Bacteria resistant to antibiotics have now spread to every part of the world and might lead to a future where minor infections could kill, according to a report published Wednesday by the World Health Organization.

In its first global survey of the resistance problem, WHO said it found very high rates of drug-resistant E. coli bacteria, which causes problems including meningitis and infections of the skin, blood and the kidneys. The agency noted there are many countries where treatment for the bug is useless in more than half of patients.

WHO's report also found worrying rates of resistance in other bacteria, including common causes of pneumonia and gonorrhea.

Unless there is urgent action, "the world is headed for a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill," Dr. Keiji Fukuda, one of the agency's assistant director-generals, warned in a release.

WHO acknowledged it couldn't assess the validity of the data provided by countries and that many had no information on antibiotic resistance available.

Health experts have long warned about the dangers of drug resistance, particularly in diseases such as tuberculosis, malaria and flu. In a report by Britain's Chief Medical Officer last year, Dr. Sally Davies described resistance as a "ticking time bomb" and said it was as big a threat as terrorism.

In 1928, Alexander Fleming's discovery of penicillin revolutionized medicine by giving doctors the first effective treatment for a wide variety of infections. Despite the introduction of numerous other antibiotics since then, there have been no new classes of the drugs discovered for more than 30 years.

"We see horrendous rates of antibiotic resistance wherever we look...including children admitted to nutritional centers in Niger and people in our surgical and trauma units in Syria," said Dr. Jennifer Cohn, a medical director at Doctors Without Borders, in a statement. She said countries needed to improve their monitoring of antibiotic resistance. "Otherwise, our actions are just a shot in the dark."

WHO said people should use antibiotics only when prescribed by a doctor, that they should complete the full prescription and never share antibiotics with others or use leftover prescriptions.

source: latino.foxnews.com

The Health Ministry says an Indonesian citizen is suspected to have contracted the Middle East Respiratory Syndrome Corona Virus (MERS-CoV) and is now receiving a medical treatment at King Saud Hospital in Jeddah, Saudi Arabia.

"The Indonesian citizen has long been domiciled in Saudi Arabia and is not on an umroh (minor haj) pilgrim. The patient allegedly infected with the corona virus is being treated at King Saud Hospital, Jeddah, since April 20," said the ministry's director general of disease control and environmental health, Tjandra Yoga Aditama, in a statement in Jakarta on Tuesday, as quoted by Antara news agency.

There are no details on the current condition of the Indonesian, identified only by the initials NA, 61.

Tjandra said however, the ministry had continued to coordinate with related Saudi Arabian authorities to monitor the case.

"I talked directly to the Foreign Ministry's director general for Asia-Pacific and Africa last night and have just been contacted by the Indonesian Ambassador in Saudi Arabia, confirming that there is a MERS-CoV-infected patient from Indonesia," said Tjandra.

He said the ministry was closely monitoring the MERS-CoV cases that had been spreading in several Middle Eastern countries.

The World Health Organization (WHO) reported that a number of MERS-CoV cases were found in Mecca and Medina, two main cities for hajj and umroh pilgrims in Saudi Arabia.

"For Indonesia, this becomes very crucial because many umroh pilgrims from Indonesia visit those two cities during the pilgrimage season," said Tjandra.

Saudi Arabia's Health Ministry said Sunday that eight more people have died after contracting the lethal virus related to SARS as the kingdom grapples with the rising number of cases, The Associated Press reported.

It said it had detected a total of 16 cases of the MERS-CoV over the past 24 hours. The latest cases bring the number of people who have died after contracting the disease in Saudi Arabia since September 2012 to102. To date a total of 339 cases have been recorded in the kingdom. (ebf)

source: www.thejakartapost.com

Cases of the MERS Coronavirus have significantly increased in the last few months, and in recent weeks there have been reports of the virus in new countries including Egypt, Malaysia, the Philippines, and Indonesia, leaving officials struggling to figure out why infections have increased.

See How The MERS Coronavirus Affects the Body

The MERS Coronavirus, which stands for Middle Eastern Respiratory Coronavirus, was first identified in late 2012 and causes acute respiratory illness, shortness of breath and in severe cases kidney failure. The virus is related to the SARS virus and the common cold.

There have been 350 cases and more than 100 deaths reported worldwide from the virus, although the World Health Organization (WHO) has laboratory-confirmed only 254 cases with 93 deaths. Most of the reported infections have come from Middle East countries including Saudi Arabia, Jordan and the United Arab Emirates.

