Dr Ado Bwaka, WHO-IST, Ouagadougou
Ado Bwaka is the EPI/Polio Team Leader at the Inter-Country Support Team (IST) West Africa, WHO, based in Ouagadougou, Burkina Faso.
Prior to joining this position, Ado Bwaka was the Polio Consultant in charge of the Democratic Republic of Congo (DRC) for McKing Consulting Corporation, a Bill and Melinda Gates (BMGF) funded US Consulting firm in charge of coordination and administration consultancy support in polio affected
He supported the Ministry of Health and GPEI partners in providing oversight of the implementation of emergency plans to stop polio.
Dr Bwaka previously worked as the State Coordinator in Nigeria with WHO for ten years. He provided technical assistance and leadership in polio eradication, surveillance and improving routine immunization and maternal and child health. He supported the implementation of the Integrated Disease Surveillance and Response (IDSR) and contributed to the control of meningitis and other vaccine preventable diseases outbreaks that occurred during his assignment in the northern Nigeria.
Dr Bwaka also held the position of Africa Regional Coordinator with the Emmaus Suisse, an NGO supporting tuberculosis and leprosy Programmes in Cameroon and Central Africa Republic.
He was assigned as a CDC Consultant with the STOP Programme in Niger Republic in 2004. The same year, he worked as Health and Nutrition Coordinator with COOPI/UNHCR in Sudanese refugees’ camp in Eastern Chad.
In his earlier days, Ado served in various positions in the DRC Ministry of Public Health from a district medical officer to a provincial coordinator and surveillance focal point.
He volunteered himself to clinically managed patients who were quarantined at the early stage of the Ebola Virus Disease outbreak in Kikwit, DRC in 1995.
Dr Ado Bwaka received his medical degree from the University of Kinshasa, DRC and a master’s degree in public health from the Catholic University of Louvain, Brussels, Belgium.
Meningococcal meningitis epidemics remain a dramatic public health problem in Africa. Before 2010, these epidemics were predominantly due to Neisseria meningitidis serogroup A (NmA). Since the first introduction of MenAfriVac conjugate vaccine in 2010, around 300 million people aged 1 – 29 years have been vaccinated through campaigns in 21 of the 26 countries of the African meningitis belt. Seven of these countries have already introduced MenAfriVac into their routine immunization programmes: Ghana and Sudan in 2016; Mali, Burkina Faso, Central African Republic, Chad and Niger in 2017. Other countries are planning to do so in 2018-2019, together with mass vaccination campaigns where relevant.
Since then, the incidence of NmA meningitis has declined by 99%. While an overall 58% reduction in incidence of meningitis and 60% decrease in risk of epidemics have been observed, other types of meningitis (NmC, , NmW, NmX and S. pneumoniae) are still being observed. During the 2017 epidemic season, 24 546 suspected cases of meningitis of which 1 612 deaths (CFR: 6.6%) were recorded as of week 26. A total of 125 districts reached the alert threshold and an additional 52 districts reached the epidemic threshold. The predominant germs were NmC (36.5%), S. pneumoniae (27.6%), NmX (13.5%) and NmW (9.9%); while 2 NmA cases were confirmed one each in Nigeria and Guinea. NmC meningitis outbreaks were reported in Nigeria (14 542 suspected cases; 1 166 deaths), Niger (3 317 suspected cases, 198 deaths), Cameroon (Yaoundé central prison: 16 suspected cases, 8 deaths) and Liberia (meningococcemia, 31 suspected cases, 13 deaths). An NmW outbreak was reported in Togo (517 suspected cases, 35 deaths), and a mixed NmW & S.pneumoniae outbreak in Ghana (827 suspected cases, 78 deaths). In addition NmX was reported in atypical high proportions in Chad and Niger (43% and 18% of all positive CSF samples, respectively).
In response to these epidemics, meningitis surveillance was strengthened and the WHO protocol for case management was implemented. Additionally, with the support of the International Coordinating Group on vaccine provision, reactive vaccination campaigns using multivalent polysaccharides vaccines (ACWY, ACW and AC) were carried out in Nigeria, Niger, Cameroon and Togo. Conjugate C vaccines were administered only in Nigeria.
The control of meningitis outbreak is faced with challenges of insufficient funding to implement epidemic preparedness and response plans, low laboratory capacity for outbreak confirmation, lack of national contingency stockpiles of vaccines, scarcity of the global vaccine supply, and unaffordability of multivalent conjugate vaccines.