Risky behaviour – smoking, illegal drug use, excessive drinking, unhealthy eating and unsafe sex – is on the rise worldwide and poses a growing threat to health, particularly in poorer countries, according to a World Bank report.

Smoking exacts a particularly high toll. Nearly 80% of the 6.3m deaths from smoking in 2010 occurred in middle- and low-income countries, says the Risking Your Health report.

Smoking is decreasing in richer countries but increasing in parts of the developing world. The Bank says low- and middle-income countries are in the grip of a tobacco epidemic, characterised by a sharp rise in smoking, particularly among men, after it peaked in rich countries in the 1960s and 70s.

In China, where smoking accounts for 1.2m deaths a year, it is the number one killer. In 2009, the country consumed more than 38% of the world's cigarettes, followed by Russia, the US, Indonesia and Japan.

The report finds that tobacco-related illnesses place a considerable financial burden on countries. The bank cites a study in Bangladesh that found families with at least one member afflicted by a tobacco-related illness, such as heart disease, lung cancer and oral cancer, spent 5.1% of their household monthly expenditure on tobacco and 10.2% on treating their illnesses.

In Vietnam, even after accounting for government subsidies, the out-of-pocket expenses for each hospital admission of lung cancer, chronic obstructive pulmonary disease and heart disease amounted to $285, or about 34%, of per capita gross domestic product.

In an area of Tanzania, health spending triggered by HIV and Aids was more than 70% greater than for other diseases over a two-year period. Together with funeral costs, this amounted to more than the annual household income.

"Individuals' risky behaviours that cluster among the poor ripple throughout entire populations, crippling families' potential and undermining the great health and economic progress we've seen in low- and middle-income countries in recent years," said Tim Evans, director of health, nutrition and population at the World Bank.

"Reversing the tide of these pernicious behaviours by promoting societal conditions for better health choices will pay dividends for families and countries across the globe, ultimately helping us end extreme poverty and promote inclusive and healthy growth."

Legislation and taxation, for example, tend to be effective, the report concludes, especially when combined with strong enforcement. Cash transfers have also proved to be promising in some settings. Behaviour change campaigns, such as school-based sex education and calorie-labelling laws, are often less effective on their own. Instead they benefit from being part of broader programmes to change risky behaviour.

Repeated messaging is effective, as with the case of graphic labelling on cigarette packets that reinforce the message to smokers each time they reach for a cigarette. Comprehensive advertising bans on cigarettes are more effective than partial bans.

While taxes on tobacco and alcohol can be shown to reduce consumption, particularly in richer countries, the evidence on behaviour change from tax on unhealthy foods is more mixed. A recent attempt by Denmark to tax high-fat food products increased prices by 9%, but the attempt failed, in part because consumers shopped across the border.

The report also notes fundamental differences in being able to change behaviour relating to alcohol, tobacco and food.

"People need to eat to survive, while they can abstain from tobacco and alcohol without health consequences," the report says. "Many unhealthy foods are inexpensive, while healthier foods are more expensive and require more time for shopping and cooking (cheap doughnut compared to expensive broccoli, for example) ... Differentiated taxes could modify relative prices, but the broad range of healthy and unhealthy foods makes it difficult to avoid substitution among unhealthy foods."

Programmes tend to be more successful if they take into account local culture. Brazil successfully carried out a tobacco substitution programme as it involved the community in the choice of the substitute crop and method of farming. In contrast, Bolivia's coca substitution initiative met with less success as it was imposed on the community.

On HIV prevention, the report says the evidence on the efficacy of conditional cash transfers remains limited, but there have been some encouraging results. In Malawi, small financial incentives have been shown to increase the uptake of HIV testing and counselling. Another study in Malawi conducted similar transfers for adolescents in which cash was conditional on school attendance – in addition to increased enrolment and attendance, the programme caused a reduction in HIV and HSV-2 (herpes simplex virus–type 2, the common cause of genital herpes) incidence.

source: www.theguardian.com

An Indonesian boy, who made headlines for smoking since he was two years old, has finally kicked the habit. However, Aldi Rizaln, now aged five, has switched to gorging on junk food.

