Cardiovascular diseases are a major killer around the world, even in developing countries, and high blood pressure is a risk factor for these diseases.

Eating too much salt can lead to high blood pressure, stroke and heart attack, even where it's least expected. Researchers in Kenya from the Weill Cornell Medical College say hypertension is on a startling rise in sub-Saharan Africa. The problem is so severe in the Americas that PAHO - the Pan American Health Organization - launched a program called SaltSmart. Branka Legetic is the program coordinator.

"Hypertension is a leading problem throughout the whole world. It actually contributes to most of the risks as well as most of the diseases that are so called non-communicable diseases. It is number one," said Legetic.

Legetic says most people don't know the dangers of eating too much sodium, the chemical found in salt. The World Health Organization recommends no more than five grams of sodium per day, the amount in a teaspoon of salt. The goal of SaltSmart is to get people to cut their salt intake in half by the year 2020.

"We know that the people now consume 10 grams, 11 grams of salt, 17 grams of salt. In some Caribbean countries, so it's three times or two times more than recommended," she said.

In the U.S., Million Hearts, a government-sponsored program, aims to prevent 1 million heart attacks and strokes by 2017. Dr. Janet Wright is the executive director.

"We're asking for this effort to begin with the individual, within each of us. I think so many of us have been touched by heart disease because it is still the number one killer in the country, one out of three deaths," said Wright.

Wright explains that simple practices can go a long way to achieving this goal.

"It could be adding a fruit or a vegetable. It could be building your way up to 150 minutes of exercise each week. And it can also mean working with your health care team to stay on medicines if they've been prescribed," she said.

Wright says missing even a day's medication damages the heart, the kidneys, eyes and blood vessels. Branka Legetic also says healthy eating habits could go a long way because there is a lot of salt in processed foods.

"I think that the people have to be conscious about how much to eat and then what do they eat, and really strive toward more and more fresh and unchanged products," she said.

Th Pan American Health Organization is working with food manufacturers to reduce the amount of sodium that goes into processed food. Until that happens, the simplest way is to cut down on consumption of processed and restaurant foods.

source: www.voanews.com

World Bulletin/News Desk

Acting on directives by Turkish Prime Minister Recep Tayyip Erdogan, the Turkish Health Ministry is looking for doctors to work at a hospital built by the Turkish Cooperation and Coordination Agency (TIKA) in Sudan.

Eyeing Turkish doctors to begin its services, Nyala Sudanese-Turkish Training and Research Hospital in the capital Nayala of Sudan's South Darfour state needs specialists in 14 majors to train Sudanese doctors.

The hospital includes 150 normal beds, 46 beds in the high-intensive care unit, 3 operating rooms, 2 delivery rooms, a full-equipped radiology unit and a laboratory.

Turkish doctors will train 107 junior physicians in 15 majors.

For the assignment in Sudan, the Turkish Health Ministry calls upon Turkish doctors in specialties of internal medicine, general surgery, gynecology and obstetrics, pediatrics, cardiology, orthopedics, traumatology, ophthalmology, urology, otolaryngology, infection diseases, anesthesiology and reanimation, radiology, medical biochemistry and pathology.

Doctors with good command of English or Arabic will be preferably chosen for the assignment.

Since 1958, Project HOPE has worked to make health care available for people around the globe, providing humanitarian assistance through donated medicines, medical supplies and volunteer medical help. It is committed to long-term sustainable health care and its work includes educating health professionals and community health workers, strengthening health systems, fighting diseases such as TB, HIV/AIDS and diabetes.

Project Hope is also acutely aware that non-communicable diseases (NCDs) such as diabetes, cancer, and heart disease are placing an increasing burden on patients, healthcare systems, and economies. According to the World Health Organisation, NCDs account for 63 per cent of global deaths and nearly 80 per cent of deaths in low-to middle-income countries. Yet there are few successful models for NCD treatment and care that currently exist in the developing world. To tackle this situation, Project Hope has questioned how it can engage with corporate volunteers to help in improving global health and also improve their own skills and careers.

