RxPG News : World Healthcare

Mexico expects swine flu infections to peak at New Year

Fri, 27 Nov 2009 05:44:59 PST

( from http://www.rxpgnews.com ) Mexico City, Nov 27 - Mexico expects a peak in influenza A - infections in late December and early January, Mexican Health Minister Jose Angel Cordova Villalobos said Thursday.

Cordova Villalobos said that those are teh dryest and coldest weeks of the year in Mexico, and 'the virus spreads faster' in dry conditions.

'There will be more cases and more deaths, but the important thing will be to contain them,' he said during a meeting with federal and state health officials.

The H1N1 flu virus, which was first detected in April in Mexico and has since become a global pandemic, has claimed 610 lives and infected a total of more than 65,000 people in the country, according to the Health Ministry.

Mexico has already received 865,000 vaccine doses. Vaccinations started Wednesday in the central state of Guanajuato, initially limited to medical personnel and pregnant women.

A second batch of 650,000 doses is expected Dec 7, with the bulk of the 30 million doses that Mexico bought from European laboratories to arrive in starting in January.

Australia confirms its first swine flu case

Sat, 09 May 2009 10:11:07 PST

( from http://www.rxpgnews.com ) Sydney, May 9 - A woman who arrived back in Australia on a flight from Los Angeles to Brisbane last week has been confirmed as the country's first swine flu patient.

Queensland health authorities said the woman tested 'weak positive' for the new influenza A - virus and has already recovered.

'This is clearly a serious development but we are in a situation where the best medical advice seems to be indicating that this person would not have been infectious,' state chief medical officer Jeanette Young said.

'Because at this stage there is no evidence of any live infection in Australia, the advice currently is for us not to change that alert level.'

The woman reported her symptoms to health authorities at Brisbane airport Thursday after coming off Qantas flight QF16. She remained in Brisbane with family members.

'Because we're taking every precaution, we'll be contacting passengers from the same flight sitting close to the woman, and her close family, to check if they have had any illness and alert them to seek medical advice if they become unwell,' Young said.

The World Health Organisation reported Friday that 2,500 people in 26 countries had tested positive for the influenza A - virus.

Of the 567 people tested for swine flu in Australia, 544 have been cleared and the rest are awaiting results.

Swine Influenza A (H1N1) Spreads Outside Mexico

Sun, 26 Apr 2009 06:09:37 PST

( from http://www.rxpgnews.com ) The United States Government has reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas) and nine suspect cases. All seven confirmed cases had mild Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No deaths have been reported.

The Government of Mexico has reported three separate events. In the Federal District of Mexico, surveillance began picking up cases of ILI starting 18 March. The number of cases has risen steadily through April and as of 23 April there are now more than 854 cases of pneumonia from the capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been reported. And from Mexicali, near the border with the United States, four cases of ILI, with no deaths, have been reported.

Of the Mexican cases, 18 have been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those are genetically identical to the Swine Influenza A/H1N1 viruses from California.

The majority of these cases have occurred in otherwise healthy young adults. Influenza normally affects the very young and the very old, but these age groups have not been heavily affected in Mexico.

Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.

The Swine Influenza A/H1N1 viruses characterized in this outbreak have not been previously detected in pigs or humans. The viruses so far characterized have been sensitive to oseltamivir, but resistant to both amantadine and rimantadine.

WHO is coordinating the global response to human cases of swine influenza A (H1N1) and monitoring the corresponding threat of an influenza pandemic.

The World Health Organization has been in constant contact with the health authorities in the United States, Mexico and Canada in order to better understand the risk which these ILI events pose. WHO (and PAHO) is sending missions of experts to Mexico to work with health authorities there. It is helping its Member States to increase field epidemiology activities, laboratory diagnosis and clinical management. Moreover, WHO's partners in the Global Alert and Response Network have been alerted and are ready to assist as requested by the Member States.

WHO acknowledges the United States and Mexico for their proactive reporting and their collaboration with WHO and will continue to work with Member States to further characterize the outbreak.

Illegal kidney trade thrives in Pakistan

Sun, 20 Jul 2008 14:33:08 PST

( from http://www.rxpgnews.com ) Islamabad, July 20 - In what seems to be a sub-continental malaise, illegal trade in kidneys is thriving in Pakistan, like it does in parts of neighbouring India.

For many poor Pakistanis, selling a kidney has become a major 'business' to meet their expenses and to pay off their loans, hospital sources and civil society organizations say.

Under the law, trade in human organs is illegal but, going by figures provided by different hospitals, an average of 30 people, including women, throughout the country sell their kidneys every month under the guise of 'donations'.

'I've been offered Rs.80,000 - for my kidney,' Rafiq Hussain, who has come here from Sialkot in Punjab to sell his kidney, told IANS.

He said he would use the money for paying off a loan or else he would have to give one of his daughters in marriage to a landlord who has loaned him money for the last 10 years.

'In 1997, I got Rs.10,000 from a landlord and more and more later to meet my needs,' Hussain said, refusing to name the landlord.

Hussain, in fact, lauded the landlord for 'just asking for the - amount without any interest'.

'I was informed by his manager to either return the money before August or marry off my daughter to the landlord, who already has two wives,' Hussain said, adding that he had no option but to sell his kidney.

He said he first went to Lahore to sell his kidney but was offered a very low price as compared to Islamabad.

'I've already got Rs.60,000 and Rs.20,000 will be paid after the operation,' he said, displaying no fear over losing one of his kidneys.

A doctor IANS spoke to found nothing wrong with the 'donation' route.

'We talk to each and every donor and get him to sign a consent form before we perform an operation. I know - trade is going on, but all these people sign a document saying they are willingly donating an organ,' said Sami Ahmed, one of several surgeons conducting kidney transplants.

Arguing in favour of donations, he said: 'So far, I've conducted 137 operations and none of the donors has faced any problems. This is saving the lives of ailing people who could die if their kidneys are not replaced.'

NGO CARE that is working against the sale of human organs has a different point of view.

'Most of the kidney transplants are conducted on rich Pakistanis and foreigners with the donors getting far less than what the doctors charge for the operation,' CARE director Veena Kashif said.

'According to our survey, the surgeon gets between two and three lakhs -, while about one lakh goes to the middleman and only Rs.50,000 to 70,000 on an average is paid to the seller,' she said.

According to Kashif, her organization was making every effort to stop the illegal kidney trade.

'Why don't people get kidneys from their close relatives? Why is it that only poor people have to lose their organs for the wealthy people?' she wondered.

Kashif lamented that the so-called donors were not cooperating with her in making out a legal case against the doctors and middlemen who are the major beneficiaries of the trade.

On an average, a kidney transplant costs between Rs.400,000 and Rs.500,000 - depending on the surgeon and the hospital involved.

And, after the operation, the donors are pushed into a common ward and sent home just a day later, those who receive a transplant are kept in special rooms for five to seven days, a nurse in the Kidney Hospital in Rawalpindi told IANS.

She said that during her eight years with the hospital, no donor had died in the hospital but many patients who had got a transplant had died in the hospital.

An Australian kidney specialist recently sparked a bitter ethics row by calling for organ sales to be legalised to stop patients travelling overseas to buy them in the black market.

Nephrologist Gavin Carney said Australia should allow the sale of organs - which currently attracts a penalty of six months in jail and a $4,400 dollar - fine - to help bring down the bloated transplant waiting list.

Commenting on the issue Sami said that this should be legalized but with certain conditions like the donors' health bill being paid by the kidney recipient.

According to Pakistani law, only close relatives or volunteers can donate their organs and a committee of experts has to certify that the donation was voluntary.

The law mandates action against any physician guilty of violating the laws and lays down a 10-year jail sentence for anyone involved in commercial trading of organs.

So far, five doctors have been arrested for their involvement in the illegal organ trade but all of them were bailed out within a few days of their arrest.

Healthcare reform in Hungary facing serious challenges

Mon, 17 Mar 2008 07:54:29 PST

( from http://www.rxpgnews.com ) Budapest, March 17 - Hungary's plans to overhaul its ailing healthcare system by allowing private capital into the health insurance market are on the rocks as political pressure mounts following a referendum in which voters have rejected other welfare-state cuts.

Voters turned out in droves Sunday to reject fees for medical treatment and higher education - a result seen as a stinging defeat for the government and its economic reforms.

Analysts say the rejection of the fees - which were part of efforts to reduce the budget deficit and, ultimately, get Hungary ready to adopt the euro - dents the government's ability to continue with reforms.

The next casualty is looking increasingly likely to be a move to introduce private capital into the health insurance system as the political uncertainty frightens off investors.

'As an investment, the risk is quite high. Also, given the elections in 2010 any investor should price in the probability of a significant change,' Gyorgy Barcza, chief economist at Hungary's K&H Bank, told DPA.

Pollsters give the government between 15-20 percent of the vote at the moment. Barring a miracle, main opposition party Fidesz is set to gain power in 2010.

Fidesz has vowed to scrap the private insurance system when it gains power and make the investors pay the costs of winding up the system. However, it does not seem content to wait until then.

The government is already facing a likely referendum challenge to the plan this autumn and Fidesz, which called the previous referendum, this week said it would do everything it could to block the new system.

Neighbouring Slovakia has already seen a rebellion against private insurers in the healthcare system, with Prime Minister Robert Fico last year forcing through legislation preventing them from making a profit.

In Hungary the private capital plan faces more opposition than did the fees for visiting the doctor and hospital stays.

Opponents - who come from across the social and political spectrum and include the chamber of doctors - say private firms will either refuse to insure the elderly and chronically ill or do so at a premium.

Nonetheless the government, which says universal healthcare will still be guaranteed under the new system, is sticking to its guns.

The socialist-model healthcare system has been a black hole for government funding since the change of system in 1990. Drug subsidies have been slashed and beds cut, but the government says more pressure needs to be taken off the central budget.

Health Minister Agnes Horvath, whose position may now be in doubt after the referendum loss, believes a capital injection can be used to upgrade crumbling infrastructure and competition will dramatically improve services at a reduced cost to the government.

However, without investors the system will not get off the ground.

Adding to the mix, the return on investment is not very high for any investor brave enough to take the risk - something Horvath herself has admitted.

According to a senior source, who has represented major international insurance firms in Hungary for over ten years, the investment does not come up to scratch.

'I would not recommend investing in this business,' he told DPA. 'The business cases just work after 10 to 15 years and some scenarios will be negative forever.'

'For 25 to 50 million euros - you can buy smaller-to-medium-sized insurance companies and pension funds all over the region. ... These business cases have a higher probability of positive figures than the health reform in Hungary,' he added.

