Geneva – Dr. Tedros Adhanom Ghebreyesus of Ethiopia is receiving praises from around the world following his election as the new Director General of the World Health Organization (WHO).

Dr. Tedros who endured a rugged Africa’s choice to lead the UN, World Health Organization defeated Britain’s David Nabarro at the World Health Assembly in Geneva Tuesday.

The final vote was 133 for Ethiopia’s former health minister to 50 for Nabarro, with each member state having one vote.

Dr. Lawrence O. Gostin, University Professor, Georgetown University, Washington, DC, in a statement to FrontPageAfrica  heaped praise on Dr. Tedros Adhanom Ghebreyesus on his election as WHO Director-General.

Dr. Gostin said as the first African head of WHO and as a leader in building robust health systems, Dr. Tedros has a historic opportunity to transform WHO.

“The success of the Organization is too important to the world’s health for anything but a successful transformation, so I call on all advocates for the​ right to health to support him. And I call on the new DG to embrace a progressive, rights-based leadership of WHO.​”

Added Dr. Gostin: “Dr. Tedros will lead WHO at the most pivotal moment in its history, with its legitimacy​ badly eroded due to the weak response to the Ebola epidemic. ​

WHO’s success is vital to health around the world, and Dr. Tedros will have to restore its reputation as a competent, professional, and accountable organization. His very first step in office should be a full-throated endorsement of human rights and the right to health.”

Dr. Gostin averred that  given Ethiopia’s record of human rights abuses, it is vital for Dr. Tedros to speak truth to power and condemn all violations of human rights.

“At the same time, he must embrace WHO’s founding mission of standing up for the right to health. Gaining the respect of civil society is equally important to ensure bottom-up advocacy for WHO’s strategy, programs, and funding.

He should immediately convene civil society leaders — from global leaders to grassroots leaders from marginalized communities — to ensure full participation in WHO governance decisions.” 

Dr. Tedros was involved in a late battle to win the WHO leadership amid criticism from his rival from Dr. Nabarro, who took aim at Dr. Tedros, accusing him of Covering up three cholera epidemics in Ethiopia, when he was health minister.

Dr. Tedros strongly denied the allegations and insisting that he was not surprised at all but quite disappointed that Dr. Nabarro’s camp – which he said included high-ranking British Health officials – had switched to running ‘a last-minute smear campaign to shatter his bid.

Several prominent figures came to Dr. Tedros’s aide including Dr. Thomas R. Frieden, a physician specializing in infectious diseases and public health, and former director of the Centers for Disease Control and Prevention, who in a letter to the New York Times dismissed suggestions that Dr. Tedros was responsible for the mishap in Ethiopia.

Dr. Frieden added that multiple independent evaluations have confirmed that under Dr. Tedros’s leadership, Ethiopia is one of the few countries in Africa to have rapidly reduced infant mortality and achieved the Millennium Development Goal in this area.

“Cholera can be a devastating disease, but rapid action saves lives and stops outbreaks.

Dr. Tedros created a network of nearly 40,000 female community health workers who were trained, supported and supervised to implement programs, including oral rehydration therapy, that prevents death from diarrhea and other causes.”

Dr. Tedros received an overwhelming backing from the African continent although Liberia in the early stages of the process was leaning toward support for France, whose candidate, Douste-Blazy had selected Health Minister Dr. Bernice Dahn, as his running mate.

In an interview on France 24 TV Channel, conducted with Minister Dahn and Douste-Blazy, the Liberian Health Minister promised to support Douste-Blazy and also persuade other African countries to do so.

The French channel stated that both Dr. Dahn and Douste-Blazy were contesting as a set and on the same ticket, but Blazy did not make the cut.

Geneva – Dr Tedros Adhanom Ghebreyesus is having a week from hell. The Ethiopian who is one of three vying for the coveted Director General of the World Health Organization(WHO) at next week’s General Assembly in Geneva, finds himself at the tail end of a barrage of allegations in what aides say are negative attacks aimed at fracturing his chances to head to world body.

Sania Nishtar [Pakistan], and David Nabarro of the United Kingdom were selected by the WHO Executive Board in January and given a shot in elections next week.

A report in the New York Times this week, citing allegations from Nabarro, one of Dr. Tedros’ challengers took aim at the Ethiopian, accusing him of Covering up three cholera epidemics in Ethiopia, when he was health minister, posing serious detriments to his chances of heading the WHO.

Tedros has denied the allegations and according to the Times insists that he was not surprised at all but quite disappointed that Dr. Nabarro’s camp – which he said included high-ranking British Health officials – had switched to running ‘last-minute smear campaign to shatter his bid.

In the last 48 hours however, several prominent international figures have come to Dr. Tedros’s aid.

Dr. Thomas R. Frieden, a physician specializing in infectious diseases and public health, and former director of the Centers for Disease Control and Prevention, in a letter to the New York Times dismissed suggestions that Dr. Tedros was responsible for the mishap in Ethiopia.

Said Dr. Frieden: “Although not optimal, many countries report cholera to the World Health Organization as acute watery diarrhea, as Ethiopia has.

This allows reporting and response without laboratory confirmation, but in no-way indicates that Tedros Adhanom Ghebreyesus, a former health minister of Ethiopia, is any less qualified to become director general of the W.H.O.”

Dr. Frieden added that multiple independent evaluations have confirmed that under Dr. Tedros’s leadership, Ethiopia is one of the few countries in Africa to have rapidly reduced infant mortality and achieved the Millennium Development Goal in this area.

“Cholera can be a devastating disease, but rapid action saves lives and stops outbreaks. Dr. Tedros created a network of nearly 40,000 female community health workers who were trained, supported and supervised to implement programs, including oral rehydration therapy, that prevent death from diarrhea and other causes.”

Dr. Frieden said that as director of the Centers for Disease Control and Prevention, he personally traveled to Ethiopia several times and saw impressive progress strengthening community health, improving hospital care and establishing disease-tracking systems.

