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Guinea - Diphtheria outbreak 2023 - 2024

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  • Guinea - Diphtheria outbreak 2023 - 2024

    Translation Google

    Siguiri: several deaths out of 25 cases of diphtheria reported in Naboun and Kourémalé

    Diphtheria, a respiratory or skin infection that induces damage to the central nervous system, throat or other organs, was detected in two rural communes of Siguiri. According to our information, the localities of Naboun (5 cases for 3 deaths) and Kourémalé (20 cases for 7 deaths) are the areas affected by this disease. A team from Doctors Without Borders (MSF) has already visited it, reports the correspondent based in the prefecture.

    Reached by telephone, a manager of the Kourémalé health center, who preferred to remain anonymous, confirmed the passage of a team from Doctors Without Borders (MSF) on the spot and on the current state of the patients. " That's right. There is diphtheria in Kourémalé. The Doctors Without Borders team had come to Kourémalé for a consultation. She did not want to communicate for the moment. Clandestine sensitizations have begun. The prefectural director of health says that he would not have had the order first to communicate on the epidemic. Of the 20 cases, 7 passed away. The health center even sent some patients to Siguiri. These are in good condition, ”he explained to our interlocutor.

    From Siguiri, Koutoubou Condé for
    AUGUST 23, 2023

    La diphtérie, infection respiratoire ou cutanée qui induit des atteintes du système nerveux central, de la gorge ou d’autres organes, a été détecté dans deux communes rurales de Siguiri. Selon nos informations, les localités de Naboun (5 cas pour 3 morts) et de Kourémalé (20 cas pour 7 morts) sont les zones concernées par cette […]


    Guinea: An epidemic kills around twenty people in Siguiri..

    It's not about Ebola, or Covid19, measles or even meningitis, this time it's about a new epidemic of another type. Diphtheria. This disease has already claimed several victims in the northeast of Guinea.

    The prefecture of Siguiri, located in the northern part of the country (Upper Guinea), is the epicenter of this epidemic which killed around twenty patients. A hundred cases have been identified according to the Ministry of Health and Public Hygiene.

    “Diphtheria has been formally identified. We are around 20 deaths. For the cases followed, we have about 109,” the senior adviser to the Minister of Health, Dr Bachir Kanté, told

    Since its detection in July 2023, the Ministry of Health and Public Hygiene has reactivated its epidemiological care operations centers.

    “ The emergency operations center is set in motion to take care of patients who are mainly children. Today, care is effective in the epidemiological treatment centers at the level of the prefectural hospitals. We have the contribution of the technical and financial partners, Médecins Sans Frontières ,” said Dr. Bachir Kanté.

    According to the Minister's senior adviser Mamadou Pèthé Diallo, diphtheria is a disease that is preventable by vaccination.

    “ We are preparing vaccination campaigns from Siguiri, fortunately we have vaccines that were planned for routine. Thanks to our partners who supply us, we have been authorized to use them to respond. This is what is being prepared in the coming days , “added Dr. Bachir in an interview with a journalist from this Saturday, August 26, 2023.

    According to health specialists, Diphtheria is a disease caused by several species of corynebacteria of the diphtheriae complex. Typical diphtheria is a respiratory infection that induces damage to the central nervous system, throat or other organs, leading to death by asphyxiation.

    To be continued…

    Siddy Koundara Diallo

    Created on Saturday, August 26, 2023 4:40

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2
    Translation Google

    Health: the diphtheria epidemic kills 37 in the Kankan region

    Posted By: Mohamed Moro Sacko On: Friday, September 01, 2023 At 12:12 P.M.

    The disease called diphtheria is ravaging the Kankan region, Guineanews has learned. However, at the level of the Regional Health Directorate, there is radio silence.

    Indeed, since July 2023, diphtheria, an infectious disease caused by the bacterium Corynebacterium diphtheriae, has been claiming victims in Upper Guinea, particularly in the Kankan region.

    Currently, 37 cases of death have been recorded, all children between 0 and 7 years old, according to the World Health Organization.