The new model is based on the Dutch health insurance system, which allows private insurance companies to compete within a strictly regulated framework.

Hungary employed former Dutch health minister Hans Hoogervorst to advise them on how to structure the new system.

Under the new model, the current central fund will be replaced with 22 regional funds into which private companies can invest up to a level of 49 percent. The tender is to be called this summer and funds are expected to begin operating by early 2009.

Profits for each fund will be capped at two percent of capitation income - a per capita figure paid to each fund by a central body responsible for collecting contributions.

Each fund is allowed to insure between 500,000 and two million people, and according to ministry figures, the most an operator of a small fund could hope to make per year would be around 500,000 forints -. The maximum profit would be roughly four times that.

Investors must stump up six to 24 billion forints to buy into the funds, depending on how many people are insured.

Colombo AIDS event reveals a 'safe pearl in ocean'

Tue, 21 Aug 2007 13:47:09 PST

( from http://www.rxpgnews.com ) Colombo, Aug 21 - Every morning, A.H. Sheriffdeen, one of the chief organisers of a large regional AIDS meeting being held in the capital of war-ravaged Sri Lanka, says a little prayer.

'My first prayer of the day is that things shouldn't flare up,' said Sheriffdeen, co-chair of the International Conference on AIDS in the Asia Pacific.

His prayer is not a bit out of place, nor a day too late. Having beaten off competition from China, India and Indonesia to host this prestigious international event, Sheriffdeen cannot afford to take any chances in a nation where a 25-year civil war between government forces and armed Tamil rebels has left some 60,000 people dead, according to government estimates.

The conference - known by its acronym ICAAP - is a major event in the calendar of the health community in the Asia-Pacific, particularly those dealing with HIV/AIDS, an epidemic that afflicts 5.4 million people in the region and continues unabated.

Holding a successful international event in the midst of raging civil conflict is key to Sri Lanka's efforts to convince the international community - from sceptical Western governments to wealthy but worried tourists - that this island-nation, known as the Pearl of the Indian Ocean, is a safe place.

'Or at least it is no more unsafe than any other country,' Sheriffdeen told IANS Tuesday. 'None of the Asian countries is free of conflict. Even Europe has its problems.'

Some 2,500 delegates and media representatives from 70 countries have turned up for the Aug 19-23 event, which is aimed at halting the progress of the epidemic in a crowded region that is home to the majority of the world's population - China and India alone accounting for more than 2.2 billion people.

For Sri Lankans, it even means more: it is billed as the biggest international event held in this country for decades.

Among the international delegates here are medical scientists, non-government and UN representatives, government policymakers, doctors and academics - as well as people living with HIV or AIDS - who have been sharing their experiences, learning the latest science and lobbying with government officials.

They have packed hotels, restaurants, shops and streets, bringing a fresh air of normalcy to a city that remains under a tight security net at all hours of the day.

Their bustling presence is cause for more than a little satisfaction in Colombo. As Health Minister Nimal Siripala de Silva told delegates Sunday, 'I appreciate your courage to break past undue fears, created by some elements through a misinformation campaign to impose a travel embargo on Sri Lanka.'

With his government bristling at travel advisories that put Sri Lanka in a no-go zone for Western tourists, de Silva declared the conference 'will reveal the truth to the global community.'

The security of delegates - and of the conference itself - is uppermost in the minds of organisers. And arrangements for the 200 media attending the opening ceremony was so thorough, some journalists complained it bordered on the paranoid.

Journalists, photographers and cameramen were taken to the ministry of media, where security personnel gave them a professional but uncompromising body and laptop search. Neither delegates nor the media was allowed to take mobile telephones to the opening.

'Anything could happen any time,' organiser Sheriffdeen said. 'But the rebels are very sensible people. They don't attack aid workers, and they won't do anything to harm the international community.'

'In fact, I specifically told security to ease restrictions.'

Bravely, Sri Lanka decided to bid for the conference in 2004, soon after being hit by the tsunami that devastated many countries of the Asia-Pacific region. The metaphor-laden theme of the conference is 'Waves of Change, Waves of Hope'.

There are already some glimmers of hope for Sri Lanka - after years of decline, tourist arrivals picked up in August, said Hiran Cooray, president of the Tourist Hotels Association.

And lined up after the AIDS conference for this year are a series of international events, such as a tea convention, a counter-terrorism conference and an England cricket tour.

At this meet, Sri Lankans have rolled up their sleeves to make a success of the event: full-time journalists, for instance, have taken time off to work as volunteers to run the busy media centre. 'An international group asked for as much as half a million dollars to run the media centre - and we are doing it for free,' said one such senior journalist.

'You know, at the end of the day, all the skills are here,' said one.

Global AIDS figures to come down

Sun, 19 Aug 2007 14:45:21 PST

( from http://www.rxpgnews.com ) Colombo, Aug 19 - Some 25 years after the discovery of the first case of AIDS, the global figure for people living with the virus will come down when fresh figures are released in November, a senior official of the United Nations AIDS umbrella disclosed Sunday.

The scale-down in the epidemic is being attributed to a new counting methodology pioneered jointly by the Indian government and the UN - which saw the figures for Indians living with HIV/AIDS decline from 5.7 million to around three million two months ago.

'The global numbers will come down a bit - but I can't tell you exactly how much. For that you will have to wait until November when our annual report is released,' UNAIDS Deputy Executive Director Deborah Landey said at a press conference to kick off the eighth International Congress on AIDS in Asia and the Pacific -.

'The prevalence rates from country to country may come down but our concern is that declining numbers could conceal the complexity of the picture and we are very worried about complacency setting in,' Landey said in response to a query by IANS.

'For instance, prevalence rates can decline simply because people are dying. We will try to capture some of the complexity of data in November,' she added.

According to figures released by UNAIDS last year, there are between 34 and 42 million people living with HIV or AIDS worldwide, and Landey thought the figures to be announced in November will stay in that broad bracket.

One of the main reasons for the decline will be the methodology of Population Household Survey - house-to-house counting that Landey said is particularly good for rural areas - which was used in India to gauge the extent of the epidemic for the first time earlier this year.

The same methodology has now been tried out in 22 countries in Africa and the Caribbean, and 20 of them have returned lower figures for HIV/AIDS - a fact that is certain to bring down the global numbers.

'Good and accurate data are evolving. What India has done very well is to tap different survey methodologies,' Landey added.

But she sounded a note of caution: while Population Household Surveys were good at capturing rural data, they can do little about people who are not at home when health workers pay a visit. And these can include high-risk groups such as truck drivers, migrant workers and sex workers.

Landey's startling disclosure about the expected decline in numbers comes at a crucial juncture in the global fight against HIV/AIDS - with more and more money being put into prevention and access to life-saving drugs that were once out of reach of poor people, the international campaign to fight the spread of the disease is seeing its first glimmer of hope.

The danger, say health experts in Colombo, is that news about declining numbers will lead to governments becoming complacent in the fight against HIV/AIDS.

'We are worried about complacency,' said Landey. 'Countries that have become complacent have seen the epidemic go up.'

Some 2,500 health experts and community workers from 70 countries across Asia-Pacific are attending the ICAAP meeting from 19 to 23 August.

They will exchange notes and share lessons in best practices so that Asia-Pacific can avoid the experience of sub-Saharan Africa - a region that has been devastated by HIV/AIDS, said Athula Kahanda Liyanage, secretary to the Sri Lankan health ministry.

Ukraine says bird flu vaccine almost ready

Fri, 10 Aug 2007 12:51:49 PST

( from http://www.rxpgnews.com ) Kiev, Aug 10 - Ukraine has almost completed clinical trials for a bird flu vaccine, the head of the Ukrainian State Veterinarian Department said.

Since 2003, when bird flu first hit countries in Asia, international experts have feared the virus could mutate into a form that spread easily among people, sparking a global pandemic.

'Ukraine's biological industry has developed two types of bird flu vaccines,' Hryhoriy Ivanov said.

'The laboratory tests have proved successful, while we still have to conduct field tests,' he added.

Ukraine's Crimea Autonomy is one of most vulnerable places for bird flu outbreaks, as migrant birds use the autonomy as a stopover during their migration. Last year, bird flu outbreaks were registered in Crimea's 42 residential areas.

Ivanov added that it is highly likely the vaccine will work, as results of laboratory tests proved that the vaccine 'is very effective.'

Russia completed the first phase of clinical trials for a human vaccine against the H5N1 bird flu virus in late March.

Researchers said they had developed vaccine production techniques and commercial production could be started immediately in the event of a pandemic.

4.3 million new HIV infections in 2006: UNAIDS

Wed, 22 Nov 2006 20:23:02 PST

( from http://www.rxpgnews.com ) New Delhi, Nov 22 (IANS) The global AIDS epidemic continues to spiral with 4.3 million new infections reported in 2006, with sub-Saharan Africa alone accounting for 65 percent of the cases, states a new UNAIDS report.

The UNAIDS/WHO 2006 AIDS Epidemic Update released in Geneva Tuesday estimates that globally 39.5 million people are living with HIV. Of these, about 8.6 million are in Asia, including the 960,000 people who became newly infected in the past year.

India is estimated to have around 5.2 million HIV infected cases, the second largest after South Africa.

According to the report, of the 4.3 million new infections, 2.8 million occurred in sub-Saharan Africa and there were important increases in Eastern Europe and Central Asia, where there are some indications that infection rates have risen by more than 50 percent since 2004.

'There is increasing evidence of HIV outbreaks among men who have sex with men in Cambodia, China, India, Nepal, Pakistan, Thailand and Vietnam as well as across Latin America but most national AIDS programmes fail to address the specific needs of these people,' states the report.

Referring to India, the report says that the bulk of HIV infections in the country occur during unprotected heterosexual intercourse. Consequently, women account for a growing proportion of people living with HIV (some 38 percent in 2005), especially in rural areas.

A large proportion of women in India with HIV appear to have acquired the virus from regular partners who were infected during paid sex.

In 2006, 2.9 million people died of AIDS-related illnesses.

While evidence points to a resurgence in new HIV infection rates in some countries which were previously stable or declining, there is also a decline in infection rates in some countries as well as positive trends in young people's sexual behaviours, says the report.

Expressing a major concern, it says 'HIV prevention programmes are failing to address the overlap between injecting drug use and sex work within the epidemics of Latin America, Eastern Europe and particularly Asia'.

'It is imperative that we continue to increase investment in both HIV prevention and treatment services to reduce unnecessary deaths and illness from this disease,' says WHO Acting Director-General Dr Anders Nordstram.