This organisation has the ability to unite global health experts from pharmaceutical companies and not-for-profits to solve these health issues. It understands how to engage volunteers from the business world and knows that it is the little things that count, such as volunteers having access to Internet, telephones and transportation as they may well otherwise abandon assignments if they are not able to stay in touch with their families at home and feel safe. Project Hope also appreciates that many of the volunteers may not have travelled outside of the U.S. before and may experience shock and confusion by their initial exposure to impoverished environments.

Therefore, Project Hope's strong relationship with Lilly, a leading pharmaceutical company, which has been going for more than 50 years, has been influential. Lilly recently sponsored the organization's fundraising gala in New York where they together unveiled a new video highlighting their work to improve diabetes and hypertension care for people living in the informal settlement of Zandspruit in Johannesburg, South Africa.

In 2011 Lilly announced an investment of $30 million over five years to create the Lilly NCD Partnership, a signature program designed to research new, comprehensive approaches to treat NCDs in the developing world. Lilly is working with world-class health organisations in Brazil, India, Mexico and South Africa, countries that suffer a large burden of NCDs, to develop effective, efficient and sustainable programs that can meaningfully improve outcomes for those in need. Meeting the enormous health needs in the developing world is not glamorous work and it is often anonymous. Project HOPE is the cheerleader that stands on the sidelines to encourage companies like Lilly to change things.

(source: www.justmeans.com)

LONDON, June 30 (Reuters) - Doctors could save three million more lives worldwide by 2025 if they offer AIDS drugs to people with HIV much sooner after they test positive for the virus, the World Health Organisation said on Sunday.

While better access to cheap generic AIDS drugs means many more people are now getting treatment, health workers, particularly in poor countries with limited health budgets, currently tend to wait until the infection has progressed.

But in new guidelines aimed at controlling and eventually reducing the global AIDS epidemic, the U.N. health agency said some 26 million HIV-positive people - or around 80 percent of all those with the virus - should be getting drug treatment.

The guidelines, which set a global standard for when people with human immunodeficiency virus (HIV) should start antiretroviral treatment, were drawn up after numerous studies found that treating HIV patients earlier can keep them healthy for many years and also lowers the amount of virus in the blood, significantly cutting their risk of infecting someone else.

"We are raising the bar to 26 million people," said Gottfried Hirnschall, the WHO's HIV/AIDS department director.

"And this is not only about keeping people healthy and alive but also about blocking further transmission of HIV."

Some 34 million people worldwide have the HIV virus that causes AIDS and the vast majority of them live in poor and developing countries. Sub-Saharan Africa is by far the worst affected region.

But the epidemic - which has killed 25 million people in the 30 years since HIV was first discovered - is showing some signs of being turned around. The United Nations AIDS programme UNAIDS says deaths from the disease fell to 1.7 million in 2011, down from a peak of 2.3 million in 2005 and from 1.8 million in 2010.

Swift progress has also been made in getting more HIV patients into treatment, with 9.7 million people getting life-saving AIDS drugs in 2012, up from just 300,000 people a decade earlier, according to latest WHO data also published on Sunday.

Indian generics companies are leading suppliers of HIV drugs to Africa and to many other poor countries. Major Western HIV drugmakers include Gilead Sciences, Johnson & Johnson and ViiV Healthcare, which is majority-owned by GlaxoSmithKline.

"IRREVERSIBLE DECLINE"?

Margaret Chan, the WHO's director general, said the dramatic improvement in access to HIV treatment raised the prospect of the world one day being able to beat the disease.

"With nearly 10 million people now on antiretroviral therapy, we see that such prospects - unthinkable just a few years ago - can now fuel the momentum needed to push the HIV epidemic into irreversible decline," she said in a statement.

The WHO's guidelines encourage health authorities worldwide to start treatment in adults with HIV as soon as a key test known as a CD4 cell count falls to a measure of 500 cells per cubic millimetre or less.

