A strain of the polio virus has been found at an international airport in Brazil, but there are no human cases, the World Health Organization has said.

A WHO statement released on Monday said the virus was found in samples taken from sewage at Viracopos International Airport in Sao Paulo state in March.

It said the local population's high immunity to the disease "appears to have prevented transmission".

Brazil has been polio-free since 1989 and has high vaccination coverage.

The virus was found in "sewage only" and subsequent analysis of similar samples have either been negative or only positive for "non-polio enteroviruses", the organisation said.

The WHO said the sample was a close match with a recent strain isolated in a case in Equatorial Guinea.

The risk of the polio virus spreading from Equatorial Guinea is described as "high" by the UN agency, but it said the risk from Brazil remained "very low".

Polio invades the nervous system and can cause irreversible paralysis within hours. There is no cure for the disease but it can be prevented by immunisation.

Brazil's last national immunisation campaign was conducted a year ago and coverage in Sao Paulo state has been higher than 95%, the WHO said.

source: www.bbc.com

The World Health Assembly is the decision-making body of the World Health Organization (WHO), attended every year by leading government health officials from its 194 member nations. Recently, I was pleased to participate as a member of the U.S. delegation in the 67th meeting of this important group in Geneva.

One of the key topics addressed during this year's assembly was the critical role played by regulatory systems to ensure the safety, quality, and efficacy of medical products. Resolutions addressed the need to monitor and act on the rise in antimicrobial resistance, strengthen regulatory systems, and enhance access to biotherapeutic products.

As part of the resolution on antimicrobial resistance, the WHO will develop a draft global action plan to combat this problem. Member states were urged to strengthen their drug management systems, support research to extend the lifespan of existing drugs, and encourage the development of new diagnostics and treatment options.

The passage of a resolution to strengthen regulatory systems is itself a milestone for global health. It endorses a comprehensive approach to strengthening medical product regulation, and represents a basic change from traditional capacity-building that has focused primarily on sharing technical expertise. The new systems-oriented approach embraces the need for a strong legal framework, and the use of data and information technology, leadership, governance, partnership, and sustainable financing to strengthen regulatory effectiveness and efficiency.

The adoption of this resolution, co-sponsored by Australia, Brazil, Colombia, Mexico, Nigeria, South Africa, Thailand, and the United States, demonstrates a true international partnership across regions, with many nations affirming their commitment to working individually and together to strengthen their regulatory systems. This is the only way governments and their regulatory authorities can continue to build a global product safety net that will benefit patients and consumers around the world.

During the assembly, I had the privilege of co-hosting a special session entitled, "Regulatory Systems Strengthening: Mobilizing People and Resources" with the Mexican Secretary of Health, Dr. Mercedes Juan Lopez. The distinguished panel included Malebona Precious Matsoso, director general for the Department of Health in South Africa; Dr. Mark Dybul, executive director for The Global Fund to Fight AIDS, Tuberculosis and Malaria; Dr. Marie-Paule Kieny, assistant director-general for the World Health Organization; and Dr. Vincent Ahonkhai, the senior regulatory officer of the Bill and Melinda Gates Foundation. The discussions focused on several important themes, including the multiple benefits of strong regulatory systems for the public health, national security, and economic development and investment.

The panelists highlighted the unique challenges and opportunities faced by regulators because of globalization and the extraordinary increase in the global supply of medical products, and the high cost of regulatory system failures to patients and their trust in the health system. More specifically, the discussions focused on the critical role that regulators play in ensuring access to lifesaving medical products by creating an environment of good regulatory practices that support innovation and research, and protect the public from threats resulting from substandard or counterfeit products.

Panelists also reported on progress that is being made as nations increasingly collaborate to share information, reduce inefficiencies, and work toward regulatory convergence. For example, participants learned about the World Health Organization's decades-long efforts to support countries in strengthening their systems, and about WHO's prequalification program to ensure that select priority essential medicines, diagnostics, and vaccines are of high quality, safety, and efficacy for international procurement agencies and developing countries with limited regulatory capacity.

These kinds of collaborative strategies are essential in this global age. Only by strengthening our international partnerships, and by building regulatory systems that work together and support each other, can we ensure the quality, safety and efficacy of the medical products that the citizens of our nations depend upon.

source: www.qualitydigest.com

An Ebola outbreak continues to spread in three West African countries, and the death toll in the outbreak has risen to 337, the World Health Organization says.

Health officials have struggled to contain the outbreak, which is believed to have begun in Guinea, where the majority of the cases and deaths have been.