'In sub-Saharan Africa, the worst affected region, life expectancy at birth is now just 47 years, which is 30 years less than most high-income countries.'

The update underlines how weak HIV surveillance regions like Latin America, the Caribbean, the Middle East and North Africa often means that people at highest risk -- 'men who have sex with men, sex workers, and injecting drug users' -- are not adequately reached through prevention and treatment strategies because not enough is known about their particular situations and realities.

The report also stresses that levels of knowledge of safe sex and HIV remain low in many countries, as does perception of personal risk.

Even in countries where the epidemic has very high impact, such as Swaziland and South Africa, a large proportion of the population do not believe they are at risk of becoming infected.

Future of sexual and reproductive health at tipping point according to global study

Wed, 01 Nov 2006 16:09:37 PST

( from http://www.rxpgnews.com ) The first-ever global study of sexual and reproductive health - to be published in the medical journal The Lancet starting this week - shows a picture of declining financial support, increased political interference and an overall reluctance to tackle threats to sexual and reproductive health.

The evaluation, coordinated by the World Health Organization (WHO), shows that the level of disability and premature death due to sexual and reproductive health is huge and increasing. Unsafe sex is the second most important cause of illness and death in developing countries and ninth in developed countries.

The analysis reveals a picture of growing unmet needs and neglect. More than half a million women die as a result of complications in pregnancy and childbirth every year. Access to contraception has increased worldwide but there are still an estimated 120 million couples who do not get the contraceptives they would like or need. An estimated 80 million women have unintended or unwanted pregnancies each year. 45 million end in abortion. WHO figures quoted in the survey show that there are 19 million unsafe abortions carried out each year, resulting in around 68 000 deaths and millions of injuries and permanent disabilities.

"These statistics represent an appalling catalogue of human tragedy," says Joy Phumaphi, WHO Assistant Director-General for Family and Community Health. "Far from making progress we seem to have been going backwards since the notion of reproductive health was born in Cairo in 1994. The issue is dropping down the international agenda and governments seem to be reluctant to tackle this most fundamental threat to health and well-being."

Several examples of this decline are quoted in the study. Between 1995 and 2003, donor support for family planning fell from $ 560 million to $ 460 million. According to the survey, family planning services in Africa need an extra US $ 70 million just to achieve the mid range of fertility projections recommended by the United Nations. Additionally, funding for contraceptive development has declined compared to microbicide research for HIV/AIDS. As well as surveying the statistical evidence on the increase in sexual and reproductive ill-health, the series highlights the importance of understanding sexual behaviour.

The survey of data from 59 countries shows that contrary to common belief, there is no universal trend to earlier first sexual intercourse. However, later marriages mean that there are more opportunities for premarital sex which is resulting in high rates of unintended pregnancy, unsafe abortions and sexually transmitted infections among the young.

According to Dr Paul Van Look, Director of Reproductive Health and Research at WHO, "Sexual behaviours and norms vary enormously around the world and unfortunately many people, including politicians and even health professionals, are uncomfortable dealing with such matters. This survey sounds an urgent alarm that if we do not address sexual and reproductive health openly and directly the toll of death and disability will remain with us for many years to come."

Given the diversity of sexual and reproductive behaviours revealed by the study, the authors call for a mix of prevention strategies and caution against quick fixes and a "one size fits all" approach. They call for greater efforts to tackle the links between sexual and reproductive ill-health and poverty, gender inequalities and negative social attitudes.

The Lancet Series on Sexual and Reproductive Health will be published in the coming weeks. The series will focus on issues such as adopting a public health approach to sexual and reproductive behaviours to reduce death and disability from unsafe sex, the impact of unsafe abortions, and the need to prioritize sexual and reproductive health, family planning and contraception to achieve the Millennium Development Goals.

Community model effective in allotting anti-AIDS medication

Thu, 17 Aug 2006 15:56:37 PST

( from http://www.rxpgnews.com ) When there are millions of patients clamoring for anti-AIDS drugs and precious little to go around, who decides which patients go to the front of the line? The answer, says Stanford AIDS researcher Dennis Israelski, MD, is relatively simple: the affected community.

Israelski, clinical professor of infectious diseases at the School of Medicine, is medical director of the nongovernmental organization, AIDS Empowerment and Treatment International, or AIDSETI, a network of 23 associations in 14 sub-Saharan African and Caribbean countries, whose mission is to support the scale-up of sustainable systems of HIV/AIDS health care through community empowerment.

"I believe if you give the affected communities the necessary resources, appropriate tools and training, it will do a better job in providing care and treatment than approaching the problem from the top-down," said Israelski, who is also the medical director of the AIDS Program in San Mateo County, Calif.

AIDSETI's cohort is estimated to be 100,000 people living with HIV/AIDS. In a new, small-scale study, to be presented Aug. 17 at the International AIDS Conference in Toronto, Israelski and his colleagues found that the group has been effective in distributing antiretroviral drugs to the patients who need them most.

"What we found in our initial evaluation indicates an equitable distribution of medications, based on gender and severity of illness," said Seble Getachew Kassaye, MD, a postdoctoral scholar in infectious disease at Stanford and first author of the study. Moreover, patients who received drugs showed substantial increases in their CD4 counts, a measure of immune system function, the researchers found.

Given the results, researchers believe the program could be a model for scaling up antiretroviral treatment in more poor nations, alongside other treatment programs.

In 1999, when AIDSETI was founded, there were few programs providing care for people living with HIV and AIDS in Africa, and only a limited supply of drugs were being distributed - without clear guidelines or medical supervision, Israelski said.

AIDSETI organizers seized on the concept of community-driven development, a well-known model of international development championed by AIDSETI cofounder Hans Binswanger, a World Bank economist. He had originally advocated such an approach to combat the effects of poverty, but he and others who launched AIDSETI adapted it for the first time for use in a health-care setting, Israelski said.

AIDSETI organized a network of associations of people living with HIV/AIDS throughout sub-Saharan Africa and the Caribbean. It provided antiretroviral treatment and helped to disseminate medical guidelines for the effective management of such care - before the advent of the major international funds to combat HIV/AIDS. The associations offer other services as well, such as nutritional support, psychological counseling, legal aid and help starting income-generating activities.

Patients treated through the associations must meet standard clinical criteria, including reduced levels of CD4 immune cells, to qualify for anti retroviral therapy. Still, there are long waiting lists for these precious, life-prolonging drugs. Under AIDSETI guidelines, first priority is given to people in the community who are actively involved in promoting HIV prevention and treatment messages. The next in line are children of community activists who have died, foster parents, essential health-care workers and patients most likely to adhere to a treatment regimen.

To gauge the effectiveness of the program, the researchers examined data for more than 1,500 of the group's patients in four countries: Burkina Faso, Kenya, Tanzania and Zimbabwe. The patients, 1,035 women and 491 men, had been enrolled in the program between 2003 and 2005. The number of patients on antiretroviral therapy doubled during the two-year period, with 29 percent of participants on the medications by the spring of 2005.

About one-third of the patients had undergone testing for CD4 counts, with results showing significant improvements in their immunologic status.

Israelski said the effectiveness of the program varies from country to country. In the study, patients in Zimbabwe and Kenya showed significant improvement over time. The trend was not as clear in Tanzania and Burkina Faso, where significant progress has been made since the study with World Bank funds supporting the roll out of antiretroviral treatment at six sites.

Israelski said one of the most robust AIDSETI groups is in Burundi, where there is nearly universal access to antiretroviral treatment despite more than 10 years of civil unrest. "This has been a favored model by the government in Burundi to meet the challenge of providing access to quality care and treatment of HIV/AIDS," he said.

The AIDSETI organization is an extension of Israelski's experience in San Mateo County, where he has observed the benefits of bottom-up over top-down approaches. "Community empowerment works to improve the life of stigmatized and marginalized groups, whether it's in East Palo Alto or Ouagadougou," Israelski said.

Burkina Faso reaches major milestone in protecting its people against tropical parasites

Fri, 16 Jun 2006 23:21:37 PST

( from http://www.rxpgnews.com ) With the recent completion of the latest rounds of treatment targeting the entire country, Burkina Faso has become the first in the WHO African Region to achieve nationwide coverage with anthelminthic drugs against three major neglected tropical diseases: lymphatic filariasis (elephantiasis), schistosomiasis and soil-transmitted helminthiasis (intestinal parasites).

Over the last few months, combined school-based and community-based interventions targeted the whole of this West African country, from Ouagadougou to the remotest villages, distributing praziquantel and albendazole to approximately 3.3 million school-age children, and albendazole and ivermectin to the entire eligible resident population (approximately 10 million).

"Africa indeed has taken the lead. This achievement is a major step forward. Even with limited resources, the world can be changed with political commitment, dedication of health personnel and support from international partners," said Dr Lorenzo Savioli, Director of the Department for Control of Neglected Tropical Diseases at WHO headquarters. "Now the challenge is to make this effort a sustainable and regular one".

The whole of Burkina Faso can be described as being endemic for lymphatic filariasis, schistosomiasis and soil-transmitted helminthiasis. Globally, these three diseases affect more than two billion people worldwide, and more than 300 million individuals suffer from severe clinical complications. A large proportion of this burden affects poor communities in Africa.

Transmission occurs when microscopic larvae of these worms penetrate the skin (by direct contact or mosquito bite) or when their eggs are ingested with contaminated water or soil. Heavy infection can hamper physical and intellectual development, and is responsible for severe morbidity after a few years of chronic infection and re-infection.

"The international commitment to make drugs available free of charge to our country greatly benefits poor communities and is a major contribution to the development of Burkina Faso: it is a highly commendable public health intervention," said Dr Souleymane Sanou, Director for Disease Control at the Ministry of Health in Burkina Faso. "We hope that in the near future we will be able to intensify control measures against other neglected diseases such as trachoma".

The success in Burkina Faso was fuelled by international commitment to intensified control of neglected tropical diseases. The campaigns were conducted by the Ministry of Health with support from various partners, including the World Health Organization, the Liverpool Lymphatic Filariasis Support Centre, Department for International Development (UK), Emory Lymphatic Filariasis Support Center, Helen Keller International, Fondation pour le Développement Communautaire (Burkina Faso), Bill and Melinda Gates Foundation, Handicap International, Réseau International Schistosomoses Environnement Aménagements et Lutte, Schistosomiasis Control Initiative and various multinational pharmaceutical manufacturers.

"The commitment of the government of Burkina Faso in supporting total coverage for lymphatic filariasis elimination is recognized and highly commended by WHO, and this serves as a shining example in the Region. I would like to thank all the national and international partners that are involved in the fight against neglected tropical diseases" said Dr James Mwanzia, Director of the Division of Communicable Disease Prevention and Control at the WHO Regional Office for Africa.

