Indonesian deputy Health Minister Ali Gufron said on Monday that there was no Indonesian pilgrim infected with Ebola virus or Corona virus, which are spreading in Saudi Arabia.

The deputy minister said the death of pilgrims from Indonesia in the Middle East country was caused mostly by cardiovascular disease, followed by respiratory and other diseases.

"Until now there is no fatality linked with Ebola virus or Corona virus. We thank to God," he said at the Health Ministry.

As many as 109 Indonesian pilgrims died in Saudi Arabia when they were performing hajj pilgrimage this year, rising from 86 people last year.

In 2012, 141 Indonesian pilgrims died in Saudi Arabia and in 2011,145 people.

Indonesian government has been successful in stopping the spread of H5N1 virus in the country, which had been hit hardest by the virus with more than 100 deaths.

Most of Indonesia's 238 million population are Muslims, and the country sends thousands of Muslims to Saudi Arabia annually to perform hajj pilgrimage.

source: http://www.globalpost.com

Through the beginning of October, there have been 7,491 probable, confirmed and suspected cases of Ebola in West Africa, according to the latest "Ebola Response Roadmap" from the World Health Organization.

But the worldwide number is higher: For the first time during the deadliest Ebola outbreak in history, the WHO has included the United States on the "Ebola Response Roadmap," including the single case from Texas in its update.

According to the WHO's update, which was released Friday, the Ebola death toll is up to 3,439 in West Africa. All but eight of the deaths came in the Ebola-ravaged nations of Liberia, Sierra Leone and Guinea. (The others were in Nigeria, where the outbreak may be coming to an end.)

The number of U.S. Ebola cases remained at one through early Friday afternoon, even as health officials in Texas said that "approximately 10 people" who had contact with the Ebola patient in Dallas are considered higher risk. Also on Friday, Howard University Hospital in Washington said that a patient was being evaluated after coming to the facility "presenting symptoms that could be associated with Ebola."

source: http://www.washingtonpost.com

Developing countries aiming to build strong family planning programs often look to Indonesia as a model — and with good reason.

For years, Indonesia had one of the strongest and most successful national family planning initiatives in the world. With the backing of Muslim leaders, the country doubled its contraceptive prevalence rate to nearly 60 percent between 1976 and 2002, and halved its fertility rate from 5.6 to 2.6 children per woman. This undoubtedly helped lay the groundwork for Indonesia's rapid and impressive annual economic growth of at least 5 percent since 1980.

However, Indonesia's remarkable progress has recently stagnated. In the past decade, the country's fertility rate has remained the same, its CPR has risen a meager 1.5 percent, and its maternal mortality ratio remains high at 190 deaths per 100,000 live births. This is largely due to a complex devolution process that shifted power over family planning programs from the national to the district level, leading to confusion around roles and responsibilities — and, at times, inaction.

Thankfully, though, things are about to change. Since the 2012 London Summit on Family Planning, the Indonesian government has announced efforts to revitalize the country's national family planning program. Among other things, the government committed to:

• Strengthen the program at the provincial and district levels, to bolster local access to family planning.
• Provide family planning services and supplies free of charge as part of the country's universal health coverage program that was launched in January.
• Boost health worker training efforts, particularly around long-acting reversible methods.
• Improve 23,500 family planning clinics by the end of the year.
• And, ultimately, achieve a fertility rate of 2.1 children per woman by 2025.

These efforts are supported by a much stronger budget. In fact, the country's allocation for family planning quadrupled from $65.9 million in 2006 to $263.7 million in 2014, and the government is committed to maintaining this investment.

In August, the National Population and Family Planning Board and the Johns Hopkins Bloomberg School of Public Health signed a collaboration memorandum to help ensure that more women across Indonesia have contraceptive access and, importantly, options. Through our programs — including Advance Family Planning and the Center for Communication Programs — JHSPH is now working at the national and local levels to create momentum and bring about real and lasting change.

We're doing this in a number of ways. One of our most exciting projects, led by CCP, involves working with the two largest Muslim organizations in the country, Muhammadiyah and Nahdlatul Ulama, to reach women in their homes and in their communities. In partnership with the Yayasan Cipta Cara Padu Foundation, we are working with the women's branches of these groups in 11 districts to integrate information and messaging on family planning and reproductive health into ongoing programming, including prayer groups and Koran readings. In addition, we are tapping into the pre-K and day care networks to reach young mothers with children under 5. Through these networks, we hope to reach 1,500 to 5,000 young mothers and parents per district.

