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Sierra Leone: WFP Sierra Leone Country Brief, March 2016

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Source: World Food Programme
Country: Sierra Leone

Highlights

  • WFP is currently preparing a new recovery operation to strengthen livelihoods for highly food insecure people and smallholder farmers, improve nutritional status of women and children, and ensure national stakeholders develop disaster risk management capabilities.

  • In coordination with the Ministry of Education, Science and Technology, WFP is preparing to restart food for education activities by providing a take home ration for children in food insecure areas.

  • Food and cash transfers to Ebola Virus Disease (EVD) orphans and survivors are ongoing nationwide, supporting 18,800 orphans and their caregivers, and 2,703 Ebola survivors.

Operational Updates

  • In support of EVD preparedness measures based on recent outbreaks in Guinea and Liberia, WFP has mobilized contingency stocks in warehouses near the border. Additionally, logistics transport assessments have been updated to ensure the most accurate information is available should food assistance or common services support be required.

  • WFP in collaboration with the Ministry of Agriculture, Forestry and Food Security conducted training for the Statistical Division of the Ministry in market price data collection using harmonized units of measurement and smart phones.

  • The fifth round of cash based transfers (CBT) to 2,703 Ebola survivors was completed, with each survivor receiving a CBT of USD 58.

  • WFP is in the process of signing contracts with smallholder farmers for the purchase of rice to be distributed under WFP activities. Next month trainings will be delivered to farmer organizations in production to post harvest handling to support them to further increase their productivity and incomes.


Kenya: Kenya: Kakuma New Arrival Registration Trends 2016 (as of 2 May 2016)

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Source: UN High Commissioner for Refugees
Country: Burkina Faso, Burundi, Cameroon, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Eritrea, Ethiopia, Guinea, Guinea-Bissau, Iran (Islamic Republic of), Kenya, Nigeria, Pakistan, Russian Federation, Rwanda, Saudi Arabia, Sierra Leone, Somalia, South Sudan, Sudan, Uganda, United Republic of Tanzania, Yemen, Zimbabwe

World: Sahel Region, Central and West Africa - Food Security Situation in 2016 (Current) over RBD Countries (19 Apr 2016)

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Source: World Food Programme
Country: Benin, Burkina Faso, Cabo Verde, Cameroon, Central African Republic, Chad, Côte d'Ivoire, Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Sao Tome and Principe, Senegal, Sierra Leone, Togo, World

World: Preparatory Workshop for the Word Humanitarian Summit (WHS)

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Source: Berghof Foundation
Country: Sierra Leone, Somalia, Syrian Arab Republic, World

A month preceding the World Humanitarian Summit, the Berghof Foundation, together with its consortium partners AFFORD and the Danish Refugee Council, organized a preparatory workshop for diaspora organisations and initiatives engaged in humanitarian action. 11 representatives from Sierra Leonean, Somali and Syrian diaspora organisations that are invited to the summit in Istanbul attended the workshop on 21 April in Berlin.

The participants engaged in a joint review of the results of the WHS consultation process and discussed the summit agenda, stakeholders' expectations, commitments made and expected outcomes of the summit.

Building on selected policy documents and reports as well as recommendations formulated in the framework of the DEMAC initiative (Diaspora Emergency Action and Coordination), commitments for a joint paper reflecting the views of the present diaspora organisations were developed at the workshop. These commitments are to be elaborated into a joint diaspora commitment paper that will be presented to the broader international humanitarian community at the World Humanitarian Summit. These commitments of diaspora organisations seek to contribute to the UN Secretary-General's Agenda for Humanity to better prepare for and respond to humanitarian crises.

The workshop is part of DEMAC's overall mandate to explore intervention methods and organisational capacities of diaspora organisations engaged in humanitarian action and to improve coordination between diaspora actors and the 'conventional' international humanitarian system.

A diaspora recommendations paper and a statement calling for an improved operational and strategic cooperation between diaspora humanita­rians and the conventional humanitarian system had been presented and fed into the WHS Global Consultations in October 2015. DEMAC also has been nominated as WHS focal point for the diaspora stakeholder group.

Sierra Leone: A progress report on the West Africa Ebola epidemic: Testimony before the Senate Foreign Relations Committee Subcommittee on Africa and Global Health Policy

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Source: Center for Global Development
Country: Guinea, Liberia, Sierra Leone

Amanda Glassman Vice President for Programs and Director of Global Health Policy Center for Global Development

Along with my colleagues at the Center, I have been watching the Ebola epidemic unfold in West Africa and keeping a close eye on the world’s response. As you know, this outbreak was unprecedented in scale and impact. Liberia, Sierra Leone, and Guinea endured a total of more than 28,600 cases of the virus and 11,300 deaths. The disease took a heavy toll not only on families, but also on the health systems and economies of the afflicted countries.

