Category: Medical

In the following article, which was originally carried in ChinAfrica, a publication issued under the auspices of Beijing Review, Fikrejesus Amahazion, an Eritrean educator and researcher, explains how cooperation in the healthcare sector epitomises the close friendship between China and Eritrea.

In November 2022, members of the Chinese medical team, working side-by-side with Eritrean doctors, performed complex spinal surgeries on patients in the capital Asmara for the first time in the nation’s history. This coincided with the 25th anniversary of the first dispatch of a Chinese medical team to Eritrea and served as “a timely and powerful reflection of the longstanding ties and enduring friendship between China and Eritrea.”

Contacts between China and Eritrea, the author notes, date back almost 2,000 years. However, “contemporary ties can be traced back to Eritrea’s long struggle for independence, when China offered support to Eritrea’s independence movement.”

In Amahazion’s view, “A key factor that underlies the success of health cooperation between Eritrea and China, as well as the broader relationship, is the firm commitment to the principles of mutual understanding, trust, and respect…The Eritrean government has historically insisted on establishing genuine partnerships and cooperation, while retaining firm control of its development agenda and local implementation. It encourages assistance addressing specific needs that cannot be met internally, and that complements and strengthens, rather than replacing, the country’s own institutional capacity to implement projects.”

This is rooted in a great desire to avoid crippling dependence and to foster a strong, clear sense of responsibility for and genuine ownership of the country’s future among all citizens. “For its part,” he notes, “China’s own approach to assistance has considerable similarities.”

Local media outlets in Eritrea recently reported about how members of the Chinese medical team, working side by side with Eritrean doctors, performed complex spinal surgeries on patients at Halibet Hospital in Asmara in November 2022. The extremely technical operations, which are the first-ever procedures of their kind within Eritrea, are an exciting landmark in the country’s medical sector and history.

Coinciding with the 25th anniversary of the first dispatch of Chinese medical team to Eritrea, the recent surgeries also serve as a timely and powerful reflection of the longstanding ties and enduring friendship between China and Eritrea, especially in the field of health. For a quarter of a century, health cooperation between China and Eritrea has positively contributed to the lives and wellbeing of the Eritrean people nationwide, and also helped to move the country’s health system forward.

Historical background

Although it has received significant global attention in recent years, China’s engagement with Africa actually dates back centuries and spans a number of ancient dynasties. Modern Sino-African ties can be traced to the earliest years of African independence in the 1950s and 1960s. Since then, China has become the continent’s leading trading partner, while Chinese investment in and lending to African countries have grown rapidly. Over the years, the relationship has steadily broadened to reach an array of other sectors, including culture, digital infrastructure and technology, security, and education.

Health, too, has been an increasingly critical area of cooperation, with China extending support to building or renovating many hospitals and health facilities across the continent. Prominently, the headquarters of the Africa Centres for Disease Control and Prevention, which is being funded and built with Chinese support, is expected to open its doors in the near future. Additionally, China has worked with African countries to offer thousands of scholarships and short-term training opportunities for African students, as well as provided significant funding support for health projects, medicines and equipment.

During the COVID-19 pandemic, China supported Africa’s prevention and control measures, contributing multiple batches of medical resources and vaccines, committing to making vaccines available as a global public good, and dispatching doctors across the continent to help with capacity-building and strengthening of local responses.

Crucially, with the pandemic having plunged Africa into its first recession in 25 years, China also remained at the forefront of the continent’s economic recovery. It maintained robust economic and trade cooperation with Africa, while also signing debt service suspension agreements with multiple African countries, thus becoming the biggest player in terms of relieving African debt among the G20 countries.

China’s medical teams are arguably the flagship of its multifaceted health cooperation with Africa. Since April 1963 when it first sent a group of doctors to Algeria, then recovering from war, China has sent numerous medical teams – coming to an overall total of over 20,000 doctors, nurses, clinicians and other health professionals – to most countries across the continent. These highly diverse teams have provided vital, often life-saving, services, helped to train countless local personnel, collaborated with local personnel on innovative research, and contributed to building capacity and strengthening local health systems.

Health cooperation with Eritrea

As with Africa, Eritrea’s relationship with China is not new. In fact, it stretches back almost 2,000 years to as early as about the year 100, involving maritime trade and commercial activities, as well as the dispatch of emissaries. However, contemporary ties can be traced back to Eritrea’s long struggle for independence, when China offered support to Eritrea’s independence movement.