    According to the explanations of Jean Traoré, Head of Communication and Media Unit of the ANSS at the microphone of our colleagues from UNIVERSCIENCES, the patients are brought to the Kankan regional hospital for treatment.

    “Our teams are on the ground to carry out investigations in order to find out the causes and the modes of spread of the disease. I specify that it is the zones of Siguiri, Mandiana which are more concerned. At the moment, 212 people are being monitored in these three prefectures,” he said.

    Reached by our local editorial staff, the Kankan Regional Health Department does not want to communicate on this situation, because a WHO mission is announced in the days that follow.

    The catch is that diphtheria is a serious disease that is spreading through the region with its corollary victims.

    People with diphtheria may develop fever, fatigue, and weakness. General symptoms of malaise, fatigue and weakness may be present. If left untreated, the toxins produced by the bacteria can lead to serious complications, such as heart and nerve problems.

    Diphtheria is usually spread by airborne droplets from an infected person's cough or sneeze.

    In the meantime, no official communication has been made by the Guinean health structures to allow the communities to understand what is happening.

    La maladie appelée diphtérie fait des ravages dans la région de Kankan, a appris Guinéenews. Cependant, au niveau de la Direction régionale de la santé, c'est le silence radio.En effet, depuis le mois de juillet 2023, la diphtérie une maladie infecti
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela


    • #3

      Week 34: 21 - 27 August 2023
      Data as reported by: 17:00; 27 August 2023




      117 Cases
      37 Deaths
      31.6 % CFR


      Suspected case of diphtheria have been reported in
      Kankan region of Guinea since 4 July 2023. Laboratory
      confirmation was obtained on 20 July. During week 34
      (ending 27 August), 18 suspected cases, including
      seven deaths, were reported from two Districts; Siguiri
      (17 cases) and Mandina (1 case).

      From the beginning of the outbreak on 4 July to 27
      August, a total of 117 suspected cases were reported,
      including seven confirmed cases. In total, 37 deaths
      have been reported, including all confirmed cases. Nine
      (24.3%) deaths occurred in the community. At present,
      189 active contacts are under followed up.

      Siguiri District is the most affected with 100 cases
      (85.5%). The other Districts reporting cases are Kankan
      (8 cases), Mandiana (7 cases) and Kouroussa (2 cases).
      Only the Kérouané District in the Kankan region did not
      report any cases.

      Of the reported cases, 69(59%) are female. The age
      group 1-4 years is the most affected with 60 cases
      (51.3%), followed by the age groups 5-9 years and 10+
      years with 26 cases each (22.2%) and the age group
      under 1 year with five cases (4.3%). Of the 64 patients
      who were admitted to treatment centers, 28 (43.8%)


      • The Regional Coordination Unit is managing response
      activities and holds daily meetings.

      • Surveillance activities have been heightened in
      the affected Districts to reinforce case detection and
      reporting at facility and community levels, as well as the
      conduct of in-depth case investigations for new clusters
      of cases.

      • Case management activities are ongoing at health
      facilities in the Districts. This is a free service for all
      Diphtheria related cases.

      • Risk communication activities have been scaled up in
      the affected areas. Community engagement activities,
      are ongoing to create awareness in the affected areas.

      • Other response measures include laboratory diagnosis,
      and prepositioning of essential medical supplies


      According to WHO and UNICEF estimates of national
      immunization coverage, routine immunization coverage
      for the third dose of pentavalent vaccine (which includes
      diphtheria vaccine) was 47% in Guinea in 2022, and even
      lower in the Kankan region according to a recent survey.
      This low coverage, combined with other factors, could
      facilitate the spread of the outbreak. Given the high case
      fatality rate, surveillance should be strengthened to detect
      additional cases early, and case management should be
      improved to save more lives.

      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela


      • #4
        Translation Google

        Kankan: diphtheria epidemic kills 54 people

        BY ABDOUL MALICK DIALLO September 27, 2023 at 4:00 p.m.

        Reported on July 20, 2023, in Siguiri, in the Kankan health region, the diphtheria epidemic reached the prefectures of Mandiana, Kouroussa and Kankan.