The latest data also show that after 20 years of control interventions, the prevalence of onchocerciasis in highly-endemic foci in Burkina Faso has dropped from 80% to 1.3%. Annual or semi-annual treatment with ivermectin is still ongoing but the disease is no longer a public health problem.

Burkina Faso has also reported a 43% reduction in indigenous cases of dracunculiasis (guinea-worm disease) in 2005 compared with 2004, and the Ministry of Health is now concentrating its efforts on the last pockets of endemicity, predominantly in the nomadic areas in the north-eastern area of the country.

World Health Assembly Resolution 50.29 of 1997 set the goal of achieving elimination of lymphatic filariasis as a public health problem, while WHA Resolution 54.19 of 2001 urged endemic countries to protect at least 75% of their school-age population against schistosomiasis and intestinal parasites.

The Best and Worst Countries to Be a Mother

Wed, 10 May 2006 02:57:37 PST

( from http://www.rxpgnews.com ) Save the Children, a U.S. - based independent global humanitarian organization, released today its annual Mothers Index that ranks the best - and worst - places to be a mother and a child. The Index, highlighted in the organizations State of the Worlds Mothers 2006 report, ranks the status of mothers and children in 125 countries based on 10 indicators pertaining to health and education.

Save the Childrens State of the Worlds Mothers 2006 report takes a closer look at the inextricable link between the health and survival of mothers and babies, narrowing in on simple, affordable solutions that can help save 3 million of the 4 million newborns who die every year.

Scandinavian countries sweep the top rankings of the best places to be a mother, while countries in sub-Saharan Africa dominate the bottom tier. The United States ties for 10th place with the United Kingdom.

"The Mothers Index illustrates the direct line between the status of mothers and the status of their children," said Charles MacCormack, President and CEO of Save the Children. In countries where mothers do well, children do well; in countries where mothers fare poorly, children fare poorly. If we are to improve the quality of life for children, we must start by investing in the health and well-being of their mothers.

Zeroing in on only those indicators that capture childrens well-being, Somalia finishes in last place. More than 1 out of every 7 children in Somalia die before his or her first birthday, 71 percent of the population has no access to safe drinking water, and 17 percent of children are suffering from malnutrition. The situation for Somali mothers is equally dismal: 1 in 10 women dies in childbirth; 75 percent of all newborns are delivered without skilled health personnel and 78 percent of pregnant women have anemia.

Life is not easy for moms and children in the bottom-ranked countries. Most have never been to school. Mothers are lucky to survive childbirth, and their babies fortunate to survive the first month, yet alone the first year of life, said MacCormack. But the good news is that we know what it takes to help these moms and children survive and thrive.

Humanitarian organizations like Save the Children are working in partnership with communities and governments to provide proven programs that benefit mothers and children in developing countries. Save the Childrens 70-plus years of experience on the ground have shown us that increasing access to education and child and maternal healthincluding family planningare critical to the well-being of children and their mothers, he said.

The Mothers' Index identifies female education, presence of a skilled attendant at birth and access to, and use of, family planning services, as the three areas most strongly associated with child survival and well-being.

According to the report, women who are educated are more likely to postpone marriage and early childbirth, seek health care for themselves and their families, and encourage all of their children, including girls, to go to school. As contraceptive use rises and mothers are able to space their births at healthy intervals, deaths among mothers and children decline. For example, in the United States, 71 percent of women use modern birth control, 1 in 2,500 mothers dies in childbirth and 7 out of 1,000 infants do not live to see their first birthday. Compare this to Mali, where 6 percent of women use birth control, 1 in 10 mothers dies in childbirth, and 1 in 8 infants dies before reaching age 1.

The Mothers' Index exposes an enormous disparity between the highest- and lowest-scoring countries and underscores an urgent need to address this divide. For instance, in Sweden, which tops the list, nearly all women are literate. In contrast, only 34 percent of Ethiopian women are literate. And a mother in Ethiopia is 37 times more likely to see her child die in the first year of life than a mother in Sweden.

The report highlighted that compared to a mother in the top 10 countries, a mother in the bottom 10 countries is 28 times more likely to see her child die in the first year of life and over 750 times more likely to die herself in pregnancy or childbirth. In the bottom 10 countries, nearly 1 out of 3 children is not enrolled in school and only 1 out of 4 adult women is literate. In the top 10 countries, virtually all children go to school and all women are literate. Skilled health personnel attend fewer than 15 percent of births in Afghanistan, Bangladesh, Ethiopia and Nepal. Fewer than 5 percent of women use modern contraception in Chad, Guinea, Guinea-Bissau, Democratic Republic of the Congo, Niger, Rwanda and Sierra Leone.

Imran Khan to set up second cancer hospital

Wed, 26 Apr 2006 14:49:37 PST

( from http://www.rxpgnews.com ) Cricketer-turned-politician Imran Khan plans to open a second cancer hospital, this time in the southern port city of Karachi.

The new facility will come up in Karachi by January next year, the Daily Times reported.

Khan, who heads the Tehreek-e-Insaf political party, had set up the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore in 1994.

The state-of-the-art cancer centre was Khan's tribute to his mother Shaukat Khanum, who died of cancer.

Khan, who heads the Shaukat Khanam Memorial Trust and has striven to gather funds for the project since the past nine years, said in Karachi that work would begin later this year.

The American architect who had designed the Lahore hospital has also designed the Karachi facility.

Considerable gaps exist among European national pandemic plans

Thu, 20 Apr 2006 15:53:37 PST

( from http://www.rxpgnews.com ) Considerable gaps exist among European national pandemic plans, according to a new report published in the online edition of The Lancet on 20 April 2006.

The report, 'How prepared is Europe for Pandemic Influenza? An analysis of national plans', issued by the London School of Hygiene and Tropical Medicine (LSHTM), reveals marked discrepancies in pandemic preparedness across Europe. The authors conclude that further planning and implementation is needed so that governments can effectively respond in the event of a pandemic, recommending action by the European Union to ensure governments work together towards a coordinated approach.

Dr Richard Coker, the report's lead author said: 'Wide gaps exist in the pandemic preparedness of European nations. With the ongoing spread of the H5N1 avian influenza virus in birds, and the impending threat of a pandemic, European nations need to work together to adequately prepare for the onset of such a pandemic.'

The LSHTM researchers reviewed the preparedness initiatives of all 25 European Union member states, as well as Bulgaria, Norway, Romania and Switzerland. 21 published national plans were eligible to be included in the final analysis.

The completeness and quality of these 21 national preparedness plans was assessed based on the World Health Organization's (WHO) preparedness checklist , addressing levels of:

* Planning and coordination
* Surveillance
* Public health interventions (public health control measures, vaccines and antivirals)
* Health system response
* Maintenance of essential services
* Communication
* Putting plans into action

Based on these evaluation criteria, the completeness score of the plans ranged from 24% to 80%, with the average level of completeness calculated as 54%.

With 194 confirmed cases of avian influenza in humans to date , experts, including the WHO, agree that the next influenza pandemic is inevitable. Detailed planning is essential to ensure a coordinated response to a pandemic, both across Europe and within each member state, to minimise serious illness, deaths and overall societal disruption. The WHO's Global Influenza Preparedness Plan provides guidelines for governments on preparing for and managing an influenza pandemic is the benchmark against which all national preparedness planning should be implemented.

Dr Coker said, 'As yet, Europe is only moderately prepared for the threat of an influenza pandemic. The existing gaps underline the need for increased cooperation between countries in policy, planning and resource distribution. It is vital that the European Union takes action to ensure that such gaps are filled and Europe is adequately prepared across regional, national and international levels."

The LSHTM researchers acknowledge that only those plans available for analysis at the time of research (November 2005) were included and further plans, or portions of plans, under review, amendment or pending finalisation were therefore not included in the analysis. As such, it is possible that some of the gaps exposed are being or have since been addressed.

Six Hong Kong women lose breasts after operation

Sat, 15 Apr 2006 18:25:37 PST

( from http://www.rxpgnews.com ) Health officials here Thursday warned women to avoid controversial breast enlargement gel injections after six women lost parts of their breasts due to complications.

Fifty-three women from Hong Kong have complained of complications such as infections and abscesses after having polyacrylamide gel injected into their breasts.

Six women had to have parts of their breasts surgically removed after suffering severe complications from the operation, a spokesman for the health department here said.

Ninety percent of the women who suffered complications had the gel injected at hospitals across the border in mainland China while the other victims had operations in Hong Kong and Thailand.

Hong Kong is now liasing with customs officials to ban the use of the gel for breast enlargements and is warning women not to use the treatment, the spokesman said.

Gel injections are an old-fashioned enlargement treatment using a combination of synthetic polymer and water, which experts say is non-biodegradable and cannot be absorbed into the body.

Hong Kong's Consumer Council has handled dozens of complaints about the breast gel injections and said some women who received the treatment could not breast feed babies.

Parents can view premature babies in ICU online

Fri, 14 Apr 2006 22:19:37 PST

( from http://www.rxpgnews.com ) A trial service here is enabling parents and relatives of premature babies to view the tiny infants online, a hospital said Friday.

A camera hooked up beside the baby's cot in the neonatal intensive care unit allows tired parents to view the live footage on 3G-enabled mobile phones, Singapore General Hospital said.

The Virtual Visit service is on a three-month trial, during which the infants go online for three 90-minute sessions a day.

The service launched by the hospital's department of neonatal medicine and Singapore Telecommunications was not intended to replace parental contact but to complement it, department head Yeo Cheo Lian said.

It "supplements parental contact and allows other family members to bond with the baby and be involved in his care right from the beginning", Yeo said.

The service is free during the trial period. Once it is over, parents will likely be charged about 5 Singapore dollars ($US 3.12) a day to cover the maintenance of the cameras, Yeo said.

Poison Plant Oleander Fuels Suicides in Sri Lanka

Wed, 12 Apr 2006 13:16:37 PST

( from http://www.rxpgnews.com ) Common roadside yellow oleander plants have fuelled suicide rates in Sri Lanka with people consuming its poisonous seed often for the most trivial reasons, a British doctor says.

This is an ornamental plant often used for hedging that grows all over the island. It has yellow trumpet-like flowers and a fruit the size of a conker. Inside is a single large seed and one of these seeds is enough to kill you, the online edition of BBC News reported.

Although the plant grows in large parts of the tropics, it's only in Sri Lanka that it has become associated with suicide - and only fairly recently, with an incident 25 years ago.

