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Members of the Regional Subcommittee for Polio Eradication and Outbreaks in the Eastern Mediterranean reviewed recent developments during the 69th session of the Regional Committee.
It was the sixth meeting of the subcommittee since it was formed during the 67th Regional Committee.
During the meeting, Member States and partners reiterated their commitment to freeing current and future generations of children from polio and called for sustained efforts to end polio once and for all, including the wild poliovirus outbreaks that persist in Afghanistan and Pakistan.
Representatives of the partners of the Global Polio Eradication Initiative (GPEI) and the Regional Directors of the United Nations Children's Fund (UNICEF) Offices in the Middle East and North Africa and South Asia gave interventions in support of the ongoing work to end polio in the Region.
Member States represented in person or virtually included Bahrain, Djibouti, Egypt, Islamic Republic of Iran, Iraq, Lebanon, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Tunisia, United Arab Emirates, and Yemen.
Dr. Hamid Jafari, Director of the Region's Polio Eradication Program, updated Member States on efforts to stop transmission of wild and variant polioviruses in the Eastern Mediterranean.
Since the 68th session of the Regional Committee, nationwide vaccination campaigns have resumed in Afghanistan, the Region has implemented outbreak response campaigns using the new oral polio vaccine type 2 (nOPV2), and concerted and sustained efforts have led to the closure of a poliovirus outbreak in Sudan.
and a high-risk event in the Islamic Republic of Iran. Dr. Jafari informed the Member States about the epidemiological situation in the last two countries in the Region (Afghanistan and Pakistan) with transmission of wild poliovirus.
Despite a surge in cases in 2022, concerted efforts in Pakistan have led to only one lineage of viruses surviving in southern Khyber Pakhtunkhwa.
The country's top priorities now are stopping the circulation of endemic polio in southern Khyber Pakhtunkhwa, implementing intensive cleaning campaigns in any districts that detect wild poliovirus type 1, and preventing transmission in high-risk districts.
Great strides In Afghanistan, increased access to children has been a game changer.
The program now has an opportunity to focus its efforts on stopping transmission in the eastern region and preventing a spillover from Khyber Pakhtunkhwa in Pakistan into southeastern Afghanistan and from the eastern region into Pakistan.
Current program focuses are reaching missing children, strengthening cross-border coordination, and building partnerships with the Essential Immunization Program and organizations that provide humanitarian services.
In his capacity as Chairman of the Regional Certification Commission, Dr. Yaqob Al Mazrou noted that although the Eastern Mediterranean Region is the last WHO Region with endemic poliovirus and faces recurrent humanitarian crises and challenges, it has made great strides towards the eradication of poliomyelitis.
While he noted that 20 of the 22 countries in the Region have met the program's standards for polio eradication certification, he urged Member States to continue to intensify surveillance due to the increased risk of poliovirus spread.
Dr. Al Mazrou also explained recent innovations in the Regional Certification Commission, including the pioneering Annual Electronic Certification Report system.
The repository, part of the legacy of the eradication program, will house certification reports and information on countries' experiences in polio eradication, enabling fast and detailed data analysis and saving time by facilitating faster responses.
HE Dr. Hanan Mohamed Al Kuwari, Minister of Public Health of Qatar and co-chair of the Regional Subcommittee for Polio Eradication and Outbreaks, explained that the epidemiological situation in the Region has evolved in recent months.
The circulation of low-level wild polioviruses that survived in bags has caused spikes in cases, and poliovirus variants that spread across borders have persisted in some countries.
With several countries in the Region facing complex and multilevel emergencies (natural disasters and conflicts along with health crises), vaccines are increasingly out of reach for many children.
The implications of this were highlighted by Dr. Hussain Abdul Rahman Al-Rand, on behalf of HE Dr. Abdul Mohammed Al Oweis, Co-Chair of the Regional Subcommittee on Polio Eradication and Outbreaks.
Dr. Chris Elias, Chairman of the Polio Oversight Board and Chairman of Global Development at the Bill & Melinda Gates Foundation, underscored that one of the common threads of the ongoing poliovirus outbreaks in the Region is limited access to all the children.
He stressed that the national polio program was unable to reach all children with oral polio vaccine due to "a tragic combination of insecurity, violence, lack of political will, and community rejection."
He reiterated that the polio program does not face a technical challenge, since polio vaccines work, but the ability to administer vaccines to all children is urgently required.
Given the increasing movement of populations and polioviruses across borders, all partners reiterated their commitment to intensify efforts to end polio in the Region.
They agreed to expand strategies and tactics, including polio surveillance and access to children, to ensure that polioviruses do not have a chance to spread.
The efforts of Member States to end the circulation of polio have the unwavering support of the WHO Regional Director for the Eastern Mediterranean, Dr Ahmed Al-Mandhari.
