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Posts published in “HIV/AIDS”

Democratic Republic of the Congo: République Démocratique du Congo: UNHCR Mise a Jour Intermediaire (1 – 15 janvier 2019)

Source: UN High Commissioner for Refugees
Country: Angola, Burundi, Central African Republic, Democratic Republic of the Congo, Rwanda, South Sudan

Ce document fournit une mise à jour intermédiaire sur les principaux évènements ayant lieu entre la pub...

Democratic Republic of the Congo: Democratic Republic of the Congo UNHCR Mid-Month Update (1 – 15 January 2019)

Source: UN High Commissioner for Refugees
Country: Angola, Burundi, Central African Republic, Democratic Republic of the Congo, Rwanda, South Sudan

This document provides a mid-month update on major developments between the publication of UNHCR’s mont...

Kenya: UNICEF Kenya Humanitarian Situation Report January to December 2018

Source: UN Children's Fund
Country: Democratic Republic of the Congo, Ethiopia, Kenya, Somalia, South Sudan

HIGHLIGHTS

• In 2018, approximately 700,000 people were food insecure by August 2018, down from 3.4 million in August 2017.

• The above-average ‘long’ rains resulted in mass displacement with 311,000 people displaced by mid-May 2018.

• In 2018, a total of 306,514 children were reached with life-saving health interventions through integrated health outreach. While over 2.9 million children were reached as part of the polio vaccination campaign for the Horn of Africa.

• With UNICEF support, 245,219 acutely malnourished children were admitted for treatment in therapeutic and supplementary feeding programmes in 2018.

• Over 189,883 people in drought, cholera and flood-affected counties benefitted from permanent access to safe water through repair of water points.

• In 2018, UNICEF’s Humanitarian Action for Children appeal of US$ 34.2 million had a funding gap of 58 per cent.

Situation Overview and Humanitarian Needs

Approximately 2.55 million people were food insecure in March 2018, down from 3.4 million in August 2017, as Kenya continued to face the effects of the severe drought from the previous year and high staple food prices. However, by August 2018 the population requiring food assistance had reduced significantly to 700,0009 , due to substantial crop production, low market prices and available supplies in the local markets following record-high ‘long’ rains from March – May. According to the National Drought Management Authority, all 23 Arid and Semi-Arid Lands (ASAL) counties were categorized in the normal drought phase by August 2018 (stressed, IPC phase 2), and majority of the open water sources were filled with water, stabilizing average return distances to water points. According to the Famine Early Warning Systems Network (FEWSNET), the October to December short rainy season was significantly below average and crop production is expected to be 70 percent of average. As a result, deterioration in food security will most likely be gradual, and additional ASAL counties are anticipated to move to Stressed level (IPC phase 2) from February 2019.

At the beginning of 2018, acute malnutrition remained at critical levels (phase 4, GAM WHZ 15 - 29.9 per cent) in Turkana Central, North, West and South, Tana River, Wajir North, North Horr and Laisamis sub-counties, while Isiolo and Kajiado reported a serious nutrition situation (phase 3, GAM WHZ 10.0 -14.9 percent). The nutrition situation improved due to the improvement in food security with the children in need of treatment for severe acute malnutrition (SAM) reducing to 85,105 by August 2018, down from 104,614 children in January 2018. However, critical GAM levels (15 - 29.9 per cent) were sustained in Mandera, Turkana, Samburu, and parts of Baringo (East Pokot), and Marsabit (North Horr) counties, primarily driven by poor childcare feeding practices and lack of suitable access to health facilities. Serious GAM levels (10 - 14.9 per cent) are anticipated in Wajir, Garissa, Isiolo, Laikipia, Tana River, and Marsabit (Laisamis) counties in January 2019.

The above-average long rains also resulted in massive flooding in 40 out of 47 counties, with 800,000 people affected, including 311,000 displaced (approximately 47 per cent children), 186 killed and nearly 100 injured by mid-May 2018. Of the displaced children, about 18,725 (42 per cent girls) required child protection interventions and about 46,000 children could not access schooling by mid-May as 329 schools were hosting people displaced by the floods. Timely emergency assistance to affected populations in the most hard-to-reach areas was compromised as major roads and school infrastructure was damaged. With the cessation of the long rains in May, floodwaters receded in most of the flood-affected areas which improved road access and displaced populations returned to their homes by end of June. However, in Tana River county, farms and villages mainly in Tana Delta area were still flooded, and most of the displaced were still living in camps, with 10 internally displaced population (IDP) camps still hosting 400 households.