It has also touched Sierra Leone and Liberia, where it recently flared again after about two months with no new cases.

"This is a complex outbreak involving multiple locations in three countries with a lot of cross-border movement among the communities," Fadela Chaib, a spokeswoman for the UN health agency, wrote in an email.

"This makes this one of the most challenging Ebola outbreaks ever."

In an update published on its website on Wednesday, the agency said that more than 500 suspected or confirmed cases of the virus had been recorded.

That appears to be a large increase since the last update, published about a week earlier, when the agency reported about 240 had died of the disease. But there is sometimes a significant lag in tallying cases, and the organisation said the numbers were constantly in flux as test results came in.

"The jump in cases is due to reclassification, retrospective investigation, and consolidation of cases," Chaib wrote.

This is the first time Ebola has struck three countries at once and the first major outbreak in West Africa. Fear of the disease, for which there is no cure, has hampered efforts to isolate the sick.

Chaib said more work was required to get sick people into treatment facilities and to track down people that the sick had come into contact with, so they could be monitored for symptoms.

source: www.aljazeera.com

A group of 129 physicians, epidemiologists and others from 31 countries sent an open letter to the World Health Organization on Monday urging the United Nations agency to hold firm in what seems to be its intention to impose strict regulations on electronic cigarettes.

The letter was a response to one sent last month by 53 other experts who urged the WHO to go easy on e-cigarettes, which the advocates called "part of the solution" in the fight against smoking.

The latest letter, in contrast, said manufacturers should be required to present data that show the products are safe and help smokers quit, and disclose ingredients in the "vaping" liquid the devices burn.

Regulating e-cigarettes like tobacco products, the signatories wrote, is necessary to "prevent initiation of use among youth and other non-tobacco users, protect bystanders in public areas from involuntary exposure, regulate marketing, and prohibit unsubstantiated claims."

E-cigarettes use battery-powered cartridges to produce a nicotine hit via inhalable vapour without the tar and other carcinogens in inhaled tobacco smoke. Advocates said classifying e-cigarettes as tobacco products, and requiring comparable regulation, would threaten their potential to reduce the death and disease caused by smoking.

Their letter said e-cigarettes "could be among the most significant health innovations of the 21st century," adding that "the urge to control and suppress them as tobacco products should be resisted."

It remains unclear whether most e-cigarette consumers will be smokers using the devices to quit or non-smokers to whom they are a "gateway" product to nicotine addiction and smoking. One study published last month in the journal Circulation reported that most e-cigarette consumers are "dual users," both smoking and vaping.

The letter from opponents warned that although e-cigarette vapour has fewer toxic components than regular smoke, more than half a dozen studies have shown it can include ultrafine particles damaging to lungs, plus "carcinogens and reproductive toxins, including benzene, lead, nickel, and others."

The letter was organized by tobacco scientist Dr. Stanton Glantz of the University of California, San Francisco, and others.

The WHO is assessing its position on e-cigarettes, and has indicated it is leaning toward restrictions like those on all nicotine-containing products, including banning advertising and flavours.

source: www.theglobeandmail.com

Citing a need to respond to important infectious disease threats in South East Asia, public health officials from Thailand, Viet Nam and Indonesia agreed today to actively collaborate on a new study on sepsis, an major cause of death due to infectious diseases in the region.

The extent of sepsis in South East Asia is currently unknown but health care experts suspect that it accounts for a substantial number of deaths there. Preliminary results from a currently unpublished Thai study show that one in 6 patients who presented with sepsis died, a figure much higher than expected.

"We need to know the extent of sepsis, its causes and outcomes, so we can treat it more effectively and thereby save thousands oflives in South East Asia," said Dr Nguyen Tran Hien, Director of the National Institute of Hygiene and Epidemiology, Ministry of Health, Viet Nam, and Chair of the Governing Board of SEAICRN, speaking today at SEAICRNs annual meeting.

The sepsis study, which began late 2013 in Thailand and in early 2014 in Viet Nam, and which will start in Indonesia in late 2014, is supported by the Ministries of Health in Indonesia, Thailand and Vietnam, and by SEAICRN's global partners, which include the US National Institute of Allergy and Infectious Diseases, the Wellcome Trust and the World Health Organization (WHO).

"I urge that the Ministry of Health in all South East Asia countries actively participate in this important sepsis study," said Dr Muhamad Karyana, Chairman of INA-RESPOND, Center for Applied Health Technology and Clinical Epidemiology, Ministry of Health, Indonesia. "It is crucial that policy makers and leading research institutes collaborate and conduct high-quality research to provide evidence-based information to improve health care in our region."

