This issue focuses on the ongoing Yellow fever , Ebola Virus Disease (EVD), Cholera, Zika outbreaks and the health consequences of El Niño.

There has been re-emergence of urban Yellow Fever (YF) outbreaks in Angola that have spread to the neighboring DR Congo and some cases have been exported to China and Kenya. Another outbreak of Yellow Fever has been reported in Uganda but it is not epidemiologically linked to the Angola or DR Congo outbreaks. Instead it is linked to a YF outbreak that occurred in Northern Uganda in 2010.

Flare-ups of the EVD outbreaks occurred in Guinea and Liberia. Following the ad-vice from the International Health Regulation (IHR) emergency committee on EVD, the WHO terminated the recommendation that made the EVD epidemic a public health emergency of international concern (PHEIC) in West Africa in accordance with IHR (2005).

Cholera outbreaks have been the most protracted public health events (PHEs) in the period under review affecting 14 countries, with Tanzania and DR Congo being the most affected. Other major outbreaks that have been reported include: Zika Vi-rus Disease in Cape Verde; Meningitis in West Africa; Lassa Fever in Benin, Nige-ria, and Togo; and Measles in Niger and Nigeria.

Humanitarian crises in the Central African Republic, South Sudan and Burundi that have been associated with displacement of thousands of people have resulted in major health consequences. Floods and drought related to El Nino are affecting millions of people in Eastern and Southern Africa , including: Ethiopia, Zimbabwe, Malawi, Lesotho, South Africa, and Zambia. Food insecurity and sever acute mal-nutrition has significantly increased in several areas of the affected countries.

View/download the bulletin: Outbreaks and Emergencies in the WHO African Region Bulletin Vol. 6 Issue 2, 30 April 2016 (1.38 MB)

WASHINGTON/LONDON/ROME – A major contemporary analysis of global school meals practices, designed to help strengthen these vital social investments, was released today by Imperial College London’s Partnership for Child Development (PCD), the World Food Programme (WFP), and the World Bank (WB).

The Global School Feeding Sourcebook: Lessons from 14 countries was produced in response to demand from governments and development partners for guidance on designing and implementing large-scale sustainable national school feeding programmes that can meet globally approved standards.

The Sourcebook documents and analyzes a range of government-led school meals programmes to provide decision-makers and practitioners worldwide with the knowledge, evidence and good practice they need to strengthen their national school feeding efforts.

With school meals’ proven ability to improve the health and education of children while supporting local and national economies and food security, school feeding programmes exist in almost every country in the world for which there is data, for a total annual global investment of US$75 billion. This provides an estimated 368 million children – about one in five - with a meal at school daily. However, too often, such programmes are weakest in countries where there is the most need.

With high-level collaboration with government teams from 14 countries (Botswana, Brazil, Cabo Verde, Chile, Cote D’Ivoire, Ecuador, Ghana, India, Kenya, Mali, Mexico, Namibia, Nigeria and South Africa) the Sourcebook includes a compilation of concise and comprehensive country case-studies. It highlights the trade-offs associated with alternative school feeding models and analyzes the overarching themes, trends and challenges which run across them.

In a joint foreword, World Bank Group President Dr. Jim Yong Kim and World Food Programme Executive Director Ertharin Cousin said that the research showed how school meals programmes help to get children into the classroom and keep them there, “contributing to their learning by avoiding hunger and enhancing cognitive abilities.”

“Today, national school feeding programmes are increasingly embedded in national policy on poverty elimination, social protection, education and nutrition,” they added.

Lead Editor and PCD’s Executive Director Dr Lesley Drake, said, “The overall message from this research is that there is no ‘one size fits all’ for school feeding and there are many routes to success. Context is key. This sourcebook will act as a valuable tool for governments to enable them to make evidenced-based decisions that will improve the effectiveness of their school feeding programmes.”

The Sourcebook follows Rethinking School Feeding (WB, 2009) and The State of School Feeding Worldwide (WFP, 2013) as the third in a trilogy of agenda-defining analysis produced by the World Bank, WFP and PCD global partnership. These have shaped the way in which governments and donors alike approach school feeding. “Helping countries to apply this knowledge [in the Sourcebook] to strengthen national school feeding programmes will contribute to reducing the vulnerability of the poorest, giving all children a chance for an education and a bright future and eliminating poverty,” said Kim and Cousin.

The Sourcebook is free to download at www.hgsf-global.org, www.wfp.org and World Bank’s Open Knowledge Repository

For further information please contact:

Francis Peel, PCD, Imperial College London, +44 (0)207 594 3292, f.peel@imperial.ac.uk
Frances Kennedy, World Food Programme, +39 066513 3725 frances.kennedy@wfp.org
Patricia da Camara, World Bank, +1 (202) 473-4019, pdacamara@worldbankgroup.org

Notes to Editors

The Partnership for Child Development (PCD) is a global consortium of civil society organizations, academic institutions and technical experts, based within the School of Public Health at Imperial College London. Working in over 50 countries, it has been at the forefront of harmonizing multi-sectoral efforts to enable low-income countries to implement effective, scaled, and sustainable school health and school feeding programmes. www.imperial.ac.uk/PCD Follow us on Twitter @HGSFGlobal

The World Food Programme (WFP) is the world's largest humanitarian agency fighting hunger worldwide, delivering food assistance in emergencies and working with communities to improve nutrition and build resilience. Each year, WFP assists some 80 million people in around 80 countries. www.wfp.org Follow us on Twitter @wfp_media

The World Bank Group’s (WBG) mission is to fight poverty and improve living standards for people in the developing world. The Bank is the world’s largest external financier of education in developing countries, from pre-primary and primary education all the way to higher education. Since 2000, the Bank has invested US$42 billion in education. www.worldbank.org/education Follow us on Twitter@WBG_Education

Sourcebook Key Findings

The analysis examines the 14 national programmes in terms of Five Quality Standards as identified in Rethinking School Feeding (WB, 2009) that are needed for school feeding programmes to be sustainable and effective. These standards include: design and implementation; policy and legal frameworks; institutional arrangements; funding and budgeting; and community participation.

