measles cases in these countries. DISCUSSION After the adoption of the WHO measles mortality reduction strategy in 2001, MCV1 coverage, based on WHO/UNICEF estimates, increased in nearly all countries in the African region by 2009; 17 had R80% coverage, and 13 had R90% coverage. Table 2. Measles Case-Based Surveillance Reports and Performance Indicators, , World Health Organization African Region Year Number of countries with measles case-based surveillance Number of suspected measles cases reported 17,100 14,185 21,580 24,636 37,162 35,984 Number of confirmed measles cases a ,286 14,445 Incidence of confirmed measles per 100,000 population Annualized non measles febrile rash illness rate (target:.2 per ,000 population) b Number of countries that met target: R80% of reported cases investigated with blood specimens Number of countries that met target: R80% of districts reporting R1 suspected case with blood specimen collected Number of countries that have met the target:.2 per 100, population non-measles febrile rash illness reporting rate Number of countries that met both targets: R80% of districts reporting R1 suspected case with blood specimen collected and.2 per 100,000 population nonmeasles febrile rash illness rate NOTE. a Confirmed by either laboratory testing or epidemiological link. b Indicator introduced in S202 d JID 2011:204 (Suppl 1) d Masresha et al

6 Since 2001,.425,336,965 children have received measles vaccination through SIAs. By 2008, reported cases had decreased by 93% to a historic low for Africa, and estimated measles-related mortality had decreased by.92% in the region, compared with estimates for 2000 [13]. These achievements prompted the adoption of a pre-elimination goal to achieve 98% mortality reduction by 2012, compared with 2000 [15]. Routine immunization services benefited overall from financial resources through the GAVI Alliance awards for health systems strengthening to attain improved vaccination coverage. The Reaching Every District (RED) approach to strengthening routine vaccination services at the district level ensures that sustained demand is created through appropriate programmatic decision making and community linkages to service delivery [25, 26]. The RED approach is currently being implemented in 45 countries in the region. Despite improvements in MCV1 coverage at the national level, subnational gaps in coverage persist, with nearly 7.8 million infants in the African region not receiving MCV1 in 2008 [5]. National level administrative coverage achieved during measles SIAs was R95% in 80 of the 125 SIAs. However, inaccurate target populations have led to overestimates of coverage in some countries. Efforts are under way to improve the estimation of population denominators and to identify best practices in SIA planning and implementation. Supervision and monitoring during SIAs can identify gaps in campaign performance and quality and provide the opportunity to implement corrective measures while the SIA is ongoing [18]. Population-based post-campaign coverage surveys should be routinely conducted to verify coverage and identify areas with low vaccination coverage [27]. Since 2001, countries in the region have conducted measles SIAs with the technical and financial support of the Measles Initiative, a partnership led by the American Red Cross, the Centers for Disease Control and Prevention, UNICEF, the United Nations Foundation, and the WHO [28]. The partners are continually seeking resources for SIAs and also advocate to governments and local organizations to gain their support. These support activities are critical, because SIAs will continue to be a strategy for filling gaps in population immunity in the African region. Measles case-based surveillance has been established in 40 of the 46 countries in the region; aggregate case surveillance is used in the remaining 6 countries. Despite steady improvements in performance, 20 of the 40 countries missed the targets for at least 1 of the main performance indicators in 2009, and surveillance remains suboptimal in several countries, including Angola, the Democratic Republic of the Congo, Guinea, Madagascar, Mozambique, and Tanzania. Efforts are being made to strengthen case-based surveillance in these and other countries through technical assistance, capacity building, performance monitoring at subnational levels, and fostering better integration with the AFP surveillance system. Well-functioning surveillance is essential for the early identification and epidemiological analysis of outbreaks and as a tool for analyzing the impact of control strategies. From 1 December 2009 through 30 June 2010, confirmed measles outbreaks were reported in 27 countries in the WHO African region through the IDS and case-based surveillance systems, including.79,000 suspected measles cases and.1100 measles-related deaths. The largest numbers of suspected cases were reported by South Africa (15,520 cases), Malawi (11,461), Zimbabwe (8173), Nigeria (6432), and Chad (5832). The largest numbers of deaths attributed to measles were reported by Zimbabwe (517) and Chad (230). Outbreak response activities, including strengthening case management and routine immunization services, were conducted in these countries. In addition, several countries, including Chad, Ethiopia, Mali, Malawi, Namibia, Swaziland, South Africa, and Zimbabwe, conducted outbreak response vaccination activities either in limited geographic areas or on a nationwide scale. The measles outbreaks that occurred in several countries since 2008 indicate low population immunity levels as a result of suboptimal routine and SIA vaccination coverage in some areas and countries. Reported national coverage.90% for MCV1 and SIAs in some of these countries (eg, Benin, Burkina Faso, and Tanzania) suggests overestimates of coverage. Outbreaks with a large proportion of cases in children,5 years of age that have occurred in countries (eg, Angola, Nigeria, and Zimbabwe) within 1 2 years after a follow-up SIA suggest suboptimal implementation of the SIAs. In Botswana, South Africa, Swaziland, and Zimbabwe, the outbreaks were partly related to vaccination refusals from some religious groups. Analysis of surveillance data from these countries found that the age distribution of cases in these outbreaks included older children and young adults; however, the highest age-specific attack rates were among children,5 years of age, and the proportion of patients who had been vaccinated was low. To sustain the gains achieved thus far and to attain the regional measles pre-elimination goal for 2012, ongoing commitment from the member states, implementing partners, and donors is needed. Competing national priorities and inadequate local and partner financing limit efforts to conduct timely SIAs, high-quality measles surveillance, and responses to outbreaks. The implementation of measles control activities has been possible through the financial and technical support of the Measles Initiative. Continued advocacy and resource mobilization by all stakeholders will be critical to ensure further progress toward achieving the pre-elimination goal in the African region. Supplementary Data Supplementary data are available at org/ online. Measles Mortality Reduction in Africa d JID 2011:204 (Suppl 1) d S203