The flooding also compounded ongoing disease outbreaks, with 5,470 cholera cases (78 deaths and case fatality rate of 1.4 per cent) reported across 19 counties; 111 Rift Valley Fever human cases (14 deaths) reported across Wajir (75), Marsabit (35) and Siaya (1) counties and 1,465 chikungunya cases reported. The first cholera outbreak began on 26 December 2014 and ended on 19 August 2018.The next cholera outbreak started on 8 September 2018 and ended 23 October 2018 with only 40 cases in three counties. Since the last case, three incubation periods have passed and by the 20 November the Government declared the outbreak under control10 . Additionally, 24 measles cases were reported in Wajir county in February and a circulating vaccine derived type 2 polio virus was found in a sewage sample in Nairobi county in May 2018. Since the beginning of the year, six counties (Mandera, Garissa, Wajir, Nairobi, Kitui and Murang’a) reported measles outbreaks with a total of 744 cases with 66 confirmed and one death reported by end of the year. There was significant reduction in the number of measles cases reported in the last quarter of the year in Mandera and Nairobi following the vaccination campaign, with no new cases reported between August and December 2018. However, there was a spike in the cases reported in Wajir County towards end of the year, with 15 cases being reported between 7 and 21 December 2018.

In the first half of the year, drought-related inter-ethnic conflicts and insecurity in Garissa, Mandera, Turkana, Samburu, Baringo, West Pokot, Wajir, Tana River intermittently affected access to learning and constrained emergency education assessments and interventions. In Baringo County, 133 schools were affected, and 20 schools were closed in February, affecting access for approximately 30,000 learners. On 12 February, a terrorist-related attack by armed militants led to the death of two non-local teachers in Qarsa Primary School, Wajir County, and resulted in 900 non-local teachers leaving Wajir county, negatively impacting learning for approximately 45,000 children. Inter-ethnic conflicts in Narok South, Baringo and Marsabit counties led to the temporary closure of over 30 schools, interrupting learning for more than 8,000 children (40 per cent girls) in September and October 2018.

A sudden influx of asylum seekers from Ethiopia to Moyale in Marsabit county due to intercommunal conflict was reported in March 2018, with a total of 10,557 people (over 80 per cent women and children) registered at the peak of the crisis. The Dambala Fachana camp in Moyale that was hosting the asylum seekers was closed on 29 September, with 302 individuals transferred to Kakuma, while 700 individuals opted to return to Ethiopia. In December, conflict was reported in the border area, and Kenya Red Cross estimates that a total of 8,620 household crossed the border to Mandera county and are integrated in the host community of Banisa and Takaba. According to the UNHCR November 2018 update, Kenya hosts 470,088 refugees and asylum seekers (56 per cent children). Almost 55 per cent of refugees and asylum seekers in Kenya originate from Somalia. Other major nationalities are South Sudanese (24.4 per cent), Congolese (8.7 per cent) and Ethiopians (5.9 per cent). Since the beginning of the year, 5,116 refugee children (3,170 boys and 1,946 girls) have arrived in Kakuma and Kalobeyei refugee camps.

Uganda: Humanitarian Action for Children 2019 – Uganda

Source: UN Children's Fund
Country: Burundi, Democratic Republic of the Congo, South Sudan, Uganda

Due to ongoing conflict, poverty and food insecurity in neighbouring countries,
Uganda is expected to receive over 1 million South Sudanese, 600,000 Congolese and 40,000 Burundian refugees by 2020.

Children make up 60 per cent of refugee and host community populations, and many lack access to essential services and are facing serious protection risks.

More than half of all primary-level children and over 90 per cent of secondary-level children are out of school, and 22 per cent of children in integrated refugee settlements are enrolled in grades lower than expected for their age.

The global acute malnutrition rate is above 10 per cent and over 40 per cent of women and children are anaemic. Water deprivation affects 62 per cent of those living in host communities and 69 per cent of refugees living in Uganda for more than five years, and water resource management in refugee settlements is disconnected from humanitarian action. Nearly one third of refugee settlement households lack single family latrines. For children and women living with HIV, access to and utilization of HIV prevention, care and treatment are inadequate. The country is struggling to manage disease outbreaks, including cholera, and the risk of an Ebola outbreak remains significant.

Humanitarian strategy

UNICEF supports the implementation of durable solutions to chronic displacement in Uganda in line with the country’s Refugees and Host Population Empowerment Strategic Framework,
Settlement Transformation Agenda and Comprehensive Refugee Response Framework. UNICEF will continue to support the Government to adapt its nutrition, health, water, sanitation and hygiene (WASH), child protection, education and social protection systems to humanitarian situations. Using a decentralized approach, UNICEF will strengthen its humanitarian response, including by localizing capacity building, monitoring and reporting and procuring essential equipment and supplies.

Community-based support will improve the delivery of targeted protection and basic services for affected children and adolescents. UNICEF will work with the Government and partners at the national and sub-national levels to strengthen multi-year planning processes to leverage domestic and international resources for at-risk communities. Government contingency planning and response efforts will be supported to mitigate the effects of disease outbreaks and natural disasters.

