​The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue covers the period 24-30 January 2016 and includes updates on Zika virus, Ebola virus disease and MERS.

Insécurité alimentaire élevée dans les zones de conflits et dans certaines zones pastorales

Messages clés

• L'approvisionnement alimentaire et la disponibilité sont satisfaisants dans tous les bassins commerciaux de la région grâce aux bonnes récoltes pluviales de 2015 et aux récoltes de cultures de contre saison en cours. Toutefois, dans certaines régions du Tchad et dans les zones de conflits autour Lac Tchad, la disponibilité céréalière est toujours inférieure à la moyenne en raison des déficits de production enregistré en 2015 et des récoltes attendues également inférieures à la moyenne pour la contre saison en cours.

• L’offre, la demande et les stocks sur les marchés sont à des niveaux moyens ce qui rend les prix stables et conformes aux tendances saisonnières, exceptés au Ghana où ils seront supérieurs à la moyenne à cause des déficits de production et de la dépréciation de la monnaie locale. Toutefois, les achats habituels commerçants, institutionnels et pour l’alimentation animale peuvent augmenter la pression de la demande et pousser les prix à la hausse en avril/mai, comme en année normale. Ces hausses qui resteront dans la moyenne, ne constitueront pas une source de préoccupation pour l’accès alimentaire pour la plupart des ménages même pauvres.

• La consommation alimentaire continue de s’améliorer et de se diversifier pour la majorité des ménages au regard des stocks disponibles, des récoltes de produits frais de contre saison et de la mise en œuvre des stratégies habituelles de moyens d’existence. Par conséquent, l’insécurité alimentaire Minimale (Phase 1 de l’IPC) continue à être la plus répandue. Cette situation générale pourra se maintenir jusqu’en fin mars 2016.

• Dans les zones pastorales et agropastorales contiguës du Tchad et du Niger, l’état d’embonpoint des animaux se dégradera localement dans les mois prochains suite à une insuffisance des pâturages. Par contre au Mali, les conditions pastorales et commerciales sont moyennes mais la taille réduite des troupeaux ne permet pas aux ménages pauvres d’acquérir les revenus comme d’habitude dans les régions de Tombouctou et de Gao. L’insécurité alimentaire de type Stress (Phase 2 de l’IPC) se répand localement dans toutes ces zones entre janvier et mars 2016.

• Au nord-est du Nigeria et dans les régions voisines autour du Lac Tchad, l’insurrection Boko Haram perturbe encore les marchés et le commerce transfrontalier, tout en réduisant les activités et l’accès alimentaire malgré les récoltes en cours. L’insécurité alimentaire du niveau Crise (Phase 3 de l’IPC) ou Stress (Phase 2 de l’IPC) persistera et continuera jusqu’en mars 2016 du fait des revenus et productions inférieurs à la moyenne et du mauvais fonctionnement des marchés. Il en est de même en République Centrafricaine malgré la tenue des élections en fin décembre.

• En Guinée, Sierra Leone et Liberia, Ebola tend vers sa fin mais avec souvent des cas sporadiques comme ce fut tout récemment en Sierra Leone. Ces apparitions sont sans effets importants sur la sécurité alimentaire. Avec les nouvelles récoltes et la normalisation des activités économiques, une insécurité alimentaire Minimale (Phase 1 de l’IPC) se maintient excepté en Sierra Leone où le Stress (Phase 2 de l’IPC) subsistera localement vu le pouvoir d’achat encore insuffisant pour permettre les dépenses de base non alimentaires des ménages.

Global leaders are failing to honour their promises to communities devastated by Ebola in West Africa, with $5.8 billion of pledged recovery funds proving almost impossible to track, Oxfam warned today.

Six months since the International Conference on Ebola Recovery in New York, at least $1.9 billion worth of promised funds have not been delivered, while scant information is available about the remaining $3.9 billion.

Aboubacry Tall, Oxfam’s Regional Director for West Africa, said: “We know that $1.9 billion of the promised funds have not even been committed to a specific country but we can’t say for sure how much of the remaining committed money has been effectively delivered.

“A lack of transparency throughout the whole process, from donors to implementing organizations to programs on the ground means we’re finding it hard to understand which donors have given what money, to whom and for what purpose.”

The Ebola outbreak has set the affected countries back years; shattered already inadequate health systems and ruined people’s livelihoods. Donors and the Governments of Sierra Leone, Liberia and Guinea must act now to meet their commitments to communities by publishing accurate, timely and detailed information on aid delivery and Ebola recovery efforts.

It has taken almost two years, more than 11,300 deaths, massive provision of resources, technical assistance and billions of US dollars from around the world to tackle the Ebola epidemic in West Africa. Yet despite this, last week, another 150 people were exposed to the risk of Ebola in Sierra Leone according to the World Health Organisation. This is not the end of Ebola in West Africa or globally.

