WHO Angola Update
Nr. 05 – October 2001. 1st year
WHO Country
Strategy ( CCS )
control efforts, reinforce AFP epidemiological
surveillance
and
use
inter-personal
communication as a tool for social
mobilization.
WHO Angola technical staff, including
the
14
epidemiological
surveillance
technicians recently posted to the Provinces
and officials from various MoH Departments,
reviewed the current state of polio eradication
activities in the country. To this end a seminar
was held in Luanda on 25 and 26 October, as
part of the recent WHO retreat, with the aim of
identifying the implementation constraints of
the antennas set up in the 18 Provinces and
reinforcing technical assistance to health
programmes in Angola.
Also present at the meeting were Dr.
Babanyi, Coordinator of the Polio Eradication
Initiative in the WHO African Region, Dr.
Rigobert Adegbini of WHO/AFRO, Dr. René
Van der Werd of WHO Geneva and Dr. Steven
MacLaughlin of CDC (Center for Diseases
Control), USA. Under specific discussion was
the integration of the technicians at Provincial
level as well as the role that they have been
performing in supporting the Polio Eradication
Initiative.
In the conclusions approved at the
end of the meeting, the delegates noted
improvements in the surveillance indicators in
the last six months, as well as a better
performance in the organization of polio NIDs.
The implementation of “Kick Polio Out
of Africa” initiative, has started in 1995 with the
support of WHO, UNICEF, USAID, Rotary
international, DFID/GB, CDC/Atlanta, CORE,
the governments of Holland and Portugal,
Odebrecht, among other partners.
Cooperation
A
mission
from
the
WHO
headquarters in Geneva and WHO/AFRO was
in the country from 1 – 7 October 2001 to
begin the preparation of the WHO Cooperation
Strategy with Angola. The aim of this first
mission was to start a dialogue with the
government and all the partners in health
development, evaluate the situation of the
health sector and draw up an initial draft
cooperation strategy, as well as the initial
administrative
implications
on
the
Organization.
WHO started this process, which shall
cut across all countries in the six different
regions, in order to consolidate its cooperation
and technical assistance policy. Angola was
one of the first 8 countries selected for the
implementation of the process.
The strategy-drafting period is 20
weeks. The second mission to Angola is
scheduled for February 2002.
Vaccine-Preventable Diseases
Angola participated in an assessment
meeting of experts from the 5 countries of
Central Africa that are carrying out joint polio
eradication activities, which was held from 11
– 13 October in Kinshasa, DRC. The meeting
was to assess the outcome of the last joint
cross-border NIDs during which about 17
million children of 0 – 5 years in Angola, DRC,
Congo
Brazzaville
and
Gabon
were
immunized.
The Angolan delegation to this
meeting included Dr. Fátima Valente, WHO
Angola Head of Polio team, Dr. Rui Gama
Vaz, EPI experts and polio initiative partners.
The meeting also helped to define
coordination mechanisms for the NIDs
planned for 2002.
With the assistance of the bordering
countries, NGOs and the FAA (Angolan Armed
Forces) in the coverage of inaccessible areas,
3.9 million children were immunized during the
last NIDs in Angola.
In
Kinshasa,
the
participating
countries were encouraged to continue quality
Disease Prevention
and Control
Malaria Control
Angola was part of a committee of 8
African experts appointed to draft a study
protocol on the economic impact of Malaria in
Africa. Dr. Basílio Cassoma, National Malaria
Control Program (NMCP) expert and Angolan
representative in the committee, informed that
the country already has its own protocol, which
shall be implemented by WHO/AFRO in 2002.
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According to data available from a study
carried out by two Angolan experts, Dr. Raúl
Feio and Dr. Filomeno Fortes, the annual cost
implication of malaria in Angola is 125 million
Dollars.
The special joint RBM and IMCI group
met in Harare on 25 – 28 October 2001, as
recommended at the first meeting of the group
in 2000. Multilateral and Bilateral Cooperation
bodies, NGOs, private sector and research
institutions participated in the meeting. Angola
was represented by 3 MoH technical staff. The
meeting served as a forum for information
sharing between countries and to evaluate
progress made in the implementation, as well
as review the achievements and consider
challenges faced in the general application of
the strategies.
An AFRO/SAMC technical mission
supported the National Malaria Program from
18 – 02 November 2001. Activities to be
carried in the next months include provincial
working missions for the preparation of
provincial malaria epidemic control plans and
technical capacity building workshops for the
prevention, preparation and early detection
and response to the epidemic.
Angola received a 20 thousand
Dollars worth free batch of DFMO, a medicine
applied on patients at the critical stage of the
disease, in October.
Furthermore, as part of the Leprosy
Elimination
Initiative,
MoH
promoted
awareness campaigns for the implementation
of a project for the coverage of 80% leprosy
patients in the country, using the therapy
recommended by WHO. MoH, WHO and ILEP
NGO held workshops on capacity building and
planning actions for increased geographical
coverage with the MDT (Multi Drug Therapy).
