Tuesday, May 16, 2017

Candidate to Lead the W.H.O. Accused of Covering Up Epidemics - The New York Times







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Tedros Adhanom Ghebreyesus in 2016. He has been accused of covering up cholera outbreaks by an associate of a rival for World Health Organization director general.CreditFabrice Coffrini/Agence France-Presse — Getty Images


A leading candidate to head the World Health Organization was accused this week of covering up three cholera epidemics in his home country, Ethiopia, when he was health minister — a charge that could seriously undermine his campaign to run the agency.
The accusation against Tedros Adhanom Ghebreyesus was made by a prominent global health expert who is also an informal adviser to Dr. David Nabarro, a rival candidate in the race for W.H.O. director general.
Dr. Tedros, who uses his first name in his campaign, denied the cover-up accusation and said he was “not surprised at all but quite disappointed” that Dr. Nabarro’s camp — which he said included high-ranking British health officials — had switched to running what he called a “last-minute smear campaign.”
The vote for the next director general of the W.H.O. is to take place at a weeklong meeting of the world’s health ministers in Geneva beginning May 22.
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Dr. Nabarro, reached by telephone on Saturday in China, said he knew of the accusations — especially because world health officials believe Ethiopia is suffering a cholera outbreak even now, while still denying it — but he insisted that he had not authorized their release.
“I absolutely did not know,” he said.
His adviser, Lawrence O. Gostin, the director of the O’Neill Institute for National and Global Health Law at Georgetown University, called attention to Ethiopia’s long history of denying cholera outbreaks even as aid agencies scramble to contain them. Some of those outbreaks occurred on Dr. Tedros’s watch.
Mr. Gostin said he acted without consulting Dr. Nabarro, and did so because he believed the W.H.O. “might lose its legitimacy” if it is run by a representative of a country that itself covers up epidemics.
“Dr. Tedros is a compassionate and highly competent public health official,” he said. “But he had a duty to speak truth to power and to honestly identify and report verified cholera outbreaks over an extended period.”
In an interview, Dr. Tedros, who was Ethiopia’s health minister from 2005 to 2012 and remains highly regarded for his accomplishments then, denied covering up cholera.
Outbreaks occurring in 2006, 2009 and 2011, he said, were only “acute watery diarrhea” in remote areas where laboratory testing “is difficult.” That is what the Ethiopian government said then and is saying now about an outbreak that began in January.
W.H.O. officials have complained privately that Ethiopian officials are not telling the truth about these outbreaks. Testing for Vibrio cholerae bacteria, which cause cholera, is simple and takes less than two days.
During earlier outbreaks, various news organizations, including The Guardian and The Washington Post, reported that unnamed Ethiopian officials were pressuring aid agencies to avoid using the word “cholera” and not to report the number of people affected.
But cholera bacteria were found in stool samples tested by outside experts. As soon as severe diarrhea began appearing in neighboring countries, the cause was identified as cholera.
United Nations officials said more aid could have been delivered to Ethiopia had the truth been told.
Somalia, which borders Ethiopiais currently battling a large cholera outbreak, and a new vaccine is being deployed there. Aid officials believe cholera is also circulating in the neighboring regions of Ethiopia, but without confirmation, they cannot release the vaccine. Ethiopia’s health ministry is still calling it “acute watery diarrhea,” and told VOA News last month that it would not change that report without laboratory confirmation, which it said it did not have.
Under the International Health Regulations, which apply to all W.H.O. members, countries must accurately report disease outbreaks. But the W.H.O. can officially report only what countries say. Historically, some countries have tried to cover up or play down outbreaks of human or animal diseases for fear that travel restrictions would be imposed, tourism would suffer or food exports would be curtailed — or simply as a matter of national pride.


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A woman with her baby, who was severely malnourished and had diarrhea, in 2011 in Ethiopia. Ethiopia suffered extensive outbreaks of diarrheal disease in 2006, 2009 and 2011.CreditLuc van Kemenade/Associated Press


The regulations were strengthened after China denied for months in 2003 that it had a serious outbreak of lethal respiratory disease in its southern cities. That outbreak ultimately became known as SARS, for severe acute respiratory syndrome, and spread to several other countries, including Canada.
Dr. Margaret Chan, the current W.H.O. director general, is from China, but was never accused of participating in China’s cover-up. She was the director of health in Hong Kong at the time and led effective responses to both avian flu and SARS.
China has since changed its policy and now is often praised for acknowledging outbreaks promptly, fighting them aggressively and cooperating with other health agencies.