In high-risk communities, applying and scaling up existing civic engagement platforms, such as U-report, will promote accountability to affected populations, build linkages between communities and local governments and guide responsive district and sub-district planning and budgeting. Gender, HIV and AIDS, conflict sensitivity and communication for development programming will be mainstreamed into all interventions.

Results from 2018

As of 31 October 2018, UNICEF had US$22.5 million available against the US$66.1 million 2018 appeal (33 per cent funded). UNICEF supported integrated refugee/host community planning for education, health and nutrition and strengthened the coordination of basic service sectors in the refugee response.

Nutrition and HIV and AIDS results were higher than expected considering the limited funding available, primarily due to UNICEF’s investment of core and other resources in key services. High-risk districts successfully maintained a cure rate above 75 per cent for malnourished children, but a change in the intervention focus from district-wide to the sub-district level resulted in low coverage of vitamin A supplementation. Fourteen motorized water systems enabled access to water for 93 per cent of the target population.

UNICEF supported the Ministry of Health to strengthen its preparedness and response to the threat of Ebola from the Democratic Republic of the Congo, and use communication for development interventions to contain cholera outbreaks.

The reduced number of refugees in 2018 meant that fewer unaccompanied and separated children received protection services, including alternate care and psychosocial support. The education response was 62 per cent funded, but unanticipated delays in replicating an approved multipurpose education facility limited education results.

World: Humanitarian Action for Children 2019 – Eastern and Southern Africa

Source: UN Children's Fund
Country: Burundi, Comoros, Democratic Republic of the Congo, Ethiopia, Madagascar, Mozambique, Rwanda, South Sudan, Uganda, United Republic of Tanzania, World, Zimbabwe

Eastern and Southern Africa

The Eastern and Southern Africa region is affected by recurrent disasters that are undermining the hard-fought development gains of recent years and resulting in major social and economic setbacks. More than 30 million people, including 17 million children (45 per cent) are in need of humanitarian assistance due to climate-related shocks, health emergencies and displacement. Droughts, floods and cyclones have left more than 27 million people food insecure. The El Niño-related drought developing in southern Africa is affecting more than 8 million people in the six most-affected countries,3 and flooding will likely increase the burdens on vulnerable drought-affected communities. In addition, populations in Comoros, Madagascar and Mozambique remain at risk due to seasonal cyclones and tropical storms. The public health risk in the region is also growing, with 10 out of the 21 countries reporting some 35,000 cases of cholera and acute watery diarrhoea and 420 deaths — a 1.2 per cent case fatality rate — since the beginning of 2018. The Ebola Virus Disease outbreak in the North Kivu and Ituri provinces of the Democratic Republic of the Congo continues to threaten neighbouring countries. Other health risks include outbreaks of yellow fever in Ethiopia, plague in Madagascar and typhoid fever in Zimbabwe. The situation in South Sudan remains catastrophic for children, with more than 2.1 million people seeking refuge in neighbouring countries, including 1.3 million children on the move.6 The political instability in Burundi and the Democratic Republic of the Congo has led to growing humanitarian needs for children and their families, who have been forced to flee into neighbouring countries.

Regional humanitarian strategy

Humanitarian funds channelled through the Eastern and Southern Africa Regional Office are strategically allocated to facilitate response to children’s most pressing needs, across the region. These funds also enable countries to enhance their preparedness and response to emergencies, particularly those emergencies that require a multi-country, integrated and immediate response, and those countries that are likely to require new humanitarian programming in 2019 but without dedicated appeals in Humanitarian Action for Children 2019. This regional appeal focuses on four components. The first is to support multi-country actions for children and women who are displaced and have crossed borders as refugees or migrants by providing technical assistance to governments and other service providers on child protection case management, family tracing and reunification and alternative care for unaccompanied and separated children, as well as basic services for health, water, sanitation and hygiene (WASH), nutrition and education. This also includes facilitating the generation and dissemination of child-focused knowledge products, tools and guidance for effective programme monitoring and advocacy. The second is to support climate-induced disaster response, including to drought- and flood-affected countries, through the delivery of life-saving interventions for children, in partnership with national and international actors. This component will use a multi-sectoral and integrated approach in key sectors, including WASH, nutrition, education and health, and support sector coordination. The third is to support preparedness and response to health emergencies by providing clean water supply, household sanitation and hygiene and WASH in schools and health facilities, and contribute to strengthening national systems to respond to Ebola, should the outbreak spread from the Democratic Republic of the Congo. The fourth is to provide regional technical assistance, quality assurance and oversight to support countries to achieve humanitarian results in nutrition, health, WASH, child protection, education, HIV and AIDS, social protection and communication for development. The Regional Office will also facilitate country collaboration across borders to ensure that assistance is provided to populations in vulnerable border regions and harmonized across country offices. UNICEF will also support capacity building for effective preparedness for, response to and recovery from humanitarian situations, and emergency preparedness and response training, including on humanitarian performance monitoring and sector-specific humanitarian action. The Regional Office will also support country offices to maintain preparedness by meeting the minimum preparedness standards set out in the Emergency Preparedness Platform.