        To date, health authorities in the region have deplored 54 deaths, distributed as follows: 42 in Siguiri, 11 in Kankan and 1 in Kouroussa (sitRep 36). As well as 255 suspected cases counted and all contacts are followed. To date, 62 people are under treatment in the Kankan and Siguiri treatment centers.

        The ongoing epidemic in the Kankan health region has mainly affected children under 12 years old and girls represent almost 60% of this affected age group.

        “In addition to patient care, vaccination of contacts is also one of the response actions undertaken by the Ministry of Health through its technical services in collaboration with partners. 9,415 people are already vaccinated among contacts. Actions are continuing and a regional response plan is being developed and submitted to the authorities for funding with a view to rapid control of the epidemic,” explained Sory 2 Keira, head of the risk communication, social mobilization and community engagement department. to the National Health Security Agency (ANSS).

        An infectious respiratory disease, diphtheria causes damage to the central nervous system, throat or other organs leading to death by asphyxiation.

        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela


        • #5

          Diphtheria - Guinea
          18 October 2023

          Situation at a Glance

          On 5 September 2023, the Ministry of Health notified WHO of a diphtheria outbreak in Guinea. From 4 July to 13 October 2023, a total of 538 cases of diphtheria, were reported in the Kankan region, in the east-central part of Guinea. Of the total cases reported, 520 are suspected and 18 confirmed with 58 deaths including 13 among confirmed cases (case fatality rate (CFR) among all cases, 11%). The 1-4 years age group accounted for the largest proportion of reported cases. Diphtheria is a highly contagious vaccine-preventable disease caused mainly by the bacteria Corynebacterium diphtheriae which can be fatal in 5-10% of cases, with a higher mortality rate in young children. However, in settings with poor access to diphtheria antitoxin, the CFR can be as high as 40%. Diphtheria remains a significant health problem in countries with poor routine vaccination coverage. According to WHO/UNICEF estimates of national immunization coverage (WUENIC), the immunization coverage with the diphtheria tetanus toxoid and pertussis (DTP3) containing vaccine was reported to be 47% for 2022 in Guinea and has remained below 50% since 2014. This is insufficient for achieving the coverage of 80–85% required to maintain community protection. WHO assesses the risk of diphtheria to be high in Guinea, considering the chronically low vaccination coverage.
          Description of the Situation

          On 5 September 2023, the Ministry of Health notified WHO of the current diphtheria outbreak in Guinea. On 4 July 2023, two children aged 2 and 4 years, attended the otolaryngology department of the Siguiri prefectural hospital in the Kankan region of Guinea, for similar symptoms (dyspnea, dysphasia, fever, cough). They were hospitalized for tonsillitis and respiratory infection and received antibiotic treatment before being referred to the Kankan regional hospital for additional care.
          Since 4 July and as of 13 October 2023, 538 cases have been reported, including 18 confirmed cases. In total, 58 deaths including 13 among confirmed cases were registered (case fatality rate (CFR) among all cases, 11%)., and 461 contacts are being followed up. Of the cases reported, 62% are female. The 1-4 years age group, with 445 cases, accounted for the largest proportion of reported cases, 82%, followed by the 5-9 years age group, with 5% and 5% for the 10 years and above age group. Children under the age of 12 months make up 7% of reported cases. None of the 538 cases were vaccinated.
          Kankan Region is divided into five prefectures and only the Kérouané prefecture has not reported any cases to date.
          The prefecture of Siguiri is the most affected, with 510 cases (95%). Of the 363 patients admitted to the treatment centers in Siguiri, 37 (10%) have died.
          Other prefectures reporting cases are Mandiana (13 cases), Kankan (13 cases) and Kouroussa (two cases). Of the 15 patients admitted in the treatment center in Kankan, 12 (80%) have died.
          The treatment centers in the country do not have the capacity in terms of human resources and material for adequate case management. Suspected and confirmed cases were treated with Amoxicillin and Azithromycin as first line therapy. Antibiotic prophylaxis (Amoxicillin, Azithromycin) was administered to the direct contacts.
          Figure 1: Distribution of diphtheria cases in Kankan region, Guinea, as of 13 October 2023

