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Japan to give more than $2 million to Pakistan as assistance in fight against COVID-19 | The Express Tribune.

[April 1, 2020]

Japan will give Pakistan $2.16 million as assistance in the fight against the novel coronavirus.

A statement said that Japan has decided to give a grant of $1,620,000 through The United Nations Children’s Fund (UNICEF) and USD 540,000 through the International Organization for Migration (IOM) to Pakistan.

“This support will boost Pakistan’s capacity to quickly track the coronavirus affected persons and treat them accordingly.”

“This assistance will reduce and delay the transmission of COVID-19, to minimize serious disease due to COVID-19 and reduce associated deaths, to ensure ongoing health services during epidemic peak periods and to minimize the socio-economic impact,” added the statement.

The funds will be used to provide the necessary equipment and material to prevent the spread of COVID-19 and technical assistance on the ground at the request of the Pakistani government.

The Japanese ambassador, Matsuda Kuninori, also commended the efforts of the Pakistani government and its people in the fight against the pandemic.

“The Government of Japan always stands with Pakistan to fight against such viruses, referring to Japanese Assistance of 229 Million USD in total provided to Pakistan for polio eradication since 1996. Simultaneously the Government of Japan would like to cooperate with the Government of Pakistan to fight against the Novel Coronavirus (COVID-19) Infection.”

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Afghanistan: Weekly Humanitarian Update (23 March to 29 March 2020) | ReliefWeb.

[Source: OCHA] [Published: 1 Apr 2020] [Origin: View original]

Northeast: Over 20,000 people received humanitarian assistance.

Fighting between a Non-State Armed Group (NSAG) and Afghan National Security Forces (ANSF) continued in Badakhshan, Baghlan, Kunduz and Takhar provinces. An NSAG reportedly coordinated multiple attacks and took control of Yamgan district in Badakhshan province while fighting continued in the Maimai and Khustak areas in Jorm district.

546 people who were affected by severe flooding and rainfall received shelters and life-saving humanitarian assistance in Khwaja Ghar and Dasht-eQala districts in Takhar province.

20,720 people affected by conflict received humanitarian assistance in Baghlan, Takhar and Kunduz provinces. Moreover, 994 internally displaced persons (IDPs) affected by conflict were assessed and will receive assistance in the coming days in Baghlan province.

East: 5,000 people received humanitarian aid.

Clashes continued between the ANSF and an NSAG in Nangarhar, Kunar and Laghman provinces.

On 27 March, the first COVID-19 case was reported in the eastern part of the country. On 29 March, a laboratory was established for COVID-19 testing in Jalalabad city, Nangarhar province. This laboratory can conduct up to 100 tests in 24 hours.

Reportedly, severe flooding impacted 220 families (1,540 people) in Laghman, Kunar and Nangarhar provinces. Inter-agency assessment teams were deployed to affected areas to identify the needs of impacted families.

Last week, interagency assessment teams identified 3,241 IDPs to receive humanitarian assistance in the coming days across the east; and 4,970 IDPs and returnees received humanitarian assistance in Nangarhar, Laghman and Kunar provinces. In addition, 4,625 returnees, IDPs and people from host communities were reached with emergency outpatient health services. A total of 310 children were vaccinated for polio and measles.

UN Office for the Coordination of Humanitarian Affairs:
To learn more about OCHA's activities, please visit

Download report (PDF | 407.17 KB)

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Testing times... | News and Comment from Roy Lilley.

[1st April 2020]

Leaders, if you listen to the lecturers, academics and the people who put other people under the microscope, have to be multi-faceted with a cornucopia of talents and skills.

Leadership dissected; Democratic Leadership and Autocratic, Laissez-Faire, Strategic, Transformational, Transactional, Coach-Style and Bureaucratic Leadership.

To be honest, I'm not sure about any of it.  For me it's about being authentic.  That comes from being visible, connecting with people.  The Italians call it simpatico.

Head and shoulders, there is one quality, one sterling attribute, above all else I value and that is honesty.  

Truth, the stripped-pine truth.  Of course, if the truth is bad news, there is a skill in delivering it... at a pace and time that people can cope with. 

But, it's still the truth.  When a leader is caught in a lie, they become 'no good to man-nor-beast'... as The Duchess used to say.

Leaders are just like the rest of us... they make mistakes, misunderstand, get hold of the wrong end of the stick.  That's because leaders are human.  When they do get in a tangle, real leaders put their hands up; 'Listen folks, I got that wrong... we need to recalibrate, start again, have a rethink.'

Leaders are honest.  The truth is free but comes with a terrible price if it's ignored and the cost is credibility.

I am trying to decide if Michael Gove, my MP, is truthful.

If he's not, he forfeits public trust.  If he 'misspoke', got things elbow-about-face, he should say so.

Last Sunday I sat on the sofa and listened as he gave me and the millions of others watching Sky TV, the unequivocal impression that 10,000 people had been tested for C-19.  

It was not true.  On the 28th we tested 6,999 people and on the 29th we tested 6,961.

Later in the day a press person was obliged to dissemble on his behalf and pretend Gove had intended to imply we had the 'capacity to test 10,000 people'.

He could so easily have said; 'sorry folks, misunderstood the brief, we can test 10,000 and will do, soon, everyone is working their socks off...'

That would have required honesty, truth and leadership.  Instead, there's a row.

Why is this important?  Because there is now a question mark over Gove.  Can we trust anything he says?

It is also important because we are in the middle of a global pandemic and we cannot answer these questions;
  • Who's got it
  • Who's had it
  • Who's going to get it
  • Where...
I know a small group of NHS managers have been working their backsides off to improve our testing response.  I assure you, whatever the failure of testing, it is not the fault of the NHS.  A stumbling Number 10 will try a shove the blame anywhere but them.

We have to look at PHE, testing is their role, and whose Colindale laboratories where soon overwhelmed with testing and their organisational response.

We have to look at government and ask were they slow, off the back-foot, in buying whatever you need to buy... there seems to be a global shortage of the gloop and jiggle machines and there is no indication it will get better.

We have to look at procurement, fragmented by devolved responsibilities, the Home Nations in competition to buy scarce reagents.  Where was HMG?

We have to ask why HMG have not asked booze manufacturers, perfume distillers, manufacturers with laboratories, to turn their attention to making whatever reagent-jollop needs to be made.

We have to ask why, if it is true that there are 44 molecular virology labs in the UK, they are not being asked to process 500 tests a day and that would give us 154,000 tests a week... a start.  Work 24-7, we'd get closer to serious numbers.

... and when we look at all these things, what will we learn?  Dunno... because, without honesty we will still be listening to rubbish about a 'bad test being no test' or we are 'doing well in the world table-of-testing' and 'we can't buy the stuff'.

We need to test pretty well everyone and when we've done it, test them again and then re-test them.  Ten thousand, 25k, gets nowhere near it.

Government has to learn these may be difficult days but above all, they are testing times.  
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China Concealed Extent of Virus Outbreak, U.S. Intelligence Says | Bloomberg.

[April 1, 2020, 4:15 PM GMT+1] Nick Wadhams and Jennifer Jacobs write:

China has concealed the extent of the coronavirus outbreak in its country, under-reporting both total cases and deaths it’s suffered from the disease, the U.S. intelligence community concluded in a classified report to the White House, according to three U.S. officials.

The officials asked not to be identified because the report is secret and declined to detail its contents. But the thrust, they said, is that China’s public reporting on cases and deaths is intentionally incomplete. Two of the officials said the report concludes that China’s numbers are fake.

The report was received by the White House last week, one of the officials said.

The outbreak began in China’s Hubei province in late 2019, but the country has publicly reported only about 82,000 cases and 3,300 deaths, according to data compiled by Johns Hopkins University. That compares to more than 189,000 cases and more than 4,000 deaths in the U.S., which has the largest publicly reported outbreak in the world.

[Continue reading in source article]

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Assessment of immunity to polio among Rohingya children in Cox’s Bazar, Bangladesh, 2018: A cross-sectional survey | PLOS Medicine.

[Open Access] [Received: September 27, 2019; Accepted: February 27, 2020; Published: March 31, 2020]



We performed a cross-sectional survey in April–May 2018 among Rohingya in Cox’s Bazar, Bangladesh, to assess polio immunity and inform vaccination strategies.

Methods and findings.