By the time the World Health Organization (WHO) declared Ebola a public health emergency in August 2014, it was clear additional resources were urgently needed to help West Africa contain the disease. Congress stepped up to the plate, appropriating $5.4 billion in emergency funding, including nearly $2.5 billion to the US Agency for International Development (USAID) for international response, recovery, and preparedness.

My testimony will focus on three areas, providing specific recommendations to Congress to help West Africa heal and regain lost ground, and to ensure that the United States is better protected and prepared to face future global health threats.

(1) Remain committed to recovery with an approach that addresses the needs of households, health systems, and firms.

(2) Enhance efforts to promote global health security by improving coordination, developing clearer incentives, and exploring new ways to manage risk.

(3) Track money and progress to ensure accountability and learn what works.

Sierra Leone: WHO Ebola Situation Report - 5 May 2016

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Source: World Health Organization
Country: Guinea, Italy, Liberia, Mali, Nigeria, Senegal, Sierra Leone, Spain, United Kingdom of Great Britain and Northern Ireland, United States of America

  • The Public Health Emergency of International Concern (PHEIC) related to Ebola in West Africa was lifted on 29 March 2016. A total of 28 616 confirmed, probable and suspected cases have been reported in Guinea, Liberia and Sierra Leone, with 11 310 deaths.

  • In the latest cluster, seven confirmed and three probable cases of Ebola virus disease (EVD) were reported between 17 March and 6 April from the prefectures of N’Zerekore (nine cases) and Macenta (one case) in south-eastern Guinea. In addition, having travelled to Monrovia, Liberia, the wife and two children of the Macenta case were confirmed as Ebola cases between 1 and 5 April.

  • The index case of this cluster (a 37-year-old female from Koropara sub-prefecture in N’Zerekore) had symptom onset on or around 15 February and died on 27 February without a confirmed diagnosis. The source of her infection is likely to have been due to exposure to infected body fluid from an Ebola survivor.

  • All contacts that were linked to the 13 cases (including nine deaths) in Guinea and Liberia completed the 21-day follow-up period on 27 April.

  • In Guinea, the last case tested negative for Ebola virus for the second time on 19 April. In Liberia, the last case tested negative for the second time on 28 April.

  • The 42-day (two incubation periods) countdown must elapse before the outbreak can be declared over in Guinea and Liberia. In Guinea, this is due to end on 31 May and in Liberia, this is due to end on 9 June. The response to this outbreak was supported in Guinea by vaccination of contacts and contacts of contacts. This campaign began on 22 March and vaccinated over 1500 people.

Risk assessment:

Active surveillance is ongoing in Guinea and Liberia and will continue 42 days after the last case tested negative for Ebola virus. The performance indicators suggest that the Guinea, Liberia and Sierra Leone still have variable capacity to prevent (EVD survivor programme), detect (epidemiological and laboratory surveillance) and respond to new outbreaks (Table 1). The risk of additional outbreaks originating from exposure to infected survivor body fluids remains.

World: Diaspora Humanitarianism - Transnational Ways of Working

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Source: Danish Refugee Council, Berghof Foundation
Country: Sierra Leone, Somalia, Syrian Arab Republic, World

The DEMAC research report outlines the basic features of formalized collective interventions by Sierra Leonean, Somali and Syrian diaspora-based relief organisations and initiatives based in the UK, Denmark and Germany, respectively, by elucidating their responses to the humanitarian crises in their countries of origin/heritage and neighbouring countries.

Based on interviews conducted in Denmark, Germany, Lebanon, Sierra Leone, Somalia (Somaliland), Turkey, and the UK, desk-based study, cross-referencing surveys, and mappings, the report identifies the instruments and explains the ways through which diaspora humanitarians operate to provide relief to affected people in need. Informative yet largely explorative in nature, the report elicits potential areas of increased and more effective cooperation and coordination between diaspora organisations and initiatives engaged in humanitarian action and ‘traditional’ actors of the international humanitarian system.

The central questions this report seeks to answer are:

  • What are driving motivations for diaspora organisations to engage in humanitarian action?

  • What are the prevalent response modes and mechanisms in diaspora humanitarian response?

  • How do diaspora and conventional humanitarian actors cooperate and collaborate?

  • How diaspora organisations, local organisations and ‘conventional’ humanitarian actors perceive one another?

  • What are the main challenges to interventions of diaspora humanitarians?

The outputs of this research are aimed at diaspora organisations and initiatives engaged in humanitarian action, nongovernmental organisations and donor agencies interested in engaging with diaspora organisations as well as organisations outside the humanitarian sector, such as academic institutions or private enterprises, seeking to engage with highly innovative actors in humanitarian action.

It is produced as part of the DEMAC (`Diaspora Emergency Action and Coordination’) initiative implemented by Danish Refugee Council, AFFORD-UK & Berghof Foundation to improve diaspora emergency response capacity and coordination with the conventional humanitarian system.