Two girls in the northern part of the island took the seed and died.

As a result of the newspaper publicity it entered the public consciousness. "The next year," says Michael Eddleston, the British doctor who has spent much of the past 10 years in Sri Lanka, "there were 23 cases; the year after that 46, then 126, and ever since then it has continued to rise year on year as it spreads across the island."

"It completely overwhelms the health service. Often young people use it as a way of getting back at people. They get scolded and they take a yellow oleander seed.

"I remember one girl said her mother wanted her to get up and do the shopping. She said no, her mother scolded her and she took a yellow oleander seed."

Eddleston claims that there is no treatment available in Sri Lanka because it's too expensive and to treat one patient could cost around $3,000.

"Most of the time people get oleander with very small, minor reasons. I think we have to do something to reduce the rate of admission to the hospital."

Eddleston recommends a government campaign to get people to cut down their yellow oleander trees.

Europe slow to add infant pneumococcal vaccine to national programmes despite strong US results

Tue, 11 Apr 2006 12:44:37 PST

( from http://www.rxpgnews.com ) Up to 90 per cent of cases of invasive pneumococcal diseases (IPD) - which includes serious infections like meningitis - occur in otherwise healthy young children, according to a study published in the April issue of IJCP, the International Journal of Clinical Practice.

Yet a number of European countries still only vaccinate selected at-risk groups against IPD, despite growing evidence that universal vaccination of infants and young children reduces their risk and also provides added indirect "herd" protection for other unvaccinated members of the community.

Children in high risk groups include those with underlying medical conditions, such as sickle cell disease, HIV or diabetes.

The general European situation contrasts with the United States, which adopted universal vaccination with the 7-valent pneumococcal conjugate vaccine in August 2000, following the advice of the US Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics.

The CDC recommended vaccinations for infants and children under two years-old, with catch-up vaccinations targeted at children aged two to five years with particular health problems. US authorities also highlighted the need for certain minority and ethnic groups to be added to the list, together with children attending day care.

A European assessment carried out by the authors in August 2005 showed that most countries - Belgium, Germany, Denmark, Finland, the UK, Ireland, Iceland, Norway, Portugal and Sweden - did not offer universal national or regional IPD immunisations, while Austria and France provided the most comprehensive guidelines for vaccinating at-risk groups.

Since then the UK Government has announced that the 7-valent pneumococcal conjugate vaccine will be added to childhood immunisation programmes from this year, pointing out the "immense impact" it has had in the US.

The Netherlands has also announced that the vaccine will be include in the national childhood immunisation programme from April 2006.

"Restricting pneumococcal immunisation to children who have a serious health problem that could make them more susceptible means that only a small percentage of the overall cases of childhood IPD may be prevented. Herd protection cannot be achieved without broad vaccine coverage" says lead author Dr Mark Fletcher, Director of International Scientific and Clinical Affairs at Wyeth Vaccine Research, Paris. Most children hospitalised for IPD do not belong to a recognised at-risk group, he adds. Surveys in the US and Europe have shown that only ten to 27 per cent of children developing IPD have an underlying health problem.

Certain factors increase the risk for IPD. For example:

* Children who attend group day care face a two to three times greater risk than children who stay at home.

* Low birth-weight babies face a 2.6 greater risk than normal birth-weight babies and premature babies face a 1.6 greater risk than full-term babies.

* Rates increase dramatically if children have conditions such as HIV and AIDS (11,300 cases a year per 100,000 children under three) or sickle cell disease (5,500 to 6,500 cases a year per 100,000 children under five).

* Surveys carried out in the US before the 7-valent pneumococcal conjugate vaccine was universally introduced there showed that African American children under the age of two had a 1.6 greater risk than white children of the same age.

The IJCP paper also carries a detailed analysis of vaccine prescriptions in the UK, which shows that at least 4,080 children received the pneumococcal vaccine between January 2002 and August 2004.

Research carried out with child experts in various medical specialties identified that UK children with nine key illnesses received the vaccine. Children suffering from coeliac disease were the largest group (34 per cent), followed by sickle cell disease (15 per cent) and chronic cardiac disease (12 per cent).

Other illnesses included cystic fibrosis, chronic liver disease, renal failure, chronic lung disease and HIV.

"But identifying high-risk individuals is often difficult and pneumococcal vaccination programmes that target only certain subpopulations will still miss people who could develop pneumococcal disease" concludes Dr Fletcher.

"US studies carried out since the introduction of universal vaccination show that IPD has fallen among vaccinated groups and has also led to a decrease in non-vaccinated groups.

"For example, studies published in 2005 show that three years after routine vaccination was introduced in the US, the CDC noted a 94 per cent reduction in IPD caused by strains covered in the vaccine in children under five years old.

"In addition, the incidence of disease caused by these strains fell by 55 per cent among adults aged 50 years or older, who tend to be more susceptible to IPD than younger adults. This clearly demonstrates that universally vaccinating children provides herd protection for other unvaccinated groups.

"Based on the success of the US experience, universal vaccination appears to be the most effective option for protecting all children, including those who are at risk simply because of their young age.

"An added bonus is that it also appears to protect other unvaccinated members of the community."

WHO warns of health system collapse in Asia-Pacific

Fri, 07 Apr 2006 03:56:37 PST

( from http://www.rxpgnews.com ) Health systems in Asia and the Pacific are on the brink of collapse if governments fail to address the plight of health workers, the World Health Organisation (WHO) warned Thursday.

Shigeru Omi, WHO regional director for the Western Pacific, said decades of cost-cutting and under-investment have forced health workers to leave and seek better paying jobs outside the region.

On the eve of World Health Day on April 7, Omi urged Asia-Pacific governments to provide better living and working conditions to their health workers.

"It is high time health workers were paid decent salaries and provided with the right working conditions and the right equipment to do the work they are trained to do," he said.

"Health workers are among the unsung heroes of our times," he added. "They work long hours in difficult conditions, often with little rewards and sometimes at risk to their own health."

Omi suggested that governments should come up with national strategic plans for health workers, including health insurance and subsidised mortgages.

WHO has devoted this year's World Health Day to honour the world's health workforce.

Pakistan has bleak future in public health, warns report

Mon, 03 Apr 2006 23:13:37 PST

( from http://www.rxpgnews.com ) Nearly 10 percent of Pakistan's 155 million population carries the deadly hepatitis virus, a group of medical professionals said Monday.

"Hepatitis B and C is a time bomb waiting to explode unless the government takes drastic measures to control it," said the president of the Pakistan Medical Association, Dr Omar Ayub, quoting the organisation's annual 2006 report.

The association represents medical practitioners and surgeons across Pakistan and its warning is based on the number of patients seeking treatment against the deadly virus.

"This (hepatitis) threat is 100 times more serious than AIDS because there has been a sharp decline in the quality of life over the last few years, because of poverty and inadequate health cover," Dr Ayub pointed out.

"The government must also launch awareness campaigns through the media and significantly enhance the allocation for health in its annual budget," Ayub added.

During fiscal 2005-06, the government allocated 4,128 million rupees (about $70 million) for the health sector, which is less than 2 percent of the total spending.

In the largely poor population, only one doctor is available for 1,900 people while there is one specialist for 14,500 persons.

The inadequate infrastructure also leaves big space for quacks who through attractive advertisements, mostly in the vernacular Urdu language press, offering cheap remedies for hepatitis B and C, cancer and kidney ailments.

The government has already drafted a law to discourage and punish quacks but has not succeeded yet to put it before the legislature.

The association's report said that the life expectancy in Pakistan has declined from 63 to 60 years.

Increased health problems for Pakistani population living near the Tasman Spirit oil spill

Mon, 03 Apr 2006 07:06:37 PST

( from http://www.rxpgnews.com ) People living on the coast of Pakistan affected by the Tasman Spirit oil spill, in August 2003, experience more health problems than individuals living inland. A study published today in the open access journal BMC Public Health reveals that individuals living on the coast of Karachi, near the oil spill, report an average of 14 different health symptoms. This is more than three times the number reported by populations living two or 20 kilometres away from the coast.

In the first study of its kind coming from a less developed country affected by an oil spill, Naveed Janjua and colleagues from Aga Khan University in Karachi, the Sindh Environmental Protection Agency in Karachi and the University of Alabama at Birmingham, USA, studied a group of 216 individuals living on the coast of Karachi. The study period started in September 2003, 3 weeks after the Tasman Spirit spilled its oil off the coast of Karachi. Janjua et al. also studied a group of 83 individuals living two kilometres from the coast and a group of 101 individuals living 20 kilometres from the coast. The authors asked participants to fill in a questionnaire about their living conditions and their health - in particular about a list of 48 symptoms including eye, skin, respiratory, gastrointestinal and general symptoms.

Janjua et al.'s results show that the group living on the coast near the oil spill reported having more multiple health problems than the other two groups. Out of the list of 48 symptoms investigated, the group living on the coast reported having a mean symptom score of 14.1, compared with a score of 4.4 for the group living two kilometres away and 3.8 for the group living 20 kilometres inland. The authors conclude that the long-term effects of crude oil spills on the health of local populations should be further investigated.

Health is big business in Germany

Fri, 10 Mar 2006 21:27:37 PST

( from http://www.rxpgnews.com ) When it comes to wellness, sport, vitality or anti-ageing, German consumers are willing to spend lavishly and this has led to a booming $87-billion market for health products in the country.

According to expert Leo Nefiodov, who studies economic trends, "over the next 50 years health is going to be the most important growth factor for economy and society as a whole."

Nefiodov believes the buoyancy of the health sector marks the beginning of a sustainable period of economic growth and the health industry has already begun usurping information technology at the cutting edge of industrial development.

A survey by a health institute run by Matthias Horx showed that two-thirds of Germans regularly spend money on their health.

The findings are supported by data from the federal statistics ministry which shows that in 2003 private households parted with a total of 29.4 billion euro ($35.3 billion dollars) for health-promoting products compared with 28.5 billion euro the year before.

The figure does not even include the countless cookbooks, gym subscriptions, "active" holidays or the money spent on health additives sold in pharmacies.

Germany's foodstuffs industry has products that are not just nourishing but healthy as well. Modern German supermarkets are more like pharmacies these days with shelves full of "pro-biotic" yoghurts, wine gums with added salts and minerals or calcium-boosted orange squash.

Exact figures are hard to come by since so many sectors of the German economy are trying to cash in on the health-consciousness of the nation's citizens - be they publishing houses, tourist authorities of garment manufacturers.

According to the German Wellness Federation, this wide-ranging sector expects a turnover of 72.9 billion euros ($87.9 billion) this year - an increase of six percent compared to the previous year.