Design and implementation

School feeding is most frequently designed as a social protection measure for poor and vulnerable communities with the key outcome being an improvement in education through increased enrolment, reduced absenteeism, and enhanced gender equality. For example primary school enrolment in Nigeria’s Osun State increased by 28 percent since the introduction of free school meals. Increasingly, policy makers are seeing school feeding as a means to tackle health and nutrition issues whether that be stunting and anaemia caused by undernutrition or obesity caused by over nutrition. In Ghana, the government uses a digital school meals planner to develop nutritionally balanced school meals using local ingredients.

Another trend is for countries to connect school feeding with local food production and purchase, also known as Home Grown School Feeding. This benefits both rural economies and school children alike as children benefit from nutritious fresh food and farmers benefit from being able to sell their produce a new market. In Brazil, for example, it is federal law that 30 percent of food for school meals is procured from small family-run farms.

Policy and legal frameworks

Effective programmes need well-articulated policy and legal frameworks. Every country reviewed in the study has included school feeding in its regulatory framework. This has been achieved using different types of legislative and executive measures dependent on the national context.

Institutional arrangements

There is no single institutional design, but the key determinants of success include co-ordinating stakeholders from across multiple sectors; ensuring that there is enough government capacity at national and local levels; and creating mechanisms to ensure quality and accountability of the school feeding programmes. The cross-sectoral aspect of school feeding is exemplified by Kenya, where its programmes are coordinated jointly by the Ministry of Education and the Ministry of Agriculture.

Funding and budgeting

School feeding costs usually represent a small fraction of educational expenditure (typically 10-15 percent) with the purchase of food being the main cost-driver. Identifying sustainable and protected sources of funding remains the key challenge for many low-income countries. Analysis shows that there is strong political will to continue to fund school feeding as it is a popular intervention with the public, but not all funding is public, and private sector partnerships are a growing area of financial support. In Cape Verde schools can partner with local businesses such as hotels for extra funds which can be put towards cooking facilities.

Community participation

The strongest and most sustainable programmes are those that respond to community need, are locally-owned and incorporate some form of parental or community contribution. In Namibia, many communities are expected to provide fuel, cooking utensils and storerooms. Indirect benefits of school feeding include employment opportunities for example, in Chile, low-income mothers are given catering training. School feeding can also mean increased income and training for smallholder farmers; as well as complementary school health activities, as in both Mexico and Brazil where parents are taught about the importance of nutritionally balanced diets.

WASHINGTON/LONDRES/ROMA – La Alianza para el Desarrollo Infantil del Imperial College de Londres (PCD por sus siglas en inglés), el Programa Mundial de Alimentos (PMA) y el Banco Mundial han hecho público hoy un importante análisis de las prácticas mundiales en comidas escolares, diseñado para ayudar a fortalecer este tipo de inversión social esencial.

El Libro de consulta de la alimentación escolar mundial: lecciones de 14 países se ha creado para responder a la demanda de los gobiernos y de los socios de desarrollo de una guía para diseñar y llevar a cabo grandes programas sostenibles de alimentación escolar a nivel nacional que cumplan los estándares reconocidos.

El Libro de consulta documenta y analiza una serie de programas de comidas escolares liderados por los gobiernos para proporcionar a los dirigentes políticos y profesionales de todo el mundo el conocimiento, las pruebas y las buenas prácticas que necesitan para mejorar sus esfuerzos respecto a la alimentación escolar nacional.

Está demostrado que las comidas escolares mejoran la salud y la educación de los niños, a la vez que apoyan la economía local y nacional y la seguridad alimentaria. Por ello, existen programas de alimentación escolar en prácticamente todos los países del mundo de los que hay datos. En estos programas se invierte un total de 75 mil millones de dólares cada año a nivel mundial, que proporcionan a alrededor de 368 millones de niños (1 de cada 5) una comida diaria en la escuela. Sin embargo, demasiado a menudo, dichos programas son más débiles en los países donde más se necesitan.

Con la colaboración de alto nivel de equipos de gobierno de 14 países (Botsuana, Brasil, Cabo Verde, Chile, Cote D’Ivoire, Ecuador, Ghana, India, Kenia, Mali, México, Namibia, Nigeria y Sudáfrica) el Libro de consulta incluye una compilación de estudios de caso amplios y concisos de estos países. Destaca las decisiones asociadas a modelos de alimentación escolar alternativos y analiza los temas, las tendencias y los retos más comunes.

En el prólogo conjunto, el presidente del Grupo del Banco Mundial, el Dr. Jim Yong Kim y la directora ejecutiva del Programa Mundial de Alimentos, Ertharin Cousin, declaran que la investigación muestra cómo los programas de comidas escolares ayudan a que los niños vayan a clase y permanezcan en ellas, «contribuyen a su aprendizaje evitando el hambre y mejorando sus habilidades cognitivas».

«Hoy en día, los programas nacionales de alimentación escolar están cada vez más incluidos en las políticas nacionales de erradicación de la pobreza, protección social, educación y nutrición», añadieron.

