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COVID-19 on increase in Americas, Africa – WHO

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WHO says life expectancy increased from 46 to 73 years

… As U.S. surpasses 1m COVID-19 deaths***

COVID-19 cases and deaths continue to decline but omicron sub-variants are driving an increase in the Americas and Africa.

Director-General of the World Health Organisation (WHO), Tedros Ghebreyesus, told journalists at the weekly briefing in Geneva on Wednesday that despite weekly fatalities being at their lowest since March 2020, they don’t tell the full story.

Also read: Post-COVID-19: Obaseki decries brain drain in health sector

He said “The South African scientists who identified Omicron late last year have now reported two more Omicron sub-variants, BA.4 and BA.5, as the reason for a spike in cases in South Africa.

“It’s too soon to know whether these new sub-variants can cause more severe disease than other Omicron sub-variants, but early data suggest vaccination remains protective against severe the disease and death.

“The best way to protect people remains vaccination, alongside tried and tested public health and social measures.

“This is another sign that the pandemic is not done with us, and there are some clear takeaways,’’ he said.

The WHO chief reiterated that the best way to save lives, protect health systems and minimise cases of “long COVID” is by vaccinating at least 70 per cent of every country’s population – and 100 per cent of most at-risk groups.

He said although more jabs had become available, a lack of political commitment, operational capacity problems, financial constraints, misinformation, and disinformation, had been limiting vaccine demand.

“We urge all countries to address these bottlenecks to provide protection to their populations,” the top WHO official said.

According to him, testing and sequencing remain critical, noting that both sub-variants were identified because South Africa is still doing the vital genetic sequencing that many other countries have stopped.

Ghebreyesus cautioned that many countries were blind to how the virus is mutating – not knowing what lies ahead.

“Scant availability and high prices of effective antivirals continue to render them inaccessible to low- and middle-income countries.

“Coupled with low investment in early diagnosis, it is simply not acceptable that in the worst pandemic in a century, innovative treatments that can save lives are not reaching those that need them,” he said.

WHO supports fair reward for innovation and while ACT Accelerator partners are negotiating lower costs and increased availability, “we cannot accept prices that make life-saving treatments available to the rich and out of reach for the poor.”

He informed the journalists that he would be traveling to Poland on Thursday, for the International Donors’ Conference for Ukraine.

“The health challenges in Ukraine are worsening by the day, especially in the country’s east,” the official said, noting that WHO has now verified 186 attacks on healthcare in the country.

The WHO chief highlighted the importance of humanitarian corridors by pointing out that WHO and its partners were able to receive and provide healthcare to scores of civilians fleeing Mariupol.

He urged Russia to allow all remaining civilians to leave the shattered port city and all other areas where they are “at great risk”.

Turning to the Horn of Africa and the Sahel, Ghebreyesus spelled out that the climate crisis, spiking food prices and food shortages are threatening to cause famine and further insecurity.

According to him, 15 million people are estimated to be severely food insecure in Ethiopia, Kenya and Somalia, noting that the region is experiencing its worst droughts in 40 years.

He said repeated attacks on scarce water resources in Burkina Faso are depriving citizens of access to the minimum amount of water they need just to survive.

Meanwhile, in the Democratic Republic of the Congo, WHO is supporting vaccinations for an Ebola outbreak.

“WHO is responding to a huge range of challenges around the world – to say nothing of our work outside of emergencies to strengthen health systems and promote the conditions in which people can live healthy lives,” he said.

In another development, the U.S. on Wednesday surpassed one million COVID-19 deaths, according to data compiled by the American broadcast television network, NBC News.

The number – equivalent to the population of San Jose, California, the 10th largest city in the U.S. – was reached at stunning speed, 27 months after the country confirmed its first case of the virus.

“Each of those people touched hundreds of other people.

“It’s an exponential number of other people that are walking around with a small hole in their heart,” said Diana Ordonez, whose husband, Juan Ordonez, died in April 2020 at age 40.

While deaths from COVID-19 have slowed in recent weeks, about 360 people have still been dying every day.

According to World Health Organisation (WHO), COVID-19 cases and deaths continue to decline but omicron sub-variants are driving an increase in the Americas and Africa.

