Category: Health Care

Key Highlights

Note: This report aggregates price data and trends for two rounds—Round 48 (data collected between 7 and 11 February 2022) and Round 49 (data collected between 21 and 25 February 2022). For simplicity purposes, the aggregated rounds (Rounds 48 & 49) will simply be referred to as Round 49.

• Overall, household expenditure marginally increased during the month of February. The Survival Minimum Expenditure Basket (SMEB) modestly increased by 0.3 percent in urban areas; 1.9 percent in the rural Northern Region; and 0.8 percent in the rural Central Region, while the rural Southern Region registered a decrease in expenditure of 2.2 percent.

• The price of maize grain slightly eased by 2.0 percent from a national average of MK 199 per kg in January to MK 195 per kg in February. The provision of relief items—which was largely maize grain—to households affected by floods in districts in the Southern and some parts of the Central Regions have likely supressed the overall average market prices of maize in the country.

• The price of beans significantly increased by 5.9 percent from an average of MK 1,245 to MK 1,318 per kg. Cowpea and pigeon pea prices also noticeably rose by 6.0 percent and 9.4 percent, respectively, likely a result of low carryover stocks from the previous season coupled with anticipated poor production this year due to prolonged dry spells followed by flood damage.

Source: World Food Programme

RTS,S/AS01 (RTS,S) is the first vaccine recommended by WHO for use against a human parasitic disease of any kind. If introduced widely, it could save tens of thousands of lives each year. The Government of Malawi was the first to launch the vaccine in a landmark pilot programme in April 2019. In this Q&A, Dr Mike Chisema, Malawi Ministry of Health, reflects on the pilot experience and how coordination with the national malaria programme was a key factor for success.

Q: On 6 October 2021, WHO recommended the first malaria vaccine for children at risk. What were some of your first reactions?

This was an important decision, a time to celebrate and appreciate Malawi’s role in reaching this point, and what we’ve achieved as a country. The reaction in Malawi was very positive, and people welcomed the inclusion of the malaria vaccine as an additional instrument that can support progress toward malaria elimination, as it reduces illness and child deaths from malaria in endemic countries, including in high-burden ones like Malawi.

Q: What’s been most notable about Malawi’s experience with the RTS,S malaria vaccine to date?

The collaboration between the Expanded Programme on Immunization (EPI) and the National Malaria Control Programme (NMCP) during the pilot was a success, and that of the evaluation partners (led by the University of Malawi College of Medicine). Normally, as the EPI, we meet quarterly with technical working groups, bi-annually with the Malawi Immunization Technical Advisory Group (MITAG), and then we have some meetings with committees aligned to different vaccines. For the malaria vaccine, we were constantly in touch with the NMCP and other stakeholders and this helped us remain vibrant in our implementation.

The introduction of the malaria vaccine provided an opportunity to expand and diversify our approach to immunization delivery more broadly, as other routine immunization services were able to benefit from whatever was being done for the malaria vaccine pilot. Even the roll-out of COVID-19 vaccines benefited from these synergies.

Q: How did the routine immunization programme benefit from the pilot?

First, we were able to expand the country’s entire immunization supply chain. Sometimes you find that you can hardly get the vaccines to the people, perhaps due to lack of resources, but here we had an opportunity to improve our systems, and to make sure districts were not stocked out of any vaccines. We never had any stock outs of the malaria vaccine because there was massive communication with cluster facilities and districts. Second, regarding vaccine safety, the reporting of adverse events following immunization improved quite a lot, not just for the malaria vaccine but also for routine immunizations.

The pilots had an impact on the delivery of immunization trainings. We learned so much about how to provide education tools to health care workers, improve information, education and communication activities, as well as about risk communications and community engagement—and we’ve been able to apply all of these lessons learned to other routine immunizations.

Q: We hear about COVID-19 impeding progress against other diseases. How did the malaria vaccine experience support the roll-out of COVID-19 vaccines?

Overall, it’s about the support and knowledge we gained. WHO provided both technical and financial support, and in the course of doing that for the malaria vaccine, they also supported the COVID-19 vaccine roll-out, which was very powerful. We are very lean when it comes to human resources, and now we had this extra support for the delivery of the malaria vaccine pilot, as well as other vaccines.

The malaria vaccine pilot offered an opportunity to find new ways and means to get into the communities and mobilize them to demand the vaccine. That made it easier when COVID-19 vaccines were introduced.