We will also equip volunteers from these Muslim women's groups with electronic tablets that they can bring house to house and use in their daily interactions. These tablets are preloaded with videos and educational materials on family planning and proper use of methods. They can also be integrated with other information and communications technologies, such as text message services for new mothers, interactive counseling services and Web-based monitoring of activities.

This outreach will be coupled with the "Right Time, Right Method, My Choice" mass media and social media campaign, which aims to reach 2.9 million women of reproductive age in the target districts through radio, TV, print and online outlets. CCP is also optimizing the use of smartphone apps to reduce barriers to obtaining accurate and timely family planning information, including about methods, health centers and providers.

By working with well-respected members of the community to spread family planning messages, we hope we can show that family planning is both socially and religiously acceptable and dispel common myths and misconceptions around the use of modern contraceptives. Breaking through these cultural barriers will have a tremendous impact on demand for and use of family planning.

Through the revitalization process, Indonesia can, once again, be a shining example of what's possible when you make family planning a national priority. Most importantly, it will ensure that all Indonesian women have access to the contraceptive options they want and need.

We know that when women have control over their own fertility and can plan their families, they are more likely to survive childbirth and raise healthier children. We are confident that Indonesia's national family planning program will benefit women, their families, their communities — and, ultimately, our country — for years to come.

This article is part of a series by the Bill & Melinda Gates Foundation that culminates on World Contraception Day. Check out more stories about global health and other important issues at the Impatient Optimists blog.

source: https://www.devex.com/

High levels of bed occupancy are associated with increased inpatient and thirty-day hospital mortality in Denmark, according to research published in the July issue of Health Affairs.

Authors Flemming Madsen, Steen Ladelund, and Allan Linneberg received considerable media attention in Denmark for their research findings. For one major Television channel, it topped Germany's victory in the World Cup finals.

In another story from the Danish newspaper, Information, Councillor Ulla Astman, Chairman of the North Denmark Regional Council and second highest ranking politician, who runs all of the Danish public hospitals, reportly stated that "we have to live with it [the increased mortality]," since Denmark cannot afford to reduce bed occupancy.

"Or die with it," said lead author Madsen, a pulmonary physician and director of the Allergy and Lung Clinic in Helsingør, Denmark, at the July 9 Health Affairs briefing, "Using Big Data To Transform Care." Madsen, who left his position as director of the Department of Internal Medicine at Frederiksberg Hospital in Copenhagen to pursue this research, believes that Astman's statement explains why Denmark has a bed shortage problem and supports his argument that bed shortage is a result of planning.

"It is dangerous to focus on productivity without looking at the consequences," says Madsen.

What's the Research?

Currently, in the United States, emergency departments are often crowded with patients seeking acute care. But emergency medicine is not yet a specialty for Denmark. While hospital bed shortages are common in North America, the United Kingdom, and Australia, bed occupancy rates in Danish hospitals' departments of medicine average 100 percent, report Madsen and his Health Affairs coauthors.

For their research, they decided to study bed occupancy and mortality rates to see if there was an association between the two. They looked at more than two million admissions from 1995 to 2012 from 322 departments of medicine at 72 hospitals in Denmark (excluding pediatric, psychiatric, and surgical departments).

Because Danish citizens have national health insurance, the authors used data from the National Health Database. They found high bed occupancy rates were associated with a 9 percent increase in both in-hospital mortality and thirty-day mortality rates. Admissions outside of normal working hours in addition to admissions during January, February, March, and July (possibly due to staff reduction, a result of vacation timing in Denmark) were also associated with increased mortality.

source: http://healthaffairs.org

World-class Formula One drivers roared through the Marina Bay Street Circuit last night, as the air quality here worsened.

The three-hour Pollutant Standards Index (PSI) climbed throughout the day to hit the unhealthy level of 129 at 9pm, while the 24-hour reading was in the moderate range of 59-67.

At 11pm, the three-hour PSI went down to 102 and the 24-hour PSI rose to 64-70.

The hazy conditions were "due to an incoming haze cloud from Sumatra" in Indonesia, said minister for the environment and water resources Vivian Balakrishnan on his Facebook page.

In its advisory, the National Environment Agency (NEA) said satellite images showed 64 hot spots in Sumatra yesterday, while Kalimantan had 73. Widespread smoke was visible in southern Kalimantan.

Indonesia's National Disaster Mitigation Agency said in a statement that it had conducted cloud-seeding operations to induce rain in South Sumatra over the weekend, which resulted in a sharp drop in the number of hot spots to 31 yesterday afternoon. Four helicopters were deployed for water-bombing operations to put out fires in the province.

"Many of the fires were on plantations and land near settlements, which indicates they were deliberately burnt," agency spokesman Sutopo Purwo Nugroho said. "The combination of illegal logging and forest fires is common in South Sumatra."

