is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which can only survive in humans, as it is not found in other animals, soil or other non-living things.

TB typically affects the lungs as M. tuberculosis needs oxygen to survive. That is why the M. tuberculosis complexes are always found in the air sacs of the upper lung.

However, TB can affect any part of the body, like the lymph nodes, bones, kidney, brain, spine, reproductive organs, and even the skin.

TB is the second biggest infectious disease killer globally.

Its incidence in Malaysia rose from 64.7 per 100,000 population in 2000 to 71.35 per 100,000 population in 2011. The number of reported TB cases increased from 15,875 in 2005 to 20,666 in 2011.

An estimated one-third of the world's population are infected with TB bacteria.

About one in 10 of these develop active disease, i.e. they have symptoms, get sick and spread TB to others.

However, the vast majority have latent TB, i.e. they test positive for the disease and their chest X-rays may show evidence of TB, but they have no symptoms, do not get sick or spread TB to others.

The active disease

Active TB develops when two events occur.

Firstly, the bacteria enters the body through the breathing of contaminated air containing microscopic droplets from a TB sufferer when he or she coughs, sneezes, speaks, sings or laughs.

Only people with active TB can spread the disease to others.

Secondly, the body's immune system cannot control the growth and spread of the disease after the initial infection.

Active TB is more likely to occur in people with poor immunity, e.g. drug users, children below the age of five years, senior citizens, diabetics, the malnourished, HIV/AIDS sufferers and chemotherapy recipients.

More than 20% of TB cases worldwide are attributable to smoking. Overcrowding and social deprivation are also risk factors.

The risk is also increased in people who have not had adequate treatment for TB in the past.

M. tuberculosis grows in the lungs and can spread to other parts of the body within days, weeks, months or years after the initial infection, depending on the level of immunity.

TB affects all age groups, with more young adults being affected.

People who have HIV are 21 to 34 times more likely to become sick with TB.

The spread of TB requires close contact with someone who has the active disease.

The World Health Organisation estimates that people with active TB can infect up to 10-15 other people through close contact over the course of a year.

The symptoms of active TB include fever, night sweats, unexplained weight loss, tiredness and poor appetite.

The symptoms of TB of the lungs include chronic cough (more than three weeks), chest pain and bloody sputum. As some symptoms are vague, they can go unnoticed.

The symptoms of TB affecting other organs varies, depending upon the organ affected. For example, bone pain, if the bones are affected, or subfertility, if the fallopian tubes are infected.

Treating TB

Certain signs in a person's medical history and physical examination will raise the doctor's suspicions of TB.

The doctor may then order a Mantoux test.

This involves injecting tuberculin under the skin of the forearm.

A red swelling forming around the injection site within 72 hours is positive, i.e. it means the person has been exposed to M. tuberculosis or bacteria related to M. tuberculosis, or has been vaccinated with the TB vaccine. It does not mean that there is active disease.

Imaging techniques, e.g. X-rays, may show evidence of TB infection.

Sputum and other samples are taken to test for M. tuberculosis by trying to grow the bacteria from those samples in the laboratory.

However, as M. tuberculosis grows slowly, it can take about four weeks to confirm the diagnosis, and an additional two to three weeks to determine which antibiotics to use in treatment.

Other tests may be necessary, especially for TB in organs other than the lungs.

TB is curable in most sufferers with the appropriate antibiotics.

Successful treatment requires close cooperation between patients, doctors and nurses.

The treatment usually involves taking several antibiotics for at least six months, and sometimes, longer.

Drug resistance is on the rise and requires the use of special antibiotics – all of which have potentially serious side effects.

Strict compliance to the treatment regime as instructed by the doctor, will go a long way in controlling this threat.

As TB is an airborne infection, its spread can be prevented with adequate ventilation and limited contact with those having the active disease.

Effective preventive measures include early diagnosis and treatment, maintaining a healthy immune system, and addressing the health needs of those at increased risk.

This could involve preventive antibiotics.

The Bacille Calmette-Guerin (BCG) vaccine is fairly effective in protecting children against the severe complications of TB.

Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organization the writer is associated with. For more information, e-mail This email address is being protected from spambots. You need JavaScript enabled to view it.. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

source: www.thestar.com.my

Middle East respiratory syndrome virus, (MERS) is an emerging infectious disease without a cure. Symptoms of the disease include fever, cough and shortness of breath. While there have been no cases reported in the U.S., the virus remains a serious threat.

