25 April 2009 — In this episode, as we mark World Malaria Day on 25 April, we look at what needs to be done in all endemic regions to control, eliminate and ultimately eradicate malaria.

Listen to this episode – duration 00:06:40 [mp3 3.8Mb]

Transcript of the podcast

Veronica Riemer: In this episode, as we mark World Malaria Day on 25 April, we look at what needs to be done in all endemic regions to control, eliminate and ultimately eradicate malaria.

Dr Awa Marie Coll-Seck, Executive Director of the Roll Back Malaria Partnership hosted by WHO tells us why we should all be concerned.

Dr Awa Marie Coll-Seck: Malaria kills 3000 children a day, slows down economic development and keeps people poor. Malaria concerns everyone because its impact is truly global. It devastates families and communities in 109 countries around the world. Because it is transmitted by mosquitoes which do not respect national borders, the disease can be imported in countries that are currently malaria-free.

Veronica Riemer: Dr Coll-Seck talks about those people most at risk.

Dr Awa Marie Coll-Seck: The main victims of malaria are very young children and pregnant women. When it doesn’t kill, the disease impairs a child’s learning ability. It prevents the young generation from getting good education and access to better economic opportunities in the future.

Veronica Riemer: 3.3 billion people, or nearly half of the world’s population, is at risk of malaria and almost 1 million people die from this disease each year. And yet malaria is easy to prevent and treat. One particular success story comes from Zambia. Elizabeth Chizema-Kawesha, Zambia’s Malaria Control Manager, tells us more.

Elizabeth Chizema-Kawesha: For a long time now malaria has been the number one cause of attendance to hospitals both as outpatients and inpatients. It has also been the leading cause of death in our institutions as well as those that die from home. But with the interventions that we have put in and in addition to the ambitious goals that Zambia set itself in partnership with the National Malaria Control Programme, we have been able to adopt cost effective interventions, and we are now beginning to see a remarkable reduction in both severe malaria cases as well as deaths. From the recent review we have recently conducted we observed that the number of deaths have reduced by over 66%.

Veronica Riemer: Dr Mac Otten, Coordinator for Surveillance, Monitoring and Evaluation at the Global Malaria Programme, at the World Health Organization tells us how this has been achieved.

Dr Mac Otten: One of the reasons it appears, for the success in Zambia, the 66% reduction in deaths, is because they targeted bednets to their entire population, not just the very very high risk children and pregnant women. In Zambia they delivered two to three nets for every household, so that everybody was covered, so there was enough killing power so to speak from having two or three nets in the house and not only protected those who were not sleeping under the net but also even neighbours who didn’t have a net. This is especially important we think in very high transmission countries, especially in western-central Africa. Zambia, around 2006/2007 started this process of targeting everybody and that is one reason why in the last two years they have had this enormous drop in malaria specific mortality.

Veronica Riemer: In addition to providing bednets to its entire population, two other methods of controlling the transmission have also been effective.

Dr Mac Otten: The second is effective malarial treatment and that is mostly now new anti malarial drug called artemisin combination therapy. The third is spraying insecticide on the walls of houses with the same principle as the nets. The mosquitos come into the house and they land on the walls and they pick up insecticide and are killed. So those are the three main interventions that countries are using to reduce malaria deaths.

Veronica Riemer: Grants worth US$ 120 million from the Global Fund as well as support from partners including the President’s Malaria Initiative, the Malaria Control and Evaluation Partnership in Africa and the World Bank have made this success possible. Zambia’s efforts will be promoted as a model for other countries to follow on the occasion of World Malaria Day, on 25 April.

Elizabeth Chizema-Kawesha: It is important that they draw lessons from the scale up of the malaria control programmes in Zambia. When we started we did not have adequate resources and therefore we were able to provide resources where it was most needed. For instance the insecticide treated bednets were targeted at the rural areas where it was not feasible to spray, and the spraying on the walls with the chemicals that actually killed the mosquitoes were then targeted to more urban areas where households were very close together. When you have ambitious goals you will set out your own targets, you begin to look for resources so that you can meet those targets.

Veronica Riemer: That was from Elizabeth Chizema-Kawesha from Zambia’s National Malaria Control Programme. If you would like to learn more about this subject, there are links to related information on the transcript page of this podcast episode. Look for the link to the podcast on the home page of our web site, at www.who.int.

That’s all for this episode of the WHO podcast. Thanks for listening.

If you have any comments on our podcast or have any suggestions for future health topics drop us a line. Our email address is Podcast@who.int.

For the World Health Organization, this is Veronica Riemer in Geneva.

21 April 2009 — Meningitis is an infection of the meninges, the thin lining that surrounds the brain and the spinal cord. It is epidemic prone, and this episode discusses the transmission of the disease and its symptoms.

Listen to this episode – duration 00:04:44 [mp3 2.7Mb]

Transcript of the podcast

Ashok Moloo: You’re listening to the WHO podcast, and my name is Ashok Moloo. An epidemic of meningitis is currently sweeping through sub-Saharan Africa. We talk to experts about the disease and find out how the epidemic is being fought.

Meningitis is an infection of the meninges, the thin lining that surrounds the brain and the spinal cord. Different bacteria can cause meningitis. Dr Stephane Hugonnet from WHO’s Epidemic Readiness and Interventions Department tell us how the disease gets transmitted and the symptoms.

Dr Stephane Hugonnet: You catch meningitis through droplets that are emitted by a patient when he is talking, he is coughing or when he is sneezing. There are some situations where transmission can be facilitated, for instance when you sleep in the same room as the patient, or spend a long time with him, at home and using the same knives, forks, plates and living in the same compounds.

