WHO Angola Update
Nr. 05 – October 2001. 1st year
WHO Country Cooperation control efforts, reinforce AFP epidemiological
surveillance and use inter-personal
Strategy ( CCS ) communication as a tool for social
A mission from the WHO WHO Angola technical staff, including
headquarters in Geneva and WHO/AFRO was the 14 epidemiological surveillance
in the country from 1 – 7 October 2001 to technicians recently posted to the Provinces
begin the preparation of the WHO Cooperation and officials from various MoH Departments,
Strategy with Angola. The aim of this first reviewed the current state of polio eradication
mission was to start a dialogue with the activities in the country. To this end a seminar
government and all the partners in health was held in Luanda on 25 and 26 October, as
development, evaluate the situation of the part of the recent WHO retreat, with the aim of
health sector and draw up an initial draft identifying the implementation constraints of
cooperation strategy, as well as the initial the antennas set up in the 18 Provinces and
administrative implications on the reinforcing technical assistance to health
Organization. programmes in Angola.
WHO started this process, which shall Also present at the meeting were Dr.
cut across all countries in the six different Babanyi, Coordinator of the Polio Eradication
regions, in order to consolidate its cooperation Initiative in the WHO African Region, Dr.
and technical assistance policy. Angola was Rigobert Adegbini of WHO/AFRO, Dr. René
one of the first 8 countries selected for the Van der Werd of WHO Geneva and Dr. Steven
implementation of the process. MacLaughlin of CDC (Center for Diseases
The strategy-drafting period is 20 Control), USA. Under specific discussion was
weeks. The second mission to Angola is the integration of the technicians at Provincial
scheduled for February 2002. level as well as the role that they have been
performing in supporting the Polio Eradication
Vaccine-Preventable Diseases In the conclusions approved at the
end of the meeting, the delegates noted
Angola participated in an assessment improvements in the surveillance indicators in
meeting of experts from the 5 countries of the last six months, as well as a better
Central Africa that are carrying out joint polio performance in the organization of polio NIDs.
eradication activities, which was held from 11 The implementation of “Kick Polio Out
– 13 October in Kinshasa, DRC. The meeting of Africa” initiative, has started in 1995 with the
was to assess the outcome of the last joint support of WHO, UNICEF, USAID, Rotary
cross-border NIDs during which about 17 international, DFID/GB, CDC/Atlanta, CORE,
million children of 0 – 5 years in Angola, DRC, the governments of Holland and Portugal,
Congo Brazzaville and Gabon were Odebrecht, among other partners.
The Angolan delegation to this
meeting included Dr. Fátima Valente, WHO Disease Prevention
Angola Head of Polio team, Dr. Rui Gama and Control
Vaz, EPI experts and polio initiative partners.
The meeting also helped to define Malaria Control
coordination mechanisms for the NIDs
planned for 2002. Angola was part of a committee of 8
With the assistance of the bordering African experts appointed to draft a study
countries, NGOs and the FAA (Angolan Armed protocol on the economic impact of Malaria in
Forces) in the coverage of inaccessible areas, Africa. Dr. Basílio Cassoma, National Malaria
3.9 million children were immunized during the Control Program (NMCP) expert and Angolan
last NIDs in Angola. representative in the committee, informed that
In Kinshasa, the participating the country already has its own protocol, which
countries were encouraged to continue quality shall be implemented by WHO/AFRO in 2002.
According to data available from a study Angola received a 20 thousand
carried out by two Angolan experts, Dr. Raúl Dollars worth free batch of DFMO, a medicine
Feio and Dr. Filomeno Fortes, the annual cost applied on patients at the critical stage of the
implication of malaria in Angola is 125 million disease, in October.
Dollars. Furthermore, as part of the Leprosy
The special joint RBM and IMCI group Elimination Initiative, MoH promoted
met in Harare on 25 – 28 October 2001, as awareness campaigns for the implementation
recommended at the first meeting of the group of a project for the coverage of 80% leprosy
in 2000. Multilateral and Bilateral Cooperation patients in the country, using the therapy
bodies, NGOs, private sector and research recommended by WHO. MoH, WHO and ILEP
institutions participated in the meeting. Angola NGO held workshops on capacity building and
was represented by 3 MoH technical staff. The planning actions for increased geographical
meeting served as a forum for information coverage with the MDT (Multi Drug Therapy).
sharing between countries and to evaluate MoH technicians from different Provinces
progress made in the implementation, as well converged in Luanda and Lubango.