"We still don't fully understand that virus, and how it's spreading, and we don't have tools yet in place to treat it or prevent it with vaccine," says Tom Inglesby, director and CEO of the Center for Health Security at the University of Pittsburgh Medical Center.

As of Dec. 17, there have been nearly 165 cases of MERS worldwide, 70 of them fatal. The first case of MERS in a human was reported in September 2012, according to the World Health Organization. The majority of reported cases have been in the Middle East, in places like Saudi Arabia, Kuwait, Oman and Qatar, hence the moniker, but France and the U.K. have also been touched by the illness. Scientists believe they may have found a genetic link to the virus in camels, but they still do not know how humans are exposed or infected with the virus.

According to WHO's International Health Regulations, the disease is cited as a serious concern but not a "public health emergency of international concern," reports Trust for America's Health (TFAH) in a study released Tuesday.

Still, health experts have warned doctors and other health care workers that they must be vigilant.

"Because of the frequency of travel between the Middle East and the U.S, it would not be surprising if in the year ahead we had a case of MERS," says Inglesby.

The Center for Disease Control and Prevention has advised anyone who develops a fever, cough or shortness of breath within two week of traveling to countries within the Arabian Peninsula to visit a health care provider.

State health laboratories can test whether or not a person has contracted the MERS virus. And Inglesby says there is "some awareness" of the disease in hospital emergency rooms and clinics.

"It's basically a matter of continuing vigilance in the health care community. So that [health care workers] would have the proper suspicion of seeing someone who they believe might have the disease and getting the right lab test," he adds.

And while it may not be a "public health emergency," it's still a danger. "At least from the number of people who have confirmed viruses, there is a very high case fatality rate, which makes it a very important virus in the world," says Inglesby.

MERS is one example of the types of outbreaks the U.S. could see in the coming years, says Inglesby, who also underscores the need to be vigilant in the fight against infectious diseases.

If a case were to be discovered, the patient would likely be isolated and given supportive care, and staff would be advised to follow these CDC recommendations.

A concern, however, for Inglesby and other experts is that roughly 40,000 public health workers, as well as numerous researchers and scientists have lost their jobs due to budget cuts in the last 5 years. These jobs are important since scientists in particular have a critical role to play in fighting emerging infectious disease, and often help perform the first line of defense.

"The CDC has a wonderful disease detection program that's incredibly important to sustain, because we need to find those emerging new diseases quickly, so that we can find their cause, develop treatments [and] do everything public health people do to contain an outbreak," says Dr. Jeffrey Levi, executive director of TFAH.

source: www.usnews.com

Atrial fibrillation, long considered the most common condition leading to an irregular heartbeat, is a growing and serious global health problem, according to the first study ever to estimate the condition's worldwide prevalence, death rates and societal costs.

The World Health Organization data analysis, led by Sumeet Chugh, MD, associate director of the Cedars-Sinai Heart Institute, shows that 33.5 million people worldwide – or .5% of the world's population – have the condition. Funded partly by the Bill & Melinda Gates Foundation and the Cedars-Sinai Heart Institute, the analysis was conducted with the assistance of the University of Washington's highly respected Institute for Health Metrics and Evaluation, which seeks to identify the world's major health problems so society can best allocate medical resources and funding.

Atrial fibrillation occurs when electrical impulses in the upper chambers of the heart, called the atria, become chaotic and cause an irregular heartbeat. The irregular heartbeat can result in heart palpitations along with a variety of symptoms such as fatigue. When the heart isn't pumping blood effectively, blood can stagnate and clot. If the clots break apart and travel to the brain, they can cause a stroke.

The study, believed to be the first to determine the number of people globally with atrial fibrillation, is published online in the peer reviewed medical journal Circulation and is scheduled to be published in the Feb. 25 print edition of the journal.

"Atrial fibrillation has a huge cost in every sense of the word," Chugh said. "It can lead to stroke, hospitalization, as well as lost productivity. Our findings indicate that atrial fibrillation is on the rise around the world and it's a huge public health burden."

During the analysis, Chugh and a team of researchers systematically analyzed data from selected population-based research studies, from among 1,784 published medical research studies on atrial fibrillation, to estimate global and regional prevalence, incidence and mortality related to this condition.

