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Victims of false teeth. Photo: thenormaproject.org

The World Health Organization (WHO) on Friday announced the inclusion of noma disease in its official list of neglected tropical diseases (NTDs).

The decision was recommended by the 17th meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases. The decision has been welcomed because it is likely to expand health services to the world's most vulnerable populations. 

Noma or cancrum oris affects the face, eating the soft tissues and often destroying the bones completely. Sometimes it destroys the nose or even the eyes. This complication has been mainly common in West Africa. No wonder the Nigerian government and some activists from Nigeria and Côte d'Ivoire among others have been campaigning to have it listed among the World’s Neglected Diseases.

Studies in countries where it is prevalent, indicate that it affects mainly children under the age of seven. Malnutrition, a lack of vaccinations, poor oral hygiene, and poverty have been listed among the many contributing factors to noma. 

WHO director-general, Dr. Tedros Adhanom Ghebreyesus said noma is more than a disease, it is a social marker of extreme poverty and malnutrition, affecting the most vulnerable populations.

By classifying noma as a neglected tropical disease, we are shining a light on a condition that has afflicted marginalized communities for centuries. We are committed to working with affected countries and communities to address the drivers of noma, and alleviate the suffering it causes,” said Ghebreyesus.

According to WHO, noma is a severe gangrenous disease of the mouth and face, that primarily affects malnourished young children (aged between 2 and 6 years) in regions of extreme poverty. It starts as an inflammation of the gums, which, if not treated early, spreads quickly to destroy facial tissues and bones.

It frequently leads to death, with survivors suffering severe disfigurement. Accurate estimation of the number of noma cases is challenging due to the rapid progression of the disease and the associated stigma, which contributes to leaving many cases undiagnosed. Cases of noma are mostly found in sub-Saharan Africa, although cases have also been reported in the Americas and Asia. In Uganda, studies have linked this complication to false teeth (ebiino/ebinyo) extraction. 

A study published in 2017 in the Journals of Case Reports said: "False teeth” (ebiino/ebinyo) refers to gingival swelling that occurs during the eruption of the primary canine teeth in infants and consists of the extraction of deciduous canine tooth buds. This practice, which is part of infant oral mutilation, is relatively common in African countries with an incidence that varies from place to place, ranging between 15 per cent and 80 per cent, especially in Angola, Tanzania, Somalia, Kenya, Sudan, Nigeria, and Uganda. 

The study further states that the practice arises from the belief that these “killer” canines cause fever, diarrhea, and any other infant illness, thus necessitating their removal, usually by traditional herbalists using unclean instruments and fingernails. 

In Bushenyi district in western Uganda, a study showed that more than one in two of the households had a child younger than 5 years old who had had false teeth in the last 5 years as of 2007, with more than 80 per cent of the respondents using traditional medicine alone or in combination with modern medicine to treat “false teeth disease.

The National Oral Health Policy developed by the ministry of Health does not however mention noma. Evidence from WHO indicates that noma is caused by bacteria found in the mouth. There are multiple risk factors associated with this disease, including poor oral hygiene, malnutrition, weakened immune systems, infections, and extreme poverty. 

Noma isn't contagious but tends to strike when the body's defenses are down. Early detection is essential, as therapy is most effective at the early stages of disease when it causes severe swollen gums, known as acute necrotizing gingivitis. Treatment involves antibiotics, advice and support on practices to improve oral hygiene with disinfectant mouthwash (salt water or chlorhexidine could be used) and nutritional supplements. 

If diagnosed during the early stages of the disease, treatment can lead to proper wound healing without long-term consequences. In severe cases though, surgery may be necessary. Children who survive the gangrenous stage of the disease are likely to suffer severe facial disfigurement, have difficulty eating and speaking, face social stigma and isolation, and need reconstructive surgery.  

The recognition of noma as an NTD aims to amplify global awareness, catalyse research, stimulate funding, and boost efforts to control the disease through multisectoral and multi-pronged approaches. Interventions addressing the burden of this devastating disease will contribute to achieving universal health coverage, as they will specifically target pockets of underserved populations.

