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Democratic Republic of the Congo: WHO AFRO Outbreaks and Other Emergencies, Week 28: 8 – 14 July 2019; Data as reported by 17:00; 14 July 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Kenya, Liberia, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 71 events in the region. This week’s edition covers key new and ongoing events, including:

  • Circulating vaccine-derived poliovirus type 2 (environmental sample) in Ghana

  • Ebola virus disease in Democratic Republic of the Congo

  • Humanitarian crisis in Cameroon

  • Humanitarian crisis in Central African Republic.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

This week, health authorities in Ghana confirmed circulating vaccine-derived poliovirus type 2 (cVDPV2) in an environmental sample. Additionally, two case-patients with acute flaccid paralysis (AFP) tested positive for genetically linked cVDPV2 in Haut Lomami Province, Democratic Republic of the Congo.

The frequency of occurrence of cVDPV2 events in the African Region has been increasing (lately), with three major loci, situated in the Democratic Republic of the Congo, the Lake Chad basin and the Horn of Africa. These epicentres are characterized by major prolonged complex humanitarian emergencies – with insecurity, disrupted health systems and social dislocation. However incidentally, the countries around these epicentres also have conditions that are conducive to the rapid spread of polioviruses, namely accumulation of unprotected persons, suboptimal sanitation and high population mobility. The circulation of vaccine-derived polioviruses in the African region is likely to become a major public health problem if not tackled decisively at this point in time.

The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo continues. The occurrence of a confirmed case in Goma on 14 July 2019, while long anticipated and prepared for, emphasises the enormous challenges around control of this outbreak, reinforcing the need for strong and consistent implementation of all public health measures. While progress is slowly being made, the ongoing response operations are being challenged by suboptimal resourcing, negatively impacting on the entire response. Member States and other donors are strongly encouraged to provide additional funding in order to ensure that hard won progress in containing this EVD outbreak will not suffer a potentially devastating setback due to financial limitations

Democratic Republic of the Congo: WHO AFRO Outbreaks and Other Emergencies, Week 27: 1 – 7 July 2019; Data as reported by 17:00; 7 July 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Liberia, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

Overview

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 74 events in the region. This week’s edition covers key new and ongoing events, including:

  • Circulating vaccine-derived poliovirus type 2 in Angola
  • Ebola virus disease in Democratic Republic of the Congo
  • Dengue fever in Côte d’Ivoire
  • Humanitarian crisis in north-east Nigeria.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • A new case of genetically-distinct circulating vaccine-derived poliovirus type 2 (cVDPV2) has been confirmed in Cuvango district, Huila Province, central Angola. This is the second cVDPV2 outbreak in Angola in 2019, occurring over 1 000 kilometers away from the first event. The occurrence of this event (symbolic) and the increasing frequency of cVDPV2 emergence across the African Region is becoming a major public health issue, given the compromised sanitation situation, high population mobility and challenges faced by the national immunization programmes. While comprehensive responses are being undertaken, these events should serve to remind all countries in the African region of the importance of improving the quality of routine and supplementary immunization activities and maintain high levels of polio (and all other antigens) vaccination coverage to minimize the risk and consequences of poliovirus circulation.

  • The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo continues, with persistent low transmission intensity. The weekly incidence showed some reduction in the number of new confirmed EVD cases this week, albeit with a fluctuating pattern. All efforts to step up and sustain ongoing response operations need to continue.

Democratic Republic of the Congo: WHO AFRO Outbreaks and Other Emergencies, Week 26: 24 – 30 June 2019; Data as reported by 17:00; 30 June 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Liberia, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 76 events in the region. This week’s edition covers key new and ongoing events, including:

  • Circulating vaccine-derived polio virus type 2 in Democratic Republic of the Congo
  • Ebola virus disease in Democratic Republic of the Congo
  • Hepatitis E in Namibia
  • Humanitarian crisis in Burkina Faso.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • Health authorities in Democratic Republic of the Congo reported two simultaneous events of genetically-distinct circulating vaccine-derived polio virus type 2 (cVDPV2) in Kasai and Sankuru provinces. In both events, two case-patients with acute flaccid paralysis were confirmed with geneticallylinked circulating vaccine derived poliovirus type 2. The two events become the fifth and sixth genetically-distinct cVDPV2 outbreaks in the country. While comprehensive responses are being undertaken, these events highlight the need to maintain high levels of routine polio vaccination coverage in all countries in the region to minimize the risk and consequences of any poliovirus circulation.
  • The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of the Congo continues, with insecurity incidents reported in Beni this week targeting Ebola response personnel. The weekly incidence showed minimum reduction in the number of new confirmed EVD cases this week, as the transmission intensity keeps fluctuating. All efforts to step up and sustain ongoing response operations need to continue.