Conducted by the South East Asia Infectious Disease Clinical Research Network (SEAICRN), the sepsis study seeks to identify the causes and outcomes of sepsis, improve its treatment, and help public health authorities and medical researchers across South East Asia better respond to other potentially deadly public health threats in South East Asia as new infectious diseases emerge.

"New and emerging infectious diseases are another threat to human health in Thailand and South East Asia, and researchers andpolicy makers need to be prepared to act promptly when they emerge," said Dr Supamit Chunsuttiwat, Senior Medical Officer, Department of Disease Control, Ministry of Public Health, Thailand.

"We learned during the 2005 H5N1 avian influenza outbreak that waiting for an outbreak to start makes it difficult to perform the best and most informative research," said Dr Direk Limmathurotsakul, Assistant Professor at the Faculty of Tropical Medicine, Mahidol University and Director of SEAICRN. "Initiating and collaborating on large multi-national clinical studies like this one to define the causes, management and outcome of sepsis will allow us to detect new emerging infectious diseases in South East Asia and plan a coordinated, more effective response."

Founded in 2005 in response to growing concerns about the H5N1 avian influenza pandemic, SEAICRN is a collaborative partnership of national public health agencies and medical researchers ideally positioned to swiftly initiate research in response to infectious disease threats. SEAICRN also aims to increase scientific knowledge and directly contribute to improvedclinical management of infectious diseases, such as sepsis, leptospirosis, dengue infection, and hand, foot, and mouth disease (HFMD) caused by Enterovirus 71 (EV71).

Participating SEAICRN institutes in Thailand include Siriraj Hospital, the Faculty of Tropical Medicine and Mahidol-Oxford Tropical Medicine Research Unit (MORU) at Mahidol University, Queen Sirikit National Institute of Child Health (Bangkok), Chiangrai Prachanukroh Hospital (Chiangrai), and Sappasithiprasong Hospital (Ubon Rathchathani).

In South East Asia, SEAICRN participating institutes include Indonesia's Cipto Mangunkusumo Hospital (Jakarta), Dr Sardjito Hospital (Vogyakarta) and Dr Wahidin Soedirohusodo Hospital (Makassar); and Viet Nam's Children Hospital 1 (Ho Chi Minh City), Children Hospital 2 (Ho Chi Minh City), Hospital for Tropical Diseases (Ho Chi Minh City), National Hospital for Pediatrics (Hanoi), National Hospital for Tropical Diseases (Hanoi), and Hue Central Hospital (Hue).

SEAIRCN's global partners who provide financial, scientific, operational and administrative support include the University of Oxford and the Wellcome Trust from the United Kingdom; the USA's National Institutes of Health's National Institute of Allergy and Infectious Diseases (NIH/NIAID); the World Health Organization (WHO), Mahidol-Oxford Tropical Medicine Research Unit (MORU), Oxford Universities Clinical Research Unit (OUCRU) from Viet Nam, INA Respond, FHI 360 and Social & Scientific Systems, Inc.

source: english.vietnamnet.vn

The 2014 World Cancer Report, issued by the World Health Organisation (WHO), indicates that the number of new cancer cases has reached an all-time high.

On the 19 May 2014, Dr Margaret Chan, the Director-General of the WHO, gave a stirring speech to the 67th Health Assembly on the heavy health burden associated with cancer. Dr Chan was particularly interested in public health measures designed to combat the global tobacco epidemic.

Investor State Dispute Settlement Clauses

Dr Chan expressed her opposition to the use of investor-state dispute settlement clauses by Big Tobacco 'to handcuff governments', particularly in respect of lost profits following the introduction of cigarette packaging designed to reduce smoking. In a similar vein, former Australian Prime Minister Julia Gillard has warned that investor-state provisions give companies 'a new place to take disputes — a tribunal that stands separate from and above domestic legal systems'.

Philip Morris, an American tobacco and cigarette company, has challenged Uruguay's graphic health warnings for tobacco products under an investment agreement between Uruguay and Switzerland,as well as Australia's plain packaging of tobacco products under an investment agreement between Australia and Hong Kong.

There have been parallel problems in the field of access to medicines. Eli Lilly, an American pharmaceutical company, has challenged Canada's patent laws under an investment clause of the North-American Free Trade Agreement.More generally, the United Nations Conference on Trade and Development (Unctad) has reported a sharp rise in investor-state dispute settlement disputes.