While public health experts have been tracking the disease for nearly two years, in recent weeks health officials are reporting a sharp rise in cases. The WHO reported at least 78 confirmed cases since the beginning of the year, and that diagnosed cases sharply increased in mid-March.

This week the WHO released a report, which said that among newly diagnosed cases up to 75 percent could be human-to-human transmission, since a large number of health workers were infected with the disease. However there is evidence that the reason for the increase could be related to increased testing for the virus and a seasonal increase in the disease rather than virus mutation.

Dr. Ian Lipkin, an epidemiologist and professor of Epidemiology at the Mailman School of Public Health at Columbia University, has been investigating the virus and said 75 percent of camels in Saudi Arabia have had the disease. Lipkin points out that as camels are born in the spring the virus can spread from the young animals to people who interact with them.

"The younger animals have the virus and become infected and become little virus factories," said Lipkin, who explained that camels are extremely common in Saudi Arabia and surrounding countries.

"It's almost like dogs in the U.S. Except they eat the camels ... there's so much opportunity," for the virus to spread, he said.

Lipkin also pointed out that when patients are treated with invasive pulmonary measures, the virus "deep in the lungs" can come to the surface and infect health care workers treating these patients. Lipkin said to combat the spread, more oversight will be needed to both regulate people's interactions with camels and to protect healthcare workers from infection.

Currently there is no vaccine for the MERS Coronavirus. There have been no reported cases in the U.S. and the CDC has not issued any travel advisories related to the disease.

source: abcnews.go.com

According to the World Health Organization, nearly 6 million people, including 600,000 non-smokers who are exposed to tobacco smoke, die from smoking-related diseases annually. While cigarette consumption is declining in developed countries, the trend is the opposite in developing countries. According to the Campaign for Tobacco-Free Kids, tobacco kills 225,000 smokers in Indonesia every year.

Indonesia is known to be the world's main producer of clove cigarettes, as well as one of the biggest tobacco consumers in the world. A lack of control and enforcement of laws related to tobacco by the government has made Indonesia a favorable market and home for major tobacco companies. Even worse, Indonesia seems to position itself as a champion of big tobacco companies' interests.

At the international level, Indonesia, supported by the tobacco industry, initiated a claim against Australia's laws on tobacco plain-packaging through the World Trade Organization's dispute settlement process. Indonesia is the fifth country to do so. Other complainants that have brought the claim are Ukraine, Honduras, the Dominican Republic and Cuba. Under Australia's plain-packaging laws, all tobacco products have to be sold in drab olive-green boxes, use a brand name displayed in a standard size and font but without brand imagery or logos, and contain graphic images of the health effects of smoking.

The Australian market is not profitable for Indonesia's cigarette exports. The smoking rate in Australia has declined steadily in the past few years and Indonesia's exports of cigarettes to Australia are minuscule. The involvement of Indonesia in this case is mainly to help big tobacco companies to prevent further losses. The action is expected to deter other countries that are considering similar schemes to reduce the appeal of smoking. Should Australia's measures be found to be contrary to WTO law, tobacco companies will also benefit from Indonesia's participation if Australia does not comply with adverse rulings.

Compared to other developing-country complainants, Indonesia has more power and capability in imposing retaliatory threats against Australia. However, imposing retaliation can economically harm both targeted and retaliating states. WTO retaliation is normally in the form of increasing tariff against the products of violator states. The imposition of retaliation may result in market distortion and welfare loss for consumers and local industries relying on the imported products in the retaliating state and exporters in the violator state.

Indonesia is the only country in Southeast Asia that has not ratified the WHO Framework Convention on Tobacco Control (FCTC). The FCTC is often praised as the world's first modern public health treaty. The convention provides a set of rules that govern the production, sale, distribution, advertisement and promotion and taxation of tobacco. Today, there are more than 170 WHO member states that have become parties to this convention.

There have been debates over whether or not Indonesia should accede, but it was reported recently that there is no plan under President Susilo Bambang Yudhoyono's administration to ratify.

The tobacco industry has claimed that ratifying the FCTC will have a negative effect on tobacco and clove farmers, factory workers and vendors. This claim is fatuous. Farmers generally do not rely only on one crop, and there are various alternatives. Additionally, the low price of cigarettes in Indonesia means that taxes are low and labor and materials are cheap. Farmers and factory workers remain vulnerable to economic fluctuations.