Democratic Republic of the Congo: WHO AFRO Outbreaks and Other Emergencies, Week 25: 17 – 23 June 2019; Data as reported by 17:00; 23 June 2019

Source: World Health Organization
Country: Angola, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Lesotho, Liberia, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This Weekly Bulletin focuses on selected acute public health emergencies
occurring in the WHO African Region. The WHO Health Emergencies Programme
is currently monitoring 77 events in the region. This week’s edition covers key
new and ongoing events, including:

  • Cholera in Nigeria
  • Ebola virus disease in Democratic Republic of the Congo
  • Humanitarian crisis in Ethiopia
  • Humanitarian crisis in South Sudan.

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

A table is provided at the end of the bulletin with information on all new and
ongoing public health events currently being monitored in the region, as well as
recent events that have largely been controlled and thus closed.

Major issues and challenges include:

The outbreak of Ebola virus disease (EVD) in North Kivu and Ituri provinces,
Democratic Republic of the Congo continues, with fluctuating transmission
intensity. There has been a period of improved security recently, allowing
response teams to access communities and operate more freely. As a result,
indicators over the past few weeks provide early signs of an easing of the
transmission intensity in major hotspots. However, concerns remain over the
number of new cases still occurring in areas that previously had lower rates of
transmission. Additionally, the lack of funding to support response operations
has reached a worrying level. The international community must step up
funding to support the ongoing response and strengthen preparedness in
Democratic Republic of the Congo and neighbouring countries.

Health authorities in Nigeria have confirmed a new cholera outbreak in Adamawa
State, one of the three states in north-east Nigeria with prolonged complex
humanitarian emergencies. These states are vulnerable to experiencing large
cholera outbreaks, as has been seen in the recent past. It is therefore critical
that the current cholera outbreak is responded to swiftly at the initial stages
to prevent escalation of the situation.

Democratic Republic of the Congo: WHO AFRO Outbreaks and Other Emergencies, Week 24: 10 – 16 June 2019; Data as reported by 17:00; 16 June 2019

Source: World Health Organization
Country: Angola, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Lesotho, Liberia, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

Overview

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 75 events in the region. This week’s edition covers key new and ongoing events, including:

  • Ebola virus disease in Uganda
  • Ebola virus disease in Democratic Republic of the Congo
  • Measles in Democratic Republic of the Congo
  • Humanitarian crisis in Mali.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • The emergence, this week, of a cluster of Ebola virus disease (EVD) cases in Kasese District, western Uganda raised a lot of attention in the region and globally. This event affirmed the continuous risk of spread of the outbreak in the region and re-echoes the importance of enhancing preparedness and readiness measures in the neighbouring countries. The robust response mounted by health authorities in Uganda emphasized one of the key principles of International Health Regulations (IHR) 2005, namely ‘containment at source’. This is premised on attaining requisite capabilities for rapid detection and swift control of health events at their onset, thus preventing escalation of small outbreaks into large epidemics. The event in Uganda is a reminder to all State Parties in the African Region to work towards attaining the core capacities stipulated in the IHR (2005).

  • The Democratic Republic of the Congo has been experiencing recurrent measles outbreaks since 2010, with a significant surge in 2019. The Ministry of Health has formally declared the measles epidemic and is calling for all stakeholders to step up response efforts. The response to the measles outbreak (and many other health events) in Democratic Republic of the Congo have been challenged by under-resourcing, weak health systems, insecurity and social disentanglement.