Rohingya children aged 1–6 years (younger group) and 7–14 years (older group) were selected using multi-stage cluster sampling in makeshift settlements and simple random sampling in Nayapara registered camp. Surveyors asked parents/caregivers if the child received any oral poliovirus vaccine (OPV) in Myanmar and, for younger children, if the child received vaccine in any of the 5 campaigns delivering bivalent OPV (serotypes 1 and 3) conducted during September 2017–April 2018 in Cox’s Bazar. Dried blood spot (DBS) specimens were tested for neutralizing antibodies to poliovirus types 1, 2, and 3 in 580 younger and 297 older children. Titers ≥ 1:8 were considered protective. Among 632 children (335 aged 1–6 years, 297 aged 7–14 years) enrolled in the study in makeshift settlements, 51% were male and 89% had arrived after August 9, 2017. Among 245 children (all aged 1–6 years) enrolled in the study in Nayapara, 54% were male and 10% had arrived after August 9, 2017. Among younger children, 74% in makeshift settlements and 92% in Nayapara received >3 bivalent OPV doses in campaigns. Type 1 seroprevalence was 85% (95% CI 80%–89%) among younger children and 91% (95% CI 86%–95%) among older children in makeshift settlements, and 92% (88%–95%) among younger children in Nayapara. Type 2 seroprevalence was lower among younger children than older children in makeshift settlements (74% [95% CI 68%–79%] versus 97% [95% CI 94%–99%], p < 0.001), and was 69% (95% CI 63%–74%) among younger children in Nayapara. Type 3 seroprevalence was below 75% for both age groups and areas. The limitations of this study are unknown routine immunization history and poor retention of vaccination cards.


Younger Rohingya children had immunity gaps to all 3 polio serotypes and should be targeted by future campaigns and catch-up routine immunization. DBS collection can enhance the reliability of assessments of outbreak risk and vaccination strategy impact in emergency settings.

Author summary.

Why was this study done?

  • Between August 2017 and January 2018, almost 700,000 Rohingya people arrived in Cox’s Bazar District, Bangladesh, and settled in 2 refugee camps and in makeshift settlements around the camps. Crowding and inadequate access to safe water, sanitation, and healthcare facilitated outbreaks of infectious diseases that spread to the surrounding community.
  • Ongoing outbreaks of measles and diphtheria in May 2018, despite several vaccination campaigns, suggested that some children remained unprotected for vaccine-preventable diseases.
  • We conducted this survey to evaluate immunity against poliovirus and guide new vaccination activities.

What did the researchers do and find?

  • We conducted a cross-sectional survey among Rohingya children 1–14 years of age during April–May 2018 that included an interview about vaccines received in recent campaigns and collection of blood samples through finger prick to test for antibodies against poliovirus.
  • Protection against poliovirus type 1 was lower among children aged below 7 years than in older children in the makeshift settlements, despite most children having received several doses of oral polio vaccine in campaigns.
  • Protection against all poliovirus was lowest in children below 3 years of age.

What do these findings mean?

  • These findings suggested that children below 7 years of age recently arrived in the camp/settlements had immunity gaps after the vaccination campaigns that increased the risk of polio outbreaks.
  • Based upon this information, we recommended to the agencies that conducted the campaigns that they include polio vaccines in future campaigns targeting only children below 5 years of age.
  • Rapid scale-up of routine immunization services would be necessary to close immunity gaps among children below 2 years of age.
  • Collection of dried blood specimens through finger prick for antibody testing is feasible in emergency settings, and provides crucial information for assessment of outbreak risk and impact of outbreak response strategies.

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Coronavirus poses latest threat to battered health system in DR Congo | UN News.

[31 March 2020]

© UNICEF/Karel Prinsloo
A mother holds her 3-month-old baby as he receives a vaccination against measles at a health centre in Lubumbashi, Democratic Republic of the Congo.

The looming threat of the new coronavirus disease COVID-19 is just the latest challenge to the beleaguered health care system in the Democratic Republic of the Congo (DRC), which is struggling with deadly measles and cholera epidemics that have killed thousands of children over the past year, the UN children’s fund (UNICEF) said on Tuesday.

As the DRC has also been battling an Ebola outbreak in the volatile eastern region, UNICEF fears mounting cases of COVID-19 will further strain the public health system in a country that is among the most at risk in Africa.

Coronavirus will most likely divert the available national health capacity and resources, and leave millions of children affected by measles, malaria, polio and many other killer diseases,” said UNICEF Representative Edouard Beigbeder, speaking from the capital, Kinshasa.

While the DRC has so far recorded nearly 100 cases of COVID-19 and eight deaths, the measles epidemic has generated 332,000 cases and killed over 5,300 children since early 2019, making it the worst in the world. At the same time, 31,000 cases of cholera were reported during this period.

And although the Ebola outbreak garnered international attention and has been contained, UNICEF said it had “unfortunate side-effects” as resources to fight childhood killers like measles, cholera and malaria, instead went towards stemming the disease.

Health system ‘on life support’.

Strengthening the battered healthcare system in the DRC is vital to protect young lives, a new UNICEF report titled ‘On Life Support’ argues.