La editora principal y directora ejecutiva de PCD, la Dra. Lesley Drake, expresó que, «El mensaje general de esta investigación es que no hay una "talla única" para la alimentación escolar y que hay muchos caminos hacia el éxito. El contexto es esencial. Este libro de consulta actuará como una herramienta muy valiosa para los gobiernos que les permitirá tomar decisiones basadas en las pruebas, mejorando la efectividad de sus programas de alimentación escolar».

El Libro de consulta, junto a Replanteamiento de la alimentación escolar (WB, 2009) y El estado de la alimentación escolar a nivel mundial (PMA, 2013) forma parte de una trilogía realizada por la alianza global del Banco Mundial, PMA y PCD. Estos análisis han definido la manera en la que los gobiernos y los donantes abordan la alimentación escolar.

“Ayudar a los países a aplicar este conocimiento [en el Libro de consulta] para mejorar los programas de alimentación escolar contribuirá a reducir la vulnerabilidad de los más pobres, dando la oportunidad a todos los niños de recibir una educación y tener un futuro brillante y eliminando la pobreza", sostienen Kim y Cousin.

El Libro de consulta se puede descargar de manera gratuita en www.hgsf-global.org, www.wfp.org y el Repositorio Abierto de Conocimiento del Banco Mundial

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Si desea más información por favor contacte con:
Francis Peel, PCD, Imperial College London, +44 (0)207 594 3292, f.peel@imperial.ac.uk
Frances Kennedy, Programa Mundial de Alimentos, +39 066513 3725 frances.kennedy@wfp.org
Alejandro Chicheri, Programa Mundial de Alimentos, América Latina y el Caribe, +507 317 3900, Mov. +507 6671 5355 alejandro.chicheri@wfp.org
Patricia da Camara, Banco Mundial, +1 (202) 473-4019, pdacamara@worldbankgroup.org

Notas para los editores

La Alianza para el Desarrollo Infantil (PCD) es un consorcio mundial de organizaciones de la sociedad civil, instituciones académicas y expertos técnicos, con sede en la Escuela de Salud Pública del Imperial College de Londres. Presente en 50 países, ha estado al frente de la armonización de los esfuerzos de diversos sectores para permitir que los países con bajos ingresos lleven a cabo programas de salud y alimentación escolar efectivos, amplios y sostenibles. www.imperial.ac.uk/PCD Síganos en Twitter @HGSFGlobal

El Programa Mundial de Alimentos (PMA) es la mayor agencia humanitaria que lucha contra el hambre en el mundo, proporcionando asistencia alimentaria en emergencias y trabajando con las comunidades para mejorar la nutrición y aumentar la resiliencia. Cada año, PMA brinda asistencia a unos 80 millones de personas en 80 países.

Visite: www.wfp.org/eshttp://www.facebook.com/ProgramaMundialdeAlimentos

http://twitter.com/wfp_es

El mandato del Grupo del Banco Mundial (GBM) es luchar contra la pobreza y mejorar los niveles de vida de las personas que viven en los países en vías de desarrollo. El Banco es el mayor financiero externo de educación en los países en vías de desarrollo, desde la educación infantil y primaria hasta la educación superior. Desde el año 2000, el Banco ha invertido 42 mil millones de dólares en educación. www.worldbank.org/education Síganos en Twitter @WBG_Education

Principales hallazgos del Libro de Consulta

El análisis examina los 14 programas nacionales en relación a Cinco Estándares de Calidad, identificadas en Replanteamiento de la alimentación escolar (WB, 2009), que deben cumplir los programas de alimentación escolar para ser sostenibles y eficaces. Estas normas incluyen: diseño y puesta en marcha; marco normativo y legal; disposiciones institucionales; fondos y presupuesto; y participación de la comunidad.

Diseño y puesta en marcha

La alimentación escolar se diseña normalmente como una medida de protección social para las comunidades pobres y vulnerables, donde el beneficio más importante es la mejora de la educación mediante el aumento de la matriculación, la reducción del absentismo y la mejora de la igualdad de género. Por ejemplo, la matriculación en escuelas primarias del Estado de Osun en Nigeria ha aumentado un 28% desde que se introdujeron las comidas escolares gratuitas. Cada vez más, los responsables políticos ven la alimentación escolar como un medio para abordar los problemas de salud y nutrición, ya sea el retraso en el crecimiento o la anemia causada por la desnutrición o la obesidad causada por la sobrenutrición. En Ghana, el gobierno usa una agenda digital de comidas escolares para desarrollar comidas escolares equilibradas nutricionalmente usando ingredientes locales.

Otra tendencia que se puede observar en estos países es conectar la alimentación escolar con la producción y la venta de alimentos local, esto se conoce como Alimentación Escolar de Producción Local. Esto beneficia a la vez a las economías rurales y a los niños en edad escolar, ya que los niños reciben alimentos frescos y nutritivos y los agricultores pueden vender sus productos en un nuevo mercado. En Brasil por ejemplo, por ley el 30% de los alimentos usados en las comidas escolares se adquiere en pequeñas granjas familiares.

Marco normativo y legal

Los programas eficaces necesitan tener un marco normativo y legal bien articulado. Todos los países del estudio han incluido la alimentación escolar en sus marcos normativos. Esto se ha conseguido por medio de diferentes tipos de medidas legislativas y ejecutivas según el contexto nacional.

Disposiciones institucionales

No hay un único diseño institucional, pero los factores clave para el éxito incluyen: coordinar a los participantes de varios sectores, asegurar que el gobierno tiene capacidad suficiente a nivel nacional y local, y crear mecanismos para asegurar la calidad y la fiabilidad de los programas de alimentación escolar. El aspecto intersectorial de la alimentación escolar se refleja en Kenia, donde sus programas son coordinados por el Ministerio de Educación y el Ministerio de Agricultura.

