Category: Health

WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, expressed the organization’s commitment to supporting Rwanda via his X account, stating, “Rwanda’s Ministry of Health has reported cases of Marburg. WHO is scaling up its support and will work with the government of Rwanda to stop the spread of the virus and protect people at risk.”

On Friday, September 27, 2024, the Ministry of Health confirmed cases of MVD and announced heightened measures to prevent further transmission of the virus.

In a statement, the ministry reported that the disease, which causes severe haemorrhagic fever, has been confirmed in “a few patients in health facilities across the country,” and that investigations are underway to identify the source of the infection.

The ministry has urged anyone experiencing symptoms such as high fever, severe headaches, vomiting, muscle pain, and stomach aches to contact the Rwanda Biomedical Centre (RBC) via its toll-free number 114 or visit the nearest health facility.

Marburg virus disease, part of the same viral family as Ebola, causes severe haemorrhagic fever, leading to multiple organ failure and, in many cases, excessive bleeding. The virus can affect both humans and nonhuman primates and is zoonotic, meaning it is transmitted from animals to humans.

According to WHO, initial human infection with the Marburg virus typically occurs after prolonged exposure to mines or caves inhabited by colonies of Rousettus bats, which are natural carriers of the virus.

Once a person is infected, the virus can spread through human-to-human transmission via direct contact with blood, secretions, or other bodily fluids from an infected person, as well as through contact with contaminated surfaces and materials, such as bedding and clothing.

The virus was first identified in 1967 in the German city of Marburg, during an outbreak linked to laboratory work involving African green monkeys (Cercopithecus aethiops) imported from Uganda.

Since then, outbreaks and sporadic cases have been reported in countries including Angola, the Democratic Republic of Congo, Kenya, South Africa, Zimbabwe, and Uganda.

Normally, stunting manifests in delayed physical growth, impaired cognitive development, and increased vulnerability to illness. Prevention involves proper maternal nutrition, exclusive breastfeeding, good hygiene, and ensuring access to nutritious foods and healthcare during early childhood.

In Rwanda, efforts to address stunting and promoting maternal and child health through antenatal and early childhood interventions are intensely underway with an ambitious stunting prevention trial set to begin in 2025.

This impending trial is seen as a significant step forward in combatting stunting and improving maternal and child health especially in rural Rwanda by assessing whether providing comprehensive antenatal and postnatal care can reduce stunting and significantly enhance health outcomes for mothers and their children.

A recent stakeholders’ meeting held in Kigali disclosed that the trial, involving 60 health centers in rural areas, will compare two groups; one receiving current antenatal and postnatal care and the other receiving a more comprehensive package, which includes advanced tools for pregnancy monitoring and additional nutritional support for children.

According to Dr. Edgar Kalimba, a senior consultant pediatrician at King Faisal Hospital and Principle Investigator (PI) in the project, the study will focus on the first 1,000 days of life—a crucial period for child development.

“We aim to measure various outcomes, including maternal weight gain during pregnancy, the prevalence of preterm births, low birth weight, and the number of children who are stunted by the age of two,” Kalimba elaborated.

The trial will also monitor children’s cognitive and social development, alongside maternal health indicators such as hemoglobin levels and pregnancy duration.
A unique aspect of the trial will be its sub-studies investigating the predisposing conditions of stunting, such as epigenetic factors and diving into the root causes to gain deeper insights.

It is planned that prenatal interventions will follow both national and international guidelines and include low-dose aspirin, calcium, omega-3 fatty acids, and L-arginine supplementation. Early enrollment in antenatal care will be strongly advocated to ensure timely intervention for pregnant mothers.

Postnatal care will align with the latest World Health Organization (WHO) and UNICEF recommendations which stipulate nine scheduled visits, including a home visit from birth to 24 months.
These visits will include health assessments, growth monitoring, and family support, supplemented by small-quantity lipid-based nutrient supplements for children aged 6 to 18 months.

“This trial could transform how we address stunting and maternal health in rural areas, potentially serving as a model for broader healthcare improvements across the country,” Kalimba noted.

Along with other co-PIs, Kalimba will work with the Ministry of Health through Rwanda Biomedical Center (RBC) and the National Child Development Agency (NCDA) to ensure that the outcomes of the clinical trial are quickly scalable across the country.

This initiative reinforces the importance of collaborative efforts to tackle stunting and improve maternal and child health in Rwanda. The results could shape future policies and interventions, offering a blueprint for stunting prevention not just in Rwanda but across similar settings globally according to officials from the Ministry of Health.

