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Archive for March 12th, 2012

Several dozen families have been sheltering in caves in Arhab district, 30km northeast of the capital Sana’a

Posted by African Press International on March 12, 2012

YEMEN: Arhab District returnees lack water for crops

Several dozen families have been sheltering in caves in Arhab district, 30km northeast of the capital Sana’a

SANA’A,  – Abdullah al-Marrani, his wife and nine children left the caves they were sheltering in in mid-February and returned home, but life is not much better in their village of Shaab in Arhab District, some 30km northeast of the Yemeni capital Sana’a.

They live in a single room – the only roof left in their two-storey house which was severely damaged during clashes between Republican Guards (led by Brig Ahmad Ali, son of ex-president Ali Saleh) and opposition gunmen.

Al-Marrani decided to bring his family back home when fighting died down in the wake of the November 2011 power transfer deal.

“This is the only room spared by the conflict. All the other rooms, the kitchen and the two bathrooms are rubble. We relieve ourselves outdoors, al-Marrani told IRIN, adding that they also have to fend off snakes, rats and scorpions.

The family’s main source of income, `khat’, dried up after they were unable to farm because of the violence. “The food aid we receive from relief agencies doesn’t suffice for all of us… We can skip meals and tolerate hunger, but our younger children cannot,” he said.

Displacement for nearly seven months has severely disrupted the district’s agricultural production, including grapes, oranges and cereals.

Most of the 1,500 families who fled the district and sheltered in nearby caves or in Amran Governorate relied on pumped water to irrigate their `khat’ farms, according Abdualim al-Hamdi, head of local NGO Arhab Social Charitable Society (ASCS).

“We hardly find enough water for domestic use… How can we water the plants if we cultivate our farms?” said Qannaf al-Edhari, a `khat’ grower in the district’s Beit al-Edhari village.

Wells damaged

According to Mansour al-Haniq, a Member of Parliament from Arhab District, some 25 artesian wells in the area have been destroyed or damaged. “None of them operate these days. In some villages like Shaab and Zandan, water pumps were stolen,” he added.

If the wells are repaired, two months of cultivation is required before any `khat’ can be produced, and six months in the case of grapes, said Sheikh Saleh al-Marrani from Shaab village.

Abdulkhaliq al-Rajawi of ASCS told IRIN that nearly 80 percent of families had returned to their homes in Jarmouz, Beit al-Edhari and Shaab villages, but that some villages like Labu, Sheraa and Samnah were still seeing intermittent clashes between Republican Guards and opposition gunmen. “Most of the families haven’t yet returned to their homes in these three villages due to intermittent shelling,” he said.

A January 2012 assessment by Vision Hope International (VHI), showed that 70 percent of internally displaced persons (IDPs) in Arhab District had returned home but lacked water and were often unable to farm because of the destruction of wells, Adriaan Jagersma of VHI told IRIN.

VHI was currently distributing food to thousands of IDP returnees including flour, cooking oil, beans, sugar and rice.

Al-Rajawi of ASCS told IRIN there are currently two active humanitarian agencies assisting returnees: VHI, and the Adventist Development and Relief Agency (non-food items such as blankets, mattresses).

Five hundred homes have been damaged or destroyed in Arhab District, said Ahmad al-Rahabi, chief evaluator of material losses at the National Organization for Defending Rights and Freedoms, known as HOOD.


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Taking stock at 11 weeks of life

Posted by African Press International on March 12, 2012

HEALTH: Malaria stunts foetal growth

Taking stock at 11 weeks of life

BANGKOK,  – Malaria infection during the earliest months of pregnancy stunts foetal growth even when the mothers do not have any malarial symptoms, according to a large-scale study conducted along the Thai-Burmese border. 

“Malaria needs to be taken into account from the beginning of the pregnancy and not only in the last months before the birth,” François Nosten, director of the Mae Sot-based Shoklo Malaria Research Unit (SMRU), which tracked 3,779 women’s pregnancies from 2001-2010, told IRIN.

SMRU is attached to the Mahidol University-Oxford University Tropical Medicine Research Programme in Bangkok, which is supported by the UK-based health programmes donor, Wellcome Trust.

Pregnant women are among the most vulnerable to malaria infections as pregnancy reduces a woman’s immunity, making her more susceptible to malaria infection and increasing the risk of illness, severe anaemia and death, according to the World Health Organization (WHO).

And while the impact of malaria on later stages of pregnancy and birth weight are well documented (increased risk of spontaneous abortion, stillbirth, premature delivery and low birth weight), the SMRU study is among the first to show a direct impact of malaria on early foetal growth, even in areas where malaria infections have plummeted.

Hidden parasite reservoir

People who have been repeatedly struck by malaria can develop partial immunity and may not have symptoms, despite harbouring the parasite.

And in communities where malaria infections have dropped (mainly due to prevention and treatment), the parasite level can also be so low as to not show up in tests, noted David Bell, head of malaria diagnostics at the Geneva-based research organization, Foundation for Innovative New Diagnostics (FIND). 

Evidence that this hidden parasite reservoir can harm foetuses boosts the need for prevention even in areas that have already slashed infections, noted Andrea Bosman with the WHO Global Malaria Programme.