          Figure 2: Suspected diphtheria cases by epidemiological week in Guinea, as of 13 October 2023


          Diphtheria is a highly contagious vaccine-preventable disease caused mainly by Corynebacterium diphtheria but also byCorynebacterium ulcerans. It spreads between people mainly by direct contact or through the air via respiratory droplets. The disease can affect all age groups; however, unimmunized children are most at risk.
          Symptoms often come on gradually, beginning with a sore throat and fever. In severe cases, the bacteria produce a poison (toxin) that causes a thick grey or white patch at the back of throat. This can block the airways, making it hard to breathe or swallow, and also creates a barking cough. The neck may swell in part due to enlarged lymph nodes.
          Treatment involves administering diphtheria antitoxin (DAT) as well as antibiotics. Vaccination against diphtheria has been effective in reducing the mortality and morbidity from diphtheria dramatically. Diphtheria is fatal in 5-10% of cases, with a higher mortality rate in young children. However, in settings with poor access to DAT, the CFR can be as high as 40%.

          Public Health Response
          • Guinea has strengthened epidemiological surveillance for early detection and case management.
          • Daily coordination and monitoring meetings on the response activities are underway at the Regional level, led by the regional health inspector and with the support of WHO, MSF- Belgium and other partners in the region.
          • Notification of all suspected cases of diphtheria, investigation initiation, and monitoring of contacts as soon as possible has been enhanced.
          • Contact tracing, identification of an isolation zone at the Balato health post in the prefecture of Kouroussa and briefing of the healthcare workers on the case definition and prevention measures are ongoing.
          • Case management activities such as antibiotic therapy (Amoxicillin, Azithromycin), treatment of suspected cases, antibiotic prophylaxis (Amoxicillin, Azithromycin) for the direct contacts and free case management at treatment centers with support from MSF are provided.
          • Risk communication and community engagement efforts, such as raising awareness of cases in the community and identifying and briefing a communicator to raise awareness among parents of patients is ongoing.

          WHO Risk Assessment

          Diphtheria is a vaccine-preventable disease caused by exotoxin-producing Corynebacterium diphtheriae, transmitted from person to person through close physical and respiratory contact. It can cause infection of the nasopharynx, which may lead to breathing difficulties and death. Diphtheria is fatal in 5 - 10% of cases, with a higher mortality rate in young children. Treatment involves administering diphtheria antitoxin as well as antibiotics. Vaccination against diphtheria has reduced the mortality and morbidity of diphtheria dramatically.
          The DAT supply is currently very constrained and insufficient to respond to current demands, as there is only a limited number of manufacturers and large outbreaks are being reported in different regions of the world.
          The risk of diphtheria in Guinea is considered high due to the low DTP3 vaccination coverage in the affected region (36% according to the survey coverage in households, 2023) and 47% national DTP3 vaccination coverage between 2014-2022 (per WHO/UNICEF estimates), and the risk at the regional level is moderate and low at the global level. The outbreak is also characterized by high case fatality among confirmed cases. Other factors include: the over population of the Siguiri health district, which is the epicenter of this outbreak, the weakened healthcare system and several concurrent epidemics in the area.
          The overpopulation of the Siguiri health prefecture, the epicenter of this epidemic, the insufficient poorly qualified health personnel, and the limited material resources of the health system weakens the response to this outbreak. In addition, the country is facing several concurrent epidemics in the area, such as pertussis, poliomyelitis, and rabies. Adding this to a context of extreme vulnerability due to mining activities, which induce significant population movement, reduce air quality, and increase the risk of natural disasters such as floods and landslides, impacting people’s health.
          This emphasizes the urgent need to strengthen diphtheria vaccination coverage nationwide, especially in the epicenter and strengthen case management at hospital facilities dealing with diphtheria cases.