Aldi, a native of Sumatra in Indonesia, was pushed in the spotlight in 2010, when he was seen puffing on a cigarette while riding his tricycle. His habit of smoking 40 cigarettes a day led the Indonesian government to launch an anti-smoking campaign for children, Daily Mail reported. The toddler was soon shifted to a rehabilitation centre and was enrolled in play therapy sessions for some time.

A recent investigation showed that the boy hasn't smoked for more than a year, but has developed an unusual craving for unhealthy foods, making him overweight compared to other children of his age.

Nutritionist Fransisca Dewi told Daily Mail that the boy consumes nearly three cans of condensed milk every day, in addition to "too many carbohydrates."

"Aldi is very overweight, his weight doesn't match his age. His ideal weight is 17kg to 19kg. He's 24kg already," he said.

According to doctors, smoking has played a major role in increasing the boy's appetite. "Nicotine can increase the endocrine hormone in the body. This condition can cause resistance to insulin," Paediatric specialist Dr William Nawawi, told Daily Mail. "The blood will not be able to break glucose from food. This will make Aldi become bigger and bigger."

Though Aldi's case appears to be a rare case, smoking at a young age is not completely new in Indonesia, where there are no strict rules to prevent youngsters from buying cigarettes.

According to Mirror, a six-year-old boy named Maulana Susanto started smoking when he was just two years old. "He's been smoking since he was two. He was on a pack a day. Now he goes to school just one or two cigarettes are enough," Maulana's mom told the tabloid. "Yes I want him to stop but nobody comes to help me."

Indonesia is one of the few countries which are yet to sign the UN Tobacco Control Agreement that imposes strict restrictions on marketing cigarettes to a country. Indonesian health officials attributed this reason as a contributing factor to the rise in the number of children smoking cigarettes. "I think the tobacco industry have used all their skills and resources to get hold of these kids. The number of people who have started smoking between five and nine years of age has increased sevenfold," said health minister Dr Nafsiah Mboi.

source: www.ibtimes.co.in

British doctors are working as part of a massive international effort to help those affected by Typhoon Haiyan, which hit the Philippines with devastating force on 8 November. The storm has long since passed, but the medical and humanitarian situation is constantly evolving.

"We are mostly seeing trauma and fractures right now... but in week two going into week three you start seeing an increase in patients with chronic conditions," says Dr Julie Hall, the World Health Organization's (WHO) representative in Manila.

Post-disaster conditions create the perfect environment for the spread of disease. Contaminated water supplies are the biggest problem, putting huge numbers of people at risk of water-borne diseases like cholera and typhoid.

Dr Hall, originally from Knaresborough in North Yorkshire, says the WHO has not been informed of any significant outbreaks yet, but says that could be because of the lack of communication with affected areas.

Medication problem

"The telecoms have been down for a long time... the reporting systems are only just starting to get up and running," she says. "Mobile phones are given to health workers in the facilities and they SMS at the end of the day how many diarrhoea patients or suspected measles cases they have seen. We are not getting those reports yet."

Another issue is that people with things like heart conditions or diabetes have gone without their regular medication for more than a week now. That will start taking its toll. "It's the lack of medication and care," Dr Hall says.

"But also any event that puts such a stress on the population, you do see a rise in heart disease and stroke." According to the WHO, 28 international medical teams are currently in the Philippines but only eight of these have started work.

At 21:00 GMT on Sunday, the WHO said another 14 were expected to be operational "in the next 48 hours". It says the Philippines government does not need any more foreign medical teams now, but will call on countries in the coming weeks to provide relief for current teams.

