WHO is launching today a new strategy to respond to the urgent problem of antimalarial drug resistance in Africa.
The strategy is being released during World Antimicrobial Awareness Week, a global annual campaign to improve awareness of the growing threat of resistance to antibiotics and other medicines.
In recent years, there have been reports from Africa of emerging parasite resistance to artemisinin – the core compound of the best available medicines to treat malaria.
There are also worrying signs that parasites in some areas may be resistant to drugs that are commonly combined with artemisinin.
Vigorous measures are needed to protect their efficacy.
“Although antimalarial drug resistance is a serious cause for concern, artemisinin-based combination therapies (ACTs) remain the best available treatment for uncomplicated P.
falciparum malaria,” notes Dr Pascal Ringwald, lead author of the new strategy and a Coordinator in the WHO Global Malaria Programme.
“Health care providers should continue to prescribe and use ACTs to treat confirmed malaria.”ACTs at a glanceWHO currently recommends 6 different artemisinin-based combination therapies (ACTs) as first- and second-line treatment for uncomplicated P.
Isolated from the plant Artemisia annua, artemisinin and its derivatives are powerful medicines known for their ability to rapidly reduce the number of Plasmodium parasites in the blood of patients with malaria.
ACTs combine an artemisinin derivative (artesunate, artemether or dihydroartemisinin) with a partner drug.
The role of the artemisinin compound is to reduce the number of parasites during the first three days of treatment, while the role of the partner drug is to eliminate the remaining parasites and cure the infection.
Rising resistance to antimalarial drug regimensOn a global scale, parasite resistance to artemisinin has been identified in the Greater Mekong sub region and several areas in Africa – notably Uganda, Rwanda and Eritrea.
While artemisinin resistance alone rarely leads to treatment failure, resistance to both artemisinin and the partner drug within ACT drug regimens can lead to high rates of treatment failure – as seen in recent years in parts of the Greater Mekong subregion.
To date, resistance to ACT partner drugs has not been confirmed in Africa, and the treatment remains highly efficacious.
However, there are some worrying signals: data are lacking for several countries, and contradictory findings on ACT efficacy need to be further assessed.
Potential impactGiven the heavy reliance on ACTs in Africa, full-blown treatment failure could have very serious consequences.
“We don’t have that many options for malaria drugs,” notes Dr Dorothy Achu, WHO’s new Team Lead for Tropical and Vector Borne Diseases for the WHO African Region.
As it stands, we just have artemisinin-based combination therapies for uncomplicated malaria.
So any threat to these drugs could lead to lots of cases and deaths, which we obviously want to avoid,” she added.
In 2016, researchers at Imperial College London modelled the potential impact of widespread resistance to both artemisinin and a partner drug in Africa.
Under this scenario, there would be an estimated 16 million more malaria cases each year, and about 360 000 more severe cases requiring hospitalization – leading, in turn, to nearly 80 000 additional malaria deaths annually.
Under this same scenario, the yearly economic impact across the African continent was estimated at US$ 1 billion.
New strategyThe new WHO strategy builds on lessons learned from past global plans and complements existing strategies, including broader efforts to respond to antimicrobial resistance.
It aims to minimize the threat and impact of antimalarial drug resistance in Africa through 4 pillars:Strengthen surveillance of antimalarial drug efficacy and resistance.
Optimize and better regulate the use of diagnostics and therapeutics to limit drug pressure through pre-emptive measures.
React to resistance by limiting the spread of antimalarial drug-resistant parasites Stimulate research and innovation to better leverage existing tools and to develop new tools against antimalarial drug resistance.
The strategy’s 20 recommended interventions include, for example, generating standardized data on drug efficacy, promoting equitable access to quality diagnostics and drugs, ensuring optimal vector control coverage in priority areas, and developing innovative tools to limit malaria infection and transmission.
Interventions should be tailored to the local context, with the support of global and regional stakeholders.
All of these interventions require strong health systems and investments in primary health care, which are the backbone of any successful response to malaria.