“The world would be safer and healthier if WHO facilitates this type of progress in more countries.”

Dr. Peter Byass, a professor in the Department of Public Health and Clinical Medicine at the University of Sweden, writing in the Lancet.com this week said while all three candidates are well qualified and experienced in their own ways and all fulfil WHO’s established criteria, Dr. Tedros is the best candidate.

Dr. Byass says he first met Tedros more than 20 years ago when he led the vector-borne diseases programme in northern Ethiopia. At that time, he recalls, villages were being encouraged to construct rainfed reservoirs to safeguard their water supplies.

“That was important, against the background of earlier devastating droughts and famines—but Tedros was concerned with what the health implications of large water bodies close to habitation might be.

With support from the Swedish International Development Agency (Sida) and WHO, Tedros undertook a large-scale study of the effects of the dams—with the result that malaria was found to be seven times more frequent among children living close to the new dams.”

Dr. Byass explains that Tedros was instrumental in mobilising and inspiring communities toward better health.

Dr. Byass says Dr. Tedros’s determination to get effective support and solutions for Ethiopia’s major health problems has been recognised internationally, leading to him serving terms as Chair of Roll Back Malaria and the Global Fund. “Bill Clinton described him as “one of the ablest public servants I ever worked with”.

Dr. Tedros, according to Dr. Byass has the experience of raising and managing budgets in the billions for international organisations like the Global Fund, as well as for implementing health reforms in Ethiopia.

“The current health budget in Ethiopia is only marginally below WHO’s current global budget, even though one might argue that both are far too small. Tedros has turned around monolithic organisations with integrity and charm.”

Dr. Tedros has the overwhelming backing of the continent despite an initial objection from Liberia, as members states look to cast their votes at next week’s World Health Assembly from May 21-31.

The Ethiopian has targeted among his priorities if elected, universal health coverage; health emergency preparedness; women, children and adolescents; health impacts of climate and environmental change; and creating a transformed WHO that is effectively managed, adequately resourced, results-focused and responsive.

FrontPageAfrica reported last year, that Liberia’s Health Minister Dr. Bernice Dahn, was contesting along with France’s Douste-Blazy against the decision of the AU.

In an interview on France 24 TV Channel, conducted with Minister Dahn and Douste-Blazy, the Liberian Health Minister promised to support Douste-Blazy and also persuade other African countries to do so.

The French channel stated that both Dr. Dahn and Douste-Blazy were contesting as a set and on the same ticket. But Blazy did not make the cut.

Monrovia – Depression is said to be on the increase in Liberia and the World Health Organization (WHO) has said it is due to the lack of post-war counseling and the effects of the Ebola Virus Disease.

Report by J.H. Webster Clayeh – websterclayeh@frontpageafricaonline.com

Liberia’s chief medical officer, Dr. Francis Katteh, said calculations shows that there are over one million depressive people living in Liberia.

Liberia has an estimated population of four million.

According to the WHO, there are about 322 million people around the world who are affected by depression, which is also said to be the leading cause of disability worldwide.

According to Dr. Katteh, the Ebola Virus Disease has reawakened the traumatic problem caused by the 14 years civil unrest.

The Chief Medical Officer advised that the early a depressed person is taken to a health center the better it would be for the recovery of such person.

He added that Ministry of Health and Carter Center have trained health workers to deal with such problem.

Also speaking, the Country Representative of WHO Dr. Alex Gessasira called on countries to support mental health programs by allocating adequate human and financial resources to respond to the growing burden that world faces.

“I appeal to member states to include mental health in their national health agenda. WHO is committed to support countries to address depression as an important public health problem,” Dr. Gessasira said.

According to the WHO Country Representative, developing community-based services that would focus on depression and talk out against stigma will encourage more people to seek treatment.

“This can be done by having conversations about depression, the same way we do with any other diseases”.

He added: “Individuals, families, caregivers and communities can take steps to help prevent depression by avoiding stressful situations, alcohol abuse, and drugs. Medications on the other hand are recommended if they are natural and have well documentation behind their use. CBD oil from cannabis is recommended in this regard for its powerful anxiolytics and anti-depressive effects, writes researcher Nina Julia.
use. Depression is preventable and treatable if diagnosed early.”

Depression can lead you to suicide, which is the second leading cause of death in 15 to 29 year olds globally. Depression varies by age, in adults aged 55 to 74 years, but also occurring in children and adolescents.

Left untreated, depression can be recurrent, long-lasting and debilitating.

It impairs an individual’s ability to cope with daily activities and can have devastating consequences for relationships with families and friends.

Geneva, Switzerland – Vice President Joseph Boakai has been meeting with the head of the World Health Organization in Geneva, Dr. Margaret Chan and the two discuss a wide range of issues affecting the health sectors of developing nations.

Vice President Boakai paying a courtesy calls on Dr. Chan and her Staff.

In her welcome remarks Dr. Chan said ‘I am very proud of Liberia and recounted that Ebola is a natural occurrence and ecological evolution that no nation has control over.

She said countries such as Brazil, Angola and China have had their share of the epidemics and those countries that experience these outbreaks should not feel ashamed because these are natural happenings that no one can cause or stop.

Dr. Chan praised the Government and people of Liberia for their response to the Ebola crisis.

She noted that we live in a complex world full of uncertainties and those emergencies as Ebola requires team work, the political will and community action which the people of Liberia clearly demonstrated during the epidemic. She warned that such outbreaks know no borders and that no one country can stop an epidemic.

For his part, Vice President Boakai said, no one is safe in a world of uncertainties and that global action was required to handle emergencies such as the ebola epidemic that surfaced in theMano River basin.

He praised the WHO for the role that it played during the ebola crisis.

Dr. Chan spoke of the need for reforms in the health sectors of developing countries because according to her the population is changing so are the diseases adapting, changing and resisting new treatments, adding health care reform is an on- going journey.

She warned that if resources for the nation are placed in the hands of the wrong people it can be a problem for the rest of the population especially for the health sector.