The turnover in organically grown foodstuffs grew by 10 percent in 2004 to stand at around 3.4 billion euros.

Germany's countless, non-profit-making sports associations benefit as well. A total of 27 million Germans are members of around 90,000 clubs and the number is growing.

The trend is matched by the private sector. Around 4.7 million members sweat it out at 5,600 gyms, 400,000 more than in 2004, reported the Deloitte auditing organisation.

Germany's medical health insurance companies have already reacted to the health boom.

"Our bonus programme rewards health-conscious behaviour," said Axel Wunsch of the Barmer Ersatzkasse. He pointed out that 12 million people have already participated in the "Germany Gets Moving" campaign designed to promote regular sporting activity.

The German media has jumped on the health bandwagon too. "Periodicals with articles about natural medicine have seen their circulations rise significantly," said Stefan Michalk of the Federation of German Newspaper Publishers.

The new trend has drawn some ire from within the pharmacological industry which is experiencing a particularly turbulent period along with the rest of the health system.

Manufacturers of generic products such that market cheaper versions of expensive "brand-name" medicines are enjoying a buoyant market. The big companies, on the other hand, have seen their sales stagnate. Turnover in 2003 stood at 23.6 billion euro and last year saw no significant increase, said a spokeswoman for the Federation of Research Chemists.

Bird flu rakes in more EU aid than quake

Thu, 19 Jan 2006 02:08:37 PST

( from http://www.rxpgnews.com ) The European Commission Wednesday acknowledged it was providing more aid to fight bird flu than to victims of the devastating earthquake that hit the northern areas of Pakistan and India last October.

A commission spokesman said the bloc had sent 200 million euros ($242 million) in assistance to Pakistan and India following the Oct 8 quake that killed 75,000 people and rendered 3.5 million people homeless in Pakistan.

The death toll in India is put at 1,400 people.

EU aid for bird flu research and for countries hit by avian influenza is estimated at 240 million euros ($291 million dollars), the spokesman said, adding that a recent conference in China on raising more funds to help combat the deadly virus had been a "tremendous success".

Bird flu outbreaks in China and parts of Southeast Asia and Turkey have led to the culling of thousands of poultry.

An estimated 79 people are reported to have died from the disease in Asia and Turkey following contact with sick birds, according to the World Health Organisation.

64% of new HIV infections occurring in sub-Saharan Africa - WHO

Fri, 25 Nov 2005 06:04:38 PST

( from http://www.rxpgnews.com ) There is new evidence that adult HIV infection rates have decreased in certain countries and that changes in behaviour to prevent infectionsuch as increased use of condoms, delay of first sexual experience and fewer sexual partnershave played a key part in these declines. The new UN report also indicates, however, that overall trends in HIV transmission are still increasing, and that far greater HIV prevention efforts are needed to slow the epidemic.

Kenya, Zimbabwe and some countries in the Caribbean region all show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya from a peak of 10% in the late 1990s to 7% in 2003 and evidence of drops in HIV rates among pregnant women in Zimbabwe from 26% in 2003 to 21% in 2004. In urban areas of Burkina Faso prevalence among young pregnant women declined from around 4% in 2001 to just under 2% in 2003.

These latest findings were published in AIDS Epidemic Update 2005, the annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO). The joint report, which this year focuses on HIV prevention, was released today in advance of World AIDS Day, marked worldwide on the first of December.

Several recent developments in the Caribbean region (in Bahamas, Barbados, Bermuda, Dominican Republic and Haiti) give cause for guarded optimismwith some HIV prevalence declines evident among pregnant women, signs of increased condom use among sex workers and expansion of voluntary HIV testing and counselling.

Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean. There were an additional five million new infections in 2005. The number of people living with HIV globally has reached its highest level with an estimated 40.3 million people, up from an estimated 37.5 million in 2003. More than three million people died of AIDS-related illnesses in 2005; of these, more than 500000 were children.

According to the report, the steepest increases in HIV infections have occurred in Eastern Europe and Central Asia (25% increase to 1.6 million) and East Asia. But sub-Saharan Africa continues to be the most affected globally with 64% of new infections occurring here (over three million people).

We are encouraged by the gains that have been made in some countries and by the fact that sustained HIV prevention programmes have played a key part in bringing down infections. But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it, said UNAIDS Executive Director Dr Peter Piot. It is clear that a rapid increase in the scale and scope of HIV prevention programmes is urgently needed. We must move from small projects with short-term horizons to long-term, comprehensive strategies, he added.

Impact of HIV treatment

The report recognizes that access to HIV treatment has improved markedly over the past two years. More than one million people in low-and middle-income countries are now living longer and better lives because they are on antiretroviral treatment and an estimated 250 000 to 350 000 deaths were averted this year because of expanded access to HIV treatment.

Commenting on the potential enhanced impact of integrating prevention and treatment, the 2005 report emphasizes that a comprehensive response to HIV and AIDS requires the simultaneous acceleration of treatment and prevention efforts with the ultimate goal of universal access to prevention, treatment and care.

"We can now see the clear benefit of scaling up HIV treatment and prevention together and not as isolated interventions," said WHO Director-General Dr LEE Jong-wook. "Treatment availability provides a powerful incentive for governments to support, and individuals to seek out, HIV prevention information and voluntary counselling and testing. Effective prevention can also help reduce the number of individuals who will ultimately require care, making broad access to treatment more achievable and sustainable."

Future challenges for strengthening HIV prevention

New data show that in Latin America, Eastern Europe and particularly Asia, the combination of injecting drug use and sex work is fuelling epidemics, and prevention programmes are falling short of addressing this overlap. The report shows how sustained, intensive programmes in diverse settings have helped bring about decreases in HIV incidenceamong young people in Uganda and Tanzania, among sex workers and their clients in Thailand and India, and among injecting drug users in Spain and Brazil.

The report notes that, without HIV prevention measures, about 35% of children born to HIV-positive women will contract the virus. While mother-to-child transmission has been virtually eliminated from industrialized countries and service coverage is improving in many other places, it still falls far short in most of sub-Saharan Africa. An accelerated scale-up of services is urgently needed to reduce this unacceptable toll.

Levels of knowledge of safe sex and HIV remain low in many countries even in countries with high and growing prevalence. In 24 sub-Saharan countries (including Cameroon, Côte dIvoire, Kenya, Nigeria, Senegal and Uganda), two-thirds or more of young women (aged 15-24 years) lacked comprehensive knowledge of HIV transmission. According to a major survey carried out in the Philippines in 2003, more than 90% of respondents still believed that HIV could be transmitted by sharing a meal with an HIV-positive person.

Finally, weak HIV surveillance in several regions including in some countries in Latin America, the Caribbean, the Middle East, and North Africa is hampering prevention efforts and often means that people at highest risk men who have sex with men, sex workers, and injecting dug users are not adequately covered or reached through HIV prevention and treatment strategies.

The annual AIDS Epidemic Update reports on the latest developments in the global AIDS epidemic. With maps and regional estimates, the 2005 edition provides the most recent estimates on the epidemics scope and human toll, explores new trends in the epidemics evolution, and features a special section on HIV prevention.

WHO report finds domestic violence is widespread

Fri, 25 Nov 2005 05:53:38 PST

( from http://www.rxpgnews.com ) The first-ever World Health Organization (WHO) study on domestic violence reveals that intimate partner violence is the most common form of violence in womens lives - much more so than assault or rape by strangers or acquaintances. The study reports on the enormous toll physical and sexual violence by husbands and partners has on the health and well-being of women around the world and the extent to which partner violence is still largely hidden.

"This study shows that women are more at risk from violence at home than in the street and this has serious repercussions for women's health," said Dr LEE Jong-wook, Director-General of WHO at the study release in Geneva. "The study also shows how important it is to shine a spotlight on domestic violence globally and treat it as a major public health issue."

The study is based on interviews with more than 24 000 women from rural and urban areas in 10 countries: Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru, Samoa, Serbia and Montenegro, Thailand, and the United Republic of Tanzania. The Women's Health and Domestic Violence Against Women study makes recommendations and calls for action by policy makers and the public health sector to address the human and health costs, including by integrating violence prevention programming into a range of social programmes.

The study finds that one quarter to one half of all women who had been physically assaulted by their partners said that they had suffered physical injuries as a direct result. The abused women were also twice as likely as non-abused women to have poor health and physical and mental problems, even if the violence occurred years before. This includes suicidal thoughts and attempts, mental distress, and physical symptoms like pain, dizziness and vaginal discharge. The study was carried out in collaboration with the London School of Hygiene and Tropical Medicine, PATH and national research institutions and women's organizations in the participating countries.

The degree to which the health consequences of partner violence in the WHO study are consistent across sites, both within and between countries, is striking, noted Dr Charlotte Watts, from the London School of Hygiene and Tropical Medicine, a member of the core research team for the study. "Partner violence appears to have a similar impact on womens health and well-being regardless of where she lives, the prevalence of violence in her setting, or her cultural or economic background."

Domestic violence is known to affect women's sexual and reproductive health and may contribute to increased risk of sexually transmitted infections, including HIV. In this study, women who were in physically or sexually abusive relationships were more likely to report that their partner had multiple sexual partners and had refused to use a condom than women in non violent relationships. Women who reported physical or sexual violence by a partner were also more likely to report having had at least one induced abortion or miscarriage than those who did not report violence.

Although pregnancy is often thought of as a time when women should be protected, in most study locations, between 4% and 12% of women who had been pregnant reported being beaten during pregnancy. More than 90% of these women had been abused by the father of the unborn child and between one quarter and one half of them had been kicked or punched in the abdomen.

For policy makers, the greatest challenge is that abuse remains hidden. At least 20% of women reporting physical violence in the study had never told anyone before being interviewed. Despite the health consequences, very few women reported seeking help from formal services like health and police, or from individuals in positions of authority, preferring instead to reach out to friends, neighbours and family members. Those who did seek formal support tended to be the most severely abused.

This is the first ever study conducted in Thailand on this issue and has made us better understand the extent of violence that women experience in our country," noted Dr. Churnrurtai Kanchanachitra from Mahidol University, and a member of the study team in Thailand. "The findings helped us to develop the national plan for the elimination of violence against women and children."