There were no hot spots in Riau and Jambi provinces.

Dr Sutopo said the effort to tackle the haze as a result of forest fires was ongoing, through land and air operations, law enforcement and community education, and that law enforcement was a top priority.

Singapore's NEA said the haze may continue today, as prevailing winds are forecast to blow from the south-east or south. Overall air quality is expected to fluctuate between the high-end of the moderate band (51-100) and the low-end of the unhealthy range (100-200).

The agency reminded the public that health impact depends not only on the PSI level, but also on one's health status and the length and intensity of outdoor activity. It advised people with chronic lung or heart disease to avoid prolonged or strenuous outdoor physical exertion. (***)

source: http://www.thejakartapost.com

In this issue of PLOS Medicine, Kathleen Holloway from WHO and David Henry (University of Toronto, Canada) evaluated data on reported adherence to WHO essential medicines practices and measures of quality use of medicines from 56 low and middle income countries for 2002-2008. They compared the countries' government-reported implementation of 36 essential medicines policies with independent survey results for 10 validated indicators of quality use of medicines (QUM). They claim that the results provide the strongest evidence to date that WHO essential medicines policies are associated with improved medicines use.

Over-use and under-use of medications is a global public health problem with serious consequences, including antibiotic resistance, avoidable adverse drug events, and untreated and undertreated illnesses leading to hospitalization and death. Since 1977, the World Health Organisation (WHO) has advocated the concept of Essential Medicines and developed a range of policies to promote quality use of medicines. However, whether these policies lead to better medication usage has not been clear.
The authors first derived estimates of the impact of individual policies by comparing QUM in countries that did or did not report implementing them. Working with a list of the most effective policies (27-policy and 18-policy variables) and using a single composite indicator for QUM, the authors found that the more essential medicines policies reported, the higher the composite QUM indicator [(r) = 0.39 (95% CI 0.14 to 0.59), P=0.003]. When they stratified the countries by gross national income per capita,, they found that the 27-policy variable was significantly associated with QUM for those with a GNI below the median value of US$2333 [(r)=0.43 (95% CI 0.06, 0.69), P=0•023]; but not for those above the median value [(r)=0.22 (95% CI -0.15, 0.56), P=0.261]. Limitations of the study included substantial missing data, but imputation of missing data supported the main results, and that the adherence to essential medicines policies were reported by the countries rather than measured directly.

The authors state, "Our most important findings were 2-fold. First, some essential medicines policies—particularly the provision of undergraduate training in standard treatment guidelines to doctors and nurses, provision of free essential medicines, and having a ministry of health unit promoting QUM—were associated with improved medicines use. Second, there was a positive correlation between the number of medicines policies that countries reported implementing and the quality of their medicines use. This correlation was strongest and statistically significant in countries with national per capita wealth levels below the median of the study countries (US$2,333), underscoring the importance of essential medicines policies in low-income countries."
They conclude, "International support for the WHO, increasingly, is being channelled to vertical disease programmes (e.g., addressing AIDS, tuberculosis, and malaria) and away from horizontal programmes designed to support development and maintenance of health policies and standards. The medicines policies and data discussed here were developed and collected as part of the WHO core "normative" functions, which are now under threat. It is important that the critical role of the WHO is recognised and that these efforts are sustained and enhanced."

source: http://medicalxpress.com

FREETOWN, Sierra Leone – The World Health Organization said Saturday it could not meet a request from Sierra Leone to evacuate a doctor who contracted the deadly Ebola disease.

Dr. Olivet Buck is the fourth doctor from Sierra Leone to come down with Ebola, which has been blamed for 2,400 deaths in West Africa, according to the WHO. Liberia, Sierra Leone and Guinea have recorded the vast majority of cases.

Sierra Leone requested funds from the World Health Organization to evacuate the doctor to Germany on Friday. A letter from President Ernest Bai Koroma's office said he had approved Buck's evacuation to a hospital in Hamburg, Germany, "where they are in readiness to receive her."

Buck, a citizen of Sierra Leone, would be the first doctor from one of the countries hit hardest by Ebola to receive treatment abroad. The other three doctors from Sierra Leone died in the country.

The letter, sent to the WHO's country representative on Friday and seen Saturday by The Associated Press, said Buck tested positive for Ebola on Tuesday. "We have been informed that Dr. Buck is quite ill," it said.

A spokesman for the WHO said on Saturday, however, that it could not comply with the request and instead would work to give Buck "the best care possible" in Sierra Leone, including access to experimental drugs.

"WHO is unable to organize evacuation of this doctor to (Germany) but is exploring all options on how to ensure best care," WHO spokesman Tarik Jasarevic said.

