30 / 09 / 2019

AHO has plan to combat tropical and infectious diseases in Africa

More than a billion people across the world, mostly in low and lower- Middle income countries, are affected by neglected tropical diseases. Africa bears the most highest burden of these debilitating infections and at least one neglected tropical disease is endemic in most countries. AHO talks to Graciano Masauso, President of Africa Health Organisation (AHO).



What is the current scenario of tropical disease in Africa?

There are various tropical diseases in Africa. Dengue, rabies, lymphatic filariaris and malaria are some of them. Apart from neglected tropical diseases such as malaria, lymphatic filariaris, we don’t have proper information about other tropical diseases. Information is also not available on zoonoses — infectious disease caused by bacteria, virus and parasites that spread between animals and humans. It is also said that trypanosomiasis, a disease caused by parasitic protozoan trypanosomes has been seen in the country, but no information has been provided yet. Many of the diseases are under-reported.


Does global warming impact tropical and infectious disease?

Rising global temperature increases the distribution range and virus transmission. Malaria and dengue are Sensitive to climate change.  Cutaneous leishmaniasis — diseases transmitted by infected female phlebotomine sand fly — have been reported in areas where they were not found earlier. After 2016, the number of cutaneous leishmaniasis patients has increased. Rise in temperature and change in rainfall pattern provide breeding ground for vectors.


What are the ways to prevent dengue?

Integrated vector management, including vector control, search and destroy campaigns and public education are extremely important. Mass awareness campaign should be carried out. Fogging should  be done only when the habitats of mosquitoes are destroyed and mosquitoes living in homes and inner spaces are destroyed.


Is Africa vulnerable to globally emerging diseases? What are the ways to control them?

Africa is vulnerable to globally emerging diseases because of climate change, rise in temperature and migration. There are high chances of other tropical and infectious diseases which have broken out in other countries reaching the country. The authorities concerned must be informed about such diseases. Surveillance is also necessary to know about the possibility of emergence and re-emergence of diseases. It is also necessary to know about changes occurring in the pathogens.


What is the role of vector control inspectors?

Vector control inspectors have knowledge of habitat, nature of vectors, ways to control them and how they contribute to transmission of diseases. They are also responsible for scheduling inspections and operations. Using a variety of strategies they help  prevent the spread of both the vector and the disease.

It’s sad that some governments in Africa have removed the post of vector control inspectors at a time when dengue has spread across the countries, the governments must give them more responsibilities and help them learn through trainings as they are needed during such outbreaks. Each province should have at least four to five vector control inspectors.


Is collaboration necessary in the health sector?

There are various international organisations collaborating and cooperating with the government. Some organisations are helping us make guidelines, while some support us financially. Africa Health Organisation is providing technical assistance.

Until we have knowledge about the diseases, back-up plans to prevent and control their spread, investigation capabilities and skilled technical human resource we can’t do much on our own.


Are we prepared to combat health emergencies?

We have preparedness plans for cholera, influenza and other diseases. But we are not in a position to implement them.


How can communication and social mobilisation tools be useful for eradicating tropical and infectious diseases?

The public should be made aware. Whenever there is an outbreak there are rumours as we have seen with dengue this year. Risks should be communicated so that people don’t panic. Various volunteer groups can be mobilised to help prevent the disease from spreading. These groups reduce panic by disseminating right information and supporting the governments in its technical works. If the governments can’t control the outbreak it could lead to various other social problems. In situations when the governments closes everything and stops mobility of people during health emergencies there could be problems of food crisis. Vaccines could be limited. To help prevent such situations, the government needs help from people.


What programmes should the governments bring?

Firstly, the governments should work with proper plans. For instance, the governments came up with mass drug administration programmes to combat soil transmitted ailments and cases of leprosy, lymphatic filariasis and many other diseases have declined. If there are plans and strategies, it won’t be difficult to eliminate tropical and infectious diseases.  With the countries adopting the three-tier government system, there has been confusion regarding duties and responsibilities within the system. The governments can come up with a central disease control division to contain infectious and tropical diseases. Dengue has given us a great lesson. Strategies should be worked out to prevent dengue spread. Action-oriented planning is necessary.

The governments should make plans in such a way that eggs and larvae of mosquitoes are destroyed immediately after rainfall.  The governments should classify diseases on the basis of risks, severity and casualties. It also should specify diseases on the basis of geographical location, maintain proper data and deploy technical manpower with financial assistance for surveillance.

Such measures will help us prepare for the emergence of diseases.