The World Health Organisation has called for increased domestic and international funding to end tuberculosis by 2030.
In the 2018 Global TB Report released last Tuesday, the global health body said that fewer people fell ill and died from the highly infectious disease last year, with global efforts having averted an estimated 54 million deaths since 2000. However, the WHO warns that countries are still not doing enough to end the disease, as TB remains the world’s deadliest infectious disease.
The report urges political leaders gathering this week for the first-ever United Nations High Level Meeting on TB to take decisive action. Nearly 5o heads of state and government are expected to attend.
In Kenya, where tuberculosis is the fourth leading cause of death, after a dramatic decline in TB deaths from roughly 10,000 in 2015 to 4,735 in 2016, there was a resurgence in 2017 with 9,081 deaths, according to the Economic Survey 2018. In 2017, Kenya reported and treated 85,188 TB patients, among them 7,771 children, making it one of the countries with the highest burden of the disease.
While launching the first Tuberculosis Patient Cost Survey in July, Cabinet Secretary for Health Sicily Kariuki, said there are plans to include TB treatment in the National Hospital Insurance Fund benefit package, as a way of funding treatment locally. The Ministry of Health has been rooting for implementation of appropriate and affordable primary healthcare interventions that will help end TB.
Ms Kariuki said that affected households would be linked to existing social protection and food security programmes. This is because although TB diagnosis and treatment is free, nutrition, transport and other costs associated with seeking and receiving healthcare and the related loss of income may worsen poverty and health.
“Such costs make TB patients less likely to present for care, complete TB testing and initiate and adhere to treatment. They place an economic burden on households, worsening poverty and increasing deaths due to the disease,” she said. Providing safety nets can cushion patients against the direct costs they incur while seeking treatment. The Ministry of Health also undertook to improve TB sample referral mechanisms and ensure the availability of free diagnostic and treatment services. The study revealed that patients with drug-resistant TB spend an average of Sh145,109 during treatment, while those with drug-sensitive TB incur Sh25,874 in direct and indirect costs. Moreover, 63 per cent of patients with drug-resistant TB lost their jobs due to the disease. All these factors undermine treatment and efforts to curb the spread of disease.
In the Global TB Report, WHO Director-General Tedros Adhanom Ghebreyesus said the world must capitalise on the new momentum and act together to end the terrible disease.
“The WHO report provides an overview of the status of the epidemic and the challenges and opportunities countries face in responding to it,” he said, adding that ending the epidemic requires action beyond the health sector, to address the risk factors and determinants of disease. Globally, TB deaths have decreased over the past year. In 2017, an estimated 10 million people were diagnosed with tuberculosis, and 1.6 million (including 300,000 HIV-positive patients) died. Since 2000, a 44 percent reduction in TB deaths occurred among people with HIV compared with a 29 per cent decrease among those who were HIV-negative. Faster reductions in new cases have occurred in Europe (five per cent per year) and Africa (four per cent per year) between 2013 and 2017. Some countries are moving faster than others – as seen in Southern Africa, with annual declines in new cases of four per cent to eight per cent in countries such as Lesotho, Namibia, South Africa, Zambia, and Zimbabwe.
Drug-resistant TB remains a global public health crisis: In 2017, over half a million people were estimated to have developed disease that was resistant to rifampicin – the most effective first-line TB drug. The vast majority of these people had multidrug-resistant TB (MDR-TB), that is, combined resistance to rifampicin and isoniazid (another key first-line TB medicine).
Public officers above 58 years and with pre-existing conditions told to work from home: The Standard
Head of Public Service Joseph Kinyua. [File, Standard]
In a document from Head of Public Service, Joseph Kinyua new measure have been outlined to curb the bulging spread of covid-19. Public officers with underlying health conditions and those who are over 58 years -a group that experts have classified as most vulnerable to the virus will be required to execute their duties from home.
However, the new rule excluded personnel in the security sector and other critical and essential services.
“All State and public officers with pre-existing medical conditions and/or aged 58 years and above serving in CSG5 (job group ‘S’) and below or their equivalents should forthwith work from home,” read the document,” read the document.
To ensure that those working from home deliver, the Public Service directs that there be clear assignments and targets tasked for the period designated and a clear reporting line to monitor and review work done.
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Others measures outlined in the document include the provision of personal protective equipment to staff, provision of sanitizers and access to washing facilities fitted with soap and water, temperature checks for all staff and clients entering public offices regular fumigation of office premises and vehicles and minimizing of visitors except by prior appointments.
Officers who contract the virus and come back to work after quarantine or isolation period will be required to follow specific directives such as obtaining clearance from the isolation facility certified by the designated persons indicating that the public officer is free and safe from Covid-19. The officer will also be required to stay away from duty station for a period of seven days after the date of medical certification.
“The period a public officer spends in quarantine or isolation due to Covid-19, shall be treated as sick leave and shall be subject to the Provisions of the Human Resource Policy and procedures Manual for the Public Service(May,2016),” read the document.
The service has also made discrimination and stigmatization an offence and has guaranteed those affected with the virus to receive adequate access to mental health and psychosocial supported offered by the government.