It is time for Indonesia to prioritize the well-being and health of its people. Weak enforcement and legislative control will only benefit large tobacco companies. Meanwhile, the costs of smoking to society are immeasurable. The fact that cigarettes often are the second-largest item of household expenditure after food for the poorest families in Indonesia is upsetting. Ratifying the FCTC should be a priority for the next government.

source: www.thejakartaglobe.com

LAHORE: The World Health Organization (WHO) has launched a global scheme -- Good Governance for Medicine (GGM) Programme -- in Pakistan with an objective to prevent corruption by promoting good governance in the pharmaceutical sector and to ensure provision of essential medicines to the masses.

Since the medicines represent one of the largest components of health expenditure, the GGM Programme is the first initiative of its kind which has been kicked off in Pakistan to bring revolutionary reforms in the system that revolves around the registration, manufacturing, distribution, supply, and selling of drugs. It will help avert the Punjab Institute of Cardiology, Lahore's, like drug reaction scam.

WHO Pakistan's Country Adviser on Essential Medicines Syed Khalid Saeed Bukhari said the WHO had selected 15 countries from 22 member states of the Eastern Mediterranean region, including Pakistan, to run the global programme as a pilot project. The other countries are: Lebanon, Jordan, Afghanistan, Bahrain, Egypt, Iran, Iraq, Kuwait, Morocco, Palestine, Sudan, Tunis, Syria and Yemen.

He said the GGM Programme currently operates in 26 countries across the six WHO regions and these states are at different stages of implementation. Other major reasons associated with the scheme are to curb corruption in pharmaceutical sector by increasing transparency and accountability and promoting ethical practices.

The federal and all provincial governments have nominated two each advisers/assessors for this prgramme while four are nominated by the private sector. A total of 30 advisers will be engaged by the WHO to materialize the scheme, he said.

Mr Bukhari said the WHO had initiated the programme in 2004 keeping in view the health sector a very real target for corruption and other unethical practices.

He said the WHO had been giving much weightage to this programme because despite many efforts to make essential medicines accessible to all, it was estimated that one-third of the global population did not have regular access to them.

The GGM Programme was launched in three steps/phases that included national transparency assessment, development of a national GGM framework and implementation, he said.

The scheme would be materialized within about three months in phases. In the wake of its starting phase, the first session of experts of both the WHO and Pakistani nominated advisers will be held on Monday (today) in Lahore, Khalid Bukhari said.

PHASE I:

The first phase is to measure transparency in the public pharmaceutical sector by providing a comprehensive analysis of the level of transparency and its vulnerability to corruption.

The national assessment will be carried out using the WHO standardized assessment instrument which focuses on central functions of the pharmaceutical regulation and supply systems.

The objective of the national assessment is to provide the country with a comprehensive picture of the level of transparency and potential vulnerability to corruption of eight functions of the pharmaceutical sector: registration of medicines, control of medicine promotion, inspection of establishments, control of clinical trials, licensing of establishments, selection of essential medicines, procurement of medicines and distribution of medicines.

The assessment is an essential step in developing national programme for promoting good governance in the public pharmaceutical sector and revising related administrative procedures through a national consultation process.

The transparency assessment is not an end in itself, but rather the beginning of a process aimed at bringing long-lasting changes through efforts to promote good governance practices among health professionals in the public pharmaceutical sector.

The implementation of assessment's recommendations will build a more transparent and accountable pharmaceutical sector, improving equitable access to good-quality and safe medicines.

PHASE II:

Following the national assessment, the basic components of the GGM Programme will be defined through a nationwide consultation process with key stakeholders and will be based on experience accumulated in various countries.

These components will include an ethical framework and code of conduct, regulations and administrative procedures, collaboration mechanisms with other good governance and anti-corruption initiatives, whistle-blowing mechanisms, sanctions for reprehensible acts and a GGM implementing task force.

The results of the assessment in Phase I -- identifying the loopholes in the systems -- will help in applying the discipline-based approach. In the light of the findings, laws and administrative structures and procedures will be adjusted in terms of medicines regulation and supply.

PHASE III:

The last step will be to implement a national programme of good governance for medicines and institutionalization.

The implementation of the programme requires the systematic training of government officials and health professionals.

source: www.dawn.com

During an official visit of the UNAIDS Deputy Executive Director, Jan Beagle to Indonesia, national and provincial municipal leaders, development agencies and civil society organizations underlined the importance of scaling up and investing in city-based HIV strategies as a critical action towards accelerating progress in the AIDS response.