The World Health Organization Boss pointed out that at least forty five percent of the national budget should be allocated to health and further warned that if the children today and not healthy, the economy tomorrow will also be sick, a dispatch from Geneva said.

Monrovia  –  The Ministry of Foreign Affairs wishes to clarify a front-page story published in the FrontPageAfrica newspaper, Vol. 10 No. 173 of Thursday, September 15, 2016, under the caption: “Africa Betrayal?”; and to, on the contrary, affirm the Government of Liberia’s commitment to the African Union’s Decision to support the candidature of the Federal Democratic Republic of Ethiopia in election for the position of Director-General of the World Health Organization (WHO) in 2017.

In its story, FrontPageAfrica indicated among other issues that while the African Union has endorsed Ethiopia’s candidature for the position of Director-General of the World Health Organization, at the African Union Heads of State and Government gathering in January 2016, Liberia is contesting along with France’s candidate against the decision of the African Union.

On the contrary, the Government of the Republic of Liberia wishes to confirm its support for the candidature of the Federal Democratic Republic of Ethiopia, for the position of Director General of the World Health Organization, in conformity with a decision reached at the 26th Summit of Heads of State and Government of the African Union in Addis Ababa, in January 2016. 

The Government of Liberia however avers that prior to the submission of Ethiopia’s candidature to the African Union for consideration and subsequent endorsement by the continental body, the Government of France had earlier directly requested Liberia’s support for France’s candidature for the position of Director-General of WHO with the proviso that Liberia’s Health Minister Mrs. Bernice Dahn would surface in the position of Deputy Director-General.

In view of the foregoing, the Government of Liberia acceded to the request and agreed to support the candidacy of France.

However, in light of the African Union’s decision to endorse the candidacy of Ethiopia, and in the interest of sustaining Liberia’s image as a respectable member of the African Union, the Government of Liberia decided to conform with the decision of the rest of Africa.

Meanwhile, France remains an invaluable partner of the Republic of Liberia on many other international and local fronts which would be undoubtedly maintained in the interest of our two countries.

Monrovia – The position of the next Director General of the World Health organization has started and the final vote does not take place until May, 2017 but a number of candidates have already declared their intention to fill the high profile position.

So far, three candidates have declared their intentions to occupy the position including Philippe Douste-Blazy, who served two terms as France’s Minister of Health and later became Foreign Minister; Tedros Adhanom Ghebreyesus, Ethiopia’s current Minister of Foreign Affairs and Sania Nishtar, former Minister of Health of Pakistan.

It is likely that other candidates will emerge before the close of the nomination period for the next Director General of the WHO and it is expected that October World Health Assembly will be a useful opportunity for member states to take soundings about the issues that will decide the election (geography, gender, and proven political skills will likely be as important as technical expertise).

As part of the process to fill the position, in January, 2017, the Executive Board of the WHO can propose up to three names to be considered by the World Health Assembly.

Africa’s turn?

There are debates within WHO circle that it is time for an African to lead the global health organization.

Believing that it is time for the continent to head the WHO, Africa presented a united front and endorsed the candidacy of Ethiopia’s former minister of health Tedros Adhanom in the decision made at the January 2016 Summit of AU Heads of State and Government in Addis Ababa, Ethiopia.

Abdelmalek Boudiaf, Algeria’s Minister of Health and coordinator of the African Group at the WHO said that Tedros’s candidacy is “legitimate” and his possible election “would only be fair for Africa”.

Chairperson of the African Union Commission, South African Nkosazana Dlamini-Zuma also attended the conference in support to Africa’s candidate for WHO director-general position.

The nomination of Africa’s candidate, Dr. Tedros Adhanom, is deeply tied with Ethiopia’s achievement on many of the health goals of the Millennium Development Goals (MDG’s) during his tenure.

Liberia’s betrays Africa?

While the African Union has endorsed the candidacy of Ethiopia Adhanom at the AU head of State and Government gathering, Liberia’s Minister of Health Dr. Bernice Dahn is contesting along with France’s Douste-Blazy against the decision of the AU.

In an interview on France 24 TV Channel, conducted with Minister Dahn and Douste-Blazy, the Liberian Health Minister promised to support Douste-Blazy and also persuade other African countries to do so.

The French channel stated that both Dr. Dahn and Douste-Blazy rae contesting as a set and on the same ticket.

Stated the introduction statement on the TV interview “In July, the World Health Organization will choose a new director general. One of the candidates is France’s Philippe Douste-Blazy, a former Health, Culture, and Foreign Affairs Minister.

A cardiologist by profession, he is Chairman of UNITAID, a global health NGO largely financed by a levy on airline tickets.

He is joined on the set and on the ticket by Liberia’s Health Minister Bernice Dahn. They tell Marc Perelman what their priorities would be for the WHO”.

Responding to a question from the host on whether she Africa will support Douste-Blazy, Dr. Dahn said “I am here as a professional colleague who has come to support him on this day that he is declaring his intention.

The position of Director General is normally highly political, highly competitive, and highly technical, countries do make the decisions, with his political agenda as a friend, I can help him to market that with my other African colleagues”.

Dr. Dahn as part of the campaign process for election of Douste-Blazy the Liberian health minister said the WHO needs to build the capacity of countries to meet the international health regulations.

Said Dr. Dahn: “From Liberia perspective, it is advisable to build country capacity to meet the international health regulations, we all signed unto the health regulations but the implementation of the regulations has been very slow.

As a country whenever they ask us to access ourselves and we asked them to defer until the outbreak of Ebola, but we also see the outbreak Ebola as an opportunity to build the systems to meet the International health regulations”.

Minister Dahn expressed that countries spent millions of dollars to bring the health emergency in the three affected West Africa countries under control but said it is time to refocus and make interventions in building the health care delivery system in these countries.

“If you listen to the news you hear the United States Africa spent US$1.2 billion to respond to Ebola in the three affected countries.

Could we have spent that to strengthen our systems to prevent the outbreak to the scale at which it went, yes, so this is time to relook, refocus and intervene”, Minister Dahn added.