Tall said: “In order for the countries to quickly build the health systems they require, governments and communities need to know what aid they are getting, when it is coming, where it is going and they need to have a say in how it is used. We urge donors to ‘put their money where their mouths are’ and demonstrate what transparency really means by, at a minimum, publishing information in accordance with International Aid Transparency Initiative standards”.

As African Heads of State meet in Addis Ababa this week to discuss making 2016 the year of Human Rights in Africa, Oxfam is calling on them to focus attention on the Right to Health. 15 years ago, African leaders made a commitment to provide 15% of their budgets to the health sector - urgent action is required to achieve this. Adequate investment in health systems, water, sanitation and hygiene is vital to protect lives.

The slow identification and response by government health services to the recent cases in Sierra Leone and Liberia clearly demonstrate that they are still not capable of responding effectively to Ebola and other highly contagious diseases.

Tall said: “Although Oxfam and other organisations responded by mobilising community volunteers, this is not enough. If we are going to succeed, communities need to be a part of the process and a part of the planning, from the very beginning.”

After the recent outbreak of Ebola in Liberia, I was horrified to see the same patterns of distrust emerging. Rumours were rampant, some people didn’t believe it was Ebola and others felt that it had been re-introduced on purpose. Rumours like these are extremely dangerous and can lead to community complacency.”

In order to prevent the same tragedy from happening again, Oxfam urges the Governments of Sierra Leone, Liberia and Guinea to empower communities to take a leading role in their own healthcare, by making sure that local people are put at the heart of decisions about where resources go, and how they are used. Oxfam’s experience during the Ebola response has shown that community leadership and trust in local health systems is absolutely vital and should be considered a medical necessity.

Ends

Photos from Oxfam's Ebola recovery work available here

For more information or to arrange an interview, please contact:

In the UK: Meg Pruce +44 (0) 7824 824359 / +44 (0) 1865 472240 mpruce1@oxfam.org.uk or Ian Bray +44 (0)1865 472289 / +44 (0)7721 461339 ibray@oxfam.org.uk

Addis Ababa: Helen Yosef Hailu – on phone +251 11661 1601 / Mobile: +251 911 126098 / Email helen.yosef@OxfamInternational.org

Dakar: Aissatou Sall – on phone +221 33 859 3723 / Mobile: +221 77 223 4389 / Email asall@oxfam.org.uk

Welcome to Issue 43 of THE ASSESSOR, WFP’s Food Security Analysis e-Newsletter!

• “VAM Talks” Podcast Goes Live

• mVAM in Malawi

• ALNAP Case Study on mVAM

• El Niño Implications and Scenarios for 2015/16

• Focus on the El Niño impact in the Southern African Region

• Market Analysis

• Food Security Information Network

• Emergency Food Security Assessments

• Baseline Studies

• Inter-Agency Work

• Capacity Development and Guidance

• Gender Analysis in VAM

• Focus on Latin America and the Caribbean

Highlights of the week
- Second new Ebola case in Sierra Leone

Completeness of Reporting

All the 112 districts reported with average reporting rate of 75% in week 3 2016.47 districts (42%) achieved the national target of ≥80% of the health facilities reporting. 12 districts had all their facilities reporting. Kampala and Buvuma districts have continued to have reporting rates of less than 30%. The regional level performance as well as best districts and worst districts in week 3 have been presented in Figures 1, 2& 3. As shown in Figure 3 the number of districts with low reporting rates are on the decline whereas the number of top performing districts are on the rise.

Posted 28 January: The Ministry of Health and Sanitation (MOHS) has reported that two people suspected to have Ebola in the southern district of Pujehun were detected on 27 January. No further information is available on whether these two people are contacts in the recent cluster.

In other news, there has been ongoing community tension in northern Kambia province. Health authorities have been tracing contacts and enforcing restrictions in Barmoi Luma town after a 22-year-old girl, who later died and tested positive for Ebola, had been in the area whilst symptomatic. Following closures of the local market there have been protests, resulting in several people being shot and a police station being burned down.

Updated 31 January: The MOHS has removed the two suspected cases in Pujehun from it's daily Ebola report. There is however one new suspected case in Western Area Urban, which contains the capital Freetown.

In addition, 11 contacts from five households in Kambia district were discharged from follow-up. Over 175 contacts remain in the 21-day monitoring period.

Updated 1 February: An additional 14 people in urban and rural Western Area have been tested for Ebola as suspected cases. Authorities are continuing with heightened surveillance for the disease in order to rapidly identify any new cases associated with this recent outbreak. Only two cases have tested positive in this cluster so far, however six high risk contacts remain in a voluntary holding centre in Freetown, in case they develop symptoms.

On January 14, 2016, the World Health Organization (WHO) declared the end of the latest Ebola outbreak in Liberia, which marked the first time since the start of the epidemic that Guinea, Liberia and Sierra Leone had reported no cases for at least 42 days. 

