Civil society in Sierra Leone are once again calling on the Government of Sierra Leone to increase sensitization of Ebola awareness campaigns in the country after confirm cases of the virus in Guinea.
Shiekh Tamba Jusu, the chairman of the Kombra Network in iKailahun district, east of Sierra Leone, said massive sensitization is needed to prevent the spillover of Ebola into the country.
Jusu said the authorities must pay attention to public awareness raisng as part of Sierra Leone’s community engagement efforts in response to the threat of the Ebola epidemic across the border.
“Massive sensitization is what we are asking local authorities to give us support for, and we want them to consider particularly religious leaders to preach to the people through sermons, which is an effective way of appealing to people,” Jusu told KMN.
The Guinean government last week confirmed the outbreak of the Ebola Virus Disease (EVD), after four people reportedly died after exhibiting symptoms akin to the hemorrhagic fever disease.
As of Thursday, February 17, reports indicated that the death toll had increased to five, as health authorities struggle to prevent wide spread transmission.
The World Health organization has issued an alert to six countries neighboring Guinea, which are said to be at high risk of transmission of the virus in the event the epidemic gets out of hand. These countries include Guinea’s MRU neighbors – Sierra Leone, Liberia and Cote d’Ivoire, as well as Senegal and Guinea Bissau.
The latest Ebola outbreak in Guinea comes nearly five years after the end of the 2014-2016 West African Ebola epidemic, which also began in Guinea and spread to nine other countries across the world, including Liberia and Sierra Leone. The three MRU countries were the worst affected, as they accounted for most of the cases (nearly 30, 000) and fatalities (over 11, 000).
The 2014 outbreak entered Sierra Leone through Kailahun, which is close to Guinea’s Forest Region. According to local authorities, there are multiple illegal border crossing points between the two countries at that end. And this, says Mr Jusus, is a major concern.
However, Sierra Leone and Guinea have agreed on opening their borders.
Jusus says the reopening of the border has made the job more complicated and requiring more attention to control movement across the borders.
“Strategies are there in place, but we still see the border issue as unfortunate,” he said.
He added: “We cannot do anything about it because it is an agreement between the leaders… but that has increased the work on us, because we have a lot of porous borders. At the moment the Moa River is such that people can even cross it by foot.”
The angry group of boys is defiant, claiming the victim was not suffering from Ebola. He was an older man in his 70s and was recently ill, and the boys, wary of the spates of deaths and the information they are getting about the burial processes of Ebola victims, are angry and desperate.
“We will bury our dead! We will bury our dead!” they shouted.
The police stood perplexed at the angry youths while the members of the burial team waited in the vehicle. The boys are still blocking the road when another group, holding the body in a stretcher, walked through the space provided by the others, and faced the police.
One of the police officers, still maintaining a distance from the boys, informed them it’s for their good that they are advising them to adhere to medical advice.
“We are not doing this to disrespect the dead. We are all in this trouble, and we are all losing loved ones. Show reason and protect yourselves,” the officer continued. “It is important for the body to get tested for Ebola. If it is negative, we will return the body to you”.
Some bystanders standing far off and listening to the police shouted at the boys to let go of the body. Some of the boys are defiant, but noticing that few others have started leaving, the four boys holding the stretcher placed the body on the ground and also left.
An independent monitoring board has recommends the early termination of Ebola Therapeutics Trial in DRC Because of Favorable Results with Two of Four Candidates.
The
Pamoja Tulinde Maisha (PALM [together save lives]) study is a randomized,
controlled trial of four investigational agents (ZMapp, remdesivir, mAb114 and
REGN-EB3) for the treatment of patients with Ebola virus disease.
The
study began on November 20, 2018 in the Democratic Republic of the Congo (DRC)
as part of the emergency response to an ongoing Ebola outbreak in the North
Kivu and Ituri Provinces.
The
trial which enrolled 681 patients toward an enrollment total of 725 started in
August 9, 2019. Patients were enrolled at four Ebola Treatment Centers (ETCs)
in Beni, Katwa, Butembo and Mangina and the trial was overseen by staff from
the Institut National de Recherche Biomédicale (INRB); the DRC Ministry of
Health; and three medical humanitarian organizations: the Alliance for
International Medical Action (ALIMA), the International Medical Corps (IMC),
and Médecins Sans Frontières (MSF).