She said Liberia has developed an investment plan to build a resilient health care delivery system and is working with partners to build a system that will withstand an new emergency.

“At the moment we still have the partners with us, trying to help us build that system but we also see some of the funding that was emergency related has been withdrawn.

So, if we do not build the system and you withdraw the support, it means you are putting us in a position where we will have to go back to an emergency and you will have to respond.

So, there is a need to build the system, to make it resilient and so that we cannot become a threat to the world again”, Minister Dahn continued.

Minister Dahn ignores President Sirleaf stance

President Ellen Johnson Sirleaf attended the January 2016 Summit of AU Heads of State and Government in Addis Ababa, Ethiopia where the decision was made by African Presidents to endorse Ethiopia’s Tedros Adhanom’s but the stance by her Minister to support Douste-Blazy is against the decision of the AU.

The Executive Council of the African Union (AU) except for one vote from the Senegalese representation, endorsed the bid of Tedros Adhanom’s (PhD) to replace Margaret Chan as Director-General of the World Health Organisation (WHO).

Tedros Adhanom’s is known for his contribution to the development of the country’s health sector during his tenure as Minister of Health (MoH) between 2005 and 2012.

Tedros’ attempt is the second recent attempt by an official of the incumbent Ethiopian government, after that of Sufian Ahmed, former minister of Finance & Economic Development (MoFED) and now advisor to Prime Minister Hailemariam Desalegn, to replace Donald Kaberuka (PhD) as President of the African Development Bank (AfDB) failed in 2015.

Tedros effort, however, seems to have gained traction with the support from the continental body.

It is said that Tedros bid, which is being made a year and a half before Chan’s term ends, has the full support of the government. Tedros has a PhD in Community Health, an MSc in Immunology of Infectious Diseases, and a BA in Biology.

Like Gaddafi

Liberia was one of the first African countries to speak against former Libyan leader Muammar Gaddafi when the former Libyan leader who was a major contributor to the African Union was under attack.

Monrovia – Herbal treatment or traditional medicine is popular amongst Liberians especially in rural communities but there are concerns about some health ramifications associated with the use of herbs.

Report by: Alpha Daffae Senkpeni, alpha.senkpeni@frontpageafricaonline.com

Also known as Alternative Health Providers, herbalists were criticized during the peak of the Ebola outbreak in Liberia when infected people sought treatment from these Traditional Healers (THs), and when they couldn’t healed these ailing individuals, it created perceptions that herbalists also contributed to the spread of the Ebola virus.

Liberia has serious deficit in the number of medical doctors with a World Health Organization (WHO) statistics showing that there are approximately 0.5 doctors and other health practitioners per 1000 persons living in the country, something considered far below the WHO standard which is put at 80% of the total health care coverage.

This has prompted the Director of Culture and Native Affairs at the Ministry of Internal Affairs to reemphasize the relevance of integrating traditional medicine with the country’s biomedical health sector.

Chief Jukon Kuyon says this will help to save more lives considering the shortage of doctors in the country.

“If the alternative medicine hospital can be built alongside the conventional medicine hospital like JFK, Jackson F. Doe Hospital or Phebe hospital…, with the information desk officer and the various traditional health practitioners it will help solve a lot of medical problems in the country,” explains Chief Kuyon. 

Chief Kuyon believes this will prevent individuals from seeking treatment from the wrong herbalists and will offer a chance for patients that are unable to be treated by medical doctors.

“Let the medical doctors and the herbalists be side-by-side so that when doctors cannot determine that a sickness is a conventional sickness, they will give it (the case) to alternative health providers that will be right nearby and it will help to save lives,” he added.

The Director of Culture and Native Affairs at the Ministry of Internal Affairs added that constructing the necessary facilities at medical centers in the country will ensure THs that are spread throughout rural communities come together and be guided. Chief Kuyon is confident this approach will curtail previous incidences that have led individuals to uncertified herbalists in the country.

There have been several calls for Liberia’s health sector to partner with traditional herbalists in finding alternative medications especially when many rural Liberians continue to remain accustom to the practice.

“This will obviously help avert some of the complications hindering public health care in our country especially with concerns arising from how some of these herbalists conduct their treatments,” a Liberian Doctor who prefers anonymity told FrontPage Africa.

Chief Kuyon added: “If any of their medicine can save one or two, three patients we can start changing their medicine into conventional medicine also. But because we have been demonized some people are shying away from our sciences but our science is one of the best.”

In December 2014, the Ministry of Health launched a five-year plan on the usage of herbs at all health centers across the country as part of its new health system but the full realization of this initiative is farfetched.

The plan, according to the MoH’s Division of Complementary Medicine, will run until 2019.

A recent research by a Non-Governmental Organization, Platform for Dialogue and Peace (P4DP) shows that Traditional Healers (THs) are potential allies in building Liberia’s resilient health sector considering their role.

The study recommends that the setting up of herbal treatment medical unit at all major medical centers to allow smooth collaborations and referrals to ensure lives are saved.

The Chief is also calling on the WHO, the Ministry of Health, P4DP and the Ministry of Internal Affairs to work along with certified THs to initiate the program.

The P4DP study also suggests that integrating herbalists within the health sector, educating them about public health diseases, and initiating a policy for the preservation and conversation of herbal medicine will reduce their secret or uninformed operations which can be detrimental to public health, while also stressing the significance of collecting data on THs to support the building of their capacity. 

In April 1986, the Liberian legislature passed a bill into law to create the division of Complementary Medicine at the Ministry of Health which is responsible for certifying traditional healers in the country.

The Renewed calls for the comprehensive integration of herbal treatment with biomedicine in Liberia comes less than two years after the deadliest Ebola outbreak in history hit West Africa when lack of trust in Liberia’s health sector coupled with an already porous system worsen the situation.

Although Liberia health policy encourages traditional treatment, it is far behind considering the strides other West African nations have made in the integration of the two kinds of treatments.