Medical services there are ill-equipped and underfunded, trained staff are in short supply, and around half of all facilities lack safe water and sanitation.

UNICEF estimates more than nine million children across the country require humanitarian assistance, including health care.

Most live in the three eastern provinces affected by the Ebola outbreak, where many doctors and nurses chose to take better-paying jobs in Ebola response.

Ongoing militia violence in these areas – including attacks against health centres –forced nearly one million people to flee their homes in 2019, thus making it harder for families to access health facilities.

“Unless health facilities have the means to deliver immunization, nutrition and other essential services, including in remote areas of the country, we risk seeing the lives and futures of many Congolese children scarred or destroyed by preventable diseases”, Mr Beigbeder warned.

Increase support for public health.

UNICEF is calling on the Congolese Government to allocate more public funding for basic health care services that support pregnant women, newborns and young children, and to prioritise the strengthening of routine immunization.

Currently, less than six per cent of the annual budget goes towards healthcare, which must change, according to Xavier Crespin, the agency’s Chief of Health in the country.

“Instead of expending huge efforts and resources on an ad hoc response to individual health emergencies, those same resources should be directed towards strengthening the national health system,” he said.

“That means a big investment in routine immunization, in adequate staffing and salaries, and in equipment that is currently in extremely short supply, especially outside urban areas.”

UNICEF is also urging donors to support national efforts to improve routine health care services in order to better protect children against communicable diseases.


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Measles and polio may come 'roaring back' as global vaccination programmes shut down | The Telegraph.

[31 March 2020]

Experts warn of a resurgence of childhood diseases as essential services are disrupted by the coronavirus pandemic.


The coronavirus outbreak could lead to a resurgence of childhood diseases such as measles and polio, as the pandemic has shut down routine vaccination schedules and disrupted supply chains, experts have warned.

While the unprecedented interventions introduced to stem the Covid-19 pandemic should prevent other disease outbreaks in the short term there is a real concern about a potential explosion of infectious, preventable illnesses when life returns to “normal”. 

Across the globe, planned efforts to vaccinate children against childhood diseases, including measles and polio, have already been suspended. 

Dr Robin Nandy, global chief of immunisation at Unicef, told the Telegraph that the UN agency has paused all routine and emergency vaccinations because of concerns that they could further the spread of the coronavirus

“We do not want to contribute to the Covid problem through immunisation programmes, so we are recommending that all campaigns are temporarily suspended as they bring a lot of people together. We don’t want to do any harm.” 

“It would be inappropriate for us to recommend a campaign when the government is ordering a shut down as it would be impossible to conduct it at the right time,” he added. 

Already, about 20 million children a year miss out on vital vaccinations according to Unicef and the World Health Organization. A report last year showed that global coverage for childhood vaccines including diphtheria, tetanus and pertussis and measles has stagnated at roughly 86 per cent since 2010, well below the 95 per cent required to avert outbreaks.

At his daily press briefing on Monday Dr Tedros Adhanom Ghebreyesus, director general of the WHO, said that essential health services must not fall victim to the coronavirus epidemic.

“Previous outbreaks have demonstrated that when health systems are overwhelmed, deaths due to vaccine-preventable and treatable conditions increase dramatically.

“Even though we're in the midst of a crisis, essential health services must continue. Babies are still being born, vaccines must still be delivered, and people still need life-saving treatment for a range of other diseases,” he said.

In Pakistan, Afghanistan and Nigeria polio vaccination campaigns have stopped as workers have been redeployed to Covid-19 prevention. These countries are the last reservoirs of the disease in the world and Dr Kate O'Brien, WHO's director of immunisation, acknowledges suspension will have harm global polio eradication efforts.

“We do expect a rise in polio cases as a result of the impact of Covid-19. WHO is resolved to finish the job [of eradication]. We want to make sure the programme is able to not only lend support to protecting communities from Covid-19 but build on that and resume when the outbreak is over,” she said. 

Dr O'Brien added that WHO did not have systematic surveillance of which countries had suspended vaccination programmes.

“Our concern is global - for every child, everywhere. Vaccines are for the life course and it's not just infants and children. Adolescents, pregnant women and older people all need vaccines. Our concerns are for every country and every person who needs a vaccine.”

There is particular concern about measles as there has been a huge resurgence of this highly contagious disease in the last few years due to falling vaccination rates. 

In 2018 there were 9.7m million cases of measles and 142,300 deaths – the vast majority of which were in children under the age of five. Experts believe that the figures for 2019 will be even higher after the widespread outbreaks in the Democratic Republic of Congo (DRC), where 6,000 children died, and Samoa. 

