AFRICA: New meningitis vaccine a �revolution�

Photo: Claire Barrault/ECHO

A child receiving meningitis vaccine in Nigeria (file photo)

DAKAR, 14 October 2010 (IRIN) – The emergence of a new meningitis vaccine, rather than a large-scale outbreak of the disease, has prompted the current vaccination drive across West Africa. Health officials say the vaccine marks a �revolution� in preventing the highly contagious and fatal disease.

Health workers in Burkina Faso, Mali and Niger – the three countries selected for introduction of the vaccine – are preparing for country-wide campaigns set for December, having just completed a limited pilot phase.

�This vaccine, which targets the bacterium [meningococcus A] most frequently causing epidemics, is about preventing epidemics, not waiting, then reacting,� Mamoudou Harouna Djingarey of the Meningitis Vaccine Project (MVP) in Burkina Faso told IRIN. Up to now countries in the region vaccinated communities only once an outbreak had started.

Routine vaccinations with polysaccharide vaccine – used hitherto in the region – were not viable because the vaccine protects for only two to three years, and is not effective in children under two.

The just-launched meningococcal A conjugate vaccine – developed by Serum Institute of India under a partnership by the World Health Organization (WHO) and the international NGO PATH – provides protection for 10 years.

�To achieve a vaccine four times stronger than existing ones, at 200 CFA francs per dose, [40 US cents, compared to about US$1 for past vaccines] and which will protect for 10 years, is truly a revolution for public health,� Djingarey said.

�This will allow countries to avoid huge meningitis A epidemics and save their resources for other public health needs.� Health experts note that the infection will circulate less with the new vaccine, thereby protecting even non-vaccinated populations from the disease, one of the region�s greatest public health burdens.

The so-called �meningitis belt� of sub-Saharan Africa, from Senegal to Ethiopia, has the world�s highest rates of meningitis, with epidemics generally coming in the dry season from December to June. In 2009, 14 African countries reported 88,199 suspected cases with at least 4,050 deaths, according to WHO.

ReliefWeb Meningitis belt in Africa

This year the region to date is seeing lower numbers but more patients are dying, according to MVP.

Different strains

While meningitis A is the most common cause of epidemics, other strains emerge some years as well, such as W135 in Chad in 2009�and strain X in Burkina Faso earlier this year.

Countries still must be ready to react with vaccination campaigns for other strains of meningitis and in this sense preparedness remains a challenge, health experts say.

But meningitis A has by far been the biggest problem, said Marie-Pierre Preziosi, medical officer with the product research and development team in WHO�s immunization, vaccines and biologicals department.

�Meningitis A is responsible for nearly all of the epidemics in the past century – so while there are other strains that emerge� there has never been another strain that has been so prominent,� she told IRIN.

Funding gaps

Funding constraints have threatened meningitis vaccine supplies in the past and money is needed to fully roll out the new vaccine, Preziosi said. �There are sufficient doses available of the meningococcal A conjugate vaccine to start the nationwide campaigns in Burkina Faso, Mali and Niger, but there is a funding gap of $475 million to complete these drives and to roll out in the other meningitis belt countries.”

Burkina Faso, Mali and Niger were selected as the first countries to introduce the vaccine due primarily to their high prevalence of meningitis as well as their capacity to carry out mass vaccination campaigns.

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ZIMBABWE: Mining industry attracts child labour as economy picks up

Photo: Kevin Walsh/Flickr

Mines become a beacon for the desperate

SHURUGWI , 14 October 2010 (IRIN) – The economic upswing in Zimbabwe is luring�workers under 18-years-old�to the now bustling mining town of Shurugwi, about 350km south of the capital Harare in Midlands Province.

Tinashe Mugwira, 15, left home in January this year and walked the 50km to Shurugwi in search of work at the mines in the mineral belt known as the Great Dyke, where gold, chrome and nickel are found.

“I had always heard that these Chinese were employing young children for as long as they can work on the mines, so I decided to come here when I stopped going to school after my father fell ill and my mother could not raise money for food,” a skinny Mugwira told IRIN.

Foreign mining companies started investing in the area after locally owned mining firms went bankrupt due to the�country’s decade-long recession. Child rights activists say the use of child labour is becoming “common practice” in many of the country’s mines.

Mugwira said he was one of scores of children working on the opencast mine – ferrying chrome ore in buckets and wheelbarrows – with no formal contracts, protective clothing or medical benefits.

“I get US$10 for every ton I fetch and it takes me about three days to do so. We work from sunrise to sunset together with the adults and are treated the same, but the job is so hard,” he said.

Mugwira has been bedridden three times since he began working at the mine, suffering from severe coughing and headaches, but has never received medical treatment and was unable to say what his medical condition was.

He lives in a squatter settlement at the foot of the nearby Boterekwa escarpment, with other children and their adult colleagues, many of whom work as illegal gold-miners.

A friend from school working with him on the chrome mine was recently taken to Shurugwi hospital by his older brother, an illegal gold miner, after falling ill. He died of respiratory complications shortly after being admitted.

“It is risky working on these mines but I have no choice. I am the [oldest] in our family and my brothers and sister will die of hunger if I go back home without money,” said Mugwira.