According to WHO, 80% of Africans use traditional medicine, and in Ghana research shows that over 70% of Ghanaians depend on herbal treatment.

According to the African Research Institute, the Ghanaian Government certified and recognized institutions involved with the testing of herbal medicine while some government health facilities have already integrated herbal medicine with biomedical treatments.

In Cameroon, the country’s central government surveyed and licensed traditional doctors as part of a global strategy, led by the World Health Organization. The aim was for traditional doctors to provide basic biomedical services in rural areas which is yielding significant progress.

Monrovia – President Ellen Johnson Sirleaf has commended the EU for its immense and generous contributions to Liberia’s recovery while saluting the Europeans for their collective efforts in the fight against Ebola.

According to an Executive Mansion release, President Sirleaf was speaking on Monday, May 9, 2016 during the celebration Europe Day; historically commemorating Schuman’s Declaration, when 66 years today the farsighted politician advocated the unification of Europe in the aftermath of World War II.

She said the Schuman’s Declaration is not only perceived as a founding text of European integration, but also an encouragement for the continued promotion of world peace.

The declaration, she added is very inspirational in content: “World peace cannot be safeguarded without the making of creative efforts proportionate to the dangers which threaten it”.

President Sirleaf prevailed on the EU Envoy to convey to His Excellency, Donald F. Tusk, President of European Council, the EU staff, as well as citizens of the European Union in Liberia, warm sentiments and sincere best wishes on behalf of the Government and people of Liberia.

Liberia, she recounted the celebration of Europe Day on May 11, 2015, which coincided with the WHO Declaration of Liberia as Ebola-free; a status, she added Liberia maintains despite two brief interruptions.  “More importantly, perhaps, we have demonstrated a response capability to address any possible future outbreak” the Liberia Chief Executive noted.

The EU, she intimated has continued to be a strong partner to Liberia, working with the administration in support of critical priority areas including, infrastructure, security, human rights, agriculture, energy, and education.

She praised the additional broad plan that includes Liberia for completing the West African Coastal Corridor by making available funds for the Sanniquellie – Danane stretch connecting Liberia to Ivory Coast, which according to the Liberian leader supports our regional integration plan.

President Sirleaf furthered that the European Union in collaboration with UNDP is also currently providing support to the Inter-Parliamentary Consultative Committee.

Liberia she said notes the progress made in the implementation of the Voluntary Partnership Agreement (VPA), which aims to ensure that Liberia exports only legal timber products to the EU, and looks forward to series of meetings convened by Liberia-EU VPA Joint Implementation Committee (JIC) to accelerate this initiative.

According to President Sirleaf in a few days: “We will again assemble under the auspices of the EU-Liberia – Political Dialogue on May 17 to reassess the achievements and prospects of our partnership. As always, we anticipate that this discussion will be held under an atmosphere of geniality and frankness”.

She called for the need to celebrate the dynamic partnership between Liberia and the EU, as we recount the immeasurable benefits to the people of Liberia.  “We are aware that the need for continued partnership has never been more desired then now, a need to collaborate on matters of illegal migration, terrorism, CBRN Risk Mitigation, Schengen visa issuance in Liberia and the promotion of a green climate, amongst others” – President Sirleaf stressed.

Meanwhile, President Sirleaf conveyed Liberia’s heartfelt best wishes on such notable occasion, to H.E. Mr. Donald F. Tusk, President of the European Council, H.E. Mr. Jean-Claude Juncker, President of the European Commission, and to assure them of Liberia’s renewed commitment and collaboration in our shared endeavours to reinforce and develop EU-Liberia partnership for our common good.

Also speaking, European Union’s Ambassador to Liberia, Tina Intelmann reiterated the EU’s commitment aimed at supporting the government and people of Liberia, adding that such commitment remains strong.

She named the government’s Agenda for Transformation, direct budgetary support to the Government of Liberia, contribution to the rehabilitation of the Red-light to Gbarnga Road Project, the Mount Coffee Hydro project as well as support to the Educational and Agricultural sectors as targeted areas of EU support.

Ambassador Tina Intelmann pledged the EU’s commitment to continuously work with Liberia in meeting the needs of the Liberian people.

“Currently, we are also undertaking the responsibility for the distribution of service lines for the Liberia Electricity Corporation from Mount Coffee to Monrovia and other parts of Liberia, for the purpose of providing the people basic social needs and services”, Ambassador Intelmann indicated.

 “The European Union is very much committed to cutting down carbon admission. We are in the business of setting aside funding for the purpose of helping Liberia to fight Climate Change as well,” she concluded

Monrovia – Liberia’s and Guinea’s last known Ebola patients in a latest flare-up of the disease that hit both countries have now been discharged. All remaining contacts of confirmed cases that were placed under a 3-week period of medical monitoring have been cleared.

Liberia’s Ministry of Health, WHO and partners involved in the response held a ceremony at the Ebola treatment facility in Monrovia to celebrate the recovery and discharge of a 2-year-old boy, the final patient in the flare-up in Liberia.

His 5-year-old brother recovered a week earlier. On 29 April, the country also began a 42-day period of increased surveillance – amounting to two 21-day incubation cycles of the virus.

Guinea’s final Ebola patient, a 70-year-old man, tested negative for the virus a second time on 19 April and returned to his village in the southern prefecture of Macenta to a warm welcome. Guinea began its 42-day countdown on that day, and will be able to declare the flare-up over on 31 May if there are no additional cases.

An inter-agency cross-border response

This latest re-emergence of Ebola came to light on 16 March when Guinean national health authorities and WHO were alerted to suspect deaths and infections in the southern prefecture of Nzérékoré. A rapid case investigation confirmed the new cluster of Ebola cases.

In all, 8 people in Guinea’s Nzérékoré and Macenta prefectures died from Ebola and 2 survived during the flare-up. Most of the cases were from the same extended family.

More than 1,000 people who may have had contact with the confirmed cases were identified, and following intensive community sensitization and outreach, the majority of the contacts were placed under medical observation for 21 days.