Democratic Republic of the Congo: WHO AFRO Outbreaks and Other Emergencies, Week 23: 3 – 9 June 2019; Data as reported by 17:00; 9 June 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

Overview

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 72 events in the region. This week’s edition covers key new and ongoing events, including:

  • Malaria in Burundi
  • Measles in Comoros Islands
  • Ebola virus disease in Democratic Republic of the Congo
  • Humanitarian crisis in Central African Republic.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • There has been a significant reduction in the number of new Ebola virus disease cases and deaths reported in Democratic Republic of the Congo in the last weeks. While it is still too early to make any conclusions, this observed declining trend is very positive and encouraging. There have been several initiatives and efforts to step up the response to the outbreak in the past weeks.
    While still being aware of the prevailing risk factors in the communities, it is anticipated that these initiatives and intensified efforts will turn the tide on the ongoing high levels of transmissions of infections. The national authorities and all stakeholders need to sustain implementation of effective public health measures in order to bring this outbreak to an end.

  • Health authorities in Burundi have detected a potential malaria outbreak in several health districts in the country. This event comes barely one year after the occurrence of a large malaria outbreak in 2017, signifying the vulnerability of the country to malaria epidemics. The national authorities and partners need to capitalize on the early detection of this event and mount a robust response in order to bring the outbreak to a speedy end and avoid escalation of the situation.

Mozambique: WHO AFRO Outbreaks and Other Emergencies, Week 22: 27 – 2 June 2019; Data as reported by 17:00; 2 June 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sao Tome and Principe, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 72 events in the region. This week’s edition covers key new and ongoing events, including:

  • Anthrax (probable) in Lesotho
  • Vaccine derived poliovirus type 2 (environmental sample) in Cameroon
  • Ebola virus disease in Democratic Republic of the Congo
  • Cholera in Zambia
  • Chikungunya in Congo.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • The Ministry of Health in Lesotho has reported a probable outbreak of anthrax in the outskirts of Maseru, the capital city, following an epizootic confirmed by the veterinary authorities. This event has quickly raised concerns in the sub- region, including potential implications for trade. The responsible authorities in Lesotho need to act swiftly to contain this outbreak while the neighbouring countries need to improve preparedness and readiness measures, and act judiciously in response to the event, in line with provisions of the International Health Regulations (2005) and the Terrestrial Animal Health Code.

  • A circulating vaccine derived poliovirus type 2 (cVDPV2) has been isolated in an environment sample in Mada health district, Far North Province, Cameroon. The isolated virus has been linked to the ongoing cVDPV2 strain circulating in neighbouring Nigeria, which originated in Jigawa State. This event is important in view of the fact that poliovirus, targeted for global eradication, spreads easily and across large distances. To that effect, all countries, particularly those in the Lake Chad Basin, are urged to step up acute flaccid paralysis surveillance and should maintain a high immunization coverage to minimize introduction of any new virus.

Mozambique: WHO AFRO Outbreaks and Other Emergencies, Week 22: 27 May – 2 June 2019; Data as reported by 17:00; 2 June 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sao Tome and Principe, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 72 events in the region. This week’s edition covers key new and ongoing events, including:

  • Anthrax (probable) in Lesotho
  • Vaccine derived poliovirus type 2 (environmental sample) in Cameroon
  • Ebola virus disease in Democratic Republic of the Congo
  • Cholera in Zambia
  • Chikungunya in Congo.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • The Ministry of Health in Lesotho has reported a probable outbreak of anthrax in the outskirts of Maseru, the capital city, following an epizootic confirmed by the veterinary authorities. This event has quickly raised concerns in the sub- region, including potential implications for trade. The responsible authorities in Lesotho need to act swiftly to contain this outbreak while the neighbouring countries need to improve preparedness and readiness measures, and act judiciously in response to the event, in line with provisions of the International Health Regulations (2005) and the Terrestrial Animal Health Code.

  • A circulating vaccine derived poliovirus type 2 (cVDPV2) has been isolated in an environment sample in Mada health district, Far North Province, Cameroon. The isolated virus has been linked to the ongoing cVDPV2 strain circulating in neighbouring Nigeria, which originated in Jigawa State. This event is important in view of the fact that poliovirus, targeted for global eradication, spreads easily and across large distances. To that effect, all countries, particularly those in the Lake Chad Basin, are urged to step up acute flaccid paralysis surveillance and should maintain a high immunization coverage to minimize introduction of any new virus.