          WHO Advice

          The control of diphtheria is based on primary disease prevention by ensuring high population immunity through vaccination and secondary prevention of spread by the rapid investigation of close contacts to ensure prompt treatment of those infected.
          Epidemiological surveillance ensuring early detection of diphtheria outbreaks should be in place in all countries, and all countries should have access to laboratory facilities for reliable identification of toxigenic C. diphtheriae. Adequate quantities of diphtheria antitoxin should be available nationally or regionally for the medical management of cases.
          Vaccination is vital to preventing cases and outbreaks, and adequate clinical management involves administering diphtheria anti-toxin to neutralize the toxin and antibiotics reducing complications and mortality.
          WHO recommends early reporting and case management of suspected diphtheria cases to initiate the timely treatment of cases and follow-up of contacts and ensure the supply of diphtheria antitoxin.
          WHO advises implementing the following Infection Prevention & Control (IPC) measures in health care settings:
          At screening/triage, immediately place patients with symptoms of Upper Respiratory Tract Infection (URTI) in a separate area until examined, and, if a probable case, cohorted with patients with the same diagnosis. Keep the isolation area segregated from other patient-care areas.
          In addition to using standard precautions, patients with known or suspected respiratory diphtheria are placed under droplet precautions. Patients with known or suspected cutaneous diphtheria should be placed under contact precautions. Maintain one meter between patients. Keep patient care areas well- ventilated. Avoid patient movement or transport out of the isolation area. If movement is necessary out of the isolation area, have the patient use a medical mask and cover any wounds/lesions on the patient’s body.
          Case management should be carried out following the WHO guidelines. In addition, high-risk populations such as young children under five years of age, school children, the elderly, close contact with diphtheria cases, and healthcare workers should be vaccinated on a priority basis. A coordinated response and community engagement can support further transmission and control of the ongoing outbreak.
          Prophylactic antibiotics (penicillin or erythromycin, dependent on the isolate antibiotic sensitivity) are indicated for close contacts for seven days. If the culture is positive for toxigenic Corynebacterium spp.., the contact should be treated as a case with an antibiotic course for two weeks (DAT is not needed for asymptomatic cases or cases without a pseudo membrane).
          Although travelers do not have a particular risk of diphtheria infection, it is recommended that national authorities remind travelers going to areas with diphtheria outbreaks to be appropriately vaccinated in accordance with the national vaccination scheme established in each country before travel. A booster dose is recommended if more than five years have passed since their last dose.
          WHO does not recommend that any general travel or trade restrictions be applied to Guinea based on the information available for this event.

          Further InformationCitable reference: World Health Organization (18 October 2023). Disease Outbreak News; Diphtheria in Guinea. Available at:


          • #6
            Translation Google

            Guinea in the grip of a serious diphtheria epidemic while the country lacks health personnel

            According to the WHO, at least 62 infected people have died since the outbreak of the epidemic in July in the Upper Guinea region (East). This highly contagious disease, mainly affects early childhood, attacks the respiratory tract and causes death by asphyxiation.

            Published on :01/11/2023 - 10:37
            Modified :01/11/2023 - 11:43

            By : RFI

            The Ministry of Health alerted the World Health Organization ( WHO ) last September about the diphtheria outbreak in the Kankan region, the epicenter being in the gold mining town of Siguiri, near the Malian border. When the disease appeared four months ago, mortality stood at 36%. This rate was divided by three after the treatment protocol put in place with the National Health Security Authority of Guinea and the NGO Médecins sans frontières (MSF).

            According to the UN health organization , the spread of the diphtheria epidemic comes from the low vaccination coverage which concerns less than half of the territory since 2014. To blame, vaccines out of stock, non-compliance with the cold chain and the significant lack of health personnel.

            “ Classes opened, and children who were on vacation from one region to another began to mix. So they had plenty of time to transmit the disease during the infectious period at school level , explains Dr Seydou Dia, WHO emergency manager in Guinea. We had admissions at the level of three to four cases per day, now we are at almost ten cases per day, and today MSF is wondering if we can have containers to transform their offices into places of hospitalization. So this is a situation that is developing unfavorably. »

            The WHO states that several countries in the sub-region are affected by the diphtheria epidemic. A possible consequence of the fight against the Covid-19 pandemic, which had been prioritized to the detriment of other diseases.