Uganda: UNICEF Uganda Humanitarian Situation Report – November 2018

Source: UN Children's Fund
Country: Burundi, Democratic Republic of the Congo, Rwanda, Somalia, South Sudan, Uganda

Highlights

• No Ebola case has been reported in Uganda despite the persistent influx of refugees from the Democratic Republic of the Congo (DRC) and regular trade activities across the DRC/Uganda border. This is largely attributed to the intensive Ebola prevention and preparedness efforts by the Ministry of Health and partners, including UNICEF. Over 100,000 people, including 35,000 children, were reached with messages on signs, symptoms, prevention and control of Ebola by UNICEF and the Uganda Red Cross Society.

• Uganda continues to host over 700,000 refugees and asylum seekers from South Sudan, nearly 285,000 from DRC, over 33,000 from Burundi and 50,000 from Somalia, Rwanda and other countries.

• Over 800 unaccompanied and separated children received alternative care services in South Sudanese and Congolese refugee settlements; approximately 1,000 children and adolescents accessed formal or informal education; and 48,000 people accessed appropriate sanitation facilities in refugee hosting districts.

• The overall number of children admitted for severe acute malnutrition has reduced significantly over the last two months from over 1,700 to 934 and currently at 485.

Situation Overview and Humanitarian Needs

Refugees: Uganda hosts over 700,000 refugees and asylum seekers from South Sudan, nearly 285,000 from DRC, over 33,000 from Burundi and 50,000 from Somalia, Rwanda and other countries.

The Government has developed the Uganda 2019-2020 Refugee Response Plan (RRP) to maintain Uganda’s asylum space and preserve equal and unhindered access to its territory; implement protection processes that promote the full enjoyment of rights and uphold international protection standards; and ensure that Uganda’s refugee response paradigm progressively shifts from care and maintenance to inclusion and self-reliance. UNICEF contributed to its development.

Disease outbreaks:

Ebola preparedness and response As of 26 November 2018, the Public Health Emergency Operations Centre of the Ministry of Health (MoH) had not confirmed any cases of Ebola Virus Disease (EVD) in Uganda. Comprehensive surveillance continues in all communities, health facilities and at formal and informal border crossings in all of the 28 at-risk districts.
MoH and district authorities, with support from partners, continue to identify and isolate alert cases, with blood samples taken for testing to the Uganda Virus Research Institute.
According to the MoH and the World Health Organization (WHO), and in line with the EVD National Preparedness Plan, there is need to strengthen Ebola infection prevention and control interventions in all high-risk districts to reduce the transmission of infections. UNICEF is working closely with community leaders and local structures to communicate on the disease and orient local populations on actions they should take to prevent contracting and spreading it.

Other outbreaks

Since the beginning of the year, 20 cases of, and six deaths from, Crimean-Congo Haemorrhagic fever (CCHF) have been reported in Kakumiro, Isingiro, Kiboga, Kiryandongo, Nakaseke and Sembabule districts; 35 cases of, and 18 deaths from, Rift Valley Fever (RVF) had been reported in 17 districts; 364 measles cases were reported in 79 districts, and 167 cases of Rubella in 36 districts.
Following the confirmation of a dengue fever case on 27 November, the Ministry of Health has instituted epidemiological linking and enhanced contact tracing for the case. No cholera cases were reported in November.

South Sudan: South Sudan: “The most challenging thing for patients is the difficulty of accessing maternal health services

Source: Médecins Sans Frontières
Country: South Sudan

Milscent Moyo
MSF Midwife and Maternity and Neonate Supervisor
Milscent Moyo, from Zimbabwe, just completed a six-month assignment at Aweil State Hospital, South Sudan, where MSF operates one of the few maternity wards where a woman can safely give birth in former Northern Bahr El Ghazal State.

In September, there was a peak in births in the Doctors Without Borders/Médecins Sans Frontières (MSF) maternity ward at Aweil State Hospital, and we were getting an average of 120-plus deliveries per week, with maybe five or six C-sections and two or three vacuum deliveries. There are two midwives and one nurse aide dedicated to delivery room, managing all these patients—sometimes 10 women in labor per 12-hour shift. It's a really challenging situation, and we need to manage those who are imminent deliveries, those who are having obstetric emergencies like increased high blood pressure and those with vaginal bleeding, and when we stabilize them we go back and see that everybody else is taken care of.

