Health

The UK has announced a significant package of support to help tackle the outbreaks of Mpox and Marburg virus in central Africa. This includes up to £9 million in funding to bolster efforts in the Democratic Republic of Congo (DRC), Uganda, and other affected countries. UK experts from the UK Public Health Rapid Support Team have been deployed to provide technical expertise to the Africa Centres for Disease Control and Prevention, assisting in strengthening surveillance systems, healthcare services, and community awareness. Additionally, the UK is collaborating with Rwanda to support its response to the Marburg virus outbreak, mobilizing £1.9 million in aid to provide expertise and enhance outbreak management.

This assistance comes at a critical time, as Africa faces significant public health challenges from both diseases. The UK's partnership with organizations like UNICEF, the World Health Organization (WHO), and Africa CDC aims to not only respond to these immediate threats but also build long-term resilience in healthcare systems across the region. The funds will contribute to saving lives, protecting vulnerable communities, and strengthening health systems to safeguard the continent against future outbreaks.

Read more on this link . 

Since the start of 2023, Tanzania has experienced a troubling rise in road traffic accidents, with over 1,550 people killed in crashes by mid-December. These accidents have not only taken a heavy human toll but also exerted a significant economic and social burden on the country. Addressing the issue of road safety requires a comprehensive understanding of the causes of accidents, their impacts on public health and the economy, as well as potential solutions.

Causes of road traffic accidents in Tanzania

The causes of road traffic accidents in Tanzania are multi-faceted, stemming from a combination of human error, vehicle conditions, and poor infrastructure.

• Human Factors: Driver behavior plays a crucial role in road safety. Speeding, reckless driving, failure to follow traffic laws, and distracted driving are some of the most common causes of accidents. Alcohol consumption and fatigue also contribute to a significant number of crashes, particularly during long-distance travel.
• Poor Road Conditions: A significant portion of Tanzania's road network, especially in rural areas, is in poor condition. Potholes, lack of road markings, and insufficient lighting make driving hazardous. Many roads are narrow and unable to accommodate the growing number of vehicles, leading to frequent accidents.
• Vehicle Conditions: Many vehicles on Tanzanian roads are poorly maintained, which increases the likelihood of mechanical failures. Faulty brakes, worn tires, and outdated safety features have all been linked to serious accidents.
• Overloading: Overloading is another critical factor that contributes to road accidents. Buses and trucks often carry more passengers and goods than their capacity allows, leading to instability, reduced maneuverability, and an increased risk of collisions.

Health and economic impacts

Road accidents in Tanzania have far-reaching consequences on both the health sector and the economy.

• Health Impact: Road traffic injuries are a leading cause of hospital admissions and a major contributor to the burden on Tanzania's healthcare system. Victims of road accidents often require long-term medical care and rehabilitation, which strains already limited healthcare resources. Moreover, the psychological trauma faced by survivors and their families cannot be overstated.
• Economic Impact: The economic cost of road traffic accidents is substantial. According to studies, road accidents in Tanzania result in a loss of approximately 3% of the country's Gross Domestic Product (GDP). These losses arise from healthcare expenses, lost productivity due to injuries and deaths, and damage to vehicles and infrastructure. Additionally, many accident victims are of working age, which further exacerbates the economic consequences by removing key contributors from the workforce.

Efforts to improve Road Safety

Several initiatives have been launched to curb the growing number of road accidents in Tanzania, but much more needs to be done.

• Government policies: The Tanzanian government has made efforts to improve road safety through policies and regulations. These include stricter enforcement of traffic laws, the introduction of speed limits, and mandatory vehicle inspections. The use of seat belts, helmet laws for motorcyclists, and campaigns to reduce drunk driving have also been promoted.
• Road infrastructure development: Ongoing road infrastructure projects are expected to improve safety conditions. The expansion and modernization of major highways, improved road signage, and better traffic management systems can reduce the frequency and severity of accidents.
• Driver education and awareness campaigns: Efforts to educate drivers on safe driving practices are crucial. Road safety campaigns targeting both professional drivers (e.g., bus and truck operators) and private vehicle owners can help change driving behaviors. Public awareness programs focusing on the dangers of speeding, drunk driving, and the importance of regular vehicle maintenance are key to preventing accidents.
• Global support and partnerships: Organizations like the Global Road Safety Facility (GRSF) have been working with the Tanzanian government to improve road safety. Their involvement includes providing funding for infrastructure improvements, capacity-building efforts, and data collection systems that can help policymakers make informed decisions.

