As much as half of the estimated US$80 billion in annual government spending on health care in the Arab world is going to waste due to widespread inefficiencies, a Dubai health official says.

A plague of issues such as the over-prescription of drugs and needless medical tests are costing the sector dearly, according to Haidar Al Yousuf, the head of funding at the Dubai Health Authority.

"In our region ... 50 per cent of the money we spend on health, due to inefficiency, is not properly utilised," he said.

"I don't think we need to pump more money into the health system – we just need to use that money more efficiently and ensure that it goes to the right place."

In the United States, a report by the non-profit Institute of Medicine estimated that 30 per cent of total healthcare spending in 2009 was wasted, amounting to total losses of $750bn.

But the proportion of spending wasted in some Middle East and North Africa (Mena) countries could be much higher, Mr Al Yousuf said.

"A lot of doctors prescribe a lot of medication – they order a lot of tests, but there is no matching of what is actually needed by the patient and what is being done," he said.

He said the problem of inefficient healthcare spending was far less pronounced in markets such as Dubai, which introduced compulsory health insurance in 2014, and Abu Dhabi, which made health insurance mandatory for all employees in 2005.

Such systems are preferable to public-sector "block-budget" funding, prevalent in much of the wider region, where top-line spending levels are allocated by governments, Mr Al Yousuf said. "In general, these large public systems ... tend to be extremely inefficient, especially for healthcare."

Mr Al Yousuf was speaking at last week's Telegraph Middle East Congress in London, and was part of a discussion moderated by Mohammed Al Otaiba, the editor-in-chief of The National.

Fellow panellists noted the importance of the private sector in building the Arab world's future infrastructure needs, including in the healthcare sector.

The Middle East and North Africa's total healthcare spending is estimated to be $125bn this year, according to Al Masah Capital, a Dubai-based alternative-investment management firm. Government spending is estimated to account for 64 per cent – or $80bn – of the total market, with private-sector healthcare spending making up the rest.

The role of the private sector is expected to increase in the Mena market, according to Al Masah Capital. It forecasts that the private-sector healthcare market will be worth $61bn in 2020, more than double its size in 2011.

Mr Al Yousuf said he expects more governments in the region to move to insurance-led healthcare systems. "We see the whole region moving away from those block-budget funding models into much more accountable health-financing systems, like health insurance and social insurance," he said.

Political and economic leaders convened in London during last week's conference. Speakers included Reem Al Hashimy, the UAE Minister of State; Saudi Arabia's Prince Saud bin Khalid Al Faisal; Hany Kadry Dimian, Egypt's finance minister; and Boris Johnson, the London mayor.

source: http://www.thenational.ae/

The World Health Organization said its landmark tobacco control treaty is making inroads in slowing the global tobacco epidemic. But as it observes the 10th anniversary of the entry into force of the Framework Convention on Tobacco Control, the U.N. agency warns the fight to prevent millions of tobacco-related premature deaths is far from over.

The World Health Organization said it is celebrating a number of successes in reducing tobacco use during the past 10 years.

Since the Framework Convention on Tobacco Control entered into force, the U.N. agency notes the number of countries introducing graphic pictures and health warnings on cigarette packages has increased from five to 50.

It finds more than 80 percent of the 180 countries ratifying the treaty adopted new tobacco control legislation or strengthened existing laws. Technical Officer with the Framework Convention Tibor Szilagyi told VOA countries implementing measures required under the Convention are seeing positive results.

"They have started seeing decreases of let us say 15 to 30 percent in the past 10 years in tobacco use prevalence, which means that millions of deaths have been averted by the implementation of this treaty," stated Szilagyi.

But the World Health Organization reports about six million people a year die prematurely from causes related to tobacco, the majority in low- and middle income countries. It warns tobacco use will account for more than eight million deaths each year by 2030, if the epidemic is unchecked.

The agency accuses the tobacco industry of using its economic power to influence governments not to enact control policies. It said the industry uses slick media campaigns to entice women and young people to pick up the smoking habit.

Dr. Szilagyi said countries in Africa are targets of these ploys and many have succumbed to the economic temptations dangled before them. But he notes many do not. He said Kenya, Mauritius, and South Africa among others have resisted the tobacco industry and made strong progress in implementing the Convention.

He said another challenge is emerging tobacco products. "This includes electronic cigarettes and electronic nicotine delivery systems and non-nicotine delivery systems, but also those products, which have been traditionally used in some countries, but not in others," he explained. "For example, water pipe tobacco, which becomes trendy and widespread among mostly young people in those countries where water pipe was not traditionally used."

The Framework Convention continues to be strengthened through additional protocols. Parties to the Convention are in the process of promoting ratification of a new protocol dealing with illicit trade in tobacco products.

source: http://www.voanews.com/

By using the same syringe to give injections to multiple people, health practitioners around the world are significantly driving the spread of many deadly infectious diseases. In an effort to deal with this problem, the WHO is pushing for syringes that cannot be used more than once — and they want this worldwide switch to happen as early as 2020.