Speaking with the National AIDS Commission Director Dr Kamal Siregar, Ms Beagle stressed the importance of focusing on city-based HIV responses at a time when the majority of people living with HIV and from key populations at risk reside and/or work in municipal centres. Dr Siregar noted how scaling up programmes and efforts at the city level will enable greater reach to people in need of HIV services, especially among key populations at higher risk.

Jakarta, the capital city of Indonesia is one of the provinces with highest numbers of new HIV infections in Indonesia. The estimated number of people living with HIV in the city as of 2013 is approaching 100 000. According to national surveillance data, estimated HIV prevalence among key populations at higher risk in the city is higher than national averages with 56.4% prevalence found among people who use drugs, 17.2% among men who have sex with men and 10.5% among female sex workers.

Indonesia's Deputy Minister of Health echoed the need to make cities central to HIV responses noting that city populations often contain large numbers of young people and that youth focus and engagement for HIV is also critical.

Enhanced city-based focus was also welcomed by the Secretary General of the Association of Southeast Asian Nations (ASEAN), which is spearheading the ASEAN 'Cities getting to Zero' initiative. Meeting with Ms Beagle, ASEAN Secretary General Le Luong Minh stressed how the 'Cities getting to Zero initiative' is focusing on 13 ASEAN cities and municipal areas—which account for large proportions of HIV burden in their countries (including three in Indonesia)—to catalyze country actions towards the achievement of the 2012 ASEAN Declaration on Getting to Zero New HIV Infections, Zero Discrimination, Zero AIDS-related Deaths.

UNAIDS is working to increase the focus on city-based HIV responses. Cities and their importance within the HIV response will also be discussed at the International AIDS Conference to be held in Melbourne, Australia from 20-25 July.

Quotes

"We need to expand comprehensive HIV prevention and treatment in cities to reach the maximum amount of people. We also need to replicate quality and proven city programmes – to from one city to another to help faster and better scale up."

Kamal Siregar, Director of the National AIDS Commission of Indonesia

"In our ASEAN 'Cities getting to Zero' initiative, the enrolled cities have been very active and enthusiastic. Learning about similarities and differences between the cities on HIV issues is very important. We are documenting the experiences and this will be released later this year."

ASEAN Secretary General Le Luong Minh

"From a programme coverage perspective and from an effective investment perspective, increased focus on cities and metropolitan areas can make an important impact. Cities in Indonesia have significant experiences to share that highlight both successes and challenges."

UNAIDS Deputy Executive Director, Jan Beagle

source: www.unaids.org

The Canadian official who heads the WHO's polio eradication effort says of the many challenges facing the quarter-century-old program, evidence of polio in Cameroon — which borders on the troubled Central African Republic — is currently one of the most concerning.

The polio eradication campaign has faced a number of significant setbacks in the past year or so, with outbreaks in the Horn of Africa — Somalia, Kenya and Ethiopia — as well as war-torn Syria.

But of the ongoing outbreaks, Dr. Bruce Aylward said the situation in Cameroon is the one which worries him the most at the moment, listing a number of reasons.

Analysis of polioviruses from Cameroon suggests they have been circulating unchecked and undetected for at least a couple of years. Several recent nationwide vaccination campaigns have not appeared to halt the spread. And viruses from Cameroon have spread to neighbouring Equatorial Guinea.

That highlights the risk of further spread to another neighbour, the Central African Republic, where ethic-inspired killing is raising the spectre of another Rwanda. This week the United Nations agreed to send a nearly 12,000-person-strong peacekeeping force to the country.

"You sure as hell don't want (the Central African Republic) to get reinfected," said Aylward, a native of Newfoundland who is the World Health Organization's assistant director general for polio, emergencies and country collaboration.

Aylward was in Ottawa this week bringing Canadian officials up to speed on the shape of the ongoing eradication effort. A longtime donor to the effort, last year Canada pledged $250 million for the 2013-18 period. This week the federal government threw in an extra $3 million, to help with the effort to extinguish the outbreak in the Horn of Africa.

To date this year there have been 56 confirmed polio cases, three times as many as were seen last year at this time. Most of the cases — 43 — have occurred in Pakistan, one of three countries where polio remains endemic. (That means the country has never stopped transmission of the virus within its borders.)

The other two countries on the endemic list are Nigeria, which has only had one case so far this year, and Afghanistan, which has had four. For quite a while, most of the cases in Afghanistan have been caused by viruses that had come over the border from Pakistan.