The spread of the monkeypox outbreak has been sporadic in the Eastern Mediterranean Region, with 33 laboratory-confirmed cases in 6 countries and no associated deaths reported.
Most cases have no history of travel to areas where the outbreak circulates widely.
The average age among reported cases is 31 years old, but the age ranges from 8 to 59.
Among the reported cases was an 8-year-old boy in Lebanon.
“The monkeypox outbreak is not exclusive to one group of people, and anyone can get the disease by coming into direct skin-to-skin contact with someone who has symptoms or by touching infected objects,” said Dr. Ahmed Al-Mandhari.
, WHO Regional Director for the Eastern Mediterranean.
“All of us are at risk.
So even if we have only a few cases in our Region, let's take the risk seriously and take the necessary steps to stop transmission and protect people, especially vulnerable groups."
The response to the monkeypox outbreak involves a comprehensive approach that engages and protects affected communities, intensifies surveillance and public health measures, strengthens clinical management and infection prevention and control in hospitals and clinics, and accelerates research on the efficacy of vaccines, therapies and other instruments.
The WHO Regional Office for the Eastern Mediterranean is supporting Member States and partners in all these areas, with a special focus on vulnerable groups.
New information about modes of transmission, severity of illness, therapy, and vaccine efficacy is being revealed as more research is done.
Building on the lessons from COVID-19, the research is being integrated into overall monkeypox response efforts.
Although most people with monkeypox will recover without specific treatment within a few weeks, the disease has the potential to cause serious complications that, in some circumstances, can lead to death.
During the current global outbreak, there have been only 12 deaths out of more than 34,000 cases, with none occurring in our Region.
But in previous outbreaks, death rates have been much higher; therefore, we must take this new public health threat very seriously.
Monkeypox can also cause a variety of signs and symptoms, including rash, fever, swollen lymph nodes, fatigue, headache, and muscle aches.
Only a small percentage of patients will require hospital treatment, and those at higher risk of serious illness or complications, including pregnant people, children, and people who are immunocompromised.
It is still important to note that monkeypox is completely preventable and simple measures can reduce the risk of infection.
Currently, the best of these is to avoid close contact with someone who has monkeypox.
Vaccine supplies are limited in quantity.
When these vaccines become available, WHO recommends targeted vaccination for people exposed to someone with monkeypox and people at high risk of exposure, including health care workers, some laboratory workers, and those with multiple sexual partners.
Unlike COVID-19, mass vaccination against monkeypox is not recommended due to the different mechanisms by which the disease is transmitted and because more targeted vaccination approaches may be effective in protecting people most at risk .
However, data on the efficacy of these vaccines in preventing monkeypox in clinical practice and in field settings are still limited.
Many unknowns remain about its clinical effects and its most appropriate use in different contexts.
Furthermore, to minimize the unnecessary negative impact of the disease on trade, travel, tourism or animal welfare and to avoid offending cultural, social, national, regional, professional or ethnic groups, the WHO convened an ad hoc meeting with a group of scientists last week about considering changing the name of monkeypox.
After extensive review, the group agreed to hold an open public consultation for a new disease name for monkeypox.
For just over a month, from May 7 to June 16, 2022, Fatumo Yusuf Diriye spent 3 hours every day walking to and from the nearest water source, 6 km away, to fetch water for his family. . Since he could only carry 2 'jirigaans” or buckets of water at a time, and he had to wait for his turn in a long queue, his family had to use this water sparingly. They resorted to using ashes or sand to clean their hands.
Fatumo knows that having to deal with unsafe water has contributed to her 3 children under the age of 5 coming down with diarrhea many times before. On many occasions, she has had to take them to the nearest health center for support. This is a burden that families like Fatumo's, who depend on their daily earnings at a local market, can do without.
Government visit and WHO officials
One day in early May 2022, Fatumo heard that a team of high-level officials from the Government and the World Health Organization (WHO) were visiting the camp where she lived, in northern Galkayo, to assess the effects of the ongoing drought. Although she was unable to go see them, she later heard that some members of the community had asked the senior team leaders to help them repair 2 water pumps that had not worked for longer than she could remember. The Salama water pump, which is a well near Fatumo's house, was one of them, and the Halaboqad well was the second that had not worked for quite some time.
The high-level visiting team was led by HE Dr. Fawziya Abikar Nur, Federal Minister of Health and Human Services, and HE Abdi Nasir Yusuf Haji, Deputy Minister of Health of the state of Puntland. Representing WHO, Dr. Ahmed Al-Mandhari, WHO Regional Director for the WHO Eastern Mediterranean, and Dr. Mamunur Rahman Malik, WHO Representative in Somalia, were also part of the team.