Mozambique: WHO AFRO Outbreaks and Other Emergencies, Week 21: 20 – 26 May 2019; Data as reported by 17:00; 26 May 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sao Tome and Principe, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This Weekly Bulletin focuses on selected acute public health emergencies
occurring in the WHO African Region. The WHO Health Emergencies Programme
is currently monitoring 73 events in the region. This week’s edition covers key
new and ongoing events, including:

  • Anthrax outbreak in Guinea
  • Ebola virus disease outbreak in the Democratic Republic of the Congo
  • Humanitarian crisis in Central African Republic
  • Humanitarian crisis in Nigeria
  • Yellow fever in Uganda.

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

A table is provided at the end of the bulletin with information on all new and
ongoing public health events currently being monitored in the region, as well as
recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • The humanitarian crises in both Central African Republic and North East
    Nigeria continue, with healthcare delivery disruption through directly targeted
    attacks or as a result of collateral damage. Healthcare staff, partners and
    local authorities continue to provide care in these insecure environments
    and should be commended. However, increased support from the local and
    international community in terms of both human resources, interventions to
    improve security measures, as well as funding, is much needed to ensure the
    appropriate humanitarian assistance is provided to the affected populations.

  • Cases of Ebola virus disease (EVD) continue to be confirmed in North Kivu
    and Ituri provinces of the Democratic Republic of the Congo at an alarming
    rate, with security problems and community resistance a continuing problem.
    The announcement this week of a new UN Emergency Ebola Response
    Coordinator to oversee the coordination of international support for the Ebola
    response and ensure that appropriate security and political measures are in
    place to enable the Ebola response is a positive move. Working to support the
    Government in strengthening political engagement and operational support
    to negotiate access safely to communities in all areas and increase support
    for humanitarian coordination will be key to controlling the outbreak.

United Republic of Tanzania: UNICEF Eastern and Southern Africa Regional Humanitarian Situation Report – Quarter 1, 2019

Source: UN Children's Fund
Country: Angola, Burundi, Democratic Republic of the Congo, Eswatini, Lesotho, Madagascar, Malawi, Mozambique, Namibia, Rwanda, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

Highlights

  • The ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC) continues to threaten neighbouring countries including Uganda, Burundi, Rwanda, South Sudan, Tanzania and Zambia. UNICEF continues to play a key role in the UN wide Ebola prevention and preparedness response, reaching more than 65,000 people with key Ebola messages and EVD prevention supplies.

  • More than 25,000 children have been vaccinated against measles and approximately 60, 000 refugees and host community members accessed safe water for drinking, cooking and personal hygiene.

  • Rwanda, Tanzania and Zambia host almost 530,000 refugees and asylum seekers, largely from Burundi and the DRC. UNICEF and partners ensured quality and equity-based education for more than 112,000 refugee children in Tanzania, Rwanda and Zambia.

  • UNICEF continues to strengthen community surveillance and referral systems through active case management of acute malnutrition throughout the region. From January to March, 548 children were admitted for treatment of severe acute malnutrition (SAM) in Eswatini, Tanzania and Zambia, including 376 refugee children with SAM in Tanzania.

Regional Situation Overview & Humanitarian Needs

The Eastern and Southern Africa region (ESAR) is affected by recurrent disasters that are undermining the hard-fought development gains of recent years and resulting in major social and economic setbacks. In Eswatini, Lesotho, Rwanda, Tanzania, Zambia - the countries covered by this report- more than 1.6 million people, including over 790,000 children, are in need of humanitarian assistance due to climate-related shocks, health emergencies and displacement.

The Ebola Virus Disease outbreak in the North Kivu and Ituri provinces of the DRC continues to threaten neighbouring countries. As 1 April, more than 1100 people have been infected with the disease, including over 692 deaths since the outbreak was declared on 1 August 2018 (WHO). The response to the outbreak has been hampered by insecurity, frequent movement of people in the affected areas, and resistance from some communities, creating a high-risk of cross border transmission into neighbouring countries in the region. In response to this risk, UNICEF, along with the UNCTs, intensified preparedness levels against Ebola importation in Uganda, Burundi, South Sudan and Rwanda (priority one countries) and Angola, Tanzania and Zambia (priority two countries). Rwanda has 10 districts bordering the DRC and Uganda, and there are more than 10,000 daily travelers between Goma and Rwanda resulting in a high level of risk. During the reporting period, EVD was contained to the DRC and no confirmed cases in the ESAR.

