Fiebre amarilla en Africa: su impacto en salud pública y perspectivas para su control en el siglo XXI

In the last two decades, yellow fever re-emerged with vehemence to constitute a major public health problem in Africa. The disease has brought untold hardship and indescribable misery among different populations in Africa. It is one of Africa's stumbling blocks to economic and social development. Despite landmark achievements made in the understanding of the epidemiology of yellow fever disease and the availability of a safe and efficacious vaccine, yellow fever remains a major public health problem in both Africa and America where the disease affects annually an estimated 200,000 persons causing an estimated 30,000 deaths. Africa contributes more than 90% of global yellow fever morbidity and mortality. Apart from the severity in morbidity and mortality, which are grossly under reported, successive outbreaks of yellow fever and control measures have disrupted existing health care delivery services, overstretched scarce internal resources, fatigued donor assistance and resulted in gross wastage of vaccines. Recent epidemics of yellow fever in Africa have affected predominantly children under the age of fifteen years. Yellow fever disease can be easily controlled. Two examples from Africa suffice to illustrate this point. Between 1939 and 1952, yellow fever virtually disappeared in parts of Africa, where a systematic mass vaccination programme was in place. More recently, following the 1978-1979 yellow fever epidemic in the Gambia, a mass yellow fever vaccination programme was carried out, with a 97% coverage of the population over 6 months of age. Subsequently, yellow fever vaccination was added to the EPI Programme. The Gambia has since then maintained a coverage of over 80%, without a reported case of yellow fever, despite being surrounded by Senegal which experienced yellow fever outbreaks in 1995 and 1996. The resurgence of yellow fever in Africa and failure to control the disease has resulted from a combination of several factors, including: 1) collapse of health care delivery systems; 2) lack of appreciation of the full impact of yellow fever disease on the social and economic development of the affected communities; 3) insufficient political commitment to yellow fever control by governments of endemic countries; 4) poor or inadequate disease surveillance; 5) inappropriate disease control measures, and 6) preventable poverty coupled with misplaced priorities in resource allocation. Yellow fever can be controlled in Africa within the next 10 years, if African governments seize the initiative for yellow fever control by declaring an uncompromising resolve to control the disease, the governments back up their resolve with an unrelenting commitment and unwavering political will through adequate budgetary allocations for yellow fever control activities, and international organisations, such as WHO, UNICEF, GAVI, etc., provide support and technical leadership and guidance to yellow fever at risk countries. Over a ten-year period, of stage-bystage mass yellow fever vaccination campaigns, integrated with successful routine immunisation, Africa can bring yellow fever under control. Subsequently, for yellow fever to cease being a public health problem, Africa must maintain at least an annual 80% yellow fever vaccine coverage of children under the age of 1 year, and sustain a reliable disease surveillance system with a responsive disease control programme. This can be achieved at an affordable annual expenditure of less than US$1.00 per person per year, with a reordering of priorities.Durante las últimos dos décadas, la fiebre amarilla ha vuelto a emerger con fuerza hasta constituirse en un grave problema de salud pública en Africa, trayendo indecibles sufrimientos a mucha de su población y convirtiéndose en un obstáculo más para su desarrollo social y económico. A pesar de los destacados logros alcanzados en el conocimiento de la epidemiología de esta enfermedad y de la disponibilidad de una vacuna segura y eficaz, la fiebre amarilla continúa siendo un serio problema de salud pública tanto en Africa como en América en donde anualmente afecta a 200.000 personas, aproximadamente, y causa alrededor de 30.000 muertes. Africa contribuye con más del 90$1,00 por persona al año, lo cual es muy razonable siempre y cuando se reordenen las prioridades presupuestales

Raznolikost antigena nigerijskih sojeva virusa influence konja H3.