7 Funding This work was supported by the World Health Organization (to B. M, A. F., M. E., R. K., and D. N.) and the Centers for Disease Control and Prevention (to S. S., M. A., and J. G.) Acknowledgments We thank all immunization officers, surveillance medical officers, and measles laboratory personnel across the African region who were involved in the implementation of the strategies for measles control and the Measles Initiative for providing financial and logistical support to member states towards measles mortality reduction and pre-elimination in the African region. References 1. Guyer B, McBean AM. The epidemiology and control of measles in Yaoundé, Cameroun, Int J Epidemiol 1981; 10: Cutts F, Henderson R, Clements C, Chen R, Patriarca P. Principles of measles control. Bull World Health Organ 1991; 69: Bele O, Barakamfitiye DG. The Expanded Program on Immunization in the WHO African region: current situation and implementation constraints. Sante 1994; 4: Centers for Disease Control and Prevention. Progress toward measles control African region, MMWR Morb Mortal Wkly Rep 2009; 58: World Health Organization. WHO/UNICEF estimates of national immunization coverage, WHO-UNICEF estimates of MCV coverage. Accessed 19 August World Health Organization. Expanded programme on immunization (EPI), measles control in the WHO African region. Wkly Epidemiol Rec 1996; 71: Biellik R, Madema S, Taole A, et al. First 5 years of measles elimination in southern Africa: Lancet 2002; 359: Otten M, Kezaala R, Fall A, et al. Public-health impact of accelerated measles control in the WHO African Region Lancet 2005; 366: World Health Organization. Progress towards measles control in WHO s African Region, Wkly Epidemiol Rec 2009; 84: Wolfson LJ, Strebel PM, Gacic-Dobo M, Hoekstra EJ, McFarland JW, Hersh BS. Has the 2005 measles mortality reduction goal been achieved? A natural history modelling study. Lancet 2007; 369: World Health Organization/United Nations Children s Fund. Global immunization vision and strategy immunization/givs/en/index.html. Accessed 19 August Centers for Disease Control and Prevention. Progress in global measles control and mortality reduction, MMWR Morb Mortal Wkly Rep 2008; 57: Centers for Disease Control and Prevention. Global measles mortality, MMWR Morb Mortal Wkly Rep 2009; 58: WorldHealthOrganizationRegionalOffice for Africa. Report of the second meeting of the African regional measles technical advisory group publications-measles&catid=1974&itemid=2734. Accessed 16 March World Health Organization, Regional Office for Africa. WHO AFRO IVD Programme Task Force on Immunization (TFI) Recommendations Accessed 19 August World Health Organization. Measles vaccines: WHO position paper. Wkly Epidemiol Rec 2009; 84: Strebel PM, Papania MJ, Dayan GH, Halsey NA. Measles vaccine. In Plotkin SA, Orenstein WA, Offit PA eds: Vaccines, 5th ed. Philadelphia: Saunders Elsevier, 2008: World Health Organization. Regional Office for Africa. Measles SIA Field Guide, content&view=article&id=1939:measles-supplemental-immunizationactivities-sias-&catid=1974&itemid=2734. Accessed 16 March World Health Organization. WHO/UNICEF Joint reporting process, reporting/en/index.html. Accessed 19 August Burton A, Monasch R, Lautenbach B, et al. WHO and UNICEF estimates of national infant immunization coverage: methods and processes. Bull World Health Organ 2009; 87: World Health Organization Regional Office for Africa. Guidelines for measles surveillance, com_content&view=article&id=2383:publications-measles&catid=1974& Itemid=2734. Accessed 16 March World Health Organization. Response to measles outbreaks in measles mortality reduction settings, WHO_IVB_09.03_eng.pdf. Accessed 18 March World Health Organization Regional Office for Africa. Case-based measles surveillance with lab confirmation, afro.who.int/index.php?option=com_content&view=article&id=1938: case-based-measles-surveillance-with-lab-confirmation-&catid=1974& Itemid=2734. Accessed 18 March World Health Organization. Measles reported cases. immunization_monitoring/en/globalsummary/timeseries/tsincidencemea. htm. Accessed 19 August Ryman T, Macauley R, Nshimirimana D. Reaching every district (RED) approach to strengthen routine immunization services: evaluation in the African region, J Public Health 2009; 32: World Health Organization, Regional Office for Africa. Implementing the reach every district approach, a guide for district health management teams ard/immunization-and-vaccines-development/ivd-publications.html. Accessed 19 August World Health Organization Regional Office for Africa. Evaluation guidelines for measles supplemental immunization activities, article&id=2383:publications-measles&catid=1974&itemid=2734. Accessed 16 March The Measles Initiative. The Measles Initiative, measlesinitiative.org/. Accessed 19 August S204 d JID 2011:204 (Suppl 1) d Masresha et al

Performance of National Measles Case-Based Surveillance Systems in The WHO African Region

Performance of National Measles Case-Based Surveillance Systems in The WHO African Region Research Article Open Access Performance of National Measles Case-Based Surveillance Systems in The WHO African Region. 2012 2016 Balcha Masresha 1 *, Reggis Katsande 1, Richard Luce 2, Amadou Fall 3,

More information

MEASLES ELIMINATION BY 2020: A STRATEGY FOR THE AFRICAN REGION. Report of the Secretariat. Executive Summary

MEASLES ELIMINATION BY 2020: A STRATEGY FOR THE AFRICAN REGION. Report of the Secretariat. Executive Summary 16 June 2011 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-first session Yamoussoukro, Côte d Ivoire, 29 August 2 September 2011 Provisional agenda item 13 MEASLES ELIMINATION BY 2020: A STRATEGY

More information

IMMUNIZATION & VACCINE PREVENTABLE DISEASES

IMMUNIZATION & VACCINE PREVENTABLE DISEASES IMMUNIZATION & VACCINE PREVENTABLE DISEASES MONTHLY IMMUNIZATION UPDATE IN THE AFRICAN REGION July-August 2015 (Vol 3, issue N 6 ) Special issue on WHO/UNICEF Estimates of National Immunization Coverage

More information

POLIOMYELITIS ERADICATION: PROGRESS REPORT. Information Document CONTENTS BACKGROUND PROGRESS MADE NEXT STEPS... 12

POLIOMYELITIS ERADICATION: PROGRESS REPORT. Information Document CONTENTS BACKGROUND PROGRESS MADE NEXT STEPS... 12 5 August 9 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Fifty-ninth session Kigali, Republic of Rwanda, August 4 September 9 POLIOMYELITIS ERADICATION: PROGRESS REPORT Information Document CONTENTS

More information

What is this document and who is it for?

