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Infectious disease surveillance update
Newsdesk
Coordination of funding is a major priority for IHP+, which is helping health ministries set priorities and make compacts with various international and national agencies. Compacts outline different scenarios for investment so that initiatives can be scaled up depending on the finances attracted, and are open to independent review. The important concept is to use the knowledge and skills of various agencies to strengthen national plans and attract funding, while streamlining the process in which currently several agencies review such plans. These agencies can then also look at cross-sectoral issues such as HIV/AIDS. The first such compact is in development with Ethiopia. Sippel notes that in Ethiopia, bilateral donors from the Netherlands, Ireland,
Canada, and the UK “have pooled their resources” to support civil society and the government in diverse areas. “These donors examine the on-the-ground realities in the country and then fund what is needed”, ensuring that local non-governmental organisations also have access to funds. She advocates that the US government could learn from this approach to “have a collaborative role, engaging with other bilaterals and national governments”. The WHO consultation concluded that action is needed towards a systematic way of managing positive synergies between global health initiative programmes and health-care system strengthening. This action requires coordination of global policy, says Fryatt, and ultimately, says England, the
large increase in investment required for health-care system strengthening needs “big changes in the funding mechanisms: a global health fund instead of a three-diseases fund”. Demey responds that whether the Global Fund should widen its scope is a legitimate question. “It is up to our donors (both public and private) and our recipient countries—who are all represented on our board—to decide.” What is agreed is that country ownership of policy is crucial, as well as the involvement of civil society within country ownership. The energy and civil-society experience of HIV/AIDS programmes is now needed, says Fryatt, to spread more widely across the health sector.
Kelly Morris
Imported malaria in the UK The number of imported cases of malaria in the UK grew steadily from 1987 to 2006, according to the UK Health Protection Agency’s Malaria Reference Laboratory; an increasing proportion of these cases were attributable to Plasmodium falciparum rather than Plasmodium vivax. In an observational study, researchers looked at the origins of 39 300 cases of malaria diagnosed in the UK during the 20-year period. 20 488 cases occurred in UK travellers, rather than in visitors to the UK. People visiting friends and relatives accounted for 64·5% of these cases; travel to Nigeria and Ghana—neither common tourist destinations—accounted for half of all imported falciparum cases. The authors report that only 42% of UK travellers took malaria chemoprophylaxis and people visiting friends and relatives in their country of origin were less likely to report the use of prevention measures. “These data represent a public-health failing but also an opportunity. They show that health messages are not getting through to ethnic minority groups www.thelancet.com/infection Vol 8 August 2008
visiting friends and relatives, especially in west Africa”, the study’s authors Adrian Smith and colleagues said. Jane Zuckerman (Royal Free and University College Medical School, London, UK) commented: “Smith and colleagues report a significant decrease in imported cases of P vivax after travel to the Indian subcontinent, a result of successful vector eradication in many urban areas. Pursuing a similar policy in Africa may reduce the incidence of malaria in endemic areas, while also reducing the risk of malaria to travellers, all of which may negate the necessity for prophylaxis in the future”.
Polio in Nigeria With a new outbreak of type 1 wild poliovirus (WPV1) in northern Nigeria now spreading into neighbouring countries, there is concern that a potential international outbreak on the scale of the one that struck 20 countries between 2003 and 2006 will follow. Compared with the same period last year, there has been a ten-fold increase in the number of new cases caused by WPV1 in Nigeria during 2008.
Over the past months, polio from Nigeria has spread west to Benin, north to Niger, and east to Chad; the risk of further spread is heightened by the upcoming rainy season and the anticipated large-scale population movements for the Hajj pilgrimage later in 2008. The new outbreak of polio in Nigeria has occurred because more than 20% of children have not been immunised in key high-risk areas in the north of the country.
HIV/AIDS: a “global disaster” The HIV epidemic has been classified as a long-term and complex disaster by the International Federation of Red Cross and Red Crescent Societies (IFRC) in this year’s World Disasters Report, which usually focuses on natural disasters. “This year’s report is the first to focus on one condition and with good reason. For sub-Saharan African societies and for numerous marginalised groups, who are left to cope with death, disease, and destitution, HIV is undoubtedly a disaster”, said IFRC Secretary General Markku Niskala.