Sierra Leone: Sierra Leone Food Security Outlook Update April 2016

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Source: Famine Early Warning System Network
Country: Sierra Leone

Food security is gradually improving in some urban districts

KEY MESSAGES

  • Market and household stock levels will continue to decline faster than normal through the end of the lean season in July as a result of below-average 2015/16 production. Additionally, Sunday market bans across the country are continuing to limit economic activity.
    Although early rice harvests are expected to improve food availability somewhat, most areas of the country will remain in Stressed (IPC Phase 2) acute food insecurity through September 2016.

  • Market functionality continues to gradually improve. The majority of public gathering restrictions have been lifted and households are producing off-season crops including vegetables, mangoes, cassava, and palm oil to generate additional income. Additionally, the electricity grid is experiencing fewer outages as the system’s payment model completed updates. This has led to further improvements in urban livelihood activities that were limited during the Ebola crisis. Bo and Western Area Rural and Urban Districts have improved to Minimal (IPC Phase 1) food insecurity.

  • Land preparations for cash and staple crops for the upcoming 2016/17 agricultural season is ongoing, however reports indicate household incomes from these activities remain somewhat below average. Average to below-average rainfall is forecasted for this season. Given plans for normal distributions of inputs by the Ministry of Agriculture, this year’s crop production is expected to improve compared to the 2015/16 season.


Mali: Sécurité Alimentaire et implications humanitaires en Afrique de l’Ouest et au Sahel, N°73 - Mars - Avril - 2016

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Source: World Food Programme, Food and Agriculture Organization
Country: Burkina Faso, Cameroon, Central African Republic, Chad, Côte d'Ivoire, Gambia, Ghana, Guinea, Libya, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Sudan, Togo

L'essentiel:

  • De bonnes productions agricoles 2015-2016 sont confirmées auSahel et en Afrique de l’Ouest.

  • 6,7 millions de personnes sont affectées par l’insécurité alimentaire et nutritionnelle dont près de 4,2 millions de personnes déplacées au Sahel et en Afrique de l’Ouest en raison de l’insécurité civile qui sévit dans le bassin du Lac Tchad, au Nord du Mali, en Libye, en République Centrafricaine et au Soudan.

  • Globalement les marchés demeurent bien approvisionnés et sont caractérisés par des prix des denrées alimentaires stables ou en baisse par rapport à l’année passée et à la moyenne quinquennale.

  • Des précipitations globalement proches de la moyenne à déficitaires sont attendues sur la majeure partie de la région du Golfe de Guinéeà la période mars - mai 2016.

World: Communicable disease threats report, 1-7 May 2016, week 18

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Source: European Centre for Disease Prevention and Control
Country: Afghanistan, Angola, Argentina, Brazil, Chile, French Guiana (France), Guadeloupe (France), Guinea, Liberia, Martinique (France), Pakistan, Papua New Guinea, Saint Martin (France), Sierra Leone, World

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 1-7 May 2016 and includes updates on Zika virus, Ebola virus disease, and yellow fever in Angola.

Kenya: Kenya: Kakuma New Arrival Registration Trends 2016 (as of 8 May 2016)

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Source: UN High Commissioner for Refugees
Country: Burkina Faso, Burundi, Cameroon, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Eritrea, Ethiopia, Guinea, Guinea-Bissau, Iran (Islamic Republic of), Kenya, Nigeria, Pakistan, Russian Federation, Rwanda, Saudi Arabia, Sierra Leone, Somalia, South Sudan, Sudan, Uganda, United Republic of Tanzania, Yemen, Zimbabwe

Sierra Leone: Sierra Leone - Liberia call for more collaboration to End Ebola

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Source: Government of Sierra Leone
Country: Guinea, Liberia, Sierra Leone

The leaders of Sierra Leone and Liberia on Friday 6 May, 2016, called for more collaboration to end Ebola in their respective countries.

The call came following a joint communique signed by both President Dr Ernest Bai Koroma and his Liberian counterpart, Ellen Johnson Sirleaf who was on a one-day working and friendly visit to Sierra Leone.

The two heads of state, according to the communique, agreed on not only ending the Ebola epidemic in their respective countries, but also exchanged views on political, security, health, socio-economic cooperation as well as progress and challenges with national dimensions of the implementation of the post-Ebola recovery programmes.

Ending Ebola in the respective countries and in the sub-region, the two heads of state expressed satisfaction and optimism, and reiterated the need for cooperation with each other in the implementation of their post-Ebola recovery/reconstruction programmes.

Both President Koroma and President Johnson Sirleaf also agreed to intensify bilateral teamwork at all levels - intelligence sharing and security alertness, considering recent atrocities caused by terrorist networks in Burkina Faso, Nigeria, Côte d'Ivoire and Mali. They therefore heightened the need for peace and sustainable development in the MRU basin after Ebola.