What is this document and who is it for? Measles and Rubella Initiative s Standard Operating Procedures for Accessing Support for Measles and Rubella Supplementary Immunization Activities During 2016 In the context of measles and rubella elimination

More information

Global reductions in measles mortality and the risk of measles resurgence

Global reductions in measles mortality and the risk of measles resurgence Global reductions in measles mortality 2000 2008 and the risk of measles resurgence Measles is one of the most contagious human diseases. In 1980 before the use of measles vaccine was widespread, there

More information

CONTENTS. Paragraphs I. BACKGROUND II. PROGRESS REPORT ON THE AFRICAN REGIONAL IMMUNIZATION STRATEGIC PLAN

CONTENTS. Paragraphs I. BACKGROUND II. PROGRESS REPORT ON THE AFRICAN REGIONAL IMMUNIZATION STRATEGIC PLAN 23 September 2013 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-third session Brazzaville, Republic of Congo, 2 6 September, 2013 Agenda item 14 IMMUNIZATION IN THE AFRICAN REGION: PROGRESS REPORT

More information

PROGRESS REPORT ON CHILD SURVIVAL: A STRATEGY FOR THE AFRICAN REGION. Information Document CONTENTS

PROGRESS REPORT ON CHILD SURVIVAL: A STRATEGY FOR THE AFRICAN REGION. Information Document CONTENTS 29 June 2009 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Fifty-ninth session Kigali, Republic of Rwanda, 31 August 4 September 2009 Provisional agenda item 9.2 PROGRESS REPORT ON CHILD SURVIVAL: A

More information

TFI Proceedings, Recommendations and implications for 2005

TFI Proceedings, Recommendations and implications for 2005 January 2005 N 053 TFI 2004 - Proceedings, Recommendations and implications for 2005 The 12th meeting of the Task Force on Immunization (TFI) in Africa and the 11th meeting of the Africa Regional Inter-

More information

PROGRESS REPORT ON THE ROAD MAP FOR ACCELERATING THE ATTAINMENT OF THE MILLENNIUM DEVELOPMENT GOALS RELATED TO MATERNAL AND NEWBORN HEALTH IN AFRICA

PROGRESS REPORT ON THE ROAD MAP FOR ACCELERATING THE ATTAINMENT OF THE MILLENNIUM DEVELOPMENT GOALS RELATED TO MATERNAL AND NEWBORN HEALTH IN AFRICA 5 July 2011 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-first session Yamoussoukro, Côte d Ivoire, 29 August 2 September 2011 Provisional agenda item 17.1 PROGRESS REPORT ON THE ROAD MAP FOR

More information

Measles Supplementary Immunization Activities and GAVI Funds as Catalysts for Improving Injection Safety in Africa

Measles Supplementary Immunization Activities and GAVI Funds as Catalysts for Improving Injection Safety in Africa SUPPLEMENT ARTICLE Measles Supplementary Immunization Activities and GAVI Funds as Catalysts for Improving Injection Safety in Africa Edward J. Hoekstra, 1 Maya M. V. X. van den Ent, 1 Halima Dao, 1 Hala

More information

IMMUNIZATION VACCINE DEVELOPMENT

IMMUNIZATION VACCINE DEVELOPMENT IMMUNIZATION VACCINE DEVELOPMENT MONTHLY IMMUNIZATION UPDATE IN THE AFRICAN REGION July-August 2016 (Vol 4, issue N 5) Special issue on 2015 WHO/UNICEF Estimates of National Immunization Coverage (WUENIC)

More information

IMMUNIZATION VACCINES & EMERGENCIES

IMMUNIZATION VACCINES & EMERGENCIES No report No data No data IMMUNIZATION VACCINES & EMERGENCIES ROUTINE IMMUNIZATION PERFORMANCE IN THE AFRICAN REGION October 2013 issue Number of children vaccinated with the 3 rd dose of DTPcontaining

More information

ANNEX Page. AFR/RC61/11 4 July 2011 ORIGINAL: ENGLISH REGIONAL COMMITTEE FOR AFRICA

ANNEX Page. AFR/RC61/11 4 July 2011 ORIGINAL: ENGLISH REGIONAL COMMITTEE FOR AFRICA 4 July 2011 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-first session Yamoussoukro, Côte d Ivoire, 29 August 2 September 2011 Provisional agenda item 16 PROGRESS REPORT ON POLIOMYELITIS ERADICATION

More information

1) SO1: We would like to suggest that the indicator used to measure vaccine hesitancy be DTP 1 to measles first dose dropout.

1) SO1: We would like to suggest that the indicator used to measure vaccine hesitancy be DTP 1 to measles first dose dropout. To SAGE Secretariat, WHO Dear Professor Helen Rees, Dear Dr. Jean Marie Okwo-Bele, On behalf of the Civil Society Constituency of the GAVI Alliance, we would like to thank SAGE and its members for the

More information

POLIO ERADICATION IN THE AFRICAN REGION: PROGRESS REPORT. Information document EXECUTIVE SUMMARY

POLIO ERADICATION IN THE AFRICAN REGION: PROGRESS REPORT. Information document EXECUTIVE SUMMARY 7 July 2006 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Fifty-sixth session Addis Ababa, Ethiopia, 28 August 1 September 2006 Provisional agenda item 10.1 POLIO ERADICATION IN THE AFRICAN REGION: PROGRESS

More information

Malaria Funding. Richard W. Steketee MACEPA, PATH. April World Malaria Day 2010, Seattle WA

Malaria Funding. Richard W. Steketee MACEPA, PATH. April World Malaria Day 2010, Seattle WA Malaria Funding Richard W. Steketee MACEPA, PATH April World Malaria Day 2010, Seattle WA Malaria Funding Is there a plan? Is there money? Where does the money come from? Is the money moving efficiently?

More information

Introduction of the Second Dose of Measles Containing Vaccine in the Childhood Vaccination Programs Within the WHO Africa Region Lessons Learnt

Introduction of the Second Dose of Measles Containing Vaccine in the Childhood Vaccination Programs Within the WHO Africa Region Lessons Learnt the Second Dose of Measles Containing Vaccine in the Childhood Vaccination Programs Within the WHO Africa Region Lessons Learnt. J Immunol Sci (2018); S Research Article Open Access Introduction of the

More information

SUPPLEMENTARY APPENDICES FOR ONLINE PUBLICATION. Supplement to: All-Cause Mortality Reductions from. Measles Catch-Up Campaigns in Africa

SUPPLEMENTARY APPENDICES FOR ONLINE PUBLICATION. Supplement to: All-Cause Mortality Reductions from. Measles Catch-Up Campaigns in Africa SUPPLEMENTARY APPENDICES FOR ONLINE PUBLICATION Supplement to: All-Cause Mortality Reductions from Measles Catch-Up Campaigns in Africa (by Ariel BenYishay and Keith Kranker) 1 APPENDIX A: DATA DHS survey