Noma is often managed by oral health programmes in endemic areas and collaboration with NTD programmes at the operational level can be strengthened, notably by integrating noma within the activities aimed at detecting and managing skin-related neglected tropical diseases (skin NTDs).

The Government of Nigeria spearheaded action to have noma included in the list of NTDs. In January 2023, an official request was submitted to WHO on behalf of 32 member states. The request was supported by a detailed dossier highlighting the burden and distribution of noma and providing evidence to demonstrate fulfillment of the criteria set by WHO.

Several partner institutions contributed by sharing information and conducting advocacy. With noma now on the list, the total number of NTDs listed by WHO are twenty-one.  By URN/The Observer

Foreign Affairs CS Musalia Mudavadi. [File, Standard]

Kenya has distanced itself from claims of involvement in the internal affairs of Democratic Republic of Congo. This comes hours after DRC recalled its ambassadors from Kenya and Tanzania for consultations after a new Congolese military alliance that includes rebels was launched in the Kenyan capital.

In a statement on Sunday morning, Foreign Affairs CS Musalia Mudavadi says investigations into the allegations ongoing adding that Kenya is a country where ‘freedom of the press is vouchsafed’. 

“Kenya strongly disassociates itself from any utterances or activities likely to injure the peace and security of the friendly Nation of DRC and has commenced investigation to determine the identities of the makers of the statement and the extent to which their utterances fall outside constitutionally protected speech,” Musalia’s statement reads in part.

“The Ministry wishes to note that Kenya is an open and democratic state where freedom of the press is vouchsafed. As such, nationals and non-nationals may engage the Kenyan media without reference to the government,” 

The envoy to Tanzania was recalled because Tanzania hosts the headquarters of the East African Community, which Congo also belongs to.

Earlier on Saturday, the Kenyan embassy's head of mission had been summoned to the foreign ministry in Kinshasa. The Kenyan government could not immediately be reached for comment.

On Friday, Congolese politicians and groups including the M23 rebels, who have seized territory in eastern Congo, and Corneille Nangaa, a former Congo election commission chief, launched the Congo River Alliance in Nairobi. By Winfrey Owino, The Standard

These are essential steps to achieving sustainable and inclusive growth, bolstering its economy, and improving the well-being for all citizens

The World Bank approved a Development Policy Financing (DPF) operation of $80 million, which supports the Republic of Congo’s reforms to strengthen revenue mobilization and public financial management and improve the conditions for inclusive and sustainable growth. 

The reforms supported by the Development Policy Financing are critical to enhancing the country’s fiscal performance and governance while diversifying the economy.This DPF is the second in a programmatic series of three over the period 2022-2024 financed by the International Bank for Reconstruction and Development (IBRD) and the International Development Association (IDA)* with the aim of putting the economy on the path of recovery in line with the Governments’ National Development Plan 2022-2026.

“The reforms supported by the Development Policy Financing are critical to enhancing the country’s fiscal performance and governance while diversifying the economy,” says Cheick Fantamady Kante, World Bank Country Director for the Republic of Congo. “These are essential steps to achieving sustainable and inclusive growth, bolstering its economy, and improving the well-being for all citizens”.

The operation supports two priorities: The first aims to strengthen fiscal sustainability and governance through modernizing tax and customs administration, strengthening regulation of the oil sector, improving the oversight of public finances, and enhancing the efficiency of the public procurement system. The second focuses on supporting economic diversification and inclusion through improved business environment, social protection for the most vulnerable populations, and improved access to electricity and basic services like health and education.

These efforts will be essential to building the country’s resilience to future shocks while expanding fiscal space for investments in infrastructure and human capital. Improving budget allocation and spending on technical and vocational education can equip trainees with the practical skills needed to compete in the job market, contributing to economic growth and reducing poverty. Operationalizing the national safety net program will also enhance social protection, targeting the most vulnerable segments of society.

Distributed by APO Group on behalf of The World Bank Group.