Ashok Moloo: The bacteria can be carried in the pharynx and sometimes overwhelm the body’s defences allowing infection to spread through the bloodstream and to the brain and meninges. The symptoms can be severe and deadly.

Dr Stephane Hugonnet: The disease will start with abrupt onset of temperature, headaches, stiff neck, vomiting. In very severe cases the patient can be in coma and eventually die. Meningitis is an extremely serious disease, and even with appropriate treatment up to 10% of the patients can die and unfortunately among the survivors about 20% can have definitive sequelae such as deafness or brain damages. Hopefully, there is a good treatment and there are several antibiotics that can be used to treat meningitis.

Ashok Moloo: Meningitis is a yearly occurrence in sub-Saharan Africa, in an area known as the “Meningitis Belt”. This area stretches from Senegal in the west to Ethiopia in the east, an area with a population of 300 million people. The epidemic peaks during the dry season, between December and June. This year, Nigeria, Niger and Chad are particularly badly affected.

Timely immunization in epidemic areas can prevent 70% of cases. Since January this year, more than 4 million doses of vaccines have been distributed in Nigeria for mass immunization. But do we have enough vaccines to respond to the epidemic in Niger and Chad? William Perrea from WHO’s Epidemic and Pandemic Alert and Response department explains the situation.

William Perrea: For the time being yes, we have, thanks to the support of GAVI (Global Alliance for Vaccines and Immunization) and ECHO (European Commission Humanitiarian Aid Office) we have been able to establish an emergency stockpile that is today up to 10 million doses. However, taking into account the size of the Nigerian population, and knowing that other countries like Sudan maybe affected as well this year, we know that this vaccine may not be enough. We are working with the manufacturers to try to increase the availability of vaccine for the rest of the epidemic season and for the next epidemic seasons to come. But we have to understand that the situation is delicate. If the situation becomes more serious, we may be facing shortages of vaccine.

Ashok Moloo: That was William Perrea from WHO. If you would like to learn more about this subject, there are links to related information on the transcript page of this podcast episode. Look for the link to the podcast on the home page of the web site, at www.who.int.

That’s all for this episode of the WHO podcast. Thanks for listening.

If you have any comments on our podcast or have any suggestions for future health topics drop us a line. Our email address is Podcast@who.int.

For the World Health Organization, this is Ashok Moloo in Geneva.

7 April 2009 — WHO has launched a campaign to make hospitals and other health facilities safe in emergencies. In this episode, we examine what the issue is.

Listen to this episode – duration 00:04:55 [mp3 2.8Mb]

Transcript of the podcast

Akunda Pallangyo: You’re listening to the WHO podcast, and my name is Akunda Pallangyo. On World Health Day today, WHO has launched a campaign to make hospitals and other health facilities safe in emergencies. In this episode, we examine what the issue is.

Dr Bushra Shams: We don’t have a set-up, no record, laboratory, no drugs. So we need to work from the very beginning, from the very scratch, first thing.

Akunda Pallangyo: That is Dr Bushra Shams, a TB control officer from Pakistan, talking about the damage that the earthquake caused to health facilities in 2005. Natural disasters, conflicts, outbreaks and other emergencies inflict deadly damage not just on communities but hospitals, clinics and their staff that are meant to provide health care to the public. WHO has launched a campaign – starting on World Health Day on the 7th of April – to make health facilities safe for emergencies. WHO Director-General Dr Margaret Chan highlighted the issue at the global launch of World Health Day in the Chinese capital of Beijing.

Dr Margaret Chan: A safe hospital is one that is able to withstand emergencies, withstand floods, earthquakes and strong wind and continue to provide appropriate life-saving functions, to protect people, to save life and limbs, to reduce the suffering of people, from disasters.

Akunda Pallangyo: Emergencies in 2008 affected 211 million people worldwide and killed almost a quarter of a million. Health facilities also suffered. In China, 11 000 health facilities were damaged or destroyed in the 2008 earthquake. More than half of the 16 000 hospitals in Latin America and the Caribbean are in areas at high risk for disasters.

Dr Margaret Chan: To commemorate World Health Day this year, WHO is advocating a series of best practices that can be implemented, in any resource setting, to make hospitals safe during emergencies. Apart from choosing a safe location for building health facilities and providing resilient construction, good planning and carrying out emergency exercises in advance can help maintain critical functions.

Akunda Pallangyo: In some countries, up to 80% of the health budget is spent on building hospitals and other health facilities. Rebuilding a hospital that has been destroyed virtually doubles the initial cost. Yet it costs little to make existing hospitals resilient to extreme events.

Dr Margaret Chan: Experience in Latin America and the Caribbean shows that retrofitting a structurally sound facility will cost no more than 1% of the hospital’s budget, but will protect up to 90% of that investment.

Akunda Pallangyo: Health facilities are vulnerable to other emergencies too. Armed conflicts often target health services and cut access to care, as does poor preparation for disease outbreaks. Underinvestment, poor planning and construction and the absence of emergency planning as well as training, prevent health facilities from doing their life-saving work. International film star Jet Li is going to advocate this issue as a WHO Goodwill Ambassador. He shared his ideas at the event in Beijing.

Jet Li: Today is a very special day in Beijing, my first day working. I am so happy. I want to share my belief to everybody in the world: I always think the world becomes one family. We need to help each other, work together. Health is very important.

Akunda Pallangyo: If you would like to learn more about this subject, there are links on the transcript page of this episode. Look for the link to the podcast on the home page of the web site, at www.who.int

That’s all for this episode of the WHO podcast. Thanks for listening.

If you have any comments on our podcast or have any suggestions for future health topics drop us a line. Our email address is Podcast@who.int.

For the World Health Organization, this is Akunda Pallangyo in Geneva.