            Selon l'OMS, au moins 62 personnes infectées sont décédées depuis l'apparition de l'épidémie en juillet dans la région de Haute-Guinée (Est). Cette maladie, très contagieuse, touche surtout la petite…
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela


            • #7
              Why diphtheria is making a comeback

              JANUARY 23, 20247:30 AM ET
              By Simar Bajaj

              It had been over 30 years since the last case of diphtheria was seen in Guinea. So when patients began showing up six months ago with what looked like flu symptoms — fever, cough and sore throat – doctors weren't alarmed. Until the children started dying.
              Guinea was particularly vulnerable because of its low diphtheria vaccination rate – only 47% in 2022, with the hardest-hit Siguiri prefecture having even lower coverage at 36%.
              In Guinea, Doctors Without Borders says its staff has supported local health workers in addressing diphtheria. Together, they've reduced mortality at Siguiri's Center for the Treatment of Epidemics from 38% to 5% over the past few months.
              But the scarcity of vaccines means they've only been available for patients and their close contacts in Siguiri. As diphtheria continues to spread in Guinea, Mutreja worries about growing antibiotic resistance and the spread of new variants, which could render existing antitoxins and vaccines ineffective.
              With an effective vaccine, cases of the potentially fatal disease plummeted. But West Africa is now seeing thousands of new cases and hundreds of deaths.

              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela


              • #8

                Week 5: 29 January - 4 February 2024
                Data as reported by: 17:00; 4 February 2024




                3 445 Cases
                83 Deaths
                2.4% CFR

                EVENT DESCRIPTION

                Guinea has been experiencing a diphtheria outbreak
                with a significant number of reported cases.

                From weeks 1 to 5 of 2024 (ending 4 February), there were
                1 184 suspected cases and five deaths, averaging 237
                suspected cases per week during this period. Although
                there has been a slight decline in cases since week 3
                of 2024, the epidemic curve shows a general trend of
                increasing number of reported cases with progressively
                higher peaks since the beginning of the outbreak.

                Since the outbreak began on 4 July 2023, until
                4 February 2024, Guinea has recorded 3 445 suspected
                cases of diphtheria, including 3 207 confirmed cases
                and 83 deaths, resulting in a case fatality rate (CFR) of
                2.4% among suspected cases.

                Of the confirmed cases, 39 (1.2%) were laboratory
                confirmed, 107 (3.3%) were epidemiologically linked,
                and 3 061 (95.4%) were clinically compatible. Females
                accounted for 52% of cases and 65% were under 15
                years of age.

                Initially, the outbreak was localized in the Kankan region.
                As of week 3 of 2024, seven of Guinea’s eight regions
                have been affected, including the capital, Conakry.
                Kankan region accounts for most reported cases, with
                96.7% (3 332 cases) attributed to this region. Boké
                region is the only one that has not reported any cases.


                The response to the outbreak is being coordinated
                by a national strategic committee and regional
                coordination teams that include several partners.

                Intensified surveillance efforts in active case finding
                along with a strategy for tracing outpatient cases are
                being implemented

                Ongoing community engagement efforts continues,
                encompassing diphtheria and vaccination
                awareness sessions with various community
                stakeholders, including contacts, traditional leaders,
                and the general population.

                Clinical case management protocols are being
                implemented, combined with the provision of
                psychosocial support to households affected by

                A vaccination campaign is being organized with
                support from GAVI.


                Since the outbreak began in July 2023, significant
                portion of all suspected diphtheria cases were
                reported in the first five weeks of 2024. Although
                surveillance has improved, the persistent gradual
                rise in cases suggests the presence of underlying
                factors exacerbating the situation. Close monitoring
                is essential, and further response measures are
                imperative to effectively control this outbreak.

                The World Health Organization (WHO) is building a better future for people everywhere. Health lays the foundation for vibrant and productive communities, stronger economies, safer nations and a better world. Our work touches lives around the world every day – often in invisible ways. As the lead health authority within the United Nations (UN) system, we help ensure the safety of the air we breathe, the food we eat, the water we drink and the medicines and vaccines that treat and protect us. The Organization aims to provide every child, woman and man with the best chance to lead a healthier, longer life.
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela