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The World Health Organization (WHO) African Region is struggling with increasing harm associated with alcohol consumption. Legislators of Sao Tome and Principe, concerned about this harm and the high prevalence of alcohol use disorders, designed a comprehensive alcohol control bill to tackle this situation. Input into the design of the bill was obtained through interviews involving many stakeholders. The process had five phases: (i) scoping the problem to understand the social burden of the harm caused by alcohol consumption; (ii) updating the evidence on alcohol policies and identifying areas for legislative interventions; (iii) drafting the bill; (iv) aligning the legislative framework of the bill; and (v) initiating the parliamentary procedure. The new bill scored 92/100 using a standardized alcohol control policy scale. The bill covers all domains of WHO's 2010 global strategy to reduce the harmful use of alcohol, and includes the three most cost-effective interventions for reducing alcohol consumption: increased excise taxes on alcohol; bans or comprehensive restrictions on exposure to alcohol advertising; and restrictions on the availability of retailed alcohol through reduced hours of sale. The National Assembly plenary session upheld the bill, which is now under evaluation of the specialized First Commission on Political, Legal, Constitutional and Ethical Affairs. Approval of the bill requires the final voting once it is back with the National Assembly and its promulgation by the President. Drafting an alcohol control bill which is country-led, inclusive, evidence-based and free of interference by the alcohol industry helps prioritize public health objectives over other interests. La Region africaine de l'Organisation mondiale de la Sante (OMS) fait face a une hausse des degats causes par l'alcool. Preoccupes par la situation et par la forte prevalence des troubles lies a cette consommation, les legislateurs de Sao Tome-et-Principe ont elabore un projet de loi detaille afin d'y remedier. A l'origine de sa conception, plusieurs entretiens avec differentes parties prenantes. Le processus s'est divise en cinq phases: (i) definir l'etendue du probleme pour evaluer le fardeau que les degats provoques par l'alcool font peser sur la societe; (ii) actualiser les donnees probantes relatives aux politiques en matiere d'alcool et identifier les domaines necessitant une intervention legislative; (iii) rediger le projet de loi; (iv) aligner le cadre legislatif du projet de loi; et enfin, (v) initier la procedure parlementaire. Le nouveau projet de loi a obtenu un score de 92/100 sur une echelle d'evaluation standard des mesures de lutte contre l'alcool. Il couvre tous les themes repris dans la Strategie mondiale de l'OMS visant a reduire l'usage nocif de l'alcool, publiee en 2010. Il prevoit egalement les trois interventions les plus rentables en termes de diminution de la consommation d'alcool: l'augmentation des taxes d'accise sur l'alcool; l'interdiction ou l'instauration de conditions strictes en matiere d'exposition a la publicite pour l'alcool; et une disponibilite restreinte des boissons alcoolisees dans le commerce en limitant les heures de vente. LAssemblee nationale a soutenu le projet de loi en seance pleniere. Il est desormais en cours d'evaluation au sein de la premiere Commission specialisee en affaires politiques, juridiques, constitutionnelles et ethiques. Pour etre adopte, le projet de loi doit revenir a l'Assemblee nationale pour un vote final, puis etre promulgue par le president. Une loi globale de lutte contre l'alcool, elaboree par le pays lui-meme, fondee sur des faits et n'ayant subi aucune ingerence de la part de l'industrie de l'alcool contribue a faire passer les objectifs de sante publique avant d'autres interets. La Region de Africa de la Organizacion Mundial de la Salud (OMS) esta tratando de hacer frente a los crecientes danos derivados del consumo de alcohol. Los legisladores de Santo Tome y Principe, preocupados por estos danos y por la alta prevalencia de los trastornos por consumo de alcohol, disenaron un proyecto de ley integral para el control del alcohol con el fin de solucionar esta situacion. Las contribuciones al diseno del proyecto de ley se obtuvieron a traves de entrevistas en las que participaron muchas partes interesadas. El proceso consto de cinco fases: (i) la delimitacion del problema para comprender la carga social de los danos causados por el consumo de alcohol; (ii) la actualizacion de los datos sobre las politicas de alcohol y la identificacion de las areas de intervencion legislativa; (iii) la redaccion del proyecto de ley; (iv) la adaptacion del marco legislativo del proyecto de ley; y (v) el inicio del procedimiento parlamentario. El nuevo proyecto de ley obtuvo una puntuacion de 92/100 segun una escala estandarizada de politicas para el control del alcohol. El proyecto de ley abarca todos los ambitos de la estrategia mundial que la OMS puso en marcha en 2010 para reducir el uso nocivo del alcohol, e incluye las tres intervenciones mas rentables para reducir el consumo de alcohol: el aumento de los impuestos especiales sobre el alcohol; la prohibicion o la restriccion general de la exposicion a la publicidad del alcohol; y la restriccion de la disponibilidad del alcohol al por menor mediante la reduccion del horario de venta. La sesion plenaria de la Asamblea Nacional respaldo el proyecto de ley, que ahora esta bajo evaluacion de la Comision Primera especializada en Asuntos Politicos, Juridicos, Constitucionales y Eticos. La aprobacion del proyecto de ley requiere la votacion final una vez que regrese a la Asamblea Nacional y que el Presidente lo promulgue. La elaboracion de un proyecto de ley para el control del alcohol que sea liderado por el pais, inclusivo, basado en la evidencia y libre de interferencias por parte de la industria del alcohol ayuda a priorizar los objetivos de salud publica sobre otros intereses., Introduction For several decades, alcohol consumption has been one of the leading factors for preventable deaths and the burden of diseases globally, (1) causing 3 million deaths annually. (2) Higher [...]