Displacement continues to drive high assistance needs with 4.1 million refugees in the region - 25% of the total global refugee population. South Sudan and Burundi are the main sources of origin for refugees in ESA, while Uganda, Ethiopia, Angola, Tanzania and Rwanda are the main host countries. Armed conflict and political instability in South Sudan, Burundi and the DRC has led to growing humanitarian needs for children and their families, who have been forced to flee into neighbouring countries. Almost 60 per cent of the refugee population are children across the region. Between January and March, some 17,843 Congolese fled to neighbouring countries, with a significant increase in refugee flows to Uganda (UNHCR).

By March 2019, Tanzania hosted 325,291 refugees and asylum seekers. Of these, 282,650 are hosted in three refugee camps in Kigoma region (Nduta, Mtendeli and Nyarugusu), while 42,000 reside in villages and settlements across northwestern Tanzania. The majority of the refugees are Burundians (198,177 who have sought asylum in Tanzania since 2015). This number is added to the caseload of 84,473 refugees from DRC, many of whom have lived in Tanzania for the past 20 years. Fifty six percent of the refugee population are children under 18 years, and children under five comprise 20 per cent of the refugee population. Additionally, there are more than 7,500 unaccompanied and separated children in the camps receiving protection services. Tanzania has not received new asylum seekers from Burundi in either 2018 or 2019, which may be due to the continuing restrictions on access to territory since 2017, including closure of all border entry and reception points for Burundian asylum seekers in 2018.

Voluntary repatriation of Burundian refugees resumed in February 2019, after a temporary hold in mid-December 2018 due to lack of resources. The number of refugees registering for voluntary repatriation has decreased in 2019, with more than 50 per cent retractions, no shows and convoy dropouts reported since November 2018. Since the beginning of the voluntary repatriation exercise in September 2017, a total of 61,342 Burundian refugees have been assisted to return and another 20,000 refugees have shown interest to return. During the reporting period, 5278 Burundi refugees were returned to Burundi from Tanzania through the assisted repatriation programme.

According to UNHCR, there were 148,323 total refugees and asylum seekers in Rwanda as of 31 March. Of the total, 70,570 are individually registered Burundian refugees, while 75,212 are from the DRC. In addition, there were 642 groupregistered Burundian refugees and 1,848 Congolese asylum seekers. From January to March, there were 834 new arrivals (UNHCR). Children makeup 49 per cent of the Burundian refugee population. The Government of Rwanda established Mahama Refugee Camp in April 2015, which hosts 59,319 Burundian refugees, making it the largest refugee camp in Rwanda. In addition, there are over 12,000 Burundian refugees in the urban areas of Kigali and Huye.

By the end of March, there were 78,938 persons of concern 56,082 refugees and asylum seekers in Zambia (UNHCR). Of these, 45,805 are from the DRC and are 14,136 registered refugees (58 percent are children) residing in Mantampala settlement. Following the relative peace after the presidential election in the DRC, the number of refugees in Mantapala refugee settlement has remained stable with only 36 new arrivals in 2019. A smaller number of refugees and asylum seekers are from Burundi (5,583) and Somalia (3,262).

Food insecurity in southern Africa started atypically as early as September 2018 in some countries due to the poor 2018 harvest from prolonged dry spells during the second half of the 2017/2018 rainy season. Prolonged seasonal rainfall deficits since the beginning of the southern African monsoon have negatively impacted the grounds of many countries in the region, including southern Angola, northern Namibia, southern Zambia, and northern Zimbabwe. Many areas across the region are experiencing Crisis and Emergency (IPC Phase 3 and 4) outcomes. October 2018 to March 2019 IPC Regional Map showed areas of concern as southern Malawi, most of Zimbabwe, Grand Sud of Madagascar, southern Mozambique, western Zambia, southern Lesotho, and eastern Eswatini.

According to the findings of the November 2018 IPC assessment in Lesotho, an estimated 325,318 people (273,635 people in rural areas and 51,683 people in urban areas) are in need of humanitarian assistance. In the same period, Maseru, Mohale’s Hoek, Qacha’s Nek and Quthing districts were projected to be IPC Phase 3 (Crisis) or higher while the other six districts were projected to be in IPC Phase 2 (Stressed). Due to the deterioration of the humanitarian situation, the Government of Lesotho and partners undertook a rapid needs assessment in March 2019. The first set of results showed that 487,857 people (407,191 in rural areas and 80,666 in urban areas) are currently in need of humanitarian assistance, especially in the WASH, Health, Nutrition, Child Protection and HIV/AIDS sectors. Furthermore, 640,000 people in rural and urban areas are projected to be food insecure during the period July 2019-June 2020. According to the Lesotho Meteorological Services, in the period March-May 2019, below-normal rainfall is projected, further increasing the possibility of a negative impact on the winter planting and harvest.