However, the same day WHO made this announcement, Sierra Leone confirmed a new Ebola case, a woman who had died two days previously. The Ebola epidemic in West Africa is not yet over, but it is very close. The world must remain vigilant and focused on sustaining zero cases across all of the affected countries, especially with the threat of flare-ups of the disease, while helping these three countries recover and rebuild their economies and health systems. 

We continue to work closely with the affected countries, the United Nations, WHO, bilateral, civil society and private sector partners to support response and recovery. This includes restoring basic health services, helping countries get all children back in school, farmers back planting in their fields, businesses back up and running, and investors back into the countries. We are helping countries reignite their economies, strengthen their health systems, and build back better.

A top priority for World Bank Group support is to build a strong and well-trained health workforce in the three countries, and build resilient health systems that can deliver essential, quality care in even the most remote areas; improve disease surveillance; and quickly detect, treat and contain future outbreaks.

The primary cost of this tragic outbreak is in human lives and suffering—but the crisis has also wiped out hard-earned development gains in the affected countries, and will worsen already entrenched poverty. On April 17, 2015, the World Bank Group issued an economic update showing the Ebola crisis continues to cripple the economies of Guinea, Liberia and Sierra Leone, even as transmission rates show significant signs of slowing. The Bank Group estimates that these three countries will lose at least US$2.2 billion in forgone economic growth in 2015 as a result of the epidemic.

Other recent studies have found that the socioeconomic impacts of Ebola in Liberia and Sierra Leone have included job losses, smaller harvests and food insecurity, though the use of public services appears to be improving.

To ensure that the world is better prepared and respond much more quickly to future disease outbreaks, the World Bank Group, the World Health Organization, and other partners, are developing a plan for a new Pandemic Emergency Facility that would enable resources to flow quickly when outbreaks occur.

The World Bank Group also has established an Ebola Recovery and Reconstruction Trust Fund to address the urgent and growing economic and social impact of the crisis in the region.

Where we stand now

As of Dec. 01, 2015, the World Bank Group has mobilized US$1.62 billion in financing for Ebola response and recovery efforts to support the countries hardest hit by Ebola. This includes US$260 million for Guinea; US$385 million for Liberia and US$318 million for Sierra Leone. The US$1.62 billion total also includes US$1.17 billion from IDA, the World Bank Group’s fund for the poorest countries and at least US$450 million from IFC, a member of the World Bank Group, to enable trade, investment and employment in Guinea, Liberia and Sierra Leone.

An initial $518 million commitment from IDA is helping Guinea, Liberia and Sierra Leone provide treatment and care, contain and prevent the spread of infections, help communities cope with the economic impact of the crisis, and improve public health systems. This includes:

• Paying for essential supplies and drugs, personal protective equipment and infection prevention control materials, health worker training, hazard pay and death benefits to Ebola health workers and volunteers, contact tracing, vehicles, data management equipment, door-to-door public health education outreach, and, in Liberia, psychosocial support for those affected by Ebola.
• Supporting a surge of foreign health workers to the three countries.
• Providing budget support to help the governments of Guinea, Liberia and Sierra Leone cope with economic impact of the outbreak, and financing the scale-up of social safety net programs for people in the three countries.

Of the initial $518 million committed through IDA, $390 million is comprised of new money provided in grants from the World Bank Group’s IDA Crisis Response Window; $110 million is from national IDA and Crisis Response Window funds for development policy operations; and $18 million was reallocated from existing health projects in the three affected countries. Of the $518 million IDA commitment, as of Dec. 1 2015, $460 million, or 89%, had been disbursed to the three countries and implementing UN agency partners

Of the at least $450 million from IFC in commercial financing that is enabling trade, investment and employment in Guinea, Liberia and Sierra Leone, $250 million is for a rapid response program, which is helping to ensure continued operations of business and supplies of essential goods and services. An additional $200 million is for an Ebola recovery program, which will finance medium- and long-term projects post-crisis. IFC is also providing advisory services to 800 small and medium enterprises on health, security and environment issues related to Ebola.

Contact: Melanie Mayhew

Last Updated: Feb 02, 2016

The Peace and Security Council of the African Union (AU), at its 570th meeting held on 21 January 2016, adopted the following decision on the Ebola Virus Disease (EVD) outbreak in the three most affected countries in West Africa, namely, Guinea, Liberia and Sierra Leone:

Council

1. Takes note of the comprehensive Final Exit Report of the African Union Support to the Ebola Outbreak in West Africa (ASEOWA) and the Evaluation Report of the African Union’s Response to the Ebola Virus Disease Outbreak in West Africa, submitted by the Commission to Council. Council also received statements from the representative of Senegal, in its capacity as the current Chair of the Economic Community of West African States (ECOWAS), as well as from the representatives of France, the United Kingdom, the United States of America, the European Union and the United Nations;

2. Recalls all its earlier pronouncements on the EVD, in particular, Press Statement PSC/PR/BR. (DLXV) adopted at its 565th meeting held on 17 December 2015;