The report recommends a range of vital interventions to change attitudes and challenge the inequities and social norms that perpetuate abuse. It further recommends integrating violence prevention programming into ongoing initiatives aimed at children, youth, HIV/AIDS, and sexual and reproductive health. Health service providers should be trained to identify women experiencing violence and to respond appropriately. Prenatal care, family planning or post abortion care are potential entry points to provide care, support, and referral to other services. Schools need to be safe places, support systems for victims must be strengthened and prevention programmes put in place. Raising awareness of the problem among the general public is critical. . "Domestic violence can be prevented and governments and communities need to mobilize to fight this widespread public health problem," said WHO's Dr Claudia Garcia Moreno, Study Coordinator. "WHO will continue to raise awareness about violence and the important role that public health can play to address its causes and consequences. Globally, we need to stop the violence from happening in the first place, and to provide help and support to women who are in abusive relationships."

WHO's Global Campaign for the Prevention of Violence supports governments to develop comprehensive violence prevention programmes to address domestic violence alongside other types of violence.

Poorest countries well behind global health goals

Sat, 12 Nov 2005 19:07:38 PST

( from http://www.rxpgnews.com ) Despite a world strategy for health agreed five years ago, most of the poorest countries on earth are lagging far behind achieving it, say a series of papers published on BMJ.com today (11/11/05).

If these countries are to make meaningful progress on the strategy aims - the Millennium Development Goals - most will have to raise funds or be forced to reallocate monies from other programmes, argue the authors, all experts from the World Health Organisation.

The Millennium Development Goals were agreed between 189 of the world's major western nations and much of the developing world. Those specifically on health were designed to take action on five key fronts: reducing mother and infant deaths, tackling child poverty, preventing the spread of HIV/AIDS, and controlling malaria and tuberculosis.

Current approaches must change if the goals are to be achieved more quickly. In curbing the spread of HIV/AIDS, treatment with first-line antiretrovirals has now become at least as cost effective as some of the well known preventive interventions, such as voluntary counselling and testing, say the authors. Educating sex workers, mass media messages, and treating people for other sexually transmitted infections, should also be the focus of new campaigns.

Mothers and newborns must have both basic and emergency medical services as a priority, and all children should get measles immunisation and micronutrients as a matter of course, say the authors.

The fight against malaria demands a much larger injection of resources than currently available, and substantial investment is also needed to meet targets on reducing tuberculosis, they argue.

The papers, which examine the cost-effectiveness of health policies in Africa and South-East Asia, preview a two-day Paris summit next week (14-15 November 2005) to look at why the Millennium Development Goals have not been met.

Both Africa and South-East Asia have such a huge degree of need, and so many underused interventions, that it is difficult to redeploy resources currently being spent on achieving the goals. But policy should shift to escalating the most cost-effective activities, say the authors.

"These results represent the best evidence currently available. We hope that this series contributes to not only improving population health with the available resources, but to raising more funds for health as well," they conclude.

An accompanying editorial says that, in addition to better implementation of cost-effective health interventions, three key challenges must be addressed if the Millennium Development Goals are to be met.

Finance issues must be resolved, say the authors. Many developing countries are way behind target on allocating 15% of public funds to healthcare. And only the Scandanavian countries have met the donor nations' goal to give 0.7% of gross national product to official development assistance.

If improvements are to be sustainable they must be backed by local stability and growth, as well as adequate local resources, say the authors. Thailand for instance has redeployed 30% of its national budget since 1985 to social (including health) development - and away from national security and public debt.

Fairer international trade policies are also important. High farming subsidies in developed nations have meant much lower economic growth in less developed countries, particularly among poor farmers.

The second challenge is rethinking how financial aid is allocated. Too much global aid is earmarked for certain programmes, which can distort an individual country's healthcare priorities. As a result health workers are shifted from badly funded but important programmes to support better paid global initiatives.

International migration of health workers exacerbates matters, say the authors. Nine of the 20 countries with the highest emigration rates are in sub-Saharan Africa - where the Millennium Development Goals are least likely to be reached.

The third challenge is to get accurate information on what is being achieved, so that policy makers can monitor progress towards the goals.

If the Millennium Development Goals are not to end up just another unfinished programme, these three areas, together with cost-effective measures, must be addressed.

WHO for better control of PHEIC outbreaks

Fri, 09 Sep 2005 17:36:38 PST

( from http://www.rxpgnews.com ) For the countries of the Asia Pacific region, two important measures will help to strengthen national capacity for controlling the spread of infectious diseases, particularly those with possibility of trans -border transmission. Delegates to the 58th Regional Committee for the South-East Asia Region discussed the revision of the International Health Regulations, which are globally applicable, and also the development of the Asia-Pacific strategy on emerging diseases.

Over the past few years, countries of the Asia-Pacific region have experienced significant health, social and economic impacts due to outbreaks of newly emerging diseases, including nipah virus, severe acute respiratory syndrome (SARS) and Avian Influenza (H5N1). Besides the death and damage to health, Avian Influenza, for example, cost the countries of the Asia Pacific region, estimated economic losses of around US $ 8-12 billion, primarily from the death or culling of 140 million chickens.

The geographic area encompassed by two WHO regions the SEARO (South-East Asia Region) and WPRO (Western Pacific Region) has also seen a resurgence of known communicable diseases like dengue, meningoccoccal infection, typhoid fever, cholera and leptospirosis. Their occurrence indicates the vulnerability of this region to emerging infectious diseases. Dr Samlee Plianbangchang, Regional Director of WHO South-East Asia Region cautioned that, In an era of globalization and an interconnected world, an infectious disease in any country can potentially constitute a threat to global health security.

Experiences from recent disease outbreaks have demonstrated that cooperation between Member States and WHO contributed significantly to mobilizing experts and resources. Recognizing the need to develop strategic approaches to address these evolving needs, the two WHO regional offices for the South-East Asia region and the Western-Pacific region, in consultation with the Eastern Mediterranean Region, have developed the Asia-Pacific Strategy on Emerging diseases

This strategy seeks to reduce the risk of emerging diseases and minimize their negative impacts. Its scope is broad with a wide range of actions including surveillance and outbreak alert and response; laboratory systems; infection prevention and control; zoonoses prevention and control; epidemic preparedness; information management and risk communication. These actions are linked and are interdependent and are organized with the framework of five key objectives. These objectives are (1) to develop and sustain a regional collaborative framework; (2) to reduce the risk of emerging diseases and related threats to health (3) to strengthen early detection of emerging diseases; (4) to strengthen early response to emerging diseases and minimize related threats to public health and (5) to improve national and regional preparedness to respond to emerging diseases.

Globally, the International Health Regulations (IHR), administered by WHO, are the only legally binding instrument covering measures for preventing cross-border spread of infectious disease. The world is beset with global threats from new and emerging infectious diseases as well as other potential public health emergencies of international concern. It became clear that the existing Health Regulations were inadequate to address these challenges and threats.

The Forty-eighth World Health Assembly had called for a revision of the existing regulations. In the South-East Asia region, there have been intensive discussions with countries and with partners outside the health sector, making substantial contributions to the IHR process. After similar discussions held around the world, the World Health Assembly adopted these revised Regulations, in May this year.

In a bid to strengthen national capacity to combat infectious diseases and to comply with the revised International Health Regulations, WHO will assist countries in carrying out an assessment of national capacities, preparation of epidemic/pandemic preparedness and response plans, stockpiling and supply of life saving medicines and laboratory supplies, said Dr Samlee. To meet the challenges of developing core capacity and health system development, including human resources, WHO will provide its technical support, and through regional consultation, prepare a regional strategy and plan of action for implementation. It will also mobilize extra budgetary funds to help build core capacity in the countries, he added.

Immunization program in Israel resulted in 95 % reduction in hepatitis A incidence

Wed, 13 Jul 2005 12:14:38 PST

( from http://www.rxpgnews.com ) A national immunization program for infants in Israel has resulted in a 95 percent reduction in overall hepatitis A incidence, according to a study in the July 13 issue of JAMA.

Until 1999, Israel was considered a country with intermediate hepatitis A virus endemicity (a disease constantly present to greater extent in a particular locality). Although the overall incidence has been progressively decreasing since the 1960s, the annual reported incidence during the 1992-1998 period ranged from 33 to 70 per 100,000 population, with marked fluctuations. Reports of outbreaks, especially those involving young children, increased. Because most young children have asymptomatic or unrecognized infection, they play an important role in hepatitis A virus transmission as a source of infection. Therefore, routine childhood vaccination would theoretically prevent infection in age groups that account for a substantial proportion of cases, eliminate a major source of infection for other children and adults, and eventually prevent infections in older persons as vaccinated children grow to adulthood, because immunity to hepatitis A virus by vaccination is long-lasting.

Health officials in Israel decided to introduce universal vaccination of toddlers against hepatitis A because of epidemiologic evidence and a cost-benefit analysis of the program. The program started in July 1999 and is included in the National Health Services list so that the vaccine is given free of charge. A dose is given at ages 18 and 24 months. Immunization of older high-risk groups, such as drug users, continued.

Ron Dagan, M.D., of Ben-Gurion University of the Negev, Beer-Sheva, Israel, and colleagues examined the impact of the toddlers-only vaccination program of hepatitis A disease in all ages in the 5.5 years following initiation of the program. Overall vaccine coverage in Israel in 2001-2002 was 90 percent for the first dose and 85 percent for the second dose.

A decline in disease rates was observed before 1999 among the Jewish but not the non-Jewish population. The researchers found that after initiation of the program, a sharp decrease in disease rates was observed in both populations. The annual hepatitis A incidence rate of 2.2 to 2.5 per 100,000 during 2002-2004 represents a 95 percent or greater reduction for each year with respect to the average incidence during 1993-1998 (50.4 per 100,000). For children aged 1 through 4 years, a 98.2 percent reduction in hepatitis A disease was observed in 2002-2004, compared with the prevaccination period. However, a sharp decline was also observed in all other age groups (84.3 percent [less than 1 year], 96.5 percent [5-9 years], 95.2 percent [10-14 years], 91.3 percent [15-44 years], 90.6 percent [45-64 years], and 77.3 percent [65 years or older]). Among the Jewish population in the Jerusalem district, in whom the active surveillance program was successfully conducted, a more than 90 percent reduction of disease was demonstrated. Of the 433 cases reported nationwide in 2002-2004 in whom vaccination status could be ascertained, 424 (97.9 percent) received no vaccine and none received 2 doses.

"In the next decade, many regions worldwide will move from a state of high endemicity to a state of intermediate endemicity. The Israeli program of universal toddlers-only vaccination can serve as a paradigm of a simplified model of effective vaccination for both developed and developing countries," the authors conclude.

In an accompanying editorial, Pierre Van Damme, M.D., Ph.D., and Koen Van Herck, M.D., of the University of Antwerp, Belgium, comment on the studies in this week's JAMA on hepatitis A vaccination programs.