Fondos y presupuesto

Los costes de la alimentación escolar suelen representar una pequeña fracción de los gastos en educación (10-15 por ciento, normalmente), la mayor parte de los recursos se emplean en comprar los alimentos. Identificar fuentes de financiación sostenible y protegida sigue siendo el mayor reto para muchos países con bajos ingresos. Los análisis muestran que hay una fuerte voluntad política de seguir financiando la alimentación escolar ya que es una intervención popular entre el público, pero no toda la financiación es pública, y los socios del sector privado son una fuente creciente de apoyo financiero. En Cabo Verde, las escuelas pueden asociarse con negocios locales, como hoteles, para obtener fondos que pueden ser usados en las cocinas.

Participación de la comunidad

Los programas más fuertes y sostenibles son aquellos que responden a las necesidades de las comunidades, se gestionan localmente e incorporan alguna forma de contribución paterna o comunitaria. En Namibia, muchas comunidades deben proporcionar combustible, utensilios de cocina o despensas. Uno de los beneficios indirectos de la alimentación escolar son las oportunidades laborales. Por ejemplo, en Chile, las madres con bajos ingresos reciben formación en hostelería. La alimentación escolar también tiene como consecuencia el aumento de ingresos y formación para los pequeños agricultores; así como actividades complementarias de salud escolar, como en México y Brasil, donde los padres aprenden sobre la importancia de las dietas equilibradas nutricionalmente.

Washington/Londres/Rome – Une analyse contemporaine importante de la pratique de repas scolaires mondial, conçue pour aider à renforcer ces investissements sociaux cruciaux, a été publiée aujourd’hui par le Partnership for Child Development de l’Imperial College de Londres (PCD), le Programme alimentaire mondial des Nations Unies (PAM) et la Banque Mondiale.

Le guide de référence de l’alimentation scolaire mondial : Leçons provenant de 14 pays a été fait en réponse à la demande des gouvernements et des partenaires de développement pour obtenir des informations sur la conception et la mise en œuvre des programmes d’alimentation scolaires nationaux durables à grande échelle qui peuvent répondre à des normes approuvées au niveau mondial.

Le guide de référence recense et analyse une gamme de programmes de repas scolaires dirigés par le gouvernement pour fournir aux décideurs et aux praticiens du monde les connaissances, les preuves et les bonnes pratiques dont ils ont besoin pour renforcer leurs efforts d'alimentation scolaire national.

Grâce à la capacité reconnue des repas scolaires pour améliorer la santé et l'éducation des enfants, tout en soutenant les économies locales et nationales et la sécurité alimentaire. Les programmes d'alimentation scolaire existent dans presque tous les pays du monde pour lequel il existe des données, pour un investissement global annuel total de 75 milliards de dollars américains. Environ 368 millions d'enfants ; soit environ un sur cinq ; bénéficient d’un repas par jour à l’école. Cependant, trop souvent, ces programmes sont les plus faibles dans les pays où les besoins sont les plus importants.

Avec un haut niveau de collaboration avec les équipes gouvernementales de 14 pays (Botswana, Brésil, Cap Vert, Chili, Côte d'Ivoire, Equateur, Ghana, Inde, Kenya, Mali, Mexique, Namibie, Nigeria et Afrique du Sud) le guide de référence comprend une compilation d’études de cas nationales concises et complètes. Il met en évidence les compromis associés aux modèles d'alimentation scolaire alternatif et analyse les thèmes principaux, les tendances et les défis qui les utilisent.

Dans une préface conjointe, le Président du Groupe de la Banque Mondiale Dr Jim Yong Kim et la Directrice Exécutive du Programme alimentaire mondial Madame Ertharin Cousin ont déclaré que des recherches ont montré comment les programmes de repas scolaires aident à envoyer les enfants dans la salle de classe et à les y maintenir, soit à «contribuer à leur apprentissage en évitant la faim et améliorer les capacités cognitives ".

«Aujourd'hui, les programmes d'alimentation scolaires nationaux sont de plus en plus intégrés dans la politique nationale pour l'élimination de la pauvreté, la protection sociale, l'éducation et la nutrition», ont-ils ajouté.

Le rédacteur principal et le Directeur Exécutif du PCD Dr. Lesley Drake, ont déclaré: «Le message central de cette recherche est qu'il n'y a pas un « modèle unique » pour l'alimentation scolaire, il y a plusieurs routes vers le succès. Le contexte est fondamental. Ce guide de référence agira comme un outil précieux pour les gouvernements pour leur permettre de prendre des décisions basées sur des faits avérés qui amélioreront l'efficacité de leurs programmes d'alimentation scolaire ".

Le guide de référence suit Repenser l'alimentation scolaire (WB, 2009) et L'État de l'alimentation scolaire dans le monde (PAM, 2013) comme le troisième d'une trilogie de l'analyse Agenda-defining produit par la Banque mondiale, le PAM et le partenariat mondial du PCD. Ceux-ci ont façonné la manière dont les gouvernements et les donateurs abordent l'alimentation scolaire.

"Aider les pays à appliquer ces connaissances [dans le guide de référence] pour renforcer les programmes d'alimentation scolaire nationaux qui contribueront à réduire la vulnérabilité des plus pauvres, en donnant à tous les enfants une chance pour une éducation, dans l’espoir d’un avenir brillant et pour éliminer la pauvreté», ont déclaré Kim et Cousin.

Le guide de référence est téléchargeable gratuitement sur www.hgsf-global.org, www.wfp.org et Repository Open Knowledge de la Banque mondiale.

