The global burden of Improvised Explosive Devices

Iain Overton and Jennifer Dathan

There is no day that goes past without the impact of an improvised explosive device (IED) making headlines around the world. Of all explosive weapons used, the IED is the most widespread, the most harmful and the most pernicious. Based on the belief that to overcome a problem, we must first understand it, this monitor is a small step in seeking to address the terrible realities of today.
It is a monitor that is, also, a response to a call to action.

In July 2016, the United Nations Secretary-General released a report called “Countering the threat posed by improvised explosive devices”. Within its pages lay a recommendation: ‘Further research on various dimensions of IED issues, including prevention, preparedness, response and recovery’ was called for, so as to ‘help inform a better understanding of the multifaceted approach required to address the issue of IEDs’ (Recommendation 22). In addition, in late 2016, the Afghanistan government proposed, for the second year, a resolution: “Countering the Threat Posed by Improvised Explosive Devices.” It was adopted by the General Assembly on December 5th 2016. Its text encouraged greater research and awareness-raising on improvised explosive devices (IEDs).

Accordingly, based on data from AOAV’s own Explosive Violence Monitor, and further in-depth research by experts in this field, AOAV presents this monitor on IED harm, developments, tactics, and users.
For more information, please go to AOAV’s website: www.aoav.org.uk or contact its Executive Director,
Iain Overton, at ioverton@aoav.org.uk.

26 October 2017 – The provincial health department of Khyber Pakhtunkhwa Province in Pakistan has reported an additional 12 430 suspected cases of dengue fever and 4 deaths since last week. So far, a cumulative total of 87 250 cases have been reported since 19 July 2017, including 18 892 laboratory-confirmed cases and 58 deaths.

The district Peshawar has reported the highest number of cases, with a current total of 78 844 suspected cases, including 16 991 confirmed cases and 53 deaths.

The Provincial Directorate of Health is coordinating efforts of the Dengue Response Unit in collaboration with WHO. This includes providing technical guidance and support for health workers in the areas of surveillance, laboratory diagnosis, case management and social mobilization.

Awareness sessions have been held for religious leaders, school teachers and head masters to advise the community on dengue causes and prevention. Lady health workers have been engaged to conduct door to door activities for raising awareness of dengue symptoms and ensuring the referral of suspected cases to health facilities. Households in various areas of Peshawar have been sprayed with larvicide (space spraying) and provided health education on dengue prevention.

Dengue is a mosquito-borne viral infection that causes a severe flu-like illness, and sometimes causes a potentially lethal complication called severe dengue. The viruses are passed on to humans through the bites of an infective female Aedes mosquito, which acquires the virus while feeding on the blood of an infected person. Dengue is one of the fastest spreading viral infections in the world, and is endemic to Pakistan.

Polio this week as of 25 October 2017

• New on polioeradication.org: Award winning animations Responding to a Polio Outbreak, Reaching Every Last Child, and The Polio Surveillance System.

• On 24 October, millions of people around the globe engaged in actions for World Polio Day. Highlights included the 5th annual World Polio Day event, bringing together experts and celebrities to share progress on the road to polio eradication, hosted by Rotary and the Bill & Melinda Gates Foundation in Seattle, Washington, USA; and a show of support from individuals, national governments, and media outlets around the world.

• Read World Polio Day coverage about the unsung heroes of polio eradication and how we are ending polio. From the field, read Polio and Me: A Syrian Doctor’s Story, how one man became a doctor to end polio and protect children from the disease that crippled him as a young boy.

• In a remarkable endorsement, German Chancellor Angela Merkel used her weekly podcast to draw attention to the World Polio Day (celebrated in Germany on 28 October) and the considerable progress in polio eradication.

• Summary of newly-reported viruses this week: Afghanistan: Two new wild poliovirus 1 (WPV1) positive environmental samples reported, one from Nangarhar and one from Kandahar provinces. Pakistan: One new wild poliovirus 1 (WPV1) positive environmental sample reported, in Sindh province.

• Additionally, an advance notification was received this week of a new WPV1 case in Afghanistan from Shahwalikot district in Kandahar province.  The case will be officially reflected in next week’s global data reporting.

• See country-specific sections for further details.

Afghanistan

• Two new wild poliovirus type 1 (WPV1) positive environmental samples were reported in the last week, one received from Nangarhar district in Jalalabad province, collection 23 September, and one received from Kandahar district, Kandahar province, collection 5 October.

• No new wild poliovirus type 1 (WPV1) cases were reported in the past week. The total number of officially reported WPV1 cases in Afghanistan in 2017 remains seven.

• An advance notification was received this week of a new WPV1 case from Shahwalikot district, Kandahar province with onset of paralysis on 2 October. The case will be officially reflected in next week’s global data reporting.

• A response vaccination campaign has been completed for to the most recent WPV1 case in the country (occurring in Batikot district, Nangarhar province). The campaign targeted over 140,000 children in five districts of the eastern region.

• The next sub-national immunization days are planned during the first half of November 2017.

• Read the latest polio update from Afghanistan to see information on cases, surveillance and vaccination campaigns.

Pakistan

• One new wild poliovirus type 1 (WPV1) positive environmental sample was reported in the last week. The sample was collected on 11 October, from Karachi Gadap district, Sindh province.

• No new wild poliovirus type 1 (WPV1) cases were reported in the past week. The total number of WPV1 cases in 2017 in Pakistan remains five.

• Preparations are underway for the next round of sub-national immunization days (SNIDs), which will begin on 30 October 2017.

• Read the latest polio update from Pakistan to see information on cases, surveillance and vaccination campaigns.

Nigeria

• No new cases of wild poliovirus type 1 (WPV1) were reported in the past week. The total number of WPV1 cases for 2016 remains four and no cases have been reported in 2017. The most recent case had onset of paralysis on 21 August 2016 in Monguno Local Government Area, Borno.

• Nigeria continues to implement an emergency response to the detected WPV1 strain and circulating vaccine-derived poliovirus type 2 (cVDPV2) strains affecting the country (last detected in 2016).

• Detection of polio cases in Nigeria underscores the risk posed by low-level undetected transmission. As part of the emergency response, subnational surveillance continues to be strengthened.

• The next scheduled SIA activity will take place at the beginning of November, using bOPV vaccine to protect over 10 million children under the age of 5 years from polio.

Lake Chad Basin

• The detection of wild poliovirus type 1 (WPV1) (Borno state, Nigeria in 2016) and circulating vaccine-derived poliovirus type 2 (cVDPV2) (Borno and Sokoto states in 2016) continue to pose a risk to the neighbouring countries of the Lake Chad basin.

• Emergency outbreak response efforts continue across the Lake Chad basin, together with activities to fill subnational surveillance gaps across the region.

• These activities include efforts to vaccinate children at markets, in internally displaced persons camps, and at international borders.