The two leaders agreed on providing support for ECOWAS programmes for political and economic integration and promised to attend the forthcoming ECOWAS summit of heads of state and government in Dakar, Senegal in June 2016.

Addressing a meeting shortly after the signing ceremony, President Koroma said Sierra Leone will continue to engage with Liberia to finding lasting solutions to the current economic situation facing the three Ebola hard-hit countries of Guinea, Liberia and Sierra Leone.

President Koroma commended President Johnson Sirleaf for her relentless efforts in defeating Ebola in Liberia.

President Ellen Johnson Sirleaf, in her response, extended gratitude to the Government and People of Sierra Leone for the warm reception on her arrival at the Presidential Lounge in Lungi.

She disclosed that she had, prior to her visit, held similar engagement with Guinean President, Prof. Alpha Conde. She noted that she was making her first visit to the country after the Ebola outbreak and expressed heartfelt condolences to the families of those who lost their lives to the disease. President Johnson Sirleaf promised continuous cooperation with Sierra Leone within the MRU framework.

Madam Johnson Sirleaf also commended health workers for their dedication and diligent service in the fight against Ebola, adding that Liberia will continue to stand by Sierra Leone to push for greater development. She extended an invite to President Koroma for a reciprocal visit.

World: Polio this week as of 04 May 2016

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Source: Global Polio Eradication Initiative
Country: Afghanistan, Benin, Burkina Faso, Côte d'Ivoire, Guinea, Lao People's Democratic Republic (the), Liberia, Madagascar, Mali, Mauritania, Myanmar, Niger, Nigeria, Pakistan, Senegal, Sierra Leone, Ukraine, World

  • From the 17 April to the 1 May, 155 countries and territories participated in the historic trivalent to bivalent oral polio vaccine switch, withdrawing the type two component of the vaccine to protect future generations against circulating vaccine derived polioviruses. Track the switch live.

  • A group of independent experts in Ukraine met to assess the country’s response to the polio outbreak and concluded that transmission of the poliovirus has likely stopped in the country. However, they emphasized the need to continue to strengthen immunization and surveillance to protect children in Ukraine against further outbreaks.

Sierra Leone: Alone and at risk: Sierra Leone's baby-faced mothers

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Source: Agence France-Presse
Country: Sierra Leone

Freetown, Sierra Leone | AFP | Wednesday 5/11/2016 - 03:20 GMT

by Jennifer O'MAHONY

Dizzy and sweating, 15-year-old Isatu Koroma sits with her eyes closed in the maternity ward in Sierra Leone where she has spent the last 10 days, as her tiny little daughter begins to cry.

Koroma badly needs blood after a complicated delivery -- relatives are expected to donate here but none has visited, also leaving the nurses to pay for her to eat.

Health workers in the west African country are battling a teenage pregnancy epidemic that peaked when the Ebola crisis was at its height late in 2014, and they say it shows no sign of slowing.

Ward sister Josephine Samba describes the girl's pregnancy as "an accident", whispering that Koroma's own mother died two months after she was born as she cajoles her into breastfeeding the as yet unnamed baby.

Schoolgirls are so regularly admitted to Princess Christian Maternity Hospital (PCMH) in Freetown that they attract little attention.

Coyness about discussing sex in Sierra Leone veils the fact that during the chaos of the Ebola crisis many teenagers were raped or forced to have sex for money to contribute to household expenses, according to research by several children's charities and UN agencies.

"There were a lot more (teen pregnancies) during the Ebola breakout. Most of them were at home. There was no school, so everything was just upside down," Samba says.

After Sierra Leone announced its first Ebola cases in May 2014, schools were closed and movement severely restricted, leaving girls more vulnerable to abuse.

Since then the UN Population Fund (UNFPA) has counted more than 18,000 teenage pregnancies, with the number of pregnant girls up by 65 percent in certain districts.

Unsafe abortion

Internationally recognised as the country with the world's highest maternal mortality rate, at 1,360 deaths per 100,000 live births, Sierra Leone could ill afford the blow to its health system that Ebola dealt, diverting resources and staff away from maternal health.

The result is thousands of girls who will never live to become women, as UNFPA estimates that 40 percent of all maternal deaths occur among those under 18.

A lack of birth control and conservative abortion laws mean that many girls, upon realising they are pregnant and fearing they will be forced to drop out of school, attempt to abort with drugs or seek out backstreet providers who employ methods such as bicycle spokes to terminate pregnancies.

Louise Nordstrom, a Swedish midwife working on a UNFPA training programme for birth attendants at the hospital, described a recent, typical case of a young student who arrived at PCMH with severe stomach pains.

"You could see she was in agony. I asked her if she knew she was pregnant," Nordstrom said, keeping one eye on a screaming woman waiting to be taken to theatre for an emergency caesarian section.

