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  • Kebijakan Kesehatan Indonesia

    World Health Organization Aims For Zero Leprosy By 2020

    The World Health Organisation aims to reduce to zero by 2020 the number of children diagnosed with leprosy and related deformities.

    The decision is part of a new strategy launched against leprosy by the global health body, which also called for stronger commitments and accelerated efforts to stop disease transmission and end associated discrimination and stigma, to achieve a world free of leprosy.

    "The new global strategy is guided by the principles of initiating action, ensuring accountability and promoting inclusivity. These principles must be embedded in all aspects of leprosy control efforts," Poonam Khetrapal, regional director for the World Health Organisation's South-East Asia Region, said at the launch of the global strategy for 2016-2020 "Accelerating towards a leprosy-free world".

    The new strategy also aims to reduce the rate of newly-diagnosed leprosy patients with visible deformities to less than one per million; and ensure that all legislation that allows for discrimination on the basis of leprosy is overturned.

    "The key interventions needed to achieve the targets include detecting cases early before visible disabilities occur, with a special focus on children as a way to reduce disabilities and reduce transmission, targeting detection among higher risk groups through campaigns in highly endemic areas or communities, and improving health care coverage and access for marginalised population," said Ms Khetrapal.

    She said screening all close contacts of leprosy affected people, promoting a shorter and uniform treatment regime, and incorporating specific interventions against stigma and discrimination are the other strategic interventions that endemic countries need to include in their national plans to meet the new targets.

    "The new strategy builds on the success of previous leprosy control strategies. It has been developed in consultation with national leprosy programs, technical agencies and NGOs, as well as patients and communities affected by leprosy," she said.

    The strategy focuses on equity and universal health coverage which will contribute to reaching Sustainable Development Goals on health.

    According to the health data, the main and continuing challenges to leprosy control have been the delay in detection of new patients and persisting discrimination against people affected by leprosy which has ensured continued transmission of the disease.

    India, Brazil and Indonesia account for 81 percent of the newly diagnosed and reported cases globally.

    Leprosy was eliminated globally in the year 2000 with the disease prevalence rate dropping to below one per 10,000 population.

    Though all countries have achieved this rate at the national level, at the sub-national level, it remains an unfinished agenda.

    Leprosy continues to afflict the vulnerable, causing life-long disabilities in many patients, subjecting them to discrimination, stigma and a life marred with social and economic hardships..

    http://www.ndtv.com/

     

    Not Spending Money on Mental Health Costs the World $1 Trillion a Year

    Spending on counseling or medication to treat mental health issues can be an expensive, but new research from the World Health Organization indicates that the global community cannot afford to not treat mental illnesses.

    Every dollar invested in mental health treatment sees a $4 return based on better health and ability to work, according to a WHO study published on Tuesday. The first-of-its-kind study estimates the global cost of untreated mental health disorders to be $1 trillion a year.
    "We know that treatment of depression and anxiety makes good sense for health and wellbeing; this new study confirms that it makes sound economic sense too," Margaret Chan, the director-general of WHO, said in a statement.

    The study's release coincides with the 13th Annual World Health Care Congress, which began on Monday in Washington, D.C. Over the next two days, officials from WHO, the World Bank, and various aid organizations will develop an international agenda to expand mental health programs.

    Researchers calculated treatment costs and health outcomes in 36 countries of varying wealth from 2016 to 2030. Applying a meta-analysis of past studies regarding depression and anxiety's impact on workplace productivity and absenteeism, they estimated that a failure to scale up mental health programs would lead to 12 billion days (or 50 million years) of lost work annually over the next 15 years.

    Rates of depression and anxiety have increased 50 percent (from 416 million to 615 million people) from 1990 to 2013. That figure will likely increase, given that nearly 20 percent of people involved in emergencies or humanitarian crises, such as the Syrian conflict, experience depression or anxiety.

    Yet available treatment remains minimal. Governments spend an average of 3 percent of their health budget on mental health, according to WHO's figures. That's left a large number of people in need of services without help, especially in poor nations.

    In some low-income countries in Africa, Asia, and Latin America, there are as few as a single mental health worker for a population of 1 million or more. Wealthy nations typically have one mental health worker for every 2,000 people.

    To properly address mental health, governments in the 36 counties examined will need to invest $147 billion, primarily on counseling services and medication. WHO's research found that an uptick in available services will lead to a 5 percent increase in work participation, which will in turn generate $399 billion. Increased mental health programs will also contribute to overall health, with researchers estimating the investment will translate to an additional 43 million years of healthy living, valued at $310 billion.

