Global tobacco death toll still climbing


The percentage of men and women who use tobacco every day has dropped in most nations since 1990, but the total number of smokers and tobacco-related deaths has increased, a consortium of researchers reported Thursday.

Mortality could rise even further as major tobacco companies aggressively target new markets, especially in the developing world, they warned in a major study, published in the medical journal The Lancet.

One in four men and one in 20 women smoked daily in 2015, according to the Global Burden of Diseases report, compiled by hundreds of scientists.


That was a significant drop compared to 25 years earlier, when one in three men and one in 12 women lit up every day.

But the number of deaths attributed to tobacco — which topped 6.4 million in 2015 — went up by 4.7 per cent over the same period due to the expanding world population, the report found.

"Sadly, all those deaths were preventable," senior author Emmanuela Gakidou from the Institute for Health Metrics and Evaluation at the University of Washington told AFP.

"The deaths of all the people who will die next year and the year after that, and so on, are also preventable."

More than 930 million people smoked daily in 2015, compared to 870 million in 1990 — a seven per cent jump.

Smoking causes one in 10 deaths worldwide, half of them in just four countries: China, India, the United States and Russia.

Together with Indonesia, Bangladesh, the Philippines, Japan, Brazil, and Germany, they account for fully two-thirds of global tobacco use.

"Smoking remains the second largest risk factor for early death and disability" after high blood pressure, Gakidou said.

Some countries have seen sharp reductions in smoking driven by some combination of higher taxes, education campaigns, package warnings and programmes to help people kick the nicotine habit.

Brazil was among the leaders over the 25-year period examined, with the percentage of daily smokers dropping from 29 to 12 per cent among men, and from 19 to eight per cent among women.

But Indonesia, Bangladesh and the Philippines — where 47, 38 and 35 per cent of men smoke, respectively — saw no change from 1990 to 2015.

In Russia — where tobacco control policies were not put into place until 2014 — the percentage of women who smoke climbed by more than four per cent over the same period.

Similar trends are emerging in much of Africa, the authors cautioned.

The World Health Organization (WHO) projects that the number of men and women smoking in sub-Saharan Africa will go up 50 per cent by 2025, compared to 2010 levels.

"Future mortality in low- and middle-income countries is likely to be huge," John Britton from the University of Nottingham's UK Centre for Tobacco and Alcohol Studies wrote in a comment, also in The Lancet.

Responsibility for the global tobacco epidemic lies mainly with a handful of multinational companies based in rich countries, he said.

"The modern tobacco industry profits from enslaving children and young people in poor countries into a lifelong addiction, and ultimately taking their lives for profit," he told AFP.

The global response — including a 180-nation "tobacco control" treaty inked in 2005 — has focused mostly on users and not the supply, he added.

The WHO has noted that "tobacco is the only legal drug that kills many of its users when used exactly as intended by the manufacturers".

It is estimated that half of daily smokers will die prematurely due to their tobacco habit unless they quit.

Failure to stop the epidemic means that "scarce resources will be used to treat tobacco-caused problems such as cardiovascular disease, cancers and chronic respiratory disease," Gakidou said.

Happy World Health Day

Happy World Health Day!

But is it ‘happy’, considering that today starts a year-long focus on depression, with the Depression: Let’s Talk campaign launch?

It’s a multi-billion dollar organisation, so what on earth could we get the WHO as a present? Surely, at nearly 70, with a lifetime spent tackling conditions such as HIV and Ebola, we really should give the WHO a little something? Right?

Depression is the worldwide leading cause of disability and ill health with over 300 million people living with it.

And, rather depressingly, that is up almost 20% in the last 10 years. Of the few people that are diagnosed with depression, only a minority receive adequate treatment - studies show that as little as 1 in 27 in low or middle income countries, and 1 in 5 in high income countries.

So there has been a focus on improving mental health diagnosis and treatments recently - there was a five Year Forward View paper published by the NHS last year, and a Governmental response to it this year.

Aside from the obvious benefits of investing more in the treatment of depression, there are also significant financial incentives. For every US$ 1 invested in scaling up treatment for depression and anxiety leads to a return of US$ 4 in better health and ability to work, according to research.

So we know that we need to start doing things differently. We are starting to do things differently. There are many admirable efforts with charities, organisations and healthcare professionals to end the stigma associated with depression and mental health conditions, and to provide help for people affected by them. And these are making progress.