More information

IMMUNIZATION VACCINE DEVELOPMENT

IMMUNIZATION VACCINE DEVELOPMENT IMMUNIZATION VACCINE DEVELOPMENT MONTHLY IMMUNIZATION AND POLIO UPDATE IN THE AFRICAN REGION January February 2017 (Vol 5 issue N 1) District data completeness and coverage of DTP3 containing vaccine per

More information

Overview of WHO/UNICEF Immunization Coverage Estimates

Overview of WHO/UNICEF Immunization Coverage Estimates Overview of WHO/UNICEF Immunization Coverage Estimates Marta Gacic-Dobo, Anthony Burton, David Durrheim Meeting of the Strategic Advisory Group of Experts on Immunization (SAGE) 8-10 November 2011 CCV/CICG,

More information

Ouagadougou Declaration

Ouagadougou Declaration Ouagadougou Declaration on Primary Health Care and Health Systems in Africa: Achieving Better Health for Africa in the New Millennium A declaration by the Members States of the WHO African Region 30 April

More information

CANCER OF THE CERVIX IN THE AFRICAN REGION: CURRENT SITUATION AND WAY FORWARD

CANCER OF THE CERVIX IN THE AFRICAN REGION: CURRENT SITUATION AND WAY FORWARD 23 June 2010 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: FRENCH Sixtieth session Malabo, Equatorial Guinea, 30 August 3 September 2010 Provisional agenda item 7.4 CANCER OF THE CERVIX IN THE AFRICAN REGION:

More information

IMMUNIZATION VACCINE DEVELOPMENT

IMMUNIZATION VACCINE DEVELOPMENT IMMUNIZATION VACCINE DEVELOPMENT IMMUNIZATION AND POLIO UPDATE IN THE AFRICAN REGION July August 2017 (Vol 5 issue N 4) Special issue featuring WHO/UNICEF Estimates of National Immunization Coverage (WUENIC

More information

AIDS in Africa. An Update. Basil Reekie

AIDS in Africa. An Update. Basil Reekie AIDS in Africa An Update Basil Reekie Contents General Statistics The trend of HIV in Africa Ugandan experience UNAIDS 2006 Latest African Statistics by Country HIV Intervention Light at the end of the

More information

FRAMEWORK FOR IMPLEMENTING THE GLOBAL STRATEGY TO ELIMINATE YELLOW FEVER EPIDEMICS (EYE), IN THE AFRICAN REGION. Report of the Secretariat

FRAMEWORK FOR IMPLEMENTING THE GLOBAL STRATEGY TO ELIMINATE YELLOW FEVER EPIDEMICS (EYE), IN THE AFRICAN REGION. Report of the Secretariat 13 June 2017 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-seventh session Victoria Falls, Republic of Zimbabwe, 28 August 1 September 20177 Provisional agenda item 11 FRAMEWORK FOR IMPLEMENTING

More information

GOAL 2: ACHIEVE RUBELLA AND CRS ELIMINATION. (indicator G2.2) Highlights

GOAL 2: ACHIEVE RUBELLA AND CRS ELIMINATION. (indicator G2.2) Highlights GOAL 2: ACHIEVE RUBELLA AND CRS ELIMINATION (indicator G2.2) Highlights As of December 2014, 140 Member States had introduced rubella vaccines; coverage, however, varies from 12% to 94% depending on region.

More information

Scaling Up Nutrition Action for Africa

Scaling Up Nutrition Action for Africa Scaling Up Nutrition Action for Africa Where are we and what challenges are need to be addressed to accelerate malnutrition? Lawrence Haddad Global Alliance for Improved Nutrition Why should African political

More information

GABON. Neglected tropical disease treatment report profile for mass treatment of NTDs

GABON. Neglected tropical disease treatment report profile for mass treatment of NTDs GABON Neglected tropical disease treatment report 2017 1 2017 profile for mass treatment of NTDs NEGLECTED TROPICAL DISEASES Neglected tropical diseases (NTDs) are a group of preventable and treatable

More information

UNAIDS 2013 AIDS by the numbers

UNAIDS 2013 AIDS by the numbers UNAIDS 2013 AIDS by the numbers 33 % decrease in new HIV infections since 2001 29 % decrease in AIDS-related deaths (adults and children) since 2005 52 % decrease in new HIV infections in children since

More information

Global Vaccine Action Plan

Global Vaccine Action Plan Global Vaccine Action Plan Regional reports on progress towards GVAP RVAP goals Annex to the GVAP Secretariat Annual Report 2017 World Health Organization 2017 Some rights reserved. This work is available

More information

Update from GAVI Aurelia Nguyen

Update from GAVI Aurelia Nguyen Update from GAVI Aurelia Nguyen (Copenhagen, Denmark, 27 June 2012) GAVI vaccine support Currently supported vaccines: pentavalent, pneumococcal, rotavirus, meningitis A, human papillomavirus (HPV), rubella,

More information

CDER EDITORIAL Through this issue of the

CDER EDITORIAL Through this issue of the REGIONAL OFFICE FORAfrica DATA VALID EFFECTIVE 17 FEBRUARY 2010 In this issue CDER Editorial 65 Breaking news: cerebrospinal meningitis epidemics 65 Summary findings from IDSR weekly surveillance of diseases

More information

ASLM Anti-microbial Resistance in Africa and Global Health Security. 9TH INTEREST WORKSHOP May 2015 Harare

ASLM Anti-microbial Resistance in Africa and Global Health Security. 9TH INTEREST WORKSHOP May 2015 Harare ASLM Anti-microbial Resistance in Africa and Global Health Security 9TH INTEREST WORKSHOP 2015 8 May 2015 Harare Recent Jim O Neil Report commissioned by the UK government predicts dire consequences of

More information

THE SITUATION OF YELLOW FEVER IN THE AFRICAN REGION: THE PLAN TO END YF EPIDEMICS IN 2026

THE SITUATION OF YELLOW FEVER IN THE AFRICAN REGION: THE PLAN TO END YF EPIDEMICS IN 2026 THE SITUATION OF YELLOW FEVER IN THE AFRICAN REGION: THE PLAN TO END YF EPIDEMICS IN 2026 Dr Zabulon Yoti WHO AFRO Technical Coordinator for Health Emergencies 1 About 100 acute public health events annually