    "This is not just a public health issue—it's a development issue," Jim Yong Kim, president of the World Bank Group, said in a statement. "We need to act now because the lost productivity is something the global economy simply cannot afford."

    http://www.takepart.com/

     

    Diabetes: Curbing the epidemic on our hands

    The world celebrates World Health Day on Thursday and the WHO has decided to put diabetes in the spotlight for this year's theme. Diabetes, along with other non-communicable diseases (NCDs), is the leading cause of death in Southeast Asia, taking the lives of up to 8.5 million people each year, one-third of whom are under 70 years old, leading to productivity losses.

    As a developing country, Indonesia is facing a double burden of diseases. We are still fighting infectious diseases, without realizing that NCDs have grown silently to become the top killer.

    In 2014, approximately 71 percent of deaths were attributed to NCDs and 6 percent of the total were due to diabetes. Yet, most of the population is still not aware of the urgency of combatting this disease.

    Researchers have identified modifiable risk factors to prevent diabetes, i.e. maintaining normal body weight, eating a healthy diet and engaging in adequate physical activity.

    The 2014 Global Status Report on NCDs revealed that 84 percent of Indonesian adolescents were physically inactive. The percentage of the Indonesian population that is overweight steadily increased from 2010 to 2014, from 17.2 to 20.7 percent and 24.4 to 28.1 percent for men and women, respectively.

    Obesity also showed an increasing trend over recent decades and obesity prevalence in women has roughly doubled compared to that of men (7.8 percent vs 3.6 percent). Statistics showed a similar pattern in all other countries, which is why halting the epidemic should be our overarching goal now.

    How did we end up like this?

    First and foremost, this happened because of a lack of education. People still strongly believe that diabetes is a genetic disease; hence they embrace the diagnosis as part of inevitable heritage from their ancestors. Yes, genetic abnormality comes into play in type 1 diabetes. And yes, genetic hereditary may contribute to predisposition for type 2 diabetes, but the disease itself develops throughout one's lifespan due to multifactorial causes.

    People are also unaware of the early symptoms of diabetes, which usually include constant fatigue, thirst and cravings.

    When you have a family predisposition to diabetes, it is better to get regular checkups and to start paying attention to your lifestyle.

    Second, it is because we live in what public health experts call an obesogenic environment — an environment that promotes gaining weight and one that is not conducive to weight loss. Jakarta is a perfect example.

    We have all gone through the phase of making life goals to work out more and eat healthily. But many of us have failed. Staying outdoors is out of the question as the air is severely polluted, sidewalks are crowded with vendors and using private vehicle is much more comfortable than sharing public transportation.

    All these things beyond our personal choice that directly — or indirectly — affect our population's health are called social determinants of health.

    Over time, governments have made tremendous efforts to create a less obesogenic environment for us. We have seen an amazing transformation in Bandung, as well as improvement in public transportation and investment in green spaces in Jakarta.

    What can we do to curb the epidemic?

    We can start with ourselves and families, with good intentions to live long and healthy lives.

    New research in India shows that consumption of white rice is the main culprit of the high prevalence of diabetes in India and more generally Southeast Asia. Nutritionists recommend red or brown rice.

    The WHO has also released new recommendations for daily sugar intake of a maximum of 25 grams (six teaspoons) and integrating more than 400 grams of vegetables and fruits daily into the diet.

    It is always better to avoid processed foods as they usually contain high salt, high sugar and high fat. Physical activity should be at least 150 minutes per week of moderate intensity exercise.

    Or there is always the choice of taking the stairs, campaigned a few months ago at the WHO headquarters as #WalkTheTalk #StepUp.

    Although the social determinants of our health mostly rely on policymakers and governments, we have the power to put pressure on this matter and urge them to address the problem. Governments must understand that globalization and urbanization play major roles in shaping our society.

    Therefore, they need to work beyond health sectors intertwined with this problem.

    Collaboration between transportation, urban planning, sport and education departments is necessary to reach physical activity targets. Amsterdam has not always been the cycling-friendly city we all know today, but people advocated for their rights and the transformation has been nothing short of great.

    Multisectoral population-based action related to the production, distribution and marketing of food is also needed to protect our consumption patterns.

    The UK recently undertook new measures in tackling childhood obesity by implementing a sugar tax on high-sugar drinks and allocating the surplus to fund sports programs in elementary school.

    All in all, population health should be the priority in every process of creating new policies.

    Time is pressing and the burden is growing. If we continue with business as usual, we know where this epidemic curve is heading.

    As public health expert Majid Ezzati said regarding obesity: "Unless we make healthy food options like fresh fruits and vegetables affordable for everyone, and increase the price of unhealthy processed foods, the situation is unlikely to change."