I know you’re busy, but please, take a few minutes to watch these videos from the WHO. Pretend it’s Instagram if you have to. They explain depression in a way that might help you spot it those around you, or maybe even in yourself.

And as you do so, look around. 1 in 4 of us will have a mental health disorder in a year. It’s a pretty good idea to be aware of the signs of depression, as if you’re looking at 3 people, odds are someone will be affected. Don’t forget to count yourself.

So maybe this is the gift we can give the WHO. It is actually a gift we give to each other and ourselves. We can increase our understanding of depression, our ability to recognise it, and our awareness of how to get help for it. We can increase the conversations we have about it, and the support we give to those who are affected by it.


World Health Day - ‘depression, let’s talk’

WORLD Health Day, celebrated on 7 April every year to mark the anniversary of the founding of the World Health Organisation (WHO), provides an unique opportunity to mobilise action around a specific health topic of concern to people all over the world.

The theme of 2017 World Health Day campaign is “depression - let's talk”.

Depression affects people of all ages, from all walks of life, in all countries. It causes mental anguish and impacts on people's ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living. At worst, depression can lead to suicide, now the second leading cause of death among 15 to 29-year-old people.

Yet, depression can be prevented and treated. A better understanding of what depression is, and how it can be prevented and treated, will help reduce the stigma associated with the condition, and lead to more people seeking help.

Living with someone with depression can be difficult. Here are some tips on what to do to help someone you live with who is depressed, while taking care of yourself at the same time.

What you should know

  • Depression is an illness and not a character weakness.
  • Depression can be treated. What treatment is best and how long the depression lasts depend on the severity of the depression.
  • The support of carers, friends and family facilitates recovery from depression. Patience and perseverance is needed, as recovery can take time.
  • Stress can make depression worse.

What you can do for people who are depressed:

  • Make it clear that you want to help, listen without judgement, and offer support.
  • Find out more about depression.
  • Encourage them to seek professional help when available. Offer to accompany them to appointments.
  • If medication is prescribed, help them to take it as prescribed. Be patient; it usually takes a few weeks to feel better.
  • Help them with everyday tasks and to have regular eating and sleeping patterns.
  • Encourage regular exercise and social activities.
  • Encourage them to focus on the positive, rather than the negative.
  • If they are thinking about self-harm, or have already intentionally harmed themselves, do not leave them alone. Seek further help from the emergency services or a health-care professional. In the meantime, remove items such as medications, sharp objects and firearms.
  • Take care of yourself too. Try to find ways to relax and continue doing things you enjoy.

Life changes which come with aging can lead to depression - to prevent and treat the elderly:

  • Depression is an illness characterised by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks.
  • In addition, people with depression normally have several of the following: a loss of energy; a change in appetite; sleeping more or less; anxiety; reduced concentration; indecisiveness; restlessness; feelings of worthlessness, guilt, or hopelessness; and thoughts of self-harm or suicide.
  • Depression among older people is often associated with physical conditions, such as heart disease, high blood pressure, diabetes or chronic pain; difficult life events, such as losing a partner; and a reduced ability to do things that were possible when younger.
  • Depression is treatable, with talking therapies or antidepressant medication or a combination of these.


Measles outbreak spreads across Europe as parents shun vaccinations, World Health Organisation warns

Major measles outbreaks are spreading across Europe despite the availability of a safe, effective vaccine, the World Health Organisation has warned.

Anti-vaccine movements are believed to have contributed to low rates of immunisation against the highly contagious disease in countries such as Italy and Romania, which have both seen a recent spike in infections.

Zsuzsanna Jakab, the WHO’s regional director for Europe, said it was “of particular concern that measles cases are climbing in Europe” when they had been dropping for years.

Preliminary data for February indicate a sharp rise in measles cases, up from the 559 reported across the continent in January, said the WHO.

“Today’s travel patterns put no person or country beyond the reach of the measles virus,” said Dr Jakab. ”Outbreaks will continue in Europe, as elsewhere, until every country reaches the level of immunization needed to fully protect their populations.”

In Italy, an alarming resurgence of the disease has been blamed on the anti-vaccination stance of the populist Five Star Movement (M5S), which took a quarter of the vote in the country’s 2013 general election, reported The Guardian.

More than 700 cases of measles have been registered so far this year, according to the Italian health ministry, compared to 220 in the same period last year.

Measles is six times more contagious than the flu and complications arise in one in five cases including ear infections, pneumonia, deafness and even death.

