Global & Disaster Medicine

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World Fistula Day

Kenya Star

“…..The three-day conference, under the theme of “Ending Obstetric Fistula in a Generation” is part of the commemorations to mark the World Fistula Day, observed today.

Other related activities include an ongoing Fistula screening and medical intervention of the condition at Gatundu Level 5 hospital.

Obstetric Fistula is a devastating and demeaning condition caused by prolonged obstructed labour, leaving a woman with insufficient voluntary control over urination. It also causes suffering, indignity and disability. The condition is preventable and treatable.

Strong smells occasioned by this condition forces many affected women to remain in hiding away from any public interactions including being shunned by insensitive family members. Separation and divorce are some of the other consequences of the condition.

Globally, an estimated 2 million mothers suffer the stigma of Obstetric Fistula while giving birth……”

 


Haiti: Vendors act as pharmacists and confessors. “People have no secrets from us. They tell us about their infections, digestion, and sexual matters. For each problem we have a pill.”

National Geographic

“….The portable pharmacies may look like contemporary art installations or candy store displays, but they can be as dangerous as Russian roulette. The government’s lack of oversight allows untrained merchants like Bonord to obtain and sell pharmaceutical products: generic medicines from China, expired pills, counterfeit drugs imported from the Dominican Republic.

The activity is technically illegal, but the laws are rarely enforced by the Ministry of Public Health and Population. So the vendors sell anything they can get their hands on, from abortion pills to Viagra knockoffs. Sometimes they give bad advice to their clients. One seller told a teenager to take powerful antibiotics for his acne…..”

 


A new report from the National Academies of Sciences, Engineering, and Medicine identifies global health priorities in light of current and emerging challenges and makes 14 recommendations for the U.S. government and other stakeholders to address these challenges, while maintaining U.S. status as a world leader in global health.

National Academies

May 15, 2017

FOR IMMEDIATE RELEASE

New Report Recommends Priority Actions to Achieve Global Health Security, Protect U.S. Position as Global Health Leader, and Safeguard Billions of Dollars in Health Investments

WASHINGTON – A new report from the National Academies of Sciences, Engineering, and Medicine identifies global health priorities in light of current and emerging challenges and makes 14 recommendations for the U.S. government and other stakeholders to address these challenges, while maintaining U.S. status as a world leader in global health.

“The increased interdependency of countries, economies, and cultures resulting from tremendous growth in international travel and trade over the last several decades has brought improved access to goods and services, but also a variety of health threats,” said Jendayi Frazer, co-chair of the committee that conducted the study and wrote the report and adjunct senior fellow for Africa studies at the Council on Foreign Relations.  “The United States must preserve and extend its legacy as a global leader, partner, and innovator in global health through forward-looking policies, country and international partnerships, and, most importantly, continued investment.  Doing so will not only lead to improved health and security for all U.S. citizens but also ensure the sustainable thriving of the global population.”

“By investing in global health over the next 20 years, there is a chance to save the lives of millions of children and adults,” said committee co-chair Valentin Fuster, physician-in-chief at Mount Sinai Hospital and director of Mount Sinai Heart.  “The health and well-being of other countries both directly and indirectly affect the health, safety, and economic security of Americans.  The U.S. government should maintain its leadership position in global health as a matter of urgent national interest and as a global public benefit that enhances America’s international standing.”

While prioritization of resources for each issue or disease is necessary, it is also essential to embrace a systems-focused approach to capacity building and partnership to achieve results more comprehensively.  The committee identified four priority areas encompassing the 14 recommendations for global health action:

Achieve global health security. In the last 10 years, outbreaks of potentially pandemic influenza, Middle East Respiratory Syndrome Coronavirus, Ebola, and Zika have threatened populations around the world. In each case, global and national responses, including those of the United States, have been reactionary, uncoordinated, ineffective, and expensive, the report says.

The presidential administration should create a coordinating body within the U.S. government with the authority and budget to develop a proactive, cost-effective, and comprehensive approach to preparedness for and response to international public health emergencies. The U.S. departments of Health and Human Services, Defense, and Agriculture, and U.S. Agency for International Development (USAID) should continue investments at the national level and increase investments at the international level to improve capabilities to confront the growing threat of antimicrobial resistance.  In addition, the administration also should strengthen preparedness and response capacity in low- and middle-income countries through training and information exchange efforts.

Maintain a sustained response to the continuous threats of communicable diseases.  Dedicated efforts over the last few decades have resulted in millions of lives saved from AIDS, TB, and malaria, yet these three diseases continue to pose immediate and long-term threats to the health of populations around the world, the report says.  For example, more than 36 million people are living with HIV, with 2 million infections occurring yearly.