• In Chad, the AVADAR project is being introduced in the Hadjar Lamis region. This is a mobile-based surveillance application developed by eHealth Africa, the Bill & Melinda Gates Foundation, WHO, and Novel-T, which allows users to easily report cases of acute flaccid paralysis in health facilities and local communities. The programme is already in operation in other regions in Chad, as well as in Cameroon, Niger and Nigeria.

• Planning continues to ensure that immunization days in early November in all Lake Chad Basin countries go ahead as planned. Countries are conducting meetings to incorporate lessons learned from previous campaigns into the November campaigns.

• A large livestock vaccination campaign targeting international nomads is planned for the end of November.

• Preparations continue for the second Outbreak Response Assessment (OBRA) for the region. This is taking place from 29 October -10 November in the Central African Republic and in Nigeria, and from 1-15 November in Chad and Niger.

• Read the latest polio update from the Lake Chad Basin to see information on cases, surveillance and vaccination campaigns

Central Africa

• No new cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) were reported this week in the Democratic Republic of the Congo (DR Congo).

• The total number of cVDPV2 cases this year is nine, in two separate outbreaks: in Haut Lomami province (seven cases, with onset of paralysis of the most recent case on 27 July); and in Maniema province (two cases with onset of paralysis on 26 March and 18 April, with an additional isolate detected in a healthy individual with sample collection on 2 May).

• Outbreak response continues to take place, including use of monovalent oral polio vaccine type 2 (mOPV2) in line with internationally-agreed outbreak response protocols.

• This month, over 10 million children were immunized as part of a bOPV subnational immunization campaign, facilitated and led by volunteers and staff from WHO, UNICEF, and partner agencies.

• The next immunization activity, taking place in November, is a mop-up campaign of Tshopo province, and several provinces in the south of the country. Using mOPV2, vaccinators aim to protect over 800,000 children from polio.

• In Haut Lomami and Maniema social mobilization is being used to show parents how important it is for their child to receive polio vaccine.

• Surveillance and immunization activities are being strengthened in neighbouring countries.

• The country office continues to be supported by HQ to ensure the close analysis and mapping of cases and outbreak response.

The Middle East

• In Syria, No new cases of cVDPV2 were reported this week. The total number of cVDPV2 cases in this outbreak remains 52. All confirmed cases to date have had onset of paralysis between 3 March and 25 August 2017.

• The bulk of all cases continue to be from two districts in Deir Ez-Zor governorate; Mayadeen (42) and Boukamal (6).

• Two immunization rounds have now been completed in both Deir Ez-Zor and Raqqa governorates bringing the first phase of the outbreak response to a close. Post Campaign Monitoring results for the second Raqqa round are still being compiled into a final report. However, initial data suggests that 84% of children were reported as vaccinated through market surveys.

• IPV campaign activities aiming to reach children aged between 2-23 months in 2 districts of Raqqa governorate (Raqqa and Thawra) have also now concluded. Work is on ongoing to start this activity in Tell Abyad district as quickly as possible.

• A two-day workshop was held at WHO offices Amman on 15-16 October to review the ongoing risks of continued polio transmission in Syria and develop contingency plans for any potential breakthrough cases in known outbreak zones or spread of virus to new areas of the country. Draft plans developed outline the steps needed, if further polio transmission is detected, to ensure rapid and effective vaccination of Syrian children no matter where in the country they live. This was a key recommendation of a series of meetings to review the cVDPV2 outbreak response, held in Beirut on 30 September 2017.

• Read the latest polio update from Syria to see information on cases, surveillance and vaccination campaigns.

KEY INDICATORS

589 Registered intentions to seek asylum in Serbia

34% of registered refugees and migrants were minors

2 Applications for asylum

0 Persons granted refugee status

1 Persons granted subsidiary protection

• After a lull during the summer, the number of new arrivals grew again: 672 new arrivals (as compared to 351 in August) were encountered and assisted. 49% were men, 17% women and 34% children (incl. 28 newly arrived unaccompanied or separated children). 58% originated from Iraq, 9% arrived from Afghanistan, 8% from Syria, 12% from Pakistan and 13% from other countries. 69% arrived to Serbia from Bulgaria.

• Excellent progress was made in school enrolment: by the end of September, the number of refugee, asylum-seeking and migrant children attending public primary schools reached 450 (including 100 who were schooled inside the Transit Centres of Sombor, Subotica and/or Kikinda).

• Also, the number of departures and thus testimonies of collective expulsions increased from 930 in August to 1,024 in September, of which 432 from Hungary, 254 from Croatia and 338 from Romania, with many alleging to have been denied due access to asylum procedures and some to have been maltreated.

• A growing number of crimes allegedly committed by unregistered migrant men from North Africa, led to concerns in Šid and Belgrade.

• At night of 09-10 September a young man from Algeria lost his life while another sustained severe burns when touching overhead cables at Sid rain station.

• On 26 September, in a village near Kikinda (North), the police found the body of a young foreign man.
  It appears that he had planned to irregularly cross into Romania but died of a heart attack.

Joint news release CDC/GAVI/UNICEF/WHO

26 OCTOBER 2017 | GENEVA/NEW YORK/ATLANTA - In 2016, an estimated 90 000 people died from measles - an 84% drop from more than 550 000 deaths in 2000 - according to a new report published today by leading health organizations. This marks the first time global measles deaths have fallen below 100 000 per year.

"Saving an average of 1.3 million lives per year through measles vaccine is an incredible achievement and makes a world free of measles seem possible, even probable, in our lifetime," says Dr Robert Linkins, of the Measles and Rubella Initiative (MR&I) and Branch Chief of Accelerated Disease Control and Vaccine Preventable Diseases at the Centers for Disease Control and Prevention. M&RI is a partnership formed in 2001 of the American Red Cross, the US Centers for Disease Control and Prevention, the United Nations Foundation, UNICEF, and WHO.

Since 2000, an estimated 5.5 billion doses of measles-containing vaccines have been provided to children through routine immunization services and mass vaccination campaigns, saving an estimated 20.4 million lives.

"We have seen a substantial drop in measles deaths for more than two decades, but now we must strive to reach zero measles cases," says Dr Jean-Marie Okwo-Bele, Director of WHO's Department of Immunization, Vaccines and Biologicals. "Measles elimination will only be reached if measles vaccines reach every child, everywhere."

The world is still far from reaching regional measles elimination goals. Coverage with the first of two required doses of measles vaccine has stalled at approximately 85% since 2009, far short of the 95% coverage needed to stop measles infections, and coverage with the second dose, despite recent increases, was only 64% in 2016.