"Soon after she went to pee in a bed pan and out came the dead foetus. It was very obvious she had been taking some drugs at home; she knew she was pregnant; she was afraid and didn't want to have the baby so she induced an abortion herself."

Many girls wait until it's far too late before seeking hospital care, says Alimamy Philip Koroma (no relation to the teenage mother), one of Sierra Leone's pre-eminent obstetric and gynaecology specialists.

"Some of them don't even come to the antenatal clinic, they stay at home because of fear of their (school) colleagues seeing them," he told AFP.

"Sometimes their pelvis is not prepared enough to have a child," he said, also referring to haemorrhage and septicaemia as particular risks for girls arriving after attempting unsafe abortions.

School dropouts

In this difficult context, Mohammed El Hassein, reproductive health specialist at UNFPA, said the three priorities were to improve progress in the uptake of family planning, bolster the image of midwives and ensure access to emergency obstetric care.

But the problem is particularly entrenched among young people.

"We are trying to train the (contraception) providers to be youth-friendly," he told AFP.

And for those who survive childbirth, life choices are restricted.

The government has only recently allowed school-aged mothers to go back to class and many of those who do lack the support they need.

"Before the reopening of school the child was very small and on breast milk. There was no one to take care of her except me," said Neima Foday, 19, speaking to AFP in the town of Kailahun with 13-month-old baby Ishmail on her knee.

"I'm a bit worried because my friends are attending school and I'm not," she said, adding that without an education she knew money would always be a problem.

Asked if Ishmail's father was contributing to his son's upkeep, Foday shook her head.

"I haven't seen him since I told him I was pregnant," she said.

jom/nb/ser/ric

© 1994-2016 Agence France-Presse

World: Forced Migration Review No. 52: Thinking ahead: displacement, transition, solutions

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Source: Forced Migration Review, University of Oxford
Country: Brazil, Burundi, Canada, Colombia, Ghana, Iraq, Lebanon, Liberia, Myanmar, Nigeria, occupied Palestinian territory, Sierra Leone, Somalia, Sweden, Syrian Arab Republic, Uganda, United Republic of Tanzania, World, Yemen

The new issue of FMR explores the ideas and practices that are being tried out in order to engage both development and humanitarian work in support of ‘transitions’ and ‘solutions’ for displaced people. What we need, says one author, is “full global recognition that the challenge of forced displacement is an integral part of the development agenda too”. FMR issue 52 includes 32 articles on ‘Thinking ahead: displacement, transition, solutions’, plus ten ‘general’ articles on other aspects of forced migration.


World: Consolidating gains and accelerating efforts to control and eliminate malaria in developing countries, particularly in Africa, by 2015 - Note by the Secretary-General (A/70/833)

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Source: UN General Assembly
Country: Algeria, Angola, Argentina, Armenia, Azerbaijan, Botswana, Cabo Verde, Cambodia, China, Costa Rica, Democratic Republic of the Congo, Eritrea, Ethiopia, Georgia, Guinea, India, Iraq, Kyrgyzstan, Lao People's Democratic Republic (the), Liberia, Morocco, Mozambique, Myanmar, Namibia, Nigeria, Paraguay, Rwanda, Sao Tome and Principe, Sierra Leone, South Africa, Sri Lanka, Swaziland, Tajikistan, Thailand, Turkey, Turkmenistan, United Arab Emirates, Uzbekistan, Viet Nam, World, Zambia, Zimbabwe

The Secretary-General has the honour to transmit to the General Assembly the report of the Director-General of the World Health Organization, submitted in accordance with General Assembly resolution 69/325.

Report of the Director-General of the World Health Organization on consolidating gains and accelerating efforts to control and eliminate malaria in developing countries, particularly in Africa, by 2015

Summary

The present report is submitted in response to General Assembly resolution 69/325. It provides a review of progress in the implementation of the resolution, focusing on the adoption and scaling-up of interventions recommended by the World Health Organization in malaria-endemic countries. It also provides an assessment of progress towards the 2015 global malaria targets, including Millennium Development Goal 6, targets set through the African Union and the World Health Assembly, and goals set through the Global Malaria Action Plan of the Roll Back Malaria Partnership. It elaborates on the challenges limiting the full achievement of the targets, and provides recommendations to ensure that progress is accelerated towards the goals of the Global Technical Strategy for Malaria 2016-2030 in the coming years.

I. Introduction

  1. While malaria is a preventable and treatable disease, it continues to have a devastating impact on people’s health and livelihoods around the world. In 2015, approximately 3.2 billion people were at risk of the disease in 95 countries and territories, and an estimated 214 million malaria cases occurred (uncertainty range: 149 million-303 million). The disease killed 438,000 people (uncertainty range: 236,000-635,000), mostly children under 5 years of age in sub-Saharan Africa. The World Health Organization (WHO) recommends a multi-pronged strategy to reduce the malaria burden, including vector control interventions, preventive therapies, diagnostic testing, quality-assured treatment and strong malaria surveillance.