Formal diplomatic relations began after Eritrea’s independence in May 1993. China opened an embassy in Asmara. Since then, the Eritrea-China partnership has steadily expanded and strengthened. Health has been among the most extensive and important areas of bilateral cooperation.

Opened in 2003 following three years of construction, Eritrea’s largest medical facility and first fully equipped modern hospital, Orotta Hospital, was built through the close partnership of Eritrea and China. Continued bilateral cooperation in subsequent years has resulted in regular upgrades to and considerable expansions of the facility, which serves patients from across the country. China has also donated medical equipment and medicines that are used in facilities nationwide.

In addition, since 1997, a total of 15 Chinese medical teams, comprising well over 200 doctors and health professionals, have worked in Eritrea. During deployments that have lasted one to two years, these teams have worked closely alongside Eritrean health professionals to provide high-quality medical services and support general health improvements.

Through formal training and mentoring, demonstration and observation, and introduction of new techniques or approaches such as traditional Chinese medical practices and medicines, the medical teams have helped to reinforce Eritrea’s health capacity, while also expanding and strengthening the skills of local health personnel. At the same time, the visiting medical teams have had the opportunity to learn from their Eritrean colleagues, as well as grow and develop professionally from the cases that may be unique or completely different from what they are familiar with.

Mutual respect and shared principles

A key factor that underlies the success of health cooperation between Eritrea and China, as well as the broader relationship, is the firm commitment to the principles of mutual understanding, trust, and respect. The two countries’ approaches to international assistance and development also closely align, providing a solid foundation for their health partnership to thrive and succeed.

The Eritrean government has historically insisted on establishing genuine partnerships and cooperation, while retaining firm control of its development agenda and local implementation. It encourages assistance addressing specific needs that cannot be met internally, and that complements and strengthens, rather than replacing, the country’s own institutional capacity to implement projects. This approach is rooted in a great desire to avoid crippling dependence, as well as ensure local agency and foster a strong, clear sense of responsibility for and genuine ownership of the country’s future among all citizens.

For its part, China’s own approach to assistance has considerable similarities. According to China’s Foreign Aid (2011), in providing foreign aid, “China does its best to help recipient countries to foster local personnel and technical forces, build infrastructure and develop and use domestic resources, so as to lay a foundation for future development and embarkation on the road of self-reliance and independent development.” Furthermore, China’s assistance has historically been anchored in equality and mutual benefit with no strings attached, while the country has no intention of imposing ideology, values, or development models on other countries. The quarter century of bilateral health cooperation between Eritrea and China, which is just one dimension of their larger and still growing relationship, has been extremely positive. Not only has it helped to promote the health and wellbeing of locals while contributing to building the capacity and resilience of the national health system, it has also strengthened the longstanding bonds between the two countries.

Source: Dehai Eritrea Online

More countries have worked to eliminate dengue, leprosy and other neglected tropical diseases (NTDs) over the past decade, but greater efforts and investment are needed in the face of pandemic-related disruptions, the World Health Organization (WHO) said on Monday.

To mark World Neglected Tropical Diseases Day, the UN agency has released a report highlighting progress and challenges in delivering care for these 20 conditions, which mainly affect the world’s poorest people.

NTDs are caused by a variety of pathogens including viruses, bacteria, parasites, fungi and toxins, and can be deadly. Other examples are Buruli ulcer, Chagas disease, chikungunya, rabies, scabies and yaws.

Stigma and hardship

They are mainly prevalent in tropical areas, primarily in locations where water safety, sanitation and access to healthcare are inadequate. These diseases often cause life-long stigma, and resulting economic hardship, and have devastating health, social and economic consequences.

Although nearly 180 countries and territories reported at least one case of NTDs in 2021, just 16 nations account for 80 per cent of the global burden. Globally, some 1.65 million people are estimated to require treatment for at least one of these diseases.

“Around the world, millions of people have been liberated from the burden of neglected tropical diseases, which keep people trapped in cycles of poverty and stigma,” said Tedros Adhanom Ghebreyesus, the WHO Director-General.

“But as this progress report shows, we still have a lot of work to do,” he added.

Building on progress

The report showed that the number of people requiring NTD interventions fell by 80 million between 2020 and 2021.

Furthermore, eight countries had eliminated at least one of these diseases during this period. As of last year, the number stood at 47 countries, and more were on the road to achieving this target.

These accomplishments build on a decade of significant progress, said WHO, with 25 per cent fewer people requiring interventions in 2021 than in 2010.

Additionally, more than a billion people were treated for NTDs each year between 2016 and 2019.