One of the foreign medical teams is from the UK, sent by the Department for International Development. Half of the 12-strong team is now on board HMS Daring, which is heading to remote islands off the north of Cebu, where there has been limited medical help so far.

The other half is heading for Tacloban, the scene of some of the worst devastation, where the medics are expected to arrive on Monday. Orthopaedic surgeon Dr Steve Mannion, a member of the team which left the UK last week, says they have been told what to expect in Tacloban.

"There are people presenting with very badly crushed lower limbs which may need amputation," he says.

"A week after the typhoon people are presenting with very, very badly neglected septic wounds and there have even been three deaths from septic wounds in the last few days."

Many in Tacloban and in other more remote areas have still not received the medical care they so desperately need. Treating infected wounds remains a top priority to stop more people losing limbs, or dying from sepsis. Diarrhoeal disease outbreaks tend to start around 10 days after a disaster like this strikes.

They can lead to extreme dehydration which can be fatal, especially in children. The medical teams on the ground are bracing themselves as aid teams continue to try to get clean water supplies up and running. The main islands affected were poorer areas of the Philippines.

Many children are not immunised against measles or polio. A mass vaccination programme will start next week. The WHO aims to reach around half a million unimmunised children in Samar and Leyte.

source: www.bbc.co.uk

Casbalanca- According to daily newspaper La Libération, the Moroccan Ministry of Health recently announced the launching of the 2013/2005 action plan aimed at reducing the rate of maternal mortality in nine priority regions. This program is working with a budget of 271 million dollars.

This plan, 97% of which was funded by the Ministry, while specialized UN agencies financed the rest, has two key objectives: the reduction of maternal mortality by 82% and limiting the number of deaths to 60 deaths per 100,000 live births.

This program also aims to reduce the number of deaths of children aged under 5 years to 23 per 1,000 live births.

The plan includes measures seeking to positively impact the current situation of maternal and infant mortality and aspires to effectively achieve its development goals by 2015 at the national level.

According to La Libération, the Minister of Health, El Houssaine Louardi, emphasized the need to improve the quality of care related to pregnancy and newborns, the promotion of high-quality pediatric care, the development of an integrated management of child health and the strengthening of the national immunization program, as well as monitoring and evaluating these measures at the regional level.

According to the same source, the minister stated that a special committee set up at the central level, as well as regional commissions in the new targeted areas will be responsible for monitoring and evaluating the measures included in this plan.

The minister also noted that nine regions were selected based on a survey on population and health conducted in 2011. This survey unveiled malfunctions in medical coverage and maternal and child health.

The minister explained that the launch of this plan is part of serious efforts to achieve the fourth and fifth objectives of the Millennium Development Goals and help the kingdom meet international standards in the field of maternal and child health.

source: www.moroccoworldnews.com

Health Minister Nafsiah Mboi said that Indonesia would finally accede to the Framework Convention on Tobacco Control (FCTC) before the end of this year, a major step in the fight against prevalent smoking addiction.

"The treaty accession will be completed through a presidential decree. The President has agreed [to accede to the treaty]. God willing we will accede to the treaty before the end of the year," Nafsiah said.

As previously reported Nafsiah said that three ministries, namely the Trade Ministry, Industry Ministry and the Manpower and Transmigration Ministry, had previously rejected the accession, and added that it would hurt tobacco farmers and reduce the state's income in tobacco excise, which had a big contribution to the state budget.

"All three ministries have agreed to accede to the treaty. They have agreed that the accession is solely aimed at protecting the public," Nafsiah told reporters on the sidelines of the closing ceremony of National Health Day on Friday.

According to Nafsiah, the government is currently drafting the text to be submitted to the Foreign Ministry before being signed by President Susilo Bambang Yudhoyono.

In 2003, all WHO member states, including Indonesia, approved a World Health Assembly resolution that mandated the establishment of a framework convention on tobacco control.