"Finding out the scope of the problem is step No. 1," Chugh said. "Our hope is that we can develop a sustainable global plan to manage atrial fibrillation and find new and effective ways of preventing this condition."

Among the study's findings:

In 1990, an estimated 570 of 100,000 men had atrial fibrillation. In 2010, the prevalence rate for men was 596 of 100,000.

For females, an estimated 360 of 100,000 women had atrial fibrillation in 1990. In 2010, that rose to 373 of 100,000.

In 1990, the number of new cases of atrial fibrillation in men was estimated at 61 per 100,000 population. In 2010, the number of men with new cases of atrial fibrillation rose to 78 per 100,000.

The number of new cases of atrial fibrillation in women was 43 per 100,000 population in 1990. In 2010, the number of new cases in women was 60 per 100,000.

Although deaths linked to atrial fibrillation are rising around the world, more women with atrial fibrillation are dying in developing countries. In the U.S., deaths linked to atrial fibrillation now are comparable between the sexes.

"A lot more research is needed to fully understand this continuing worldwide increase," Chugh said. "Although the chance of developing atrial fibrillation does increase with age, these findings are not entirely explained by the aging world population. Several other factors have been suggested and need to be better evaluated, from obesity and hypertension to air pollution."

source: www.redorbit.com

JARKARTA: State-owned insurance companies in Indonesia are bracing for the rollout of what will be the world's largest healthcare scheme, meaning better access to health services for millions of Indonesians who previously could not afford them.

Roughly a third of Indonesia's population lives under the poverty line and has no or very little access to healthcare.

A new healthcare scheme to take effect on January 1 will provide millions of the poor with free healthcare, including treatment for major health conditions and chronic diseases.

"One time my child was treated in a hospital for three days and the bill was so expensive. If we are covered by the healthcare insurance scheme, I'd be happy because it means free medical treatment," said Munah, a patient.

The new healthcare system is designed as a cross subsidy scheme.

Professor Hasbullah Thabrany, chairman of the centre for health economics and policy studies, said: "The higher income will pay a nominally higher contribution because the percentage is about the same. Lower income will pay a nominally lower contribution, but when it comes to the benefit, (both groups) will get the same medical benefit.

"So by this design, the rich can share to the poor, the healthy can share to the sick and the young will also share to the old people."

Five per cent of each person's salary will go to the insurance premium while the poor will be given free health insurance.

A new umbrella agency called the Social Security Organising Body will manage the health coverage for Indonesians already subscribed to the various state insurance schemes.

The agency will be quasi-public and aims to get rid of bureaucratic red tape and late insurance claim payments that plague the current healthcare system.

It will have an estimated 117 million subscribers to begin with and will gradually cover all Indonesians by 2019.

The scheme will also insure domestic workers and contract-based workers who currently do not qualify for workers' insurance.

In anticipation of an influx of people seeking free healthcare at hospitals in the next two years, the Jakarta administration is also stepping up its health services.

"In Jakarta there's a policy that will take effect in 2015 which requires all local health clinics in the district level to have medical wards. Right now not all of the city's health clinics have wards," said Health Clinic head Dr Dyah Eko.

The new health scheme is a mammoth project -- in the first stage, it will cover 86 million uninsured citizens who are considered poor, which is twice the number compared to uninsured Americans covered under Obama's new Affordable Care Act.

However, experts acknowledge that the current state subsidies for the poor are still not enough and that efforts are being made to increase state subsidies for the poor to better suit average market medical costs.

source: www.channelnewsasia.com

On a Sunday morning, Effendi prepared to open his warung , or roadside grocery stall, in South Jakarta.

As soon as he did, two boys, aged about 14, came up to buy a pack of cigarettes. Effendi handed them the pack and took their money, no questions asked.

When he was later told that selling cigarettes to minors was prohibited under a regulation issued last year, Effendi looked genuinely surprised.

"Really? I never heard such thing. Those boys could have been buying the cigarettes for their parents. There's no way for me to find out if they intend to smoke it themselves," he told Jakarta Globe.

"What's the punishment for the violation?" he added.

He looked relieved when told that despite the regulation, there were no serious consequence for violators. However, he said that if stricter sanctions were imposed, he would gladly comply with the rules.

"I don't mind asking people to show me their ID card if there is a clear regulation, but since there is no punishment it's hard to imagine people would care, let alone comply," Effendi said.