Dr. Aline Uwimana, Head of the Maternal, Child, and Community Health Division at RBC says that Rwanda’s intensity in combating child stunting is part of its National Strategy for Transformation 2 (NST2), which aims to reduce stunting rates from 33% to 15% by 2029.

One of the key initiatives is the upcoming stunting prevention trial, which is expected to bring significant advancements in understanding and addressing the root causes of stunting. The trial will focus on nutrition, maternal health, and innovative approaches to combat the socioeconomic inequalities that contribute to stunting.

“This upcoming stunting prevention trial will provide critical insights into the effectiveness of various interventions we have implemented. It will allow us to fine-tune our strategies, particularly in addressing the gaps that still exist among the most vulnerable communities,” she said.

Multiple Micronutrient Supplements (MMS), which have already shown promising results in other regions will be included and this is viewed as a game-changer for pregnant women and young children in Rwanda.

“The MMS has been proven to reduce adverse pregnancy outcomes, including low birth weight and preterm births. By starting this trial, we aim to gather concrete data that will help us scale up this intervention nationwide, ensuring that all pregnant mothers have access to the necessary supplements to protect their health and that of their children,” she explained.

The trial is also expected to benefit from Rwanda’s multi-sectoral approach, which combines nutrition, healthcare, education, and water and sanitation improvements.

According to her, it’s not about just distributing supplements; it’s about creating an environment where every child has access to nutritious food, clean water, and quality healthcare. This will provide the evidence needed to strengthen these connections and improve the overall well-being of the Rwandan child.

One of the key goals of the trial is to address the socioeconomic inequalities that have contributed to stunting in Rwanda. Research shows that intergenerational transfer, including maternal health and nutrition, accounts for 31% of the inequality in stunting. Uwimana pointed out that the trial would focus on closing this gap.

“By targeting the most affected groups, we can ensure that the benefits of our programs reach every corner of the country. This trial will help us identify the most effective ways to reduce stunting, particularly among children whose families have been hardest hit by socioeconomic disparities,” she explained.

Dr. Uwimana is confident that this project will pave way for more extensive and sustainable programs not only for Rwanda but other countries facing challenges of child stunting.

“By investing in cutting-edge research and evidence-based strategies, we are ensuring that future generations of Rwandan children will grow up healthier, stronger, and ready to contribute to the country’s development,” she emphasized.

The 2025 stunting prevention trial represents a crucial step in Rwanda’s ongoing battle against child stunting. Through innovative approaches and a commitment to data-driven strategies, the country is setting a strong foundation for a healthier and more prosperous future.

“Yes, the number has risen. Two more cases have been reported, bringing the total to six,” Niyingabira told IGIHE.

The first case was confirmed in July, with the initial four cases involving individuals who had recently traveled to the Democratic Republic of Congo (DRC).

More than 22,000 suspect cases, with more than 1,200 suspected deaths, have been reported in DRC since January 1, 2023.

In response, Rwanda recently launched its first phase of a vaccination campaign, aiming to vaccinate 10,000 people. This initiative focuses on high-risk groups, including healthcare workers, cross-border traders, hospitality staff, and others likely to be exposed to the virus.

Sources indicate that the vaccination of 10,000 individuals is expected to be completed within one week.

Across Africa, 2,912 new Monkeypox cases have been reported within a week, including 374 new infections and 14 deaths. The spread of a new variant, referred to as clade 1b, has raised concerns, with cases detected in the DRC, Burundi, Kenya, and Rwanda.

On September 13, the World Health Organization (WHO) approved the use of the MVA-BN vaccine for Monkeypox. This vaccine had already been authorized in the United States, Canada, the United Kingdom, and the European Union.

Developed by Danish pharmaceutical company Bavaria Nordic A/S, the vaccine is administered to individuals aged 18 and older in two doses. The second dose is given four weeks after the first. In Rwanda, the current vaccination campaign is administering a single dose of 0.5 ml.

Research indicates that the first dose of the vaccine provides 76% protection against Monkeypox, with the second dose increasing protection to 82%.

{{Symptoms and treatment of Monkeypox}}

Monkeypox symptoms usually appear three to 14 days after infection. The virus typically causes a rash that starts on the face, hands, and genital areas, but it can spread to other parts of the body. The rash consists of fluid-filled blisters that eventually dry up and form scabs as the individual recovers.