According to Nafsiah, Indonesia has been very active in formulating the FCTC in 2002-2003, yet Indonesia is the only ASEAN member country that has not ratified the treaty.

The treaty is aimed at promoting public health by monitoring tobacco use, protecting people from tobacco smoke, enforcing bans on tobacco advertising as well as raising taxes on tobacco products.

source: news.asiaone.com

Tibetans share concerns with other people worldwide about the rising incidence of diabetes and its' associated complications. Kalon Dr. Tsering Wangchuk of the Department of Health of the Central Tibetan Administration (CTA) has commented about this illness on World Diabetes Day, as reported upon by the Central Tibetan Administration. World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization to deal with growing concerns about the escalating health threat which diabetes now presents us with.

Wangchuk raises an awareness of the critical role of education and prevention in the fight against diabetes. The growing problem with diabetes is no joke. The World Health Organization says close to 3.4 million people died from complications which were caused by diabetes in 2010. About 347 million people across the world suffer from diabetes. About 20% of these deaths occur in developed countries, with about 80 % of deaths occurring in undeveloped and developing countries.

Diabetes has become one of the most commonly diagnosed diseases amongst the Tibetan people. Because of the prevalence with which it is seen in Tibetan clinics, the Tibetans must educate their own community in more depth about diabetes. Tibetans need to educate their youngsters, students, adults and the elderly in order to prevent them from becoming sick or even dying from this disease.

Tibetans are being encouraged to concentrate on educating their health care professionals so that they will be able to educate the Tibetan people on how to avoid getting diabetes, while providing treatment of diabetes for patients who already suffer from the disease. These initiatives should help Tibetans to better confront the problem of diabetes.

source: www.examiner.com

Unable to bear the stench and sight of unclaimed cadavers in the streets, and fearful of possible health hazards, local officials have begun burying them in mass graves.

However, the World Health Organization cautioned the country's Department of Health (DOH) against mass burials. According to the WHO's "Management of Dead Bodies in Disaster Situations" manual sent to the DOH, immediate mass burials without proper identification may violate some rights.

"Burial of bodies in common graves or the use of mass cremation is unnecessary and a violation of the human rights of the surviving family members," it said.

WHO added that "practices such as the use of common graves or cremation make identification impossible, besides violating religious and cultural beliefs." The agency stressed that identification of bodies should be done "so that the desires and the customs of the families are respected." It noted that the rights of ethnic communities, which are protected by law, may also be violated by mass burials.

"Indigenous communities tend to practice ancestral customs with regard to death that are different from the most popular Western religions, and that are intrinsic to their cultures and traditions," it added. WHO also stressed that contrary to common knowledge, the threat of infections from exposed corpses is limited.

"When death is the result of a disaster, the body does not pose a risk for infection," it said, stressing that "victims should never be buried in common graves." Communities in Palo, Leyte have put up messages and signs asking authorities to remove the bodies for fear these will cause an outbreak of diseases.

"Paki-kuha ang patay, magkakasakit na mga tao dito. (May) 30 patay sa St. Peter, agnas," read one message. The mass burial of at least 150 bodies, none of whom have been identified, near a church in Palo caused some families added grief. Jinky Adel, together with relatives, struggled to bury their grandmother in a cemetery.

"Ayaw naming masama sa mass grave, kaya naghanap kami ng paraan para mailibing namin [ang lola ko]," she said. Other residents opted to line up bodies along the sidewalk in the hopes the government would come to pick up the corpses. However, the WHO said body temperatures drop quickly after death.

"Even the most resistant bacteria and viruses die quickly in an animal that has died recently. This makes it extremely difficult for microorganisms to transfer from dead bodies to vectors, and from vectors to human populations," it said. National Epidemiology Center director Dr. Eric Tayag concurred, explaining that dead bodies do not necessarily cause epidemics after a natural disaster.