The most challenging thing for patients is the difficulty of accessing maternal health services. Ours is one of very few medical facilities where a woman can give birth with skilled care in Northern Bahr El Ghazal State. We run one of only two maternity wards in the state that can provide C-sections, and the only one with sufficient staffing and a blood bank.

Once the pregnant women are admitted in a timely manner in our facility, they are taken good care of. The mortality rate in our maternity is generally very low. When patients are referred from other facilities, however, they often arrive too late and they may die before we can save them. Without good roads or vehicles, transportation is a major challenge, which means that some patients in need don’t even make it. They may be late in reaching a primary health care center, and that center may only have one ambulance, which is not always functioning. We often see women who arrive with dust up to their knees after walking for two days to reach our hospital. It is even worse during raining season when most of the communities are completely cut off due to flooding.

The other issue is malnutrition. Many of our patients are malnourished and yet have this desire to have five-plus children, regardless of their nutritional status. And they don't know what their options are for contraception.

What we've done is we've tried to incorporate contraception education in our rounds every single day. Once the doctor reviews the patient we have to make sure that the woman gets information about contraception. Most of them say, "OK, wait for my husband," but when the husband comes and the midwife follows up with them, most of them opt for it. They often prefer injectable contraception which lasts for three months. And then hopefully they can continue the care in their community clinic or a primary health care center, where they get family planning services.

Another initiative we have is helping midwives learn to use a diagnostic tooled called Point of Care Ultrasound, or POCUS. I think it’s a very good initiative, firstly for building the skills of the midwives and also for the clinical care for the patients. Because there are cases when the midwives are able to identify a very complicated condition, which the obstetrician can confirm, and refer a patient to the operating theater. It's a movement in the right direction, since we want to focus more on the complicated cases.

At the same time, the biggest need I see is for basic maternal care services at the local level. Some health care centers don't have a trained midwife. But this is where the good management of pregnant women starts, with monitoring of potential problems, and preventive treatments such as iron supplements, malaria prophylaxis, and testing and treatment for HIV and syphilis.

If there could be a skilled midwife in every community that our patients come from, it would be so much better. These issues should really be attended to during pregnancy. And if there's a skilled midwife, they would be able to recognize problems during pregnancy and make a referral to our center, so that the woman can be cared for properly.

Uganda: The Democratic Republic of Congo Regional Refugee Response Plan (RRRP) January 2019 – December 2020

Source: UN High Commissioner for Refugees
Country: Angola, Botswana, Burundi, Central African Republic, Congo, Democratic Republic of the Congo, Kenya, Lesotho, Madagascar, Malawi, Mozambique, Namibia, Rwanda, South Africa, South Sudan, Uganda, United ...

World: 2018 Progress Report: PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020)

Source: Government of the United States of America
Country: Botswana, Cameroon, Côte d'Ivoire, Democratic Republic of the Congo, Eswatini, Ethiopia, Haiti, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Uganda, Ukraine, United Republic of Tanzania, Viet Nam, World, Zambia, Zimbabwe

Overview

The American people’s compassion and generosity have saved more than 16 million lives and brought us closer than ever to controlling the HIV/AIDS pandemic – community by community, country by country.

Fifteen years ago when the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) was launched this remarkable progress was hard to imagine. At that time an HIV diagnosis was a death sentence in many countries, and entire families and communities were falling ill. Most of the prior gains in global health and development were being lost and the very fabric of societies were being ripped apart by the loss of teachers, doctors, and nurses. In the hardest-hit regions of sub-Saharan Africa, infant mortality doubled, child mortality tripled, and life expectancy dropped by 20 years. Only 50,000 people in Africa had access to any lifesaving antiretroviral treatment (ART).

Faced with this death and devastation, the United States has responded, resoundingly. The United States is the world’s leader – and largest donor – in the response to the global HIV/AIDS crisis. Since PEPFAR’s establishment in 2003, with strong bipartisan support across three U.S. presidents (George W. Bush, Barack Obama, and Donald J. Trump) and from eight U.S. congresses, the U.S. government, through PEPFAR, has invested more than $80 billion in the global HIV/AIDS response, the largest commitment made by any nation to address a single disease. By focusing resources where the HIV burden was the greatest and the most impact could be achieved, PEPFAR has delivered remarkable results in just 15 years.

PEPFAR is a remarkable example of what is possible when we focus and join hands with countries and communities and ensure all U.S. taxpayer dollars with which we are entrusted are held to account. It demonstrates the impact of U.S. foreign assistance when we focus on the mission with transparency and demand greater effectiveness and efficiency.