Meanwhile, the U.S. Centre for Disease Control and Prevention (CDC) on Tuesday recommended travellers continue to wear masks in airplanes, trains and airports despite a judge’s April 18 order declaring the 14-month-old transportation mask mandate unlawful.

The CDC said it based its recommendation on current COVID-19 conditions and spread as well as the protective value of masks.

The Justice Department in April filed notice it would appeal the ruling and it had until May 31 to do so.

But the government has made no effort to seek immediate court action to reinstate the mandate.

The mask mandate had been due to expire on Tuesday just before midnight unless the CDC sought an extension of a Transportation Security Administration directive.

A CDC spokeswoman said, “As a result of a court order, the mask order is no longer in effect and is not being enforced.”

At a Senate hearing Tuesday, Transportation Secretary Pete Buttigieg, cast doubt on the idea that the administration wanted to reimpose the mask mandate.

“The appeal concerns whether the CDC has the authority to (require masks) in this pandemic or in any pandemic, which is completely distinct from whether a mask mandate ought to be applied any given day,” Buttigieg said.

Buttigieg said he agreed that based on conditions on April 13, when the mandate was extended for 15 days, it should have been allowed to expire but said it was a CDC decision.

Hours after the April 18 ruling, the Biden administration said it would no longer enforce the mask mandate, which prompted airlines to let passengers end wearing masks mid-flight.

 

Health and Safety

Japa: FG Prohibits Leave Of Absence For Health Workers

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The Federal Government has placed a ban on leave of absence for health professionals relocating abroad.

The Minister of State for Health, Dr Tunji Alausa, who disclosed this on Saturday in Abeokuta said that health workers going abroad to seek greener pastures must “henceforth resign their appointment before embarking on such journeys”.

The Minister who spoke during his visit to the Neuro-Psychiatric Hospital, Aro, said the directive was contained in the Executive Order issued by President Bola Tinubu.

He said the decision was taken to combat the challenge of brain drain fondly called ‘Japa Syndrome’ confronting the health sector.

The minister also disclosed that the federal government had commenced aggressive recruitment of manpower in the health sector.

According to him,  the annual enrollment of Nurses which used to be about 28,000 had been increased to 68,000 adding that by the end of the year, it would have gone up to 120,000.

*President Bola Ahmed Tinubu

He said President Tinubu acknowledged the people as the biggest asset of the country and had vowed to take proactive measures to improve the health sector for their benefit.

On the shortage of manpower in the health sector, Alausa said the President had ordered massive recruitment of personnel to bridge the gap.

“In addition to the massive engagement of Nurses, we have equally doubled our enrollment for Doctors, Dentistry, and Pharmacists.

“However, the government has not prohibited anyone who wants to move to the UK or Australia to take up appointments not to do so.

“It is a free world. But, you cannot eat your cake and have it. If you are going, just resign your appointments with the federal government, rather than applying for a leave of absence.

“That is the Presidential Executive Order which has been communicated to all the Chief Medical Directors of Federal Government owned health facilities to implement,” he said.

The minister explained that the challenge had been that many health professionals who applied for leave of absence would travel outside the country to practice and make money, yet their names would still be in the payroll of the government

“So, to resolve this problem, the President has directed that any health worker going abroad to work should just resign his or her appointment.

“This way, you won’t be blocking others who want to work,” he said

Responding to demands on increased funding, infrastructural development and welfare packages of health workers,  Alausa assured that his ministry would leave no stone unturned to improve the fortunes of the health sector in the country.

The minister commended the Provost and Chief Medical Director of the hospital, Dr Paul Agboola for his commitment towards providing qualitative healthcare for Nigerians.

Earlier, Agboola hailed the minister for his selflessness and passion to turn things around for good in the health sector.

He said that,  as a result of the approval given by the minister, the hospital had embarked on many new projects, including a 40-bed mother-and-child hospital

Agboola said that his administration remained committed to doing everything necessary and possible to continually make the hospital the centre of excellence in neuro-psychiatric across the globe.

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Health and Safety

Lagos Set To Enforce Drainage Right-of-way In Apapa

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The Lagos State government says it will start enforcement operations in Apapa to re-establish the three-metre drainage right-of-way for all its drainage channels on Monday.