3. Commends the Commission of the African Union, in particular, the Department of Social Affairs, for the leadership role it demonstrated in the successful fight against the EVD, as well as in the current post-EVD socio-economic recovery efforts in the most affected countries, through the African Union Support to the Ebola Outbreak in West Africa (ASEOWA). In particular, Council commends the ASEOWA health care volunteers who risked their precious lives in order to save other lives. In this regard, Council requests the Commission to recognize the efforts of all those who participated in the fight against Ebola under ASEOWA, including the staff from the AU Commission;

4. Congratulates the authorities and people of the three most affected countries, in West Africa, for successfully controlling the EVD. Council commends them for their ongoing post-EVD socio-economic recovery efforts and urges them to persevere. In this regard, Council reiterates the need for these countries to adopt a very comprehensive approach that effectively addresses the wider social, psycho-social, economic and political consequences of the EVD outbreak, including the need to invest more in strengthening the health systems in order to build the necessary resilience against future public health threats;

5. Underscores the imperative need for the Commission to continue to closely monitor the post-EVD situation in the three most affected countries, in spite of them having been already declared Ebola-free by the World Health Organization (WHO). In this regard, Council urges the three most affected countries to continue to remain extra-vigilant vis-à-vis the risk of new EVD outbreaks and cases of relapses, as well as to maintain effective surveillance mechanisms, including cross-border surveillance;

6. Stresses the importance of expediting the establishment of the Africa Centres for Disease Control and Prevention (Africa CDC). In this regard, Council welcomes the ongoing efforts being deployed by the Commission to this end. Council also welcomes the ongoing efforts to establish the African Health Volunteer Corps;

7. Underscores the need, in view of Africa’s prevention efforts, for the WHO to expedite the certification process for the Ebola vaccine production;

8. Expresses deep appreciation to all AU Member States which extended support of various forms to the three most affected countries and urges them to maintain this spirit of pan-African solidarity, which will be instrumental in effectively addressing similar future epidemics and other complex emergences. Council also expresses deep appreciation to the African private sector for the generous assistance it extended to the three countries most affected by the EVD. Council further expresses its deep appreciation to the AU partners, as well as to the wider international community for their continued support in the fight against the EVD and urges them to continue to extend their support towards the post-EVD socio-economic recovery efforts of the three most affected countries;

9. Endorses all the recommendations contained in the two reports submitted to the Council by the Commission. In this regard, Council requests the Commission to take necessary follow-up action and to provide regular updates to the Council on the implementation of these recommendations;

10. Decides to remain actively seized of the matter.

CENTRAL AFRICAN REPUBLIC

IDP RETURNS IN OUHAM PROVINCE

Around 3,800 voluntary returnees were recently registered in Kambakota village in Ouham Province. They had been forced to flee their homes during clashes between armed groups in December 2015. Now back to their villages, they are facing tough living conditions . Priority needs include potable water, health services and education.

PRESIDENTIAL RUN-OFF SET FOR 14 FEBRUARY

Run-off presidential election that had been due on 31 January will now be held on 14 February, the presidency announced on 28 January. The second round will be between two former prime ministers: Anicet Georges Dologuélé and Faustin Archange Touadéra.
The delay was prompted by organizational problems. Fresh legislative polls will also be held on the same day.

CHAD

TEN KILLED IN SUICIDE ATTACKS

Suspected Boko Haram members on 31 January raided two villages on the shores of Lake Chad in Hadjer-Lamis region and killed at least 10 people. Eight people were killed in Guité village and two others in the nearby Mitériné village in near-simultaneous suicide blasts. Some 55 people were injured in both attacks, 20 of them seriously and have been transferred to the capital N’Djamena.

NIGERIA

SCORES KILLED IN VILLAGE RAIDS

Scores of people were killed and injured on 30 January in an attack perpetrated by suspected Boko Haram fighters on the villages of Dalori and Walori near Maiduguri. The attack reportedly involved armed raiders and suicide bombers. Over 300 houses were burned down and the number of fatalities given by local sources ranges between 65 and 250. Most of the wounded have been taken to medical facilities in Maiduguri, where some survivors reportedly continue to arrive.

SIERRA LEONE / EVD

THREE INJURED IN RIOTS

Three people were seriously injured on 26 January during skirmishes between police and youths near the western Kambia town.
The youths rioted in protest against alleged lack of consultation over the closure of a local market as part of efforts to find missing contacts following the recent Ebola deaths. Meanwhile, no new cases were reported in the week ending 31 January.
Response is ongoing with the Inter-Agency Rapid Response Team at national and district level supporting the Government.
Some 126 contacts have been identified in the four districts of Kambia, Bombali, Port Loko and Tonkolii out of whom 35 considered to be high risk have been quarantined and being monitored.