The trial is monitored by an independent Data and Safety Monitoring Board (DSMB) that meets periodically to review interim safety and efficacy data and to make recommendations to the study team and the sponsors.
As a result of their August 9, 2019 review, the DSMB recommended that the study be stopped and that all future patients be randomized to receive either REGN-EB3 or mAb114 in what is being considered an extension phase of the study.
This recommendation was based on the fact that an early stopping criterion in the protocol had been met by one of the products, REGN-EB3. The preliminary results in 499 study participants indicated that those individuals receiving REGN-EB3 or mAb114 had a greater chance of survival compared to those participants in the other two arms.
The
principal investigators of the study, its statistician and its co-sponsors
accepted this recommendation, and the ETC staff at the sites were promptly
informed. In addition to limiting future patient randomizations to REGN-EB3 and
mAb114, patients who were randomized to ZMapp or remdesivir in the last 10 days
now have the option, at the discretion of their treating physician, to receive
either REGN-EB3 or mAb114.
According to the US National Institute of Allergy and Infectious Diseases (NIAID), while the final analysis of the data can occur only after all the data are generated and collected (likely late September/early October 2019), the DSMB and the study leadership felt the preliminary analysis of the existing data was compelling enough to recommend and implement these changes in the trial immediately.
NIAD
states the complete results will be submitted for publication in the
peer-reviewed medical literature as soon as possible.
The
study is co-sponsored and funded by the INRB and the National Institute of
Allergy and Infectious Diseases (NIAID) of the U.S. National Institutes of
Health; carried out by an international research consortium coordinated by the
World Health Organization (WHO); and supported by four pharmaceutical companies
(MappBio, Gilead, Regeneron, and Ridgeback Biotherapeutics).
Now in its tenth month, the Ebola epidemic in the Democratic Republic of the Congo (DRC) has claimed more than a thousand lives, prompting Secretary-General António Guterres to throw the support of “the whole United Nations system” into stemming the spread of the deadly virus.
International Federation of Red Cross and Red Crescent Societies: Clinic in Mbandaka, Democratic Republic of the Congo, where health care workers treat Ebola patients.
Mr. Guterres expressed concern over the number of new Ebola cases in the east of the DRC on Wednesday, reiterating UN support “for efforts to end the outbreak”.
“With important shifts in the response now being implemented, the Secretary-General has emphasized his commitment to a collective UN-wide approach, both in Kinshasa, where the UN is led by his special representative, and in the areas affected by the virus, where the response is led by WHO [World Health Organization], all in close liaison with Congolese leaders both in Kinshasa and eastern DRC”, said his Deputy Spokesperson, Farhan Haq, in a statement on behalf of the UN chief.
Mr. Guterres expressed his condolences to the victims’ families and reiterated that the full involvement and engagement of local people “remains the key to successfully controlling the outbreak”.
He also urged “all Congolese leaders to work together across parties and across communities to tackle the outbreak”.
“At this critical juncture”, Mr. Guterres underscored the need for “additional resources” and called on Member States and partner organizations “to ensure the responding agencies have the resources needed to succeed”.
The Secretary-General commended the Government, institutions and Congolese people themselves on the overall response so far, which has contained the outbreak to within parts of two provinces, which are home to multiple armed groups, which have been battling each other and Government forces for years.
He also applauded “the bravery of security, health and humanitarian workers who have put their lives on the line in a challenging environment marked by conflict and insecurity”, including attacks on Ebola Treatment Centres and healthcare facilities and recognized their work in vaccinating more than 100,000 people and saving the lives of hundreds who have contracted the disease.
A World Health Organization (WHO) worker prepares to administer a vaccination during the launch of a campaign aimed at beating an outbreak of Ebola in the port city of Mbandaka, Democratic Republic of Congo May 21, 2018. REUTERS/Kenny Katombe
Meanwhile, amidst continuing violence, WHO experts (SAGE) have recommended new Ebola Vaccination Guidelines to address the challenges in stemming the virus.
