The need to increase antimicrobial resistance surveillance among forcibly displaced persons (FDPs).

Antimicrobial resistance (AMR) poses a significant threat to human health as 4.95 million deaths were associated with bacterial AMR in 2019 and is projected to reach 10 million by 2050. To mitigate AMR, surveillance is an essential tool for determining the burden of AMR and providing the necessary information for its control. However, the global AMR surveillance is inadequate and particularly limited among forcibly displaced persons (FDPs) despite having higher risks of harboring these pathogens. Predisposing factors among this group include poor living conditions, limited access to treatment and diagnostic tests, and inadequate trained health professionals in refugee camps. Strengthening AMR surveillance among FDPs would address the identified gaps and facilitate formulation and implementation of evidence-based policies on AMR control and prevention response. This article provides information on the growing population of FDPs, factors contributing to the AMR burden and AMR surveillance gaps in FDPs and highlighted recommendations for control.

Food safety in vulnerable populations: A perspective on the challenges and solutions.

Vulnerable populations are a particular group that are not capable of fending for themselves due to a number of limitations. Among many things, of particular concern is the food safety challenges faced by these individuals and the high risk of susceptibility to foodborne diseases. In this paper, an attempt is made to point out the various challenges faced by vulnerable populations that make them more susceptible to foodborne illness than other healthy adults. Also, the paper highlights possible improvement pathways through which these people can have access to safe and nutritious food, and the current interventional steps taken to address the food safety risk associated with food handling activities of food meant for vulnerable groups.

Impact of COVID-19 on foodborne illness in Africa - A perspective piece.

Food safety investments in Africa, through international donors or national programs, were primarily focused on the formal market sector. However, increasing consumer food safety concerns about foods sold in the growing informal food markets, the rising foodborne disease burden in Africa, and the emergence of COVID-19 have all made food safety a major concern and ultimately brought it to an inflection point in Africa. In addition, Data on foodborne disease outbreaks revealed a scarcity of reported cases before and during the pandemic. The lack of information on foodborne disease reporting in Africa translates into one of the reasons why food safety in Africa is becoming a rising subject matter. This perspective discusses the situation of food safety in Africa before and after the COVID-19 pandemic. Finally, challenges confronting ongoing efforts to improve food safety in the post-COVID era in Africa are summarized and highlighted.

Transforming malaria prevention and control: the prospects and challenges of gene drive technology for mosquito management.

Background: In the era of insecticides and anti-malarial drug resistance, gene drive technology holds considerable promise for malaria control. Gene drive technology deploys genetic modifications into mosquito populations to impede their ability to transmit the malaria parasite. This can be either through the disruption of an essential mosquito gene or the association of gene drive with a desirable effector gene. CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) is a gene editing tool that precisely modifies mosquito vector DNA sequences and curtails the rate of pathogen transmission.Methods: A comprehensive search was conducted in the SCOPUS and MEDLINE databases (via PubMed) until October 2023. The keywords used were related to the principles and mechanisms of gene drive technology, its advantages, and disadvantages, and its ethical and regulatory considerations in sustainable malaria eradication.Results: The development of gene drive enables the preferential inheritance of specific genes in targeted mosquitoes, potentially obstructing the transmission of the Plasmodium parasite. This technology was also studied for the control of other vector-borne diseases such as dengue and chikungunya viruses. Despite its experimental superiority over other traditional methods such as insecticide-treated nets and insecticide sprays, the long-term dynamic interplay of mutation and resistance poses challenges for gene drive efficiency in sustainable malaria control.Conclusions: This commentary elucidates the underlying mechanisms and principles of gene drive technology, underscoring its promise and challenges as a novel strategy to curtail malaria prevalence. Although the release of such genetically modified mosquitoes into the natural environment would result in the eradication of the locally targeted species of mosquitoes, the complete eradication of the entire species remains questionable. Thus, the practical application raises significant ethical and regulatory concerns for further research and risk assessment, including the risk of gene drive spreading to nontarget species in the wider theatre of biodiverse species.

Increasing challenges of malaria control in sub-Saharan Africa: Priorities for public health research and policymakers.