Pour plus d’informations, veuillez contacter :

Francis Peel, PCD, Imperial College London, +44 (0)207 594 3292, f.peel@imperial.ac.uk

Frances Kennedy, Programme alimentaire mondial, +39 066513 3725 frances.kennedy@wfp.org

Patricia da Camara, Banque Mondiale, +1 (202) 473-4019, pdacamara@worldbankgroup.org

Disease epidemics result in substantial ill health and loss of lives and therefore pose a threat to global health security, undermine socio-economic lives and destabilize societies.

Disease surveillance is a critical component in detecting and effectively responding to epidemics to minimize loss of live and their disruptive consequences. Carefully assembled surveillance data at the highest possible spatial resolutions also permit the understanding of the burden of epidemics, their co-occurrence and the key biological, ecological, economic, health system and governance determinants.

It is for this purpose that the WHO-AFRO has commissioned this report. The overarching objective was to develop a comprehensive spatially defined database of outbreaks and epidemics and delineate the ecological zones of diseases that are classified as Public Health Emergency of International Concern (PHEIC) according the International Health Regulations (IHR) 2005 and malaria.

The main tasks included the assembly of an inventory of all epidemics reported in Africa from 1970-2016 characterised by date of occurrence, length of epidemic and magnitude and district of occurrence; definition of ecological zones of PHEIC diseases and malaria; the assembly of data on important socio-economic, health systems and environmental correlate and an basic statistical analysis of their relationship with occurrence and frequency of epidemics and outbreaks.

Through this study, several products have been developed including time series graphs of outbreak and epidemic occurrence by country, maps of the ecologies of the PHEIC diseases and epidemics, the distribution of these diseases by district. The databases and maps produced in this report should be considered as the foundation for tracking epidemics sub-nationally within the WHO African region. However, they require continuous verification, improvements in spatial resolution and regular updating. Finally, these data can also serve as the inputs for disease specific risk and vulnerability analysis.

Background

1. The African Public Health Emergency Fund (APHEF or the Fund) was established by the Regional Committee in 2012 with the aim of providing catalytic resources for initiating timely responses to public health emergencies. Ever since, commitments have been made at every subsequent Regional Committee session to improve the functionality of this solidarity fund.

2. Despite all the commitments made, actual contributions to APHEF have remained very low.
   Between 2012 and June 2016, only 13 countries had ever contributed to the Fund.1 Total contributions stand at US$ 3 619 438. This constitutes about 1.5% of the expected amount. Of the 13 countries that have contributed so far, Eritrea has done so three times, Rwanda twice and the rest have contributed once (Annex 2).

3. APHEF has contributed to the management of public health emergencies in the Region (Annex 3). The Fund has so far disbursed a total of US$ 2.73 million to support life-saving interventions in 13 countries.2 Only four of the countries that have received APHEF support have ever contributed to the Fund.3 None of the requested amounts for each of the emergencies could be fully allocated, mainly owing to inadequate funds. US$ 473 897 was the average requested amount, while the average allocation was US$ 210 257 (Annex 3). For 12 of the 13 requests received from 2014 to 2016, funds were made available within two working days as stipulated in the APHEF operations manual.

4. In 2016, APHEF has supported responses to the yellow fever outbreak in Angola and the El Niño crisis in Ethiopia. In 2014 and 2015, the Fund supported the provision of emergency health care to internally-displaced populations in the Central African Republic and South Sudan; refugees in Cameroon and flood victims in Burundi, Malawi and Zimbabwe. In addition, APHEF supported the responses to the outbreaks of meningococcal meningitis in Niger and Ebola in the Democratic Republic of the Congo, Guinea, Liberia and Sierra Leone. The disbursements from APHEF complement resources from other funding initiatives such as the newly established Contingency Fund for Emergencies (CFE),4 which supports WHO deployments.

5. Considering the crucial role of APHEF, the Sixty-fifth session of the Regional Committee reiterated the importance of strengthening its functionality. The ministers of health deliberated on possible demotivating factors that could explain the inadequate contributions. These included significant variations in the amounts of countries’ contributions and the limited involvement of the ministries of finance. The Committee adopted a report, AFR/RC65/R5, that called for the revision of the APHEF framework.

6. The above report requested the Secretariat to establish a multidisciplinary expert group to review the current APHEF framework and undertake an assessment to understand the reasons why countries are not making their contributions. Furthermore, it requested the Regional Director to facilitate consultations between ministers of health and finance, and other relevant sectors.

7. WHO convened a meeting of the multidisciplinary group of experts from the ministries of health and finance in June 2016. The key questions the experts deliberated upon included whether APHEF was needed, why it was not functioning optimally and how its functionality could be improved. The experts unanimously acknowledged the usefulness of APHEF and highlighted the critical challenges to be addressed. They reviewed the APHEF formula for contributions and made recommendations for consideration by the Regional Committee (Annex 1a). In addition, WHO conducted an assessment using a structured questionnaire filled by the countries, to understand the difficulties they face in honouring their contributions.

8. This paper highlights the key issues and challenges affecting the optimal functioning of APHEF. It takes into account recommendations from the multidisciplinary expert group and proposes actions for improved performance.

Gender inequality is costing sub-Saharan Africa on average $US95 billion a year, peaking at US$105 billion in 2014– or six percent of the region’s GDP – jeopardising the continent’s efforts for inclusive human development and economic growth, according to the Africa Human Development Report 2016.

The report analyses the political, economic and social drivers that hamper African women’s advancement and proposes policies and concrete actions to close the gender gap. These include addressing the contradiction between legal provisions and practice in gender laws; breaking down harmful social norms and transforming discriminatory institutional settings; and securing women’s economic, social and political participation.

Deeply-rooted structural obstacles such as unequal distribution of resources, power and wealth, combined with social institutions and norms that sustain inequality are holding African women, and the rest of the continent, back. The report estimates that a 1 percent increase in gender inequality reduces a country’s human development index by 0.75 percent.