  2. The present report highlights progress and challenges in the control and elimination of malaria in the context of General Assembly resolution 69/325. It draws on the World Malaria Report 2015, issued by WHO in December 2015. The analysis is based on the latest available comprehensive data (2014) received from malaria-endemic countries and organizations supporting global malaria efforts and includes projections to 2015 where it is feasible to do so. Data from 2015 are currently being collected and reviewed by WHO. Projections for 2015 were also published in The Millennium Development Goals Report 2015.

  3. Between 2005 and 2015, malaria received worldwide recognition as a priority global health issue. Under the umbrella of the Roll Back Malaria Partnership, endemic countries, United Nations agencies, bilateral donors, public-private partnerships, scientific organizations, academic institutions, non-governmental organizations (NGOs) and the private sector worked together to scale up WHO-recommended interventions, harmonize activities and improve strategic planning, programme management and funding availability. A steep rise in international funding enabled endemic countries to expand their malaria programmes. Since 2010, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) has provided more than $4 billion for malaria interventions, while the Governments of the United States of America and the United Kingdom of Great Britain and Northern Ireland have been the second and third largest bilateral funders.

  4. The success of efforts to control and eliminate malaria is measured through an analysis of trends in the disease burden and intervention scale-up, and a review of progress made towards a set of global goals and targets, which have been designed through intergovernmental processes or set in the context of global initiatives. For the period 2000 to 2015, the four main sets of goals and targets were: Millennium Development Goal 6, targets set through the African Union and the World Health Assembly, and goals set by the Roll Back Malaria Partnership through the Global Malaria Action Plan. Further details are provided in section IV of the report. Regional and subregional targets for malaria control and elimination are not addressed here.

Sierra Leone: UNDP kick-starts USD 4.5M post-Ebola public health and livelihoods project in border areas

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Source: UN Development Programme
Country: Côte d'Ivoire, Guinea, Japan, Liberia, Sierra Leone

Freetown, May 6 2016: The United Nations Development Programme (UNDP) has launched a new Mano River sub-regional post-Ebola medical surveillance and livelihoods initiative in Freetown, after a two-day Inception workshop which ended Friday May 6 at the Bintumani Hotel in Freetown.

The Government of Japan funded USD 4.5M project titled “Supporting and Strengthening Sub-regional post-Ebola Medical Surveillance and Socio-Economic Recovery Initiatives in West Africa” , seeks to rebuild local development and livelihood conditions in communities, especially in the remote hard-to-reach border areas in the three most Ebola affected countries and Côte d’Ivoire. The four countries are all members of the sub-regional Mano River Union (MRU) grouping, headquartered in Freetown. The project aims at promoting rapid socio-economic recovery, resilience and restoration of livelihoods and supporting existing post-Ebola recovery action plans and strategies developed by national and regional partners.

The UNDP Resident Representative and UN Resident Coordinator, Mr. Sunil Saigal, who just arrived last week to take up appointment as the new UN Chief in Sierra Leone, said during the conference that the sub-regional post-Ebola Public-Health Surveillance and Social-Economic Recovery Initiative would address critical and adverse conditions that will hopefully prevent a future localized epidemic from escalating into national and regional crisis with global ramifications by minimizing the risk of escalation.

“Post-disaster recovery programmes must integrate systems and processes so that disease surveillance is improved; that systems are built back better and that other relevant capacities are in a place with appropriate levels of funding to sustain them over the medium and long term.” Ha said.

Secretary General of the Mano River Union, Dr. Hadja Saran Daraba Kaba, noted that people in the sub-region are highly mobile and that out of an estimated 45 million people within the sub-region, 2.2 million or 5% are classified as highly mobile populations, moving constantly across these borders.

“It is my hope that as this UNDP project is formulated, it will take into cognisance this sub-regional framework that the MRU health experts have already formulated, which include the prevention and control of communicable diseases, improvement of water and sanitation, strengthening of integrated surveillance, reaction, emergency preparedness and management” The Secretary General, Dr Hadja Saran Daraba Kaba said, adding: “From the lessons learned in the fight against EVD, cross border cooperation, coordination and collaboration are key in addressing such epidemics or any other communicable diseases.”

UNDP Regional Conflict Prevention and Recovery Adviser, Mr Armand-Michel Broux, said the one year (March 2016-2017) sub-regional project will also help deepen regional integration and cooperation, improve the coordination and operational capacities of regional and sub-regional institutions like as well as support existing regional early warning responses, mechanisms and policies at regional and national levels in the post-Ebola recovery phase. He added that, the project intends to strengthen and improve the operational capacities of regional and sub-regional institutions and support existing regional early warning responses, mechanism and policies.