The committee recommended a sustained focus on HIV/AIDS through the President’s Emergency Plan for AIDS Relief (PEPFAR) with continued emphasis on accountability, efficiency, and measurement of results.  The U.S. Centers for Disease Control and Prevention (CDC), National Institute of Allergy and Infectious Diseases, and USAID should conduct a thorough global threat analysis of rising TB levels and execute a plan of action for developing new diagnostics, drugs, vaccines, and delivery systems.  In addition, relevant U.S. government agencies should continue efforts against malaria through the President’s Malaria Initiative and collaborative work with partners toward elimination of the disease, the report says.

Save and improve the lives of women and children.  Although child and maternal mortality rates have decreased, each year nearly 6 million children die before age 5, and more than 300,000 women die from pregnancy- and childbirth-related causes, the vast majority of which are preventable.  The report calls for increased funding to augment USAID’s investments in ending preventable maternal and child mortality to include priority interventions supported by rigorous monitoring and evaluation. In addition, USAID, PEPFAR, their implementing partners, and other funders should support and incorporate proven, cost-effective interventions into their existing programs for ensuring that all children reach their developmental potential and become healthy, productive adults.  This includes interventions such as providing adequate nutrition for optimal cognitive development and detecting and managing postpartum depression and other maternal mental health issues.

Promote cardiovascular health and prevent cancer.  Noncommunicable diseases (NCDs) such as cardiovascular disease (CVD), chronic obstructive pulmonary disease, and lung cancer result in 40 million deaths globally each year, almost three-quarters of which are in low- and middle-income countries.  The costs of managing these diseases are rising as well, with CVD alone projected to cost the world $1 trillion annually in treatment costs and productivity losses by 2030.  Many health systems in these countries are not adequately equipped to care for patients with NCDs, due to historical focus on infectious diseases.  The committee called for USAID, the U.S. State Department, and the CDC to support improved mobilization and coordination of private partners at the country level to implement strategies targeting CVD risk factors, early detection and treatment of hypertension and cervical cancer, and immunization against cancer-causing viruses, such as HPV and hepatitis B.

To maximize the returns on investments in these four priority areas, achieve better health outcomes, and use funding more effectively, the report says the U.S. should:

  • catalyze innovation through the accelerated development of medical products and integrated digital health infrastructure;
  • employ more flexible financing mechanisms to leverage new partners and funders in global health; and
  • maintain U.S. status and influence as a world leader in global health while adhering to evidence-based science and economics, measurement, and accountability.

The study was sponsored by the U.S. Centers for Disease Control and Prevention, U.S. Food and Drug Administration, National Institutes of Health, President’s Emergency Plan for AIDS Relief, U.S. Agency for International Development, Rockefeller Foundation, Medtronic, Merck Foundation, and BD (Becton, Dickinson and Company).  The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine.  The National Academies operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln.  For more information, visit http://national-academies.org.  A committee roster follows.

 

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Contacts:
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Liberia: WHO’s evidence suggests a mysterious illness that has sickened 28 people so far and killed 12 is linked to food or drink poisoning and is not a viral infection

The Guardian

  • The cases appeared tied to one funeral suggesting that an isolated poisoning was to blame
  • WHO and medical charity Doctors Without Borders have said the warning system put in place in Liberia after the Ebola crisis prompted fast action following the recent deaths.
  • The unexplained illness causes fever, vomiting, headaches and diarrhoea.

 


Liberia: Two more deaths have been reported in an unexplained illness cluster, raising the total to 11, and though tests have ruled out Ebola, authorities are eyeing foodborne or waterborne illnesses as the possible cause.

Liberia MOH

 


Liberia: 11 people have died and five are in hospital after contracting a mystery illness the World Health Organisation (WHO) said was linked to attendance at the funeral of a religious leader.

Reuters

  • The symptoms include fever, vomiting and diarrhea
  • Hospital staff are wearing protective equipment
  • Contacts of the sick are being traced in the community to see if they have fallen ill
  • WHO, U.S. Centers for Disease Control and other partners are providing technical and logistical support to the rapid response team that has been activated at district and county levels

 

 


WHO: “Today, almost two billion people use a source of drinking-water contaminated with faeces, putting them at risk of contracting cholera, dysentery, typhoid and polio.”

Asian Correspondent

WHO

Radical increase in water and sanitation investment required to meet development targets

News release

Countries are not increasing spending fast enough to meet the water and sanitation targets under the Sustainable Development Goals (SDGs), says a new report published by WHO on behalf of UN-Water – the United Nations inter-agency coordination mechanism for all freshwater-related issues, including sanitation.

