It has been a year of mixed results for East Africa’s health sector, with encouraging news in the fight against malaria and marburg virus but setbacks in HIV/Aids, dengue fever and diabetes.

Ebola

When Ebola struck West Africa, the response from the rest of the world was at best lukewarm, even with experts warning that neglecting infectious disease anywhere posed a threat everywhere.

The tragedy that began at the end of last year continued to be internationally ignored for five months, with Médecins Sans Frontières, warning at the end of March that the outbreak would be “unprecedented” in its spread and its toll.

Several reports warned that East African countries risked an Ebola outbreak unless they strengthened screening services at airports and border posts and followed up on all passengers arriving from West Africa after screening.

In an effort to prevent any Ebola outbreaks in the region, the East African Community partner states extended their support to West African countries. The five member states have agreed to jointly send a team of 41 medical experts and 578 health workers to help contain the virus.

Also, trials on the experimental Ebola vaccine (VSV-Zebov) began at the Kenya Coast with up to 40 health workers volunteering for the trials in Kilifi under a programme funded by the Wellcome Trust.

The vaccine trials will assess the safety profile of the vaccine at different doses and compare the immune response induced by one versus two injections.

Malaria

According to the WHO Malaria Report 2014, East Africa still records a high number of deaths from malaria though the figure has fallen sharply globally. About 20,000 deaths were reported in East Africa in 2013 with Kenya, Uganda and Tanzania accounting for 90 per cent of the estimated number of P. falciparum infections in sub-Saharan Africa.

However, there have been positive sentiments on the back of trials of a vaccine conducted in seven African countries, among them Kenya and Tanzania. Glaxo SmithKline in August submitted its first regulatory application to the European Medicines Agency for the assessment of the RTS,S vaccine.

RTS,S, the only advanced malaria vaccine in its final study trials, is intended for exclusive use against the plasmodium falciparum malaria parasite, which is most prevalent in sub-Saharan Africa.

HIV/Aids

UNAids offered a vision of 90 per cent of those living with HIV being diagnosed, 90 per cent of those individuals accessing treatment, and the treatment of 90 per cent of them being effective enough to keep levels of the virus in their systems undetectable within the next five years.

If that vision became reality, it could end HIV as a global threat before the middle of this century. But while the vision illustrated how far the global response to HIV has come, it also highlighted how far it has to go. This year, the world finally reached the “tipping point,” where the number of people starting treatment for HIV surpassed the number of people becoming infected.

But many countries have yet to get there, and many, including the East African states, are still seeing a minority of those who should be on treatment accessing it, maintaining it, and only a relative handful even having a means to know if they are virally suppressed.

In October, the first international conference dedicated to biomedical HIV prevention technologies highlighted a vision of success that will rely not on one breakthrough, but on many that will stem from responsive research and collaboration.

Featuring gains and setbacks in Aids vaccine research, microbicide research and the promise of pre-exposure preventive use of antiretroviral treatment to protect against acquisition of HIV, as well as the impacts of treatment for the virus in preventing transmission, the meeting merged explications of laboratory science with examinations of realities on the ground.

However, around half of all new HIV/Aids infections each year are people under the age of 25, with 6,000 new infections a day according to a report by UNAids. Kenya, Uganda and Tanzania were reported to be among the countries that account for 89 per cent of all new HIV infections in the world.

Tuberculosis

Tuberculosis is rated by the WHO as the the second most infectious killer disease after the Aids virus and remains one of the world’s deadliest communicable disease.

According to the World Health Organisation’s 2014 TB report, of the more than nine million people who developed tuberculosis in 2013 globally, 1.5 million died. Some 8.6 million TB cases and 1.3 million TB deaths were reported in 2012.

In East Africa, Kenya, Uganda and Tanzania face the highest disease burden. For example, in 2013, Kenya recorded the highest number of new cases at 89,796, followed by Tanzania with 65,732 and third Uganda with 47,650.
The health experts say a lack of investment in health care systems has allowed the disease persist and spread in developing countries.

Diabetes
East Africa is also reported to be facing a health time bomb with diabetes having an increasing impact on people of working age, signalling a threat to the region’s economic development.

According to the 2013 Global Diabetes Scorecard, more than three-quarters of the diabetes-related deaths that occurred in the region last year — that is more than 80,000 — were of adults aged between 20 and 60 years.

The scorecard notes that East African governments need to strengthen their existing health systems to improve the health of people living with diabetes or suffer the burden of the projected almost twofold increase in the prevalence of the disease over the next two decades.

“Although the East African countries are beginning to make progress in responding to diabetes, they need to take a stronger strategic approach to the disease,” notes the scorecard by the International Diabetes Federation.

Building on the United Nations Summit of 2011, global leaders have now signed up to an historic commitment to reduce premature deaths from diabetes and other non-communicable diseases (NCDs) by 25 per cent by 2025.

Dengue fever

The dengue fever outbreak in Tanzania has caused alarm in East Africa, especially among the countries with an Indian Ocean coastline — Kenya, Somalia, Eritrea and Djibouti. In May, Tanzanian Health Ministry revealed that more than 400 patients in Dar es Salaam had been diagnosed with dengue fever over four months and three had died.

Dengue fever affects about 390 million people every year, and is particularly prevalent on the East African coast.

Marburg

Uganda has suffered Ebola and Marburg outbreaks and the emergence of a mysterious “nodding disease” that affected children in the Acholi sub-region, in northern Uganda.

This year, the country suffered from a Marburg outbreak but was later declared free from its virus after the completion of a WHO-recommended 42-day post Marburg surveillance countdown period.