In addition to the rash, patients often experience fever, which may be mild or severe, and fatigue.

With appropriate treatment, most patients recover within two to three weeks after symptoms first appear.

In a message shared on its social media platforms on the evening of September 19, 2024, the Ministry of Health emphasized that this vaccination effort is part of Rwanda’s ongoing strategy to prevent and combat the spread of MPox, a virus that has affected many African countries, including Rwanda, where cases have already been reported.

Julien Mahoro Niyingabira, spokesperson for the Ministry, recently told IGIHE that Rwanda’s approach to preventing MPox focuses on vaccinating those at greatest risk. He clarified, “We will not begin by vaccinating everyone. Certain groups are more vulnerable, and they will be prioritized based on vaccine availability. As the situation evolves, additional groups may also be considered for vaccination.”

The African Union is coordinating vaccine distribution across several African nations, assisting in the containment of MPox on the continent.

In Rwanda, all four individuals who contracted MPox in July have received treatment and been discharged. Health authorities have reassured the public that the country is well-equipped to manage and treat MPox cases, should more arise.

Meanwhile, the outbreak has significantly impacted the Democratic Republic of Congo (DRC), which has recorded over 22,000 cases and more than 715 deaths in 2024.

The virus has now spread to 22 of DRC’s 26 provinces and is present in 13 other African countries. In response, the World Health Organization (WHO) has allocated $600 million over six months to combat the virus globally.

Health officials continue to stress the importance of preventive measures such as frequent handwashing and avoiding sexual contact—both protected and unprotected—to prevent the virus’s transmission.

MPox symptoms typically manifest within three to fourteen days of infection and include a rash that primarily affects the face, hands, and genitals.

The rash begins as small fluid-filled blisters that dry out and form scabs as the patient heals. In addition to the rash, individuals may experience fever, fatigue, and weakness.

Recovery generally takes two to three weeks, and none of the patients treated in Rwanda have required prolonged hospitalization or succumbed to the virus.

Rwanda has reported cases of the less severe grade 1B strain of MPox, similar to that found in the DRC. In contrast, West Africa has seen cases of the more severe grade 2 strain.

Rwanda’s health authorities have emphasized measures to prevent the spread of the disease. These include frequent handwashing and avoiding sexual contact, whether protected or unprotected, due to the high risk of transmission through such interactions.

Julien Mahoro Niyingabira, spokesperson for the Ministry of Health, has told IGIHE that the country’s preventive strategies include the possibility of vaccinating the population, with priority given to those at higher risk.

“There is a team in Rwanda currently studying how the vaccination could be rolled out. Should the vaccination process begin, we will inform the public accordingly,” Niyingabira stated.

He further noted that while vaccines have not yet arrived in the country, priority for vaccination will be given to the most vulnerable groups before any nationwide rollout.

“We will not start with the entire population. Certain groups are more vulnerable to infection than others. We will begin with them based on the available vaccines, and as we progress, other groups will also be considered. However, the vaccination program has not yet started in the country,” he emphasized.

Niyingabira explained that cross-border traders in districts like Rubavu and other high-risk groups may be among the first to receive the vaccine.

“First, we need to secure the vaccines, and then the vaccination program can begin. Even when the vaccine arrives, it complements the existing preventive measures, meaning vaccination is one of the strategies we plan for Mpox prevention.”

The vaccines being distributed across African countries are largely provided by the African Union.

The health authorities have assured the public that the capacity to treat the disease is in place. As of now, the four individuals who had contracted Mpox in Rwanda have all been treated and discharged.

In the region, the Mpox outbreak has severely affected the Democratic Republic of Congo, where over 22,000 cases have been reported, with more than 715 fatalities this year alone. The Mpox virus has spread to 22 of the 26 provinces in the DRC, as well as 13 other African countries.

Globally, the World Health Organization (WHO) has committed $600 million to a six-month campaign aimed at combating the epidemic in affected regions.

FWGA also works in collaboration with core, implementing, and institutional partners such as the Global Alliance for Improved Nutrition (GAIN), DSM-Firmenich, Boston Consulting Group, Vanguard Economics in Rwanda and others. This latest effort advances the Alliance’s long-term vision of catalyzing a significant shift in consumption patterns of FWGs to tackle global malnutrition and promotion of more sustainable food systems for people.