"I would bet money that if Afghanistan did not share a border with Pakistan it would stop transmission this year, or be very, very close," Aylward said.

Pakistan, though, remains a major problem for the eradication effort, a partnership of the WHO, UNICEF, Rotary International, the U.S. Centres for Disease Control and the Bill and Melinda Gates Foundation.

Repeated and sometimes fatal attacks on vaccination teams have plagued efforts to get vaccine to children. And vaccination efforts have been halted in Waziristan, a conservative tribal region in the west of the country, bordering on Afghanistan.

Aylward said there is intense transmission of polio in Waziristan, which poses "a huge risk for both national and international spread."

source: www.thestarphoenix.com

AS global temperature continues to rise due to climate change so are diseases. "Climate change endangers human health," declares Dr. Margaret Chan, the director general of the Geneva-based World Health Organization (WHO).

"Without effective action, climate change is going to be larger and more difficult to deal with than we thought," said Dr. Chris Field, who was a coordinating lead author of the report issued by the Nobel-winning Intergovernmental Panel on Climate Change (IPCC).

Health scientists pointed out that should earth's thermostat continues to rise, human health problems will also become more frequent and severe.

"The warming of the planet will be gradual, but the effects of extreme weather events will be abrupt and acutely felt," Chan said. "Both trends can affect some of the most fundamental determinants of health: air, water, food, shelter and freedom from disease."

Dr. Paul Epstein, in a recent study entitled Human Health and Climate Change, said that a warming climate, compounded by widespread ecological changes, may be stimulating wide-scale changes in disease patterns.

According to him, climate change could have an impact on health in three major ways by: creating conditions conducive to outbreaks of infectious diseases; increasing the potential for transmissions of vector-borne diseases and the exposure of millions of people to new diseases and health risks; and hindering the future control of disease.

A fact sheet released by the United Nations health agency pointed out this fact: "Climatic conditions strongly affect water-borne diseases and diseases transmitted through insects, snails or other cold-blooded animals."

Take the case of dengue fever, most common mosquito-borne viral disease of human beings. Before 1970, only nine countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries, with Southeast Asia and the Western Pacific regions as among the most seriously affected. According to the WHO, there may be 50 to 100 million dengue infections worldwide every year.

Diseases that used to be controlled are now back. In 2011 at least 158,000 people from around the world— mostly children under the age of five— died of measles. "More than 95 percent of measles deaths occur in low-income countries with weak health infrastructures," WHO deplored.

In the Philippines, measles is back in the news because of the astounding number of new cases. In fact, the Department of Health declared measles outbreaks in five cities in Metro Manila.

Weather-related problems like floods, drought, too much water, and water scarcity are most likely to bring health problems, too.

In recent years, floods have been increasing in frequency and intensity. "Floods contaminate freshwater supplies, heighten the risk of water-borne diseases, and create breeding grounds for disease-carrying insects such as mosquitoes. They also cause drownings and physical injuries, damage homes and disrupt the supply of medical and health services," the WHO fact sheet said.

"Increasingly variable rainfall patterns are likely to affect the supply of fresh water," the WHO fact sheet said. "A lack of safe water can compromise hygiene and increase the risk of diarrheal disease, which kills 2.2 million people every year."

In extreme cases, water scarcity leads to drought and famine. "By the 2090s, climate change is likely to widen the area affected by drought, double the frequency of extreme droughts and increase their average duration six fold," the UN health agency added.

Climate change also means disaster. WHO estimated some 600,000 deaths occurred worldwide as a result of weather-related natural disasters in the 1990s; some 95 percent of these were in poor countries.

Another effect of climate is sea level rise. "Rising sea levels and increasingly extreme weather events will destroy homes, medical facilities and other essential services," the WHO said. "More than half of the world's population lives within 60 kilometers of the sea. People may be forced to move, which in turn heightens the risk of a range of health effects, from mental disorders to communicable diseases."

Epstein predicts that "wide swings in weather patterns may become the norm, as sea surfaces and deeper waters continue to absorb and circulate the heat accumulating in the troposphere. At the same time, abrupt changes in climate—hopefully small enough to provide a warning and without widespread disruption—may be in store.'"

In conclusion, he pleads: "We cannot afford to continue 'business-as-usual'! Changing course will not be easy, but it is necessary. There are costs associated with acting now to slow global warming. However, in terms of future health care, productivity, international trade, tourism, and insurance costs, the savings could be huge."

source: businessmirror.com.ph