The COVID-19 impact

However, the COVID-19 pandemic has also had significant impact on community-based interventions, access to health facilities, and on supply chains for healthcare products.

As a result, 34 per cent fewer people received treatment between 2019 and 2020, even if a general resumption of activities sparked an 11 per cent increase in recovery the following year, with roughly 900 million people treated.

In 2020, WHO’s governing body, the World Health Assembly, endorsed an NTD road map for the coming decade, and the report emphasizes the need for more action and investment to reverse delays and accelerate progress.

Accountability, financing and partnerships

Promoting country ownership and accountability, as well as sustainable and predictable financing, will be key to providing quality NTD services.

WHO also stressed the importance of multi-sectoral collaboration and partnerships.

Last week, the UN agency signed a new agreement with Gilead Sciences, a research-based American biopharmaceutical company, for the donation of 304,700 vials of AmBisome, an antifungal medicine used to treat visceral leishmaniasis in countries most impacted by the disease, such as Bangladesh, Ethiopia, India, Kenya, Nepal, Somalia and South Sudan.

This new three-year collaboration, which extends a previous agreement to 2025, is estimated at $11.3 million and also will support improved coverage and access to diagnosis and treatment.

WHO urged more partners and donors to fill existing gaps that hamper the full-scale implementation of NTD activities at the global and local levels.

Source: United Nations

GENEVA — Ahead of World Neglected Tropical Diseases Day Monday, the World Health Organization is calling for action to tackle these debilitating illnesses, which affect an estimated 1.65 billion people globally.

A diverse group of 20 parasitic and bacterial tropical diseases is categorized as neglected. This is because they disproportionally affect people who live in poor, remote communities and are not on the list of global health priorities.

Ibrahima Soce Fall is director of WHO’s Department of Neglected Tropical Diseases. He says these vector-borne diseases are transmitted by insects in areas that lack safe water, sanitation, and access to health care. He says they also are spread via contaminated food and water.

Fall says they cause immense suffering because of their disfiguring and disabling impact.

“If you take diseases like onchocerciasis, you know, so-called river blindness because it can lead to blindness. The same for trachoma. So, these are so many diseases that are fatal and very debilitating,” he said.

Trachoma is an eye disease that can cause permanent blindness.

Fall says these diseases do not attract the amount of investment needed to access health services or develop new tools for diagnostics, treatments, and vaccines.

He notes some of these ailments have been around for a very long time. For instance, the biblical disease, leprosy, still exists in 139 countries and dengue, which has been around for 800 years, remains prevalent in 129 nations.

Despite the many challenges, progress is being made in the elimination of the NTDs. WHO reports the number of people requiring NTD interventions fell by 80 million between 2020 and 2021. It finds 47 countries have eliminated at least one NTD and more countries are in the process of achieving this target.

According to the Carter Center, there were only 13 human cases of Guinea worm disease last year, pushing the illness closer to eradication. The Atlanta-based center was co-founded by former U.S. President Jimmy Carter and his wife, Rosalynn Carter. When it began leading the international campaign to eradicate Guinea worm in 1986, there were an estimated 3.5 million cases in at least 21 countries in Africa and Asia.

WHO officials say the goal it has set to eliminate at least one neglected tropical disease in 100 countries by 2030 can be achieved. It says the scientific community has the tools and the know-how to save lives and prevent suffering. But WHO says nations need to act together and invest in helping get rid of this dreaded group of diseases.

Source: Voice of America

Barentu, 20 January 2023- At a meeting organized on 17 and 18 January in Barentu, it was reported that as a result of substantial investment made on both in equipment and man power the medical facilities in the Gash Barka region are providing praiseworthy health service to the public.

At the meeting, report was presented focusing on the activities implemented regarding control of communicable and non-communicable diseases, capacity improvement of health facilities and community based environmental sanitation activities as well as introduction of new equipment to health facilities.

Dr. Hayelom Kidane, head of the Ministry of Health branch in Gash Barka region, said that in 2022 delivery at health facilities has increased from 49.5 to 53.7%, vaccination coverage has reached 100% and cervical cancer vaccination to 94.2%.

Indicating that the achievement registered in the health sector was the result of the commendable participation of the public and health professionals, Ambassador Mahmud Ali Hirui, Governor of the region, said that due attention will be given to address shortcomings of health facilities and to conduct sustainable environmental sanitation activities.

Speaking at the occasion, Ms. Amina Nurhussein, Minister of Health, commended the strong participation of the public, administrations and other Government institutions in the effort by the Ministry of Health to expand and to improve health service provision.