In 1998 the British doctor Andrew Wakefield published a controversial and since-discredited study in The Lancet, which purported to show a link between the MMR vaccine – for measles, mumps and rubella – and autism in children.

Exhaustive scientific research, including a comprehensive 2014 review using data from more than 1.2 million children, have since concluded that no relationship between vaccination and autism.

Dr Wakefield was struck off the medical register after his report was found to be fraudulent.

However, many parents still choose not to vaccinate their children, with around 24,000 children in England each year at risk of measles, mumps and rubella because they have not been immunised against the diseases, according to Public Health England.

It is recommended that at least 95 per cent of the population is vaccinated against measles to ensure good protection against outbreaks of the disease.

But coverage is estimated to be lower than this in France, Germany, Italy, Poland, Romania, Switzerland and Ukraine.

Just 85.3 per cent of Italian two-year-olds were given measles vaccinations in 2015, down from 88 per cent in 2013, according to The Guardian.

Isabelle Sahinovic, the WHO’s Vaccine Safety Net co-ordinator, has said that “dangerous” misinformation about vaccines continues to spread online.

“Every day, misinformation about vaccines continues to proliferate on the internet,“ she said. ”This is dangerous.

“We need to make sure that all parents, caregivers, and healthcare professionals can easily access accurate and trustworthy information about vaccines.“


HIV-TB infections on the rise, European health officials find

The number of people developing and dying from tuberculosis (TB) is falling in Europe, but among the most vulnerable — including migrants, prisoners and people who are HIV positive — there have been worrying increases, data showed on Monday.

Figures from the European Centre for Disease Prevention and Control (ECDC) and the Europe regional office of the World Health Organization (WHO) showed new TB cases and deaths in the 53 countries of the WHO's European region fell each year by 4.3 and 8.5 per cent respectively between 2011 and 2015.

But new co-infections with TB and HIV together increased by 40 per cent from 2011 to 2015, showing that efforts to control the disease need to be far more focused on high risk groups.

"The general downward trend in reported TB cases is encouraging," the ECDC's acting director, Andrea Ammon, said in a statement. "But some groups are not benefiting from this trend and we need to target our efforts better if we want to end the TB epidemic."

She said providing testing to all TB patients for HIV, and vice versa, followed by counselling and rapid treatment, could reverse the negative co-infection trend.

Global figures released last year by the WHO showed that in 2015, some 1.8 million people died from TB. Of them, 400,000 were co-infected with the human immunodeficiency virus (HIV) that causes AIDS.

People with HIV are more vulnerable to TB because their immune systems are weakened. Experts estimate the risk of developing TB is between 26 and 31 times greater in HIV patients than in HIV negative people.

Zsuzsanna Jakab, the WHO's European regional director, said the flare-up of TB/HIV co-infections, coupled with persistently high rates of drug-resistant TB, were a serious threat to international efforts to control the disease.



WHO Lists 12 Bacteria Families That Threaten Human Health

For the first time ever, the World Health Organization has published a catalogue of 12 families of bacteria that pose the greatest threat to human health.

The move is part of the agency’s efforts to address growing global resistance to antimicrobial medicines.

According to UN Radio, Christian Lindmeier, the WHO spokesperson says the list is divided into three categories according to the urgency of need for new antibiotics; from critical to high and medium priority.

The WHO list highlights in particular the threat of the so-called gram-negative bacteria that are resistant to multiple antibiotics.

Health experts from the world’s 20 major economies, also known as the G20, are meeting in the German capital of Berlin this week to draw attention to this problem.



WHO calls for national framework to address health issues in India

New Delhi: Health issues in India are a highly debatable topic and one that needs urgent attention, primarily because of the way the problem is eating its way into the system.

The threat to health in India, in general, is devastating. Especially after the country has made such game-changing advancements in technology, it's a blow to see it go down in the health department.

The World Health Organisation (WHO) seems to have observed the downward trend too as it has emphasized the need to establish a national framework defining roles of the Centre and the states to address health issues and ensure convergence and portability.

This will also give the states the flexibility and freedom to choose their own path and progress at their own trajectory, says WHO Representative Dr Henk Bekedam.

"Diversity and equity are the two most crucial aspects of large economies like India. It is important to recognise diversity and also different health needs necessitate different approaches. Health is a state subject in India. As the Centre and states are at varying levels of development, there is a need to be cognisant of this reality," Bekedam told PTI.