as review the achievements and consider
challenges faced in the general application of Emergency Preparedness
An AFRO/SAMC technical mission Two inter-country epidemiologists for
supported the National Malaria Program from Southern Africa and the Great Lakes Region,
18 – 02 November 2001. Activities to be Dr. A. Mammo and Dr. N. Ndayimirije,
carried in the next months include provincial respectively, undertook a technical mission
working missions for the preparation of from 21 September to 03 October 2001 to
provincial malaria epidemic control plans and assess the meningitis epidemic that occurred
technical capacity building workshops for the in Benguela, Cunene, Kuando Kubango and
prevention, preparation and early detection Luanda Provinces, as well as to propose
and response to the epidemic. solutions for it. In Luanda, the mission
participated in a special review session of the
epidemic that was chaired by the National
Trypanosomiasis and Leprosy Public Health Director, Dr. Adelaide de
Control Carvalho. The outcome of the review of the
epidemic from 1994 – 2001 and the meningitis
A new form of oral treatment of control statistics were presented at this event.
trypanosomiasis based on a new Pentamidine The meeting also witnessed the participation
molecule “DB289”, has been undergoing tests of the officials from Hospitals, MoH, FAA
in Angola, since October 2001, on 30 patients health sector, health-related UN agencies,
at the first stage of the disease admitted in a NGOs and Churches. The WHO team
referral center of Viana Municipality. Apart recommended at this meeting that the national
from the oral application, the new treatment epidemiological surveillance system be
has the advantage of being applied in just five reinforced and that studies on the
days, as against a minimum of seven and characterization of the meningitis situation be
maximum of 10 days required by the continued.
intramuscular method hitherto in use. The WHO/AFRO consultants also visited
study is being carried out together with the some Municipalities in Luanda, as well as in
Swiss Tropical Institute of Basileia and North the Province of Cunene, one of those affected
Carolina University, USA. Angola has reported by the epidemic, where they gathered data on
42 thousand sleeping disease cases in the last the illness. During the campaign that involved
ten years. Treatment for sleeping disease is WHO, MSF/F, MoH and the Provincial
free and the government with WHO takes care government, more than 70 thousand people
of all medicine procurement costs. between 2 – 40 years were immunized against
WHO is developing international meningitis.
efforts to help countries where MoH reported 41 new cases and two
trypanosomiasis is endemic, as is the case of meningitis-related deaths in the six Provinces
Angola, and has got a guaranty of 25 million between 14 – 20 October. Between May and
Dollars from Adventis, a German October this year, Angola had a cumulative
pharmaceutical company. Adventis has figure of 1219 cases and 277 meningitis-
accepted to supply medicines free of charge to related deaths. The six affected Provinces are
countries where the disease is endemic for the Benguela, Cunene, Kuando Kubango, Bié and
next five years, such as Pentamidine, Zaire.
Melarsoprol and DFMO. Also, support for the With aim at facing this situation, the
production of new pharmaceutical products Provincial Committee on Potential Epidemic
and research on medicine combination and Disease decided to embark on a meningitis
field surveillance shall be guaranteed. immunization in Menongue Municipality of
Kuando Kubango Province. MSF/S together
with MoH, WHO, ACF and INTERSOS
immunized 55.775 people between 2 – 30 The “Kitandas on SIDA” is a launching
years old, (65% of the total population). pad for the commemoration of the WORLD
12 vaccinators, 24 assistants, 36 AIDS DAY. Taking part in this initiative are 6
registrars, 48 to organize the queue, 6 local NGOs, namely AALSIDA, ANGOBEFA,
supervisors and one cold chain manager ANATENO, MAR, RAIO and MAS, as well as
embarked upon this action which last 6 days. WHO technicians and Municipal authorities.
The immunization achieved 82.1% coverage During this activity, workshops were held on
or 76.1% in the suburbs and 85.5% in the city HIV/AIDS and health education materials such
center. as posters, condoms and audio-visual
Another epidemic that equally drew materials were promoted.
the attention of the national health authorities As part of the preparation for the
was measles, which recorded 257 cases and World AIDS Day, regular meetings have been
17 deaths. The outbreaks occured in Bengo, held under coordination of the Honourable
Bié, Cabinda, Huambo, Huíla, Kuanza Sul, Vice-Minister of Health, Dr. José Van-Dúnem.