Source: Ministry of Information Eritrea

UNICEF warns some 4 million children living near contaminated and stagnant waters in flood-affected districts of Pakistan are fighting for survival.

The U.N. children’s fund reports about 1.6 million children already were suffering from severe acute malnutrition and another 6 million from stunting before last year’s disastrous floods struck Pakistan.

The UNICEF representative in Pakistan, Abdullah Fadil, said the situation has likely worsened since then, putting many children at risk of dying. Speaking from the capital, Islamabad, he said 4 million children are facing a bitterly cold winter without heat and warm protective clothing.

Fadil notes families still are living under scraps of plastic in freezing conditions. He said children also are at risk of deadly diseases such as malaria and cholera in flooded areas.

“We feared initially malaria to be the biggest cause of death because of the stagnant water,” Fadil said. “Because we were able to provide bed nets and malaria medicines the crisis was averted. We estimate the mortality rates to be about three times higher than in normal times.”

Pakistan faces some of the world’s highest neo-natal deaths. The World Health Organization reports sub-Saharan Africa has the highest newborn mortality rate, followed by central and southern Asia.

Fadil said UNICEF also helped avert a cholera epidemic by providing clean drinking water and lifesaving treatment. Beyond health, he said education is a major area of concern. He noted 24,000 schools were washed away by the floods.

“We have established close to 1,000 temporary learning centers where we have about 90,000 children, a third of whom are actually first-time students,” Fadil said. “Pakistan has about 23 million children who are already out of school. We estimate due to the floods, an additional 2 million would have left and been out of school.”

Despite the ongoing situation, Fadil said UNICEF has received less than half the $173 million it needs to help millions of children recover from this climate-induced catastrophe. He said vulnerable communities require reliable access to health care, nutrition, education, protection and other essential services.

Source: Voice of America

Last month, the World Health Organization (WHO) released its 2022 World Malaria Report (WMR), an annual report that provides a comprehensive update on global and regional malaria data and trends. The following paragraphs share a few of the report’s main highlights, and also briefly recap Eritrea’s own national progress and efforts toward prevention and control (based on both local sources and the WMR).

General background

Malaria is a severe, life-threatening disease caused by Plasmodium parasites, which are spread to people through the bites of infected female Anopheles mosquitoes. Despite being readily preventable and treatable, malaria remains a massive global public health problem and it occurs in more than 100 countries and territories worldwide. About half of the world’s population is at risk, with large areas of Africa and South Asia, along with parts of Central and South America, the Caribbean, Southeast Asia, the Middle East and Oceania considered areas where malaria transmission occurs.

Global highlights

The latest WMR finds that, despite disruptions to prevention, diagnostic, and treatment services during the COVID-19 pandemic, along with other challenges (such as humanitarian crises, natural disasters, funding deficits, and global inflation, among others), countries around the world “have largely held the line against further setbacks to malaria control.” Around the world, there were an estimated 619,000 deaths due to malaria in 2021, which was about 6,000 fewer than in 2020 but still around 51,000 higher than in 2019 and prior to the onset of the COVID-19 pandemic. Furthermore, although the number of cases of malaria rose again in 2021, estimated to be about 247 million cases, the rise was at a slower pace than the previous year. (In 2020, there were 245 million cases, while 2019 saw 232 million cases.) Overall, between 2019 and 2021, an estimated additional 13.4 million cases and 63,000 deaths were attributed to disruptions associated with the COVID-19 pandemic(such as disruptions in diagnosis, treatment, or insecticide-treated mosquito net (ITN) distribution campaigns). Yet again, Africa, and Sub-Saharan Africa (SSA) more specifically, carries the greatest burden of malaria. Last year saw an estimated 234 million cases(95 percent of the global total) and 593,000 deaths (96 percent) in SSA, while the top 16 most malaria-affected countries in the world, in terms of cases, are all located in the region. Four African countries, Nigeria, the Democratic Republic of the Congo (DRC), Uganda, and Mozambique, accounted for nearly half of all cases globally, with four African countries also accounting for more than half of all malaria deaths globally (Nigeria, DRC, Niger, and Tanzania).

Eritrea

In Eritrea, malaria has been along standing challenge and the risk of malaria remains moderate to high within large swathes of the country. Forty-one of the country’s58 sub-zobas are categorized as malaria-endemic localities, with the Gash Barka, Debub, and Semenawi Keih Bahri regions accounting for greater than 90 percent of the national burden. (Gash Barka and Debub account for the vast majority of the national malaria burden.) Historically, malaria has been a formidable threat to several vulnerable population groups, such as pregnant women and children.(Young children are vulnerable as they have not developed immunity to malaria, and pregnant women are vulnerable as their immunity has been decreased by pregnancy.)

