Author: Moses Nyambalo Phiri

  • Mpox Situation in Malawi

    Mpox Situation in Malawi

    MPOX – Malawi Situation.

    National Public Health Emergency Operations Centre (PHEOC), Lilongwe, Malawi – May 17th, 2025.
    by
    Moses Nyambalo Phiri in collaboration with Grace Funsani, Noel Khunga, Chriswell Nkoloma and Settie Kanyanda.

    Malawi has confirmed two new Mpox cases on May 29, 2025, bringing the total number of confirmed cases to 17 since the initial declaration on April 17, 2025. Both new cases are from Lilongwe district: a 21-year-old male from Area 23, Traditional Authority (TA) Tsabango, and a 44-year-old male from Area 25A, TA Chitukula.

    Both individuals presented at Bwaila Hospital on May 28, 2025, with symptoms including fever and skin rash. No underlying conditions were reported for either case. Samples were collected on the same day and tested positive for Mpox in the laboratory. The 21-year-old is a student, while the 44-year-old is a driver. Neither case has a history of international travel

    The Lilongwe district Rapid Response Team (DRRT) has collected samples, and the confirmed cases are currently on home isolation. The DRRT also plans to conduct contact tracing and further investigations to establish the possible source of infection. These new cases add to the 12 previously confirmed infections. As it was of May 27, 2025, six of the earlier confirmed cases had recovered and been discharged. The confirmed cases are predominantly male and range in age from 2 to 41 years. Lilongwe accounts for the majority of cases, with single cases in Mangochi and Ntcheu districts.

    “The first case was recorded in Lilongwe district on April 16, 2025. Later additional cases were registered.  All the cases are males within the age range of 2 to 38 years: a 30-year-old from Phwetekere- Area 36, a 33-year-old from Kawale 2, 38 year-old from Chilinde, a 35 year-old from Area 36, Kandikole, an 18 year-old from Area 36, Tumbwe, Traditional Authority (TA) Tsabango, Lilongwe district, and a two year-old child from Michesi 1 village, TA Mponda, Mangochi district.Three cases from Lilongwe have recovered and have been discharged from clinical care, while the other three are still under clinical care . No death has been reported.”

    Grace Fusani – Mpox Incident Manager, PHIM.

    What response activities have so far been undertaken ?

    Cases
    Malawi Mpox Outbreak

    PHIM has activated its Incident Management System (IMS) for Mpox and is working with various sectors, including animal health, civic education, and disaster management, using One Health Approach

    Mpox Suspect in Lilongwe

    1. Surveillance.

    Rapid Response Teams (RRTs) have been deployed to conduct contact tracing and investigate cases. Surveillance systems have been enhanced at the community level, health facilities, and points of entry (PoEs).

    The district team are being trained on Mpox through a collaborative effort involving Amref Health Africa, the US CDC, and the World Bank, which have provided the necessary resources. Initial training, supported by Amref Health Africa, has been conducted in the Chitipa and Karonga districts. This district level training will be extended to all districts to ensure comprehensive staff preparedness covering critical areas such as Mpox Etiology and Virology, Transmission Pathways, Prevention and Control Measures, and Clinical Management etc.

    Chitipa -Mpox District Training 7/May/2025.

    2. Case Management.

    Case management guidelines have been developed and distributed, and isolation facilities have been identified.

    3. Labolatory.

    Samples from suspected cases are being tested using PCR, and genomic sequencing of the Mpox virus is underway.

    Mpox sample testing in the national laboratory

    Essential medicines and PPEs have been distributed to districts and Messages about Mpox prevention are being disseminated in local languages through various channels, including posters, social media, leaflets, and audio recordings. PHIM is working to address these challenges and will continue to provide updates on the situation.

  • The Public Health Institute of Malawi (PHIM) Attends the International Association of National Public Health Institutes (IANPHI) Annual Meeting.

    The Public Health Institute of Malawi (PHIM) Attends the International Association of National Public Health Institutes (IANPHI) Annual Meeting.

    IANPHI ANNUAL MEETING

    Maputo, Mozambique – April 9-10th, 2025..
    by
    Settie Kanyanda in collaboration with Moses Nyambalo Phiri..

