Huambo, Angola—It’s early morning, but Soba Arão Moma, a traditional leader in Benfica neighbourhood in Huambo province, Angola, is already interacting with residents and handing out leaflets. His mission is clear: to ensure everyone is fully informed about the meningitis outbreak affecting Angola’s Huambo province and that no sick children are at home unattended when they should be in hospital.

Moma was part of a critical collaboration by the World Health Organization (WHO), Angola’s Health Ministry, and the European Union to halt an alarming surge in meningitis cases in the province last year, reduce mortality rates, and boost healthcare capacity.

Between January and December 2023, Angola recorded a significant increase in suspected cases of meningitis, with 68,169 cases and 169 deaths. The high case fatality rate of 40% among the 336 cases reported in Huambo province means that it has accounted for almost 80% of deaths countrywide.

In general, Huambo province has been the focus of intervention to control a possible outbreak in the country since between January and December 2023, Angola recorded a significant increase in suspected cases of meningitis, with 68,169 cases and 169 deaths, of which 336 cases were reported in Huambo province, with a fatality rate of over 40%. This mortality rate is relatively high when compared to the average number of deaths recorded in the countries considered part of the meningitis belt in the WHO African region, of which Angola is not part.

Between January and May 2023, the province recorded 103 meningitis cases, resulting in 42 deaths, with a concerning 41% fatality rate. Medication shortages, healthcare personnel, and health facility understaffing exacerbated Huambo province's meningitis outbreak. To ensure an effective response and safeguard high-risk populations, a 20-day joint response mission to Huambo aimed to enhance the functionality of local health systems, improve infrastructure and medication availability, and bolster human resources.

Critical outcomes of joint efforts included training 37 healthcare technicians in risk communication and community engagement, training 30 journalists in how to communicate for meningitis prevention and response, engaging 595 community leaders, and training 1548 social mobilisers and community leaders like Moma to disseminate critical messages broadly.

"We never tired of walking the streets, passionate about conveying the crucial message to everyone that if they experienced symptoms of meningitis, they should seek immediate assistance at their nearest health facility,” recalls Moma.

The experts supported local meningitis education initiatives, identified high-risk groups, and advocated with local leaders to disseminate critical messages while conducting assessments to rapidly investigate the social factors impacting meningitis prevention.

Provincial health director Lucas Yamba says, “We have been able to count on the support of the Directorate of Public Health in this regard, with the excellent partnership of WHO.”

Through collaborative efforts involving the community, churches and traditional authorities, information about meningitis prevention and treatment was widely disseminated in healthcare facilities and communities.

“We gave talks to churches on Saturdays and Sundays, while here [at the health centre] in each of the service areas, our users also received information about meningitis,” said Martins Canuela, a technician at the Benfica Baixo health facility located in Moma’s neighbourhood.

According to Yamba, because of the push to bring the outbreak under control, mortality rates from meningitis in the last months of 2023 had decreased from 53% to 35%.

While significant strides had been made to address the meningitis crisis in Huambo, including increased awareness and reduced mortality rates, ongoing support was crucial to sustain these achievements, says Dr Yoti Zabulon, WHO Acting Representative in Angola.

“By continuing to work together and leverage partnerships, we can ensure that all communities have access to quality health care services and can effectively manage preventable diseases like meningitis,” he says.