Since independence, and particularly following the establishment of the National Malaria Control Program in 1995, Eritrea has made major inroads against the disease. Through the combination of an array of control and prevention interventions, which has included the mass distribution of long-lasting insecticide-treated nets, indoor residual spraying, drainage and larval source management, effective case management and surveillance, and strong community mobilization, awareness, and reception, the national malaria burden has been significantly reduced.

Relying on both the WMR and local sources, between 1998 and 2016, malaria incidence in Eritrea dropped significantly, declining from 157 to 34 cases per 1,000 people. Following further reductions to 18 cases per 1,000 in 2018, there has been a slight increase in cases in recent years, to 30 cases per 1,000 in 2020. (Similarly, the WMR estimates that the recent rise has been reversed, with total cases in Eritrea in 2021 decreasing by about 54 percent compared to 2019 and 2020.) Shifting to malaria deaths, they too have fallen, dropping from 405 in 1998 to 23 in 2016 and 6in 2021 (an overall reduction of approximately 99 percent). Notably, in recent years, only a small percentage of all malaria cases in the country were in highly vulnerable populations, such as children under five years of age or pregnant women.

Notably, Eritrea’s progress over the years made it one of a small number of countries to achieve the United Nations Millennium Development Goals target related to malaria (Goal 6, which it meta head of the 2015 target date). In 2016, during the 26th Summit of the African Union (AU), it even received an award from the African Leaders Malaria Alliance in recognition of its “commitment, innovation, and progress in the fight against malaria.” (The African Leaders Malaria Alliance is a coalition of AU Heads of State and Government established to drive accountability and action for results against malaria and neglected tropical diseases, and to promote reproductive, maternal and child health.)

Looking ahead, despite a recent rise in cases in some areas of the country, Eritrea is steadily transitioning from pre-elimination toward elimination of malaria, with the long-term goal of ultimately eliminating and preventing the re-introduction of malaria by 2030. (The path to malaria-free status is characterized by four distinct programmatic phases: control, pre-elimination, elimination, and prevention of reintroduction. Subsequently, once a country has proven, beyond a reasonable doubt, that the chain of local malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least three consecutive years, it is then granted a certification of malaria-free status from the WHO.)

Encouragingly, entomology laboratories for research have been established in Elabered and Tesseney, helping in the identification of species and parasites, while efforts continue to ensure early diagnosis and treatment, as it prevents deaths and contributes to reducing transmission. Additionally, local reports indicate that Eritrea will develop a refined sub-national stratification map based on epidemiological data triangulated with appropriate metrics, namely entomological, ecological/demography, and interventions coverage data, to better disaggregate the malaria situation and inform targeting of interventions.

Something to keep an eye on

In addition to the potential threat sposed by mosquito evolution and adaptability, their growing resistance to insecticide-treated nets, and anti malarial drug resistance, another issue for consideration is climate change. Specifically, scientists have indicated that climate change could significantly impact the distribution and transmission of malaria. For instance, a rise in temperature could mean that malaria parasites develop faster, thus raising the potential for transmission and burden. With Eritrea, and the Horn of Africa region more broadly, at particular threat from a changing climate, this potential issue remains one to keep an eye on.

Source: Ministry of Information Eritrea

At an activity assessment meeting the Ministry of Health branch in the Central Region conducted on 10 and 11 January, it was reported that in the past 5 years, HIV/AIDS infection in the region has declined by 64%.

According to a report presented at the meeting, the number of HIV/AIDS infections was 1.1% in 2017 and has declined to 0.4% in 2022.

Indicating that the cervical cancer vaccination program carried out at the national level was 98% successful, Dr. Mulugeta Haile, head of the Ministry of Health branch in the region, said that other non-communicable diseases have also significantly been reduced.

Dr. Mulugeta further noted that in 2022 no death due to delivery at health facilities has been reported and pre-natal treatment has increased by 62%.

Commending the activities carried out in 2022, Ms. Amina Nurhussein, Minister of Health, called for a double-fold effort for the implementation of programs of 2023.

Nr. Fesehaye Haile, Governor of the Central Region, on his part called for the sustainability of environmental sanitation activities in the city of Asmara with a view to prevent communicable diseases that could occur due to lack of sanitation.

In the Central Region, there are 26 health stations, 6 health centers, 3 community hospitals, and 1 regional referral hospital.

Source: Ministry of Information Eritrea