MoH technicians from different Provinces
converged in Luanda and Lubango.
Emergency Preparedness
Two inter-country epidemiologists for
Southern Africa and the Great Lakes Region,
Dr. A. Mammo and Dr. N. Ndayimirije,
respectively, undertook a technical mission
from 21 September to 03 October 2001 to
assess the meningitis epidemic that occurred
in Benguela, Cunene, Kuando Kubango and
Luanda Provinces, as well as to propose
solutions for it. In Luanda, the mission
participated in a special review session of the
epidemic that was chaired by the National
Public Health Director, Dr. Adelaide de
Carvalho. The outcome of the review of the
epidemic from 1994 – 2001 and the meningitis
control statistics were presented at this event.
The meeting also witnessed the participation
of the officials from Hospitals, MoH, FAA
health sector, health-related UN agencies,
NGOs and Churches. The WHO team
recommended at this meeting that the national
epidemiological surveillance system be
reinforced and that studies on the
characterization of the meningitis situation be
continued.
WHO/AFRO consultants also visited
some Municipalities in Luanda, as well as in
the Province of Cunene, one of those affected
by the epidemic, where they gathered data on
the illness. During the campaign that involved
WHO, MSF/F, MoH and the Provincial
government, more than 70 thousand people
between 2 – 40 years were immunized against
meningitis.
MoH reported 41 new cases and two
meningitis-related deaths in the six Provinces
between 14 – 20 October. Between May and
October this year, Angola had a cumulative
figure of 1219 cases and 277 meningitisrelated deaths. The six affected Provinces are
Benguela, Cunene, Kuando Kubango, Bié and
Zaire.
With aim at facing this situation, the
Provincial Committee on Potential Epidemic
Disease decided to embark on a meningitis
immunization in Menongue Municipality of
Kuando Kubango Province. MSF/S together
with MoH, WHO, ACF and INTERSOS
Trypanosomiasis and Leprosy
Control
A new form of oral treatment of
trypanosomiasis based on a new Pentamidine
molecule “DB289”, has been undergoing tests
in Angola, since October 2001, on 30 patients
at the first stage of the disease admitted in a
referral center of Viana Municipality. Apart
from the oral application, the new treatment
has the advantage of being applied in just five
days, as against a minimum of seven and
maximum of 10 days required by the
intramuscular method hitherto in use. The
study is being carried out together with the
Swiss Tropical Institute of Basileia and North
Carolina University, USA. Angola has reported
42 thousand sleeping disease cases in the last
ten years. Treatment for sleeping disease is
free and the government with WHO takes care
of all medicine procurement costs.
WHO is developing international
efforts
to
help
countries
where
trypanosomiasis is endemic, as is the case of
Angola, and has got a guaranty of 25 million
Dollars
from
Adventis,
a
German
pharmaceutical company. Adventis has
accepted to supply medicines free of charge to
countries where the disease is endemic for the
next five years, such as Pentamidine,
Melarsoprol and DFMO. Also, support for the
production of new pharmaceutical products
and research on medicine combination and
field surveillance shall be guaranteed.
2
immunized 55.775 people between 2 – 30
years old, (65% of the total population).
12 vaccinators, 24 assistants, 36
registrars, 48 to organize the queue, 6
supervisors and one cold chain manager
embarked upon this action which last 6 days.
The immunization achieved 82.1% coverage
or 76.1% in the suburbs and 85.5% in the city
center.
Another epidemic that equally drew
the attention of the national health authorities
was measles, which recorded 257 cases and
17 deaths. The outbreaks occured in Bengo,
Bié, Cabinda, Huambo, Huíla, Kuanza Sul,
Kuando Kubango, Luanda, Malange, Moxico,
Uíge and Zaire Provinces.
The humanitarian crisis was still on
focus in Bengo, 60 kilometres from Luanda,
because of the deterioration of the security
situation in the Nambuangongo Municipality,
from where thousands of people have been
fleeing to more secure areas since September
this year.
According to the Local Administration,
about 35101 IDPs, corresponding to 9763
families, were concentrated in the “Cambambe
II IDPs Camp” (Porto Kipiri Commune) that is
located a few kilometers from Caxito capital of
Bengo. Daily arrivals have been informed and
more IDPs and more than 20 thousand people
are expected from the same area in the
coming days.
On 12 October, a multi-disciplinary
MoH and WHO team visited the “Cambambe II
IDPs Camp” for a rapid assessment of the
health and nutritional situation of the
population hosted there. The team together
with the government and the local partners
established guidelines for the improvement of
the health situation of the IDPs.
