Doctors Without Borders/Médecins Sans Frontières (MSF) has been working with Sierra Leone’s Ministry of Health through the National Leprosy and Tuberculosis Control Program since 2020, with a focus on improving the diagnosis and treatment of tuberculosis (TB) in children. MSF teams work in Makeni Hospital and in 12 directly observed therapy sites located in clinics across Bombali district.

In 2022, MSF started implementing the use of new tools to help diagnose TB, in line with the newly released guidelines from the World Health Organization. These guidelines include treatment decision algorithms using stool samples for molecular testing, or urine samples for children living with HIV. MSF teams have also set up an efficient sample transportation system from 12 directly observed therapy sites to the laboratory at Makeni Hospital, where the samples undergo molecular testing.

Diagnosing TB in young children, however, is particularly challenging, since it can be very difficult for them to produce sputum (mucus expelled from the respiratory tract)— the traditional way of diagnosing TB in the lungs, known as pulmonary TB. In addition, TB in children can be located outside the lungs—a condition known as extrapulmonary TB, which makes getting samples and accurate diagnostic results even more challenging.

Malnutrition increases the risk of TB

When children are undernourished, their immune systems are compromised, putting them at heightened risk of developing TB. Malnutrition is a problem countrywide in Sierra Leone, making it even more important to be alert to the signs of TB in children.

“I left my village and brought my son here because he was not getting better,” said Aruna, father of three-year-old Augustine. “He was losing weight and coughing a lot. He sweats throughout the night—I have to get up and wipe his sweat away. He is my youngest child; I am scared to see him like this.”

Augustine was diagnosed with TB at the Makeni Regional Hospital in Sierra Leone’s Bombali district, which is supported by MSF. Alongside TB treatment, he is being fed specially formulated therapeutic milk to treat severe malnutrition. “Since he was admitted, the nurses have only been feeding him milk,” said Aruna.

“We treated a three-year-old patient for TB but, after completing her treatment, her mother brought her back because she had TB symptoms again,” said MSF nurse Umu Amara, who works at Makeni Hospital. “We did a stool test for the child and the results were still negative for TB. Because she showed all the signs of TB and she was living with HIV, we did the urine test, and the results showed she had TB.”

As with Augustine, an alarming number of children under five being treated for TB are found to be severely malnourished. MSF’s team in Bombali district also provides malnutrition treatment as part of its pediatric TB program.

Teams are treating significantly more patients

Across Bombali district, when patients come for a consultation, the teams at directly observed therapy sites check the progress of their treatment and refill TB medicine prescriptions. Malnourished children also receive supplies of ready-to-use therapeutic food—like Plumpy’Nut—sachets of peanut paste enriched with vitamins and minerals used to prevent and treat malnutrition—which they can eat at home. This reduces the number of consultations patients must attend, which is crucial in places where the closest health facility is a two-hour journey away.

“With the high number of TB cases in children in Sierra Leone, it is clear that the National Leprosy and Tuberculosis Control Program needs more support from the government and donors to scale up and replicate this successful TB diagnostic and treatment model throughout the country,” said MSF medical coordinator Dr. Kennedy Uadiale.

“By using the new tools available, bringing treatment closer to patients, and providing nutritional support in the directly observed therapy sites to children who are undernourished, we have been able to enroll and successfully treat significantly more patients,” added MSF medical team leader Jobin Joseph.

Helping children recover

Fatmata was brought to Makeni Hospital by her grandmother after she developed symptoms and was quickly diagnosed with TB. Due to the long course of treatment, which takes around six months, children like Fatmata often face prolonged absences from school. Many also find themselves isolated from their communities due to continuing stigma around the disease.

In 2023, a total of 2,148 people with drug-sensitive TB (which can be treated with first-line anti-TB drugs) were enrolled in the TB program in Bombali district. After implementing the new diagnosis tools, the number of children under the age of 15 in the drug-sensitive TB program increased substantially, from 31 in 2020 to 405 patients in 2023.

About our work in Sierra Leone

MSF has been working in Sierra Leone since 1986 and is currently providing medical care in three districts: Bombali, Tonkolili, and Kenema. At Makeni Regional Hospital, Bombali district, MSF teams support the Ministry of Health in providing treatment for patients with drug-resistant tuberculosis, while working to improve the diagnosis and care of adults and children with drug-sensitive tuberculosis in primary health care facilities across the district. In Mile 91 and Magburaka town, Tonkolili district, MSF teams work with the Ministry of Health to provide health care for mothers and children in local health centers and in Magburaka District Hospital. In Kenema district, MSF teams finished the construction of a mother and child hospital in Hangha in 2019, where its teams provide comprehensive emergency obstetric and newborn care. Our teams also provide general health care in a number of Ministry of Health-run local health centers across Kenema district.

Distributed by APO Group on behalf of Médecins sans frontières (MSF).

Today, Deputy Administrator Isobel Coleman announced the launch of the Africa Trade Desk, a signature trade platform from Prosper Africa that links large U.S. food retailers to African producers. The announcement was made during the Atlanta Phambili: A Trade&Investment Gateway to Africa&South Africa event, an event highlighting the economic relationship between the United States and Africa, with a spotlight on South Africa.