{{Measurable Impact, Lasting Change}}

With active initiatives underway in Kenya, Rwanda, and Burundi, focusing on fortified whole-grain maize, expansion plans included at least three West African nations (Ghana, Nigeria, and Benin) concentrating on parboiled unpolished rice and North Africa (Egypt), where efforts would focus on whole wheat flour.

The FWGA also set a target of at least 50% of grain foods in institutional markets and 25% in consumer markets within low and middle income countries (LMICs) to access fortified whole grain by 2032.

{{Fortified Whole Grains: A sustainable solution}}

Shifting from refined grains to FWGs offers a multitude of benefits. They can significantly improve dietary quality without increasing production costs. Fortified whole grains offer six to seven times more nutritional value than their refined counterparts, providing higher protein, fiber, and essential micronutrients.

In addition, this transition supports environmental sustainability by reducing greenhouse gas emissions as FWGs require less water, land, fertilizers, and pesticides.

{{Quotes from Key Speakers}}

{{Hon. Jean Claude Musabyimana, Ministry of Local Government for the Government of Rwanda: }}
“Together, we are more than just a coalition; we are a beacon of hope, a testament to what we can achieve when governments, the private sector, nonprofits, and communities come together with a shared vision. By working together, we can create a future where fortified whole grains are a staple in every household, ensuring the health and well-being of future generations.”

{{Roy Steiner, Senior Vice President for Food, The Rockefeller Foundation: }}
“The Fortified Whole Grain Alliance is a testament to the power of collaboration and innovation. By investing in fortified whole grains, we are investing in the health and well-being of future generations – especially people living in vulnerable communities. This initiative aligns with The Rockefeller Foundation’s commitment to building a more equitable and sustainable world where everyone, no matter their circumstances, can thrive.”

{{Lawrence Haddad, Executive Director, GAIN:}}
“GAIN is excited to be a part of the Fortified Whole Grain Alliance. This initiative has the potential to significantly impact global nutrition, especially if we focus on public procurement. By increasing the availability of fortified whole grains, we can improve the health of millions of people while benefiting the environment.”

{{Join the Movement for a Healthier Future}}

The launch of the FWGA signifies a pivotal moment in the global fight against malnutrition and the promotion of sustainable food systems. Learn more about the Alliance, its mission, and how you can be a part of this transformative movement by visiting the FWGA website: [FWGA – Fortified Whole Grain Alliance->https://fwg-alliance.org/]

{{About the Fortified Whole Grain Alliance (FWGA)}}

The Fortified Whole Grain Alliance (FWGA) is a coalition of stakeholders that span across the food system, including nonprofit and private sector members and is committed to increasing the global consumption of fortified whole grains (FWG).

It is committed to delivering its stated mission, purpose and vision by bringing together the collective expertise, resources, operations, funding, visibility, and convening power of its members.
Together, we can cultivate a future where healthy diets and a thriving planet go hand in hand.

For more information, please follow [#FWGA->https://www.linkedin.com/feed/hashtag/fwga?trk=public_post_embed-text], [#LifeinFull->https://www.linkedin.com/feed/hashtag/lifeinfull?trk=public_post_embed-text], [#SustainableFoodSystems->https://www.linkedin.com/feed/hashtag/sustainablefoodsystems?trk=public_post_embed-text] and visit:
[https://lnkd.in/dPCDVNzt ->https://lnkd.in/dPCDVNzt]
[Rikke Iben Neess->https://lnkd.in/dPCDVNzt]
[www.fwg-alliance.org->http://www.fwg-alliance.org/]

Dr. Nsanzimana emphasized that, just as other epidemics have been successfully controlled in the past, it is possible to stop Mpox through coordinated efforts.

He highlighted the significant measures being implemented to prevent the spread of the disease, noting that individuals who have been treated for Mpox have already recovered.

“We are confident that Mpox will soon be completely eradicated in Rwanda, with no new cases being reported. The necessary capacity is in place, and all sectors are contributing to these efforts. We urge everyone to seek medical attention immediately if they exhibit symptoms and to inform others they have been in contact with so that health authorities can respond swiftly,” Dr. Nsanzimana stated.

To further prevent the spread of Mpox, the Minister advised those who are infected to avoid crowded places and to take their medication at home until they have fully recovered.

He also noted that Rwanda has implemented several strategies, including working closely with community health workers who visit households to check for symptoms of Mpox. While some symptoms may resemble those of other illnesses, a medical examination is essential for a definitive diagnosis.