Kuando Kubango, Luanda, Malange, Moxico, Local and International NGOs and
Uíge and Zaire Provinces. governmental bodies are participating in these
The humanitarian crisis was still on meetings.
focus in Bengo, 60 kilometres from Luanda,
because of the deterioration of the security Environmental Health and
situation in the Nambuangongo Municipality,
from where thousands of people have been Sustainable Development
fleeing to more secure areas since September
According to the Local Administration, In October, the Environmental Health
about 35101 IDPs, corresponding to 9763 Program of the National Directorate of Public
families, were concentrated in the “Cambambe Health commenced the building of 6 double
II IDPs Camp” (Porto Kipiri Commune) that is latrines and water reservoirs in 3 primary
located a few kilometers from Caxito capital of schools in the Municipalities of Cazenga and
Bengo. Daily arrivals have been informed and Kilamba Kiax in Launda in collaboration with
more IDPs and more than 20 thousand people some local NGOs.
are expected from the same area in the The Environmental Health Program of
coming days. MoH and the Provincial Directorates of Public
On 12 October, a multi-disciplinary Health of Kuanza Norte and Kuanza Sul are
MoH and WHO team visited the “Cambambe II building latrines for schools and IDPs areas,
IDPs Camp” for a rapid assessment of the aiming at improving conditions of
health and nutritional situation of the environmental hygiene and sanitation.
population hosted there. The team together
with the government and the local partners Nutrition
established guidelines for the improvement of
the health situation of the IDPs. MoH is carrying out community-based
In the “Cambambe II IDPs Camp”, the nutritional rehabilitation programs for children
IDPs are assisted at an improvised tent health under 5 years belonging to economically
post that is managed by “COSV”. The serious underprivileged families in Moxico Province.
cases are referred to the Açucararia de Caixão This project has the participation of MINARS,
Hospital. An unspecified number of cases of Churches, as well as NGOs, namely “Save the
Measles, Malaria, Scabies and diarrhea have Children Fund”, LWF, CAPDC and MSF-
also been reported among the IDPs. The Belgium. The actions are carried out in the
mission noticed that the environmental health Intensive Nutritional Centre, at the Nutritional
and hygiene were deficient; most of the people Feeding Centre and in 27 PICs and
defecate in open air and there are breeding Community kitchens. High among the
grounds for mosquitoes, plasmodium vectors, constraints identified by the National Nutrition
around the camp. This situation is expected to Programme are the lack of potable or pipe
worsen during the rainy season. The water borne water in the Nutrition Centres and
supplied through water-tanks is insufficient. community kitchens and non-compliance with
the national norms for the Intensive Centre by
HIV / AIDS some NGOs.
A seminar on integrated nutrition was
ANASO, network of local HIV NGOs, held in Malange with the participation of 24
organized various “Kitandas on SIDA”, on 13 people including technicians from MoH, NGOs
October 2001 at “Roque Santeiro” the biggest and journalists. This meeting was held to
market in Luanda, as a way of promoting analyze the multi-disciplinary nature of
greater awareness on the disease. As at July nutritional problems. Also discussed were the
2001, MoH had reported 7,607 AIDS cases, biological aspects of micronutrients as well as
whereas UNAIDS estimates of 1999 indicate the development of practical activities in health
150 thousand HIV carriers in Angola.
institutions, MoH and other CARITAS and A national course on nutritional survey was
MINARS centres. held by ACF (Acção Contra Fome) at the
As part of the framework for the premises of DNSP in Luanda. Participants at
implementation of WHO Operational Plan for this course included six technicians including
the African Region, an Inter-country workshop two from the national nutrition program, two
on Nutrition in Emergency Situation, was held from the Directorate of Luanda, one from
in Kigali-Rwanda, from 9 – 12 October. Apart Minars and one from INE (National Statistics
from WHO, other agencies namely UNICEF, Institute). The duration of the course is six
UNDP, FAO, UNHCR, Save the Children Fund months and it shall train the six technicians on
and NUTRIPA attended the workshop. The how to carry out nutritional surveillance survey
aim of the workshop was to reinforce correct and nutritional data analysis. This course was
local management capacity for nutritional supported by UNICEF.
problems in situations of emergency. Angola
was represented by Dr. Paulina Semedo,
Director of the National Nutrition Programme.
Dr Pier Paolo Balladelli, Representative; Dr Rui Gama Vaz, Team Leader/Polio; Eng. Gabriela
Guerra, Environmental Health; Dr Balbina Félix, Disease Prevention and Control; Dr Dalva Barros,
Human Resources and Reproductive Health; Dr Domingos Nsala e Dr Arturo Silva, Emergency
Control; Dr Nkunku Sebastião, Malaria e Tripanossomiasis; Dr. Michel Kouakou, Administration;
Marques Gomes, HIV/AIDS Surveillance Project; Adolfo Sampaio, TB Project Coordinator;
Bernardino Teixeira, Leprosy Project Coordinator; Mr. José Caetano, Health Information Officer.
Address: Rua Kanhangulo nr. 197 – 7th floor Luanda – Angola
firstname.lastname@example.org, Tels: (2 442) 332398, (1 321 ) 956 38 82; Fax: (2442) 332314