|Africa News Digest
No Good Intelligence on Spread of Marburg Fever in Angola
There is no good intelligence on the spread of Marburg fever in Angola at this point, and the World Health Organization (WHO) admits it. But it is clear that the disease is still spreading. Angolan families are hiding their sick, or even fleeing from Uige province with them, in response to the publicity about the disease and the cultural divide between themselves and the health workers. Health workers' attempts to take away and immediately bury infectious corpses are being met with hostility. This is seen as treating the dead "like animals," since local culture calls for spending a good deal of time with the dead, and embracing and kissing the deceased in a last farewell.
In the case of Marburg virus, a corpse is more infectious than even a living person in the advanced stages. Whole families have been dying as a result of this clash between culture and a new necessity. The deaths of whole families only increases the trauma of the population, but does not seem to alter its state of denial. Some of the population is frightened to see health workers circulating in inflated "space suits." "We have massive problems in mobilizing the community against [the disease]," Pierre Formenty, WHO's leading specialist for new and dangerous diseases, told Agence France Presse April 13.
While the number of known cases continues to climb, the ratio of known to unknown can be assumed to have gotten smaller, as a result of the reactions of the population. Although WHO does not make this point, David Daigle of WHO admitted to the Financial Times April 14, "We're not sure where we are in this current outbreak." And WHO's Update 11 on the outbreak (April 13) acknowledges, "its dimensions are still unfolding."
The total number of known cases stood at 235, and total known deaths at 215, according to Angola Press (ANGOP) April 13.
The surveillance teams, which suspended operations April 7 when one of their vehicles was stoned by residents, resumed work April 9, despite continuing concerns for their security. Yet, what is being called "surveillance" is now "largely concentrated on the investigation of deaths and collection of bodies," according to WHO Update 11. It means that the infected are not being isolated.
WHO launched a campaign April 8 for $3.5 million to support the emergency response to the outbreak. So far, $1.7 million has been pledged.
Marburg in Angola: It's the Physical Economy, Stupid!
The town of Uige, epicenter of the Marburg fever outbreak, has "almost no running water, and no electricity, except for a few homes running on generators," according to South Africa's News24 April 13. Its story is based on AFP interviews with Pierre Formenty, WHO's leading specialist on new and dangerous diseases, and Tom Ksiazek, head of the CDC special pathogens branch. Formenty told AFP, "Uige is not a classic urban environment. It's a village with 200,000 inhabitants."
When Doctors Without Borders first arrived in Uige in late March, it "found the hospital, where most of the cases were treated, without water or electricity," according to the Financial Times April 14.
In Luanda, the capital, electricity is intermittent.
Uige, like much of Angola, was badly damaged in the 27 years of civil war. Its airstrip is still pock-marked with artillery hits. There are still so many land mines that health workers are flown between Luanda and Uige.
CDC'S Gerberding in Denial: 'We're Optimistic'
Dr. Julie Gerberding, Director of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, is whistling on her way through the graveyard, when it comes to Angola's Marburg fever outbreak. According to an April 13 Reuters account of her comments to CNN, "she said she did not believe the virus threatened to spread to the rest of the world. 'We're optimistic about this one,' she said." No doubt the virus has given her the same firm assurances that Hitler gave Chamberlain in 1938.
The CDC has eight staff members in Angola.
Ft. Detrick Studies Drug for Use Against Marburg
Scientists at the U.S. Army Medical Research Institute of Infectious Diseases (Ft. Detrick, Maryland) are "investigating whether a drug that has shown promise against the related Ebola virus might work against Marburg," according to AP April 13. Both viruses belong to the family Filoviridae. The drug cured one-third of monkeys infected with Ebola in a 2003 study. Samples of the Marburg virus have been sent to Ft. Detrick from Angola for this purpose.
Dr. Michael Ryan of WHO cautioned that, even if the drug shows promise in monkeys, it may take months before it can be tried on people. "This is an unlicensed drug and the ethics will have to be looked at extremely carefully. ... There may be a case for compassionate use, but we can't just give it to people just like that," Ryan said.