    ***
    The writer is a general practitioner at the Indonesian Red Cross (PMI) Hospital in Bogor, West Java, who graduated from the School of Medicine at the University of Indonesia. She obtained her Master's of Health Science in public health from Erasmus University in Rotterdam, the Netherlands, and was an intern at the WHO headquarters in Geneva, Switzerland.

    http://www.thejakartapost.com/

     

    World Health Day: Commissioner for Health and Food Safety Vytenis Andriukaitis highlights the Potential for the Prevention of Diabetes

    "This year the theme of World Health Day is diabetes, a potentially fatal disease that is constantly and dramatically increasing. If the trend continues it will reach epidemic proportions without making headlines. It is now time to put the evidence into practice. My deepest wish is to see a radical shift from treatment of diseases towards promotion of good health. We have solid evidence that this works."

    Currently in the EU, 32 million people are living with diabetes. Furthermore, one in five school children is obese or overweight already (a major risk factor for developing type 2 diabetes), and this number is on the rise. Globally, the number of adults living with diabetes rose from 153 million to 415 million from 1980 to 2015. By 2030, diabetes is expected to be the 7th cause of death worldwide.

    The silver lining is that in many cases, type 2 diabetes is preventable and in some cases it is also possible to reverse it. As with other chronic diseases, risk factors include an unhealthy diet, being overweight and lack of physical activity. Experience has shown that simple changes in lifestyle can be effective in preventing or delaying type 2 diabetes. These include maintaining a normal weight, regular physical exercise and a healthy diet.

    All policy tools, from education to awareness campaigns and from advertising to taxation, should be mobilised. Measures to trigger and accompany these changes should particularly focus on the younger generation and on providing healthy food in schools, replacing vending machines selling sweets or sugary drinks in schools with healthy alternatives, and making food low in salt, sugar and fat available and affordable for all.

    As for type 1 diabetes, actions to improve the lives of people living with diabetes could include the further development of eHealth solutions enabling diabetic patients to monitor their own blood glucose and transmit the information electronically to their healthcare specialist. More broadly, increasing patient access to quality care across Europe and supporting research for finding new and more effective treatments will remain key objectives of health policy.

    In the fight against diabetes and other preventable diseases, the most important remaining question is this: What will it take to truly start focusing on the promotion of good health and disease prevention? The challenge is to start seriously tackling the risk factors – not only obesity, poor nutrition, lack of exercise, tobacco, alcohol misuse and stress, but also wider social inequalities that amplify the risks for our most vulnerable citizens.

    http://europa.eu/

     

    422 million adults live with diabetes, UN health agency says

    The World Health Organization (WHO) said on Wednesday the number of adults with diabetes has almost quadrupled worldwide since 1980 to 422 million, mainly in developing countries, driven by a rise in overweight and obese people, a UN spokesman said.

    On the eve of World Health Day, which falls on Thursday, the WHO published its first "Global report on diabetes," which highlighted the need to step up prevention and treatment of the disease.

    Margaret Chan, WHO director-general, stressed that "if we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain."

    She added that even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.

    WHO notes that diabetes is a chronic, progressive noncommunicable disease characterized by elevated levels of blood glucose.

    It occurs either when the pancreas does not produce enough of the insulin hormone, which regulates blood sugar, or when the body cannot effectively use the insulin it produces.

    Among the key findings from the report are:

    -- The number of people living with diabetes and its prevalence are growing in all regions of the world. In 2014, 422 million adults (or 8.5 percent of the population) had diabetes, compared with 108 million (4.7 percent) in 1980.

    -- The epidemic of diabetes has major health and socioeconomic impacts, especially in developing countries.

    -- In 2014, more than 1 in 3 adults aged over 18 years were overweight and more than one in 10 were obese.

    -- The complications of diabetes can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation. For example, rates of lower limb amputation are 10 to 20 times higher for people with diabetes.

    -- Diabetes caused 1.5 million deaths in 2012. Higher-than-optimal blood glucose caused an additional 2.2 million deaths by increasing the risks of cardiovascular and other diseases.

    "Many cases of diabetes can be prevented, and measures exist to detect and manage the condition, improving the odds that people with diabetes live long and healthy lives," said Oleg Chestnov, WHO's assistant director-general for NCDs and Mental Health.

    "But change greatly depends on governments doing more, including by implementing global commitments to address diabetes and other (noncommunicable diseases)."

    These include meeting Sustainable Development Goals (SDGs) target 3.4, which calls for reducing premature death from noncommunicable diseases (NCDs), including diabetes, by 30 percent by 2030.