The new directives targeting the Public Services come at a time when Kenyans have increasingly shown lack of strict observance of the issued guidelines even as the number of positive Covid-19 cases skyrocket to 13,771 and leaving 238 dead as of today.
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Principal Secretaries/ Accounting Officers will be personally responsible for effective enforcement and compliance of the current guidelines and any future directives issued to mitigate the spread of Covid-19.
Uhuru convenes summit to review rising Covid-19 cases: The Standard
President Uhuru Kenyatta (pictured) will on Friday, July 24, meet governors following the ballooning Covid-19 infections in recent days.
The session will among other things review the efficacy of the containment measures in place and review the impact of the phased easing of the restrictions, State House said in a statement.
This story is being updated.
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Drastic life changes affecting mental health
Kenya has been ranked 6th among African countries with the highest cases of depression, this has triggered anxiety by the World Health Organization (WHO), with 1.9 million people suffering from a form of mental conditions such as depression, substance abuse.
Globally, one in four people is affected by mental or neurological disorders at some point in their lives, this is according to the WHO.
Currently, around 450 million people suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide.
The pandemic has also been known to cause significant distress, mostly affecting the state of one’s mental well-being.
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With the spread of the COVID-19 pandemic attributed to the novel Coronavirus disease, millions have been affected globally with over 14 million infections and half a million deaths as to date. This has brought about uncertainty coupled with difficult situations, including job loss and the risk of contracting the deadly virus.
In Kenya the first Coronavirus case was reported in Nairobi by the Ministry of Health on the 12th March 2020. It was not until the government put in place precautionary measures including a curfew and lockdown (the latter having being lifted) due to an increase in the number of infections that people began feeling its effect both economically and socially.
A study by Dr. Habil Otanga, a Lecturer at the University of Nairobi, Department of Psychology says that such measures can in turn lead to surge in mental related illnesses including depression, feelings of confusion, anger and fear, and even substance abuse. It also brings with it a sense of boredom, loneliness, anger, isolation and frustration. In the post-quarantine/isolation period, loss of employment due to the depressed economy and the stigma around the disease are also likely to lead to mental health problems.
The Kenya National Bureau of Statistics (KNBS) states that at least 300,000 Kenyans have lost their jobs due to the Coronavirus pandemic between the period of January and March this year.
KNBC noted that the number of employed Kenyans plunged to 17.8 million as of March from 18.1 million people as compared to last year in December. The Report states that the unemployment rate in Kenya stands at 13.7 per cent as of March this year while it stood 12.4 per cent in December 2019.
Mama T (not her real name) is among millions of Kenyans who have been affected by containment measures put in place to curb the spread of the virus, either by losing their source of income or having to work under tough guidelines put in place by the MOH.
As young mother and an event organizer, she has found it hard to explain to her children why they cannot go to school or socialize freely with their peers as before.
“Sometimes it gets difficult as they do not understand what is happening due to their age, this at times becomes hard on me as they often think I am punishing them,”
Her contract was put on hold as no event or public gatherings can take place due to the pandemic. This has brought other challenges along with it, as she has to find means of fending for her family expenditures that including rent and food.
“I often wake up in the middle of the night with worries about my next move as the pandemic does not exhibit any signs of easing up,” she says. She adds that she has been forced to sort for manual jobs to keep her family afloat.
Ms. Mary Wahome, a Counseling Psychologist and Programs Director at ‘The Reason to Hope,’ in Karen, Nairobi says that such kind of drastic life changes have an adverse effect on one’s mental status including their family members and if not addressed early can lead to depression among other issues.
“We have had cases of people indulging in substance abuse to deal with the uncertainty and stress brought about by the pandemic, this in turn leads to dependence and also domestic abuse,”
Sam Njoroge , a waiter at a local hotel in Kiambu, has found himself indulging in substance abuse due to challenges he is facing after the hotel he was working in was closed down as it has not yet met the standards required by the MOH to open.
“My day starts at 6am where I go to a local pub, here I can get a drink for as little as Sh30, It makes me suppress the frustration I feel.” he says.
Sam is among the many who have found themselves in the same predicament and resulted to substance abuse finding ways to beat strict measures put in place by the government on the sale of alcohol so as to cope.
Mary says, situations like Sam’s are dangerous and if not addressed early can lead to serious complications, including addiction and dependency, violent behavior and also early death due to health complications.
She has, however, lauded the government for encouraging mental wellness and also launching the Psychological First Aid (PFA) guide in the wake of the virus putting emphasis on the three action principal of look, listen and link. “When we follow this it will be easy to identify an individual in distress and also offer assistance”.
Mary has urged anyone feeling the weight of the virus taking a toll on them not to hesitate but look for someone to talk to.
“You should not only seek help from a specialist but also talk to a friend, let them know what you are undergoing and how you feel, this will help ease their emotional stress and also find ways of dealing with the situation they are facing,” She added
Mary continued to stress on the need to perform frequent body exercises as a form of stress relief, reading and also taking advantage of this unfortunate COVID-19 period to engage in hobbies and talent development.
“Let people take this as an opportunity to kip fit, get in touch with one’s inner self and also engage in reading that would help expand their knowledge.