The way forward

To successfully reduce road traffic accidents in Tanzania, a multi-pronged approach is needed. While government initiatives are essential, they must be supported by public cooperation and international partnerships. Prioritizing road safety not only saves lives but also helps to alleviate the economic burden that road accidents place on the country.

Future interventions should focus on improving road conditions, strengthening enforcement of traffic laws, enhancing vehicle safety standards, and promoting a culture of responsible driving. By addressing the root causes of road accidents and implementing sustainable solutions, Tanzania can pave the way for safer roads and a more secure future for all its citizens.

References

• Xinhua. (2023). 1,550 people killed in road accidents in Tanzania since start of 2023: minister. Link
• Global Road Safety Facility. (n.d.). Tanzania Road Safety Profile. Link
• ResearchGate. (2009). Road Traffic Accidents in Tanzania: A Ten-Year Epidemiological Appraisal. Link
• Global Scientific Journal. (2021). Road Accidents in Tanzania: Causes, Impact, and Solution. Link
• ScienceDirect. (2022). Road Traffic Accidents in Tanzania: Exploring the Economic and Health Impacts. Link

The number of recoveries from the Marburg virus in Rwanda has reached 30, while the total number of vaccinated individuals stands at 771 as of Tuesday, October 15, according to the Ministry of Health.

An update from the ministry also confirmed 62 cases of the virus, including 15 deaths and 17 patients currently in isolation receiving treatment.

By Tuesday, October 15, 2024, 30 people had recovered, and one additional death was reported, bringing the death toll to 15.

A total of 4,010 tests have been conducted so far, with 140 new tests carried out on Tuesday alone.

Since the outbreak was first declared on September 27, all new confirmed cases have been linked to the hospital cluster in Kigali, and affected individuals remain in isolation and treatment.

Read Ministry of Health's update here.

Kenya has ramped up its efforts to combat the spread of Mpox and neglected tropical diseases (NTDs) with the receipt of vital testing kits and medicines from global health partners, including the World Health Organization (WHO) and USAID. This support arrives as the country records its first Mpox death, with confirmed cases rising to 13. Health officials emphasized the significance of these resources in strengthening the nation’s capacity for disease surveillance and response, particularly in regions with high disease burdens. The Ministry of Health also announced upcoming mass drug administration campaigns aimed at controlling NTDs like lymphatic filariasis and schistosomiasis. Read more here and and here . 

 

Across Rwanda, stringent health protocols are being implemented to curb the spread of the Marburg virus. Public spaces like churches, hospitals, and busy locations such as Nyabugogo taxi park now require individuals to sanitize their hands and undergo temperature checks before entry. If a person’s temperature exceeds 36°C, further evaluations are conducted. The Ministry of Health, supported by the Rwanda Governance Board, has mandated religious institutions to enforce strict hygiene measures, discouraging risky behaviors such as certain Holy Communion practices and funeral rituals for those who died from the virus. Public compliance with these guidelines, including voluntary handwashing and mask-wearing, is on the rise. Additionally, a trial vaccination drive was launched on October 6, prioritizing high-risk individuals like healthcare workers. Read more in the New Times.

Professor Tumaini Nagu, Tanzania's Chief Medical Officer, has highlighted several key actions the government is taking in response to the Marburg virus outbreak. She emphasized that Tanzania is ramping up preparedness, especially in high-risk regions like Kagera, Rukwa, Mwanza, and Katavi. The measures include distributing over 1,000 protective gear kits to healthcare workers and conducting training to ensure staff follow strict infection prevention protocols.

Prof. Nagu reiterated the importance of protecting healthcare personnel and urged the public to report symptoms like fever, vomiting, and bleeding to avoid the spread of the virus. She also stressed the need to avoid contact with infected individuals and dead animals. Border controls have been enhanced, and public awareness campaigns are underway to educate people on prevention measures, similar to those used during the COVID-19 pandemic​ (The Citizen newspaper).