Africa hardest hit by malariaSub-Saharan Africa bears nearly the entire global burden of malaria, accounting for an estimated 96% of malaria cases and deaths in 2020; approximately 4 in 5 of these deaths were among children under the age of five.
Despite the considerable efforts to tackle malaria in Africa over the last 2 decades, progress has plateaued in recent years and, in many countries with a high burden of the disease, cases are on the rise.
Emerging threats, such as antimalarial drug resistance, could derail progress even further.
The Board of Directors of the African Development Fund, the concessional lending arm of the African Development Bank Group (www.AfDB.org), on 2 November 2022 in Abidjan, approved a $6.63 million grant to the Common Market for Eastern and Southern Africa (COMESA) to develop the pharmaceutical sector in the sub-region.
The project, which will be implemented over three years (2023-2025), is institutional support to develop the region’s pharmaceutical industry.
In particular, it will build the capacity of pharmaceutical regulatory bodies, product quality control and management systems, and research and development institutions.
The aim is to achieve the manufacture and marketing of safe, quality pharmaceutical products, for Covid-19 and other diseases.
The project will support the sub-regional body in implementing continental strategies on pharmaceutical manufacturing and assist it in streamlining and harmonizing drug registration processes, as well as ensuring access to essential medical products and technologies.
An information platform for pharmaceutical manufacturers, importers and exporters will also be created.
The project will directly benefit public institutions responsible for the pharmaceutical industry’s development, such as national drug regulatory authorities, quality control laboratories, regional pharmacy training providers, universities, and research centres.
“The aim is to empower them to support the pharmaceutical sector so that they can produce safe essential medicines locally for the needs of the population, especially women and children,” said Leila Mokaddem, the African Development Bank’s Director General for Southern Africa.
“Most countries within the region have a weak and underdeveloped pharmaceutical industry.
The region is heavily dependent on imports for most of its medical supplies.
Furthermore, due to the low local pharmaceutical production, there is a high prevalence of counterfeit pharmaceutical products in circulation, which has serious consequences for the welfare of the region’s people,” she added.
While the project is intended to directly benefit the ADF eligible countries of COMESA, other Bank Group member countries will be allowed to participate in project activities and events, but at a cost.
The Common Market for Eastern and Southern Africa is a regional economic community comprising 21 countries: Burundi, Comoros, Democratic Republic of the Congo, Djibouti, Egypt, Eritrea, Eswatini, Ethiopia, Kenya, Libya, Madagascar, Malawi, Mauritius, Rwanda, Seychelles, Somalia, Sudan, Tunisia, Uganda, Zambia and Zimbabwe.
The Swiss branch of the National Union of Eritrean Women conducted an activity assessment meeting on 5 November.
Speaking at the event, Ms. Tirhas Tewolde, chairwoman of the union branch, indicated that in the past two years the union branch despite the challenges it has been facing due to restrictions to curb the spread of the COVID-19 pandemic has been able to implement major programs.
Ms. Tirhas said that one of the major programs the union branch implemented included the inauguration of the training center in the Teseney sub-zone that was constructed at a cost of 33 million Nakfa.
At the meeting in which 44 members from 19 branches took part extensive discussion was conducted on the reports presented.
The participants also expressed readiness to strengthen participation in the national development drives and cooperation with other national associations.
Mr. Amanuel Zekarias, representative of the Eritrean Embassy and Permanent Representative of Eritrea at United Nations Institutions indicating the active participation of Eritrean women in national affairs called for strengthening organizational capacity and encouraging young women to join the union branch.
The meeting also charted out development programs for 2023.
Ethiopia’s Prime Minister Abiy Ahmed vowed on Tuesday to fulfil commitments made in a landmark peace deal with Tigrayan rebels and make “our promise a reality”, nearly two weeks after the agreement was signed.
The deal inked in South Africa on November 2 called for the disarming of the Tigray People’s Liberation Front (TPLF) and the restoration of aid to Tigray, which has been in the grip of a severe humanitarian crisis since the war broke out two years ago.
On Saturday, the warring sides agreed to facilitate immediate humanitarian access to “all in need” in Tigray and neighbouring regions in northern Ethiopia, following talks in Kenya’s capital Nairobi to discuss the implementation of the peace deal.