PEPFAR has defined the core elements of successful HIV prevention and treatment programming: the full engagement of partner governments at all levels; the rapid development and implementation of core policies that maximize the impact of our investments; the quarterly analysis of program implementation to ensure partner performance and accountability down to the level of where lifesaving services are delivered; and the close engagement of faith and community leaders to increase HIV awareness and provide supportive services.

PEPFAR is a leader in the use of granular data to drive results and increase impact year over year without increasing financial resources (Figure 1). PEPFAR has pioneered the use of large national household surveys – Population-Based HIV Impact Assessments (PHIAs) – to document the impact of HIV programming, surveys that have shown a nearly 50 percent decline in new HIV infections across many of the countries in eastern and southern Africa where the epidemic was raging before PEPFAR began.

The key ingredients for this success include:

  • Rapid, data-driven expansion of HIV prevention and treatment services targeted by geography and population with greatest need, including the rapid scale up of lifesaving ART focused on achieving viral load suppression; innovative approaches to HIV testing services; VMMC to prevent infections in young men (and thus their subsequent partners); and progress under the PEPFAR-led DREAMS (Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe) publicprivate partnership to prevent HIV infections among adolescent girls and young women.

  • Supportive partner country HIV policy environments, such as through the rapid adoption and implementation of Test and Start of ART, same-day initiation of HIV treatment, differentiated service delivery models, multi-month fulfillment of prescriptions, and the use of better and cheaper treatment regimens.

  • Political leadership from partner countries and U.S. ambassadors.

  • Meaningful engagement of civil society and communities.

  • Strategic partnerships with the private sector, faith-based leaders and organizations, and others.

World: Children, HIV and AIDS: Regional snapshot – Eastern and Southern Africa (December 2018)

Source: UN Children's Fund
Country: Angola, Botswana, Burundi, Djibouti, Eritrea, Eswatini, Ethiopia, Kenya, Lesotho, Madagascar, Malawi, Mozambique, Namibia, Rwanda, Somalia, South Africa, South Sudan, Sudan, Uganda, United Republic of Tanzania, World, Zambia, Zimbabwe

Eastern and Southern Africa is home to more than 60 per cent of children and adolescents living with HIV. This is the region where most progress in the HIV response has been made. Coverage of maternal antiretroviral treatment for pregnant and breastfeeding women living with HIV reached 93 per cent in this region in 2017. Sustaining these gains and continuing to reach children, adolescents and women at risk and living with HIV is critical. In 2017, an estimated 120,000 adolescents aged 10–19 years and 94,000 children aged 0–9 years were newly infected with HIV. They are now part of the estimated 1.9 million children and adolescents living with HIV in the region. Despite ongoing progress, 65,000 of the region’s children and adolescents died of an AIDS-related cause in 2017.

Analysis

Of the 94,000 new HIV infections among children aged 0–9 years in 2017 in Eastern and Southern Africa, the majority (51,000) occurred after birth, which reflects a failure of PMTCT programmes during breastfeeding. The ‘last mile’ towards elimination of vertical transmission relies on overcoming gaps in ongoing HIV testing, treatment and care for vulnerable mothers and their infants after birth.

Continued and accelerated progress in PMTCT programming cannot be achieved without improved HIV prevention efforts among adolescents, particularly adolescent girls and young women. The total number of annual new HIV infections among those aged 10–19 years in 2017 was only about 25 per cent lower than it was in 2010. Demographic trends indicating ongoing steep rises in adolescent populations by 23 per cent between 2018 and 2030 lend further urgency to the importance of expanded and sustained prevention efforts targeting that age group.

South Africa: Children, HIV and AIDS: Regional snapshot – Eastern and Southern Africa (December 2018)

Source: UN Children's Fund
Country: Angola, Botswana, Burundi, Djibouti, Eritrea, Eswatini, Ethiopia, Kenya, Lesotho, Madagascar, Malawi, Mozambique, Namibia, Rwanda, Somalia, South Africa, South Sudan, Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

Eastern and Southern Africa is home to more than 60 per cent of children and adolescents living with HIV. This is the region where most progress in the HIV response has been made. Coverage of maternal antiretroviral treatment for pregnant and breastfeeding women living with HIV reached 93 per cent in this region in 2017. Sustaining these gains and continuing to reach children, adolescents and women at risk and living with HIV is critical. In 2017, an estimated 120,000 adolescents aged 10–19 years and 94,000 children aged 0–9 years were newly infected with HIV. They are now part of the estimated 1.9 million children and adolescents living with HIV in the region. Despite ongoing progress, 65,000 of the region’s children and adolescents died of an AIDS-related cause in 2017.

