Global & Disaster Medicine

Archive for the ‘Global Health’ Category

Globally, some 61 million people suffer serious physical and psychological suffering and pain each year. Of this total, some 83 percent live in low- and middle-income countries where access to low-cost, off-patent morphine is rare or completely unavailable.

University of Miami

The Lancet

“…..Impediments to [opiate analgesic] use included an absence of training and awareness in medical professionals, fear of dependence, restricted financial resources, issues in sourcing, cultural attitudes, fear of diversion, international trade controls, and onerous regulation….Use of opioid analgesics has increased, but remains low in Africa, Asia, Central America, the Caribbean, South America, and eastern and southeastern Europe. Identified impediments to use urgently need to be addressed by governments and international agencies…….”


Nestlé’s direct-sales army in Brazil is part of a broader transformation of the food system that is delivering Western-style processed food and sugary drinks to the most isolated pockets of Latin America, Africa and Asia.

NY Times


“…..A New York Times examination of corporate records, epidemiological studies and government reports — as well as interviews with scores of nutritionists and health experts around the world — reveals a sea change in the way food is produced, distributed and advertised across much of the globe. The shift, many public health experts say, is contributing to a new epidemic of diabetes and heart disease, chronic illnesses that are fed by soaring rates of obesity in places that struggled with hunger and malnutrition just a generation ago….”

Resolve: A new $225 million global health initiative

Vital Strategies

September 12, 2017

Vital Strategies launches Resolve, a new $225 million global health initiative

By José Luis Castro, President and Chief Executive Officer, Vital Strategies

Vital Strategies was born out of the vision that every person deserves to be protected by a strong public health system, and the knowledge that we can rapidly save lives and build sustainable progress through assisting governments in tackling difficult health challenges.

In a short time, we have become a truly global organization, operating across sixty countries, and building a reputation as an organization with the capacity and knowledge to act swiftly, with leading public health expertise.

We have proven successes across health issues that are critical to global health, including non-communicable disease and injury prevention, tuberculosis, maternal health and more.

But there are still significant gaps. Today, I am pleased to announce we are supporting an unprecedented new initiative to address two of the largest needs.

Called Resolve, this new US $225 million Initiative will save more than 100 million lives by preventing heart attacks and strokes and will help countries close life-threatening gaps in epidemic preparedness and response. The initiative will be housed at Vital Strategies, and led by Resolve CEO and President, Dr. Tom Frieden, former director of the US Centers for Disease Control and Prevention and former commissioner of the New York City (NYC) Health Department. Born of Dr. Frieden’s experience and vision, Resolve has received a truly remarkable funding commitment from three of the world’s leading philanthropic organizations – Bloomberg Philanthropies, the Chan Zuckerberg Initiative, and the Bill & Melinda Gates Foundation.

Vital Strategies’ team of global health experts will help implement this program, providing support and technical assistance, and we will work closely with the World Health Organization (WHO), Bloomberg School of Public Health at The Johns Hopkins University, the CDC Foundation, the World Bank and the Campaign for Tobacco-Free Kids.

There are two components of this initiative. Resolve – To Save 100 Million Lives focuses on heart diseases and strokes, which kill 18 million people every year. High blood pressure alone is the world’s leading cause of death, killing 10 million people annually, more than all infectious diseases combined. Strategic investment in three key areas could deliver rapid progress to prevent 100 million deaths: improved treatment of high blood pressure, elimination of artificial trans fats, and sodium reduction.

The second component of this initiative, Resolve – To Prevent Epidemics, will help governments in low- and middle-income countries move from the Joint External Evaluation (JEE) assessments to funded, implemented, and sustained programs to make their countries, regions, and the world safer from epidemics. This part of the initiative will focus on four key areas to improve capacity and preparedness: implementing and strengthening disease tracking systems, supporting laboratory networks, developing and supporting “disease detectives,” and developing rapid response teams to prevent unchecked outbreaks.

I am honored that this initiative is being housed at Vital Strategies. This initiative is a perfect fit with our expertise of building and strategically utilizing public health intelligence, mounting strategic communication programs to shape the public health agenda and change behavior, and strengthening critical public health systems.

We look forward to working closely with Dr. Frieden in the years ahead, to save millions of people from preventable disease, disability and premature death.

Across the islands of Indonesia, more than 267,000 children are estimated to use tobacco products every day.


Brazil now faces a new threat: Oropouche fever.

NY Times

“…..The Oropouche virus, named for a river in Trinidad, where it was first isolated in 1955, circulates in monkeys and sloths in the Amazon jungle. The virus has caused occasional outbreaks, short but intense, in towns in tropical areas of Brazil, Peru and Panama, and on some Caribbean islands.

But in the last few years, Oropouche cases have turned up more often in urban areas, including some in northeast Brazil, where Zika began its explosive spread in this hemisphere.

Oropouche causes symptoms resembling those of dengue: high fever, headaches and joint pain, nausea and malaise. The infection is not normally fatal, although it can cause meningitis…….The virus is typically transmitted by a biting midge, Culicoides paraensis, that ranges from Argentina to as far north as Wisconsin……..”


Lower respiratory tract infections (LRIs) caused 2.74 million deaths worldwide in 2015, making them the fifth leading cause of death, and the second leading cause of death for children under the age of 5 years.

The Lancet

Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195 countries: a systematic analysis for the Global Burden of Disease Study 2015
Troeger, Christopher et al.
The Lancet Infectious Diseases

“…..LRIs are the leading infectious cause of death and the fifth-leading cause of death overall; they are the second-leading cause of DALYs. At the global level, the burden of LRIs has decreased dramatically in the last 10 years in children younger than 5 years, although the burden in people older than 70 years has increased in many regions. LRI remains a largely preventable disease and cause of death, and continued efforts to decrease indoor and ambient air pollution, improve childhood nutrition, and scale up the use of the pneumococcal conjugate vaccine in children and adults will be essential in reducing the global burden of LRI….”



India: An in-hospital mortality rate of nearly 70% was observed in patients with dual colistin- and carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CCRKP BSI)


  • 75 patients with colistin-resistant Klebsiella pneumoniae bloodstream infections were examined.
  • Observed:  A high in-hospital mortality rate of 69.3% (52/75 patients).
  • Among the 52 patients who did not survive, 28 patients died within 48 hours of bacteremia.

Clinical outcome of dual colistin- and carbapenem-resistant Klebsiella pneumoniae bloodstream infections: A single-center retrospective study of 75 cases in India

Kaur, Amarjeet et al.

American Journal of Infection Control


Bangladesh’s contaminated well water is considered one of the largest public health crises in the world, and yet it remains relatively unknown outside of scientific circles.


  • An estimated 40 million people — one quarter of the population — are exposed to drinking water contaminated with arsenic.
  • Chronic exposure may lead to only a few visible symptoms (skin pigmentation on the chest, hands, and feet occurs in a minority of cases), but the poison is exceptional in its ability to silently attack multiple organs over the course of years, or even decades.
  • Trace arsenic exposure in Bangladesh appears to have led to dramatic increases in cancers ranging from skin to liver to lung, in cardiovascular disease, and in developmental and cognitive problems for children.



No O2: The government hospital, part of the larger Baba Raghav Das Medical College in Gorakhpur, considered a beacon to millions of people, is now a symbol of India’s swamped, mismanaged and often corrupt public health care system.

NY Times


August 14–18, 2017, is the first Fungal Disease Awareness Week




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