Location of operation: WESTERN AFRICA
Amount of Decision: EUR 1,250,000
Decision reference number: ECHO/-WF/BUD/2006/01000
1 - Rationale, needs and target population.
1.1. - Rationale:
Communicable diseases are highly endemic in West Africa. The vaccine coverage of the population is generally low and the risk of transmission of infections is thus enhanced. Poverty, lack of basic sanitation facilities, low hygienic standards and malnutrition in postemergency or structurally weak countries increase the vulnerability to communicable diseases. However, most West African Ministries of Health still focus on "regular" diseases and do not target systematic prevention or containment of declared epidemics. Epidemics are more frequent in West Africa than elsewhere, with 20% of the world epidemic alerts for 2% of the world population. On the basis of this regular and cumulative risk in West Africa, DG Humanitarian Aid can reasonably forecast a minimal volume of needs and responses.
To reduce morbidity and mortality rates related to outbreaks, early and effective actions are required. Indeed, small initial outbreaks are frequently manageable locally, whereas major epidemics arise when they are not addressed in time. Smaller epidemics shall be equally addressed on a case by case basis to prevent their escalation to large scale epidemics, which are undeniably more difficult to manage and therefore affecting to a greater extent thepopulation. Financial contributions are usually hard to gather quickly in the early stages of an epidemic, with the result that outbreaks may develop into major disasters.
Throughout the world, DG Humanitarian Aid has been supporting emergency operations to address outbreaks of communicable diseases. Commonly, a start date of the crisis could hardly be determined, although it triggers an emergency procedure leading eventually to a Primary Emergency Decision. DG Humanitarian Aid was spending more than EUR 1 million reacting to epidemics in West Africa each year. It was therefore decided in 2004 to adopt a first ad hoc decision dedicated to combating epidemics in the region.
In 2004, DG Humanitarian Aid implemented a first "epidemics" decision, (ECHO/- WF/BUD/2004/02000) for EUR 1 million. Meningitis responses were supported in Burkina Faso and Chad, while Cholera interventions were financed in several West African capital cities - N'Djamena, Conakry and Freetown. Other funding for epidemic mitigation included responses to Yellow Fever in Burkina Faso, to Hepatitis E in Chad and to a Measles epidemic in Niger. Additional funding was granted to WHO/GOARN for rapid assessment of epidemics in West Africa.
In 2005, a second EUR 1,5 million decision (ECHO/-WF/BUD/2005/02000) was taken and allowed a rapid response to Cholera outbreaks in Monrovia, Conakry, Bissau and Sao Tome. Support was also provided to WHO's mass vaccination campaign against Yellow Fever in Côte d'Ivoire. Cholera outbreaks in Mali, Senegal, the Gambia, Mauritania, Burkina Faso, Côte d'Ivoire, Togo, Benin and Niger were closely monitored. Yellow Fever and Cholera trends were followed in the whole sector but no intervention was specifically funded.
The decision to assist the fight against epidemics in West Africa permitted over the last two years a rapid and flexible response by partners to deal with epidemics and the risks of other communicable disease and emerging pathogens. To increase its flexibility, the 2006 decision pertaining to epidemics will cover 18 months. It will ensure that operations aimed at containing and controlling confirmed epidemics are implemented swiftly during one rainy season and two dry seasons, as it starts from the 15th of February 2006. It amounts to EUR 1,25 million.