In Eswatini, the 2018/2019 seasonal projection by the Department of Meteorology indicated normal to below normal rainfall from January to March 2019. However, cyclone activity along the Mozambican channel (peaking in January to February) influenced the weather pattern, which resulted in above normal rainfall, with national rivers reaching full capacity. With the current rainfall addressing drought projections, the Government focus has been on food insecurity as a result of limited crops. Food security remains a high priority with children at risk of severe acute malnutrition. The June 2018 Vulnerability Assessment and Analysis (VAA) report found that 165,723 people (79,547 children) are faced with acute food insecurity in the lean season.

In Zambia, the 2018/2019 season rainfall forecast was largely influenced by weak state of the El Nino Southern Oscillation and the country faced prolonged dry spell conditions especially in southern and western Zambia representing 51 out of 110 districts in Zambia. This impacted negatively on water supply and crop condition especially on the rural farming households; with projection of increased basic food prices, poor harvest for subsistence farmers, depletion of animal stock and drying of sources of water for humans and animals.

World: Global Weather Hazards Summary: May 24 – 30, 2019

Source: Famine Early Warning System Network
Country: Afghanistan, Angola, Benin, Burkina Faso, Cameroon, Costa Rica, Dominican Republic, El Salvador, Ethiopia, Ghana, Guatemala, Haiti, Honduras, Kazakhstan, Kenya, Kyrgyzstan, Namibia, Nicaragua, Nigeri...

Mozambique: WHO AFRO Outbreaks and Other Emergencies, Week 20: 13 – 19 May 2019; Data as reported by 17:00; 19 May 2019

Source: World Health Organization
Country: Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sao Tome and Principe, Sierra Leone, South Africa, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 71 events in the region. This week’s edition covers key new and ongoing events, including:

  • Cyclone Kenneth in Mozambique and Comoros
  • Ebola virus disease in Democratic Republic of the Congo
  • Crimean Congo Haemorrhagic fever in Namibia - Humanitarian crisis in South Sudan.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • Three weeks after cyclone Kenneth made landfall in northern Mozambique and the Comoros Islands, the affected population continue to suffer from consequences of the cyclone, although the humanitarian conditions continue to improve. Damage caused to agriculture and livestock has contributed to a worsening of living conditions for affected populations, triggering malnutrition among children, due to food insecurity. Humanitarian access remains a challenge in affected areas, especially in Mozambique, with many areas remaining inaccessible by road and requiring access via air or river transport. Humanitarian agencies in Mozambique and Comoros have to continue to monitor and respond to health challenges – including the spread of vector-borne and water-borne diseases in affected areas.

  • The Ebola virus disease (EVD) outbreak in Democratic Republic of the Congo continues, with increasing incidence. This recent rise in the number of new cases could be partly attributed to the disruption of response interventions following the latest spate of insecurity, and continuing pockets of community mistrust. The transmission remains most intense in seven main hotspot areas: Katwa, Mabalako, Mandima, Butembo, Musienene, Kalunguta, and Beni. A new case was also reported in the health zone of Alimbongo this week, with links to cases deriving from Katwa. Responses activities are ongoing in EVD affected provinces.

World: Global Weather Hazards Summary: May 17 – 23, 2019

Source: Famine Early Warning System Network
Country: Afghanistan, Angola, Benin, Burkina Faso, Cameroon, Dominican Republic, El Salvador, Ethiopia, Ghana, Guatemala, Haiti, Honduras, Kazakhstan, Kenya, Kyrgyzstan, Namibia, Nigeria, Somalia, South Sudan...