More information

The Promise of Introducing Rubella Containing Vaccines on the Impact of Rubella and Measles Control

The Promise of Introducing Rubella Containing Vaccines on the Impact of Rubella and Measles Control The Promise of Introducing Rubella Containing Vaccines on the Impact of Rubella and Measles Control GAVI Partners Forum 4 6 December 2012, Dar es Salaam, Tanzania Maya van den Ent, MPH, UNICEF Peter Strebel,

More information

IMMUNIZATION VACCINE DEVELOPMENT

IMMUNIZATION VACCINE DEVELOPMENT IMMUNIZATION VACCINE DEVELOPMENT MONTHLY IMMUNIZATION UPDATE IN THE AFRICAN REGION November December 2016 (Vol 4, issue N 7) District data completeness and coverage of DTP3 containing vaccine per country

More information

Aboubacar Kampo Chief of Health UNICEF Nigeria

Aboubacar Kampo Chief of Health UNICEF Nigeria Aboubacar Kampo Chief of Health UNICEF Nigeria Many thanks to UNICEF colleagues in Supply Division-Copenhagen and NY for contributing to this presentation Thirty-five countries are responsible for 98%

More information

Update from the GAVI Alliance Seth Berkley, MD Chief Executive Officer

Update from the GAVI Alliance Seth Berkley, MD Chief Executive Officer Update from the GAVI Alliance Seth Berkley, MD Chief Executive Officer SAGE meeting Geneva, 8-10 November 2011 Topics to cover Update on new vaccine introduction Introductions New approvals Co-financing

More information

Children in Africa. Key statistics on child survival, protection and development

Children in Africa. Key statistics on child survival, protection and development Children in Key statistics on child survival, protection and development Key Statistics In, mortality rates among children under five decreased by 48 per cent between 199 and 13, but still half of the

More information

Annex 2 A. Regional profile: West Africa

Annex 2 A. Regional profile: West Africa Annex 2 A. Regional profile: West Africa 355 million people at risk for malaria in 215 297 million at high risk A. Parasite prevalence, 215 Funding for malaria increased from US$ 233 million to US$ 262

More information

AFRICA. The continent of All challenges

AFRICA. The continent of All challenges AFRICA The continent of All challenges Part of Resources and burden of the disease in Africa Africa=25% Rest of the World=75% Africa=0.6% Rest of the World=99.4% 0% 20% 40% 60% 80% 100% 57 Critical shortage

More information

HPV Vaccine Lessons Learned & New Ways Forward

HPV Vaccine Lessons Learned & New Ways Forward HPV Vaccine Lessons Learned & New Ways Forward The Gavi Alliance June 2016, Geneva www.gavi.org Overview 1 Background 2 Lessons learned 3 New Way Forward 2 1 Background 3 HPV Background HPV is responsible

More information

Prioritizing Emergency Polio Eradication Activities

Prioritizing Emergency Polio Eradication Activities Prioritizing Emergency Polio Eradication Activities Managing the Financing Gap the other half of the Emergency Hamid Jafari GPEI Financing 2012-13: Budget = $2.23 b - Confirmed contributions = $1.14 b

More information

Pneumococcal Conjugate Vaccine: Current Supply & Demand Outlook. UNICEF Supply Division

Pneumococcal Conjugate Vaccine: Current Supply & Demand Outlook. UNICEF Supply Division Pneumococcal Conjugate Vaccine: Current Supply & Demand Outlook UNICEF Supply Division Update: October 2013 0 Pneumococcal Conjugate Vaccine (PCV) Supply & Demand Outlook October 2013 Update Key updates

More information

Influenza Surveillance In the WHO African Region

Influenza Surveillance In the WHO African Region Vol. 2 N 52, Updated on 2 January 207 Contents Highlights ackground Methodology Review of 206 influenza virus circulation Seasonal patterns of influenza transmission Way forward Conclusion Editor Dr Ibramima

More information

Expert Group Meeting on the Regional Report for the African Gender and Development Index

Expert Group Meeting on the Regional Report for the African Gender and Development Index Expert Group Meeting on the Regional Report for the African Gender and Development Index 9-10 October 2017 United Nations Conference Centre, Addis Ababa, Ethiopia Aide Memoire July 2017 I. Background and

More information

Update on Meningococcal A Vaccine Development and Introduction

Update on Meningococcal A Vaccine Development and Introduction Update on Meningococcal A Vaccine Development and Introduction WHO Product Development for Vaccines Advisory Committee Meeting (PD-VAC) @ Geneva, 7-9 September 2015 Dr Marie-Pierre Preziosi, WHO Initiative

More information

40 years of childhood vaccination programmes in Africa. Mind the gap

40 years of childhood vaccination programmes in Africa. Mind the gap 40 years of childhood vaccination programmes in Africa Mind the gap Charles Shey Umaru Wiysonge MD, MPhil, PhD, MASSAf Centre for Evidence-based Health Care, Stellenbosch University, South Africa Email

More information

Status Report on WSS MDG Roadmaps and Country Status Overviews WSP Africa

Status Report on WSS MDG Roadmaps and Country Status Overviews WSP Africa Status Report on WSS MDG Roadmaps and Country Status Overviews WSP Africa Ede Ijjasz Global Manager Water and Sanitation Program World Water Forum, Mexico, March 18, 2006 Outline 1. The Water Supply and

More information

! Multisectoral Information, Data, Research & Evidence - for Health, Population, Human & Social Development!

! Multisectoral Information, Data, Research & Evidence - for Health, Population, Human & Social Development! Pan African Campaign To End Forced Marriage of Under Age Children Advancing Multi-sectoral Policy & Investment for Girls, Women, & Children s Health 2015 Africa Scorecard On Maternal Health & Maternal

More information

Zika Outbreak: a PHEIC & Zika virus preparedness and response ac:vi:es in the African Region. Dr Zabulon Yo, & Dr Anthony Stewart

Zika Outbreak: a PHEIC & Zika virus preparedness and response ac:vi:es in the African Region. Dr Zabulon Yo, & Dr Anthony Stewart Zika Outbreak: a PHEIC & Zika virus preparedness and response ac:vi:es in the African Region Dr Zabulon Yo, & Dr Anthony Stewart Presenta:on Outline Background informa:on on Zika Global situa:on and Zika

More information

Progress has been made with respect to health conditions.