Elfas Shangwa, chairman of the Harare-based NGO New Hope Foundation, which campaigns for the rights of children, said: “Poverty is the main cause behind this prevalent practice of child labour at mines and in other sectors of the economy.”

An IRIN correspondent visited two mines in the Shurugwi area and witnessed about 17 children working. Most were working on a temporary basis.

According to a mine worker who declined to be identified, the use of minors was not being practised by established mining companies, as checks were carried out, but was occuring at smaller mines.

Police inaction

“For a long time, we have been receiving so many reports of child labour on mines throughout the country and intend to carry out our own investigations. Unfortunately, when we report the cases to the police, they tell us they can hardly do anything because Zimbabwe does not have explicit laws on child labour,” Shangwa told IRIN.

If these children don’t come and work for us, their families will have no money to send them to school or buy food

Zimbabwe is a signatory to the UN Convention on the Rights of the Child and the International Labour Organization (ILO) anti-child labour convention, and Shangwa said his organization was lobbying government to adopt policies discouraging child labour practices.

In Mazowe, a farming district in Mashonaland Central Province, about 70km northeast of Harare, businessmen who have recently acquired small mining concessions use children to mine gold ore and then load it on to trucks.

“The issue of child labour is neither here nor there,” Isdore Rukweza, one of the businessmen who has secured mining concessions, told IRIN. “If these children don’t come and work for us, their families will have no money to send them to school or buy food.”

An activist with a locally-based NGO, Coalition Against Child Labour in Zimbabwe, who declined to be identified, told IRIN the group was embarking on a nationwide survey of child labour practices with other child rights organizations.

“We are aware that children are working long hours in unhygienic conditions for small wages. In some of these cases, adults are shunning the jobs because the employers pay very little,” the activist said.

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SUDAN: What next for IDPs as Darfur camp faces closure?

Photo: Caterina Pino/IRIN

Insecurity facing thousands of people in Kalma IDP camp

Nyala, 14 October 2010 (IRIN) – The impending closure of a major camp near the South Darfur town of Nyala has led to discussions between humanitarian agencies and the Sudanese government about the future of the tens of thousands of internally displaced people (IDPs) living there.

Below is an overview of the closure of Kalma camp and the issues raised by the planned relocation of the IDPs to a new site or back to their home areas:

Why is Kalma camp being closed?

Mainly for security reasons, according to Sudanese officials. While announcing the imminent closure in August, South Darfur Governor Abel Hamid Kasha described the camp as �the most uncooperative IDP camp in the state�, and, in an apparent reference to members of the rebel Sudanese Liberation Movement, as �a den of criminals fleeing from justice�.

He suggested that the camp�s proximity to Nyala airport posed a security threat to the aircraft of the UN-AU hybrid Mission in Darfur, UNAMID, and that a nearby railway line was also a source of concern.

Over recent years there have been clashes in Kalma between supporters and opponents – such as the SLM – of one track of government-rebel peace negotiations hosted by Qatar, and, in August 2009, between residents and security forces.

“Kalma was always considered a time-bomb for groups engaged in political activities supporting opposition parties, and the closure of the camp was discussed by government authorities long before August 2010,” one well-placed observer told IRIN.

The closure can also be seen in the context of a �radically new approach� to the Darfur crisis outlined in a key government policy document, Towards a new strategy for achieving comprehensive peace, security and development in Darfur, released in September.

�The voluntary, safe and orderly return of the displaced people of Darfur to their homes would be the ultimate indicator of a successful resolution to the conflict in the region. Organizing such a return is one of the government�s top priorities,� the document stated.

Where will Kalma�s residents go?

It is not yet clear where all the camp�s residents, some 82,000 people according to data derived from the World Food Programme�s (WFP) latest distribution in September, will end up.

Construction of a new site, a few kilometres away, near the village of Belail, is due to be completed in the next few months. It will have room for 3,000 households, or some 15,000 people, according to Sudanese authorities cited by a UN official.

The official said some 2,000 Kalma households have registered to move to the new site.

Another 2,000 households have taken part in a verification exercise before a possible return to their state of origin, West Darfur. Humanitarian agencies have begun assessing potential areas of return.

Will the relocation be voluntary?

Abdel Karim Mousa Abdel Karim, the deputy governor of South Darfur, said the government would ensure returns were voluntary, a condition also stressed in the new government policy for Darfur.

Asked whether this was an issue of concern, UN officials underlined that all resettlements should adhere to existing standards. These include Guiding Principles on Internal Displacement, which stress states� obligation to provide security and a decent standard of living to IDPs, as well as the right of IDPs to �be protected against forcible return to or resettlement in any place where their life, safety, liberty and/or health would be at risk�.

Those unwilling to leave Kalma �should have the right to remain�, said one UN official.

In August, SLM leader Abdel Wahid Al-Nur was quoted as describing the planned closure of Kalma as a �provocation and an affront to humanity, and we caution against any participation [by UNAMID] in this Final Solution”.

Will essential services be provided at the new site?

Yes, according to the government, whose Humanitarian Aid Commission is in talks with the UN and NGOs about the details of service provision.

After the clashes between Kalma residents in July, humanitarian access to the camp was greatly restricted for several weeks.

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