It was a different story at a nearby convenience store, where a female cashier asked a customer for his ID before she would sell him a pack of cigarettes.

"Our store is part of an international chain, so we have to comply with the regulation," she said.

The cashier, who declined to be named, said she only asked for ID from anyone who looked too young to smoke.

"If they look old enough we rarely asked them to show us their ID, or if they're way too young to be 18 I'll just refuse to sell them any cigarettes," she said.

Weak prohibition

The government regulation in question, issued a year ago this month, stipulates that selling cigarettes to children and pregnant women are prohibited. However, there is no mention of punishment for those flouting the ban.

"The prohibition is too weak to be called a regulation; it's a mere suggestion since there is no punishment involved for the violators," says Arist Merdeka Sirait, the chairman of the National Commission for Child Protection (Komnas Anak).

He notes that even among convenience stores, compliance with the regulation remains lax.

"Only some of the international chain stores will comply with policies that their headquarters have established, but most local convenience stores won't even bother to ask a thing," he said.

Indonesia has no mandatory minimum age for purchasing or smoking cigarettes., which are sold freely with no checks on buyers' ages. At warungs, cigarettes can be bought by the stick rather than in packs, making them even more affordable for children.

"Selling cigarettes to minors should constitute a punishable crime. That's what we need to do if we want to save our children," Arist said.

He said the government and legislators must revise the "lenient" 2012 government regulation on tobacco control and adopt the practices implemented successfully in another countries, such as Singapore and Thailand.

In Singapore, stores or vendors can lose their licenses for selling cigarettes to anyone under the age of 18.

Arist emphasized that children should not be punished for smoking, but that adults should be held responsible for preventing children from taking up the habit by refusing to sell them cigarettes in the first place.

Last year, Komnas Anak filed a class-action lawsuit against the cigarette industry and the government for failing to protect children from smoking.

The lawsuit rests on medical records and psychological exams of children addicted to smoking.

One of them, Ilham, a 9-year-old boy from Sukabumi in West Java, required a year of intense therapy to recover from his addiction, which began when he was just four years old.

Whenever he felt the urge to smoke, Arist said, Ilham would become aggressive and self-destructive, banging his head against the wall if he was denied.

Seto Mulyadi, a noted child psychologist and adviser to the Indonesian Commission for Child Protection (KPAI), echoed the same sentiment, saying the lack of a smoking age limit in Indonesia had given the country a reputation as a "baby-smoking country."

"I once gave therapy for a baby smoker, and it deeply concerned me," Seto said. He said that in addition to a smoking age limit, the government needed to implement other measures to prevent children from smoking, including banning all types of cigarette advertisements, promotions and event sponsorships by tobacco firms.

At the same time, he said, the government should provide a campaign focusing on the danger of cigarettes.

Cigarette exposure

Smoking children, adults who smoke in public places, street vendors selling cigarettes anywhere with no restrictions, and a relentless barrage of cigarette commercials televised nationally while children are watching are only a few of the problems Indonesia is currently dealing with because of lax tobacco regulations.

Even though the 2002 Broadcasting Law prohibits cigarette ads on television from being aired before 9:30 p.m., cigarette companies use many other methods to promote their products before then.

According to the World Health Organization, three of every four Indonesian children between the ages of 13 and 15 are exposed to cigarette ads on billboards and pro-tobacco messages at sports events.

A Komnas Anak study in 2012 also found 93 percent of Indonesian children were exposed to cigarette ads on television, while 50 percent regularly saw cigarette ads on outdoor billboards and banners.

According to 2010 data released by the Tobacco Control Support Center of the Indonesian Health Experts Association (Iakmi), smoking kills 235,000 Indonesians annually, while secondhand smoking claims 25,000 lives a year.

The lax smoking regulation in Indonesia has long been associated with the country's reluctance to ratify the WHO's Framework Convention on Tobacco Control.

The convention, already signed by 168 countries, calls for a ban on all forms of tobacco advertising and sponsorship. It also suggests plastering pictorial warnings across at least 30 percent of the surface area of cigarette packs, and increasing the tobacco excise.

Indonesia remains the only country in the Asia-Pacific region that has not ratified the treaty, despite being one of the most active countries in drafting the document in 2003, and one of only three countries in the world that still allows cigarette ads to run on television.