Highlights

• African women achieve only 87 percent of the human development outcomes of men

• African women hold 66 percent of the all jobs in the non-agricultural informal sector and only make 70 cents for each dollar made by men

• Only between 7 and 30 percent of all private firms have a female manager

• Gender gap costs sub-Sahara Africa $US95 billion a year

Content

• Introduction

• Overview of Public Health Events in the WHO African Region

• Yellow Fever outbreaks

  • Angola
  • DR Congo

• Cholera outbreaks in the region

• Rift Valley Fever outbreak in Niger

• Humanitarian crisis

  • Nigeria
  • South Sudan

1. Introduction

The aim of this bulletin is to provide information on public health events including emergencies to Member States, public health and health emergency professionals, health development partners and the wider audience on the status of outbreaks and health emergencies in the WHO African region.

This issue focuses on yellow fever, cholera, the humanitarian crisis in Nigeria and South Sudan and Rift Valley fever in Niger.

During the period under review, there have been urban Yellow Fever (YF) outbreaks in Angola that have spread to neighboring DR Congo with cases exported to China and Kenya. Another outbreak of Yellow Fever was reported in Uganda, however it was not epidemiologically linked to the Angola or DR Congo outbreaks. The Uganda YF outbreak was rapidly and effectively contained highlighting the importance of preparedness as stipulated in the new regional strategy for health emergencies adopted during the recent Regional Committee in Addis Ababa .

Cholera outbreaks have been the most protracted public health events (PHEs) in the period under review. Seventeen (17) countries have been affected with DR Congo, Ethiopia, Tanzania, and Kenya recording the highest numbers of cases. Cholera in DR Congo is endemic yet outbreaks regularly occur. Outbreaks have also been reported in countries bordering DRC namely CAR and Congo.

Other major outbreaks that were reported during the period under review were: Polio in Nigeria, encephalitis in Angola and Rift Valley fever in Niger.

Moreover, protracted and escalated humanitarian crises in the Burundi, north eastern Nigeria and South Sudan have resulted in the displacement of thousands of people and major health consequences.
Finally, floods and drought related to El Nino have affected millions of people in Eastern and Southern Africa, including: Ethiopia, Zimbabwe, Malawi, Lesotho, South Africa, and Zambia. Consequently, food insecurity and severe acute malnutrition has significantly increased in the affected countries.

Foreword

As we write this, Africa is suffering from the strongest El Niño it has faced in decades, causing major floods and droughts throughout Africa, leading to rising economic losses and major impacts on the lives and livelihoods of millions across the continent. Countries across the continent are declaring states of emergency, and are calling on the international community for support.

Such crises in Africa are becoming the new norm as the impacts of disasters continue to increase. Natural disasters, such as droughts, oods, landslides, storms, and earthquakes are a regular occurrence, and climate change is increasing the frequency and intensity of weather-related hazards even further. The impacts of natural disasters and climate change are further compounded by poorly planned development – as the fastest urbanizing continent in the world, Africa faces a huge challenge as people and assets continue to be placed in harm’s way.

Forced to face these challenges, African countries are emerging as strong leaders in driving the resilience agenda forward by reforming their emergency management systems, establishing new legislation for risk reduction, modernizing early warning and preparedness systems, exploring innovative risk financing solutions, and shaping the global and regional policy dialogue.

In our support to African countries, and in alignment with our twin goals of ending poverty and enhancing shared prosperity, the World Bank is stepping up its e orts to systematically invest in disaster and climate resilience, as highlighted in the Africa Climate Business Plan launched at COP21 in Paris. To illustrate this engagement, the plan intends to bring early warning systems to 100 million people across 15 African countries and pilot new urban resil- ience approaches.

These ambitious targets cannot be achieved without broad-based partnerships and cooper- ation e World Bank works with the African Union and the Regional Economic Communities, as well as technical agencies to promote coordinated and comprehensive approaches to managing common disaster and climate risks. In addition, partnerships with international organizations, bilateral donors, and major regional development partners – such as the African Development Bank – are ramping up resilience activities across the continent the World Bank’s Africa Disaster Risk Management program could not have achieved as much as it has to date without the strong sup- port of the Global Facility for Disaster Reduc- tion and Recovery (GFDRR), and its donors, particularly the European Union and Japan, who have boosted the program’s impact in recent years.

This Strategic Framework 2016–20 clearly articulates the way forward in increasing knowledge, capacity building and advocacy, partnerships and investments, as we collectively strive toward disaster and climate resilient development in Africa We thank all partners and institutions who have contributed to the development of the Framework, and look forward to joining forces on its implementation.

Who Suffers Most From Extreme Weather Events? Weather-related Loss Events in 2015 and 1996 to 2015

The Global Climate Risk Index 2017 analyses to what extent countries have been affected by the impacts of weather-related loss events (storms, floods, heat waves etc.). This year’s 12th edition of the analysis reconfirms that, according to the Climate Risk Index, less developed countries are generally more affected than industrialised countries. Regarding future climate change, the Climate Risk Index may serve as a red flag for already existing vulnerability that may further increase in regions where extreme events will become more frequent or more severe due to climate change. While some vulnerable developing countries are frequently hit by extreme events, there are also some others where such disasters are a rare occurrence.

The most recent data available – from 2015 and 1996–2015 – were taken into account to produce the following key messages:

According to the Germanwatch Global Climate Risk Index, Honduras, Myanmar and Haiti were the countries most affected by extreme weather events between 1996 and 2015.

In 2015, Mozambique, Dominica as well as Malawi were at the top of the list of the most affected countries.