Regional and sub-regional partners, UN Sister agencies (UNCDF, UNICEF, UNWOMEN and UNFPA), UNDP country offices, regional experts, government representatives, , researchers, academics, the media, civil society and community based organizations drawn from the countries most affected by Ebola were in Freetown for a two-day technical workshop to map out strategies for the acceleration of socioeconomic recovery and local development initiatives as well as intensifying surveillance in communicable and non-communicable diseases in the MRU.

Contact Information

Mr. Armand-Michel Broux, Regional Conflict Prevention and Recovery, Post-Ebola Regional Project Manager, Email: michel.broux@undp.org ; UNDP RSCA, Tel +221 773324229

UNDP Sierra Leone, Communications Unit. Email: communication.sl@undp.org. Follow us on Twitter @UNDPSierraLeone and Facebook on UNDPSierraLeone.

Tahir Basse, Knowledge Management & Communication Specialist, Regional Energy Project for Poverty Reduction, Dakar Liaison Office, RSCA. Email: tahir.basse@undp.org. Tel: +221 77 332 43 36

Sierra Leone: Sierra Leone's first Ebola-hit community reconsiders its traditions

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Source: Agence France-Presse
Country: Sierra Leone

Kailahun, Sierra Leone | Thursday 5/12/2016 - 03:12 GMT

By Jennifer O'MAHONY

Violently coughing up blood, the woman was close to collapse when brought to Kailahun hospital in eastern Sierra Leone from her village close to the Guinean border.

For nursing staff, the spectre of the killer Ebola virus had returned.

"My staff went into PTSD (post-traumatic stress disorder)," said Samuel Massaquoi, medical superintendent of the hospital. "People said that if she came from near Guinea she had Ebola."

Urging calm, the doctor immediately implemented the screening measures used at the outbreak's height, when Ebola cases arrived on a daily basis.

That was one month ago -- the patient was instead diagnosed with advanced tuberculosis -- but it is a clear example of how the the fear of Ebola still grips the heart of this community.

The district was the first in the country to record cases back in May 2014 after the initial outbreak in southern Guinea.

The virus killed around 230 people in Kailahun but its impact did not end when the area was declared Ebola-free a year ago: residents say entrenched attitudes to health and tradition have changed significantly.

"The outbreak started here. Every patient at that time was considered a suspected case," Massaquoi said, standing metres from the now empty triage building, where health workers in hazmat suits once worked in scenes resembling a horror film.

His hospital received a real boost, he said, with extra funding for equipment from the United Nations Population Fund (UNFPA), and targeted training for staff from Britain's Liverpool School of Tropical Medicine.

"It was not like this two years back. It has improved significantly," the general practitioner said. That was reflected by an uptick in the number of patients admitted post-Ebola, many of whom previously viewed the hospital as a place of death, not healing.

Traditions upended

Kailahun's first spate of cases is believed to have originated from the funeral of a traditional healer in a village close to where the Guinea, Liberia and Sierra Leone borders meet.

Ebola sufferers were crossing to see her from Guinea before she too succumbed to the virus. Many west Africans believed Ebola was a curse, and turned to their local witchdoctor rather than attempt the long distances and meet the elevated costs of government health facilities.

"Ebola came, but it came with lessons. Most of them who treated Ebola patients died," Massaquoi said.

"It was only when the powerful healers started dying that people started believing this is real. We lost quite a good amount of them," he said, with many no longer as convinced of their invincibility.

The Red Cross sought to engage the healers in the fight against the virus, persuading some to advise visitors that they could not cure Ebola, and pointing them to dedicated treatment centres.

Prevention in the form of better hygiene is highly visible in the proliferation of hand-washing stations at the string of villages that dot this rural district.

Another influential group has altered its activities post-Ebola in Kailahun: the female secret societies that dominate rural life in this part of west Africa, whose primary role is to initiate girls into womanhood.

Traditionally they would carry out female genital mutilation (FGM), a practice performed on 90 percent of girls in Sierra Leone, according to UNICEF.

But in 19-year-old Baindu Alie's village, they have stopped.

"(Families) are afraid, so there is less trust in the societies," she said.

The girls' loss of blood during the excision, usually performed with a razor, was now known to be a possible transmission point for Ebola, medical professionals in the community confirmed to AFP.

Survivor communities

Naima Morie, 20, lives down the road from the district hospital and is an Ebola survivor. Three of her family members were not so lucky, including a sister who died in her arms.

Morie had symptoms of fever, headache, vomiting and diarrhoea when she arrived at the Ebola treatment unit (ETU), and was driven there semi-conscious.

When she came round, "my whole system was very hot, boiling hot inside," she told AFP.

Morie made a full recovery, and in February gave birth to a baby boy named Joseph.

"When I was out of the ETU and went back home they were all rejoicing," she said, describing the reaction back in her village. "Now babies that are sick, they visit the hospital after seeing me survive."