Since the outbreak was declared in August 2018, WHO has said that despite the use of a highly efficacious vaccine, the number of new cases continues to rise, in part due to repeated violence, which has prevented response teams from immediately identifying and creating vaccination rings around all people at risk of contracting Ebola.
“We know that vaccination is saving lives in this outbreak,” said WHO Director-General Tedros Adhanom Ghebreyesus, but “we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible”.
“These recommendations account for ongoing insecurity and incorporate feedback from experts and from the affected communities that will help us continue to adapt the response”, he affirmed.
Among other things, new SAGE recommendations endorse pop-up and targeted geographic vaccination approaches, when appropriate; advise vaccinating the next level of people who may be exposed, such as in neighborhoods where cases have been reported within the past 21 days; and adjusting the current dose to ensure that the vaccine continues to be available to those at greatest risk of Ebola.
The eroding sea-face wall is a concern for the people of Bonthe
In January 2015, during the Ebola outbreak, I arrived in Bonthe Sherbro Island, Southern Sierra Leone, leading a team of young reporters covering districts that were recording 42 days without any Ebola case. Bonthe District was the only district that did not record a single Ebola case throughout the deadly outbreak. But the once powerful Island was suffering from a much more severe man-made disease relating to political neglect, rejection and dejection. The frustration of the almost 10,000 inhabitants was summed by their exuberant Mayor Layemin Joe Sandi in his call for an ‘urgent Cabinet decision’ to rescue Bonthe District from its predicament (see: http://slconcordtimes.com/the-cry-of-bonthe/).
Four years later, I traveled to Bonthe with NGO SEND Sierra Leone to officially launch a project for safe drinking water for 50 remote communities in the Sherbro Islands of Dema and Sittia chiefdoms. Now that there’s a new President of Sierra Leone who happens to hail from Bonthe District, I ask Mayor Sandi what is the mood in the island and what has changed in the essential areas of political administration, education, health, economy, security and sports.
Politically
At
the moment the District Officer who used to be at the Mattru Jong chiefdom has
relocated. We have started interfacing with the different organizations in
communities and this is laudable and encouraging.
In
terms of hearing our voice and central government hearing our plans, it has
changed. Now we go to offices, they listen and attend to us positively; for
example, the Ministry of Works and the Sierra Leone Roads Authority. When we
take the concern of the sea face wall, in-township road project on the poor way
it was done, they have changed the entire concept. They are doing a different
work in terms of the topography we have. As I am talking to you know, the sea
face wall and in-township road projects are ongoing but the only challenge we
have at the moment is the landing of materials because it is a riverine area.
This is slowing down the implementation and our fear now is whether they are
going to complete the projects on time if this challenge continues.
The
Ministry of Social welfare is equally doing well for us in the delivery of
services from the Council.
We
want to take good advantage of the current political will and fix the issues
affecting Bonthe as the District Headquarter Town.
Education
Bonthe
is a fine place to promote education. Council has launched the Free Quality
Education Program (FQEP) and the support is coming from the government. Books
have been distributed to schools but more is yet to be actualized. Schools that
are supposed to receive subsidies are getting that but our biggest challenge is
that the school buildings are colonial in nature.
But
if the scheme is to succeed, then government should pay more attention to
teachers and also infrastructure because when a child has a comfortable
environment to learn, then he/she will learn faster.
The
greatest challenge in the Sherbro Island has been water and the water we are
drinking has a lot of salt in it. The water resembles clay. There is no school
with WASH facilities not to talk about good toilet. We are advocating to the
Ministry to provide us with wells to solve the problem of water.
Health
We
have been doing well in the area of health and Council has been collaborating
effectively with CUAMM (Doctors with
Africa) Sierra Leone because their response in the hospital is great as
they have strengthened it with a blood bank, solar lights, funds for fuel and
lubricants which complements our efforts and ensure that things are working in
the hospital.
They
are also providing referral services for pregnant women and that has reduced
maternal mortality in the municipality. As a Council, we are ensuring that if
the organization is doing all of these, we make sure that food is in the
hospital throughout. Also, we have ensured that we provide essential drugs that
are not in the hospital free-of-cost for especially pregnant women, children
under-five and the aged.
Council
is also providing support to the doctors. I was reliably informed that
government has been paying housing allowances for doctors but nothing has been
working in that direction. Interestingly, Council has been paying for housing
for doctors.