"It will therefore be important to agree on a vision for the health sector and develop a national framework that defines roles of the Centre and the states. The agreed framework will help ensure convergence and portability. This will also give the states the flexibility and freedom to choose their own path and progress at their own trajectory," he elaborates.

Praising the Centre's role in adopting several policies such as the Draft National Health Policy 2016, the National Health Mission among others, the WHO official said it should focus on positioning health higher on its agenda with a greater investment in the public health sector.

The country should also accelerate effective financial protection, protection from diseases, fast-tracking the Sustainable Development Goal 3 (SDG3) agenda and a strong monitoring and evaluation (M&E) system, Bekedam, who took charge as the UN body's representative to India in 2015, said.

On whether the objectives of the National Health Mission pertaining to the Universal Access to Equitable, Affordable and Quality Healthcare Services was achievable or not, he sounded positive reiterating on the need a framework for it.

"The objectives are achievable but what is needed is a clear framework of accountability and programmatic adjustment based on progress made. The vision to achieve 'health for all' is possible - but for this, the process needs to be owned and led by the country."

On the WHO's role in helping India implement the Universal Health Coverage (UHC), Bekedam says, "UHC is an overarching umbrella and key to achievement of all SDG-3 targets and intrinsically linked to reducing poverty and inequities. We are working closely with the government in this area and will continue to share global best practices and lessons learnt from other countries."

He hails India's attainment of polio-free status as one of the biggest achievements in the annals of public health.

"While retaining the essential polio functions of surveillance, outbreak response and containment, we will, in consultation with the government, provide support to address new and emerging public health priorities," Bekedam says.

Africa's new continent-wide public health agency already faces funding crunch

Dakar — Africa’s new continent-wide public health agency — the Africa Centres for Disease Control and Prevention (Africa CDC) — could help prevent a repeat of the disastrous ebola epidemic by monitoring diseases across country borders and deploying a rapid task force at the first signs of an outbreak, health experts say.

The African Union (AU) launched Africa CDC on January 31 at its headquarters in Ethiopia. Epidemiologists began disease surveillance work there this month. The agency will have regional centres equipped for lab testing in Egypt, Nigeria, Gabon, Zambia and Kenya, and will expand an emergency volunteer corps, created during the Ebola epidemic, to thousands of health workers across the continent.

"What the Africa CDC can truly contribute is to bring [international disease] response closer to the countries," said incoming director John Nkengasong, a virologist and senior official at the US CDC. The agency will focus on strengthening national health systems through its regional networks, Nkengasong said, making countries less reliant on overseas medical aid, staff and equipment during outbreaks.

Although the AU first proposed the idea for an African health agency in 2013, the ebola epidemic in 2014-2015 highlighted its urgency and accelerated the planning, according to people involved. International agencies, including the World Health Organisation (WHO), were widely criticised for taking too long to respond to the ebola outbreak, which killed more than 11,300 people in West Africa.

Creating a response mechanism within Africa was a logical next step, experts said. The director of disease control and prevention in Sierra Leone, one of the countries hit hardest by Ebola, said he thought the most important aspect of Africa CDC would be collaboration with other countries’ health agencies. "I think it’s a very good idea so we can share information and work together," Foday Dafae told the Thomson Reuters Foundation, adding that the biggest challenge would likely be co-ordination.

International backing

Other health experts also praised the move, but said Africa CDC’s effectiveness could hinge on funding. "The AU initiative is evidence that countries have taken stock of the ebola crisis," said Mads Oyen, West and Central Africa emergency adviser for Unicef. "However, in order for Africa CDC to be a strong organisation, it will require long-term political will and financial commitment by national governments, as well as strong support from donor institutions."

The AU has allocated about 0.5% of its operating budget to Africa CDC; other funding will come from member states, partner countries and the private sector. The US and China are among those supporting the initiative.

The US CDC has advised the agency throughout its creation and will send two long-term advisors to the AU headquarters and support 10 African epidemiologists in the regional centres. The WHO has also provided technical assistance and will work closely with Africa CDC, said WHO Africa emergencies director Ibrahima Soce Fall, calling it a "very important step for the African region".

Experts said the agency’s relationship with the WHO will be critical to avoid being perceived as competition. Africa CDC will launch a five-year strategic plan in Addis Ababa at the end of March, and after that will build its staff. "There will be challenges," said director Nkengasong, "but the public health opportunities are huge."