"WHO will facilitate the best care possible in country for Dr. Buck, including access to experimental drugs," Jasarevic said.

There is no licensed treatment for Ebola, though a small number of patients have received unproven treatments, with mixed results. It is not clear how these treatments influenced whether the patients recovered or not.

Because Ebola is only transmitted through contact with the bodily fluids of people showing symptoms or from dead bodies of Ebola victims, health workers have been especially vulnerable as they respond to the worst outbreak in history.

A total of 301 health workers had become infected with the disease as of Sept. 7 in Guinea, Liberia and Sierra Leone, according to the WHO. Of that tally, which included suspected and probable cases in addition to confirmed ones, 144 had died.

The infections have exacerbated shortages of doctors and nurses in West African countries that were already low on skilled health personnel.

So far, only foreign health and aid workers have been evacuated abroad from Sierra Leone and Liberia for treatment.

Dr. Sheik Humarr Khan, Sierra Leone's top Ebola doctor, was being considered for evacuation to a European country when he died of the disease in late July.

Cuba's health ministry announced Friday it will send more than 160 health workers to fight Ebola in Sierra Leone, a move that WHO Director-General Dr. Margaret Chan said would "make a significant difference."

In Liberia, the country that has recorded the highest number of Ebola cases and deaths, officials on Saturday released a letter that President Ellen Johnson Sirleaf sent this week to U.S. President Barack Obama appealing for a dramatic increase in support to address an emergency she said "threatens civil order."

Sirleaf described how her country's health system had been swiftly overwhelmed by the outbreak, and how doctors were afraid to go to work after seeing their colleagues die. "Diseases that were treated with relative ease pre-Ebola now take lives because of the pall that Ebola has cast over our health system," she said.

In the letter dated Tuesday, Sirleaf asked for the U.S. to set up and operate at least one Ebola treatment unit in the capital, Monrovia, and to help restore services at 10 non-Ebola hospitals. She also requested help in maintaining "air bridges" to get supplies and personnel into the country, noting that many airlines have canceled flights in and out of Monrovia.

"I am being honest with you when I say that at this rate, we will never break the transmission chain and the virus will overwhelm us," Sirleaf said.

source: http://www.foxnews.com

Indonesia, one of only three countries in the Asia-Pacific region that is seeing a trend of increased HIV infections, must plug a $30 million funding gap in its fight against HIV, a U.N. health official said on Wednesday.

President-elect Joko Widodo, who won a July election, should build on the policies implemented by the outgoing administration, Cho Kah Sin, Indonesia country director for the United Nations Program on HIV and AIDS, told Reuters.

Indonesia's five-year strategic plan to combat HIV/AIDS ends this year and domestic funding of the plan is at about 40 percent, much lower than the targeted 70 percent, Cho said.

While the domestic budget for tackling HIV/AIDS has increased from $27 million in 2010 to $37 million this year, the current funding gap is estimated at about $30 million, and it is expected to increase to about $175 million by 2020.

"Indonesia is a middle income country [and] is going to have a challenge trying to convince international donors to continue to invest in development assistance for social and health projects," said Cho.

"Eventually it will have to provide its own funding for priorities like health," he added. "It is very important for the national government to continue to increase the proportion of funding for HIV from domestic resources."

The United Nations, in a report released every two years on the world HIV and AIDS epidemic, said last month new infection rates in Indonesia were a "cause for concern."

About 0.43 percent of the adult population, or about 640,000 people, are infected with HIV in Indonesia.

Indonesia, Pakistan and the Philippines were the only three countries in the Asia-Pacific region with a trend of increased HIV infections, the United Nations said.

Cho said he was optimistic about the fight in Indonesia.

Since 2012, the world's fourth most populous country has massively increased access to HIV testing and now offers early antiretroviral treatment.

"It's important that the new administration stay on course, continue to invest in early testing and early treatment, and build on the foundation that the minister has already put in place," Cho said, referring to Health Minister Nafsiah Mboi, who introduced a more effective response to HIV/AIDS when she was appointed in 2012.

"If this is continued, we have no doubt that this is going to be able to reverse the epidemic," Cho continued.

Advisers to Widodo could not be reached for comment.

One reason for the rise in HIV rates in Indonesia was that infections only began to start picking up in the mid-1990s, Cho said, later than in many other countries.

Also, as testing has increased and become more accepted, more people are willing to get tested and therefore know their HIV status, he said.

"Of course we don't expect these to turn the epidemic around overnight - it will take time to show but we're on the right track. She has put the foundations in place," Cho said referring to Mboi's work.

source http://www.voanews.com