AP cites unnamed disease experts as saying that it will take weeks to determine whether the disease can be stamped out before it becomes a long-term crisis.
Medical Anthropologists in Angola to Address Resistance
Two medical anthropologists have arrived in Uige, to deal with the problem of effective popular mobilization against Marburg fever. In addition to the funerary problems mentioned in the first report above, many residents believe that the health workers are the source of the disease. Or, they even think that the health workers take their sick kin to hospital and then kill them. Apparently both versions are in circulation. There have been other cases in which populations blamed health workers for the epidemic disease that they were fighting, including a recent case in Mozambique.
However, a commission drawing representatives from WHO, the CDC, and Doctors Without Borders has concluded that practices at the hospital in Uige were indeed transmitting the virus from infected patients to other patients, according to Update 2 of the International Red Cross (April 15). The hospital's Marburg isolation ward was empty as of April 14, since families refuse to allow their sick to be taken there.
The anthropologists will be joined by experts in social mobilization from Angola, D.R. Congo, and Mozambique.
Brazil for Transfer of Its HIV Drug Technology to Africa
Brazilian President Lula da Silva is discussing the transfer of Brazilian anti-HIV drug technology to Africa, in his fourth Presidential trip to Africa, which began on April 10. Lula will be visiting five African countries (Cameroon, Nigeria, Ghana, Guinea Bissau, and Senegal) on the trip. Brazil's own anti-HIV program is world-renowned, for having developed a national capability to produce generic anti-retroviral drugs at a price which permits the government to provide these medicines free to all HIV sufferers in the country. Agreements for the transfer of this technology are under discussion with at least Cameroon and Nigeria.
Nigeria and Brazil To Work for South American-African Summit
Nigeria and Brazil have agreed to work on organizing a first-ever South American-African heads of state summit, for sometime in 2006, similar to the ground-breaking South America-Arab summit set for May 2005. This was one of the agreements reported, following Lula da Silva's discussions with Nigerian President Olusegun Obasanjo on April 11. The Brazilian President said he would propose the summit to his fellow South American heads of state when they next meet in Brasilia, in August, according to Tribuna da Imprensa April 12.
Lula spoke in Nigeria of the necessity of increasing all aspects of relations with the African nations: trade, cultural, political. Brazil is offering "partnership" with Africa, he said.
In his visit to Cameroon, Lula re-opened Brazil's embassy, which had been closed in 1999 by the previous government, when Brazil was hit by its financial crisis. Lula promised that Brazilian construction firms would now return, also, to work on energy and construction projects. "I want to assure you, that this time, Brazil came to stay," the President said. A large delegation is accompanying Lula on his visit to Africa.
ICG Disputes Cheney/Bush Gang-Busters Approach to Sahel
"Islamic Terrorism in the Sahel: Fact or Fiction?" is the title of an International Crisis Group (ICG) report issued March 31. The liberal imperialist ICG is concerned that the Cheney/Bush gang-busters approach, embodied in its Pan Sahel Initiative (PSI), will create more terrorism than it suppresses. (ICG does not suggest that that might have been the intention.)
The PSI embraces Mali, Niger, Chad, and Mauritania, and expansion to additional countries is being considered. The region "is increasingly referred to by the U.S. military as 'the new front in the war on terrorism.'... However, the Sahel is not a hotbed of terrorist activity," according to the ICG. It does not consider the Salafist Group for Preaching and Combat (GSPC) to be a serious threat. (The U.S. military typically singles out the GSPC, now down to three dozen or so members, as the big threat.) The discrepancy between claim and reality was emphasized in EIW's Africa Digest in December 2004 (#50).
It notes that "Mali, a star pupil of 1990s neo-liberal democratization, runs the greatest risk of any West African country other than Nigeria of violent Islamist activity" (emphasis added).
ICG's recommendation is that the PSI "be folded into a more balanced approach to the region, one also in which Europeans and Americans work more closely together." Aid for livestock raising and tourism is needed, it says.