WHO and Angolan health officials on a mission to stamp out Guinea worm disease Credit: WHO/Omotola Akindipe
Contributions to WHO are being used to free communities from a range of dangerous infectious diseases. Some, like malaria, kill mainly children. Others, like the disfiguring Guinea worm and noma infections, are linked to poor access to clean water and other aspects of poverty.
This week, see stories about how contributions have been translated into action in Cabo Verde, where years of persistent effort have eliminated malaria; in Panama, where community collaborators are filling a health-services gap in hard-to-reach villages; and in Paraguay, where teams are going from one neighborhood to the next, removing the breeding grounds of the mosquitoes that transmit dengue fever.
Read also about work under way in Angola to eradicate Guinea worm disease, Cameroon’s significant progress in reducing HIV, success against hepatitis B in Maldives and Sri Lanka, and fighting back against cholera outbreaks in Zambia and Zimbabwe.
Cabo Verde is a now malaria-free country
WHO Director-General Dr Tedros Adhanom Ghebreyesus meets with health workers during a visit to Santa Cruz Health Centre, Santiago, Cabo Verde, on 11 January 2024. Credit: WHO/JacsSpoor
WHO has certified Cabo Verde as malaria free, marking a significant achievement in global health. Cabo Verde joins the ranks of 43 countries and one territory in receiving the certification.
Cabo Verde is the third country to be certified in the WHO African region, joining Mauritius, which was certified in 1973, and Algeria, in 2019. In 2021, 95% of the world’s malaria cases and 96% of malaria-related deaths occurred on the African continent.
“I salute the government and people of Cabo Verde for their unwavering commitment and resilience in their journey to eliminating malaria,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said on a January visit to the country. “WHO’s certification of Cabo Verde being malaria-free is testament to the power of strategic public health planning, collaboration, and sustained effort to protect and promote health. Cabo Verde's success is the latest in the global fight against malaria, and gives us hope that with existing tools, as well as new ones including vaccines, we can dare to dream of a malaria-free world.”
Also see: WHO prequalifies a second malaria vaccine, a significant milestone in prevention of the disease
In Panama, community collaborators work on the frontlines of malaria elimination
Rio Cañas, above, is one of many remote villages in Panama where malaria is present but there is no nearby health facility to cope with it. WHO-trained “community collaborators” are filling the gap. Credit: PAHO
Specially trained members of indigenous communities are proving indispensable in helping Panama respond to malaria. “Colcoms,” as they are called, travel to hard-to-reach places where health care is unavailable to provide malaria diagnosis and treatment.
This story and video from the Pan American Health Organization (PAHO) describe an outreach trip to the hamlet of Rio Cañas. The colcoms traveled five hours on precarious mountain roads to reach the town, which is not connected to electricity or telephone services and is a 40-minute speed boat ride from the nearest health centre.
“Community collaborators are a fundamental part of Panama’s malaria elimination strategy because they are immersed in the community, speak the language, are trusted and can empathize with the local people,” said Gloria Henao, International Consultant on Malaria at PAHO.
Training was supported by PAHO, the Regional Malaria Elimination Initiative, the Inter-American Development Bank and the Clinton Health Access Initiative.
In Paraguay’s capital, tackling dengue one house at a time
Crews from Paraguay’s National Malaria Eradication Service (SENEPA) and partner organizations raise awareness and eliminate breeding sites for the mosquito that transmits dengue and other diseases. Credit: PAHO
In 2023, the Americas dealt with the highest number of dengue cases in its history as hotter temperatures helped dengue-spreading mosquitos thrive.
As a countermeasure, crews from Paraguay’s National Malaria Eradication Service (SENEPA) and partner organizations have launched campaigns to remove the favored breeding grounds of Aedes aegypti, the mosquito that spreads the dangerous viral illness.
With permission from neighbors, SENEPA crews go through houses and yards, remove clutter, get rid of objects where water can collect, and treat gutters with chemicals to kill mosquito larvae. They give tips on how to prevent breeding sites, such as scrubbing pet bowls with soap each time the water is changed.
As part of their effort to curb the spread of dengue, SENEPA workers place insecticide in gutters and other spots where mosquito larvae are likely to be found. Credit: PAHO
The Aedes mosquitos that transmit dengue need only a small amount of water to lay their eggs. Above, workers remove tires, which can provide ample mosquito habitat. Credit: PAHO
Angola works to interrupt transmission of dracunculiasis (Guinea worm disease)
Teams in Onanime, Angola treat a pond of stagnant water to kill tiny crustaceans that swallow Guinea worm larvae and transmit dracunculiasis to humans. Credit: WHO/Omotola Akindipe
Angola has been working to remove the risk of dracunculiasis from the country and safeguard its neighbor Namibia, which in 2022 was certified free from the crippling parasitic disease.