Q: What lessons from the pilot would you share with other countries interested in the vaccine?

The burden of malaria is not just felt by health care providers, it’s also felt by communities. We have a role to play in providing communities with the information they need to make informed decisions about the vaccine. Countries should also recognize that there is likely to be high demand for this vaccine. In Malawi, we saw communities demanding the vaccine both where it was being provided, and in neighboring clusters, which was very good in terms of demonstrating the vaccine’s acceptability.

Countries will still need to go through the normal process of introducing a vaccine, and they should not take any shortcuts. Good ground preparation is very important: to make sure the vaccinators are informed, well trained and oriented. Countries need to make sure their supply chains and data systems are robust and in place, and that they are coordinating with relevant stakeholders – including the malaria control programme, the health education sector, people managing community engagement, influential and political leaders, and chiefs and traditional authorities. Countries should maximize every opportunity to provide the beneficiaries of the vaccine with details about the malaria vaccine and engage them in the process.

Q: What is level of interest in the vaccine and what are you hearing from national and local leaders and communities?

The reaction has been overwhelmingly positive, even before the WHO recommendation. If anything, people would have loved for this to happen earlier. When the recommendation was announced, for most leaders this is what they had been looking for. The big question now is how to manage the cost of the vaccine, how to secure funding, and how soon the vaccine can be available, knowing the anticipated global supply challenges.

Q: With the WHO recommendation and also Gavi funding for broader deployment, what happens next in Malawi?

We now have direction from the senior management at the Ministry of Health to expand introduction of the vaccine as financing for procurement of doses of vaccine becomes available. Next we will need to write proposals to Gavi and demonstrate how we will roll-out the vaccine. These are all questions we’re still trying to address.

We understand that the RTS, S supply will likely be constrained for some years. WHO is coordinating the development of a framework by expert advisers that will guide allocation of the limited vaccine doses. We appreciate the efforts of global and African partners to look for means to increase access, so we may reap the benefits of this life-saving vaccine.

Q: What additional support might Malawi need to integrate this vaccine into the national malaria control plan?

We still need strategies to target immunizations between 5, 6 and 7 months of age, knowing that most children will have received most other vaccines by then, and mothers might not have a reason to come back to the health facility. We need those strategies in place until mothers get used to it and it becomes routine. We will also need strategies to maximize and optimize vaccine uptake in the second year of life.

Source: World Health Organization

Southern Malawi has started recording a rise in cholera cases, which health authorities blame on flooding from a recent tropical storm and cyclone. More than 30 people have been infected and two have died. UNICEF is intervening to reduce the spread of the disease.

Malawi confirmed the first cholera case March 2 in the Machinga district.

Health authorities say the disease has so far hit the Nsanje and Machinga districts in southern Malawi with a cumulative number of cases now reaching 33. There have been two deaths as of Friday.

“Out of 33 cases, eight cases were still receiving treatment at the cholera treatment center, Ndamera treatment center specifically. We also have a cumulative number of two deaths. The rest were discharged,” said George Mbotwa, the spokesperson for the Nsanje District Health Office.

He says they have put in place measures to prevent and control the further spread of the disease such as surveillance and contact tracing.

“We are also doing health education; health talks in [evacuation] camps where there are a lot of people and of course in surrounding communities. We have also instituted health workers; HSAs (Health Surveillance Assistants) in all uncharted entry points where actually they are conducting health promotion in water treatment efforts, health talks and all that,” he said.

Cholera is an acute diarrheal infection caused by ingesting food or water contaminated with bacteria. The disease affects both children and adults if untreated and it can kill within hours. Cholera is more common during the rainy season.

Health authorities in Malawi say the disease is largely a result of floods caused by Tropical Storm Ana and Cyclone Gombe, which hit Malawi in the past two months.

Estere Tsoka, an emergency specialist for the U.N.’s children agency, UNICEF, in Malawi, told VOA that UNICEF is making several interventions to control the further spread of the disease.

“UNICEF is supporting the disinfection of household water sources and also chlorination of water sources at community level that got affected by the floods. UNICEF is also supporting sanitation of the cholera treatment centers that have been established so that they should not become a source of infection,” she said.

Tsoka also says plans are underway to procure a cholera vaccine.

“Also there are plans to administer oral cholera vaccine in eight districts of the country. And UNICEF is providing support to bring in the vaccines in the country and also supporting planning processes for the vaccine’s national campaign.”