Most countries that have ratified the treaty have also set limits on the smoking age, purchasing age, or both.

Indonesia has been urged by the international community to accede to the FCTC to control the fast-growing smoking habit in the country, and while the government has repeatedly stated its commitment to adopting the FCTC's principles, it has made no significant effort to do so.

The matter of Indonesia's reluctance to accede was brought up during the 4th Islamic Conference of Health Ministers, held in Jakarta in October.

One of the 40 resolutions adopted by delegates at the conference was to "encourage the member states to take steps on speedy ratification of the WHO Framework Convention on Tobacco Control, if not done so, and improve the implementation of all MPOWER measures."

MPOWER is a package of six tobacco-control measures that WHO says can "reverse the tobacco epidemic and prevent millions of tobacco-related deaths."

Of the 57 countries that make up the Organization of Islamic Cooperation, only Indonesia and Somalia have not to acceded the FCTC.

"Considering Somalia has practically no government, the message is clearly directed to Indonesia and this is embarrassing," Tara Singh Bam, a technical adviser at the Tobacco Control International Union Against Tuberculosis and Lung Disease, or Union, told the Globe.

The OIC conference also highlighted the importance of ratifying WHO protocols to eliminate the illicit trade in tobacco products and encouraged member states not to host tobacco trade fairs.

Indonesia has been widely criticized for agreeing to host World Tobacco Asia forum, slated to be held in Nusa Dua, Bali, next year. The forum showcases tobacco products and provides an opportunity for tobacco industry professionals in the Asia-Pacific region to network.

The convention, which has been rejected in many countries, notes on its official website the opportunity to invest in the tobacco industry in Indonesia because of its lucrative market and lax regulation on tobacco control.

Indonesia also has some of the cheapest tobacco prices in the world, making cigarettes affordable even for the poorest households. A pack of 20 Marlboros sells here for $1.30, including tax, compared to $9.70 in Singapore and $3.20 in Malaysia, according to cigaretteprices.net. The same product in Australia, which has some of the most stringent anti-tobacco rules in the world, sells for $17.70.

Agung Laksono, the coordinating minister for people's welfare, has called on the Trade Ministry, the Finance Ministry and the Manpower and Transmigration Ministry to stop thwarting the Health Ministry's efforts to accelerate the FCTC accession. The three ministries have promised to support the move.

However, Trade Minister Gita Wirjawan recently said he had sent a letter to the WHO on preventing any negative fallout to trade partners and investors as a result of the accession. Gita said the FCTC was not just about health issues, but implicated the well-being of tobacco farmers and the tobacco industry.

Smoking: A rights violation?

The WHO estimated that in 2011, some six million people worldwide died of smoking-related causes. The largest toll was in China, which recorded 1.2 million deaths from tobacco-related illnesses.

In Indonesia, 190,260 people died of tobacco-related cases, according to a 2010 Health Ministry report.

The WHO's 2011 Global Adult Tobacco Survey released last year showed that 67.4 percent of adult males and 4.5 percent of adult females in Indonesia were active smokers, while more than 90 million Indonesians were constantly exposed to secondhand smoking, which poses an even bigger health risk.

"If the government does still not take steps to accede to the FCTC, we can safely assume that our government has ignored and violated the right to live of every one of its citizens," said Ifdhal Kasim, a former chairman of the National Commission for Human Rights (Komnas HAM) and a tobacco control activist. "In addition, the government has also violated the law.

"Smoking affects the quality of our human resources. If we let this persist, the next generation is at stake. Our nation is at stake," Ifdhal said.

The Health Ministry has repeatedly made the case that signing up to the FCTC will not hurt the livelihoods of workers in the tobacco industry, and in fact will lead to an improvement in their welfare by better regulating the industry.

Amidhan, the head of halal products at the Indonesian Council of Ulema (MUI), the country's highest Islamic authority, said that although smoking is not prohibited under Islam, secondhand smoke can be considered harmful to others and therefore liable to a religious ban.

"There is nothing in the Holy Koran that says smoking is a sinful act," he said.