The Commissioner for the Environment and Water Resources, Mr Tokunbo Wahab, said this in a statement on Sunday in Lagos.

He said the enforcement was coming after the expiration of notices and convening of stakeholders meetings with the property owners earlier in the year to voluntarily move their fences that fell within the drainage setback.

He said the Ministry had served contravention notices to the buildings on the drainage setbacks.

He added that for several years, the ministry had not been able to access the eight major collectors for maintenance purposes due to encroachment which was a major contributor to flooding in the Apapa area.

Wahab said the state government was determined to find a lasting solution to flooding in Apapa.

He directed enforcement officers to ensure that all contravening properties were removed from the drainage right-of-way in accordance with the three metres required by law.

He gave the assurance that the government would not cherrypick properties during the enforcement process.

“We want to check the state of collectors in Apapa in order to evacuate and treat the collectors.

“The whole of the collectors in this area are blocked and the right-of-way taken over by individuals who moved their fences in order to acquire extra land thereby denying us access to the drains,” Tokunbo said.

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Health and Safety

NAFDAC NATIONAL STRATEGIC ACTION PLAN: Partners With Pharmaceutical Supply Chain Stakeholders

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…On Prevention, Detection, And Response To Substandard And Falsified Medicine

The NAFDAC has Vowed to close down the sale and distribution outlets Facilitating the Spread of Fake Drugs, as It stresses it’s determination to combat the incidence of Substandard and Falsified (SF) medicines in the country,

The National Agency for Food and Drug Administration and Control NAFDAC has subsequently engaged stakeholders in the pharmaceutical products supply chain in its resolve to put an end to the menace and effectively safeguard the health of Nigerians.

The Director General, Prof Mojisola Adeyeye, at a stakeholders meeting organized by NAFDAC on Thursday, emphasized the need to explore how to combat the sale and distribution of Substandard and Falsified Medical Products within the supply chain, insisting that the Agency would not hesitate to clamp down on wholesale and retail outlets where fake drugs are dispensed for public use.

According to her, the engagement with Pharma supply chain stakeholders in Nigeria serves as a means of thinking together and putting in place a position that will represent or guide collective efforts and strategy to prevent, detect, and respond to substandard and falsified medicinal products, adding that the goal is to ensure that medical products in circulation are of the quality standard required and safe for public use. 

The NAFDAC boss noted that the high prevalence of SF in Africa is a major threat to public health, attributing this to the fact that regulation in the region is limited with about 10% of African National Regulatory Agencies NRAs having achieved ML3. 

L-R: Director, Laboratory Services (Drugs) National Agency for Food and Drug Administration and Control (NAFDAC), Mr. Victor Abiola, Director General, NAFDAC, Prof. Mojisola Adeyeye, Director Post-Marketing Surveillance, NAFDAC, Dr. Fraden Bitrus Dasniyam, and Director Narcotics and Controlled Substances, Mrs Yedunni Adenuga, during the Agency’s engagement with the pharma supply chain stakeholders for input on the National Strategic Document on Substandard and Falsified Products in Lagos…on Thursday

Prof Adeyeye noted with dismay that this allows for poorly regulated manufacturers to supply their products in Africa where technologies to detect SF and track/trace are limited. 

She added that the menace of substandard and falsified medical products threatens access to safe, efficacious, and affordable medicines, undermining health systems and the achievement of Universal Health Coverage globally.

With the mandate to regulate and control the manufacture, importation, exportation, distribution, advertisement, sale, and use of drugs, cosmetics, chemicals, detergents, medical devices, and packaged water generally referred to as Regulated Products, she noted that this puts a burden on the Agency to lead the fight against SF medical products in Nigeria and support efforts that will see a reduction in the prevalence of SF medical products both locally manufactured and imported. 

The DG explained that NAFDAC is not the only regulatory agency in terms of substandard falsified medicines, adding that the Pharmacy Council of Nigeria (PCN) probably has more to do in the fight against fake drugs. 

She, however, relished a cordial relationship that exists between the two sister agencies, insisting that we must do this fight together. 

Prof Adeyeye explained that currently, NAFDAC is doing its best to fight this issue of Substandard and Falsified products, stating that the fight against Substandard/Falsified medical products is based on three broad thematic areas Prevent, Detect, and Respond (PDR). 

She said that NAFDAC operatives are not just going on the streets to look for substandard falsified medicines but also going after products that have been approved in Southeast Asia en route to Nigeria. 

She reiterated that 70 percent of medicines used in Nigeria come from outside which necessitated the establishment of a Pre-shipment testing scheme that has stopped over 124 products that were approved from coming into the Nigerian market. 

According to her, some of the SF medicines do not have content, some will not disintegrate, and some will not dissolve. In contrast, some of them have wrong labelling and all sorts of non-compliance, adding that the Agency is dealing with that now with the World Health Organisation (WHO). 

Prof Adeyeye further disclosed that most of the products stopped from coming into the Nigerian market have fake certificates of pharmaceutical products. Noting that it takes two to tango, Prof. Adeyeye opined that its not just India bringing substandard falsified medicines to us, it is us; Nigerians that connive with them to bring in cheap products at the detriment of lives in Nigeria. 

Furthermore, She disclosed that over 124 shipments have been stopped, adding that these are products that had been approved, that could have been in circulation in Nigeria for five years. 

So, if ten containers per year for one particular product or two containers per year should find their way into Nigeria, you can figure out what the consequences might be.

The NAFDAC boss, however, announced the berth of a new regulatory directive with emphasis on the source of raw materials used in the production process. For those that are registering new products, she said they must procure raw materials from approved sources like WHO Prequalified sources, FDA, or other stringent Regulatory Authorities. 

If you don’t source from a prequalified source, we will not register the product, she said. 

She, however, dispelled the news going around, over the alleged proliferation of fake drugs in the country, saying the proliferation news that has been going on is false. 

There is no proliferation of substandard medicines. We do a national survey, sampling of products using scientific methods from different parts of the country., she said, adding that the survey was done in 

2021 and 2022 for ant-malaria with a 10 percent prevalence level. 

We couldn’t do it in 2020 due to the COVID-19 Pandemic. She explained further, If you live very close to the border where people come in and out the prevalence may be higher there. Thats statistics. 

The average is about 10%, she said, insisting that proliferation is not synonymous with shortage because the two words are now used together. The fact that we have a shortage of medicines does not mean there is a proliferation of substandard falsified medicines.

 The survey for 2023 is not ready yet. We will publish 2021 and 2022.

She noted that the Pharmaceutical Supply chain plays a vital role in ensuring that safe, quality, and efficacious medicines reach the end users, adding that there is therefore a need to foster complementary partnerships that will seek to identify lapses in the supply chain system to improve the chances of winning the war on substandard and falsified medical products in Nigeria. 

We have formal and informal markets. Do not buy medicines from the informal market. We do a lot of raids in Oke- Arin, Idumota markets Lagos, Onitsha head bridge where you can buy a product maybe 50 per cent or 80 per cent cheaper because of low quality, she added, the state of the economy shouldn’t be an excuse for people to buy poison under the guise of cheap products.

I enjoin you to sustain your support to NAFDAC to ensure that only safe, efficacious, and quality medicines are used in Nigeria. NAFDAC, as the regulatory agency is seeking the support of all stakeholders in the pharma industry and supply chain system to improve our chances of winning the war on SF medical products.

The Supply chain stakeholders made very useful contributions for input into the National Strategic document to guide our collective efforts towards combating the menace of the SF in the country.

The stakeholders present at the supply chain engagements include the World Health Organization (WHO), United States Pharmacopeia (USP), Pharmaceutical Manufacturers Group of Manufacturers Association of Nigeria ( PMG-MAN), Association of Community Pharmacist of Nigeria (ACPN), Pharmaceutical Wholesalers Association of Nigeria (PWDAN), Nigerian Representatives of Overseas Pharmaceutical Manufacturers (NIROPHARM), Association of Pharmaceutical Importers of Nigeria (APIN), Association of Hospital and Administrative Pharmacist of Nigeria (AHAPN), Nigeria Army Medical corps, Nigeria Medical Association (NMA), National of Veterinary Medical Association(NVMA). Others are different companies represented under PMG-MAN, APIN, PWDAN, and Niropharm.

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