"Ganito 'yan: 'Pag 'yung dumi na lumabas mula sa bituka ng dead bodies ay napunta sa sources of water, 'yun ang contamination. But, as it is, it will not spread disease," he told GMA News Online on Tuesday.

WHO said every effort must be taken to identify the bodies. However, "as a last resort, unidentified bodies should be placed in individual niches or trenches, which is a basic human right of the surviving family members." — JDS/ELR, GMA News

source: www.gmanetwork.com

Report Reveals Crucial Need for Inclusion of Frontline Health Workers in Global Health Workforce Crisis Response

RECIFE, RECIFE, BRAZIL, November 11, 2013 /EINPresswire.com/ -- RECIFE, Brazil, November 11, 2013 -- The Frontline Health Workers Coalition (FHWC) commends the World Health Organization, the Global Health Workforce Alliance and contributors to the "A Universal Truth: No Health Without a Workforce Report" and calls upon world leaders to focus on inclusion of frontline health workers in the formal health system as a central mechanism for addressing current and future deficits of health workers worldwide.

The report – presented today at the Third Global Forum on Human Resources For Health in Recife, Brazil – finds that the world needs at least 7.2 million more doctors, nurses and midwives than it currently has to provide essential health services – projecting forward to a deficit of 12.9 million health workers by 2035. Eighty-three countries fall below the lowest threshold of doctors, nurses and midwives needed to provide basic health services (23 per 10,000 population). The report does not include estimated counts and gaps in the number of community health workers and others on the frontlines of care in developing countries.

"This report lays out a stark human resources challenge for the global health community to face with less than 1,000 days until the target date for achieving the Millennium Development Goals (MDGs) and post-2015 planning underway," FHWC Director Mandy Folse said. "Yet, several countries such as Ethiopia, Malawi and Nepal have recently demonstrated that a focused effort on training, supporting and integrating a cadre of community-based health workers into the formal health system delivers dramatic results in saving lives and improving health."

In Ethiopia, the Health Extension Program launched in 2003 has trained and supported more than 34,000 government-salaried women frontline health workers in communities throughout the country. The country's health minister, Dr. Kesetebirhan Admasu—speaking to the Guardian in reaction to the recent announcement of Ethiopia's early achievement of its MDG target on slashing child deaths— said these frontline workers are the key drivers for Ethiopia's 67% reduction in child mortality since 1990. In Nepal, a well-established cadre of 50,000 female community health volunteers has helped overcome a continued deficit of doctors, nurses and midwives to nearly halve maternal mortality and slash the child death rate by 64% from 1990 to 2008.

Malawi – whose President Joyce Banda in September announced the country is expanding its frontline health workforce from 10,000 to 27,000 by 2015 – already has seen its child mortality rate cut by more than half since 1990.

However, despite the growing evidence that inclusion of frontline health workers in health workforce strengthening efforts are a crucial component to global health progress, there is not data to ascertain an accurate accounting and impact of frontline health workers in many countries.

"For far too long community health workers have not been counted, supported or celebrated," said FHWC Chair Mary Beth Powers, Newborn and Child Survival Campaign Chief at Save the Children. "The doctor, nurse and midwife deficit as outlined in the report points out the need to supplement the health workforce with new skilled cadres of workers, ideally located closer to the communities in need. But without even having a good estimate of how many community health workers are out there, we really don't know the number of communities without access to the basic health care that they can provide."

FHWC commends the leadership efforts at the Third Global Forum by representatives of the United States government and other countries to address the global health workforce crisis with a particular focus on addressing the need for more skilled and better supported frontline health workers. We strongly urge inclusion of the inputs of non-state actors – including health workers themselves, civil society organizations and private sector businesses – in ongoing strategic discussions.

The Frontline Health Workers Coalition is an alliance of United States-based organizations working together to urge greater and more strategic U.S. investment in frontline health workers in developing countries as a cost-effective way to save lives and foster a healthier, safer and more prosperous world.

source: world.einnews.com