Background: The first dengue outbreak in Sao Tome and Principe was reported in 2022. Entomological investigations were undertaken to establish the typology of Aedes larval habitats, the distribution of Ae. aegypti and Ae. albopictus, the related entomological risk and the susceptibility profile of Ae. aegypti to insecticides, to provide evidence to inform the outbreak response. Methodology/Principal findings: Entomological surveys were performed in all seven health districts of Sao Tome and Principe during the dry and rainy seasons in 2022. WHO tube and synergist assays using piperonyl butoxide (PBO) and diethyl maleate (DEM) were carried out, together with genotyping of F1534C/V1016I/V410L mutations in Ae. aegypti. Aedes aegypti and Ae. albopictus were found in all seven health districts of the country with high abundance of Ae. aegypti in the most urbanised district, Agua Grande. Both Aedes species bred mainly in used tyres, discarded tanks and water storage containers. In both survey periods, the Breteau (BI > 50), house (HI > 35%) and container (CI > 20%) indices were higher than the thresholds established by WHO to indicate high potential risk of dengue transmission. The Ae. aegypti sampled were susceptible to all insecticides tested except dichlorodiphenyltrichloroethane (DDT) (9.2% mortality, resistant), bendiocarb (61.4% mortality, resistant) and alpha-cypermethrin (97% mortality, probable resistant). A full recovery was observed in Ae. aegypti resistant to bendiocarb after pre-exposure to synergist PBO. Only one Ae. aegypti specimen was found carrying F1534C mutation. Conclusions/Significance: These findings revealed a high potential risk for dengue transmission throughout the year, with the bulk of larval breeding occurring in used tyres, water storage and discarded containers. Most of the insecticides tested remain effective to control Aedes vectors in Sao Tome, except DDT and bendiocarb. These data underline the importance of raising community awareness and implementing routine dengue vector control strategies to prevent further outbreaks in Sao Tome and Principe, and elsewhere in the subregion. Author summary: During the first dengue outbreak in Sao Tome and Principe reported in 2022, entomological investigations were undertaken to establish the typology of Aedes larval habitats, the distribution of Ae. aegypti and Ae. albopictus, the related entomological risk and the susceptibility profile of Ae. aegypti to insecticides to inform the outbreak response. Surveys revealed the presence of Ae. aegypti and Ae. albopictus in all seven health districts of the country with high abundance of Ae. aegypti in the most urbanised district, Agua Grande. Both Aedes species bred mainly in used tyres, discarded tanks and water storage containers suggesting good waste management and improved water supply system could help to reduce Aedes densities and the risk of dengue transmission. Analyses also revealed that most of the insecticides tested remain effective to control Aedes vectors in Sao Tome, except dichlorodiphenyltrichloroethane and bendiocarb. These findings revealed a high potential risk for dengue transmission throughout the year and underline the importance of raising community awareness and implementing routine dengue vector control strategies to prevent further outbreaks in Sao Tome and Principe, and elsewhere in the subregion. [ABSTRACT FROM AUTHOR]

The WHO Regional Office for Africa (AFRO) continues to address many outbreaks and health emergencies, with high morbidity and mortality and major socioeconomic disruptions leading to loss of productivity and [...]