Altogether, more than 528 000 people died as a direct result of nearly 11 000 extreme weather events; and losses between 1996 and 2015 amounted to around 3.08 trillion US$ (in Purchasing Power Parities). The host region of the UN climate summit 2016 – the continent of Africa – is severely affected by climatic events with four countries ranking among the 10 countries worldwide most affected in 2015 – Mozambique (1st), Malawi (3rd), Ghana and Madagascar (joint 8th position).

Precipitation, floods and landslides were the major causes of damage in 2015. A high incidence of extreme precipitation supports the scientific expectations of accelerated hydrological cycles caused by climate warming.

Most of the affected countries in the Bottom 10 of the long-term index have a high ranking due to exceptional catastrophes. Over the last few years another category of countries has been gaining relevance: Countries like the Philippines and Pakistan that are recurrently affected by catastrophes continuously rank among the most affected countries both in the long term index and in the index for the respective year for the last six years.

Of the ten most affected countries (1996–2015), nine were developing countries in the low income or lower-middle income country group, while only one was classified as an upper-middle income country.

The climate summit in Marrakesh is giving the “go-ahead” on developing the “rulebook” for the Paris Agreement, including the global adaptation goal, adaptation communication systems, and finance assessment systems for building resilience. A review of the UNFCCC’s work on loss and damage provides the opportunity to better detail the next 5-year’s work on loss and damage, in relation to the climate regime, as well as to better understand exactly how loss and damage should be taken up under the Paris Agreement. View

OVERVIEW

• Many countries across the African continent face recurrent complex emergencies, frequent food insecurity, cyclical drought, and sudden-onset disasters such as earthquakes, floods, and storms. In FY 2016, as in previous years, USAID/OFDA not only responded to urgent needs resulting from disasters, but also supported DRR programs that built resilience and improved emergency preparedness, mitigation, and response capacity at local, national, and regional levels.

• USAID/OFDA’s FY 2016 DRR activities in Africa included instituting early warning systems for hazards, strengthening agricultural livelihoods to mitigate the effects of drought and food insecurity, and engaging vulnerable communities to understand and implement disaster preparedness and mitigation practices. USAID/OFDA assistance also promoted efforts to build national capacity for disaster response and to connect DRR actors within local, regional, and international civil society organizations operating throughout the region.

• USAID/OFDA-supported initiatives included programs that integrated DRR activities into ongoing emergency response efforts, bolstering the capacity of stakeholders to respond to continuing crises, such as complex emergencies and food insecurity.

WaPOR: database dissemination portal and APIs

The FAO portal to monitor Water Productivity through Open access of Remotely sensed derived data (WaPOR) monitors and reports on agriculture water productivity over Africa and the Near East.

It provides open access to the water productivity database and its thousands of underlying map layers, it allows for direct data queries, time series analyses, area statistics and data download of key variables associated to water and land productivity assessments.  

The portal’s services are directly accessible through dedicated FAO WaPOR APIs, which will eventually be also available through the FAO API store

Water productivity assessments and other computation–intensive calculations are powered by Google Earth Engine.

The first, beta release of WaPOR is available as of 14 April 2017. The beta release publishes Level 1 (continental, 250 m resolution) data from April 2009 to December 2016. WaPOR will be increasingly improved during the course of 2017 and beyond.

WaPOR roadmap

WaPOR: a tool to monitor water productiovity

Note by the Secretary-General

The Secretary-General has the honour to transmit to the General Assembly the report of the Director-General of the World Health Organization, submitted in accordance with General Assembly resolution 70/300.

Report of the Director-General of the World Health Organization on consolidating gains and accelerating efforts to control and eliminate malaria in developing countries, particularly in Africa, by 2030

Summary

The present report is submitted in response to General Assembly resolution 70/300. It provides a review of progress in the implementation of the resolution, focusing on the adoption and scaling-up of interventions recommended by the World Health Organization in malaria-endemic countries. It provides an assessment of progress towards the Sustainable Development Goals and resolution 70/300. It elaborates on the challenges limiting the full achievement of the targets, and provides recommendations to ensure that progress is accelerated towards the goals of the Global Technical Strategy for Malaria 2016-2030 in the coming years.

I. Introduction

1. While malaria is a preventable and treatable disease, it continues to have a devastating impact on people’s health and livelihoods around the world. There were an estimated 212 million malaria cases and an estimated 429,000 deaths from malaria globally in 2015, with 70 per cent of these deaths occurring among children under 5 years of age in sub-Saharan Africa. The World Health Organization (WHO) recommends a multi-pronged strategy to reduce the malaria burden, including vector control interventions, preventive therapies, diagnostic testing, quality-assured treatment and strong malaria surveillance.

2. The present report highlights progress and challenges in the control and elimination of malaria in the context of General Assembly resolution 70/300, drawing on the World Malaria Report 2016, issued by WHO in December 2016. The analysis is based on the latest available comprehensive data (2015) received from malaria-endemic countries and organizations supporting global malaria efforts. Data from 2016 are currently being collected and reviewed by WHO.

3. Between 2000 and 2015, malaria received worldwide recognition as a priority global health issue. Under the umbrella of the Roll Back Malaria Partnership, endemic countries, United Nations agencies, bilateral donors, public-private partnerships, scientific organizations, academic institutions, non-governmental organizations (NGOs) and the private sector worked together to scale up WHO-recommended interventions, harmonize activities and improve strategic planning, programme management and funding availability. Together with HIV/AIDS, tuberculosis and other neglected tropical diseases, malaria control was included under Goal 3, target 3, of the Sustainable Development Goals, which aims to “end the epidemics of AIDS, tuberculosis, malaria and other neglected tropical diseases” by the year 2030. WHO interprets this target as the attainment of the targets of the Global Technical Strategy for Malaria 2016-2030. The Global Technical Strategy sets the target of reducing the malaria disease burden by at least 40 per cent by 2020 and by at least 90 per cent by 2030. It also aims to eliminate the disease in at least 35 new countries by 2030.