REPUBLIQUE CENTRAFRICAINE

DES DÉPLACÉS RETOURNENT DANS LA PROVINCE DE L’OUHAM

Environ 3 800 rapatriés volontaires ont été récemment enregistrés dans le village de Kambakota, dans la province de l'Ouham. Ils avaient été contraints de fuir leurs foyers lors d'affrontements entre des groupes armés en décembre 2015. De retour dans leurs villages, ils sont confrontés à des conditions de vie difficiles. Les besoins prioritaires comprennent l’eau potable, les services de santé et l’éducation.

LES ÉLECTIONS PRÉSIDENTIELLES FIXÉES AU 14 FÉVRIER

Le second tour des élections présidentielles qui avait été fixé au 31 janvier se tiendra désormais le 14 février, a annoncé la Présidence le 28 janvier. Le second tour se jouera entre deux anciens premiers ministres: Anicet Georges Dologuélé et Faustin Archange Touadéra. Le retard a été causé par des problèmes d’organisation. De nouvelles élections législatives seront également organisées le même jour.

TCHAD

DIX TUES LORS D’ATTAQUES-SUICIDES

Des membres présumés de Boko Haram ont attaqué le 31 janvier deux villages sur les rives du lac Tchad, dans la région de Hadjer-Lamis, tuant au moins 10 personnes. Huit personnes ont été tuées dans le village de Guité et deux autres dans le village voisin de Mitériné dans des attaques-suicides quasi simultanées.
Quelque 55 personnes ont été blessées dans les deux attaques, 20 d'entre elles sont dans un état sérieux et ont été transférées à la capitale N'Djamena.

NIGERIA

DE NOMBREUX MORTS LORS DE RAIDS DE VILLAGES

Des dizaines de personnes ont été tuées et blessées le 30 janvier lors d'une attaque perpétrée par des combattants présumés de Boko Haram contre les villages de Dalori et Walori près de Maiduguri. L'attaque aurait impliqué des malfaiteurs armés et des kamikazes. Plus de 300 maisons ont été incendiées et le nombre de décès selon des sources locales varie entre 65 et 250. La plupart des blessés ont été pris en charge dans les établissements médicaux à Maiduguri, où certains survivants continueraient d’arriver.

SIERRA LEONE / MVE

TROIS BLESSÉS LORS D’ÉMEUTES

Trois personnes ont été grièvement blessées le 26 janvier au cours d’accrochages entre la police et des jeunes près de la ville de Kambia, à l’ouest. Les jeunes se sont révoltés pour protester contre la prétendue absence de consultation sur la fermeture d'un marché local dans le cadre des efforts visant à trouver des contacts disparus à la suite des récents décès dus au virus Ebola. Pendant ce temps, aucun nouveau cas n'a été signalé dans la semaine se terminant le 31 janvier.
La réponse est en cours avec l‘Équipe d'intervention rapide inter institutions au niveau national et district en soutien au gouvernement. Quelque 126 contacts ont été identifiés dans les quatre districts de Kambia, Bombali, Tonkolili et Port Loko, parmi lesquels 35 sont considérés comme à haut risque et ont été mis en quarantaine et sous surveillance.

Household food consumption is expected to remain adequate through the start of the lean season

Key Messages

• Seasonal rainfall in Kailahun is near average and similar to rainfall totals in January of 2015, indicating adequate moisture levels for agricultural activities including land preparation, and the drying of harvested rice, cocoa, coffee, and cassava crops. Market prices for rice, cassava, and sweet potato are stable and normal market activities have resumed because of the lift in the ban on weekly markets due to EVD.

• As food and cash crops continue to be harvested in Kailahun, most farmers have already sold their cocoa and coffee harvests for cash. Household access to income from the sale of rice and cassava is also starting to decrease. However, demand for agricultural labor is at normal levels and expected to increase during the planting period between April and May. These labor opportunities will increase poor household income during this period. Household food consumption is expected to remain adequate between January and the start of the lean season in May.

SUMMARY

• Human-to-human transmission directly linked to the 2014 Ebola virus disease (EVD) outbreak in West Africa was declared to have ended in Sierra Leone on 7 November 2015. The country then entered a 90-day period of enhanced surveillance to ensure the rapid detection of any further cases that might arise as a result of a missed transmission chain, reintroduction from an animal reservoir, importation from an area of active transmission, or re-emergence of virus that had persisted in a survivor. On 14 January, 68 days into the 90-day surveillance period, a new confirmed case of EVD was reported in Sierra Leone after a post-mortem swab collected from a deceased 22-year-old woman tested positive for Ebola virus. The woman died on 12 January at her family home in the town of Magburaka, Tonkolili district, and received an unsafe burial. Approximately 150 contacts associated with the case were listed in 4 districts; the total number of contacts currently under follow-up (as at 2 February) is 112. A number of contacts deemed to be at highest risk of developing EVD, including members of the close family of the index case, were transferred to voluntary quarantine facilities (VQFs) for the duration of their 21-day follow-up period. On 20 January, one of the contacts residing in a VQF in the district of Tonkolili developed symptoms and tested positive for Ebola virus. This second case in the cluster is the aunt of the index case, and cared for her during her illness. She was transferred to an Ebola treatment centre in Freetown, where she continues to receive treatment.