Far too many children - 20.8 million - are still missing their first measles vaccine dose. More than half of these unvaccinated children live in six countries: Nigeria (3.3 million), India (2.9 million),
Pakistan (2.0 million), Indonesia (1.2 million), Ethiopia (0.9 million), and Democratic Republic of the Congo (0.7 million). Since measles is a highly contagious viral disease, large outbreaks continue to occur in these and other countries in Europe and North America, putting children at risk of severe health complications such as pneumonia, diarrhoea, encephalitis, blindness, and death.

Agencies noted that progress in reaching measles elimination could be reversed when polio-funded resources supporting routine immunization services, measles and rubella vaccination campaigns, and surveillance, diminish and disappear following polio eradication. Countries with the greatest number of measles deaths rely most heavily on polio-funded resources and are at highest risk of reversing progress after polio eradication is achieved.

"This remarkable drop in measles deaths is the culmination of years of hard work by health workers, governments and development agencies to vaccinate millions of children in the world's poorest countries," said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance, one of the world's largest supporters of measles immunization programmes. "However we cannot afford to be complacent. Too many children are still missing out on lifesaving vaccines. To reach these children and set ourselves on a realistic road to measles elimination we need to dramatically improve routine immunization backed by strong health systems."

Note to editors:

Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographical area for ?12 months, in the presence of a well-performing surveillance system.

Launched in 2001, the Measles & Rubella Initiative (M&RI) is led by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and the World Health Organization. M&RI is committed to ensuring that no child dies from measles or is born with congenital rubella syndrome, reducing measles deaths by 95% by 2015, and achieving measles and rubella elimination in at least five WHO regions by 2020. The WHO Region of the Americas has sustained measles elimination since 2002, and the European and Western Pacific Regions have made significant elimination progress. All six WHO Regions have established measles elimination goals.

The latest data is published in this week's WHO's Weekly Epidemiological Report and in CDC's Morbidity and Mortality Weekly Report.

Related links:

CDC's Morbidity and Mortality Weekly Report: www.cdc.gov/mmwr/mmwr_wk.html

This publication will be live at 19:00 CET/18:00 BST/13:00 EST THURSDAY 26 OCTOBER

WHO's Weekly Epidemiological Report: http://www.who.int/wer/en/

Media Contacts:

Fadéla Chaib
Communications Officer
Telephone: +41 22 791 3228
Mobile: +41 79 475 5556
E-mail: chaibf@who.int

Sabrina Sidhu
UNICEF New York
Tel: +12128246583
Mobile +1 917 476 1537
Email: ssidhu@unicef.org

James Fulker
Gavi, the Vaccine Alliance
Telephone: +41 79 429 55 05
Email: jfulker@gavi.org

Amy Rowland
Centers for Disease Control and Prevention
Telephone: +1 770 488 5104
Email: isc4@cdc.gov

By Nadir Guramani

The Senate's Standing Committee on Human Rights on Thursday expressed severe concerns over the issue of missing persons and said that those responsible were yet to be identified.

Senator Nasreen Jalil, who was chairing a meeting of the committee, asked who was behind the disappearances of people.

"People were gone missing but still those responsible have not been identified, " she noted, adding that it was a matter of grave concern.

It is also condemnable that registration of the First Information Reports in such cases is often denied, she said.

"The issue of missing persons is still ongoing in the country as another list of 131 missing persons has surfaced," she added.

Senator Farhatullah Babar said that according to international laws, a country was bound to protect the rights of people living there. He, however, confessed that as a state they have failed to ensure the provision of human rights to people.

Referring to the violations of human rights in Punjab, Senator Mir Kabeer said that more than 100 labourers in Mandi Bahahuddin had sold their kidneys to pay back loans their parents took.

Senator Nisar Mohammad Khan also expressed concerns over violations of the rights of children and women.

In an earlier meeting, the committee had held law enforcement agencies responsible for the 'disappearing' of people.

Earlier in the day, the Supreme Court too had called for a detailed report on all missing persons detained at all government facilities.

By Behram Baloch

GWADAR: Militants be­­lon­ging to different banned separatist groups threw a hand grenade at an office of a newspaper agency in Turbat on Thursday, leaving eight people, including an on-duty traffic police constable and a child, injured.

In another attack, the militants opened fire on a vehicle carrying newspapers in Awaran area, burst all its tyres with gunshots and torched the newspapers.

Separatist militant groups have launched a campaign against media houses for not publishing their statements in newspapers.

Police officials said that the militants riding a motorbike hurled a grenade at Pak-News Agency in Turbat town, leaving eight people injured, including an on-duty traffic police constable, staff of the newspaper agency, and a child.

They said that law-enforcement personnel rushed to area and took the injured to Turbat district hospital.

The condition of the child was stated to be serious and he was taken to Karachi.

Published in Dawn, October 27th, 2017

Nansen Refugee Award winner completed education project in Punjab

KOT CHANDNA, MIANWALI, 26 October 2017 – Ms. Aqeela Asifi – the 2015 Nansen Refugee Award winner – has successfully completed her education project in Kot Chandna refugee village in Mianwali district in Punjab, benefiting over 200 female students.

The government of Punjab has formally upgraded the Community Girls Model School No 2, which is being run by Aqeela Asifi. This middle-secondary school has been expended to higher-secondary school by including 9th and 10th grade classes for refugee students.

Utilizing the Nansen award money, Ms. Aqeela Asifi implemented the education project with two components. Additional classrooms and a new science laboratory were built and equipped with beakers, charts, models, microscope and tube. A small library was established for students to read different books.

Under the project, Punjab Vocational Training Council (PVTC) executed a skill development programme for the refugee female students. As many as 42 pupils had successfully completed the five-month training courses in basic computer and tailoring.

Speaking at the project completion ceremony, the UN refuge agency Representative in Pakistan, Ms. Ruvendrini Menikdiwela lauded the efforts and dedication of Ms. Aqeela Asifi for the promotion of education for Afghan refugee girls in Pakistan. “Her decision to use the Nansen Award funding to support the upgradation of the school and create skills training opportunities for girls further reflects her genuine commitment to bring girls to the classrooms and equip them with skills,” she said.

She appreciated the Government of Pakistan and Punjab for not only hosting Afghan refugees, but also creating an enabling environment for learning and skills building. “Punjab is known for its strong commitment to education, and it is heartening to see that the Government extends the same opportunities for empowerment to Afghan refugees too,” she added.

Commissioner Afghan Refugees, Punjab, Mr. Riaz Chaudhry said that the Government has been making efforts to ensure Afghan refugees have access to education, skills training and health services in Pakistan. “Our office has made concerted efforts to help upgrade and affiliate Ms. Aqeela’s school with the Sargoda (Punjab) education board,” he said, adding they will continue to support the refugees.

Ms. Aqeela Asifi said many girl students had to stay home after completion of their grade 8 as there were no higher secondary schools in the entire camp. Owing to the upgradation of the school, now a first batch of around 14 students are enrolled in Grade 9.