4. The success of efforts to control and eliminate malaria is measured through an analysis of trends in the disease burden and intervention scale-up, and a review of progress made towards the global goals and targets of the Global Technical Strategy, which were agreed through a broad, consultative process.

Overview

• This weekly bulletin focuses on selected public health emergencies occurring in the WHO African region. The WHO Regional Office is currently monitoring 41 events: three Grade 3, seven Grade 2, five Grade 1, and 26 ungraded events.

• This weekly update focuses on key ongoing events in the region, the grade 3 humanitarian crises in Nigeria and South Sudan, the grade 2 outbreak of Ebola virus disease (EVD) in the Democratic Republic of Congo, outbreaks of dengue fever in Cote d’Ivoire,
  Lassa fever in Nigeria and an outbreak of typhoid fever in Zambia.

• For each of these events, a brief description followed by public health measures implemented and an interpretation of the situation is provided.

• A table is provided at the end of the report with information on all public health events currently being monitored in the region.

• Major challenges to be addressed include:

• Effective preparedness for prevention and rapid control of future outbreaks
• The impact of the security situation on effective response

Overview

• This weekly update focuses on selected acute public health emergencies occurring in the WHO African region. WHO AFRO is currently monitoring 41 events: four Grade 3, seven Grade 2, four Grade 1, and 26 ungraded events.

• This weekly update focuses on key ongoing events in the region, the Grade 3 humanitarian crises in South Sudan and Ethiopia, the Grade 2 outbreaks of Ebola virus disease in the Democratic Republic of Congo and meningitis in Nigeria, and necrotising cellulitis in Sao Tome and Principe, hepatitis E and meningitis outbreaks in Niger and the adverse event following immunization (AEFI) for measles in South Sudan.

• For each of these events, a brief description followed by public health measures implemented and an interpretation of the situation is provided.

• A table is provided at the end of the report with information on all public health events currently being monitored in the region.

• Major challenges to be addressed include:

• Timely communication of public health information

• Maintaining best practice healthcare protocols during emergencies

Overview

• This weekly bulletin focuses on selected public health emergencies occurring in the WHO African region. The WHO Regional Office is currently monitoring 41 events: three Grade 3, seven Grade 2, five Grade 1, and 26 ungraded events.

• This weekly update focuses on key ongoing events in the region, the grade 3 humanitarian crises in Nigeria and South Sudan, the grade 2 outbreak of Ebola virus disease (EVD) in the Democratic Republic of Congo, outbreaks of dengue fever in Cote d’Ivoire,
  Lassa fever in Nigeria and an outbreak of typhoid fever in Zambia.

• For each of these events, a brief description followed by public health measures implemented and an interpretation of the situation is provided.

• A table is provided at the end of the report with information on all public health events currently being monitored in the region.

• Major challenges to be addressed include:

• Effective preparedness for prevention and rapid control of future outbreaks
• The impact of the security situation on effective response

Overview

• This weekly update focuses on selected acute public health emergencies occurring in the WHO African region. WHO AFRO is currently monitoring 41 events: four Grade 3, seven Grade 2, four Grade 1, and 26 ungraded events.

• This weekly update focuses on key ongoing events in the region, the Grade 3 humanitarian crises in South Sudan and Ethiopia, the Grade 2 outbreaks of Ebola virus disease in the Democratic Republic of Congo and meningitis in Nigeria, and necrotising cellulitis in Sao Tome and Principe, hepatitis E and meningitis outbreaks in Niger and the adverse event following immunization (AEFI) for measles in South Sudan.

• For each of these events, a brief description followed by public health measures implemented and an interpretation of the situation is provided.

• A table is provided at the end of the report with information on all public health events currently being monitored in the region.

• Major challenges to be addressed include:

• Timely communication of public health information

• Maintaining best practice healthcare protocols during emergencies

This weekly bulletin focuses on selected acute public health emergencies occurring in the WHO African region. WHO AFRO is currently monitoring 40 events: three Grade 3, seven Grade 2, five Grade 1, and 25 ungraded events.

This week’s edition covers key ongoing events in the region, including the grade 3 humanitarian crises in South Sudan, Nigeria and Ethiopia, the grade 2 outbreaks of Ebola virus disease in the Democratic Republic of Congo and cholera in Tanzania, the Grade 1 outbreak of hepatitis E in Chad, dengue haemorrhagic fever outbreak in Mauritania, and circulating vaccine-derived poliovirus in the Democratic Republic of Congo.

For each of these events, a brief description followed by public health measures implemented and an interpretation of the situation is provided.

A table is provided at the end of the report with information on all public health events currently being monitored in the region.

Major challenges to be addressed include:

• Ensuring a functional public health surveillance system in the context of the Integrated Disease Surveillance and Response (IDSR).
  
• Intensifying water, sanitation, and hygiene (WASH) interventions as a premise to control the ongoing water-borne diseases outbreaks including acute watery diarrhoea, cholera, and hepatitis E.

Birger Fredriksen and Sukhdeep Brar
with Michael Trucano

This book offers policy options that can help reduce textbook costs and increase their supply. The book explores, in depth, the cost and financial barriers that restrict textbook availability in schools across much of the region, as well as policies successfully adapted in other countries. The book also provides a thorough assessment of the pros and cons of digital teaching and learning materials and cautions against the assumption that they can immediately replace printed textbooks.