Quickly fulfilling a promise
Fatumo, who has been living in a camp for internally displaced persons since 2017, had heard that the WHO team had agreed to provide support, but was not sure how this would turn out. To his delight and surprise, a few days later an expert arrived to assess the Salama well. About a month later, the Salama well was working again.
“Our lives have changed because we now have water from the Salama well, for drinking and also for all our domestic uses,” says Fatumo, as it now takes only 30 minutes to fetch water. The Diriye family can now collect at least 4 buckets of water, as its source, the well, is just over half a kilometer away. Hers is just one of the families living in one of the 6 camps and 2,000 households that now have access to clean water from the Salama well.
With WHO interventions to rehabilitate the Salama and Halaboqad boreholes, 19,716 people now have access to clean water. This will translate into clean drinking water, fewer waterborne diseases such as cholera and diarrhoea, healthier populations and better sanitation conditions. By protecting their families from preventable diseases, Fatumo and many parents like her are able to spend their time and resources raising their families instead of dealing with the stress of fighting disease.
Access to water is a recognized human right
Currently, only 52% of the population in Somalia has access to improved drinking water (the population using safely managed drinking water services). In internally displaced persons (IDP) camps like Salama, this number is staggeringly low. Recurring droughts, like the current one, make water an even scarcer resource.
Worldwide, WHO and the United Nations Children's Fund (UNICEF) found that in 2019, 2.2 billion people lacked access to safely managed drinking water services. In July 2010, the United Nations General Assembly recognized access to water and sanitation as a human right. The Health Assembly recognized that every human being needs access to “between 50 and 100 liters of safe, acceptable and affordable water per day for personal and domestic use”. The General Assembly also stated that a family's main source of water should be within a 1km radius of their home and that it should take no more than 30 minutes for a family to access water.
To complement this, the UN Sustainable Development Goal (SDG) 6 aims to ensure the availability and sustainable management of water and sanitation for all. This will reduce the burden of waterborne diseases and promote progress towards universal health coverage.
During his 3-day visit to Somalia, the World Health Organization (WHO) Regional Director for the Eastern Mediterranean, Dr. Ahmed Al-Mandhari, visited North Galkacyo in the Puntland state of Somalia to monitor WHO's ongoing drought response activities, see the work of community health workers in providing integrated health and nutrition services to people displaced by the recent drought in Somalia and also visit one of the population camps internally displaced people to see the challenges communities face in meeting their health, nutrition, food, and water and sanitation needs.
Later, he attended an event in Mogadishu where the WHO emergency health response plan for the drought was officially launched, which was also attended by HE Dr. Fawziya Abikar Nur, the Minister of Health and Human Services of the Federal Government of Somalia. , Mr. Jocelyn Mason, the United Nations Resident Coordinator for Somalia, interim, and Mr. Mugatte Guisse, the United Nations Humanitarian Coordinator for Somalia, interim.
The ongoing drought in Somalia and throughout the Horn of Africa is known to be the worst in the region in the last 4 decades. In Somalia alone, an estimated 6.1 million people have been affected by drought, of whom 759,400 have been displaced in search of water, food and grazing; 3.5 million lack sufficient access to water; 6 million continue to face severe food shortages, with approximately 1.4 million children facing acute malnutrition by 2022, including 329,500 likely to be severely malnourished; So far, a total of 3,675 suspected cholera cases and 2,720 measles cases have been confirmed since January 2022 in the drought-affected areas.
“Whenever natural disasters strike, disease inevitably follows, especially in fragile contexts. At all levels, WHO is leaving no stone unturned to help the people of Somalia cope with the stark effects of the drought,” said Dr. Al-Mandhari.
“As one of the first responders on the ground, WHO is working with the government, donors and other UN agencies and health cluster partners to reduce the spread of disease and complications related to malnutrition, while rebuilding health systems to deal with similar calamities. in the future."The WHO emergency health response plan for the drought in Somalia for 2022 urgently requires US$35 million over the next 10 months to carry out life-saving emergency operations and reach more than 2.5 million vulnerable people in the most affected areas of the country.
Dr. Al-Mandhari explained that the drought response plan, which will serve as a WHO model for intensifying efforts to save more lives and protect Somalis from severe forms of disease and malnutrition, was based on lessons learned from past droughts in Somalia and help prevent epidemics, save lives, protect the health and nutrition needs of communities, and avert a further health crisis.
He also commended the Federal Government and UN partners for their collaborative efforts, emphasizing that the true essence of the Eastern Mediterranean Region Vision 2023 of “health for all by all” was solidarity with drought response work. in progress. “WHO is responding to the most dire needs of Somali families and is working to ensure that all Somali households, including the most vulnerable, can access lifesaving emergency support, especially during emergencies. The WHO Emergency Health Response Plan for the drought in Somalia calls for early action without regret. It is imperative that WHO has access to flexible, smart and unallocated funds to expand our lifesaving operations in hard-to-reach areas to protect the health and well-being of people affected by drought,” said Dr. Mamunur Malik, WHO Representative in Somalia.