Maziko Matemba, the national health ambassador in Malawi, says cholera can be prevented if community health structures are financially empowered to effectively perform their task of educating communities on matters of hygiene and sanitation particularly in flood-prone areas.

“Because we already know that we normally have cholera and also floods more especially in that part of Malawi because it’s a low-lying area and our rivers do burst when the rains come more than expected,” Matemba said.

The Ministry of Health said in a statement this week that it is distributing chlorine to communities in affected areas for water treatment as well as sending cholera control information to all the people there through various channels of communication.

Source: Voice of America

Highlights

• At least seven people have been killed and hundreds displaced by Tropical Cyclone Gombe, which has caused infrastructure damage and displacement in about ten districts, mainly in southern Malawi.

• On 2 March 2022, Malawi confirmed the first case of cholera at Machinga District Hospital. As of 17 March 2022, the outbreak has been reported in two districts registering 6 cases (1 Machinga, 5 Nsanje) and one death. 2,893 children (1531 girls 1362 boys) have benefited from nutrition screening during the reporting period bringing the total reach to 27,000.

• 3,300 children have been aided to access psychosocial support services by providing children’s corner kits.

A total of 255 villages across 5 Traditional Authorities (TA) and five health care facilities have been supported with safe water access through blanket disinfection of water sources as part of efforts to control the spread of cholera.

• 8,704 people have been reached with child protection and gender-based violence community awareness activities bringing the total reached with this intervention to 18,675.

Situation Overview

At least seven people have been killed and hundreds displaced by Tropical Storm Gombe, which has caused heavy damage mainly in southern Malawi. About 10 districts have been affected by this new flooding (Mulanje, Thyolo, Chiradzulu, Phalombe, Nsanje, Chikwawa, Mangochi, Zomba, and Machinga). The flooding comes as Malawi starts to recover from the effects of tropical storm Ana, which hit the country earlier, affecting more than 900,000 people in 17 of the country’s 28 districts. Reports from Mulanje district indicate that a police station, the local Revenue Authority Offices, and an immigration office at the Mozambique border were submerged and temporarily closed. The ChikwawaNsanje road was damaged once again, making Nsanje district inaccessible by road. In several districts, sites hosting displaced people affected by tropical storm Ana and other sporadic flooding events were submerged in water. The internally displaced people (IDPs) had to be evacuated. Meanwhile, the Department of Disaster Management Affairs (DoDMA) has directed all affected districts to conduct a rapid assessment from Wednesday, March 16 to Friday, March 18. Interagency rapid assessment teams have been deployed to provide technical assistance to the District Civil Protection Committees (DCPCs), assessing the damage in three districts (Nsanje, Phalombe and Mulanje) that the recent floods have severely hit.

Outbreak of Cholera was declared in Malawi on 2 March. As of 17 March 2022, the outbreak has been reported in two districts (1 case Machinga, 5 cases Nsanje). In addition, the health authorities in Malawi declared an outbreak of wild poliovirus type 1 after a case was detected in a young child in the capital Lilongwe. This is the first case of wild Poliovirus in Africa in more than five years. No other case has been reported.

Humanitarian Strategy

The multiple burdens of floods, COVID-19, Polio, and Cholera outbreaks require a unique and urgent response to prevent the current emergencies from having a severe further impact on the wellbeing of children. UNICEF is providing immediate lifesaving and life-sustaining assistance to populations affected by climate-related shocks and preventable disease outbreaks, while also investing in resilience-building interventions focused on system strengthening. Response to the floods focuses on the four worst-affected districts of Chikwawa, Nsanje, Phalombe, and Mulanje. UNICEF delivers the services through a multi-sectoral response in child protection, education, health, nutrition, social protection, and WASH, supported by social behaviour change communication and community engagement activities.

Source: UN Children’s Fund

Malawi has launched the first round of vaccination campaign against wild poliovirus type 1 using the bivalent Oral Polio Vaccine recommended by World Health Organization (WHO). The campaign is targeting 2.9 million children under 5 years in a four-round vaccination drive after Malawi declared an outbreak on 17 February—the first such case in the country in 30 years, and the first in Africa since the region was certified free of indigenous wild poliovirus in 2020.