"However, if it disrupts other people's rights in public areas, which it clearly does, and if it endangers children's health at home, then it becomes strictly forbidden and illicit."

source: www.thejakartaglobe.com

Believe it or not, Big Tobacco is still committed to limiting and preventing anti-smoking laws globally. They have set out to deter global anti-smoking laws by citing trade and investment treaties that are currently in effect, and would imply costly court battles for all parties concerned. This is the strategic response from Big Tobacco to a rising trend in anti-smoking legislation the world over, according to an article in today's New York Times.

In 2012, Dr. Margaret Chan, director general of the W.H.O., delivered the keynote address at the 15th World Conference on Tobacco or Health in Singapore. In that speech, titled "Galvanizing global action towards a tobacco-free world ," Dr. Chan alleged that legal actions taken against Uruguay, Norway and Australia had been "deliberately designed to instill fear" in countries trying to reduce smoking.

Yet, here we are, more than a year later, and the World Health Organization cannot make a dent in the agenda of Big Tobacco. We live in a world where there seems to be a toss-up when it comes to tobacco.

On the one hand, if you are in California, you cannot even light a cigarette if you are sitting at a restaurant table outside on the sidewalk. The state believes research indicates smoking is bad for our health.

However, in Kentucky people still smoke like it was going out of style. Of course, the state has always been the proud home of Big Tobacco in many ways.

So, which is more important: the freedom to live how people want to live, or the freedom to die how they want to die?

According to the United Nations, there are two global trends in tobacco use that are worth noting. The first trend is that over the past thirty years, 1970 to 2000, world tobacco consumption, production and trade have increased steadily. However, the second trend worth noting is that during the last decade, they have slowed down. This slowdown, and even decline in several cases, "is more pronounced in developed countries, while tobacco production and use is still increasing in the majority of developing countries."

In light of this data, it all starts to make sense. Big Tobacco has set its sites on the developing world. This comes as no surprise when you consider a little more data. For example, among developing countries, China is the top tobacco smoking country in the world, with over one third of world tobacco production and consumption.

If it hurt Big Tobacco to get kicked off the sidewalks of San Francisco, can you imagine how much it will hurt when they ban tobacco in China? From the same U.N. report: "Tobacco consumption in China, although growing more slowly, is still increasing." China is both a major importer and exporter of unmanufactured tobacco.

The entire continent of Africa is also trending significantly upward in recent years when it comes to cigarette sales. Overall, more than three-quarters of all cigarette smokers now live in the developing world.

Q: Who are the top tobacco exporters in the world?
A: Brazil, the United States, and India.

Q: Who are the top tobacco importers in the world?
A: The United States, the European Union, and Russia.

So, exactly how does Big Tobacco pursue its interests in developing nations?

Case in point: Namibia.

In an attempt to curtail smoking among young women, Namibia passed a tobacco control law in 2010. Quickly the government was bombarded with hostile warnings from the tobacco industry. The communications were designed to intimidate as Big Tobacco claimed that the new statute violated the country's obligations under existing trade treaties.

"We have bundles and bundles of letters from them," said Namibia's health minister, Dr. Richard Kamwi.

That was three years ago. Today, an intimidated Namibian government has failed to follow through with enforcement of their own laws that limit advertising and require large health warnings on cigarette packaging.

Back in the U.S.A., this issue has come knocking on our door again because we are now set to complete talks on a major new trade treaty with 11 Pacific Rim countries. The USA wants this treaty to be a model for the rules of international commerce. That means Administration officials would like for the new treaty to raise the bar on standards for public health.

However, when the Administration recently singled out tobacco as a health concern, the wording upset the U. S. Chamber of Commerce, which said that regulating tobacco may also lead to regulating products like soda or sugar. That kind of regulation would be bad for business. They still have not finalized the language in the treaty.

So, it is not just a question of living or dying how you want that lies at the heart of this controversy. It is also a question of making money how you want, wherever, and whenever you want.

Tobacco opponents maintain the Big Tobacco strategy is intimidating low-to-middle-income countries from addressing cigarette smoking as a grave health threat. At the same time, the intimidating legal tactics only serve to undermine the world's largest global public health treaty, the W.H.O. Framework Convention on Tobacco Control.

That brings us back to Dr. Chan, who wants to reduce smoking by enforcing limits on advertising, packaging, and the sale of tobacco products all over the world. More than 170 countries have signed the World Health Organization treaty since 2005.

It looks like part of the Administration likes Big Tobacco and part of it does not. Either way, the World Health Organization would like for people to consider that over five million people die every year of smoking-related causes, more than die from AIDS, malaria, and tuberculosis combined.