With the five-month computer and tailoring training, Aqeela said female students are now able to earn a decent living. “The students used to purchase cloths in open market at Rs.2000 (USD20), now they can stitch their cloths for themselves, for families and neighbours. They now earn,” she said, adding she feels relieved and glad to see her students are fulfilling their dreams.

The ceremony was attended by representatives from the Norwegian Embassy, Government and Punjab Vocational Training (PVTC). Elders and students of Kot Chandna refugee village were also present at the occasion. Certificates were distributed to the students who participated in the vocational skills training at the occasion.

KEY UPDATES:

• The health cluster partners served 79,924 beneficiaries during September. Almost 62% of the beneficiaries were female and 38%were male.

• A total of 26,357 returnees received outpatient diagnosis and emergency primary health care services, including TB screening, at the Torkham crossing point.

• 258 families (1,311 individuals) of documented returnees arrived from Pakistan through Spin Boldak. 303 patients among documented returnees were treated by a health facility for which WHO supplied medicines.

• 244 families (1,507 Individuals) of undocumented returnees returned to Afghanistan through Spin Boldak border.

• 8,012 children received vaccination by health partners.

• Security remains a concern with an increase in the closure of health facilities.

• AGE-related security incidents also hindered monitoring and supervision of health activities and have forced people to leave their homes.

PROGRAMME ACTIVITIES AND ACHIEVEMENTS:

• In Kunduz, preparations, including recruitment of staff, are made to ensure operation of a trauma care unit in the regional hospital.

• Takhar and Kunduz provincial hospitals organized Mass Casualty Management (MCM) simulation exercises.

• National Immunization Day Campaigns were held on 24-29 Sep in the north and on 25-27 in southern regions. The campaigns targeted 2,932,517 children under the age of 5.

• WHO delivered Trauma Care equipment to Fatimatul Zahra provincial hospital.

• Trauma care services in Belandghar and Sultanpur Comprehensive Health Centers in Nangrahar were upgraded.

• A Mass Casualty Management plan was activated as a precaution to expected incidences during Eid-al-Adha celebrations in Kandahar.

• WHO and Emergency Health Action monitored and provided technical support for the health care of documented returnees. WHO distributed medical kits and medical supplies in the southern and eastern regions.

• Two electro-chlorination kits were installed in Laghman province to provide chlorine stock solution for the purification of drinking water. Around 380 liters of chlorine stock solution was also distributed to almost 2,440 households.

PESHAWAR: Prof Dr Siripen Kalayanarooj Director World Health Organization (WHO) Collaborating Center for Dengue Case Management, Queen Siriket Hospital Mahidol University Thailand and Prof Dr Mukada consultant WHO collaborating Center for Dengue Case Management Thailand along with Head of Office WHO sub office Peshawar Dr M Saeed Akbar and Dr Sardar visited KTH.

They visited the Dengue OPD, Dengue Facilitation Clinics, Dengue Laboratory Clinics, medical wards and other dengue facilitating unit. WHO Dengue Collaboration Center in Thailand experts were called by the Provincial Health Department to visit the hospitals catering dengue patients and affected areas.

The team visited hospital and held consultative meetings with the faculty experts and helped in developing SoPs and protocols which can be applicable throughout the Khyber Pakhtunkhwa while dealing with dengue patients. The foreign expert team will have two day comprehensive contact session on dengue case management with the consultants from all the district hospitals of KP. The dengue management experts started their sessions with MTI KTH as the hospital is facing 90% of the dengue influx and has made exclusive arrangements for the dengue patients. The experts wanted to get first hand information from the senior faculty of MTI KTH before starting the training sessions to know the ground realities. MTI KTH is following the bed management policy strictly.

Prof Dr Hashim Uddin Azam Khan Chairman Infectious Control Committee, Prof Dr Ghulam Shabir and Associate Prof Dr Wazir Mohammad Khan Medicine Department briefed foreign experts and replied to the queries regarding patient care. They explained the team about how they implement WHO, CDC, and international protocols and guidelines. The protocols and guidelines are displayed in different wards as well as clinics in the institution.

During the discussion it was pointed out that more than 30% patients do not need admissions. When a patient is diagnosed of dengue in the hospital it is very difficult to shift them to another hospital is very difficult because most of the time they refuse to go to any other hospital.

Hospital Director Dr Nekdad Khan briefed the team about the overall arrangements made by the institution for the special facilitation and arrangement of dengue patients in outbreak.

Medical Director Prof Dr Rooh-ul-Muqim explained the clinical side, hospital admission and referral policy followed by the institution.

Director Pathology Dr Asghar briefed them about how pathology department is working round the clock and details of the patient screening were shared.

Blood Bank In-charge and focal person for dengue Dr Farman Ali explained them the data collection process of the patients and how it is shared with the stakeholders for prevention of dengue.

The team was told that so far KTH has screened 69966 out of which 15441 were positive for dengue serology. 4198 patients were admitted in MTI KTH whereas 4004 were recovered and discharged till date.

The dengue management experts appreciated the efforts made by MTI KTH clinical and non clinical staff that is working day and night to facilitate the patients.

Communiqué de presse conjoint CDC/GAVI/UNICEF/OMS

26 OCTOBRE 2017 | GENÈVE /NEW YORK/ATLANTA - Selon un nouveau rapport publié aujourd’hui par plusieurs organisations de premier plan dans le domaine de la santé, la rougeole a entraîné 90 000 décès en 2016 ce qui représente une baisse de 84% par rapport à 2000, où l’on avait enregistré 550 000 décès attribuables à cette maladie. C’est la première fois que le nombre de décès dus à la rougeole est inférieur à 100 000 par an.

«Parvenir à sauver, en moyenne, 1,3 million de vies grâce au vaccin antirougeoleux est un succès extraordinaire qui nous permet de croire qu’il sera possible, voire probable, d’assister de notre vivant à l’éradication de la rougeole, déclare le Dr Robert Linkins, de l’Initiative contre la rougeole et la rubéole (M&RI) et responsable du service de la lutte accélérée contre les maladies et des maladies à prévention vaccinale aux Centers for Disease Control and Prevention. La M&RI est un partenariat conclu en 2001 entre la Croix-Rouge amércaine, les Centers for Disease Control and Prevention des États-Unis d’Amérique, la Fondation pour les Nations Unies, l’UNICEF et l’OMS.

On estime que, depuis 2000, 5,5 milliards de vaccins à valence rougeole ont été administrés à des enfants dans le cadre de services de vaccination systématique et de campagnes de vaccination de masse, ce qui a permis de sauver 20,4 millions de vies environ.