“Today, almost two billion people use a source of drinking-water contaminated with faeces, putting them at risk of contracting cholera, dysentery, typhoid and polio,” says Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health.

“Contaminated drinking-water is estimated to cause more than 500 000 diarrhoeal deaths each year and is a major factor in several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma,” added Neira.

The report stresses that countries will not meet global aspirations of universal access to safe drinking-water and sanitation unless steps are taken to use financial resources more efficiently and increase efforts to identify new sources of funding.

According to the UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) 2017 report, countries have increased their budgets for water, sanitation and hygiene at an annual average rate of 4.9% over the last three years. Yet, 80% of countries report that water, sanitation and hygiene (WASH) financing is still insufficient to meet nationally-defined targets for WASH services.

In many developing countries, current national coverage targets are based on achieving access to basic infrastructure, which may not always provide continuously safe and reliable services. Planned investments have yet to take into account the much more ambitious SDG targets, which aim for universal access to safely managed water and sanitation services by 2030.

In order to meet the SDG global targets, the World Bank estimates investments in infrastructure need to triple to US $114 billion per year – a figure which does not include operating and maintenance costs.

While the funding gap is vast, 147 countries have previously demonstrated the ability to mobilize the resources required to meet the Millennium Development Goal target of halving the proportion of people without an improved source of water, and 95 met the corresponding target for sanitation. The much more ambitious SDG targets will require collective, coordinated and innovative efforts to mobilize even higher levels of funding from all sources: taxes, tariffs (payments and labour from households), and transfers from donors.

“This is a challenge we have the ability to solve,” says Guy Ryder, Chair of UN-Water and Director-General of the International Labour Organization. “Increased investments in water and sanitation can yield substantial benefits for human health and development, generate employment and make sure that we leave no one behind.”

Additional Findings:

Official development assistance (ODA) disbursements for water and sanitation are increasing, but future investments are uncertain.

Water and sanitation ODA disbursements (spending) increased from US$ 6.3 to US$ 7.4 billion from 2012 to 2015. However, aid commitments for water and sanitation have declined since 2012 from US$ 10.4 billion to US$ 8.2 billion in 2015. Due to the multi-year nature of commitments, if commitments were to continue to decrease, it is likely that future disbursements would also decrease. Considering the greater needs to make progress towards universal access to safely managed WASH services under the SDG targets, the possibility of future reductions in aid disbursements is at odds with global aspirations.

Extending WASH services to vulnerable groups is a policy priority, but implementation is lagging.

Over 70% of countries report having specific measures to reach poor populations in their WASH policies and plans. However, the implementation of such concrete measures is lagging: few countries indicate that they are able to consistently apply financing measures to target resources to poor populations. Increasing and sustaining WASH access for vulnerable groups will not only be critical for achieving SDG 6, but also for SDG 3 on ensuring healthy lives and promoting well-being for all at all ages.

The GLAAS 2017 report presents an analysis of the most reliable and up-to-date data from 75 countries and 25 external support agencies on issues related to financing universal access to water and sanitation under the SDGs. Safe drinking-water and sanitation are crucial to human welfare, by supporting health and livelihoods and helping to create healthy environments. Drinking unsafe water impairs human health through illnesses such as diarrhea, and untreated sewage can contaminate drinking-water supplies and the environment, creating a heavy burden on communities.


WHO Reports ‘Record-breaking’ Progress: About 1.5 billion people in 149 countries, down from 1.9 billion in 2010, are affected by neglected tropical diseases (NTD)

VOA

WHO

Unprecedented progress against neglected tropical diseases, WHO reports

WHO reports remarkable achievements in tackling neglected tropical diseases (NTDs) since 2007. An estimated 1 billion people received treatment in 2015 alone.

“WHO has observed record-breaking progress towards bringing ancient scourges like sleeping sickness and elephantiasis to their knees,” said WHO Director-General, Dr. Margaret Chan. “Over the past 10 years, millions of people have been rescued from disability and poverty, thanks to one of the most effective global partnerships in modern public health”.

The WHO report, Integrating neglected tropical diseases in global health and development, demonstrates how strong political support, generous donations of medicines, and improvements in living conditions have led to sustained expansion of disease control programs in countries where these diseases are most prevalent.

Since 2007, when a group of global partners met to agree to tackle NTDs together, a variety of local and international partners have worked alongside ministries of health in endemic countries to deliver quality-assured medicines, and provide people with care and long-term management.

In 2012, partners endorsed a WHO NTD roadmap, committing additional support and resources to eliminating 10 of the most common NTDs.