    The IANPHI Annual Meeting was held from April 9 – 10 in Maputo, Mozambique and was hosted by the National Institute of Public Health (NIS) of Mozambique. The Annual Meeting was held under the Theme: “The role of National Public Health Institutes (NPHIs) in promoting healthy, equitable and resilient societies to tackle current and future threats”. The meeting was attended by over 200 attendees from different countries around the world, with fifty countries physically represented at the meeting while others joined the meeting virtually. Malawi was represented by a delegation from the Public Health Institute of Malawi (PHIM) led by Dr. Matthew Kagoli, Director of PHIM, and accompanied by Dr. Dzinkambani Kambalame from Research Division and Setiala Kanyanda, Technical Advisor to PHIM Director. Also joining the team from PHIM were Dr. Guri Rørtveit, the Director General of Norwegian Institute of Public Health (NIPH), Dr Trude Arnesen and Dr. Bjorn Iversen from the NIPH, and Katarina Dihm from GIZ, Malawi Country Office

    Several speakers at the meeting who included the Minister of Health of the Republic of Mozambique, H.E. Dr. Ussene Isse, the president of IANPHI, Prof. Duncan Selbie, the Director General of Africa CDC, Dr. Jean Kaseya, pointed out some global health threats like climate change and increased frequency of diseases as health threats which require multilateral corporations and use of scientific intelligence to address.

    Some of the challenges affecting Africa include an unprecedented health financing crisis and rising disease outbreaks such that there has been a 41% increase in disease outbreaks from 2022 to 2024. Other problems include vulnerability of health systems, less domestic resources, insecurity and humanitarian crisis. The problem of health financing is evident in that only six out of the 55 countries in Africa have a national health financing plan.

    The withdrawal of the USA from WHO has left a gap in financial power and has created a need for other countries or organizations like the European Union to come in and provide support to strengthen the WHO activities. Global economic crisis makes health suffer where women, children, and the elderly suffer most.

    That will therefore have negative consequences for global health. Public health financing is therefore key in addressing global health threats and such finances should be properly prioritized. To be successful, NPHIs should look for traditional funding through public – private health financing and regional financing to strengthen primary health care including community health surveillance. Public Health Institutes (PHIs) are therefore key in addressing these global health challenges and this highlights the need for every country to have its own PHI. Currently, IANPHI has a total of 128 member institutions from 107 countries including Malawi. Seven new members which are Siera Leon, Mali, Venezuela, Kenya, Uganda, Singapore and Northern Ireland were presented with certificates during the meeting.

    Before the establishment of NPHIs, outbreaks were being responded to by ad hoc committees and at the end of the outbreak, the committees were dissolved resulting in loss of institutional memory which is not the case with NPHIs. The NPHIs have proper and well-organized mechanisms for responding to disease outbreaks and other global health threats. The NPHIs are supposed to collaborate with each other so that they can become stronger together to be able to protect and improve the health of the people.

    One of the focus areas that IANPHI is also making efforts on is addressing the impacts of climate change which include flooding, heat, and wildfires. As a way of showing its commitment to dealing with effects of climate, IANPHI signed a Memorandum of Understanding (MoU) with the World Meteorological Office (WMO) in December 2024. Some NPHIs like Austria NPHI has already established a competence center on climate and health which bundles interdisciplinary expertise from research, policy and practice at the interface of mitigation, adaptation, health promotion and health systems.

    The Austria NPHI also developed a national heat action plan using the modular design based on WHO recommendations to assist in its response to extreme high weather conditions. Climate and health problems call for a need to advocate for strengthening capacity of NPHIs to contribute effectively to climate and biodiversity. NPHIs therefore need to collaborate with international and regional organizations in the field of climate change. Mayotte Island in the Indian Ocean suffered the effects of climate change when it experienced a lot of infrastructure damage from Cyclone Chido.

    This damage affected response activities since communication structures for data sharing were also down and this resulted in the use of paper-based data collection which caused delays in timely sharing of data. This therefore requires advocating for investment in resilient infrastructure and community training.

    Dr. Kagoli with the new Secretary General.

    During the meeting, the new IANPHI Secretary General Prof. Neil Squires was unveiled. It is interesting to note that he once worked in Malawi as a District Medical Officer at Dowa District Hospital in the 1990s. In his speech, he quoted a Malawian proverb Mutu umodzi Susenza denga in trying to mention that not one NPHI will be able to carry the IANPHI to greater heights. This means all NPHIs are responsible for the success of IANPHI.

    It was interesting to note that IANPHI presented certificates of recognition of success to one IANPHI member per IANPHI Regional Network for the outstanding research projects they did. This serves as motivation to do more and to do better. The certificates were given to Finish Institute for Health and Welfare in Europe, Mexico NPHI in Latin America, National Institute of Health of Mozambique in Africa and Korea Disease Control and Prevention Agency in Asia.

    During the meeting, a declaration was developed which will be called “Maputo Declaration” which aims at making a call to action to address public health issues. This declaration will be a strong tool in strengthening Public Health and Public Health Institutes.

    A visit to the National Institute of Health of Mozambique, revealed how far the institute has come from. It started as a Medical Research Institute of Mozambique in 1955 and has over the years changed names and its responsibilities until in 2017 when it was re-defined as a Public Health Institute. It currently has offices in all the provinces of Mozambique which are headed by a director.