Not everyone is so accepting. The stigma of Ebola remains a problem, and survivors have held protests in recent months against the government, claiming free follow-up treatment and scholarships for their children have not been delivered as promised.

According to Doctors Without Borders (MSF) there are more than 4,000 Ebola survivors living in Sierra Leone, and the virus killed many of country's already limited number of health workers.

Ebola is one in a long list of epidemics that have ravaged this community, each leaving its own generation of survivors and broken families.

Huge roadside signs in the district now proclaim: "It's not the end for Ebola survivors; it's the end for stigma", alongside more faded billboards that read "An HIV test saved my life".

jom/ser/ric/lto

World: Unlocking the community health workforce potential, post-Ebola: what models and strategies work?

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Source: Wilton Park
Country: Guinea, Liberia, Sierra Leone, World

The Ebola pandemic of 2014-16 demonstrated the crucial role of the community health workforce in preventing, responding to, and effectively treating health emergencies. As the West Africa region rebuilds its health systems after Ebola, countries and communities have identified a need to develop strategies and plans to embed the role of the community health worker (CHW) as a foundation of an effective healthcare system.

There is strong evidence of the impact CHWs can have on health outcomes for their communities. Justification for investment in in CHWs has been well established, but there remain questions about how to find the resources to do this sustainably. Real and practical challenges to building and supporting a strong community health workforce persist- challenges that existed before Ebola, but in many cases have become even worse.

Health systems recovering from the impact of Ebola have limited resources and depleted workforces. In many cases, international and domestic resources are restricted to specific diseases, and breaking free from the constraints of vertical project interventions to horizontal programmes is not simple. Governments, donors and non-governmental organizations (NGOs) are working to collaborate and adopt whole-system approaches, but this process takes enormous skill, effort, and compromise. Government leadership at national level has never been more important. Thinking about how each and every stakeholder supports health workers takes new thinking and new approaches. It means thinking systemically about what motivates and supports the health worker as a professional and as an individual.

With this in mind, the aim of the “Unlocking the community health workforce potential, post-Ebola: what models and strategies work” meeting was to develop clear ways forward for Ebola-affected countries in developing a strong community workforce; to share lessons learned from countries with strong community health systems; and to align the needs of Ebola-affected countries with global efforts to develop and support CHW programmes in a highly complex set of interrelated environments.

The meeting built on the health information systems (HIS) meeting led by the West Africa Health Organization, which took place in May 2015 in Ghanai; as well as the ‘(Re)Building health systems in West Africa: what role for ICT and mobile technologies?’ meeting held at Wilton Park in June 2015.ii The core messages from that meeting were the importance of government leadership; the need for user-centred design in technology and programs; the need for high-quality training for health workers; incentives aligned to need and performance; and the essential role of collaboration, particularly with the private sector.

This conference – again drawing together both public and private sector leaders – specifically aimed to foster better coordination; to build determination across sectors for a paradigm shift in approaches; to build bridges between technology communities and those who need to manage those systems on a daily basis; and to put the health worker at the centre of all stakeholder thinking.

“(The) acute crisis of Ebola may be over but sustained crisis and emergency still exists”

Sierra Leone: WHO Ebola Situation Report - 12 May 2016

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Source: World Health Organization
Country: Guinea, Italy, Liberia, Mali, Nigeria, Senegal, Sierra Leone, Spain, United Kingdom of Great Britain and Northern Ireland, United States of America

 The Public Health Emergency of International Concern (PHEIC) related to Ebola in West Africa was lifted on 29 March 2016. A total of 28 616 confirmed, probable and suspected cases have been reported in Guinea, Liberia and Sierra Leone, with 11 310 deaths.

 In the latest cluster, seven confirmed and three probable cases of Ebola virus disease (EVD) were reported between 17 March and 6 April from the prefectures of N’Zerekore (nine cases) and Macenta (one case) in south-eastern Guinea. In addition, having travelled to Monrovia, Liberia, the wife and two children of the Macenta case were confirmed as Ebola cases between 1 and 5 April.

 The index case of this cluster (a 37-year-old female from Koropara sub-prefecture in N’Zerekore) had symptom onset on or around 15 February and died on 27 February without a confirmed diagnosis. The source of her infection is likely to have been due to exposure to infected body fluid from an Ebola survivor.

 In Guinea, the last case tested negative for Ebola virus for the second time on 19 April. In Liberia, the last case tested negative for the second time on 28 April.

 The 42-day (two incubation periods) countdown must elapse before the outbreak can be declared over in Guinea and Liberia. In Guinea, this is due to end on 31 May and in Liberia, this is due to end on 9 June.

 Having contained the last Ebola virus outbreak in March 2016, Sierra Leone has maintained heightened surveillance with mandatory swabbing, testing of all reported deaths and prompt investigation and testing of all suspected cases. The swabbing policy will be reviewed on the 30 June.

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