Read more on this link.

With the ongoing outbreak of the Marburg virus in some regions, travelers need to be cautious and well-informed about the risks and the necessary precautions to ensure their safety. The World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the UK Foreign Office have all issued relevant advice to guide travelers in making safe decisions. Below is a summary of their recommendations and travel advice.

What is Marburg Virus?

Marburg virus is a highly contagious and deadly virus that causes Marburg Virus Disease (MVD), a hemorrhagic fever similar to Ebola. It is transmitted through direct contact with the bodily fluids of infected individuals, contaminated surfaces, or infected animals such as bats. The virus has a high fatality rate, and there is currently no specific treatment or vaccine.

Travel Recommendations

World Health Organization (WHO)

The WHO has not recommended any travel or trade restrictions with Rwanda or any other countries affected by the Marburg virus. However, the organization advises travelers to stay informed about the outbreak and take basic precautions to minimize the risk of exposure. WHO encourages all travelers to monitor official channels for updates on the outbreak and to follow local health authority guidance when in affected areas.

U.S. Centers for Disease Control and Prevention (CDC)

The CDC has issued a Level 2 travel notice for Rwanda, which means that travelers should practice enhanced precautions. Key recommendations include:

Avoiding contact with sick individuals who show symptoms consistent with Marburg Virus Disease (MVD), such as fever, vomiting, diarrhea, or unexplained bleeding.

Avoiding healthcare facilities in outbreak zones unless seeking urgent care.

Obtaining travel insurance that covers medical evacuation and treatment for infectious diseases before traveling.

Monitoring for symptoms of MVD for 21 days after leaving an outbreak area, such as fever, headache, muscle pain, rash, vomiting, or unexplained bleeding. In case of symptoms, travelers should immediately isolate and seek medical care.

CDC also advises travelers to stay updated on the outbreak and prepare for potential changes in travel conditions or advisories.

European Centre for Disease Prevention and Control (ECDC)

The ECDC emphasizes the importance of travelers being aware of the ongoing Marburg outbreak and following the guidance of local health authorities. Their key recommendations include:

Avoiding contact with individuals showing MVD symptoms and steering clear of healthcare facilities in affected areas for non-urgent medical reasons.

Avoiding wildlife habitats such as caves or mines that may be inhabited by bats, and refraining from handling or consuming bushmeat.

Reporting symptoms upon return from affected areas. Travelers returning to the EU/EEA should promptly seek medical attention if they develop symptoms consistent with MVD and disclose their travel history to healthcare providers.

UK Foreign Office

The UK Foreign Office has not yet advised against travel to Rwanda, but it acknowledges the outbreak on its website and urges travelers to consult local authorities before traveling. Organizations that send workers to affected areas are encouraged to register with the UK Health Security Agency (UKHSA) Returning Workers Scheme. This allows returning workers to be monitored for potential symptoms of MVD.

General Precautions for Travelers

Travelers heading to regions affected by the Marburg virus should consider the following precautions:

Avoid close contact with sick individuals, especially those showing symptoms such as fever, vomiting, diarrhea, or unexplained bleeding.

Steer clear of healthcare facilities in affected areas unless necessary.

Avoid high-risk activities such as visiting bat-inhabited caves or handling wildlife, particularly primates, bats, and bushmeat.

Monitor for symptoms for 21 days after leaving the outbreak area and seek immediate medical attention if symptoms develop.

Stay informed through reliable sources like the WHO, US CDC, Africa CDC, ECDC, and local health authorities about any changes in the outbreak and travel advisories.

Conclusion

While the Marburg virus outbreak poses serious health risks, taking proper precautions can significantly reduce the chances of exposure and infection. Travelers to affected areas should stay informed, avoid risky behaviors, and be prepared for potential changes in travel restrictions. By following the guidance of health organizations like WHO, CDC, ECDC, and the UK Foreign Office, travelers can protect themselves and prevent further spread of the virus.