Such disputes are not an isolated occurrence. Multinational tobacco companies have lobbied for the inclusion of investor-state dispute settlement in submissions to the United States Trade Representative for regional trade deals such as the Trans-Pacific Partnership (TPP) and the Trans-Atlantic Trade and Investment Partnership (TTIP). Big Tobacco also intends to use investment clauses as a means of delaying and frustrating the roll-out of the World Health Organization's Framework Convention on Tobacco Control across the world.

Plain Packaging of Tobacco Products

Dr Chan's speech also alluded to the battle over Australia's plain packaging of tobacco products in the World Trade Organization (WTO). Five countries — Ukraine, the Dominican Republic, Honduras, Cuba, and Indonesia — have challenged Australia's regime of plain packaging of tobacco products in the WTO. The complainants argue that the plain packaging of tobacco products violates the Trips Agreement 1994, which deals with trade-related aspects of intellectual property, as well as the GATT. The countries also allege that Australia has breached articles of the Agreement on Technical Barriers on Trade 1994. These arguments echo the position of the large multinational tobacco companies.

In response, Australia has maintained that the plain packaging of tobacco products is designed to address the global tobacco epidemic identified by the WHO, and to implement the WHO's Framework Convention on Tobacco Control. Australia has also emphasised that plain packaging of tobacco products is consistent with its international trade obligations under the Trips Agreement 1994, the Agreement on Technical Barriers on Trade 1994, and the GATT.

The five complaints have progressed slowly. There is some concern that the complainants have been stalling and delaying the dispute. In May 2014, WTO Director General Roberto Azevêdo appointed three panellists to examine the dispute against an Australian public health measure requiring tobacco products to be sold in plain packaging in the country. A decision is expected in six months.

A number of leading experts recently highlighted the strength of Australia's case in a submission and a presentation to the New Zealand Parliament. The submission observed that tobacco companies and their allies were prone to misrepresenting international trade law, by greatly overstating 'the constraints that international trade and investment agreements impose on governments' autonomy to regulate in the public interest in general and for public health in particular.' Australia's position is strongly supported by countries, such as Ireland and New Zealand, who are also implementing plain packaging of tobacco products.

Are Regional Trade Agreements Bad for Public Health

Dr Chan also expressed reservations about the public health impact of regional trade agreements, such as the TPP and the TTIP. Chan raised concerns about the impact of deals on public health issues, such as access to affordable medicines, as well as tobacco control measures like graphic health warnings, and the plain packaging of tobacco products.She observed that regional trade agreements can have a chilling effect: 'For bilateral and regional free trade agreements, as well as under World Trade Organization agreements, pressure can also come from fear that trade sanctions may be imposed by trading partners.'

Likewise, former New York Mayor Michael Bloomberg has also expressed his concerns that the TPP will promote the free trade in tobacco. Mr Bloomberg has stated that 'the Obama administration appears to be on the verge of bowing to pressure from a powerful special-interest group, the tobacco industry, in a move that would be a colossal public health mistake and potentially contribute to the deaths of tens of millions of people around the world.'

To conclude, Dr Chan emphasised that 'health is a smart investment', and that public health must be prioritised over economic interests. She argued that trade agreements which allow corporations to challenge government policies introduced to protect public health concerns are fundamentally out of step with this reality. Dr Chan looked forward to the development of strategies for a 'tobacco end game' that could end tobacco use altogether.

This article was written by Matthew Rimmer, an Australian Research Council Future Fellow, working on Intellectual Property and Climate Change. He is an Associate Professor at the ANU College of Law, and an associated director of the Australian Centre for Intellectual Property in Agriculture. This article was originally published on East Asia Forum and reproduced here with their kind permission.

Read more: Smoke and Mirrors in Trade Disputes will Harm Public Health And Weaken Tobacco Control http://www.establishmentpost.com/smoke-mirrors-trade-disputes-will-harm-public-health/#ixzz34Tz0kqsP

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source: www.establishmentpost.com

An academic at the University of Strathclyde is joining an international panel appointed by the World Health Organization (WHO) to help seek solutions to childhood obesity. Professor John Reilly, of the University's School of Psychological Sciences & Health, is one of only 17 members of the working group reporting to WHO's Director General on science and evidence for ending childhood obesity.

The group will be assessing research to inform recommendations to be made by the Director General, Dr Margaret Chan, to the World Health Assembly in 2015.