Key achievements include:

  • 1 billion people treated for at least one neglected tropical disease in 2015 alone.
  • 556 million people received preventive treatment for lymphatic filariasis (elephantiasis).
  • More than 114 million people received treatment for onchocerciasis (river blindness: 62% of those requiring it.
  • Only 25 human cases of Guinea-worm disease were reported in 2016, putting eradication within reach.
  • Cases of human African trypanosomiasis (sleeping sickness) have been reduced from 37 000 new cases in 1999 to well under 3000 cases in 2015.
  • Trachoma – the world’s leading infectious cause of blindness – has been eliminated as a public health problem in Mexico, Morocco, and Oman. More than 185 000 trachoma patients had surgery for trichiasis worldwide and more than 56 million people received antibiotics in 2015 alone.
  • Visceral leishmaniasis: in 2015 the target for elimination was achieved in 82% of sub-districts in India, 97% of sub-districts in Bangladesh, and in 100% of districts in Nepal.
  • Only 12 reported human deaths were attributable to rabies in the WHO Region of the Americas in 2015, bringing the region close to its target of eliminating rabies in humans by 2015.

However, the report highlights the need to further scale up action in other areas.

“Further gains in the fight against neglected tropical diseases will depend on wider progress towards the Sustainable Development Goals,” said Dr Dirk Engels, Director of the Department of Control of Neglected Tropical Diseases. Meeting global targets for water and sanitation will be key. WHO estimates that 2.4 billion people still lack basic sanitation facilities such as toilets and latrines, while more than 660 million continue to drink water from “unimproved” sources, such as surface water.

Meanwhile, global concern about the recent outbreaks of Zika virus disease, and its associated complications, has re-energized efforts to improve vector control. In May this year, the World Health Assembly will review proposals for a new Global vector control response. There are also brighter prospects to prioritize cross-sectoral collaboration to promote veterinary public health.

Global Partners’ Meeting

Integrating neglected tropical diseases in global health and development is being released at the Global Partners’ Meeting on Neglected Tropical Diseases (NTDs) in Geneva, on 19 April 2017.

The Meeting will celebrate efforts to “Collaborate. Accelerate. Eliminate”, and will be attended by health ministers, industry representatives, partners and a host of well-known personalities, including philanthropists, donors and stakeholders.

Besides celebrating 10 years of multi-stakeholder collaboration, the event will also mark the 5th anniversary of the WHO NTD Roadmap which established targets and milestones for the global control, elimination, and eradication of many of these diseases as well as that of the London Declaration.

Note to editors:

Neglected tropical diseases blind, maim, disfigure and debilitate hundreds of millions of people in urban slums and in the poorest parts of the world.

Once widely prevalent, these diseases are now restricted to tropical and sub-tropical regions with unsafe water, inadequate hygiene and sanitation, and poor housing conditions. Poor people living in remote, rural areas, urban slums, or conflict zones are most at risk.

More than 70% of countries and territories that report the presence of NTDs are low or lower-middle income economies.

 


World Health Day – 7 April 2017

WHO

World Health Day 2017 video

Depression: let’s talk

7 April 2017 – WHO is leading a one-year global campaign on depression. The highlight is World Health Day 2017, celebrated today. The goal of the campaign is that more people with depression, everywhere in the world, both seek and get help. Depression is the leading cause of ill health and disability worldwide. More than 300 million people are now living with depression, an increase of more than 18% between 2005 and 2015.

 


Smoking causes one in 10 deaths worldwide and half of them in just 4 countries – China, India, the US and Russia.

BBC

Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015

www.thelancet.com   Published online April 5, 2017   http://dx.doi.org/10.1016/S0140-6736(17)30819-X

Findings:  Worldwide, the age-standardized prevalence of daily smoking was 25·0% (95% uncertainty interval [UI] 24·2–25·7) for men and 5·4% (5·1–5·7) for women, representing 28·4% (25·8–31·1) and 34·4% (29·4–38·6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualized rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualized increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11·5% of global deaths (6·4 million [95% UI 5·7–7·0 million]) were attributable to smoking worldwide, of which 52·2% took place in four countries (China, India, the USA, and Russia). Smoking was ranked among the five leading risk factors by DALYs in 109 countries and territories in 2015, rising from 88 geographies in 1990. In terms of birth cohorts, male smoking prevalence followed similar age patterns across levels of SDI, whereas much more heterogeneity was found in age patterns for female smokers by level of development. While smoking prevalence and risk-deleted DALY rates mostly decreased by sex and SDI quintile, population growth, population ageing, or a combination of both, drove rises in overall smoking attributable DALYs in low-SDI to middle-SDI geographies between 2005 and 2015.

 

 


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