The ever-increasing cases and mortality due to malaria remains one of the most important public health threats, especially in sub-Saharan Africa-where this burden is considerably high. In 2020, sub-Saharan Africa accounted for about 95% of all cases and 96% of all malaria deaths with about 80% of these deaths reported in children under the age of 5. This review, adopting a public health focus, aimed to understand the challenges of malaria control in sub-Saharan Africa despite ongoing public health interventions. Our review highlights two important findings. First, the increasing resistance of malaria parasites to artemisinin-based combination therapy (ACT) and its partner drugs coupled with increased vector resistance to pyrethroids and insecticides is reversing the progress of public health interventions in keeping malaria under control. Second, the wanning for the efficacy of the WHO-approved vaccine i.e. RTS,S from 60 to 70% following 18 months of observation, and its short-term availability remains an impediment to achieving the WHO target of producing malaria vaccines with more than 75% efficacy by 2030. Our findings underline the need to reassess research priorities with a focus on vaccine production in sub-Saharan Africa. Furthermore, African governments and policymakers must be committed to invest both the political and financial capital in vaccine production and distribution.

How West African countries prioritize health.

BACKGROUND: The goal of Universal Health Coverage (UHC) is to ensure that everyone is able to obtain the health services they need without suffering financial hardship. UHC remains a mirage if government health expenditure is not improved. Health priority refers to general government health expenditure as a percentage of general government expenditure. It indicates the priority of the government to spend on healthcare from its domestic public resources. Our study aimed to assess health priorities in the Economic Community of West African States (ECOWAS) using the health priority index from the WHO's Global Health Expenditure Database. METHOD: We extracted and analysed data on health priority in the WHO's Global Health Expenditure Database across the 15 members of the ECOWAS (Benin, Burkina Faso, Cabo Verde, Cote d'Ivoire, The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone, and Togo) from 2010 to 2018 to assess how these countries prioritize health. The data are presented using descriptive statistics. RESULTS: Our findings revealed that no West African country beats the cutoff of a minimum of 15% health priority index. Ghana (8.43%), Carbo Verde (8.29%), and Burkina Faso (7.60%) were the top three countries with the highest average health priority index, while Guinea (3.05%), Liberia (3.46%), and Guinea-Bissau (3.56%) had the lowest average health priority in the West African region within the period of our analysis (2010 to 2018). CONCLUSION: Our study reiterates the need for West African governments and other relevant stakeholders to prioritize health in their political agenda towards achieving UHC.

Tackling the global health threat of arboviruses: An appraisal of the three holistic approaches to health.

Background: The rapid circulation of arboviruses in the human population has been linked with changes in climatic, environmental, and socio-economic conditions. These changes are known to alter the transmission cycles of arboviruses involving the anthropophilic vectors and thus facilitate an extensive geographical distribution of medically important arboviral diseases, thereby posing a significant health threat. Using our current understanding and assessment of relevant literature, this review aimed to understand the underlying factors promoting the spread of arboviruses and how the three most renowned interdisciplinary and holistic approaches to health such as One Health, Eco-Health, and Planetary Health can be a panacea for control of arboviruses. Methods: A comprehensive structured search of relevant databases such as Medline, PubMed, WHO, Scopus, Science Direct, DOAJ, AJOL, and Google Scholar was conducted to identify recent articles on arboviruses and holistic approaches to health using the keywords including "arboviral diseases", "arbovirus vectors", "arboviral infections", "epidemiology of arboviruses", "holistic approaches", "One Health", "Eco-Health", and "Planetary Health". Results: Changes in climatic factors like temperature, humidity, and precipitation support the growth, breeding, and fecundity of arthropod vectors transmitting the arboviral diseases. Increased human migration and urbanization due to socio-economic factors play an important role in population increase leading to the rapid geographical distribution of arthropod vectors and transmission of arboviral diseases. Medical factors like misdiagnosis and misclassification also contribute to the spread of arboviruses. Conclusion: This review highlights two important findings: First, climatic, environmental, socio-economic, and medical factors influence the constant distributions of arthropod vectors. Second, either of the three holistic approaches or a combination of any two can be adopted on arboviral disease control. Our findings underline the need for holistic approaches as the best strategy to mitigating and controlling the emerging and reemerging arboviruses.