Dr O'Brien said: “Measles anywhere is measles everywhere. We have very high concern about maintaining immunisation coverage and protecting people everywhere from diseases that will come roaring back if communities are not vaccinated.”

But with around a fifth of the global population under lockdown Dr Nandy said that social distancing measures introduced for the coronavirus may have a positive - albeit temporary - impact on other infectious diseases.

But he added that the real danger is when restrictions are lifted - unless vaccine campaigns are ramped up at this point, then the coronavirus pandemic could be shortly followed by other outbreaks, putting further pressure on already stretched health services. 

“Measures introduced to limit the spread of Covid will contribute to limiting the spread of other diseases too - but once life starts going on as usual and people mingle once again, we do not want another outbreak of a vaccine preventable disease.  

“And so we are saying that countries need to be mindful of this and start planning how to catch up on missed vaccine doses as soon as possible after disruption,” he said. 

Dr Nandy added that supply chains and the manufacture of vaccines had been hit by staff absence and border closures. 

“We are monitoring the situation on an hourly basis and doing all we can when we have a window of opportunity to supply vaccines to countries, even overstock them in some areas, so they are able to deal with the short term interruptions later.”

Dr O'Brien added that some programmes may struggle to resume after a suspension of operation.

“A pause is predicated on the assumption there could be an immediate catch up in the response whenever it is lifted. That presumes that programmes are ready to set up and people know they have to come immediately,” she said.

Yet some aid agencies are already warning that countries with weak health systems and those that have been affected by conflict will struggle to impose the type of lockdown that could stem the coronavirus outbreak and prevent a resurgence of other infectious diseases.

Countries that have reported Covid-19 cases now include Venezuela, whose health system has collapsed due to an ongoing economic crisis, and the DRC, which has been battered by a nearly two-year Ebola outbreak.

According to a new Unicef report published today, without urgent help the country's battered healthcare system will not only struggle to tackle the coronavirus, but also to contain existing measles and cholera epidemics. 

Dr Esperanza Martinez, head of health at the International Committee of the Red Cross, said countries like this were completely unprepared for mounting threat of Covid-19.

“There’s no testing and there’s also a lack of supplies. We don’t have gowns, gloves, masks or any protective gear,” she told the Telegraph. “To control the outbreak we need to test, we need to isolate, we need to put in practice basic infection prevention and control but these are extremely hard in many of the countries that are starting to show cases.”

Dr Martinez added that the virus would thrive in an environment such as an urban slum or a refugee camp where people were living in cramped conditions and social distancing and isolation would be impossible.

And without routine vaccinations, other infectious diseases could also flourish, she said. 

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Dame Jean Macnamara: Google Honours The Work Of Pioneering Polio Scientist And Doctor | The Independent.

[31st March 2020]

Google Doodle illustration by Sydney-based guest artist Thomas Campi, celebrates Australian doctor and medical scientist Dame Jean Macnamara on her 121st birthday.

Google Doodle illustration by Sydney-based guest artist Thomas Campi, celebrates Australian doctor and medical scientist Dame Jean Macnamara on her 121st birthday.

[View short video report in source article]

Chelsea Ritschel writes:

Google is celebrating the life and career of doctor and pioneering disease scientist Dame Jean Macnamara on what would have been her 121st birthday. 

Born in Australia on 1 April 1899, Macnamara realised while growing up during World War I that she wanted “to be of some use in the world”.

In 1925, Macnamara’s opportunity came, when a polio epidemic struck Melbourne the same year she graduated from medical school. 

For the next six years, Macnamara worked as a consultant and medical officer to the Poliomyelitis Committee of Victoria, where her focus turned to “treating and researching the potentially fatal virus, a particular risk for children,” according to the Doodle.

Her research on the disease, in collaboration with future Nobel Prize winner Sir Macfarlane Burnet, eventually led to the discovery that there are multiple strains of polio. The findings would be important later on when a polio vaccination was developed in 1955.

Macnamara’s dedication to researching the virus meant she also found many new methods of treatment and rehabilitation for children, which included splints and restraining devices, throughout her lifetime. 

Her method included splinting the paralysed part of the body until the damaged nerve had recovered, and then re-educating the muscles, according to the Australian National University's Dictionary of Biography.

A decade after graduating from medical school, Macnamara was appointed Dame Commander of the Order of the British Empire (DBE) in 1935.

Macnamara treated patients until her death at the age of 69 from cardiovascular disease in 1968. 

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