"The baseline differences in disease incidence between vaccinating and nonvaccinating states in the United States on which the universal vaccination recommendations were determined were eliminated and the incidence gap between high and intermediate endemic populations in Israel was narrowed or almost closed. Vaccination was a major contributor to these declines but, as discussed by both sets of authors, it is difficult to evaluate to what extent the observed reduction of the hepatitis A virus incidence rate could be attributed to improved environmental and hygienic conditions or to the epidemic cycles that characterized the epidemiology of hepatitis A virus in the past. Only continued disease surveillance will allow confirmation of the real impact and added value of these mass vaccination programs."

"...if administration of multiple vaccines or combination vaccines is not an issue, and if the vaccine cost is reasonable, toddlers-only or childhood immunization programs could become a realistic strategy in countries and regions where endemicity is shifting from high to intermediate, a situation that will increase in the next decade worldwide," the authors conclude.

Project launched to combat vitamin and mineral deficiency in Côte dIvoire

Fri, 24 Jun 2005 17:56:38 PST

( from http://www.rxpgnews.com ) A national food fortification project designed to improve the health of at least 14 million people in Côte dIvoire was launched today in Abidjan. The project, announced by Côte dIvoire Minister of State, Minister of Health and Population Dr Albert Toikeusse Mabri, is supported by a US$3 million grant from the Global Alliance for Improved Nutrition (GAIN) and contributions by the private sector and government in Côte dIvoire, and will be implemented by Helen Keller International, Côte dIvoire.

Despite a difficult political situation, the project aims to deliver fortified vegetable oil and wheat flour to 80 percent of Côte dIvoire consumers, including poor and at-risk populations in all areas of the country within three years. GAIN has been working with a broad-based national fortification alliance for the last two years to support a project that can deliver the maximum benefit to the people of Côte dIvoire, said Chairman of the GAIN Board of Directors Mr Jay Naidoo.

The public-private-partnership project involves fortification of palm and cottonseed vegetable oils with vitamin A, and fortification of wheat flour with iron and folic acid, and is included in Côte dIvoires national micronutrient deficiency control program.

The grant will fund the purchase of vitamin and mineral premix in the projects first year, provide part of the technical assistance to the countrys three main oil processors and single flour miller, strengthen public quality control systems, support a campaign to raise awareness of the value of consuming fortified food products, and meet management and monitoring costs.

Vitamin A deficiency, which affects 40-60 percent of children under five across the developing world, compromises immune systems and leads to a million deaths globally each year. Iron deficiency is the worlds most widespread health problem, impairing normal development in about half the infants born in the developing world, sapping the health and energies of 500 million women and leading to more than 60,000 deaths during childbirth a year. Folate deficiency is responsible for 200,000 severe birth defects every year in developing countries.

Vitamin A deficiencies affect 31percent of children under five in Côte dIvoire, mainly those in rural, poor and disadvantaged peri-urban areas. If no appropriate action is taken for the control of vitamin A deficiencies, more than 50 000 children under five, which represents 18 percent of the age group death rate, will die by 2006. Anaemia due to iron deficiency affects 60 percent of pregnant women, half the women of reproductive age and about 45 percent of pre-school and school children. If appropriate measures are not taken to control mothers anaemia, 3 400 mothers will die by year 2006. Folic acid deficiencies will be responsible of a high number of neural tube defects (spina - bifida).

Fortifying commonly consumed foods in Côte dIvoire and other countries offers incredibly good value for each development dollar, Mr Naidoo said. Benefits can be delivered to the poorest consumers outside the traditional health sector, through the actions of food companies.

Market leaders in food processing in Côte dIvoire are Unilever, Cosmivoire, Trituraf, and Grands Moulins DAbidjan. The project aims to achieve fortification of all vegetable oil and wheat flour produced in the country by the end of the three-year project, which should provide 50 percent of a persons daily needs for vitamin A and 30 percent for iron and folic acid.

As well as food industry representatives, the national fortification alliance in Côte dIvoire comprises government agencies, responsible for regulation, standards and public information, research institutes, and civil society organizations, committed to raising community awareness about the fortification program.

The United Nations and other development agencies recognize the importance of adequate nutrition, particularly vitamins and minerals, for the achievement of development goals such as poverty reduction, educational achievement, gender equity, child and maternal health, and helping combat diseases including HIV/AIDS and malaria.

The recent report by the Commission for Africa, chaired by British Prime Minister Tony Blair, stated reducing vitamin and mineral deficiency, through supplements and fortification, has minimal costs with big impact and estimated a US$0.2 billion investment by donors per year for five years would give comprehensive protection against vitamin and mineral deficiency for up to 380 million African women and children at risk.

Côte dIvoire is the sixth country to launch a grant funded by GAIN supporting the national fortification program. Neighboring Mali has also received a grant, and grants for Burkina Faso, Ghana and Nigeria have been approved and are in the process of appraisal and final negotiation. The expansion of fortification programs across West Africa is important due to the high degree of cross-border trade in commodities such as vegetable oil.

With the current high level of international interest in development assistance to Africa, GAIN supports a Special Initiative for Food Fortification in Africa. This would include a rapid scaling up of the number of national food fortification programs from the eight currently funded by GAIN in Africa, investment in relatively simple fortification technologies in the rapidly expanding wheat flour, maize meal and vegetable oil processing sectors, and further research and development in fortification of African foods such as cassava flour, sugar, salt and rice.

The initiative reflects the food fortification approach of the New Partnership for Africas Development (NEPAD) Nutrition Strategy, adopted by the Comprehensive African Agricultural Development Program.

The official launch of the Côte dIvoire national food fortification project was hosted by the President of the National Fortification Alliance, Minister Dr. Albert Toikeusse Mabri, and was attended by GAIN Senior Portfolio Manager Françoise Chomé and Mr. Shawn Baker, Regional Director for Africa of Helen Keller International.

10,000 children in developing countries to receive AIDS treatment

Thu, 14 Apr 2005 16:40:38 PST

( from http://www.rxpgnews.com ) UNICEF praised a Clinton Foundation plan that will significantly increase the number of children receiving life-prolonging antiretroviral (ARV) drugs specifically formulated for them.

While there has been impressive progress in treating HIV/AIDS in adults, children living with HIV, or who have AIDS, have not seen the benefits. This initiative is a great first step in the right direction, but much more needs to be done, and done quickly. Children should never be last on the list to get this kind of treatment, they should be among the first," UNICEF Executive Director Carol Bellamy said.

The plan calls for treating 10,000 HIV-positive children in 2005, and includes an agreement with CIPLA, an India-based pharmaceutical company to supply pediatric AIDS drugs at less than half current market rates.

Pediatric medicines have already been ordered for China, the Dominican Republic, Lesotho, Rwanda and Tanzania, with treatment set to begin as early as May in China. An additional five countries are to be added during 2005. Together with UNICEF and partners, the Foundation expects to be treating up to 60,000 children by 2006.

In most developing countries, challenges to providing treatment for children with AIDS include lack of facilities and technologies for early diagnosis of HIV in children, poor health infrastructure and systems, insufficient trained health personnel and the absence of appropriate pediatric ARV formulations.

Where treatments are available cost has been prohibitive, with pediatric formulations costing up to five times as much as ARV drugs for adults, in part because suppliers do not have large enough orders.

Children represent a disproportionate number of those needing immediate AIDS treatment. Today, 15,000 25,000 children out of an estimated 2.2 million children living with HIV are on treatment, with nearly half of the total in Brazil and Thailand. In 2004 alone, some 640,000 children under age 15 became infected, and around 510,000 children died of AIDS. The vast majority of children who become HIV-positive will die before age 5 without treatment. Globally, three per cent of deaths in children under 5 are now attributable to AIDS. In hard-hit countries, AIDS causes between a third and half of child deaths.

The most effective way of preventing HIV in children is to keep them from getting infected in the first place, Bellamy added. We have the drugs and technology to prevent the vast majority of infections by mother to child transmission, but are simply not scaling up interventions fast enough.

It marks a remarkable initiative and one which we congratulate President Clinton wholeheartedly on. However so much more still needs to be done to provide urgent assistance to the increasing number of children living with, and increasingly affected by HIV/AIDS.

UN condemns irresponsible attack on antiretroviral therapy

Thu, 31 Mar 2005 16:57:38 PST

( from http://www.rxpgnews.com ) A recent advertising campaign is touting the benefits of vitamin therapy above antiretroviral therapy and claiming that antiretroviral therapy is toxic. These advertisements are wrong and misleading, said the WHO, UNICEF and the Joint United Nations Programme on HIV/AIDS (UNAIDS) today.

WHO, UNICEF and UNAIDS have condemned the irresponsible linking of their names to claims that vitamins and nutrition therapy alone can prevent AIDS deaths.

A number of accounts published by Matthias Rath on his website and distributed as flyers and advertisements within South Africa state that a number of United Nations bodies including WHO, UNICEF and UNAIDS endorse his approach. The three UN organizations are extremely concerned about these misrepresentations and note that the Rath Foundation uses quotes and information from UN agencies out of context. Misrepresentation of this sort is both dangerous and unhelpful.

Over the last few years, several studies have been carried out to investigate the role of micronutrient supplements on the course of HIV/AIDS disease. The results of these studies have not been conclusive. WHO and UNAIDS recommendations for micronutrient supplementation are therefore similar for all people whether they are infected with HIV or not.

As in the population at large, a good diet that provides the full range of essential micronutrients is important to the health of people infected with HIV and can help bolster the immune system, boost energy levels and maintain body weight and well-being. Guidelines
published jointly by the Food and Agriculture Organization (FAO) and WHO in 2003 offer simple dietary suggestions for people living with HIV and AIDS.

Although they may help to meet increased nutritional requirements, nutritional supplements cannot replace eating a balanced and healthy diet. Whether a person is infected with HIV or not, WHO and UNAIDS recommend a good mixed diet, whenever possible, rather than
dietary supplements. For people on antiretroviral therapy, good nutrition and clean water help treatment work more effectively.

Vitamins and nutritional supplements alone can not take the place of comprehensive treatment and care for people living with HIV/AIDS, including prophylaxis and treatment for opportunistic infections and antiretroviral therapy, where indicated, as well as a good,
balanced diet. Antiretroviral therapy has been shown in numerous studies to reduce the replication of HIV in the body, reduce the incidence of opportunistic infections and AIDS related illness and improve quality of life. In countries where it is widely available, antiretroviral therapy has turned AIDS from a death sentence into a chronic but manageable disease. As with any other drugs, antiretroviral treatments do have side effects that have been documented in clinical trials.