«Nous assistons depuis plus de 20 ans à une baisse considérable du nombre de décès dus à la rougeole mais, maintenant, nous devons tout faire pour qu’il n’y ait plus un seul cas. La rougeole sera éliminée seulement si tous les enfants, partout, sont vaccinés contre la maladie», souligne le Dr Jean-Marie Okwo-Bele, Directeur du Département Vaccination, vaccins et produits biologiques de l’OMS.

Les objectifs en matière d’élimination de la rougeole au niveau régional sont loin d’être atteints. Le taux de couverture par les 2 doses de vaccin antirougeoleux requises stagne à 85% environ depuis 2009, bien loin des 95% nécessaires pour enrayer la maladie, et, malgré une augmentation récente, le taux de couverture par la deuxième dose n’était que de 64% en 2016.

Beaucoup trop d’enfants encore – 20,8 millions – ne reçoivent pas leur première dose de vaccin antirougeoleux. Plus de la moitié de ces enfants non vaccinés vivent dans six pays: le Nigéria (3,3 millions), l’Inde (2,9 millions), le Pakistan (2 millions), l’Indonésie (1,2 million), l’Éthiopie (0,9 million) et la République démocratique du Congo (0,7 million). Comme la rougeole est une maladie virale très contagieuse, des flambées de grande ampleur continuent à frapper ces pays et d’autres pays d’Europe et d’Amérique du Nord, exposant les enfants à de graves complications, comme la pneumonie, la diarrhée, l’encéphalite et la cécité, et pouvant même entraîner la mort.

Les organismes impliqués ont observé que les progrès accomplis vers l’élimination de la rougeole pourraient être remis en cause lorsque les ressources destinées à la lutte contre la poliomyélite, qui financent les services de vaccination systématique, les campagnes de vaccination contre la rougeole et contre la rubéole ainsi que la surveillance, diminueront puis disparaîtront après l’éradication de la poliomyélite. Les pays où l’on déplore le plus de décès dus à la rougeole sont ceux qui dépendent le plus des ressources destinées à la lutte contre la poliomyélite et donc ceux où l’on risque d’assister à une régression après l’éradication de la poliomyélite.

«Cette baisse remarquable du nombre de décès dus à la rougeole a été possible grâce à l’acharnement des agents de santé, des gouvernements et des organismes de développement qui a permis de vacciner des millions d’enfants dans les pays les plus pauvres. Cependant, nous ne devons pas être exagérément optimistes. Trop d’enfants ne bénéficient pas des vaccins vitaux. Pour que ces enfants soient vaccinés et que nous puissions nous fixer des objectifs réalistes en vue d’éliminer la rougeole, nous devons améliorer considérablement la vaccination systématique en nous appuyant sur des systèmes de santé solides», déclare le Dr Seth Berkley, PDG de Gavi, l’Alliance du Vaccin, l’un des principaux soutiens des programmes de vaccination contre la rougeole dans le monde.

Note aux rédactions

À condition qu’il existe un système de surveillance efficace, la rougeole est considérée comme éliminée lorsqu’il n’y a plus de transmission endémique du virus dans une Région ou une autre zone géographique donnée pendant 12 mois au moins.

Lancée en 2001, l’Initiative contre la rougeole et la rubéole (M&RI) est dirigée par la Croix-Rouge américaine, la Fondation pour les Nations Unies, les Centers for Disease Control and Prevention des États-Unis d’Amérique, l’UNICEF et l’Organisation mondiale de la Santé. Elle a pour but que plus aucun enfant ne meure de la rougeole ou ne soit porteur d’un syndrome de rubéole congénitale, d’avoir fait baisser de 95% le nombre de décès dus à la rougeole en 2015 et de parvenir à l’élimination de la rougeole et de la rubéole dans au moins cinq Régions de l’OMS d’ici à 2020. La rougeole est éliminée de la Région OMS des Amériques depuis 2002 et les Régions européenne et du Pacifique occidental ont fait des progrès considérables. Les six Régions de l’OMS ont défini des objectifs en matière d’élimination de la rougeole.

Les dernières données sont publiées dans le Relevé épidémiologique hebdomadaire de l’OMS de cette semaine et dans le Morbidity and Mortality Weekly Report des CDC.

Pour plus d'informations, veuillez prendre contact avec:

Fadéla Chaib
Département de la Communication, OMS
Téléphone: +41 22 791 3228
Portable: +41 79 475 5556
Courriel: chaibf@who.int

Sabrina Sidhu
UNICEF New York
Téléphone: +12128246583
Portable: +1 917 476 1537
Courriel: ssidhu@unicef.org

James Fulker
Gavi, the Vaccine Alliance
Téléphone: +41 79 429 55 05
Courriel: jfulker@gavi.org

Amy Rowland
Centers for Disease Control and Prevention
Téléphone: +1 770 488 5104
Courriel:isc4@cdc.gov

Moisture deficits continue to grow in eastern Ethiopia, Somalia, and Kenya

Africa Weather Hazards

1. Moisture deficits have grown in eastern Ethiopia, southern and central Somalia, and northeastern Kenya due to poor rainfall since late September. Over central and southern Somalia, a dry weather pattern is forecast, which could worsen conditions on the ground.

Key messages

• International prices of wheat increased in September mostly because of weather-related concerns, while maize quotations fell further on crop harvest pressure. International rice prices remained generally firm, supported by seasonally tight availabilities of fragrant rice and strong demand for higher quality Indica supplies.

• In East Africa, prices of cereals remained at levels above those of a year earlier in most countries, particularly in Ethiopia reflecting seasonal tightness amid concerns over the impact of the Fall Armyworm infestation on the main harvest and in South Sudan mainly due to the ongoing conflict.

• In Asia, prices of rice in Bangladesh increased again in September and reached record highs, with seasonal patterns exacerbated by the reduced 2017 main season output and concerns over the impact of the July-August floods on the second season crop, to be harvested from November.

146,287 TOTAL ARRIVALS TO EUROPE

137,771 TOTAL ARRIVALS TO EUROPE BY SEA

8,516 TOTAL ARRIVALS TO EUROPE BY LAND

Highlights

Compilation of available statistical data indicates that the arrivals to Europe through the Mediterranean in the first nine months of 2017 are lower when compared to the same period in 2016. As of 30 September 2017, national authorities in Greece, Italy, Cyprus, Bulgaria and Spain registered 146,287 newly arrived migrants mostly from the Middle East, Africa, South and Central Asia, a 55% decrease when compared to 322,299 recorded during the same period in 2016.

Between January and September this year there were 23,333 registered arrivals to Greece, a 86% decrease in comparison to 169,207 recorded by the end of September 2016. However, there was a 37% increase in arrivals during this reporting period, from 4,240 in August to 5,799 in September 2017.