To help contain the spread, 1500 contacts and contacts of theirs were vaccinated with an experimental Ebola vaccine. Providing the vaccine is part of an ongoing drug trial, the outcome of which will inform its possible licensing for future use.

WHO Liberia/Peter Glee

The effort to control the outbreak in Guinea was not without resistance. Some high-risk contacts went missing, including a woman whose husband was among the Ebola fatalities.  Epidemiological investigation teams later discovered that she travelled with her 3 children to Liberia to stay with relatives.

She came down with Ebola symptoms there, and died on 31 March, spreading the flare-up of Ebola to that country. Two of her three boys also became infected, but both survived. They are the 2-year-old boy and his 5-year old brother who were released from the care centre last week.

Similarly to Guinea, Liberian health authorities and partners worked to quickly trace, isolate and monitor the health of identified contacts of the 3 confirmed cases, over 100 in all, and step up infection prevention and control measures in health facilities and the impacted community.

Cross-border cooperation was also stepped up. The Ministries of Health in Guinea and Liberia, with WHO and the US Centers for Disease Control, organized additional information sharing, surveillance and overall coordination with partners in Nzérékoré.

Origins of transmission

Genetic sequencing from blood samples of the confirmed cases indicate the source of the virus is from a single and known transmission chain – suggesting exposure to infected body fluids from a survivor – rather than a re-introduction of Ebola virus from the wild.

WHO continuously stresses that flare-ups of Ebola like this one are likely to occur for some time, although with decreasing frequency, due to virus persistence in some survivors. It has been documented that Ebola virus can live in tissues and fluids of survivors, for well over a year.

WHO is working with the Ebola-affected countries to improve disease surveillance for Ebola and other infectious diseases, and strengthen health services to include improved clinical care, screening and counselling for survivors.

Monrovia – Liberia is joining the rest of the world on April 25 in observing “World Malaria Day,” which is being observed throughout the Republic as a Working Holiday.

A statement from the Executive Mansion said: “Conscious of the harmful effect and burden malaria poses on the human race, particularly in Africa, a Resolution declaring April 25 of each year as Africa Malaria Day, amended as World Malaria Day, was adopted by the Summit of African Heads of States held in Harare, Zimbabwe in 1997, which called on Member States of the Organization of African Unity (OAU), now the African Union (AU), to initiate and implement Plans of Actions that would curtail malaria and malaria-related mortality in Africa.

According to a Foreign Ministry release, April 25, 2016 is the 9th World Malaria Day, and will be celebrated in Ganta City, Nimba County, under the theme: *“End Malaria for Good”,* and the local slogan, *”Pregnant Women, Go to the Clinic for Malaria Medicine”.*

The Proclamation states that the Government of Liberia, realizing the significance of protecting the wellbeing of its citizens and foreign residents, has ratified the Convention on the Right of the Child to good health and nutrition, and, as a member of the World Health Organization (WHO), will join other global health partners in supporting all health
programs.

President Johnson Sirleaf has requested the Ministry of Health and other Government Agencies, as well as international organizations concerned to initiate and execute appropriate programs suitable for the occasion.

In Africa, malaria deaths have been cut by one third within the last decade and outside of Africa, 35 out of the 53 countries affected by malaria have reduced cases by 50 percent, and in the same period, countries where access to malaria control interventions have improved most significantly, overall child mortality rates have fallen by approximately 20 percent.

Key Malaria Facts

Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes.
In 2015, 95 countries and territories had ongoing malaria transmission,
About 3.2 billion people – almost half of the world’s population – are at risk of malaria.
Malaria is preventable and curable, and increased efforts are dramatically reducing the malaria burden in many places.
Between 2000 and 2015, malaria incidence among populations at risk (the rate of new cases) fell by 37% globally. In that same period, malaria death rates among populations at risk fell by 60% globally among all age groups, and by 65% among children under 5.
Sub-Saharan Africa carries a disproportionately high share of the global malaria burden. In 2015, the region was home to 88% of malaria cases and 90% of malaria deaths.

Malaria is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected female Anopheles mosquitoes, called “malaria vectors.” There are 5 parasite species that cause malaria in humans, and 2 of these species – P. falciparum and P. vivax – pose the greatest threat.

    P. falciparum is the most prevalent malaria parasite on the African continent. It is responsible for most malaria-related deaths globally.
    P. vivax is the dominant malaria parasite in most countries outside of sub-Saharan Africa.

Symptoms

Malaria is an acute febrile illness. In a non-immune individual, symptoms appear 7 days or more (usually 10–15 days) after the infective mosquito bite. The first symptoms – fever, headache, chills and vomiting – may be mild and difficult to recognize as malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness, often leading to death.

Children with severe malaria frequently develop one or more of the following symptoms: severe anaemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria. In adults, multi-organ involvement is also frequent. In malaria endemic areas, people may develop partial immunity, allowing asymptomatic infections to occur.
Who is at risk?

In 2015, approximately 3.2 billion people – nearly half of the world’s population – were at risk of malaria. Most malaria cases and deaths occur in sub-Saharan Africa. However, Asia, Latin America, and, to a lesser extent, the Middle East, are also at risk. In 2015, 95 countries and territories had ongoing malaria transmission.

Some population groups are at considerably higher risk of contracting malaria, and developing severe disease, than others. These include infants, children under 5 years of age, pregnant women and patients with HIV/AIDS, as well as non-immune migrants, mobile populations and travellers. National malaria control programmes need to take special measures to protect these population groups from malaria infection, taking into consideration their specific circumstances.
Disease burden

According to the latest WHO estimates, released in December 2015, there were 214 million cases of malaria in 2015 and 438 000 deaths.

Between 2000 and 2015, malaria incidence among populations at risk fell by 37% globally; during the same period, malaria mortality rates among populations at risk decreased by 60%. An estimated 6.2 million malaria deaths have been averted globally since 2001.

Sub-Saharan Africa continues to carry a disproportionately high share of the global malaria burden. In 2015, the region was home to 88% of malaria cases and 90% of malaria deaths.