Also,
we will start providing tea and other incentives for nurses, especially those
who are not on salary, who stay late at night with pregnant women so that they
will be motivated to do more.
The
monthly cleaning introduced by President Maada Bio has made Bonthe one of the
cleanest places in the country. Council is engaging 1,100 youths with all of
them receiving Le40,000 each. A total of Le44, 000,000 is being injected every
first Saturday into the community.
Council
has further purchased cleaning tools and motorbikes for monitoring during the
cleaning exercise. We ensure the
total involvement of all 18 Sectional Heads to add up to the team of Council
Staff and Councilors who ably supervise the monthly cleaning exercise. Six
million Leones for coordination is used to motivate them and fuel provided for
bikes to facilitate the monitoring process.
Additionally,
Council and the people of Bonthe Sherbro Island are happy and grateful to the
ngo SEND Sierra Leone and their donors for their just-launched project which
seeks to ensure our people have clean drinking water and other WASH facilities.
Electricity
The
solar street lights have outlived their usefulness but we have been able to
attract 200 modernized street lights, although we actually need more.
Economic
opportunities
At
the moment, economic activity is very poor which is why we are advocating for
us to go into tourism because we believe that we can turn around the economy.
Because of the low income earners we have in the district, we have low quality
and substandard goods in the market. The fish processing sites we have are
still not been utilized. We are working with the Fisheries ministry to ensure
that they are fully operationalized.
Honestly,
the economy of Bonthe is nothing to write home about and having infrastructure
in place is a basic requirement in tourism.
Our
sources of revenue are taxes, house rates and market dues but to get the people
to honour these obligations is a huge challenge for Council. If we want to
implement the law to the letter, then it will be a problem. The population size
of Bonthe is almost about 10,000.
We
want Dema and Sittia to be part of Bonthe. We are being faced with the
actualities of the day and Council should be able to generate its own revenue
to sustain it.
Sports
In
the area of sports, we have been collaborating with SLADEA and their Bread for
the World project has constructed a perimeter fence around the football
field. It has been there for a while with no one to assist us. We have taken
the issue to the Sport ministry and they have pledged to work collaboratively
with Council to have a mini stadium with a football field.
Security
We
are still deprived in the area of security. The police barracks is still here
empty, with no police officers. At the moment, we only have 10 police officers
to man the entire municipality and the entire Sherbro islands of Dema and
Sittia. We are expecting the police to have their presence everywhere to ensure
control of crime.
Challenges
We
have challenges with other institutions but what is stressing the Council so
much is staffing. Staffs are sent to us on punishment grounds. We have let the
local government service commission know that if they send any staff now on
punishment grounds, we will reject them out rightly. We think transfer should
be fairly done and staff should not be made aware that they are being
transferred to far away Bonthe on punishment grounds as they will not give
their best. Every staff in the local council family should be given a fair
opportunity to taste of every environment in this country and not special staff
for special councils. Some of them who are currently here on punishment come in
some time once a week and that undermines the operation of the Council as well
as service delivery and writing of reports. We see it as a disservice to the Council
and the country as a whole.
Credit:
Development and Economic Journalists Association (DEJA-SL).
Despite promising advances, important scientific questions remain unanswered in the effort to develop a safe and effective Ebola vaccine, according to members of an international Ebola research consortium.
April 3, 2017: Study volunteer receives an inoculation at Redemption Hospital in Monrovia, Liberia on the opening day of PREVAC, a Phase 2 Ebola vaccine trial in West Africa. NIAID
In a Viewpoint published in The Lancet, the experts review the current field of Ebola vaccine candidates and clinical trials and highlight key gaps in knowledge that need to be addressed by future research.
Researchers at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, are among the Viewpoint’s authors. All authors are with the Partnership for Research on Ebola VACcination (PREVAC). In addition to NIAID, the partnership, established in 2017, comprises experts from the French National Institute of Health and Medical Research (Inserm), the London School of Hygiene & Tropical Medicine (LSHTM), the West African Clinical Research Consortium and their collaborators. PREVAC is currently conducting a Phase 2 clinical trial in Guinea, Liberia, Sierra Leone and Mali to evaluate three Ebola vaccination strategies in people one year and older.