CDC/ Jim Gathany
Infectious disease surveillance update
For more on imported malaria in the UK see BMJ 2008; 337: a120; DOI:10.1136/bmj. a120 and BMJ 2008; 337: a135; DOI:10.1136/bmj.a135 For the wild poliovirus weekly update from the Global Polio Eradication Initiative see http:// www.polioeradication.org/ casecount.asp For more on the 2008 World Disasters Report see http:// www.ifrc.org/publicat/wdr2008/
Jennifer Horwood 469
Coordination of funding is a major priority for IHP+, which is helping health ministries set priorities and make compacts with various international and national agencies. Compacts outline different scenarios for investment so that initiatives can be scaled up depending on the finances attracted, and are open to independent review. The important concept is to use the knowledge and skills of various agencies to strengthen national plans and attract funding, while streamlining the process in which currently several agencies review such plans. These agencies can then also look at cross-sectoral issues such as HIV/AIDS. The first such compact is in development with Ethiopia. Sippel notes that in Ethiopia, bilateral donors from the Netherlands, Ireland,
Canada, and the UK “have pooled their resources” to support civil society and the government in diverse areas. “These donors examine the on-the-ground realities in the country and then fund what is needed”, ensuring that local non-governmental organisations also have access to funds. She advocates that the US government could learn from this approach to “have a collaborative role, engaging with other bilaterals and national governments”. The WHO consultation concluded that action is needed towards a systematic way of managing positive synergies between global health initiative programmes and health-care system strengthening. This action requires coordination of global policy, says Fryatt, and ultimately, says England, the
large increase in investment required for health-care system strengthening needs “big changes in the funding mechanisms: a global health fund instead of a three-diseases fund”. Demey responds that whether the Global Fund should widen its scope is a legitimate question. “It is up to our donors (both public and private) and our recipient countries—who are all represented on our board—to decide.” What is agreed is that country ownership of policy is crucial, as well as the involvement of civil society within country ownership. The energy and civil-society experience of HIV/AIDS programmes is now needed, says Fryatt, to spread more widely across the health sector.
Kelly Morris
Imported malaria in the UK The number of imported cases of malaria in the UK grew steadily from 1987 to 2006, according to the UK Health Protection Agency’s Malaria Reference Laboratory; an increasing proportion of these cases were attributable to Plasmodium falciparum rather than Plasmodium vivax. In an observational study, researchers looked at the origins of 39 300 cases of malaria diagnosed in the UK during the 20-year period. 20 488 cases occurred in UK travellers, rather than in visitors to the UK. People visiting friends and relatives accounted for 64·5% of these cases; travel to Nigeria and Ghana—neither common tourist destinations—accounted for half of all imported falciparum cases. The authors report that only 42% of UK travellers took malaria chemoprophylaxis and people visiting friends and relatives in their country of origin were less likely to report the use of prevention measures. “These data represent a public-health failing but also an opportunity. They show that health messages are not getting through to ethnic minority groups www.thelancet.com/infection Vol 8 August 2008
visiting friends and relatives, especially in west Africa”, the study’s authors Adrian Smith and colleagues said. Jane Zuckerman (Royal Free and University College Medical School, London, UK) commented: “Smith and colleagues report a significant decrease in imported cases of P vivax after travel to the Indian subcontinent, a result of successful vector eradication in many urban areas. Pursuing a similar policy in Africa may reduce the incidence of malaria in endemic areas, while also reducing the risk of malaria to travellers, all of which may negate the necessity for prophylaxis in the future”.
Polio in Nigeria With a new outbreak of type 1 wild poliovirus (WPV1) in northern Nigeria now spreading into neighbouring countries, there is concern that a potential international outbreak on the scale of the one that struck 20 countries between 2003 and 2006 will follow. Compared with the same period last year, there has been a ten-fold increase in the number of new cases caused by WPV1 in Nigeria during 2008.
Over the past months, polio from Nigeria has spread west to Benin, north to Niger, and east to Chad; the risk of further spread is heightened by the upcoming rainy season and the anticipated large-scale population movements for the Hajj pilgrimage later in 2008. The new outbreak of polio in Nigeria has occurred because more than 20% of children have not been immunised in key high-risk areas in the north of the country.
HIV/AIDS: a “global disaster” The HIV epidemic has been classified as a long-term and complex disaster by the International Federation of Red Cross and Red Crescent Societies (IFRC) in this year’s World Disasters Report, which usually focuses on natural disasters. “This year’s report is the first to focus on one condition and with good reason. For sub-Saharan African societies and for numerous marginalised groups, who are left to cope with death, disease, and destitution, HIV is undoubtedly a disaster”, said IFRC Secretary General Markku Niskala.
CDC/ Jim Gathany
Infectious disease surveillance update
For more on imported malaria in the UK see BMJ 2008; 337: a120; DOI:10.1136/bmj. a120 and BMJ 2008; 337: a135; DOI:10.1136/bmj.a135 For the wild poliovirus weekly update from the Global Polio Eradication Initiative see http:// www.polioeradication.org/ casecount.asp For more on the 2008 World Disasters Report see http:// www.ifrc.org/publicat/wdr2008/
Jennifer Horwood 469