The total number of migrants who arrived to Italy in 2017 reached 105,418 at the end of this reporting period, 20% decrease in comparison to the end of September 2016 (132,043). Transition from the second to the third quarter 2017 is marked with a drop in arrivals (59,460 in Q2 vs. 21,666 in Q3). However, the monthly data for August and September indicate a 61% increase, from 3,914 to 6,293 respectively which is in contrast to the same period in 2016 when a slight decrease has been recorded between August and September that year (3,789 vs. 3,256).

An increase is also observed in overall arrivals to Spain. By the end of September, a total of 16,173 migrants have been registered arriving to Spain by land (4,312) and sea (11,861). Available data for the same period 2016, indicates a 86% increase when compared to 30 September 2017 - from 8,673 in 2016 to 16,173 respectively.

During the months of August and September a total of 942 migrants have been recorded while trying to cross the Black Sea from Turkey to Bulgaria and Romania. For more information about DTM Event Tracking in the Black Sea check here.

Highlights

146,287 TOTAL ARRIVALS TO EUROPE

137,771 TOTAL ARRIVALS TO EUROPE BY SEA

8,516 TOTAL ARRIVALS TO EUROPE BY LAND

According to the available statistical data, at the end of the third quarter of 2017, authorities in Bulgaria, Greece, Italy, Spain and Cyprus registered 146,287 newly arrived migrants – less than half of the total arrivals recorded by the end of September 2016 (322,299). Overall decrease is mainly due to the significant drop in arrivals through the Eastern Mediterranean route, namely Bulgaria and Greece (96% and 86% respectively). However, when analysed closely, these two countries have rather diverse monthly and quarterly dynamic in arrivals between 2016 and 2017.

By the end of September, a total of 23,333 migrants and refugees arrived to Greece, a 86% decrease when compared to 2016 and 169,207 registered arrivals reported during the same period. However, Greece has observed a steady increase in arrivals throughout three quarters of 2017, from 4,407 between January and March, to 6,272 during the second quarter and finally 12,654 arrivals reported in the last three months.

The trends between second and third quarter reflect the situation in 2016, when after the initial drop in arrivals due to the implementation of the EU-Turkey Statement, a 33% increase is noted between the second and third quarter (7,498 and 9,902 respectively) which can be associated with the more stable weather during the summer months.

Data for Bulgaria shows a stabile monthly average of 61 arrivals, with exceptions noted in March when 158 apprehensions have been reported and June when only 13 migrants have been registered on entry to the country. By the end of September, 545 migrants have been registered arriving to Bulgaria, more than 20 times less than 12,270 reported previous year. In addition to that, 444 migrants have been registered for the first time when exiting the country irregularly (no information about their date of arrival to Bulgaria) and 1,498 those who were residing in country without a valid residence permits.

Furthermore, the main gateway to Europe through Central Mediterranean – Italy, has noted a 64% decrease in arrivals between the second and third quarter of 2017, 59,460 and 21,666 respectively, resulting with an overall 20% drop in arrivals between 2016 and 2017 (132,043 vs. 105,418).

The most significant increase in arrivals is noticed in regards to arrivals to Spain and Cyprus. At the end of September 2017, 16,173 migrants reached Spanish territory, almost twice the number reported for the same period one year back; 8, 673. An eightfold increase has been reported for Cyprus, 106 arrivals in 2016 vs. 818 registered by the end of the third quarter of 2017.

According to the Missing Migrants data, almost 2% of migrants who all migrants intercepted in the Mediterranean are found dead. This year, 2,661 of them lost their lives or are considered missing. Most of the bodies have been found on the Central Mediterranean route - 2, 472. When compared to the last year, there were 26% less casualties recorded (3,602 in 2016). However, with the overall decrease in arrivals this year, the proportion of dead and missing is higher than in 2016 (1,9% vs. 1,2%).

As previously indicated, the majority of migrants arrived to Europe through the Eastern and Central Mediterranean route (88% of all arrivals). However, it is important to emphasize that the two migratory routes have very different characteristics in terms of the demographic breakdown of arrived populations. Migrants from different parts of Africa are more likely to use Central route to reach Europe/Italy, while those from Middle East and Southern Asia (Afghanistan and Pakistan) are traditionally more inclined to travel to Europe through the Eastern route/Greece. The available data at the end of the third quarter of 2017 shows that Nigerians are still the number one origin country for migrants who arrived to Italy (with an exception of Bangladesh); declared by 16% of all registered migrants. Guinean nationals comprise 9% of total arrivals, followed by those originating from Bangladesh and Cote d`Ivoire represented by 8% and migrants from Mali registered in 5% of cases. Migrants from Eritrea, Gambia, Senegal, Sudan and Morocco comprise total of 25% of all arrivals equally distributed among each nationality group.

In regard to data concerning Greece, people from Syria comprise 35% of all arrivals registered by the Hellenic Coast Guard. Migrants from Iraq and Afghanistan are represented by 17% and 9% respectively. The remaining 39% are composed of migrants from 65 different nationalities mostly from Middle East and different parts of Africa.

KARACHI: The Emergency Operation Centre (EOC) for polio in Sindh is set to launch on Monday (today) a five-day polio campaign in 21 districts and towns of Sindh, including its sprawling capital, officials said on Sunday. They said the campaign would conclude on Friday.

The 21 districts and towns of Sindh include Karachi, Dadu, Ghotki, Jacobabad, Qambar, Kashmore, Larkana, Shikarpur, Sukkur, Badin, Hyderabad, Khairpur, Matiari, Naushahro Feroze, Sanghar, Benazirabad, Sujawal, Thatta and Jamshoro.

The total target for the campaign is 7,127,711 children under five years of age, of whom 1,748,244 will be vaccinated in 162 union councils of Karachi.

The coordinator for EOC said the district administrations and health management teams had improved the situation but “there is no room for complacency as the virus can return any time.

WHO report signals urgent need for greater political commitment to end tuberculosis

Tuberculosis remains leading infectious killer

30 OCTOBER 2017 | GENEVA - Global efforts to combat tuberculosis (TB) have saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37%, according to the Global TB Report 2017, released by WHO today.

Despite these achievements, the latest picture is grim. TB remains the top infectious killer in 2016. TB is also the main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV. Progress in most countries is stalling and is not fast enough to reach global targets or close persistent gaps in TB care and prevention.

"While the world has committed to ending the TB epidemic by 2030, actions and investments don’t match the political rhetoric. We need a dynamic, global, multisectoral approach." said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. "The good news is that we finally have two great opportunities to move forward: the first WHO Global Ministerial Conference to End TB in Moscow in 2017, followed by the first UN General Assembly High-Level Meeting on TB in 2018. These will build momentum, get different sectors engaged, and accelerate our efforts to make TB history."

High global burden of disease and death in 2016

In 2016, there were an estimated 10.4 million new TB cases worldwide, 10% of which were people living with HIV. Seven countries accounted for 64% of the total burden, with India bearing the brunt, followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. An estimated 1.7 million people died from TB, including nearly 400 000 people who were co-infected with HIV. This is a drop by 4% compared to 2015.

Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. WHO estimates that there were 600 000 new cases with resistance to rifampicin – the most effective first-line drug, of which 490 000 had MDR-TB. Almost half of these cases were in India, China and the Russian Federation.

"The sheer numbers of deaths and suffering speak for themselves – we are not accelerating fast enough," said Dr Mario Raviglione, Director of the WHO Global TB Programme. "Prompt action towards universal health coverage and social protection, as well as breakthroughs in research and innovations – will be critical to enable access to patient-centered care of the highest standards for all, especially the poorest, most disadvantaged people everywhere."

Persistent gaps in care and financing

Tackling the epidemic requires action to close gaps in care and financing. It also requires progress in a particular subset of high TB burden countries (1).

• Underreporting and underdiagnosis of TB cases continues to be a challenge, especially in countries with large unregulated private sectors and weak health systems. Of the estimated 10.4 million new cases, only 6.3 million were detected and officially notified in 2016, leaving a gap of 4.1 million. India, Indonesia and Nigeria accounted for almost half of this global gap.
  
• Only one in five MDR-TB cases were started on treatment. India and China accounted for 39% of the global gap. Treatment success remains low, at 54% globally.
  
• Of the almost half a million reported cases of HIV-associated TB, 15% were not on antiretroviral therapy (ART) as recommended by WHO. Most of the gaps related to HIV-associated TB were in the WHO African Region.
  
• TB preventive treatment is expanding in two priority risk groups - people living with HIV and children under 5 years. However, most people eligible for TB preventive treatment are not accessing it.
  
• For TB care and prevention, investments in low- and middle-income countries fall almost US$ 2.3 billion short of the US$ 9.2 billion needed in 2017. In addition, at least an extra US$ 1.2 billion per year is required to accelerate the development of new vaccines, diagnostics, and medicines.

"Shortfalls in TB funding are one of the main reasons why progress is not fast enough to be on track to reach the end TB targets," said Dr Katherine Floyd, Coordinator of WHO’s Monitoring and Evaluation Unit at the Global TB Programme. "We have a double challenge. More domestic funding is needed in middle-income countries, and more international donor support is needed to support low-income countries".

Political commitment and multisectoral action

Ending the TB epidemic requires action beyond the health sector to address the risk factors and determinants of the disease. For the first time the Global TB Report presents results from a new multisectoral monitoring framework that identifies linkages with the TB epidemic across seven Sustainable Development Goals (SDGs). Analysis of the latest status of the indicators for the 30 high TB burden countries show that most will be challenged to reach SDG targets.

In order to increase multisectoral action, plans to galvanize all sectors and secure attention at the highest levels have resulted in the WHO Global Ministerial Conference on Ending TB in the Sustainable Development Era, in Moscow, 16–17 November 2017. This will be followed by the very first UN General Assembly High-Level Meeting on TB in 2018, which will seek commitment from heads of state.

• Ministerial Conference on Ending TB

(1) The ten countries were: India, Indonesia, Nigeria, the Philippines, South Africa, Pakistan, Bangladesh, the Democratic Republic of the Congo, China and the United Republic of Tanzania.

For more information, please contact:

Pru Smith
WHO Department of Communications, Geneva
Telephone: +41 22 791 4458
Mobile : +41 79 477 1744
Email: smithp@who.int

Hannah Monica Dias
WHO Global TB Programme, Washington, DC
Communications and Technical Officer
Mobile : +41 79 477 0435
Email: diash@who.int

Countrywide Conflict Displacement

As of 29 October, a total of 296,190 people were displaced due to conflict in Afghanistan, an increase of more than 800 people compared to the previous week. The provinces sheltering the highest numbers of IDPs are Nangarhar (34,872), Kunduz (29,883), Badghis (24,625) and Baghlan (18,788).

Central: More than 1,060 displaced people reportedly arrived in Maydan Shahr, Wardak, 800 people in Sharana, Paktika, and 600 in Kabul City after heavy armed clashes between NSAG and ANSF in Wardak and Paktika provinces. Fighting is ongoing with additional displacement anticipated in the coming weeks. In 2017, 18,833 people have been verified as displaced in the Central Region, 6 per cent of the total displacement.

Northern/North Eastern: More than 7,300 people have reportedly been displaced from Emamsaheb, Chardara and Dasht-e-Archi to Emamsaheb Centre and Kunduz city. An additional 10,000 people have been reportedly displaced to Balkh and Sar-e-Pul provinces from Faryab, Jawzjan, Sar-e-Pul,
Baghlan and Kunduz provinces. This year, 106,923 displaced people have been verified in the two regions, 36 per cent of total displacement.

Eastern: Fighting between NSAGs in Khogyani, Nangarhar, which erupted on 15 October continue to impact upon the civilian population. Between 15,000 to 18,000 people have so far been displaced to the surrounding villages and to Sukhrod and Behsud districts. Currently, 13,475 people have been verified in need of humanitarian assistance. Since January, 46,733 people have been displaced in the Eastern Region, 16 per cent of the displacements across the country in 2017.

Southern/South Eastern: No significant displacements have been reported during the reporting period. A new polio case has been identified from Shahwalikot district, Kandahar bringing the total number of confirmed cases to six across the region so far this year. Down telephone networks in Uruzgan and Helmand has made communication difficult and disrupted assessment and response activities. A total of 66,739 people are currently displaced in the two regions, 22 per cent of the total displacements this year.

Western: No significant displacements were reported during the reporting period from Badghis, Farah, Ghor or Hirat provinces.

Nearly 100 displaced people were selected for assistance by assessment teams based on eligibility and vulnerability criteria. In total, 56,962 people are currently displaced in the Western Region, 19 per cent of the total displacements this year.

Returnees and Refugees

From 22 to 28 October, a total of 870 people spontaneously returned from Pakistan to Afghanistan, another 53 were deported, according to IOM. From Iran, 9,009 people returned spontaneously and 9,024 were deported. As of 28 October, 91,926 undocumented people have returned from Pakistan and 335,037 from Iran this year.

In the same reporting period, 782 refugees returned to Afghanistan from Pakistan, according to UNHCR. Since January, more than 54,000 refugees have returned from Pakistan, 79 per cent less compared to the 260,000 in the same period of the previous year. A total of 1,089 refugees have returned since January, half of the more than 2,100 in the same period of the previous year.

Ongoing Response Activities (please also see page 2)

During the past week, nearly 30,000 displaced people, undocumented returnees and refugees received some form of humanitarian assistance in all regions of the country.

CR: DRC provided cash assistance for food and shelter to 854 individuals displaced from Sia Gird (Ghorband) to Kabul city, in addition to hygiene and NFI kits from DACAAR and CARE respectively.