Progress has been made with respect to health conditions. health Strong performers in reducing child mortality 199-2 Niger Guinea-Bissau Guinea Ethiopia Benin 2 199 Strong performers in reducing maternal mortality 199-2 Djibouti Madagascar Eritrea Comoros Somalia

More information

Health systems and HIV: advocacy. Interagency Coalition on AIDS and Development

Health systems and HIV: advocacy. Interagency Coalition on AIDS and Development Health systems and HIV: Priorities for civil society advocacy Michelle Munro Interagency Coalition on AIDS and Development 1 Overview GTAG, civil society and health systems advocacy Health systems and

More information

PROGRESS ON HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS AND THE POST 2015 HEALTH DEVELOPMENT AGENDA. Report of the Secretariat CONTENTS ANNEXES

PROGRESS ON HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS AND THE POST 2015 HEALTH DEVELOPMENT AGENDA. Report of the Secretariat CONTENTS ANNEXES 26 November 2015 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-fifth session N Djamena, Republic of Chad, 23 27 November 2015 Agenda item 8 PROGRESS ON HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS

More information

Introduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa

Introduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa Introduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa Nigeria Center for Disease Control Federal Ministry of Health Abuja July 2015 Outline 1. Measles disease 2. Progress towards

More information

HIBA ABDALRAHIM Capsca Focal Point Public Health Authority

HIBA ABDALRAHIM Capsca Focal Point Public Health Authority HIBA ABDALRAHIM Capsca Focal Point Public Health Authority Introduction Definition Symptom Transmission Global situation Local situation Control Content Introduction Yellow fever (YF) is a mosquito-borne

More information

TT Procured by UNICEF

TT Procured by UNICEF TT TT Procured by UNICEF 2001-08 250,000,000 200,000,000 150,000,000 100,000,000 50,000,000 0 2001 2002 2003 2004 2005 2006 2007 2008 Routine SIA TT historical demand and forecast overview Upcoming Tender

More information

Regional Consultation on Nutrition and HIV/AIDS in French Speaking Countries in Africa Region

Regional Consultation on Nutrition and HIV/AIDS in French Speaking Countries in Africa Region Regional Consultation on Nutrition and HIV/AIDS in French Speaking Countries in Africa Region Evidence, lessons and recommendations for action Ouagadougou, Burkina Faso 17-20 November 2008 CONCEPT PAPER

More information

Health situation analysis in the African Region. Basic indicators 2006

Health situation analysis in the African Region. Basic indicators 2006 Health situation analysis in the African Region Basic indicators 2006 Health situation analysis in the African Region Basic indicators 2006 World Health Organization. Regional Office for Africa, 2006

More information

Progress Report: Universal Access Target Setting in East and Southern Africa

Progress Report: Universal Access Target Setting in East and Southern Africa Progress Report: Universal Access Target Setting in East and Report prepared by: Team for East & 15 September 2006 For all inquiries please contact Mark Stirling, Regional Director for Eastern and, at

More information

Task Force on Immunization (TFI) in Africa 14 th Annual Meeting. And. Africa Regional Inter-Agency Coordination Committee (ARICC) 13 th Annual Meeting

Task Force on Immunization (TFI) in Africa 14 th Annual Meeting. And. Africa Regional Inter-Agency Coordination Committee (ARICC) 13 th Annual Meeting Task Force on Immunization (TFI) in Africa 14 th Annual Meeting And Africa Regional Inter-Agency Coordination Committee (ARICC) 13 th Annual Meeting Meeting Report Maputo, Mozambique 27 29 November 2006

More information

Yellow fever Vaccine investment strategy

Yellow fever Vaccine investment strategy Yellow fever Vaccine investment strategy Background document #5 November 2013 Executive summary Since 2001, GAVI has spent ~$250M on yellow fever control $102M on routine vaccination in 17 countries ~$160M

More information

Update on PMTCT. African Health Profession Regulatory Collaborative for Nurses and Midwives. Johannesburg, Republic of South Africa, June 18-22, 2012

Update on PMTCT. African Health Profession Regulatory Collaborative for Nurses and Midwives. Johannesburg, Republic of South Africa, June 18-22, 2012 PMTCT Update Update on PMTCT Margarett Davis, MD, MPH Chief, Maternal and Child Health Branch Division of Global HIV/AIDS Centers for Disease Control and Prevention (CDC) African Health Profession Regulatory

More information

Summary World Malaria Report 2010

Summary World Malaria Report 2010 Summary The summarizes information received from 106 malaria-endemic countries and other partners and updates the analyses presented in the 2009 Report. It highlights continued progress made towards meeting

More information

Impact of Pathology Implementation Strategies in Sub Saharan Africa

Impact of Pathology Implementation Strategies in Sub Saharan Africa Impact of Pathology Implementation Strategies in Sub Saharan Africa June 2015 ascp.org PATHOLOGY IN AFRICA Large abdominal wall mass What do you do?? Large lesion non-diagnostic? Have to do additional

More information

For information on programmes in other countries and regions please access the Federation website at Programme title 2005

For information on programmes in other countries and regions please access the Federation website at   Programme title 2005 POLIO AND MEASLES Appeal no. 5AA89 Appeal target: CHF 3,52,674 1 The International Federation's mission is to improve the lives of vulnerable people by mobilizing the power of humanity. The Federation

More information

Fighting Harder and Smarter Against Malaria. Dr.Bernard Nahlen Deputy US Global Malaria Coordinator University of Georgia, February 23, 2010

Fighting Harder and Smarter Against Malaria. Dr.Bernard Nahlen Deputy US Global Malaria Coordinator University of Georgia, February 23, 2010 Fighting Harder and Smarter Against Malaria Dr.Bernard Nahlen Deputy US Global Malaria Coordinator University of Georgia, February 23, 2010 Outline Burden of malaria Global support for rolling back malaria

More information

Copyright 2011 Joint United Nations Programme on HIV/AIDS (UNAIDS) All rights reserved ISBN

Copyright 2011 Joint United Nations Programme on HIV/AIDS (UNAIDS) All rights reserved ISBN UNAIDS DATA TABLES 2011 Copyright 2011 Joint United Nations Programme on HIV/AIDS (UNAIDS) All rights reserved ISBN 978-92-9173-945-5 UNAIDS / JC2225E The designations employed and the presentation of

More information

THE DOUBLE DIVIDEND. Presented at 6 th HIV Paediatric Workshop, Melbourne 19 th July 2014

THE DOUBLE DIVIDEND. Presented at 6 th HIV Paediatric Workshop, Melbourne 19 th July 2014 THE DOUBLE DIVIDEND Action to improve survival of HIV exposed infected and uninfected children in the era of emtct and renewed child survival campaigns: Outcome of Harare Think Tank Consultation Presented