Monday, May 8, 2017

EU rejects Ethiopian Red pepper for unsafe levels of toxins - Capital Ethiopia Newspaper







(L) Addisu Alemayehu and Million Bogale
Hot pepper powder worth ten million USD has been returned to Ethiopia from European markets when it was found to have unsafe levels of Aflatoxins and Ochratoxins during testing at entrance laboratories in European countries.
Ethiopian hot pepper was banned in the UK last fiscal year until it could successfully pass quality control tests and the Ethiopian Embassy in London began working jointly with hot pepper importers to improve the product. Germany also blocked a large amount of hot pepper from entering their borders.
Stakeholders told Capital that since 2016 a huge amount of exported hot pepper was returned from Europe to Ethiopia. Europe is a major destination for Ethiopian spice and hot pepper is the spice that Ethiopia exports the most.
Since the problem came to the attention of exporters the Ethiopian Spice, Aromatic and Herbs Growers and Processors Association (ESAHGPA) has been scrambling to tackle the problem in collaboration with the Ministry of Foreign Affairs (MoFA) and its diplomatic missions in Europe.
The pepper problem was one of two topics discussed during a meeting two weeks ago at MoFA with members of the association and relevant bodies. The sector has generated about USD 9 million per year but has been severely affected, according to Addisu Alemayehu, researcher on the spice sector and secretary general of ESAHGPA.
According to Addisu, in the last five years an increasing amount of Ethiopian pepper have had unsafe amounts of Aflatoxins and Ochratoxin A.  The standard set by the region is 5 parts per billion for Alfatoxins and 15 parts per billion for Ochratoxin A.  Some of the Ethiopian hot pepper had as much as 78 parts per billion of both toxins.
“Currently we are using the private laboratory firm called Bless Agri Foods Laboratory Services PLC  and the state owned Ethiopian Conformity Assessment Enterprise to measure the level of Aflatoxins and Ochratoxin A before export,” Addisu said.
“In a 2014 EU statement Ethiopia was not included on a list of banned products but the incidents soon raised red flags,” an expert said.
On December 21, 2016 the EU issued a statement imposing special conditions governing the import of spices from Ethiopia. The regulation stated that since 2015, there have been several notifications in the Rapid Alert System for Food and Feed (RASFF) reporting high levels of Aflatoxins and Ochratoxin A in (mixtures of) spices from Ethiopia. “In order to protect human and animal health in the Union, it is necessary to provide for additional guarantees in relation to spices from Ethiopia,” it explained.
Million Bogale, General Manager of Balegreen Spice and Grain Development PLC and board Chairman of ESAHGPA told Capital that the contamination does not appear to be a result of the production process, rather the contamination is occurring when the spice is dried and delivered to market. Farmers and traders are putting water on the pepper to increase the weight. This causes Aflatoxins and Ochratoxin A to form, he said.
His association is working to change the way pepper is handled from harvest to the market. Stakeholders are traveling to rural areas to negotiate with small farmers in an attempt to convince them to harvest the product by themselves. He said that the current solution is contract with the farmers to collect the product as it is on the land. “Awareness creation is crucial to alleviate this problem toxins are very dangerous to people’s health,” Addisu said. “It is not only for the international consumer but for the health of our citizens,” he added.
Pepper exporters have been dramatically affected.
Esla Habte, General Manager of Fasika Spice PLC told Capital that the Aflatoxins and Ochratoxin are a daunting challenge.
Her company, formed 25 years ago, is one of the biggest spice exporters to Europe. The company has a capacity of exporting USD 300,000 worth of hot pepper per annum.
Since last fiscal year they have lost a lot of money because of this issue.
“This budget year we identified the problem and agreed with farmers to buy the product at their farms to alleviate the toxins,” Elsa said.
To get the product before harvest she paid three times more than the market price, according to Elsa.
“Recently, we were able to export two containers of hot pepper to Europe, mostly the UK and the quality was up to European standards,” she said.
She said that even though the product is mainly used by Ethiopian descendents it has become popular in other communities and is sold in some supermarkets like Indian shops.
Million said that the association will table a new procedure for the hot pepper process to the government. This could include improving production and creating market linkages.
Ethiopia harvests the 8th most red pepper in the world. Although it is still the country’s leading vegetable product and a major spice in Ethiopian cuisine which gives the nation’s food a unique flavor, production has gone down recently as farmers have preferred to sell peppers when they are green.