• The 4 contacts who were residing in the same VQF as the most recent case at the time she became ill will remain under observation until 11 February, 21 days after their last possible exposure. All 108 other contacts associated with the index case will complete their 21-day follow-up period on 3 February. However, 48 of the 108 are yet to be traced, and efforts to locate them will continue for at least a further 21 days from 3 February. All 48 missing contacts, 18 of whom are high risk, were originally listed in Kambia.

• Human-to-human transmission linked to the most recent cluster of cases in Liberia was declared to have ended on 14 January 2016. Guinea was declared free of Ebola transmission on 29 December 2015, and has now entered a 90-day period of enhanced surveillance that is due to end on 27 March 2016.

• With guidance from WHO and other partners, ministries of health in Guinea, Liberia, and Sierra Leone have plans to deliver a package of essential services to safeguard the health of the estimated more than 10 000 survivors of EVD, and enable those individuals to take any necessary precautions to prevent infection of their close contacts. Over 300 male survivors in Liberia have accessed semen screening and counselling services.

• To achieve the second key objective of the phase 3 response framework of managing residual Ebola risks, WHO has supported the implementation of enhanced surveillance systems in Guinea, Liberia, and Sierra Leone to enable health workers and members of the public to report any case of febrile illness or death that they suspect may be related to EVD. In the week to 31 January, 1063 alerts were reported in Guinea from all of the country’s 34 prefectures, with the vast majority of alerts (1060) reports of community deaths. Over the same period 9 operational laboratories in Guinea tested a total of 346 new and repeat samples (14 samples from live patients and 332 from community deaths) from 17 of the country’s 34 prefectures. In Liberia, 1062 alerts were reported from all of the country’s 15 counties, most of which (925) were for live patients. The country’s 5 operational laboratories tested 1003 new and repeat samples (807 from live patients and 196 from community deaths) for Ebola virus over the same period. In Sierra Leone 1287 alerts were reported from the country’s 14 districts. The vast majority of alerts (1071) were for community deaths. 1059 new and repeat samples (76 from live patients and 983 from community deaths) were tested for Ebola virus by the country’s 7 operational laboratories over the same period.

Freetown, Sierra Leone | AFP | Wednesday 2/3/2016 - 18:45 GMT

Only four people remained in quarantine in Sierra Leone on Wednesday after 55 others were declared free of the Ebola virus and released from hospital, officials and medical sources said.

But medics were urgently seeking to contact around 50 others for testing, most of them from the northern town of Kambia, health ministry spokesman Harold Williams said.

Sierra Leone was forced to re-open its Ebola treatment centres and relaunch screening systems, including checkpoints on motorways, late last month after two new cases of the tropical virus were confirmed.

"Forty-eight people are still classified as missing and 18 of them are high risk," he said, appealing for them to come forward.

"We are only concerned about whether they are infected so that we can treat them to avoid any possible spreading of the virus," he said.

The remaining four people in quarantine were scheduled to be released on February 11.

There was a carnival atmosphere in the northern city of Magburaka on Wednesday where 33 people left two isolation facilities after being quarantined for three weeks.

Among the group were children, who celebrated after being told they had not shown any symptoms of being infected by the deadly tropical virus.

After their release, the town erupted in jubilation with hundreds of people taking to the streets in t-shirts reading "Stop Ebola" and "Ebola cannot defeat us", some carrying huge amplifiers blaring traditional music while others blew horns carved out of elephant tusks.

"It is good to breathe fresh air outside quarantine and rejoin friends and relatives to resume normal life," said Foday Kandeh, a 68 year-old farmer who grows groundnuts and said he'd missed drinking palm wine.

"It is an ordeal I never want to re-live," said Kadi Sesay, a 19-year-old student.

"Besides missing classes for 21 days, the quarantine period brought all of us together... The happy ending is that none of us tested positive but our thoughts were went into overdrive thinking what if we had," she said.

"Today is a new day for all of us."

Another 22 people were released from isolation facilities in Kambia, among them a herbalist who had initially provided traditional medicine treatments to 22-year-old Marie Jalloh, who died of Ebola on January 12, a day after west Africa had been formally declared free of the deadly tropical virus.

"All of them looked hail and hearty and showed no sign of illness," one health official told AFP.

Among those released on Wednesday was Jalloh's stepfather who was released in the capital Freetown without showing any signs of infection, health monitors told AFP.

The deadliest outbreak in the history of the tropical virus wrecked the economies and health systems of the three worst-hit west African nations after it emerged in southern Guinea 2013.

The outbreak infected almost 29,000 people and killed more than 11,300, mainly in Guinea, Liberia and Sierra Leone.

rmj/hmw/pdw

Key Activities

Ebola Response

In January, WFP supported the response to the Ebola Virus Disease (EVD) outbreak by providing food assistance to people in quarantined households and quarantine/treatment centres. Logistics support including transport of non-food items, engineering and IT was provided to partners for the establishment and running of the Emergency Operations Centre (EOC) in Tonkolili District. WFP continues to provide monthly food/cash assistance to Ebola orphans and survivors to ensure that the food and nutritional needs of these vulnerable groups are met.