During pregnancy, the parasite hides in the placenta, rendering finger-prick blood tests inaccurate, Bell added. And while DNA analyses are more accurate, the technology is more expensive and less widely available.

Throughout most of sub-Saharan Africa, the WHO recommends giving anti-malarial drugs to pregnant women at intervals in case such a “hidden” malaria infection is present, but preventative treatment does not currently begin until after the first three months of pregnancy.

New evidence

On average, at the mid-pregnancy ultrasound scan in the SMRU study, the diameter of the foetus’s head – an indication of foetal growth – was 2 percent smaller when the woman was infected by malaria than if not.

The foetuses of close to 57 percent of the mothers infected with malaria had a smaller head than those who were not. Researchers said disrupted foetal growth can heighten the risk of pregnancy complications.

“The mother may not have any symptom of malaria and the reduction of the growth of the foetus is relative, not easily detected by ultrasound for individual cases [versus a large-scale study where the trend is more apparent]. The malaria infection nevertheless increases the risk of miscarriage, affects foetal growth and may hinder the child’s development later in his life,” said Nosten.

Detected early enough, it is possible to prevent the worst impacts of malaria, said Heidi Hopkins, a medical officer at FIND in Uganda.

“We can’t necessarily ‘reverse’ the damage, but the earlier we diagnose and treat, the less time the foetus and mother are exposed to the infection, so the less impact it has.”

With timely detection, “perhaps the growth of the foetus can catch up to compensate”, added Nosten.

The challenge with early detection, noted Hopkins, is many women do not know they are pregnant until several weeks into the pregnancy.

FIND and the multi-agency Special Programme for Research and Training in Tropical Diseases (TDR) are testing new rapid diagnostic tests on pregnant women in Uganda and Burkina Faso, where malaria is more prevalent than in most parts of Southeast Asia, to learn whether earlier and affordable detection is possible during pregnancy.

“A preventive and safe medication to women from the beginning of their pregnancy should be evaluated where malaria is endemic,” concluded Nosten.

Due to limited safety data, the WHO does not recommend the anti-malarial medication artemisinin during the first three months of pregnancy unless the “treatment is considered lifesaving for the mother and other treatments are considered unsuitable”.

More than 50 million pregnancies occur in malaria-endemic areas annually, mostly in sub-Saharan Africa, according to the WHO.

An estimated 10,000 of these women and 200,000 of their infants die as a result of malaria infection during pregnancy, and severe malarial anaemia contributes to more than half of these deaths.


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Commercial production of Tanzania’s first locally manufactured antiretroviral drugs will start in the next few months

Posted by African Press International on March 12, 2012

TANZANIA: New pharmaceutical plant to produce ARVs

Photo: IRIN
Locally produced antiretrovirals

DAR ES SALAAM,  – Commercial production of Tanzania’s first locally manufactured antiretroviral drugs will start in the next few months; it is hoped the country will eventually provide medicines for half of all HIV-positive Tanzanians.

A pharmaceutical plant has been built near the northern city of Arusha using a grant from the European Union of about US$6.6 million. In addition, Tanzania Pharmaceuticals Industry – in which the government has a 40 percent stake – has contributed $963,000 to the project, while German medical aid Action Medeor added $660,000.

“Anti-retroviral treatment is one of the pillars for successfully fighting the HIV pandemic. This factory will help to continuously supply the disadvantaged in Tanzania and is an important step towards improving access to therapy,” said Bernd Pastors, executive director of Action Medeor.

Tanzania has a national HIV prevalence of about 5 percent, but HIV levels are as high as 15 percent in southern areas of Iringa and Mbeya. According to the government’s 2010 country progress report for the UN General Assembly Special Session on HIV/AIDS, just 21.5 percent of HIV-positive Tanzanians had access to treatment.

Before the new factory was built, Tanzanian producers formulated active pharmaceutical ingredients (APIs) into ARVs; this means they imported the ingredients – mainly from China – and then formulated the combination and packaged the tablets. Now the whole process can be done on-site.

“This project is a departure for us, looking instead at building the capacity within Tanzania to produce its own [HIV/]AIDS pharmaceutical products at highly competitive prices, using cutting-edge technologies,” said the EU’s head of delegation to Tanzania, Ambassador Tim Clarke.

Clarke said much of this technology had been imported from similar production units in India.

The factory produced its first batches of drugs for opportunistic infections at the beginning of March; its first ARV, Efavirenz – a first-line ARV – will be produced for registration within one month following a slight delay in starting production after equipment at the plant, including copper wires and blower fans, was stolen.

Co-operation with a generic licence-holder on a fixed-dose combination ARV is also being considered as this would shorten the registration period significantly, said Christoph Bonnsman, spokesman for Action Medeor.

Under the World Trade Organization’s trade-related aspects of intellectual property rights, poor countries like Tanzania are permitted to produce essential drugs without introducing pharmaceutical product patents until 2016.

The plant’s current capacity is designed to serve a minimum of 100,000 patients with a reserve to triple the output if required – its minimum output is 100 million tablets a year.

“We cut down profit expectations to a necessary minimum to maintain the factory and thus our products will be among the cheapest ARVs available worldwide,” said Ramadhan Madabida, chief executive of the Tanzania Pharmaceuticals Industry.


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