The barrel-chested Brexiteer is back - but this week has shown he is now an irrelevance. This week marked the fourth anniversary of the catastrophic 2019 “get Brexit done” general election and whatever horrors have befallen us in the intervening years, one thing has proved rather pleasant: The silence of Mark Francois.

During the Brexit wars, the rotund MP for Rayleigh and Wickford could be relied upon to make any bad situation worse, any stupid notion even more idiotic in his role as a spokesperson for the hilariously named European Research Group (hated Europe, done no research). Few will forget – though many will have tried – how this human luncheon meat statue of Penfold from Danger Mouse clomped his way around the TV studios, burbling vaingloriously about Spartans and star chambers while dispensing gormless bons mot like “my father never submitted to bullying by any German and neither will his son” and accusing the anti-Brexit CEO of Airbus of being “a German paratrooper in his youth” (said CEO was born in 1958).

Ironically, the moment this lardy Icarus flew too close to the sun came four years ago, when the Tories won their near-landslide victory. “In 1989, the Berlin Wall came down. In 2019, the red wall came down,” gloated Francois during an election night appearance on the BBC, leaving Andrew Neil to ask “have you slightly gone mad? Are you hallucinating?” Neil knew what little Mark had yet to grasp – the size of Boris Johnson’s majority now rendered the once-influential ERG (and the DUP, and associated headbangers) impotent. There were reports that when that interview with Neil appeared on screens at Conservative HQ, Francois was jeered and heckled, including a cry of “he can say what the f*** he wants now – we don’t need the ERG any more.”

A satisfying period of silence from Francois then ensued. Until this anniversary week, when (with what must be considerable difficulty) he rose again from a well-stuffed leather armchair the same colour as his own face and inserted himself in the Rwanda debacle. Not, as you might have expected, to offer to fly asylum seekers there himself in a reconditioned Spitfire, but to wake up the sleeping ERG Spartans, star chamber and all, and have them take their place as one of the “five families” of the Tory right.

Francois has spent his life living in the past – specifically, the second world war. It must be a sign of progress that he now yearns for the days when he was almost as important as he thinks he is; that dizzy spell between the elections of 2017 and 2019.

But this is not then and Rwanda isn’t Brexit. Britain is no longer a single-issue country. The cost of living, our crumbling services and the doom-soaked economy are what concern voters most, not one small part of a wider migration policy that at best will deal (cruelly) with a couple of hundred asylum seekers. The notion that sudden success in sending a few unfortunates off to Kigali will make voters forget about 14 wasted years of Tory rule when it comes to the general election is risible. And because voters loathe division, even more Conservative psychodrama is likely to result in even more Conservative losses whenever Sunak dares to go to the country.

Even the assorted lemmings of the “five families” (TBF, Boris Johnson’s had more) recognised this, belatedly. So instead of tormenting the PM as some of them did to Theresa May, these ruthless rebels bared their teeth, sharpened their knives and promised to let Rishi Sunak do whatever he wanted, at least until everyone had enjoyed a jolly nice Christmas.  And Mark Francois was put back in his box. Please, this time let him stay there.  By STEVE ANGLESEY, The New European

One of the Kenya Airways Boeing Dreamliners at the Jomo Kenyatta International Airport (JKIA) Nairobi on July 26, 2023.[Elvis Ogina, Standard]

Kenya Airways (KQ) has explained why its flight from Kenya to Dubai turned back on Friday, December 15.  In a statement, KQ said that there was a need for a technical inspection after tyre debris from the plane was found on the Jomo Kenyatta International Airport (JKIA) runway. 

“On 15 December 2023 at approximately 21:20 HRS, JKIA Air Traffic Control encountered tyre debris during a regular runway inspection. Upon further inspection, it was established by the KQ operations team that the tyre debris was from KQ 310, which had departed on a scheduled operation from Nairobi to Dubai,” reads the statement.

KQ says its operations team contacted the Crew and agreed on a precautionary air turnback to Nairobi for further technical attention.  The plane landed at 11:46 pm safely and all its passengers were provided with accommodation as arrangements are being made to rebook them on the next available flight. By Esther Nyambura, The Standard

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