Symptoms of Mpox typically appear between three and 14 days after exposure and start with a rash that primarily affects the face, hands, and genital areas, though it can spread to other parts of the body.

The rash evolves into fluid-filled blisters that eventually dry up and scab over as the person recovers. These symptoms are often accompanied by fever, which can vary in intensity, and fatigue. Once symptoms manifest, treatment usually leads to recovery within two to three weeks. So far, no one in Rwanda has experienced prolonged hospitalization or death due to Mpox.

Mpox manifests in various forms, with Rwanda currently dealing with Grade 1B, similar to the strain found in the Democratic Republic of Congo. In contrast, West Africa is experiencing a more severe Grade 2 variant. The strain in Rwanda is closely related to the one identified in Congo.

Dr. Nsanzimana also pointed out that in Rwanda, Mpox has predominantly affected individuals involved in sex work or those with frequent sexual activity, as the disease spreads primarily through close physical contact.

This transmission method differs significantly from that of COVID-19, which primarily spreads through respiratory droplets.

Statistics indicate that individuals aged 25 to 40 are most susceptible to contracting the disease, likely due to their higher levels of sexual activity. The Ministry strongly urges people to avoid sexual contact, even when using protection, as a preventive measure against Mpox.

Amy Pope, director general of the International Organization for Migration (IOM), said the funds will also be used to provide healthcare services to internally displaced persons (IDPs) and host communities in the region.

“We must act swiftly to protect those at the highest risk and to mitigate the impact of this outbreak on the region,” Pope said in a statement issued in Nairobi, the capital of Kenya.

She said the spread of mpox disease, which has emerged as a public health emergency of international concern amid a surge in cross-border transmissions, is a critical concern, especially for vulnerable migrants, highly mobile populations, and displaced communities often overlooked in such crises.

The IOM said the required funds will be used to enhance the capacity to respond to the needs of migrants, IDPs, and host communities by supporting infection, prevention, and control measures, particularly at borders.

The UN agency said the funding will be used to build the capacity of national healthcare workers and front-line responders and enable the identification of high-risk areas to ensure effective monitoring of the disease and reduce its spread across borders.

Mpox is an infectious disease caused by the monkeypox virus that is spread through close contact, including fever, swelling of the lymph nodes, sore throat, muscle aches, skin rash, and back pain.

The rapid spread of the new strain of the disease led the World Health Organization (WHO) to declare mpox a public health emergency of international concern on Aug. 14.

According to the WHO, there are over 15,000 suspected cases in the Democratic Republic of the Congo alone, including 537 deaths. Other cases have been confirmed in Burundi, Kenya, Rwanda, South Africa, and Uganda.

The IOM said it is concerned about migrants, IDPs, and highly mobile populations in the region, who tend to be at far greater risk of infection due to their living conditions and mobile and transitory lifestyles, which can greatly limit their access to health and medical care.

The government’s decision to implement this change aims to reduce the high costs previously incurred by sending patients abroad for treatment. Instead, the focus has shifted to establishing these medical services locally.

This initiative has been achieved by bringing in experts from abroad to treat patients in Rwanda and to train Rwandan doctors, enabling them to perform these procedures independently in the future.

Figures from the Ministry of Health show that in 2018, the government provided financial support amounting to $402,900 for those seeking kidney transplants abroad.

In 2019, the amount was $278,900. The expenditure increased to $681,900 in 2020, $1,363,800 in 2021, and $2,727,800 in 2022. However, there has been no financial support allocated for such treatments abroad in 2023 and 2024.

Dr. Menelas Nkeshimana, the Head of the Department of Health Workforce Development at the Ministry of Health, told IGIHE that in addition to kidney diseases, Rwanda now offers treatment for cancer and heart diseases, reducing the need for patients to seek these treatments abroad.

“There are treatments and surgeries for heart conditions in both children and adults performed in Rwanda, aswell as cancer treatments. Currently, liver diseases, gastrointestinal diseases, hormonal diseases, prenatal conditions, and women’s health issues are also treated in Rwanda,” he said.

Dr. Nkeshimana emphasized that these diseases are treated in Rwanda by both local and international specialists, who also train students for three to four years. The goal is that in the near future, Rwandan doctors will handle these treatments independently.

“There are also 15 new courses starting in September, including training for respiratory and critical care,” he added.

Dr. Nkeshimana affirmed that the country’s strategy is to eliminate the need for Rwandans to seek treatment abroad by building local capacity, which has significantly reduced the number of patients traveling abroad for medical care.