    Governments have also committed to achieving four time-bound national commitments set out in the 2014 UN General Assembly "Outcome Document on Noncommunicable Diseases," and attaining the nine global targets laid out in the WHO "Global Action Plan for the Prevention and Control of NCDs," which include halting the rise in diabetes and obesity.

    "Around 100 years after the insulin hormone was discovered, the 'Global report on diabetes' shows that essential diabetes medicines and technologies, including insulin, needed for treatment are generally available in only one in three of the world's poorest countries," said Etienne Krug, director of WHO's Department for the Management of NCDs, Disability, Violence and Injury Prevention.

    "Access to insulin is a matter of life or death for many people with diabetes. Improving access to insulin and NCD medicines in general should be a priority," Krug said.

    World Health Day is a global health awareness day celebrated every year on April 7, under the sponsorship of WHO.

    In 1948, the WHO held the First World Health Assembly which decided to celebrate April 7 of each year, with effect from 1950, as the World Health Day.

    The World Health Day is held to mark WHO's founding, and is seen as an opportunity by the organization to draw worldwide attention to a subject of major importance to global health each year.

    http://www.shanghaidaily.com/

     

     

    WHO: Global Health Emergencies on Rise

    More than 125 million people are living in crisis-affected countries, the World Health Organization reports, saying the three greatest emergencies are Syria, Yemen and Iraq.

    The agency is appealing for $2.2 billion to come to terms with the escalating health crisis, in an effort to provide life-saving health care to 87 million people in more than 30 countries.

    In Syria, the agency says 11.5 million people need essential medicines and primary health care, as well as trauma care and mental health care.

    WHO says special care for mothers and children, as well as essential medicine and other health care, are needed by more than seven million people in Iraq and 10.6 million in Yemen.

    In South Sudan, the focus of aid for 2.3 million people will be on combating child mortality by preventing and treating malaria, diarrhea and pneumonia, according to WHO.

    Health care threatened

    War and violence have wreaked havoc on these countries, says Rick Brennan, WHO's director of emergency risk management and humanitarian response. The destruction has been felt in the loss of health infrastructure, the loss of staff, and the disruption of health programs like vaccination programs, according to Brennan.

    "I think the other issue is that none of these emergencies is going away any time soon," he said. "So, we have to shift the way that we think about providing assistance there — not only to meeting acute needs, but working with partners on the ground to increase their resilience and their capacity to provide assistance."

    Brennan says natural disasters also are of concern. He cites the health consequences of the El Nino weather phenomenon on countries such as Ethiopia, where some 400,000 children are suffering acute malnutrition.

    In addition, the U.N. agency and its partners are responding to sudden onset emergencies such as Cyclone Winston that hit Fiji in February, epidemics such as the Zika virus in Brazil, a severe outbreak of yellow fever in Angola — the worst in 30 years — and the remaining risks of Ebola in West Africa.

    http://www.voanews.com/

     

    Urban health: major opportunities for improving global health outcomes, despite persistent health inequities

    New data on the health of city-dwellers in almost 100 countries show that as the world's urban population continues to grow, health inequities - especially between the richest and poorest urban populations - are a persistent challenge, according to a report by WHO and the United Nations Human Settlements Programme (UN-Habitat).

    For example, only half of households in urban areas of 91 countries with comparable data have access to piped water, with the richest 20% of households being 2.7 times more likely to have access to piped water than the poorest 20%. In Africa, this ratio is closer to 17 times.

    About 3.7 billion people live in cities today. A further 1 billion people will be added by 2030, with 90% of the growth being in low- and middle-income countries. This intensifies the need to realize the Sustainable Development Goal (SDG) target of ensuring universal health coverage (UHC): that all people obtain the health services they need without suffering financial hardship when paying for them, by 2030.

    Health inequalities undermine progress

    The report finds that in 79 low- and middle-income countries, children in the poorest one fifth of urban households are twice as likely on average to die before their fifth birthday compared with children in the richest fifth. In nearly 9 of 10 countries for which comparable data was available, the urban poor did not achieve the Millennium Development Goal target for reducing under-five mortality.

    The report emphasizes the urgency of addressing health disparities and their determinants in cities as countries strive to achieve the SDGs and identifies innovative ways to achieve UHC that are emerging in such diverse cities as Guangzhou and Lagos, Lima and San Francisco, among many others.

    "There is an urgent need to identify and reduce health inequities, particularly for the most vulnerable populations, such as the nearly 1 billion people living in urban slums or informal settlements today," said Dr Marie-Paule Kieny, WHO Assistant-Director General for Health Systems and Innovation. "This report gives countries and cities practical tools to reduce health inequities and achieve the SDGs."