More information

COLD CHAIN EQUIPMENT OPTIMISATION PLATFORM (CCEOP)

COLD CHAIN EQUIPMENT OPTIMISATION PLATFORM (CCEOP) COLD CHAIN EQUIPMENT OPTIMISATION PLATFORM (CCEOP) Sushila Maharjan Senior Manager, Innovative Finance International Conference on Sustainable Cooling World Bank Washington DC - 29 November 2018 Reach

More information

Yellow fever laboratory capacity on-site assessments in Africa: preliminary findings

Yellow fever laboratory capacity on-site assessments in Africa: preliminary findings Yellow fever laboratory capacity on-site assessments in Africa: preliminary findings Maurice Demanou*, Barbara W. Johnson, Gamou Fall, Jean-Luc Betoulle, Chantal Reusken, Marion Koopmans, Lee Hampton,

More information

Towards an Atlas of Human Helminth Infection in sub-saharan Africa: The Use of Geographical Information Systems (GIS)

Towards an Atlas of Human Helminth Infection in sub-saharan Africa: The Use of Geographical Information Systems (GIS) Towards an Atlas of Human Helminth Infection in sub-saharan Africa: The Use of Geographical Information Systems (GIS) S. Brooker, M. Rowlands, L. Haller, L. Savioli and D.A.P. Bundy * *Ndir, O. et al.

More information

Ageing and mental health resources for older persons in the African region of the World Health Organization

Ageing and mental health resources for older persons in the African region of the World Health Organization Ageing and mental health resources for older persons in the African region of the World Health Organization Carlos Augusto de Mendonça Lima Instituto de Psiquiatria CDA, Universidade Federal do Rio de

More information

THE WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL: 10 YEARS OF IMPLEMENTATION IN THE AFRICAN REGION

THE WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL: 10 YEARS OF IMPLEMENTATION IN THE AFRICAN REGION THE WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL: 10 YEARS OF IMPLEMENTATION IN THE AFRICAN REGION AFRO Library Cataloguing-in-Publication Data The WHO Framework Convention on Tobacco Control: 10 years

More information

PROGRESS REPORT ON DECADE OF TRADITIONAL MEDICINE IN THE AFRICAN REGION. Progress Report. CONTENTS Paragraphs BACKGROUND PROGRESS MADE...

PROGRESS REPORT ON DECADE OF TRADITIONAL MEDICINE IN THE AFRICAN REGION. Progress Report. CONTENTS Paragraphs BACKGROUND PROGRESS MADE... 5 July 2011 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-first session Yamoussoukro, Côte d Ivoire, 29 August 2 September 2011 Provisional agenda item 17.2 PROGRESS REPORT ON DECADE OF TRADITIONAL

More information

Excellence and Originality from Necessity: Palliative Care in Africa. Dr Emmanuel Luyirika Executive Director, African Palliative Care Association

Excellence and Originality from Necessity: Palliative Care in Africa. Dr Emmanuel Luyirika Executive Director, African Palliative Care Association Excellence and Originality from Necessity: Palliative Care in Africa Dr Emmanuel Luyirika Executive Director, African Palliative Care Association Summary of the presentation 1. Introduction 2. Background

More information

Funding for AIDS: The World Bank s Role. Yolanda Tayler, WB Bi-regional Workshop for the Procurement of ARVs Phnom Penh, Cambodia

Funding for AIDS: The World Bank s Role. Yolanda Tayler, WB Bi-regional Workshop for the Procurement of ARVs Phnom Penh, Cambodia Funding for AIDS: The World Bank s Role Yolanda Tayler, WB Bi-regional Workshop for the Procurement of ARVs Phnom Penh, Cambodia Outline New resources needs estimates Bridging the gap Global overview of

More information

Plan of Presentation

Plan of Presentation CONTINENTAL CONFERENCE ON MATERNAL, INFANT AND CHILD HEALTH IN AFRICA Plan of Presentation Regional Frameworks on SRH Maputo Plan of Action Five-Year Review of MPoA What is CARMMA? Why CARMMA? What is

More information

Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive:

Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive: Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive: Rationale for the call to action, progress to date and dealing with realities Rene Ekpini, MD, MPH Senior Adviser,

More information

ENHANCING THE ROLE OF TRADITIONAL MEDICINE IN HEALTH SYSTEMS: A STRATEGY FOR THE AFRICAN REGION. Report of the Secretariat EXECUTIVE SUMMARY

ENHANCING THE ROLE OF TRADITIONAL MEDICINE IN HEALTH SYSTEMS: A STRATEGY FOR THE AFRICAN REGION. Report of the Secretariat EXECUTIVE SUMMARY 3 September 2013 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-third session Brazzaville, Republic of Congo, 2 6 September 2013 Agenda item 10 ENHANCING THE ROLE OF TRADITIONAL MEDICINE IN HEALTH

More information

ASLM Building laboratory capacity in Africa in a sustainable way

ASLM Building laboratory capacity in Africa in a sustainable way ASLM Building laboratory capacity in Africa in a sustainable way Tsehaynesh Messele, PhD ASLM, Chief Executive Officer Annual AMDS meeting September 29-30, 2014 Geneva Laboratory capacity gaps in Africa

More information

MONITORING THE IMPLEMENTATION OF THE HEALTH MILLENNIUM DEVELOPMENT GOALS. Report of the Secretariat. Executive Summary

MONITORING THE IMPLEMENTATION OF THE HEALTH MILLENNIUM DEVELOPMENT GOALS. Report of the Secretariat. Executive Summary 22 June 2011 REGIONAL COMMITTEE FOR AFRICA ORIGINAL: ENGLISH Sixty-first session Yamoussoukro, Côte d Ivoire, 29 August 2 September 2011 Provisional agenda item 14 MONITORING THE IMPLEMENTATION OF THE

More information

Africa s slow fertility transition

Africa s slow fertility transition Africa s slow fertility transition John Bongaarts Population Council, New York Süssmilch Lecture Max Planck Institute, Rostock 3 Sep 215 Billions 4 3 Population projections for sub-saharan Africa 215 projection