References:

World Health Organization (WHO). Marburg Virus (https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease )

U.S. Centers for Disease Control and Prevention (CDC). Marburg Virus Travel Notice (https://wwwnc.cdc.gov/travel/notices/level2/marburg-rwanda )

European Centre for Disease Prevention and Control (ECDC). Marburg Virus Disease (https://www.ecdc.europa.eu/en/marburg-virus-disease )

UK Foreign Office. Foreign Travel Advice (https://www.gov.uk/foreign-travel-advice/rwanda/health )

3rd October 2024. Rwanda’s ongoing battle with its first Marburg virus outbreak intensified as the Ministry of Health confirmed seven new cases and an additional death yesterday. In a briefing today, Health Minister Sabin Nsanzimana provided updates, including plans to begin a vaccine trial soon.

Meanwhile, two travelers returning to Germany from Rwanda tested negative for the virus after being isolated in Hamburg due to potential exposure in a Rwandan hospital where Marburg patients were being treated.

The latest figures bring Rwanda’s Marburg virus outbreak to 36 cases, 11 of them fatal, marking it as one of the largest recorded globally. In a media briefing organized by the Africa Centres for Disease Control and Prevention (Africa CDC), Nsanzimana revealed that healthcare workers make up 80% of the infected, with 29 cases reported among them. Currently, 25 individuals are receiving care in isolation, and health officials are monitoring 323 identified contacts.

The outbreak was first detected when healthcare workers began falling ill, and early patients did not respond to treatment for conditions like malaria, which shares initial symptoms with Marburg. The virus spreads through contact with infected body fluids, and many cases have been linked to an ICU cluster where the suspected index patient was treated.

Nsanzimana also announced that Rwanda is expecting 5,000 doses of remdesivir to enhance treatment efforts. The ministry plans to initiate a vaccine trial soon, with details on the vaccine and its rollout to be announced in the coming days. As of now, no specific treatments or vaccines for the Marburg virus are officially approved.

Genetic sequencing and further epidemiologic investigations are ongoing, and though Nsanzimana described the outbreak as "controlled," it is not yet fully contained.

Read more: Gilead Donates Remdesivir for Emergency Use in Response to Marburg Virus Disease in Rwanda here  and 

Marburg Virus updates on this link and the Situation in Rwanda, Epidemiology, Public health response, WHO risk assessment, WHO advice at this link.

Marburg virus disease was first recognized in 1967 during simultaneous outbreaks in Germany and Yugoslavia, linked to African green monkeys from Uganda. Since then, outbreaks have occurred mainly in Africa, with cases in Ghana, Guinea, and Uganda, among others. The disease is highly fatal, with recent outbreaks (before the current in Rwanda) in Tanzania and Equatorial Guinea in 2023. Key historical outbreaks include Angola (2004-2005) and the Democratic Republic of Congo (1998-2000), which had some of the highest fatality rates. Read more on this link

East African Community Headquarters, Arusha, Tanzania, 4th October, 2024:  The East African Community (EAC) Secretariat has called for a swift and coordinated regional response to contain the ongoing Marburg Virus Disease (MVD) outbreak declared in Rwanda. The outbreak poses a serious threat to regional health security and requires urgent action from all EAC Partner States to prevent its spread across borders.

On the 27th September 2024 Rwanda’s Ministry of Health declared the Marburg Virus Disease (MVD) outbreak and as of 30th September, 2024 there were 29 confirmed cases and 10 deaths with more than 297 contacts under close monitoring and healthcare workers have been disproportionately affected. The World Health Organization (WHO) has raised concerns about the potential regional spread of the disease due to confirmed cases in districts near the borders of the Democratic Republic of the Congo (DRC), Uganda, and Tanzania.

“There is an urgent need for a coordinated regional response to contain the spread of this highly infectious virus through swift identification, isolation, and treatment of cases and enhanced screening at borders and health facilities,” said Hon. Andrea Aguer Ariik Malueth, EAC Deputy Secretary General, in charge of Infrastructure, Productive, Social & Political sectors

He called for Partner States to strengthen their public awareness and infection control protocols including handwashing, avoiding physical contact with symptomatic individuals and surveillance at borders and health facilities.  Read more on this link