Read about a recent mission by WHO and Angolan health officials to the southern province of Cunene to assess eradication efforts; among these, surveillance, community education, and vector control.
Years of work by WHO and partners have dramatically reduced the presence of dracunculiasis in Africa and Asia. During the mid-1980s there were about 3.5 million cases of this poverty-related disease on those continents. In 2020, only 27 cases were detected, most of them in Chad and Ethiopia.
Also see:
WHO’s mobile app helps health workers address tropical diseases that affect the skin
WHO recognition of noma as a neglected tropical disease bolsters control efforts
Ramping up responses to curb cholera in Zambia and Zimbabwe
In Zimbabwe, (above) treatment centres have been set up in cholera hotspots. Credit: WHO
With WHO support, Zimbabwe is responding to a cholera outbreak that has seen cases reported in all its 10 provinces, while Zambia is running a vaccination campaign targeting 1.5 million people in the country’s worst-affected areas.
"In the fight against cholera, collaboration is key,” said Professor Jean-Marie Dangou, WHO Representative in Zimbabwe. “By working together with governments, communities and other partners, WHO leverages its expertise and resources to support a response that tackles the disease comprehensively, from improving access to clean water and sanitation to promoting hygiene practices and building long-term resilience."
In December, WHO delivered Zimbabwe a 22-metric ton consignment of cholera kits, enough to manage 600 severe and 1400 mild cases, along with about three million doses of oral vaccine. In Zambia, WHO has provided 14 tons of cholera kits and medical supplies, 23 experts to support emergency coordination, among many other measures.
Cameroon advances in the fight against HIV
Many of my patients “didn't know that you could live in the same house as someone living with HIV, eat together and sleep in the same bed without being infected,” said Sergine Nyaviene of the Tigaza Catholic Health Centre, who received WHO training in HIV care. Credit: WHO
WHO is working with Cameroon’s health providers to lower the country’s HIV burden, and the results are showing: Over the past 14 years, HIV prevalence has dropped by half among people aged 15 to 64.
In 2022, WHO deployed HIV experts to 36 health facilities in 14 health districts in the country’s East and Littoral regions to train some 200 health workers on HIV care. More than 20 000 people were screened for the virus, and most of those who tested positive started treatment.
Despite the falling number of cases, HIV remains a major public health problem in Cameroon. In 2022, more than 480 000 people were living with the virus, and nearly 1 000 new cases were diagnosed.
“One of our organization's policies is to combat the inequalities that are hampering the elimination of HIV, which is why key populations and internally displaced people are a priority focus for us,” said Dr Gilbert Tchatchoua, WHO country office expert. “These vulnerable populations often do not have access to adequate HIV services.”
Also see:
Cameroon rolls out malaria vaccine
Building momentum against diphtheria outbreaks in Nigeria
Maldives and Sri Lanka are recognized for high levels of hepatitis B protection
Preventing hepatitis B infection through immunization in infancy substantially reduces chronic infections and cases of liver cancer and cirrhosis in adulthood. Credit: WHO/Sri Lanka
WHO announced in January that Maldives and Sri Lanka had achieved hepatitis B control, a milestone that means more adults will be protected from liver disease because of vaccines they receive as infants.
The countries join Bangladesh, Bhutan, Nepal and Thailand, which achieved the same feat in 2019.
The announcement came after an expert panel verified that the two countries have had consistently high coverage of hepatitis B vaccine doses in infants and a low prevalence of the deadly disease, corroborated through serological surveys.
“I congratulate and commend Maldives and Sri Lanka on their achievement, which once again demonstrates the earnest efforts being made by the health leaders and officials, health workers and the people of these countries towards health and well-being of communities,” said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia.
WHO thanks all governments, organizations and individuals who are contributing to the Organization’s work, with special appreciation for those who provide fully flexible contributions to maintain a strong, independent WHO.
Donors and partners featured in this story include:
Africa Centre for Disease Control and Prevention
Clinton Health Access Initiative
Gavi, the Vaccine Alliance
Hilfsaktion Noma e.V.
Inter-American Development Bank
The Malaria Elimination Initiative
Oxford University
The Pan American Health Organization
Paraguay’s National Malaria Eradication Service (SENEPA)
UNICEF
Until No Leprosy Remains
WHO Collaborating Centre for Dracunculiasis Eradication at the United States Centers for Disease Control and Prevention