More information

EXPLANATION OF INDICATORS CHOSEN FOR THE 2017 ANNUAL SUN MOVEMENT PROGRESS REPORT

EXPLANATION OF INDICATORS CHOSEN FOR THE 2017 ANNUAL SUN MOVEMENT PROGRESS REPORT UNICEF / Zar Mon Annexes EXPLANATION OF INDICATORS CHOSEN FOR THE 2017 ANNUAL SUN MOVEMENT PROGRESS REPORT This report includes nine nutrition statistics, as per the 2017 Global Nutrition Report. These

More information

KEY ISSUES IN IMMUNIZATION IN AFRICA

KEY ISSUES IN IMMUNIZATION IN AFRICA SAGE Meeting April 2011 KEY ISSUES IN IMMUNIZATION IN AFRICA Deo NSHIMIRIMANA IVD / ARD / AFRO 1 Outline Efforts to reduce un-immunized children in Africa Attaining Global Polio Eradication Initiative

More information

Development of the Polio Eradication and Endgame Strategic plan

Development of the Polio Eradication and Endgame Strategic plan Development of the Polio Eradication and Endgame Strategic plan SAGE Meeting 6 November 2012 Overview Process, Consultations, Development Eradication and Endgame Outcomes and Activities Legacy Planning

More information

Global and Regional update on Polio Eradication Activities. Kenya Paediatric Association Pride Inn, Mombasa April 26, 2018

Global and Regional update on Polio Eradication Activities. Kenya Paediatric Association Pride Inn, Mombasa April 26, 2018 Global and Regional update on Polio Eradication Activities Kenya Paediatric Association Pride Inn, Mombasa April 26, 2018 Presentation Outline 1. Background information 2. Poliovirus detection & interruption

More information

Debriefing on the External Retrospective Evaluation of ACSD

Debriefing on the External Retrospective Evaluation of ACSD Institute for International Programs An international evaluation consortium ACCELERATING CHILD SURVIVAL AND DEVELOPMENT IN AFRICA (ACSD) Debriefing on the External Retrospective Evaluation of ACSD 19 February

More information

Global Fund ARV Fact Sheet 1 st June, 2009

Global Fund ARV Fact Sheet 1 st June, 2009 Global Fund ARV Fact Sheet 1 st June, 2009 This fact sheet outlines the principles and approach in determining the number of people on antiretroviral drugs (ARVs) for HIV/AIDS treatment, with a breakdown

More information

Wild Poliovirus Weekly Update

Wild Poliovirus Weekly Update 1 of 5 12/07/2010 12:09 PM Google search this site contact links donate Home > Global Situation Wild Poliovirus Weekly Update 7 July 2010 Data as at 6 July 2010 Map of polio cases worldwide Wild poliovirus

More information

FIRST GLOBAL SYMPOSIUM ON HEALTH SYSTEMS RESEARCH. Jennifer Bryce Institute for International Programs The Johns Hopkins University

FIRST GLOBAL SYMPOSIUM ON HEALTH SYSTEMS RESEARCH. Jennifer Bryce Institute for International Programs The Johns Hopkins University FIRST GLOBAL SYMPOSIUM ON HEALTH SYSTEMS RESEARCH Jennifer Bryce Institute for International Programs The Johns Hopkins University Outline 1. Lessons from the evaluation of the ACCELERATING CHILD SURVIVAL

More information

NO MORE MISSED MDG4 OPPORTUNITIES: OPTIMIZING EXISTING HEALTH PLATFORMS FOR CHILD SURVIVAL. Measles & Rubella Campaigns

NO MORE MISSED MDG4 OPPORTUNITIES: OPTIMIZING EXISTING HEALTH PLATFORMS FOR CHILD SURVIVAL. Measles & Rubella Campaigns NO MORE MISSED MDG4 OPPORTUNITIES: OPTIMIZING EXISTING HEALTH PLATFORMS FOR CHILD SURVIVAL Measles & Rubella Campaigns With fewer than 600 days remaining to the Millennium Development Goal (MDG) deadline,

More information

Wild Poliovirus*, 03 Aug 2004 to 02 Aug 2005

Wild Poliovirus*, 03 Aug 2004 to 02 Aug 2005 Wild Poliovirus*, 03 Aug 2004 to 02 Aug 2005 Wild virus type 1 Wild virus type 3 Wild virus type 1 & 3 Endemic countries Re-established transmission countries Case or outbreak following importation *Excludes

More information

STATUS REPORT ON MALARIA

STATUS REPORT ON MALARIA AFRICAN UNION UNION AFRICAINE UNIÃO AFRICANA Addis Ababa, ETHIOPIA P. O. Box 3243 Telephone +251115-517700 Fax : +251115-517844 Website : www.africa-union.org ASSEMBLY OF THE AFRICAN UNION Eleventh Ordinary

More information

Comparative Analyses of Adolescent Nutrition Indicators

Comparative Analyses of Adolescent Nutrition Indicators Comparative Analyses of Adolescent Nutrition Indicators Rukundo K. Benedict, PhD The DHS Program Stakeholders Consultation on Adolescent Girls Nutrition: Evidence, Guidance, and Gaps October 30 31, 2017

More information

Market Updates: Routine Vaccine Introductions IPV. Vaccine Industry Consultation October 2018 UNICEF Supply Division

Market Updates: Routine Vaccine Introductions IPV. Vaccine Industry Consultation October 2018 UNICEF Supply Division Market Updates: Routine Vaccine Introductions IPV Vaccine Industry Consultation October 2018 UNICEF Supply Division Outline Review of rapid introduction of IPV Overview of the current situation for 2018

More information

WHO/UNICEF Joint Annual Measles Report Strengthening Immunization Services through Measles Control

WHO/UNICEF Joint Annual Measles Report Strengthening Immunization Services through Measles Control WHO/UNICEF Joint Annual Measles Report 2010 Strengthening Immunization Services through Measles Control Table of Contents Abbreviations and Acronyms...1 Executive Summary...2 1. Introduction...4 2. Progress

More information

Blood safety in Africa: Progress made during the last decade and major challenges for the Future

Blood safety in Africa: Progress made during the last decade and major challenges for the Future Blood safety in Africa: Progress made during the last decade and major challenges for the Future By J.B.Tapko Regional Advisor for Blood Safety WHO Regional Office for Africa Outline Introduction: WHO

More information

511,000 (57% new cases) ~50,000 ~30,000

511,000 (57% new cases) ~50,000 ~30,000 Latest global TB estimates - 2007 (Updated Mar 2009) All forms of TB Greatest number of cases in Asia; greatest rates per capita in Africa Multidrug-resistant TB (MDR-TB) Estimated number of cases 9.27

More information