But, please do not kill this messenger.
By Alex Durig, Ph.D.

source: guardianlv.com

Global health officials are warning that the proliferation of antibiotic-resistance tuberculosis is a looming public health disaster that will eventually come to a head. According to the World Health Organization's (WHO) estimations, 500,000 people are infected with a TB strain that's resistant to the two drugs typically used to treat it — but many of those people go undiagnosed, and end up spreading the deadly strains even further.

Tuberculosis kills about a million people around the world, but drug-resistant strains are even more deadly. Dr. Mario Raviglione, the director of the WHO's Global Tuberculosis program, told BBC News that the growing public health threat represents a "ticking time bomb," since about 80 percent of the people who have drug-resistant TB are not currently being treated.

It's an issue that's particularly problematic in developing countries. More than half of the global cases of drug-resistant TB are in India, China, and Russia. Tuberculosis is a highly contagious airborne disease that can be spread by coming into close contact with someone who's infected, so people living in close quarters are particularly susceptible to outbreaks.

"What could happen is progressively multi-drug resistant TB takes over from normal tuberculosis," Raviglione explained. "If this happens, not only would millions of patients potentially die of this form of TB, but if I look at it from an economic perspective the cost of dealing with millions of potential cases is enormous."

Treating TB is already a costly endeavor because it requires a cocktail of several different antibiotics over a six month period. Many patients don't complete the full six months of treatment, which is allowing drug-resistant strains of the disease to proliferate — indeed, superbugs are largely driven by the misuse and overuse of antibiotics. In March, health officials explained that they urgently need over a billion dollars in funding to combat the rise of these new tuberculosis strains.

Tuberculosis isn't the only area that's in need of new treatments; other serious diseases like malaria and whooping cough are also becoming resistant to antibiotics. Public health experts have consistently warned that an impending "antibiotic apocalypse" could eventually make common infections totally incurable. But, since it's less profitable for the pharmaceutical industry to invest in developing new drugs, the scientific progress in this area has been lagging behind.

"We're just silently watching this epidemic unfold and spread before our eyes," Dr. Ruth Mcnerny, a lecturer at the London School of Tropical Medicine and an employee at the TB Alert nonprofit, told BBC News. "TB is very clever because it kills you very slowly. And while it's killing you very slowly you're walking around spreading it."

source: thinkprogress.org

MiNDbank, a new World Health Organization (WHO) database goes online today, presenting a wealth of information about mental health, substance abuse, disability, human rights and the different policies, strategies, laws and service standards being implemented in different countries. It also contains key international documents and information.

Launched on Human Rights Day, the platform is part of WHO's QualityRights initiative, aiming to end human rights violations against people with mental health conditions.

"People with mental disabilities still face discrimination, violence and abuse in all countries," says Dr Michelle Funk, from WHO's Department of Mental Health and Substance Abuse. "The easy-to-use platform was established as a tool to facilitate debate, dialogue, advocacy and research on mental health, to improve care and to promote human rights across the globe."

The care available in mental health facilities may often not only be of poor quality but can also hinder recovery. It can still be common in some countries for people to be locked away in small, prison-like cells with no human contact or to be chained to their beds, unable to move. The MiNDbank will help decision makers to address these issues, support reform efforts and ultimately improve the lives of people with mental health conditions in line with the Comprehensive Mental Health Action Plan 2013-2020, adopted by the World Health Assembly in May 2013.

The database, established with support from a broad range of partners, allows visitors to tap into the health information of WHO Member States and other partners. Users can review policies, laws and strategies and search for best practices and success stories in the field of mental health.

"If a government, for example, wishes to develop a new mental health policy in line with international human rights standards it can – on the new platform – quickly get an overview about the policies of other countries and benefit from their experiences and an array of international guidance tools and resources," explains Nathalie Drew, WHO Technical Officer working on mental health and human rights. So far, already more than 160 countries are sharing key mental health information through the MiNDbank and updates will be provided on a regular basis.

The WHO QualityRights initiative was launched in 2012, as part of the drive to raise human rights and quality standards in mental health and social care. The goal is to end human rights violations against people with mental health conditions and promote high-quality mental health services in the community.

The MiNDbank is available at www.who.int/mental_health/mindbank

source:  thejetnewspaper.com

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