Antigenic variation among three recent isolations of equine-2 H3N8 influenza viruses from Ibadan, Nigeria is reported. Antigenic analysis with panels of monoclonal antibodies (mAbs) and polyclonal antisera indicated that the three viruses were antigenically divergent, although they were all H3N8 subtype related to other equine 2 -viruses isolated between 1963 and 1987. Results of virus protein synthesis investigated by pulse-chase experiments showed heterogeneity among the proteins of the ribonucleoprotein complex and the haemagglutinin glycoproteins, which were not cleaved in tissue culture. The results of this study indicate that equine H3 HAs have evolved by a process of evolutionary divergence and mutational changes, as confirmed by genetic analysis in another study. The results also showed that antigenic variation occurs among equine H3 influenza viruses and that H3 viruses with antigenically different HA molecules could co-circulate in equine populations.Obra|ena je raznolikost antigena tri nova izolata nigerijskih sojeva virusa influence konja H3N8 iz Ibadana u Nigeriji. Analiza antigena s pločama monoklonskih protutijela (mAbs) i poliklonskim antiserumima pokazala je da su tri virusa antigenski različiti, iako su svi bili H3N8 podtipa i srodni s drugim virusima influence konja serotipa A2 izoliranim od 1963. do 1987. Rezultati sinteze virusnog proteina istraženi sa "pulse-chase" pokusima pokazali su heterogenost proteina ribonukleinskog kompleksa i hemaglutininskih glikoproteina, a koji nisu rasli u kulturi tkiva. Rezultati ovog istraživanja naznačuju da su konjski H3 HAs nastali procesom evolucijske divergencije i mutacijama, a to je potvr|eno i genetskim analizama u drugoj studiji. Rezultati tako|er pokazuju da se pojavljuju antigene varijacije među H3 virusima konjske influence i da H3 virusi s antigeno različitim HA molekulama mogu zajedno cirkulirati u populacijama konja

Raznolikost antigena nigerijskih sojeva virusa influence konja H3.

Antigenic variation among three recent isolations of equine-2 H3N8 influenza viruses from Ibadan, Nigeria is reported. Antigenic analysis with panels of monoclonal antibodies (mAbs) and polyclonal antisera indicated that the three viruses were antigenically divergent, although they were all H3N8 subtype related to other equine 2 -viruses isolated between 1963 and 1987. Results of virus protein synthesis investigated by pulse-chase experiments showed heterogeneity among the proteins of the ribonucleoprotein complex and the haemagglutinin glycoproteins, which were not cleaved in tissue culture. The results of this study indicate that equine H3 HAs have evolved by a process of evolutionary divergence and mutational changes, as confirmed by genetic analysis in another study. The results also showed that antigenic variation occurs among equine H3 influenza viruses and that H3 viruses with antigenically different HA molecules could co-circulate in equine populations.Obra|ena je raznolikost antigena tri nova izolata nigerijskih sojeva virusa influence konja H3N8 iz Ibadana u Nigeriji. Analiza antigena s pločama monoklonskih protutijela (mAbs) i poliklonskim antiserumima pokazala je da su tri virusa antigenski različiti, iako su svi bili H3N8 podtipa i srodni s drugim virusima influence konja serotipa A2 izoliranim od 1963. do 1987. Rezultati sinteze virusnog proteina istraženi sa "pulse-chase" pokusima pokazali su heterogenost proteina ribonukleinskog kompleksa i hemaglutininskih glikoproteina, a koji nisu rasli u kulturi tkiva. Rezultati ovog istraživanja naznačuju da su konjski H3 HAs nastali procesom evolucijske divergencije i mutacijama, a to je potvr|eno i genetskim analizama u drugoj studiji. Rezultati tako|er pokazuju da se pojavljuju antigene varijacije među H3 virusima konjske influence i da H3 virusi s antigeno različitim HA molekulama mogu zajedno cirkulirati u populacijama konja

Some genetic characteristics of sabin-like poliovirus isolated from acute flaccid paralysis cases in Nigeria

A total of 34 sabin strains of the poliovirus isolated from 22 children with 60-day follow-up residual acute flaccid paralysis (AFP) were genetically characterized and screened for any form of recombination. Sequence analysis of the 906-nucleotide capsid showed that all the isolates were similar to their original sabin serotypes, however two of the viruses had drifted in their 3D noncapsid regions toward a sabin-sabin and sabin-nonpolio entero combination. Routine immunization in Nigeria is low and in spite of the increase in the frequency of supplemental immunizations, a lot of children are still inadequately immunized, which may be the reason for our observation in this study. Although we are not dealing with a case of circulating vaccine derived poliovirus (cVDPV) yet, if the above condition persists, the advent of cVDVP may not be too far. There is therefore the need to maintain a high quality mass immunization and sustained routine immunization. Key words: Poliovirus, sequence, crossover, non polio enterovirus, recombination, genome, Sabin-like, vaccine, Nigeria. African Journal of Biotechnology Vol.2(11) 2003: 460-46

Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics

Coronavirus disease 2019 (COVID-19) has revealed how strikingly unprepared the world is for a pandemic and how easily viruses spread in our interconnected world. A governance crisis is unfolding alongside the pandemic as health officials around the world compete for access to scarce medical supplies. As governments of African countries, and those in low-income and middle-income countries around the world, seek to avoid potentially catastrophic epidemics and learn from what has worked in other countries, testing and other medical resources are of concern. With accelerating spread, funding is urgently needed. Yet even where there is enough money, many African health authorities are unable to obtain the supplies needed as geopolitically powerful countries mobilise economic, political, and strategic power to procure stocks for their populations. We have seen this before. In the AIDS pandemic lifesaving diagnostics and drugs came to many African countries long after they were available in Europe and North America. In 2020, this situation can be avoided. Although health system weakness remains acute in many places, investments by national governments, the African Union, and international initiatives to tackle AIDS, tuberculosis, malaria, polio, and post-Ebola global health security have built important public health capacities. Global leaders have an ethical obligation to avoid needless loss of life due to the foreseeable prospect of slow and inadequate access to supplies in Africa

The Next WHO Director-General’s Highest Priority: a Global Treaty on the Human Right to Health

Amidst the many challenges facing the next WHO Director-General, the new WHO head should find WHO’s foremost priority in its most important constitutional pillar: the right to health. The centerpiece of this endeavor should be leadership on the Framework Convention on Global Health (FCGH), the proposed global treaty based in the right to health and aimed at national and global health equity. The treaty would reform global governance for health to enhance accountability, transparency, and civil society participation and protect the right to health in trade, investment, climate change, and other international regimes, while catalyzing governments to institutionalize the right to health at community through to national levels. It would usher in a new era of global health with justice – vast improvements in health outcomes, equitably distributed. With the Framework Convention on Tobacco Control having served as a proof of concept, the FCGH would be an innovative treaty finding solutions to overcome global health failings in accountability, equality, financing, and inter-sectoral coherence. It would include a global health accountability framework, encompassing, civil society engagement, independent monitoring, and plans for redress, while catalyzing national health accountability strategies, accountability mechanisms, disaggregated data, and community participation. National health equity strategies, pro-poor pathways to universal health coverage, and robust non-discrimination provisions could elevate the voices, priorities, and ultimately power of marginalized populations. The FCGH would include a national and global health financing framework, while reaching beyond the health sector with right to health assessments, public health participation in developing international agreements, and responsibility for all sectors for improving health outcomes. The FCGH would reinvigorate WHO’s global health leadership, breathing new life into its founding principles. It could become the platform for reforming WHO as a rights-based 21st century institution, with badly-needed reforms, such as community participation, new priorities favouring social determinants of health, and a culture of transparency and accountability. The next Director-General should launch a historic effort to align national and global governance for with human rights through the FCGH, bringing the world closer to global health with justice

Prevalence of Antibodies to Crimean-Congo Hemorrhagic Fever Virus in Ruminants, Nigeria, 2015.

Crimean-Congo hemorrhagic fever virus (CCHFV) is a highly transmissible human pathogen. Infection is often misdiagnosed, in part because of poor availability of data in disease-endemic areas. We sampled 150 apparently healthy ruminants throughout Nigeria for virus seropositivity and detected virus-specific IgG in cattle (24%) and goats (2%), highlighting the need for further investigations

The Value Proposition of the Global Health Security Index

Infectious disease outbreaks pose major threats to human health and security. Countries with robust capacities for preventing, detecting and responding to outbreaks can avert many of the social, political, economic and health system costs of such crises. The Global Health Security Index (GHS Index)—the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries—recently found that no country is sufficiently prepared for epidemics or pandemics. The GHS Index can help health security stakeholders identify areas of weakness, as well as opportunities to collaborate across sectors, collectively strengthen health systems and achieve shared public health goals. Some scholars have recently offered constructive critiques of the GHS Index’s approach to scoring and ranking countries; its weighting of select indicators; its emphasis on transparency; its focus on biosecurity and biosafety capacities; and divergence between select country scores and corresponding COVID-19-associated caseloads, morbidity, and mortality. Here, we (1) describe the practical value of the GHS Index; (2) present potential use cases to help policymakers and practitioners maximise the utility of the tool; (3) discuss the importance of scoring and ranking; (4) describe the robust methodology underpinning country scores and ranks; (5) highlight the GHS Index’s emphasis on transparency and (6) articulate caveats for users wishing to use GHS Index data in health security research, policymaking and practice