The numbers are actually quite staggering. A 2014 WHO-sponsored study estimated that in 2010, upwards of 1.7 million people were infected with hepatitis B, another 315,000 with hepatitis C, and as many as 33,8000 with HIV as the direct result of using contaminated syringes. What's more, of the 16 billion injections administered each year, many are unnecessary or could be replaced with oral alternatives.

"Adoption of safety-engineered syringes is absolutely critical to protecting people worldwide from becoming infected with HIV, hepatitis and other diseases," noted Gottfried Hirnschall, Director of the WHO HIV/AIDS Department, in a statement. "This should be an urgent priority for all countries."

To make the smart syringes work, some models could include a weak spot in the plunger that causes it to break if the user tries to pull back on the plunger after an injection. Alternatively, the device could be equipped with a metal clip that prevents the plunger from moving back, or the needle could retract in the syringe barrel at the end of the injections. And to protect healthcare workers from accidentally infecting themselves with a contaminated needle, a sheath or hood could be applied over the needle after the injection.

The WHO is also calling for policies and standards for procurement, safe use, and safe disposal.

Implementing worldwide use of smart syringes by 2020 will not be easy. It'll be crucial for all stakeholders to prevent shortfalls in supply during the transitionary phase. There's also the cost factor to consider. Normal syringes cost about $0.03 to $0.04, while the new syringes cost about twice that much. The WHO is asking donors to support the switch to the new devices.

source: http://io9.com/

The World Health Organization said Friday it has approved a quick test for Ebola that will dramatically cut the time it takes to determine — with reasonable accuracy — whether someone is infected with the deadly virus.

The ReEBOV Antigen Rapid Test Kit, made by Colorado-based Corgenix, met sufficient quality, safety and performance requirements to allow it to be purchased and distributed by U.N. agencies and aid groups, WHO said.

"It may definitely help the response. I wouldn't say it's a game-changer," said Dr. Bruce Aylward, WHO's assistant director-general.

Until now, Ebola tests have been mainly conducted in laboratories. These gene-based tests are more accurate but can take between 12 and 24 hours.

The new test can provide results within 15 minutes by detecting an Ebola protein. In trials it correctly identified 92 percent of the patients with Ebola and 85 percent of those not infected.

Medical personnel will still need to conduct a backup test when someone tests negative, said Aylward. "But (the new test) might help us get to zero faster."

Almost 24,000 people have been infected and nearly 9,400 people have died from the current Ebola outbreak, which began in West Africa over a year ago.

A massive international effort was launched last year to combat the disease in the three most affected countries — Sierra Leone, Liberia and Guinea. That effort has had some success, but cases have been spiking again in some areas in recent weeks, said WHO spokeswoman Daniela Bagozzi.

source: http://abcnews.go.com/

Worldwide, consumption of healthy foods such as fruit and vegetables has improved during the past two decades, but has been outpaced by the increased intake of unhealthy foods including processed meat and sweetened drinks in most world regions, according to the first study to assess diet quality in 187 countries covering almost 4.5 billion adults, published in The Lancet Global Health journal.

The findings reveal that diet patterns vary widely by national income, with high-income countries generally having better diets based on healthy foods (average score difference +2.5 points), but substantially poorer diets due to a higher intake of unhealthy foods compared with low-income countries (average score difference -33.0 points). On average, older people and women seem to consume better diets.

The highest scores for healthy foods were noted in several low-income countries (eg, Chad and Mali) and Mediterranean nations (eg, Turkey and Greece), possibly reflecting favourable aspects of the Mediterranean diet. In contrast, low scores for healthy foods were shown for some central European countries and republics of the former Soviet Union (eg, Uzbekistan, Turkmenistan, and Kyrgyzstan).

Of particular interest was that the large national differences in diet quality were not seen, or were far less apparent, when overall diet quality (including both healthy and unhealthy foods) was examined as previous studies have done.

"By 2020, projections indicate that non-communicable diseases will account for 75% of all deaths. Improving diet has a crucial role to play in reducing this burden", says Dr Imamura. "Our findings have implications for governments and international bodies worldwide. The distinct dietary trends based on healthy and unhealthy foods, we highlight, indicate the need to understand different, multiple causes of these trends, such as agricultural, food industry, and health policy. Policy actions in multiple domains are essential to help people achieve optimal diets to control the obesity epidemic and reduce non-communicable diseases in all regions of the world."*

According to Dr Mozaffarian, "There is a particularly urgent need to focus on improving diet quality among poorer populations. If we do nothing, undernutrition will be rapidly eclipsed by obesity and non-communicable diseases, as is already being seen in India, China, and other middle-income countries."*

Writing in a linked Comment, Carlo La Vecchia from the University of Milan in Italy and Lluis Serra-Majem from the University of Las Palmas de Gran Canaria in Spain say, "The key focus of the paper remains the need to understand the agricultural, trade, and food industry, and health policy determinants to improve dietary patterns and nutrition in various areas, taking into account the traditional characteristics of diets worldwide... Information about the environmental effect of dietary patterns will be needed in the future [particularly from low and middle income countries], because food not only drives human health, but also the health of the planet."

source: http://www.eurekalert.org/

Public Health Foundation of India (PHFI) and Sustainable Development Solutions Network (SDSN), which is a global initiative of the United Nations, have joined hands to launch a free massive online open course (MOOC) on global public health from March 2.