Mozambique: WHO AFRO Outbreaks and Other Emergencies, Week 19: 6 – 12 May 2019; Data as reported by 17:00; 12 May 2019

Source: World Health Organization
Country: Angola, Burkina Faso, Cameroon, Central African Republic, Chad, Comoros, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Sao Tome and Principe, Sierra Leone, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

Overview

This Weekly Bulletin focuses on selected acute public health emergencies occurring in the WHO African Region. The WHO Health Emergencies Programme is currently monitoring 68 events in the region. This week’s edition covers key ongoing events, including:

  • Cyclone Idai in Zimbabwe, Malawi and Mozambique
  • Ebola virus disease in Democratic Republic of the Congo
  • Dengue fever in Mauritius
  • Measles in Chad
  • Humanitarian crisis in Ethiopia.

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

A table is provided at the end of the bulletin with information on all new and ongoing public health events currently being monitored in the region, as well as recent events that have largely been controlled and thus closed.

Major issues and challenges include:

  • Challenges associated with insecurity and pockets of community mistrust continue to characterize the response to the Ebola virus disease outbreak in Democratic Republic of the Congo. Several major security incidents occurred in Butembo and its neighbouring health zones during the reporting week, leading to momentary suspension of response activities in the area. While response operations have resumed, we expect that the disruption of activities due to restricted access will result in a further rise in the number of cases in the coming days. In addition to the insecurity and complex socio-political environment, the response activities continue to suffer from funding gaps. The implementation of proven public health measures must continue, while a major surge in political and financial support from all national and international actors is urgently needed in order to bring this outbreak to end. The national and local authorities, WHO and partners remain committed to this cause.

  • While good efforts have been made in response to the effects of the Tropical Cyclone Idai that hit Malawi, Mozambique and Zimbabwe early in March 2019, more humanitarian assistance is needed. All the three affected countries are still facing challenges around access to affected populations, risks of communicable diseases, limited access to healthcare services, and resettlement of displaced persons in the light of the massive destruction of homes, infrastructure and crops at a crucial time of the year. The national authorities, partners and donors need to step up provision of aid assistance in order to prevent long-term humanitarian crises in a large area of southern Africa.

World: Global Weather Hazards Summary: May 10 – 16, 2019

Source: Famine Early Warning System Network
Country: Afghanistan, Angola, Belize, Benin, Burkina Faso, Cameroon, Dominican Republic, El Salvador, Ethiopia, Ghana, Guatemala, Haiti, Honduras, Iran (Islamic Republic of), Kazakhstan, Kenya, Kyrgyzstan, Na...

Democratic Republic of the Congo: Democratic Republic of the Congo Situation: UNHCR Regional Update (March 2019)

Source: UN High Commissioner for Refugees
Country: Angola, Botswana, Burundi, Central African Republic, Chad, Congo, Democratic Republic of the Congo, Eswatini, Kenya, Madagascar, Malawi, Mozambique, Namibia, Rwanda, South Sudan, Uganda, United Republic of Tanzania, Zambia, Zimbabwe

This update concerns the situation of Congolese refugees and asylum seekers in countries in the region.

As of 31 March 2019, 833,400 Congolese refugees are being hosted in African countries. From 1 January to 31 March 2019 alone, some 17,843 Congolese fled to neighboring countries, with a significant increase in refugee flows to Uganda.
UNHCR together with 56 humanitarian and development partners launched the 2019-2020 Regional Refugee Response Plan (RRRP) on 11 December 2018 for US$743 million to help respond to the needs of Congolese refugees in Africa.

Regional Highlights and Operational Context

  • A plane carrying relief items from UNHCR, the UN Refugee Agency, landed on Wednesday, 27 March 2019 in Mozambique’s capital, Maputo, to support people affected by the Cyclone Idai. The airlift was one of the three flights meant to bring relief to some 30,000 people in Mozambique, Zimbabwe and Malawi. UNHCR aid was moved from its global stockpiles in Dubai, including family tents, plastic tarpaulins, sleeping mats, blankets, mosquito nets, solar lanterns, cooking sets, jerry cans and other relief items.
    Read more here First UNHCR relief flight lands in Mozambique http://bit.ly/2vzOJww

  • The Regional Refugee Coordinator (RRC) for the DRC situation, Ann Encontre, led UNHCR's delegation at the Ministerial consultation on displacement in the Great Lakes region, organized by the United Nations Special Envoy of the Secretary General for the Great Lakes region (UN-SESG) and the International Conference on the Great Lakes Region (ICGLR), in Entebbe, Uganda on 5-7 March 2019.
    Read more here The plight of refugees in Africa’s Great Lakes region under discussion by experts http://bit.ly/2GQzx3r

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