More than 80 million doses will be administered to more than 23 million children under 5 years in the four-round vaccination drive in five southern African countries. The first phase of the campaign targets 9.4 million children in Malawi, Mozambique, Tanzania and Zambia. Three subsequent rounds—in which Zimbabwe will also take part—are set for April, June and July

Mass vaccinations, or supplementary vaccinations, aims to interrupt the circulation of poliovirus by immunizing every child under 5 years with oral polio vaccine regardless of previous immunization status. The objective is to reach children who are either not immunized, or only partially protected, and to boost immunity in those who have been immunized. Supplementary immunization is intended to complement—not replace—routine immunization.

“Polio is a highly infectious and an untreatable disease that can result in permanent paralysis. In support of Malawi and its neighbors, we are acting fast to halt this outbreak and extinguish the threat through effective vaccinations,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “The African region has already defeated wild poliovirus due to a monumental effort by countries. We have the know-how and are tirelessly working to ensure that every child lives and thrives in a continent free of polio.”

The Minister of Health, Honourable Khumbize Kandodo Chiponda, MP said: “The Ministry of Health with support from partners has put in place strategies for eradication of Polio in the country. Malawi will continue to sustain a good coverage of all its vaccine antigen above 80% to prevent and contain vaccine preventable diseases.”

“The High-level political support and leadership of the Govt of Malawi has inspired the nation, the global community as well as in-country partners to act in unison and halt the spread of Polio. I am very optimistic about this national campaign because of the level of commitment and organization I have seen.” In addition to ending polio, another legacy of this massive national effort must be that we strengthen our systems – to detect all epidemic prone diseases as well as deliver essential health services, including routine immunization,” said Dr Janet Kayita, Acting WHO Representative in Malawi.

UNICEF Representative, Rudolph Shwenk said “No child should die or suffer for life from a preventable disease. Our joint responsibility is to ensure that something as inexpensive, safe, effective and easy to deliver as vaccines – which have already saved hundreds of thousands of children worldwide – reaches those at greatest risk in Malawi.”

“The actions during the campaign this week and the subsequent vaccination campaigns over the next few months are critically important,” said CDC Country Director, Kelsey Mirkovi. “It is up to us to prove to the world that we can vaccinate every child under 5 years old and end this virus here in Malawi, and in all of Africa, once and for all.”

The African region was declared and certified as free of indigenous wild polio in August 2020 after eliminating all forms of wild poliovirus. The region’s certification as wild polio-free remains unchanged. Laboratory analysis linked the strain detected in Malawi to the one circulating in Pakistan’s Sindh Province in 2019.

WHO has been supporting the country to reinforce response measures including a risk assessment disease surveillance, and preparations for the vaccination campaigns. A surge team from WHO is working with country-based counterparts, partner organizations and the government to end the outbreak. The WHO team is part of a broader multi-partner Global Polio Eradication Initiative support to the country.

The country has also now set up environmental surveillance for polioviruses in 11 sites across four cities. They include 3 sites in Lilongwe District that encompasses the capital Lilongwe where the initial, and so far, only case, was detected. Other sites are in Blantyre, Mzuzu and Zomba cities. Teams are collecting samples from the environment and sending them for analysis to laboratories while active surveillance is also underway in health facilities and in communities.

Polio is a viral disease with no cure. It invades the nervous system and can cause total paralysis within hours, particularly among children under 5 years. The virus is transmitted from person to person mainly through contamination hands, water or food by faecal matter. While there is no cure for polio, the disease can be prevented through administration of a safe, simple and effective vaccine

Source: World Health Organization

Malawi has rolled out a polio vaccination campaign targeting more than 2.9 million children aged 0-5 across the country.

Minister of Health Khumbize Kandodo Chiponda on Sunday officially unveiled the campaign here in the capital, saying the campaign will be carried out in four phases from March up to July, using a door-to-door strategy.

According to the minister, Malawi received 6.8 million doses of oral polio vaccine from GAVI Alliance on March 5 for two rounds of the campaign and the doses have already been distributed to all the districts in readiness for the polio vaccination campaign.

She added that Malawi is also working very closely with neighboring countries to monitor the disease.

In February, Malawi declared polio as a public health emergency after the Global Polio Laboratory Network confirmed in Lilongwe one case of type-1 wild poliovirus (WPV1), which is genetically linked to the WPV1 detected in Pakistan’s Sindh Province in October 2019.

The last polio case in Malawi was reported in 1992 and the country obtained a polio free status in 2005.

Source: Nam News Network