Responding to questions from lawmakers in Ethiopia’s capital Addis Ababa, Abiy said: “We have discussed and signed (the agreement), what is expected from us next is executing the promise we made dutifully.
” “Because of lack of trust and inability to execute what was promised, negotiations flounder,” he warned.
A Twitter post by his office later quoted him saying: “We must keep our word by making our promise a reality.
We must work hard to avoid problems during the process.
” Observers have pointed to many challenges ahead, including the resumption of aid and the thorny question of Western Tigray, a contested region which has been occupied by pro-Abiy Amhara militias since the war erupted.
The peace deal does not mention the region, raising fears of further conflict down the road.
But Abiy said the issue could be resolved through constitutional means, including a possible referendum.
“We did not go to Pretoria to debate whether Wolkait (in Western Tigray) belongs to Amhara or Tigray as it is neither the place nor the time,” he told lawmakers.
The region is claimed by Tigrayans and Amharas.
International pressure for a ceasefire had been mounting since intense fighting reignited in northern Ethiopia in late August after a five-month truce, with pro-government forces capturing a number of key towns in Tigray.
The conflict between the TPLF and pro-Abiy forces — which include regional militias and the Eritrean army — has caused an untold number of deaths, forced more than two million people from their homes and driven hundreds of thousands to the brink of famine.
Tigray has been suffering from a severe lack of food and medicine, as well as limited access to basic services including electricity, banking and communications.
The war in Africa’s second most populous country began in November 2020 when Abiy sent troops into Tigray, accusing the TPLF of attacking federal army camps.
The TPLF had dominated national politics for nearly three decades until Abiy took office in 2018.
World Diabetes Day, 14 November, was observed yesterday, 13 November, in Asmara at regional level under the theme “Expand Access to Diabetes Care”.
Indicating that the number of Diabetes patients that was about 4 thousand 600 in 2018 has currently increased to 6 thousand 800 and the death rate due to the diseases is increasing from time to time, Dr. Mulugeta Haile, head of the Ministry of Health branch in the Central Region, said that strong effort will be exerted to raise the awareness of the public on the causes and consequence of the disease.
Commending the effort on the part of the Ministry of Health to raise the awareness of the public and supply of medicines, Col. Gebrehans Woldegergis, Director General of Social Service in the region, expressed readiness of the regional administration to stand alongside the Ministry in all its endeavors.
Dr. Goitom Mebrahtu, chairman of the National Diabetes Association of Eritrea, on his part said that the objective of observance of World Diabetics Day is to develop the understanding of the public and called on patients to practice regular diet and physical exercise for they are decisive weapons to combat diabetes.
UN Secretary General Antonio Guterres has commended Nigeria’s former President, Chief Olusegun Obasanjo, the African Union Mediator, for facilitating the signing of a peace deal between the Ethiopian Government and the Tigray People’s Liberation Front (TPLF).
With the signing of the agreement, the parties in the conflict in Ethiopia’s northern region of Tigray have agreed on a “permanent cessation of hostilities’’ just more than a week after formal peace talks began in South Africa.
Guterres, in a statement by his spokesperson, Stephane Dujarric, said the agreement signed on Wednesday in South Africa represented “a critical first step” towards ending the brutal two-year war.
The UN chief said the “Agreement for Lasting Peace“ through a Permanent Cessation of Hostilities brokered by the African Union and mediated by Obasanjo was a promising start.
He said it was a promising start to finally stopping the fighting which erupted in November 2020 after months of tension which had destroyed so many lives and livelihoods.
“The secretary general urges all Ethiopians and the international community to support the bold step taken today by the Federal Government of Ethiopia and the Tigrayan leadership,’’ he said.
The secretary-general pledged his support to the parties in the implementation of the agreement.
The UN chief urged both sides to continue with negotiations on the outstanding issues in a spirit of reconciliation in order to reach a lasting political settlement.
He appealed to all stakeholders to seize the opportunity provided by the ceasefire, “to scale up humanitarian assistance to all civilians in need and to restore the desperately needed public services.