The MOOC is led by professor K Srinath Reddy of the PHFI and features international and national experts from the field of public health. The course introduces participants to science, practice, and policy environment of global public health, and highlights its centrality in the broader framework of sustainable development.

It will also cover a broad range of topics, starting with an introduction to the basics of public health and the importance of social determinants. It also looks into the importance of health systems in promoting the health of population, and the different methods being employed to achieve universality in access to affordable health services.

"It has been specially designed to meet the requirements and enhance knowledge of professionals and students in the global context, with a focus on the perspective of low and middle-income countries. We would like these courses to contribute to the comprehensive understanding of the interdisciplinary field of public health and to encourage a global dialogue on promoting good health for all," said Reddy.

The course addresses new and emerging issues, including environmental change, technologies, global governance and emphasising their links to healthcare.

The ten-week course is structured around a series of pre-recorded lectures, readings and an interactive discussion forum. These can be completed at a time depending on the student convenience.

Students who successfully complete the course requirements will receive a digital certificate of completion signed by Professor Reddy. However, students who participate actively in the forum discussions will receive certificates of completion with distinction.

source: http://www.business-standard.com/

The Health Ministry has requested a budget allocation of Rp 654 billion (US$51.27 million) to improve primary health-care facilities across Indonesia.

"Ministry data shows that many community health center [Puskesmas] facilities need improvement because of moderate to heavy damage," Health Minister Nila Moeloek said as quoted by Antara news agency on the sidelines of the 2015 central regional chapter National Health Coordination Meeting (Rakerkesnas) in Bali on Monday.

She added that the proposed budgetary allocations would be included in the upcoming revised 2015 state budget through specific-purpose grant (DAK) and assistance-provision mechanisms.

The minister further explained that the efforts were intended to boost health-care services both at primary and referral healthcare facilities.

"It is hoped that 6,000 Puskesmas will reach the standard of health-care services stipulated in the health minister's regulations," Nila said.

"It is also hoped that 184 regional referral hospitals and 14 national referral hospitals can be built in stages until 2019," she went on.

The minister said the Health Ministry would partner with the Home Affairs Ministry in strengthening health-care services at primary-care facilities.

"We need to cooperate with the Home Affairs Ministry so there will be a strong synergy between central and regional authorities because we feel that this relationship has been disconnected [after the implementation of regional autonomy]," said Nila, adding that with such a partnership, regional administrations would pay closer attention to the populace's basic health needs.

source: http://www.thejakartapost.com

By Carmen Rodriguez

Over the last two months I was shocked as an educator, mother and elected official to hear about the bogus debate in regard to vaccines on the heels of the measles outbreak in California. Let's be clear, first there is no debate, second the science is strong and indisputable -- there is absolutely no link to the measles, mumps and rubella (MMR) vaccine and autism or brain damage. Furthermore, you can make no mistake about it, the public's health is compromised every time someone opts to not vaccinate their child.

Measles itself is one of the most contagious airborne diseases on the planet. In fact, according to the Centers for Disease Control and Prevention, if one person has it, 90 percent of the people close to that person who are not immune will also become infected. Measles is a disease that can reap horrific consequences on children and anyone else that is infected by it.

Taking a step back into history, prior to the creation of a vaccine, measles would kill 6,000 people a year and even after the vaccine was developed it still was responsible for hospitalizing 48,000 a year and killing 400 to 500 individuals on an annual basis.

This was until the federal government made a push to completely eradicate the disease through nationwide inoculation. This was achieved 15-years-ago in 2000, but fast-forward to 2013 and according to the World Health Organization, our MMR vaccination rate has fallen to 91 percent. To put this in perspective there are several Third World nations with a better rate of vaccination than our country which is striking and should be reversed.

Did you know that 59 percent of the patients with measles in California are adults? I say this to stress that you are never too old to get vaccinated, in fact the federal government did not start requiring two doses of MMR until 1989, so if you only had one shot you should consult with your doctor to see if another dose of the vaccine is necessary. In addition, as a nation, we have access to a safe alternative to stop devastating diseases unlike other countries where health care workers are killed for vaccinating members of their society. My point being that the luxury of keeping yourself healthy and safe from diseases like measles is not afforded to all global citizens.

As a society we are dependent on herd immunity because there are segments of our population that are unable to be vaccinated. These are individuals who cannot be immunized including infants, individuals who have medical conditions making them immunocompromised, and a small number of people who are allergic to the vaccine. In the State of New Jersey so far we have had one reported case of the measles. I believe, as do public health officials, we need to have a constant dialogue about this issue to thoroughly discredit anyone who undermines the need for vaccinations.

Here at the Camden County Health Department, we carry the MMR vaccine at our health clinics that are open to the public every day during the work week.

source: http://www.nj.com/