Analysis

Of the 94,000 new HIV infections among children aged 0–9 years in 2017 in Eastern and Southern Africa, the majority (51,000) occurred after birth, which reflects a failure of PMTCT programmes during breastfeeding. The ‘last mile’ towards elimination of vertical transmission relies on overcoming gaps in ongoing HIV testing, treatment and care for vulnerable mothers and their infants after birth.

Continued and accelerated progress in PMTCT programming cannot be achieved without improved HIV prevention efforts among adolescents, particularly adolescent girls and young women. The total number of annual new HIV infections among those aged 10–19 years in 2017 was only about 25 per cent lower than it was in 2010. Demographic trends indicating ongoing steep rises in adolescent populations by 23 per cent between 2018 and 2030 lend further urgency to the importance of expanded and sustained prevention efforts targeting that age group.

Uganda: UNICEF Uganda Humanitarian Situation Report – October 2018

Source: UN Children's Fund
Country: Burundi, Democratic Republic of the Congo, Rwanda, Somalia, South Sudan, Uganda

Highlights

  • The refugee verification exercise that started in March 2018 by the Office of the Prime Minister and UNHCR has ended, revising the active registered population in Uganda to 1,154,352 individuals as of end of October 2018.

  • In October, over 6,536 refugees arrived from the Democratic Republic of the Congo (DRC), South Sudan and Burundi. Sixty per cent of refugees and host communities are children, who continue to be in need of essential services such as health, nutrition, WASH, child protection and education services, for their survival, development and well-being.

  • Over 7,000 children are benefitting from the recently concluded 33 multi-purpose education facilities completed in Arua and Yumbe.

  • Since the Ebola outbreak in Eastern DRC was declared on 1 August 2018, no cases have been reported in Uganda, largely as a result of intensive prevention and preparedness efforts by the Ministry of Health and partners, including UNICEF. Efforts have included risk communication activities that have reached nearly 400,000 people, including 135,000 children.

  • In October, a flood and landslide affected 13 villages in Bududa district, killing 43 people, including eight children.

Situation Overview and Humanitarian Needs

Refugees: According to UNHCR and the Office of the Prime Minister (OPM), the refugee influx remains significant. OPM and UNHCR concluded the countrywide biometric verification exercise of all asylum seekers and refugees in Uganda on 24 October 2018; the active registered population in Uganda stands at 1,154,352 individuals as of end of October. Of these, 785,104 are refugees and asylum seekers from South Sudan, 284,265 from the DRC, 33,657 from Burundi and 51,326 from Somalia, Rwanda and other countries.

Representatives from the Ministry of Gender, Labour and Social Development (MGLSD), UNICEF and the Uganda Red Cross Society (URCS) attended a workshop in Addis Ababa in October aimed at improving leadership and collaboration of local actors to enhance coordination of child protection in preparedness and humanitarian response. As part of this, an Action Plan was developed highlighting key actions that the MGLSD will take on to strengthen coordination and leadership for child protection in emergencies at national and field levels. Moving forward, the MGLSD, as the technical ministry responsible for child protection in Uganda, will co-chair the Child Protection Sector Working Group for the refugee response with UNHCR and UNICEF, and will implement activities to strengthen coordination and emergency preparedness efforts.
The workshop was organised by the Child Protection Area of Responsibility and the International Federation of Red Cross and Red Crescent Societies, in association with the Global Partnership to End Violence against Children.

Disease outbreaks:

Ebola preparedness
As of 26 October 2018, the Public Health Emergency Operations Centre of the Ministry of Health (MoH) had not reported any suspected or confirmed cases of Ebola Virus Disease (EVD) in Uganda. The MoH and partners continue to intensify risk communication, social mobilization and surveillance, including at points of entry in 28 priority districts, as per the revised national EVD contingency plan, in six existing Ebola Treatment Centres (ETC) in Entebbe, Wakiso district; Naguru, Kampala district; Bundibugyo hospital; Ntoroko health centre 3; Rwebisengo and Bwera, in addition to 10 ETCs to be established in selected very high-risk districts along the border with DRC. Comprehensive surveillance continues in all communities, health facilities and at formal and informal border crossings in all districts, especially the 20 high-risk districts. Alert cases continue to be identified and isolated with blood samples taken for testing to the Uganda Virus Research Institute.

Cholera and other outbreaks
There has been a re-emergence of cholera in Hoima/Kikuube, two months after the second round of the Oral Cholera Vaccination (OCV) campaign. Two cases aged 20 years (female) and 27 years (male) were confirmed on culture and sensitivity both from Ndongo village in Kikuube district. Cases were found in the communities. This has been attributed to poor sanitation and lack of safe water. Additionally, 14 cases and six deaths of Crimean-Congo Haemorrhagic fever (CCHF) were reported between July and October in Kakumiro, Isingiro, Kiboga, Kiryandongo, Nakaseke and Sembabule districts; 14 cases of Anthrax with no deaths in Arua, Kiruhura, Isingiro and Kween districts; and 33 cases and 18 deaths of Rift Valley Fever (RVF) had been reported in 17 districts. A total of 264 measles cases were reported in 76 districts while 157 cases of Rubella were reported in 33 districts.