Ebola virus disease remains a public health threat — the Democratic Republic of the Congo (DRC) already has experienced two Ebola outbreaks in 2018 — underscoring the need for continued efforts to develop an effective vaccine. The authors note that 36 trials of Ebola vaccine candidates have been completed and another 14 are active, according to clinicaltrials.gov. The rVSV-ZEBOV experimental vaccine, which has been deployed in the DRC, is the only candidate with some clinical efficacy data, which were obtained in a clinical trial in Guinea conducted during the 2014-2016 Ebola outbreak in Guinea.
After reviewing the status of four additional vaccine candidates under study (Ad26.ZEBOV, MVA-BN-Filo, chAd3-EBO-Z, and the GamEvac-Combi vaccine), the authors highlight areas where more research is required. Specifically, they note the need for more data in pregnant women, children and immunocompromised populations, including people infected with HIV and the elderly. Additionally, they say more research is needed on the durability and rapidity of immune responses generated by various vaccine approaches. The experts also call for studies to identify reliable correlates of protection (the specific and measurable part of an immune response that would indicate a person is protected from Ebola) as well as large-scale trials to fully evaluate the safety and efficacy of experimental vaccines.
The authors conclude by underscoring the value of embedding social science research in clinical trial design to help build trust and engagement with the affected communities. They note that in addition to the need to investigate various vaccines and vaccination strategies to respond more effectively to future outbreaks, improving the global capacity to conduct clinical research and forming collaborative partnerships, such as PREVAC, are crucial for success.
The African Union (AU) Commission, through the Africa CDC, will procure six laboratory diagnostic (Genexpert) machines and 2,000 cartridges (testing kits) for a total of US$ 147,000 to be donated to the Government to support diagnosis of Ebola virus diseases and other outbreak diseases.
Moussa Faki Mahamat, commends the Congolese Government for its swift and effective response
This comes following official announcement by the Government of the Democratic Republic of the Congo, on 24 July 2018, of the end of the Ebola virus outbreak in the country.
The Chairperson of the Commission of the African Union, Moussa Faki Mahamat, commended the Congolese Government for its swift and effective response since the outbreak was declared on 8 May 2018 in the province of Equateur.
The last case that tested negative was 42 days ago. This, as per the World Health Organization guidelines and International Health Regulations, marks the end of the outbreak.
The Chairperson of the Commission notes that the timely declaration of the outbreak, in accordance with the International Health Regulations, as well as the leadership and pro-activeness demonstrated by the Congolese Government, allowed a coordinated and efficient intervention of all concerned partners to swiftly contain the outbreak.
“The African Union Commission, through the Africa Centers for Disease Control and Prevention (Africa CDC), has made a significant contribution to the efforts aimed at containing the outbreak, in support of the Congolese-led response. The Africa CDC deployed health personnel in the affected areas, trained more than 300 local experts, procured diagnostic equipment, and supported the DRC Ministry of Health in central coordination of the response at national level,” he noted, adding that the African Union will continue to support the efforts of the Congolese Government during the 90-day period of enhanced surveillance following the official end of the Ebola outbreak.
The Ministry of Health of the Democratic Republic of Congo (DRC) declared the end of the Ebola Virus Disease (EVD) outbreak in Equateur province on 24 July 2018, after sustained national-led efforts to contain it within the affected areas.
The outbreak spread across three health zones, namely Bikoro, Iboko and Wangata in the Equateur Province, resulting in a total of 54 confirmed cases, with 33 EVD-related deaths.
On 8 May 2018, the Ministry of Health of the DRC declared a new outbreak of the EVD in the Bikoro health zone. This was the 9th outbreak of EVD over the past four decades in the country.
Following the declaration of the outbreak, the African Union (AU) Commission, through the Africa Centre for Disease Control and Prevention (Africa CDC), took a number of steps to contribute to the Government-led response, including the activation of its Emergency Operational Centre (EOC) to monitor and coordinate the AU response from the Headquarters; deployment of an advanced team of two epidemiologists within 48 hours following the outbreak, to support the Congolese Government efforts; and deployment of 37 staff both at Headquarters and to the field, including 21 surveillance experts in the affected health zones, as part of the Government-led response.
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