Some 15 countries – mainly in sub-Saharan Africa – account for 80% of malaria cases and 78% deaths globally. Since 2000, the decline in malaria incidence in these 15 countries (32%) has lagged behind that of other countries globally (53%).

In areas with high transmission of malaria, children under 5 are particularly susceptible to infection, illness and death; more than two thirds (70%) of all malaria deaths occur in this age group. Between 2000 and 2015, the under-5 malaria death rate fell by 65% globally, translating into an estimated 5.9 million child lives saved between 2001 and 2015.
Transmission

In most cases, malaria is transmitted through the bites of female Anopheles mosquitoes. There are more than 400 different species of Anopheles mosquito; around 30 are malaria vectors of major importance. All of the important vector species bite between dusk and dawn. The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment.

Anopheles mosquitoes lay their eggs in water, which hatch into larvae, eventually emerging as adult mosquitoes. The female mosquitoes seek a blood meal to nurture their eggs. Each species of Anopheles mosquito has its own preferred aquatic habitat; for example, some prefer small, shallow collections of fresh water, such as puddles and hoof prints, which are abundant during the rainy season in tropical countries.

Transmission is more intense in places where the mosquito lifespan is longer (so that the parasite has time to complete its development inside the mosquito) and where it prefers to bite humans rather than other animals. The long lifespan and strong human-biting habit of the African vector species is the main reason why nearly 90% of the world’s malaria cases are in Africa.

Transmission also depends on climatic conditions that may affect the number and survival of mosquitoes, such as rainfall patterns, temperature and humidity. In many places, transmission is seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria. They can also occur when people with low immunity move into areas with intense malaria transmission, for instance to find work, or as refugees.

Human immunity is another important factor, especially among adults in areas of moderate or intense transmission conditions. Partial immunity is developed over years of exposure, and while it never provides complete protection, it does reduce the risk that malaria infection will cause severe disease. For this reason, most malaria deaths in Africa occur in young children, whereas in areas with less transmission and low immunity, all age groups are at risk.
Prevention

Vector control is the main way to prevent and reduce malaria transmission. If coverage of vector control interventions within a specific area is high enough, then a measure of protection will be conferred across the community.

WHO recommends protection for all people at risk of malaria with effective malaria vector control. Two forms of vector control – insecticide-treated mosquito nets and indoor residual spraying – are effective in a wide range of circumstances.
Insecticide-treated mosquito nets

Long-lasting insecticidal nets (LLINs) are the preferred form of insecticide-treated mosquito nets (ITNs) for public health programmes. In most settings, WHO recommends LLIN coverage for all people at risk of malaria. The most cost-effective way to achieve this is by providing LLINs free of charge, to ensure equal access for all. In parallel, effective behaviour change communication strategies are required to ensure that all people at risk of malaria sleep under a LLIN every night, and that the net is properly maintained.

Indoor spraying with residual insecticides

Indoor residual spraying (IRS) with insecticides is a powerful way to rapidly reduce malaria transmission. Its full potential is realized when at least 80% of houses in targeted areas are sprayed. Indoor spraying is effective for 3–6 months, depending on the insecticide formulation used and the type of surface on which it is sprayed. In some settings, multiple spray rounds are needed to protect the population for the entire malaria season.
Antimalarial drugs

Antimalarial medicines can also be used to prevent malaria. For travellers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, thereby preventing malaria disease. For pregnant women living in moderate-to-high transmission areas, WHO recommends intermittent preventive treatment with sulfadoxine-pyrimethamine, at each scheduled antenatal visit after the first trimester. Similarly, for infants living in high-transmission areas of Africa, 3 doses of intermittent preventive treatment with sulfadoxine-pyrimethamine are recommended, delivered alongside routine vaccinations.

In 2012, WHO recommended Seasonal Malaria Chemoprevention as an additional malaria prevention strategy for areas of the Sahel sub-Region of Africa. The strategy involves the administration of monthly courses of amodiaquine plus sulfadoxine-pyrimethamine to all children under 5 years of age during the high transmission season.
Insecticide resistance

Much of the success in controlling malaria is due to vector control. Vector control is highly dependent on the use of pyrethroids, which are the only class of insecticides currently recommended for ITNs or LLINs.

In recent years, mosquito resistance to pyrethroids has emerged in many countries. In some areas, resistance to all 4 classes of insecticides used for public health has been detected. Fortunately, this resistance has only rarely been associated with decreased efficacy of LLINs, which continue to provide a substantial level of protection in most settings. Rotational use of different classes of insecticides for IRS is recommended as one approach to manage insecticide resistance.

However, malaria-endemic areas of sub-Saharan Africa and India are causing significant concern due to high levels of malaria transmission and widespread reports of insecticide resistance. The use of 2 different insecticides in a mosquito net offers an opportunity to mitigate the risk of the development and spread of insecticide resistance; developing these new nets is a priority. Several promising products for both IRS and nets are in the pipeline.

Detection of insecticide resistance should be an essential component of all national malaria control efforts to ensure that the most effective vector control methods are being used. The choice of insecticide for IRS should always be informed by recent, local data on the susceptibility of target vectors.

To ensure a timely and coordinated global response to the threat of insecticide resistance, WHO worked with a wide range of stakeholders to develop the “Global Plan for Insecticide Resistance Management in Malaria Vectors (GPIRM)”, which was released in May 2012.
Diagnosis and treatment

Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission. The best available treatment, particularly for P. falciparum malaria, is artemisinin-based combination therapy (ACT).

WHO recommends that all cases of suspected malaria be confirmed using parasite-based diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment. Results of parasitological confirmation can be available in 30 minutes or less. Treatment, solely on the basis of symptoms should only be considered when a parasitological diagnosis is not possible. More detailed recommendations are available in the “WHO Guidelines for the treatment of malaria”, third edition, published in April 2015.