Floods and Landslides:
In October, a flood and subsequent landslide occurred in Bukalasi sub-county, Bududa district, affecting 13 villages, injuring 21 people, and killing 43, including eight children. Rescue teams from OPM and partners conducted search and recovery of the dead bodies and evacuated the injured. The 139 displaced households are currently hosted by neighbours, relatives and friends who were in safer areas, while the Government finalizes their resettlement. Road infrastructure, water and sanitation facilities, and education facilities were destroyed by the incident. Services at the available health facilities in the area are stretched in terms of human resources and medical supplies. According to URCS, more than 4,300 people (2,583 children) across Bududa, Namisindwa, Butalejja, and Manafwa districts in the Mt. Elgon region are at risk given the meteorological forecast of normal to above normal rainfall in most parts of the country until December 2018.

Kenya: UNICEF Kenya Humanitarian Situation Report, 1 September – 31 October 2018

Source: UN Children's Fund
Country: Ethiopia, Kenya, Somalia, South Sudan, World

Highlights

  • A new wave of cholera cases was reported on 8 September. Measles outbreaks continue to be reported in Mandera, Garissa, Nairobi and Wajir counties.
  • Heavy rainfall was recorded towards the end of October, resulting in flash floods in the coastal strip and northern counties.
  • A total of 161,175 children have been vaccinated against measles during the campaign in Mandera county.
  • Three million children have been reached in round two of the synchronized polio vaccination campaign for the Horn of Africa.
  • With UNICEF support, 188,873 acutely malnourished children were admitted for treatment from 1 January to 30 September 2018.
  • A total of 23,148 children were reached with life-saving health interventions during integrated health outreaches in the period under review.
  • During the reporting period, 33,499 women, girls, boys and men had access to safe water from three rehabilitated water facilities in Garissa and Tana River counties.
  • In 2018, UNICEF requires US$ 34.2 million for its Humanitarian Action for Children Appeal that has a funding gap of 60 per cent.

Situation in Numbers

700,000
People are food insecure
(2018 Long Rains Assessment, August 2018)
329,000
Children are food insecure
(2018 Long Rains Assessment, August 2018)
85,105
Children under 5 in need of severe acute malnutrition treatment
(2018 Long Rains Assessment, August 2018)

UNICEF HAC Appeal 2018

US$ 34,235,000
*Funds available include funding received against current appeal as well as carry-forward from the previous year (US$ 5.5 million, which includes US$1.7 million for the refugee response).

Situation Overview and Humanitarian Needs

The Kenya Meteorological Department has reported that the onset of the October to December short rains was timely over most parts of the country. Very heavy rainfall was recorded towards the end of October, resulting in flash floods in the coastal strip and northern counties. This affected access to communities in Mandera during the measles campaign, which was thus extended by two days to end on 2 November 2018. November is normally the peak month for the short-rains season, and the forecast indicates that several parts of the country are likely to experience enhanced rainfall with the likelihood of flooding, landslides/mudslides in prone areas and outbreak of diseases normally associated with excessive water. According to the Kenya Red Cross Society (KRCS), effects of floods including destruction of shelter, roads and water infrastructure and possible outbreaks of cholera, malaria, yellow fever and Rift Valley fever are expected in the coastal counties of Kwale, Tana River, Kilifi, Taita, Taveta and Lamu; western counties of Kisumu, Migori, Siaya, Busia and Homa Bay; north eastern counties of Garissa, Wajir and Mandera and upper eastern counties of Isiolo, Marsabit, Samburu; and North Rift counties of Baringo and Turkana.

According to the Famine Early Warning Systems Network (FEWSNET), the historically above-average 2018 March to May long rains have continued to drive food security improvements countrywide. With an average to above-average forecast for the October to December short rains, livelihood recovery from the severe 2016/2017 drought is expected to continue, however, majority of the poorest households are likely to take longer to recover, thus maintaining the pastoral areas in Stressed (IPC Phase 2) through to January 2019. In addition, critical global acute malnutrition (GAM) levels (15-29.9 per cent) are likely to be sustained to January 2019 in Mandera, Turkana, Samburu, parts of Baringo (East Pokot), and Marsabit (North Horr) counties, driven by various factors, including poor child care feeding practices and lack of suitable access to health facilities. Serious GAM levels (10-14.9 per cent) are anticipated in Wajir, Garissa, Isiolo, Laikipia, Tana River, and Marsabit (Laisamis) counties.

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