    These provincial offices also have provincial laboratories where clinical laboratories transport the samples to the provincial laboratories and if need be, the provincial laboratories transport the samples to the Reference Laboratories.  One of the key areas of focus for the INS is research whereby in 2024 alone, a total of 80 publications were made and it currently has 65 research projects underway. This is made possible through its collaborations with both local and international research institutions.

    Dr. Zinkambani Kambalame, Head of National Public Health Research Science -PHIM, giving a presentation.

    In Malawi, the partner for this project is GIZ. During the meeting, Dr. Dzinkambani Kambalame made a presentation on Malawi specific activities. The project is expected to commence in 2025

    Team Europe organized a side meeting for a project it is carrying out to support and strengthen selected10 African National Public Health Institutes which include PHIM. The project areas include networking and collaborating with other PHIs, gender transformative research, development of policy advice for policy change, digital literacy, and Sexual and Reproductive Health Rights (SRHR) surveillance framework.

  • PHIM and Partners Strengthens District Public Health Emergency Response Capacity Through PHEOC Training.

    PHIM and Partners Strengthens District Public Health Emergency Response Capacity Through PHEOC Training.

    DISTRICT PHEOC TRAINING

    Dowa, Malawi – April 7th, 2025.
    by
    Moses Nyambalo Phiri in collaboration with Ella Chamanga, Shaibu Safali, James Jere and Settie Kanyanda.

    With significant efforts to enhance the nation’s preparedness and response framework through rolling out comprehensive Public Health Emergency Operations Centre (PHEOC) training targeted at district level public health officials, the Public Health Instittute of Malawi (PHIM) with funding from the World Bank has rolled out the first district training sessions.

    This crucial initiative stems from the recently rolled out National-PHEOC Training of Trainers (ToT) conducted weeks ago fulfilling the PHIM’s core mandate, to effectively prepare for, prevent, detect, respond to, and mitigate public health emergencies (PHEs) and threats across all levels of the Malawian health system, now focusing on district level. The training program has been designed to strengthen coordination and operational efficiency within the multi-sectoral multi-disciplinary response architecture managed by the PHEOC.

    In an era where public health threats, from infectious disease outbreaks like Cholera, Mpox and Measles arising from potential impacts of climate change, demand robust and rapid responses, the presence of highly skilled Health Care Workers (HCWs) at the district level is paramount. All twenty nine districts often represent the front lines of public health surveillance and initial response. Therefore, according to this critical need, PHIM has launched the first phase of this districts-focused training program, initially encompassing officers from seven key districts: Lilongwe, Dedza, Salima, Karonga, Nkhotakota, Balaka, and Phalombe.

    Group work during training session in Mponela.

    The District-PHEOC serves as the central nervous system for coordinating all activities during a public health emergency within the district. It functions as a hub for information gathering and analysis, resource mobilization and allocation, strategic decision-making, and communication among various responding agencies supporting the district, including government MDAs, NGOs, and international partners.

    By equipping district officers who are often the first responders and key data sources with indepth knowledge of PHEOC protocols, Incident Management Systems (IMS), risk communication strategies, and data reporting mechanisms, PHIM aims to significantly improve interagency synergy and streamline communication channels, clearer roles and responsibilities, and ultimately, a more timely, coherent, and effective response to diverse public health threats, ranging from disease outbreaks to natural disasters with health consequences.
    Dr. Mike Chisema, EPI Manager.
    Dr. Chitsa Banda, Deputy Director Rensiponsible for Research Division.

    dr. Mike chisema and dr. chitsa Banda lecturing.

    Participants in the training include District Environmental Health Officers, Health Surveillance Assistants (HSAs), DODMA officers, clinicians, and other key personnel involved in public health surveillance and response. The curriculum covers essential modules on the PHEOC structure and functions, roles within an Incident Management System, emergency coordination principles, information management, and effective communication during crises.

    Dr. Annie Chauma Mwale-PHIM, led the team of facilitators.

    This training represents a vital investment in our human resources available at the district, stated Dr. Annie Chauma Mwale – PHIM. She said “Empowering our district teams with standardized PHEOC operational skills is fundamental to building a truly resilient national public health system. When the districts are strong and coordinated, the entire national response mechanism functions more effectively, safeguarding the health and well-being of the nation.”

    PHIM plans to extend this vital training to cover all districts in subsequent phases, ensuring nationwide competency in PHEOC operations. This first phase of District – PHEOC training portrays PHIM’s unwavering commitment to proactively strengthening Malawi’s health security architecture. The skills and knowledge imparted during these sessions are expected to be instrumental in ensuring a more coordinated, rapid, and impactful response to any future public health challenges the nation may face.