Posts or Comments 18 July 2024

Monthly Archive for "May 2023"



Vaccine Bill Brieger | 14 May 2023

Tanzania needs malaria vaccines to reduce malaria burden

David Kanamugire has published a blog on the need to add the malaria vaccine to Tanzania’s arsenal of malaria elimination strategies. The original posting is found in the class blog for the Social & Cultural Basis for Community and Primary Health Programs class at the Johns Hopkins Bloomberg School of Public Health. Below is his perspectives on the issue.

Malaria is still a major public health problem. In 2021, malaria killed an estimated 619,000 people – 95 percent of them in Africa. Children under the age of 5 accounted for 80 percent of Africa malaria deaths. Tanzania is among 4 countries that account for just over half of all global malaria deaths.

The country has significantly reduced malaria cases, from a prevalence of 18% in 2008 to 8.1% in 2022. This reduction is attributed to intervention such as Insecticide Treated bed Nets, Indoor Residual Spray, effective drugs and Malaria Rapid Diagnostic tests.

But recently the global progress on malaria has stalled and this could be due to emerging drug resistance, insecticide resistance and the spreading of invasive species Anopheles stephensi. For the past 3 years, the global malaria death remains above 600,000. Therefore there is need for new approaches to help in efforts to prevent and control malaria.

Photo: Gavi, the Vaccine Alliance

Vaccines are safe and cost-effective way combat communicable diseases and improve health outcomes. One of malaria vaccine that have been approved by the WHO is R21. It was developed by Oxford and is produced at a large scale by the Serum Institute of India.

The R21 vaccine is cheap and can be easily produced thus making it ideal for Africa countries. The R21 is also effective against malaria as three initial doses followed by a booster give up to 80 percent protection against malaria.

commodities &Community &Essential Medicines &Primary Health Care Bill Brieger | 11 May 2023

Online Short Course: Essential Medicines, Commodities and Supplies

Essential Medicines, Commodities and Supplies Needed for Community Level Primary Health Care Interventions is our 2-credit online course offered from 5-9 June 2023 as part of the Global Health Systems Summer Institute. Please check the syllabus and share with colleagues.

Course Description” Essential commodities are among the 8 basic primary health care services and the 6 health systems building blocks as defined by the World Health Organization

Primary health care programs in low and middle-income countries require essential health commodities be made available at the community level. Logistic systems need to be developed to ensure that commodities are adequately estimated and delivered. In addition, systems for safely maintaining and monitoring stocks are needed at the community level.

The Summer Institute offers a variety of short-term courses in a variety of global health areas between 5-30 June 2023. The Global Health Systems Summer Institute provides early- and mid-career public health professionals with cutting-edge skills in a variety of global health topics. The Institute is also a great opportunity for part-time MPH and other Hopkins students and fellows to learn a valuable set of skills in an in-demand and rapidly growing field of public health. Below are issues covered in the Essential Medicines course.

  • Overview of Essential Medicines for Primary Health Care
  • Essential Medicines for Primary Health Care
  • Basic Primary Health Care Procurement and Logistics
  • Financing for Essential Medicines
  • Implementation of Essential Medicines Programs in Primary Health Care
  • Preventative Chemotherapy for Neglected Tropical Diseases
  • Ensuring Essential Pharmaceuticals Go “Beyond the End of the Road”
  • Supply Chains
  • The Role of Indigenous Medicine
  • Supply Chain Management for CDI: The Malaria Example
  • Logistics Management Information System in Community Based PHC
  • Community Mass Drug Distribution
  • The CDI Process: Expanding Beyond Ivermectin
  • Supply Chain Management in Ethiopia
  • Community Supply Chain Challenges in Nigeria

Borders &Conflict &COVID-19 &Ebola &Epidemic &One Health &Yellow Fever Bill Brieger | 10 May 2023

Outbreaks Emergency Preparedness And Response In Uganda

Solomon Afolabi, a graduating MPH student from the JHU Bloomberg School of Public Health examined the challenge of epidemics and outbreaks in Africa with special reference to Uganda as an example. The abstract of his report is found below.

According to the WHO, preparedness for emergency health conditions like infectious disease outbreaks should be an ongoing action supported by adequate funding, resources, partnerships, and political will that is executed at all levels to keep it sustained. Emergency preparedness is a framework that identifies practical in-country health emergency preparedness principles and elements by acknowledging lessons learned from previous response activities for priority planning, implementation, and reinforcing operational capacities.

Uganda is an ecological hotspot for various infectious diseases making the country liable to outbreaks. In the last two decades, multiple significant outbreaks have occurred, prominent of which are from yellow fever, Ebola virus disease, and COVID-19 global pandemic. Efforts to build a strategic framework for emergency outbreak preparedness and to strengthen the national operational capacity led to the establishment of the Ugandan National Institute of Public Health (UNIPH) in 2013.

This paper presents a blend of literature that takes account of the successes, challenges faced, and gaps identified in the preparedness and response capacities to the infectious disease outbreaks experienced in the last two decades. It also reviewed how the national efforts had fared in operational readiness for an emergency response to epidemics, building a resilient health system, practicing the One-Health human-animal-environment interface, and in government, community, and individual capacities to contribute effectively to strengthen the national emergency preparedness and response to these frequent disease outbreaks. The findings revealed that Uganda’s outbreak preparedness had made much progress over two decades, from the overwhelming Sudan strain Ebola virus outbreak in 2000-2001 to a similar episode from the same species in 2022 to 2023.

The response measures that feature the activation of a national response plan by the MoH were well coordinated locally to swiftly lead to the activation of NTF, NRRT, DTF, DRRT, and VHTs for immediate mobilization and deployment of operational resources to affected districts. The response was strengthened by well-organized local coordination by the MoH and development partners (WHO, CDC, UN agencies, etc.). The immediate setting up of treatment and isolation centers, provision of Ebola kits, training of more health workers, and coverage of 10 high-risk districts ensured a significant impact.

The provision of more than 5000 doses of vaccines with the support of WHO and partners was a global capacity milestone impact, and the country was declared Ebola-free in a record 69 days. Uganda’s current national emergency preparedness and response plan has received commendations locally and from global international partners, having progressively built capacity from lessons learned in just over a decade of responding to frequent infectious disease outbreaks and using the recommendations proffered accordingly.

This sustained momentum of preparedness supported the swift transition to contain COVID-19 and laid a good foundation for their strengthened readiness for an emergency response to outbreaks.