Logistics

As the lead for the Support Services Pillar of the UN ‘No Regrets’ approach, WFP continues to provide logistics support coordinated from the Port Loko Main Logistics Hub (MLB) which has a storage capacity of over 19,000m3. In addition to providing storage of non-food items such as medical equipment for partners, WFP is developing a training centre to enhance rapid response capacities of government counterparts at the Office of National Security. UNHAS flights throughout the country provide quick transport of humanitarian equipment and personnel.

Supplementary Feeding

In partnership with the Ministry of Health & Sanitation, WFP is implementing a targeted supplementary feeding programme for the treatment of moderate acute malnutrition in children age 6-59 months, as well as pregnant and nursing mothers. Over 43,000 beneficiaries are receiving support in 433 peripheral health units (PHUs) in five districts in the country.

Support to ART Clients

WFP continues to provide monthly food packages to malnourished clients on anti-retroviral therapy (ART) and their household members. Food assistance by prescription helps to improve the nutritional status of HIV+ beneficiaries while, at the same time, improving treatment adherence.

Supporting Farmers in Sierra Leone

WFP is working with more than 7,500 farmers across the country—about 50 percent of which are women—to increase agricultural productivity and access to markets. With the 2015 harvest coming to an end, WFP is preparing to commence purchases of locally grown commodities from small holder farmers.

Food Security

The data collection for the 2015 Comprehensive Food Security & Vulnerability Analysis (CFSVA) has been completed and preliminary results will be presented to stakeholders, including the Ministry of Agriculture, Forestry & Fisheries (MAFFS) and donors, on 4 February. The results of the CFSVA will be used to determine targeting for the new projects which will concentrate food assistance activities in the most vulnerable areas.

(Freetown, 3 February 2016) The Inter-Agency Rapid Response Team convened under the auspices of the Office of the United Nations Resident Coordinator wishes to mark the discharge from quarantine of a total of 73 people after 21 days of close monitoring in three districts (Tonkolili, Kambia, and Port Loko).

The discharge from quarantine is an important milestone in the Government-led Response which rapidly identified all people who had contact with the index case. It also signals the beginning of a new critical phase to account for the remaining 48 contacts in Kambia who have yet to been seen.

We are concerned for the wellbeing of these contacts and want to be sure that they have not developed any symptoms of Ebola in the past 21 days. We call upon them to make contact with members of their families or their nearest health care centre in case they become ill, to receive the support and care they deserve. We further call upon them to return to their homes and they will not be penalized, nor placed under quarantine.

Of the people who were being closely monitored, only one contact, a 38 year old aunt of the first case, developed symptoms, and tested positive for EVD on 20 January. She is currently at Military 34 hospital and is responding well to treatment. We admire her courage.

First reported on 14 January 2016, this EVD event was a particularly complex one because of the large geographic area that has to be covered, with four districts simultaneously involved. This happened at a time when Sierra Leone was more than half way through a 90 day enhanced surveillance period after the end of the first outbreak. This is a period during which all potential EVD cases were intensively tracked through heightened surveillance of live and death alerts to identify any hidden or undetected transmission chains.

The rapid identification, location, isolation of those who might have been exposed, is critical in reducing risk of potential infection to themselves, their families, and their communities. We thank all of them for their cooperation and support to this process to keep themselves and their communities safe. Thanks to this cooperation it was possible to contain and prevent the spread of infection.

The Inter-Agency Rapid Response Team was convened to assist the Government of Sierra Leone in the response. Incident management teams, including technical experts, equipment and supplies, were immediately deployed to rapidly shut down the chain of transmission. A total of 212 people were vaccinated to offer further protection to those who might have been exposed to the index case.

The source of infection remains under investigation and active case investigations continue.

Contact Information

Ebba Kalondo

Communications Lead

Mobile: +232 76 533 284

United Nations House, 55 Wilkinson Road. P.O. Box 1011, Freetown, Sierra Leone

Telephone: (232) 22-23131 I. VSAT: +31 205401 13/. FAX (232) 22-223075,. internet:

Registry.sl@undp.org

Highlights

• As of 27 January 2016, two new cases of Ebola have been confirmed in Sierra Leone. On 14 January 2016, the first confirmed case of Ebola was announced in the district of Tonkolili. The new case stems from a 22 year old female who died on 12 January 2016. While symptomatic, the index case traveled to Port Loko and Kambia, resulting in quarantined communities across the three districts. The aunt of the index case, who took care of her and was placed under quarantine, was also confirmed positive on 20 January 2016.

• Although the announcement of the new case was disappointing, the response mechanism under the leadership of the Office of National Security was rapidly activated. UNICEF was identified by the InterAgency Rapid Response Team as Incident Manager to lead the response in the field (Tonkolili and Kambia), in collaboration with WHO (Incident Commander – based in Freetown).