The Africa Trade Desk, a public-private partnership between Prosper Africa and Afritex Ventures, is set to facilitate at least $300 million in export sales between Africa and the United States within the next 18 months. The Africa Trade Desk bridges the gap between African suppliers and U.S. retailers by establishing a secure supply chain from Africa to U.S. retailers by consolidating logistics, insurance, and track and trace technology from farm to retailer. Initially, the focus will remain on specialty food products such as seafood, peppadews, stone fruit, citrus, and high-value herbs and vegetables. This initiative aggregates products from African suppliers, secures firm orders from its established network of U.S. buyers, and accesses financial resources to fund large orders. It supports U.S. retailers in diversifying their sourcing, reducing dependencies on traditional supply chains, and embracing high-quality, sustainable products from Africa, and also aims to mentor and scale African suppliers for success in the U.S. market. The Africa Trade Desk will help streamline business for African farmers by addressing hurdles including logistics and overseas marketing.

Prosper Africa is a U.S. Presidential-level national security initiative created to increase trade and investment at transformative levels. Prosper Africa is leading innovative approaches to U.S.-Africa trade relations and is changing the way we do business with Africa.

Distributed by APO Group on behalf of United States Agency for International Development (USAID).

The Duayaw Nkwanta Traditional Council has expressed immense gratitude to the Government of President Akufo-Addo, for making its dream of having a Fire Service Academy and Training School in the area possible.

The Vice President, Dr. Mahamudu Bawumia, on Tuesday March 26, 2024, commissioned a new Fire Service Training School in Duayaw Nkwanta, the second Fire training school built by the Akufo-Addo Government, to take the national tally of fire academy and training school in Ghana to three.

Speaking at the commissioning, Acting President of Duayaw Nkwanta Traditional Council, Nana Boakye Bonsu, expressed the joy and gratitude of his people to President Nana Akufo-Addo and Vice President Bawumia.

“Indeed, today is a great day for our Municipality and the Traditional Area. The reason is that the dream and concept of this wonderful project that we are witnessing today, was initiated and conceived by wonderful persons like tje late Nana Boakye Tromo III, Omanhene and Presidemt of the Duayaw Kwanta Traditional Council,” he said.

“The entire Traditional Council wants to take this opportunity to express our profound gratitude to the government.”

“Duayaw Nkwanta will always remember the President, Nana Addo Dankwa Akufo-Addo, Vice President Alhaji Dr. Mahamudu Bawumia and the NPP Government.”

Facilities at the training school include dormitory blocks for men and women, classroom blocks, administration blocks, as well as modern training equipment such as hydraulic platforms to reach the 16th floor, to fight fires and effect rescue operations.

The Vice President announced that a third Fire Service Training School built by the government in the Eastern Region,  will soon be commissioned.

Distributed by APO Group on behalf of The Presidency, Republic of Ghana.

In a further move towards pooled procurement of essential medicines and medical products, Ministers of Health from small African islands states established a secretariat and elected Mauritius as the host, taking critical steps to launch joint operations for increased access to affordable, quality-assured and safe medicines and medical supplies.

The pooled procurement programme, signed in 2020 by Cabo Verde, Comoros, Guinea-Bissau, Mauritius, Sao Tome&Principe and Seychelles, that form the Small Island Developing States (SIDS) from Africa, and endorsed by Madagascar, aims to coordinate the purchase of selected medicines and medical products affordably, harmonize medicines management systems, improve supplier performance and reduce procurement workload. The programme also sets the guiding principles and governance structure, including the creation of a secretariat, technical committees and a council of ministers.

The ministers, gathering for the 8th SIDS meeting in Victoria, Seychelles, took the new step to set up a secretariat as they embark on the final stages of the joint procurement initiative.

“Mauritius is honoured to assume this important responsibility and we thank fellow SIDS countries and Madagascar for the confidence demonstrated in us to host the pooled drugs procurement secretariat,” said Hon Kailesh Jagutpal, Minister of Health and Wellness of Mauritius. “We will assume this duty with the care and rigour that it requires for the common good of all people and countries represented.”

Pooled procurement has been on the SIDS agenda since 2017 when the countries expressed commitment to implement the initiative.

“I congratulate Mauritius on the election as host for the secretariat. This is a win for all of us. Our unique position of SIDS in the African region is what brings us together and makes us stronger,” said Cabo Verde Minister of Health, Hon Filomena Gonçalves. “We will continue to play an important role in moving the agenda of pooled procurement forward and will work closely with our partners, including WHO.” 

During the 25–27 March 2024 meeting, the ministers and government representatives also agreed to strengthen collective efforts and actions on health, including bolstering preparedness and response to health emergencies, strengthening health systems and putting in place measures to mitigate and adapt to the impacts of climate change, to which island nations are particularly vulnerable. 

“As a collective we have come together to explore different ways of working so we can make our voices heard in all the important global arenas. Even if we don’t always have the capacity on our own, through SIDS we can do it. We may be small, but we can be big in our actions,” said Hon Peggy Vidot, Minister of Health of the Seychelles. 

The meeting was the first for Guinea-Bissau, which has now become a full member of SIDS, and for Madagascar, which accepted the invitation to be part of the SIDS Network initiative and therefore part of pooled procurement efforts. 

“This meeting will be remembered as a milestone. We’ve had fruitful discussions and made important decisions that will have an impact on SIDS and the rest of the region. At WHO, we will provide technical support to SIDS to ensure the implementation of the agreed-upon actions from this meeting,” said Dr Matshidiso Moeti, World Health Organization Regional Director for Africa. 

The SIDS meeting in the African region serves as a forum for a collective voice for joint inputs into global SIDS events, including the upcoming Fourth International Conference on SIDS in Antigua and Barbuda, which will take place in late May 2024. 

Distributed by APO Group on behalf of WHO Regional Office for Africa.