” Guterres commended the AU and its High-Level Panel for the facilitation of the peace talks and South Africa, for its key role hosting the peace talks.
“The UN stands ready to assist the next steps of the African Union-led process and will continue to mobilise much-needed assistance to alleviate suffering in the affected areas,” he said.
Obasanjo, in the first briefing on the peace talks, said that Ethiopia’s government and Tigrayan authorities had agreed on an “orderly, smooth and coordinated disarmament”.
He said both sides also agreed on the “restoration of law and order, restoration of services and unhindered access to humanitarian supplies“.
At a news conference in South Africa, Obasanjo said that the agreement marked a new “dawn” for Ethiopia.
The war, which broke out in November 2020, has pitted regional forces from Tigray against Ethiopia’s federal army and its allies, which include forces from other regions and from neighbouring Eritrea.
The Eritrean Agribusiness Women's Association, in cooperation with the National Confederation of Eritrean Workers, organized a training from 20 September to 31 October for more than 40 women focused on business management and starting up farming.
According to Ms. Senait Tesfaldet, president of the association, the objective of the training was to enable women who want to go into business to have basic knowledge and those who are already in business to further develop their capacity.
Mrs. Senait also called on the apprentices to apply the training they received in the development of their activities and expressed the association's willingness to accompany them in all their efforts.
Speaking on the occasion, Mr. Arefaine Berhe, Minister of Agriculture, said that the Ministry of Agriculture, in cooperation with its partners, will continue to encourage the participation of women in agricultural activities and expressed the readiness of the Ministry to support them in all its agricultural activities.
The Eritrea Agribusiness Women's Association was established in 2003 and is made up of women who are engaged in agribusiness.
Eritrean citizen in Libya expressed determination to strengthen organizational capacity and play due role in national development agendas.
The citizens made the comment in a meeting with Mr. Isa Ahmed Isa, Eritrea's non-resident ambassador to Libya on Oct. 30.
Noting that they fully understand that Eritrea, due to its consistent people and leadership, is transforming into a bright future, the nationals expressed their conviction to do their part to thwart external conspiracies aimed at derailing Eritrea's socio-economic progress.
Ambassador Isa, for his part, provided extensive information on Eritrea's active diplomatic engagement to ensure economic partnership and sustainable social justice in the region, as well as the substantial investment being made in development programs in general and in human resource development in particular.
Calling on the nationals to take advantage of the educational and work opportunities they are receiving, Ambassador Isa expressed his willingness to accompany the activities of his community.
The national also congratulated Mr. Isa for his appointment as Ambassador of non-residents in Libya and asked for the sustainability of the meeting.
Ambassador Isa Ahmed Isa, Ambassador of Eritrea to the Republic of Sudan, presented credentials to Mr. Mohamed Yonus al-Menfi, President of the Libyan Presidential Council, on October 29 as the non-resident Ambassador of Eritrea to that country.
At the event held at the National Palace in Tripoli, Ambassador Isa conveyed a message of goodwill from President Isaias Afwerki to President Mohamed Yonus al-Menfi, expressing his willingness to work in cooperation with interested Libyan institutions to strengthen bilateral relations and cooperation between Eritrea and Libya.
President Mohamed Yonus al-Menfi for his part expressed his country's willingness to work on strengthening relations with Eritrea and especially in the diplomatic and economic sectors as well as on regional issues of interest to the two countries.
President Mohamed Yonus al-Menfi also wished President Isaias Afwerki good health and peace and prosperity to the people of Eritrea, as well as good working time for Ambassador Isa.
The Eritrean community in Qatar held its eighth congress on October 28 under the theme "Community for All".
In the congress in which several nationals participated, Mr. Ali Ibrahim, Ambassador of Eritrea in Qatar, explained the importance of community organization to strengthen unity and the bond with the homeland, as well as to preserve the noble social values and the national identity, congratulated those who contributed to the organization of the congress.
Ambassador Ali Ibrahim also expressed his willingness to accompany the community in all his efforts.
The participants, for their part, held an extensive discussion on the report presented by the outgoing executive committee and elected 11 members of the new executive committee.