In the “Cambambe II IDPs Camp”, the
IDPs are assisted at an improvised tent health
post that is managed by “COSV”. The serious
cases are referred to the Açucararia de Caixão
Hospital. An unspecified number of cases of
Measles, Malaria, Scabies and diarrhea have
also been reported among the IDPs. The
mission noticed that the environmental health
and hygiene were deficient; most of the people
defecate in open air and there are breeding
grounds for mosquitoes, plasmodium vectors,
around the camp. This situation is expected to
worsen during the rainy season. The water
supplied through water-tanks is insufficient.
The “Kitandas on SIDA” is a launching
pad for the commemoration of the WORLD
AIDS DAY. Taking part in this initiative are 6
local NGOs, namely AALSIDA, ANGOBEFA,
ANATENO, MAR, RAIO and MAS, as well as
WHO technicians and Municipal authorities.
During this activity, workshops were held on
HIV/AIDS and health education materials such
as posters, condoms and audio-visual
materials were promoted.
As part of the preparation for the
World AIDS Day, regular meetings have been
held under coordination of the Honourable
Vice-Minister of Health, Dr. José Van-Dúnem.
Local
and
International
NGOs
and
governmental bodies are participating in these
meetings.
Environmental Health and
Sustainable Development
In October, the Environmental Health
Program of the National Directorate of Public
Health commenced the building of 6 double
latrines and water reservoirs in 3 primary
schools in the Municipalities of Cazenga and
Kilamba Kiax in Launda in collaboration with
some local NGOs.
The Environmental Health Program of
MoH and the Provincial Directorates of Public
Health of Kuanza Norte and Kuanza Sul are
building latrines for schools and IDPs areas,
aiming
at
improving
conditions
of
environmental hygiene and sanitation.
Nutrition
MoH is carrying out community-based
nutritional rehabilitation programs for children
under 5 years belonging to economically
underprivileged families in Moxico Province.
This project has the participation of MINARS,
Churches, as well as NGOs, namely “Save the
Children Fund”, LWF, CAPDC and MSFBelgium. The actions are carried out in the
Intensive Nutritional Centre, at the Nutritional
Feeding Centre and in 27 PICs and
Community kitchens. High among the
constraints identified by the National Nutrition
Programme are the lack of potable or pipe
borne water in the Nutrition Centres and
community kitchens and non-compliance with
the national norms for the Intensive Centre by
some NGOs.
A seminar on integrated nutrition was
held in Malange with the participation of 24
people including technicians from MoH, NGOs
and journalists. This meeting was held to
analyze the multi-disciplinary nature of
nutritional problems. Also discussed were the
biological aspects of micronutrients as well as
the development of practical activities in health
HIV / AIDS
ANASO, network of local HIV NGOs,
organized various “Kitandas on SIDA”, on 13
October 2001 at “Roque Santeiro” the biggest
market in Luanda, as a way of promoting
greater awareness on the disease. As at July
2001, MoH had reported 7,607 AIDS cases,
whereas UNAIDS estimates of 1999 indicate
150 thousand HIV carriers in Angola.
3
institutions, MoH and other CARITAS and
MINARS centres.
As part of the framework for the
implementation of WHO Operational Plan for
the African Region, an Inter-country workshop
on Nutrition in Emergency Situation, was held
in Kigali-Rwanda, from 9 – 12 October. Apart
from WHO, other agencies namely UNICEF,
UNDP, FAO, UNHCR, Save the Children Fund
and NUTRIPA attended the workshop. The
aim of the workshop was to reinforce correct
local management capacity for nutritional
problems in situations of emergency. Angola
was represented by Dr. Paulina Semedo,
Director of the National Nutrition Programme.
A national course on nutritional survey was
held by ACF (Acção Contra Fome) at the
premises of DNSP in Luanda. Participants at
this course included six technicians including
two from the national nutrition program, two
from the Directorate of Luanda, one from
Minars and one from INE (National Statistics
Institute). The duration of the course is six
months and it shall train the six technicians on
how to carry out nutritional surveillance survey
and nutritional data analysis. This course was
supported by UNICEF.
====================================
Technical Team:
Dr Pier Paolo Balladelli, Representative; Dr Rui Gama Vaz, Team Leader/Polio; Eng. Gabriela
Guerra, Environmental Health; Dr Balbina Félix, Disease Prevention and Control; Dr Dalva Barros,
Human Resources and Reproductive Health; Dr Domingos Nsala e Dr Arturo Silva, Emergency
Control; Dr Nkunku Sebastião, Malaria e Tripanossomiasis; Dr. Michel Kouakou, Administration;
Marques Gomes, HIV/AIDS Surveillance Project; Adolfo Sampaio, TB Project Coordinator;
Bernardino Teixeira, Leprosy Project Coordinator; Mr. José Caetano, Health Information Officer.
Kanhangulo nr. 197 – 7th floor Luanda – Angola
whoang@ebonet.net, Tels: (2 442) 332398, (1 321 ) 956 38 82; Fax: (2442) 332314
Address:
Rua
Major
4
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