Antimalarial drug resistance

Resistance to antimalarial medicines is a recurring problem. Resistance of P. falciparum to previous generations of medicines, such as chloroquine and sulfadoxine-pyrimethamine (SP), became widespread in the 1970s and 1980s, undermining malaria control efforts and reversing gains in child survival. WHO recommends the routine monitoring of antimalarial drug resistance, and supports countries to strengthen their efforts in this important area of work.

An ACT contains both the drug artemisinin and a partner drug. In recent years, parasite resistance to artemisinins has been detected in 5 countries of the Greater Mekong subregion: Cambodia, Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam. Studies have confirmed that artemisinin resistance has emerged independently in many areas of this subregion. Most patients are cured when treated with an ACT if there is no resistance to the partner drug.

However, in parts of Cambodia and Thailand, P. falciparum resistance to both artemisinin and partner drugs (multi-drug resistance) has developed.

There are concerns that P. falciparum malaria in Cambodia and Thailand is becoming increasingly difficult to treat, and that multi-drug resistance could spread to other regions with dire public health consequences. Consequently, WHO’s Malaria Policy Advisory Committee in September 2014 recommended adopting the goal of eliminating P. falciparum malaria in this subregion by 2030. WHO launched the Strategy for Malaria Elimination in the Greater Mekong Subregion (2015–2030) at the World Health Assembly in May 2015, which was endorsed by all the countries in the subregion.
Surveillance

Surveillance entails tracking of the disease and programmatic responses, and taking action based on the data received. Currently many countries with a high burden of malaria have weak surveillance systems and are not in a position to assess disease distribution and trends, making it difficult to optimize responses and respond to outbreaks.

Effective surveillance is required at all points on the path to malaria elimination. Strong malaria surveillance enables programmes to optimize their operations, by empowering programmes to:

Advocate for investment from domestic and international sources, commensurate with the malaria disease burden in a country or subnational area;
Allocate resources to populations most in need and to interventions that are most effective, in order to achieve the greatest possible public health impact;
Assess regularly whether plans are progressing as expected or whether adjustments in the scale or combination of interventions are required;
Account for the impact of funding received and enable the public, their elected representatives and donors to determine if they are obtaining value for money; and
Avaluate whether programme objectives have been met and learn what works so that more efficient and effective programmes can be designed.

Stronger malaria surveillance systems are urgently needed to enable a timely and effective malaria response in endemic regions, to prevent outbreaks and resurgences, to track progress, and to hold governments and the global malaria community accountable.
Elimination

Malaria elimination is defined as the interruption of local transmission of a specified malaria parasite in a defined geographical area as a result of deliberate efforts. Continued measures are required to prevent re-establishment of transmission.

Malaria eradication is defined as the permanent reduction to 0 of the worldwide incidence of malaria infection caused by human malaria parasites as a result of deliberate efforts. Once eradication has been achieved, intervention measures are no longer needed.

The rate of progress in a particular country will depend on the strength of its national health system, the level of investment in malaria control, and a number of other factors, including: biological determinants, the environment, and the social, demographic, political, and economic realities of a particular country.

In countries with high or moderate rates of malaria transmission, national malaria control programmes aim to maximize the reduction of malaria cases and deaths.

As countries approach elimination, enhanced surveillance systems can help ensure that every infection is detected, treated and reported to a national malaria registry. Patients diagnosed with malaria should be treated promptly with effective antimalarial medicines for their own health and to prevent onward transmission of the disease in the community.

Countries that have achieved at least 3 consecutive years of 0 local cases of malaria are eligible to apply for the WHO certification of malaria elimination. In recent years, 5 countries have been certified by the WHO Director-General as having eliminated malaria: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011) and Maldives (2015). Recently 3 other countries started the certification process: Argentina, Kyrgyzstan and Sri Lanka.
Vaccines against malaria

There are currently no licensed vaccines against malaria or any other human parasite. One research vaccine against P. falciparum, known as RTS, S/AS01, is most advanced. This vaccine has been evaluated in a large clinical trial in 7 countries in Africa and received a positive opinion by the European Medicines Agency in July 2015.

In October 2015, 2 WHO advisory groups recommended pilot implementations of RTS, S/AS01 in a limited number of African countries. WHO has adopted these recommendations and is strongly supportive of the need to proceed with these pilots as the next step for the world’s first malaria vaccine. These pilot projects could pave the way for wider deployment of the vaccine in 3 to 5 years, if safety and effectiveness are considered acceptable.
WHO response

The WHO Global Technical Strategy for Malaria 2016-2030 – adopted by the World Health Assembly in May 2015 – provides a technical framework for all malaria-endemic countries. It is intended to guide and support regional and country programmes as they work towards malaria control and elimination.

The Strategy sets ambitious but achievable global targets, including:

    Reducing malaria case incidence by at least 90% by 2030
    Reducing malaria mortality rates by at least 90% by 2030
    Eliminating malaria in at least 35 countries by 2030
    Preventing a resurgence of malaria in all countries that are malaria-free

This Strategy was the result of an extensive consultative process that spanned 2 years and involved the participation of more than 400 technical experts from 70 Member States. It is based on 3 key pillars:

Ensuring universal access to malaria prevention, diagnosis and treatment;
Accelerating efforts towards elimination and attainment of malaria-free status; and
Transforming malaria surveillance into a core intervention

The WHO Global Malaria Programme (GMP) coordinates WHO’s global efforts to control and eliminate malaria by:

Setting, communicating and promoting the adoption of evidence-based norms, standards, policies, technical strategies, and guidelines;
Keeping independent score of global progress;
Developing approaches for capacity building, systems strengthening, and surveillance; and
Identifying threats to malaria control and elimination as well as new areas for action

GMP is supported and advised by the Malaria Policy Advisory Committee (MPAC), a group of 15 global malaria experts appointed following an open nomination process.

The MPAC, which meets twice yearly, provides independent advice to WHO to develop policy recommendations for the control and elimination of malaria.

The mandate of MPAC is to provide strategic advice and technical input, and extends to all aspects of malaria control and elimination, as part of a transparent, responsive and credible policy setting process.