WHO statistics indicate that at least 40 million children worldwide under the age of five were classed as obese in 2012. The total is projected to rise to at least 70 million by 2025.

Professor Reilly has conducted extensive research into childhood obesity. He has been involved in compiling a global matrix measuring and comparing the physical activity of children in 15 countries and also led the most comprehensive study yet of the association between obesity and academic attainment in adolescence. He is currently involved in childhood obesity prevention research projects in South Africa, Tanzania, Morocco, Bahrain, and Mauritius.

He said: "Childhood obesity remains an urgent problem, particularly in low- and middle-income countries, where it is increasing rapidly. It's linked to non-communicable diseases, such as cancer, chronic respiratory diseases, diabetes and heart disease. In these countries, non-communicable diseases are now the major causes of death and the position is getting worse.

"In high-income countries, childhood obesity particularly increased from the late '80s and has levelled off in the last five years but it could still pick up again.

"We'll be carrying out a rigorous review of the best evidence on childhood obesity, its economic impact and monitoring, prevention and treatment. This will help to build robust strategies for the Director General's recommendations on dealing with, and preventing, obesity and its consequences."

The WHO Director General's Ad hoc Working Group on Science and Evidence for Ending Childhood Obesity is to meet for the first time in Geneva on 17-20 June. The initiative is part of the overall WHO agenda on non-communicable diseases. Further details on the Commission on Ending Childhood Obesity can be seen at http://www.who.int/dietphysicalactivity/end-childhood-obesity/en/ 

source: indiaeducationdiary.in

Indonesian health minister Nafsiah Mboi has warned the tobacco industry to start printing graphic images associated with harm from smoking on cigarette packets before the June deadline passes.

"The regulation was not issued all of sudden, it has existed since 2009, so the pictorial health warnings should be printed and distributed by June 24," Nafsiah told the Jakarta Globe on Wednesday.

A government regulation on tobacco control, which was issued in December 2012 following the introduction of the 2009 health law, stipulated that at least 40 percent of cigarette packaging should be covered in images of tobacco-related disease.

The industry was given 18 months to comply with the regulation, but as the deadline nears, the tobacco industry and pro-tobacco lobbyists have argued the start date for the new requirement is unclear.

However, Nafsiah has criticized the Indonesian tobacco industry for stalling.

She said they had no problem following regulations in other countries.

"When they exported their products overseas they didn't mind at all to print all the graphic images that sometimes comprise 80 percent of the package," she said. "You use the images abroad but you don't want to use them in your own country hoping that Indonesians will keep puffing, this is too cruel."

Nafsiah warned that the 2009 health law clearly stipulated that anyone who produced or imported cigarettes to Indonesia without the pictorial health warning could receive a five year prison sentence or Rp 500 million ($42,000) fine.

While speaking to the Jakarta Globe, Nafsiah also struck out at House Speaker Marzuki Ali, who she said had hampered the ministry's effort to move forward with ratification of the World Health Organizations' Framework Convention on Tobacco Control (FCTC).

Although it was actively involved in drafting the treaty, Indonesia remains the only country in the Asia-Pacific region not to have ratified the convention.

In December, Indonesian ministries agreed the country must sign the treaty to protect the nation from the danger of tobacco addiction.

But several lawmakers, including Marzuki Ali, sent a letter to president Susilo Bambang Yudhoyono, which asked him to postpone the signing because a tobacco bill was being deliberated in the house.

"Tobacco farmers needn't be overly concerned or start holding protests just yet," Cabinet Secretary Dipo Alam told reporters in March. "I don't believe the president is in any rush to ratify this convention."

Nafsiah said that Indonesia's addiction to tobacco had reached an emergency level, especially for the the poorest 45 percent of households in the country.

"I used to respect the House Speaker but now I am thoroughly disappointed," she said. "Lawmakers were voted by the public to represent and protect the people, it is very sad that the House Speaker chose to side with the tobacco industry instead of his constituents."

Tobacco control activists have repeatedly criticized the bill, claiming it was initiated and funded by the tobacco industry to protect their business in a country where public health regulations lag behind much of the rest of the world and where over 37 percent of Indonesian boys between the ages of 15 and 19 were active smokers, according to a survey conducted by the Ministry of Health last year.

Nafsiah said before the present government's term ended the WHO treaty must be signed.

"Our president Susilo Bambang Yudhoyono is internationally recognized as a leader in public health sector," she said. "But some people are regretting that he did not want to leave a legacy to show that he is the president who eventually signed the treaty to join the international community."

source: www.thejakartaglobe.com