• Within the first 24 hours of the event notification, UNICEF rapidly mobilized to support the response and quarantined communities by deploying key personnel and supplies to the affected districts. To date, supplies with a total value of US$333,454 have been dispatched to the affected districts (including tents, CCC rapid response kits, WASH, Education and Child Protection supplies).

Situation in numbers

As of 27 January 2016

8,706 Confirmed cases of Ebola

3,590 Confirmed deaths from Ebola

1,459 Confirmed cases of infected children under age 18 registered by MSWGCA

8,624 Registered children who lost one or both parents due to Ebola

UNICEF funding needs to March 2016 USD 5 million

FREETOWN, SIERRA LEONE— As a child, Anne-Marie Caulkner was forced to undergo female genital mutilation, or FGM, which some people refer to as female circumcision.

The traditional practice removes some or all parts of the external female genitalia. It is seen by some as a rite of passage for girls and a way to make a girl more appealing to a husband.

Caulkner said the violation was so severe it prompted her to form her own nongovernmental organization, the National Movement for Emancipation and Progress (NAMEP). The group works with local communities to educate them about the dangerous effects of FGM, such as health complications.

On Saturday — the International Day of Zero Tolerance to Female Genital Mutilation — local leaders and residents of a community in the western part of Freetown were on hand to listen at an NAMEP event.

Chief Pa Foday Conteh has been to several of NAMEP’s discussions. He said that although FGM is a traditional practice, he understands how harmful it can be to girls. He is now talking more to men about it, but he said that changing a cultural mindset will take time.

"Some will say yes, some will say no, but as time goes on, I believe all of them … will say, yes, [ending FGM] is a good idea,”

Caulkner agreed: “We will not give up, because to any battle, there must be a challenge, there must be confrontation.”

The women who perform the cutting are known as sowies, and many see it is as a business.

Chief Kadiatu Ansu Khan is a sowie. She said that she understood the concerns of NAMEP but that financial challenges remain.

Speaking in her native Krio dialect, she said many people depend on the practice of FGM for their livelihood, and that it has helped them earn a good income.

NAMEP works with sowies to help them learn other life skills, such as tailoring.

International NGOs like the U.N. Children Fund are also working to end FGM, along with the local government.

Sandra Lattouf, UNICEF's deputy representative in Sierra Leone, said that during the Ebola crisis, the government banned the tradition because of the issue of touching. The virus is transmitted through direct contact with bodily fluids. This led to a significant decrease in the practice.

“For the time being, the ban showed ... we can change behavior, and this is where we want, really, to work with the communities, sowies and all the leaders,” Lattouf said.

She added that ending FGM is included in the Sustainable Development Goals created by the United Nations to make progress in such areas as climate change and gender equality.

Geneva, 9 February 2016 – The President of the International Federation of Red Cross and Red Crescent Societies (IFRC), Mr Tadateru Konoé, today ended his first visit to Guinea and Sierra Leone, with a call to the governments of both countries to recognize the role Red Cross volunteers can play in building community resilience to future shocks.

“More than 5,000 Red Cross volunteers in Guinea and Sierra Leone were trained during the Ebola response, many of them in infection, prevention and control,” said President Konoé. “They gained valuable experience and skills which can be used in not only responding to various disease outbreaks, but in also acting as early warning systems. I strongly believe that these volunteers can, and should, play a key role in the rebuilding of community-based health systems.”

While in Guinea, the IFRC President met with Head of State, His Excellency, President Alpha Condé, and Minister of Health, Mr Abdouraman Diallo, both of whom committed to engaging trained Red Cross volunteers to help fill gaps in community health care systems. In Sierra Leone, President Konoé discussed similar opportunities with Minister of Foreign Affairs and International Cooperation, His Excellency, Dr Samura M.W. Kamara.

“Ebola taught us the importance of investing in community-based surveillance, and early warning and response mechanisms so diseases are identified before they become full blown epidemics,” added Konoé. “But we need to go further. When public health emergencies threaten and do cross international borders, such as Ebola, and now the Zika virus in the Americas, it is vital that we share these experiences and knowledge to ensure more effective and efficient responses.”

As part of their recovery operations, the Red Cross Society of Guinea and the Sierra Leone Red Cross Society, with the support of the IFRC, are working with trained volunteers to teach additional community members how to conduct surveillance and identify symptoms of disease when they first surface. By alerting authorities and allowing the implementation of rapid response systems, an outbreak can potentially be stopped before it starts.

“I cannot emphasize enough the key role of Red Cross volunteers in the fight against Ebola, particularly in the provision of safe and dignified burials,” said President Konoé. “The outbreak would not over in Guinea, and down to minimal cases in Sierra Leone, if not for their heroic actions. Engaging these trained volunteers in strengthening community resilience is a logical next step as these countries begin to recover from this deadly outbreak.”