    While a number of urban areas have improved health coverage, the report finds that coverage for the poor still lags behind. Currently, at least 400 million women, men and children around the world are excluded from what is a basic human right: access to affordable health care. They have little or no access or to health services, and health insurance that is inadequate or non-existent. The report includes a new Urban UHC Dashboard-- an analysis of nine indicators for 94 countries-- which shows that vast inequalities in health service coverage persist, despite urban areas reporting higher coverage of services than their respective national average levels.

    Planning cities for people and health

    Increasing urbanization poses a unique set of health challenges, including the double burden of non-communicable and infectious diseases, air pollution, access to water and sanitation, and the need to improve nutrition, increase physical activity, and build resilience to health emergencies. Meeting those challenges will require countries and cities to take bold steps towards UHC.

    The ways that cities are planned, today and for the future, can profoundly affect the ability of their residents to live long, healthy and productive lives. The report presents solutions for ensuring accessibility to water and sanitation, reducing urban sprawl while developing new transport options, increasing road safety, making cities age-friendly and accessible for persons with disabilities, managing urban health emergencies and increasing resiliency, while also improving healthier homes, particularly for those living in urban slums.

    The report further presents a comprehensive set of interventions that can reduce the urban burden of non-communicable diseases. These include smoke-free city ordinances and enforcement; altering the built environment and promoting alternative transport options to foster greater physical activity and reduce air pollution; new approaches to urban food environment to reduce malnutrition and obesity; affordable and healthy housing conditions, and safety-related efforts.

    Together, these have tremendous impact on reducing diarrheal diseases, indoor and ambient air pollution, non-communicable diseases, and other diseases saving millions of lives and increasing quality of life. A variety of examples from New York City and China to Mexico City, Barcelona, and South Africa illustrate these impacts, particularly using multiple interventions.

    "In cities, progress in health depends not only on the strength of health systems, but also on shaping urban environments. Capitalizing on such interdependent factors leads to efficiency, synergies and co-benefits, and is essential to attaining the SDGs," said Alex Ross, Director of the WHO Centre for Health Development in Kobe, Japan, which led and wrote the report.

    "A healthy population is essential for creating economically competitive and inclusive cities," said Joan Clos, Executive Director of the United Nations Human Settlements Programme (UN-Habitat). "This new report documents opportunities for joint action to implement the SDGs, and is an important contribution to the Third United Nations Conference on Housing and Sustainable Urban Development to take place in Quito in October 2016 and to the realisation of the New Urban Agenda."

    Note to editors:

    This report:

    • updates the 2010 joint WHO/UN-Habitat global report "Hidden Cities: Unmasking and Overcoming Urban Health Inequities", with the latest evidence on urban health inequity patterns and their social, economic and environmental determinants. Without addressing these issues, the SDGs will not be fully achieved.
    • Systematically synthesises evidence for various inter-sectoral actions and impacts on health for issues such as noncommunicable diseases, infectious diseases, health emergencies, nutrition, environmental health (air pollution, water and sanitation), transport, housing, energy and safety.
    • Introduces the need for enhanced governance and leadership to realize results, including achieving UHC, and a number of SDG Targets. A healthy population is the basis of a city's, and ultimately a nation's and the world's, sustainable economic growth, social stability, and full realization of human potential.
    • Highlights areas for immediate intervention, as well as gaps in knowledge, particularly to document the impact of various interventions on urban health, and means to reduce health inequities.
    • Emphasizes health inequities and vulnerable populations, particularly the nearly 1 billion people living in urban slums and informal settlements today, which are projected to double by 2050.

    http://www.who.int/

     

    Zika Is Linked To Microcephaly, Health Agencies Confirm

    The World Health Organization says there is now scientific consensus that the Zika virus is connected with microcephaly — a condition in which babies are born with very small heads and brain damage.

    Scientists have been working for months to confirm a link between Zika and microcephaly, ever since Brazil reported a startling increase in cases last fall.

    Zika infection during pregnancy appears to increase the risk for several types of birth defects and miscarriages, a recent study found. And scientists have found the virus in the brains of affected babies.

    But all this evidence is circumstantial. So the big question has been: Is Zika really the culprit?

    Now WHO and the Centers for Disease Control and Prevention agree there's enough evidence to say, yes, Zika is linked to microcephaly.

    "At this point the most pressing question people want answered is, 'If I get a Zika infection during pregnancy what are the chances my baby is going to be affected?' " says Dr. Anne Schuchat, the deputy director of the CDC. "We really feel a sense of urgency to both answer that question and to help stop the spread of the virus."

    Currently the Zika virus is circulating in 33 countries in the Americas and has sickened hundreds of thousands of people.

    http://www.npr.org/