NR/NER: In Kunduz city, NRC distributed cash for 200 individuals, while ACTED distributed cash for 900 individuals.
UNHCR distributed NFIs, WFP food and DACAAR WASH packages to 1,100 IDPs. In Takhar, ACTED distributed MPC and Mission East NFIs for 600 individuals.

ER: 5,985 IDPs were assisted with food (WFP, ARCS), NFIs (UNHCR, ARCS) or cash assistance (NRC, SCI) in Khogyani, Behsud and Jalalabad. WFP distributed cash for food to 18,879 undocumented returnees in Nangarhar, Kunar and Laghman provinces. SCI distributed cash for food to 1,000 returnees in multiple districts of Nangarhar Province.

SR: Ongoing multi-sectoral humanitarian assistance was provided to 800 IDPs in Qalat, Zabul Province.

WR: ACF, DRC and NRC provided cash assistance for transportation, food, rent, fuel and shelter to 1,318 individuals, a proportion of which received food from WFP, NFIs from UNHCR and hygiene kits from DACAAR. DAIL Badghis has plans to distribute 180 tons of wheat seeds to 3,600 farmers.

Uncovered Needs and Response Gaps

CR: Shelter assistance is required for 420 individuals (60 families) in Fandaqestan valley of Sia Gird district, Parwan.
Provincial authorities have requested that humanitarians cover the gap.

Security Incidents and Access Constraints

CR: Heavy armed clashes are ongoing in Chak, Jaghato,
Nerkh and Jelrez districts of Wardak Province.

ER: NSAGs have indicated that they will close the JalalabadAsadabad highway. This is a concern for humanitarian actors as it is one of the main supply routes in the region.

NR/NER: With the winter season approaching, and given anticipated physical access constraints in Badakhshan, partners are requested to preposition emergency stocks in the province.

PESHAWAR: The death toll continues to climb in Khyber Pakhtunkhwa due to dengue fever as on Monday a 25-year boy succumbed to the disease taking the death toll to 65 across the province.

According to Incharge Dengue Rapid Response Unit, Department of Health, 25 year Waqas Omer was resident of Achni Bala was admitted on October 28 at Hayatabad Medical Complex.

He said that during last 24 hours as many as 112 patients were hospitalized due to dengue fever while 102 were discharged from different hospitals.

He said under a dengue eradication drive is 61 most affected areas of provincial capital, the district administration teams carried out fumigation.

According to Assistant Commissioner (AC) Fazal Raheem, the District administration has dispatched as many as 210 teams to different areas of the city in a bid to eliminate the Dengue mosquitoes.

Naimat Khan

KARACHI: Sindh Chief Minister Syed Murad Ali Shah has said that USAID a $241 million dollar different program such Sindh Basic Education Program (SBEP), Municipal Services delivery Program (MSDP), Jacobabad Institute of Medical Sciences (JIMS) are in progress in Sindh. “These are major interventions in education, health and municipal services sectors.”

This he said while talking to Mr John Hoover deputy chief of Mission US Embassy Islamabad and Ms Grace Shelton, US Consul General in Karachi who called on him here at the CH House Monday. The meeting was attended by Chairman P&D Mohammad Waseem and Principal Secretary to CM Sohail Rajput.

He said that he has already declared emergency in education and health sectors while special focus is being given to improve municipal services. “USAID has made some important interventions and I am personally monitoring them so that targeted population of the province can takne benefit from the schemes,” he said.

In the meeting the Chief minister, his and the US visiting diplomats reviewed the progress of the schemes launched with the grant of USAID.

It may be noted that since 2011, USAID in partnership with the provincial government has been implementing the SBEP for $165 million, including $10 million the Sindh government share. Through this partnership the SBEP improves the quality and access to education for children in Sindh by increasing and sustaining student enrollment at the primary, middle, and secondary school levels. The program is being implemented in seven districts of Northern Sindh and five towns of Karachi.

The chief minister said that for the implementation and management of the Programme, a Programme Management and Implementation Unit (PMIU) has been established in School Education department. It comprises on four sections such as construction management, Learning Reforms and Community Mobilization, Back Office Services, and Planning, Monitoring, and Evaluation.

He elaborated that major Components of SBEP include building of 106 new schools with1400 classrooms in flood-affected and other areas. Improvement of reading and numeracy skills of 750,000 children over five years, engaging up to 400 communities in the construction, operation and maintenance of schools over five years and establish effective public/private partnerships to manage these schools and ensure enrollment of at least 100,000 girls.

Syed Murad Ali Shah said that major targets of the programme are to increase knowledge and professional skills of 25,000 primary school teachers, particularly in Reading and Mathematics. “It also aimed at providing non-formal educational opportunities to 100,000 out-of-school children to enable 50,000 to transit to formal schools,” he said and added there is a target to provide capacity building opportunities to 500 government officials to implement the Sindh Government Education Reforms, increase availability of adequate health care facilities for children and train 500 government district offices/supervisors, teachers, head-teachers in developing, implementing and monitoring of Early Grade Reading Assessment (EGRA) and Early Grade Maths Assessment (EGMA).

Chairman P&D Mohammad Waseem said that so far, there have been considerable milestones achieved by SBEP that include site assessment of 875 schools completed. This assessment is helping to logically select schools for construction. Till now 33 government schools are under construction at Khairpur, Sukkur and Larkana districts. 37 SBEP targeted schools are notified as campus schools with 76 schools being consolidated and merged under government consolidation policy.

He added that the Private land owners have donated their personal land in Larkana, Sukkur and Khairpur to School Education Department for reconstruction of schools. 238 early grade teachers (Master Trainers) are trained in Reading and Mathematics Teaching Skills to further train 3,000 teachers and a comprehensive study is done by SRP to develop supplementary reading material to create a culture of reading within target schools.

Mr Wsim said that partnership with Rotary International established to equip Science and Computer Labs in hub schools and to provide reading and mathematics materials to 1,100 school libraries.

Municipal Services delivery Programme (MSDP): This programme has been launched with USAID grant of $66 million in which provincial government’s share stands at Rs926.55 million. The programme is aimed at improving and upgrading municipal services/infrastructure in six cities of the Norther Sindh. They are Jacobabad, Qambar, Shahdadkot, KN Shah, Mehar and Johi. Presently, the programme is in progress in Jacobabad and after its successful completion it would be started in other cities.

USAID has invested $10 million in establishing JIMS and expanded access to quality health care services for the residents of Jacobabad- Sindh and Balochistan. JIMS is a 133 beds hospital which offers outpatient treatment, emergency and diagnostic facilities as well as specialized services in mother and childhood center, intensive care unit and surgical facilities.

The meeting was told that the hospital was functioning properly but there are some issues which are being looked after by the chief minister personally. The US diplomats said that they were launch more schemes under the USAID for the people of Sindh.