I am confident that this joint agreement can serve as a roadmap to strengthen support to countries and enhance national efforts to address key public health challenges.
CAIRO, Egypt, January 18, 2022/APO Group/ --The WHO Regional Director for the Eastern Mediterranean, Dr. Ahmed Al-Mandhari, and the Regional Director of the International Federation of Red Cross and Red Crescent Societies (IFRC), Dr. Hossam Elsharkawi, today signed a memorandum of understanding to enhance collaboration to support countries in the Middle East and North Africa respond effectively to major public health challenges.
The objectives of the agreement between the WHO and the IFRC are to strengthen the support provided to countries to improve the health and well-being of populations living in emergencies, and to protect and improve the health of vulnerable groups by guaranteeing access to essential health services, in addition to strengthening the capacity of countries to provide access to sustainable, affordable and quality health services throughout life. The agreement also aims to strengthen leadership, governance and health promotion.
During the virtual ceremony, Dr. Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean, expressed his appreciation for WHO's valuable partnership with the IFRC. “With a long history of collaboration with the International Federation and of working together to serve humanity, I am confident that this joint agreement can serve as a roadmap to strengthen support to countries and enhance national efforts to address key challenges. public health during the COVID-19 pandemic. pandemic and beyond to meet the urgent health needs of all people in the region. It is a true interpretation of our vision; health for all and for all: a call to action and solidarity”.
In his opening remarks, Dr. Hossam Elsharkawi, IFRC Regional Director for the Middle East and North Africa, said: “Addressing current and future humanitarian challenges requires the strong commitment of all partners and courageous leadership that focus on locally led actions and interdependence. We are honored to work with WHO and leverage our network of volunteers to advance universal health coverage, strengthen emergency response and preserve the dignity of all people."
Dr. Rana Hajjeh, Director of Program Management at the WHO Regional Office, noted that the MoU focused on health challenges related to emergencies such as outbreaks, epidemics, and the COVID-19 pandemic. “The pandemic has been a game changer for all countries and has demonstrated the importance of effective emergency preparedness and response, and has highlighted how we as international organizations can provide targeted support to countries to help them develop capacities and strengthen community resilience. ”
Rania Ahmed, IFRC Deputy Regional Director, said: “Today, the WHO/IFRC agreement reaffirms our continued commitment to work together to create change that has a positive impact on people's lives. Our partnership emphasizes the need to develop policies that are responsive to community needs and promote effective community engagement and support to shape evidence-based responses that enable results at scale.”
The collaborative partnership between the WHO and the IFRC aims to further build on countries' progress in achieving universal health coverage and improving national health systems. It focuses on strengthening regional capacity to effectively prepare for and respond to emergencies. One of the main priorities of the WHO Eastern Mediterranean Region is to ensure the availability of mental health and other essential health services for all people, including displaced people and refugees.
The memorandum of understanding is effective immediately and will be implemented with the direct participation of all national stakeholders and WHO country offices in the region.
Since many more vaccines have now been delivered, we must ensure that this vaccine reaches the arms of those who need it.
CAIRO, Egypt, December 20, 2021 / APO Group / -As 2021 draws to a close, the gap in COVID-19 vaccination coverage between countries in the Eastern Mediterranean Region widens alarmingly
As of December 14, 2021, more than 500 million doses of the COVID-19 vaccine had been administered in the Region, an average of 65 doses per 100 inhabitants. However, upper- and upper-middle-income countries have administered approximately twice as many doses (92-152 doses / 100 population) as low- and lower-middle-income countries (39-79 doses / 100 population).
Nine countries have already reached the year-end goal and fully vaccinated at least 40% of their population. However, 6 countries remain below 10% coverage. Vaccine inequity threatens many vulnerable and high-risk populations in the Region.
After initial supply limitations earlier in the year, more doses of COVID-19 vaccines are now available. “Since many more vaccines have now been delivered, we must ensure that this vaccine reaches the arms of those who need it. This will protect them from serious illness and death and protect the health system, ”said Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean.
"As we now have much more experience with these vaccines, more and more people are willing to be vaccinated, we just have to simplify and facilitate their reception," added Dr. Al-Mandhari.
The WHO Regional Office for the Eastern Mediterranean continues to support countries to access more doses of vaccines and address administration issues. As of December 14, WHO and its partners helped distribute 140 million doses of vaccines in 21 countries in the Region through the COVAX mechanism.
COVID-19 vaccines prevent serious illness, hospitalization, and death, even for recently detected variants. The appearance of omicron is another reason to increase coverage, along with all other prevention measures.