The previous WHO standard was to offer treatment at a CD4 count of 350 or less, in other words when the virus has already started to damage the patient's immune system.

The guidelines also say all pregnant or breastfeeding women and all children under five with HIV should start treatment immediately, whatever their CD4 count, and that all HIV patients should be regularly monitored to assess their "viral load".

This allows health workers to check whether the medicines are reducing the amount of virus in the blood. It also encourages patients to keep taking their medicine because they can see it having positive results.

"There's no greater motivating factor for people to stick to their HIV treatment than knowing the virus is 'undetectable' in their blood," said Gilles van Cutsem, the medical coordinator in South Africa for the international medical humanitarian organisation Médecins Sans Frontières (MSF).

MSF welcomed the new guidelines but cautioned that the money and the political will to implement them was also needed.

"Now is not the time to be daunted but to push forward," MSF president Unni Karunakara said in a statement. "So it's critical to mobilise international support... including funding for HIV treatment programmes from donor governments."

The WHO's Hirnschall said getting AIDS drugs to the extra patients brought in by the new guidelines would require another 10 percent on top of the $22-$24 billion a year currently needed to fund the global fight against HIV and AIDS. (Editing by Gareth Jones)

(source: www.huffingtonpost.com)

It's a simple truism, often repeated, that other developed nations achieve better health outcomes than the United States does despite spending less money on care.

A June 16 column in the New York Times was typical: "What Sweden can tell us about Obamacare." Sweden spends less than half on health care per capita as the U.S., the author, Cornell University economist Robert Frank, points out, but achieves better outcomes by responding "efficiently" to treating illness, utilizing economies of scale for expensive procedures, and funding only treatments shown to be effective. To accomplish these objectives, he says, the Swedish model relies heavily on government authority and non-profit institutions — certainly far more than the U.S. Affordable Care Act does.

It's all so obvious and widely agreed upon among health-care experts — and completely irrelevant.

Frank's comparison reflects a common misunderstanding of the real relationships between health, health care and government policy in the U.S.

Yes, other nations do achieve better health outcomes, but this is almost entirely a matter of lifestyle (not "partly from lifestyle," as Frank and so many others believe). Throughout the developed world, improvements in big things such as infant mortality, life span, even morbidity are almost completely attributable to diet; exercise; smoking, alcohol and drug usage; education; employment and income; family structure; environment; and community safety.

LESS IS MORE

Next to these determinants, the additional contribution of more health care — along with its policy cousin, "access" to health care — is almost insignificant. It may be more accurate to say that other developed countries achieve better health results not despite spending less on care, but because they spend less on care. In doing so, they free up resources — especially public resources — for the things that really matter: education, day care, recreation, even roads and bridges.

In the United States, our bloated health economy deprives other social needs of the resources required to genuinely improve and extend lives.

Of course, none of us personally finds health care or access to it insignificant. To us, any recommended treatment — even a "preventive" test — seems essential. Much of health care is useful, some of it even lifesaving, but few of us are aware of how many people need to have the latest screenings, pills and treatments for even one person to reap a benefit. (www.thennt.com shows these numbers for common treatments.)

Health care is personal, which is why it's so powerful politically.

SAYING 'NO'

Which brings us to the second fallacy in the conventional wisdom: that foreign health care is more efficient or better-regulated than American care. It often is, but the real difference is that in every other developed country's system, someone actually has the authority and incentive to say "no."

While these systems vary (even including one, Singapore, that relies heavily on consumer choice to control demand), in each there is an actual health-care budget somewhere that can't be exceeded. It's this effective limit on demand that allows, even causes, the other factors that health analysts credit with controlling cost: volume of care, prices, waste and overinvestment.

In contrast, the essential philosophy of U.S. policy is that no one should ever be denied any "needed" test, procedure or treatment. Obviously, this philosophy is imperfectly implemented: Many Americans remain outside the system and are harmed by the high prices that are the inevitable result of our unwillingness to control demand. Indeed, a desire to bring these people into the system underpins efforts to shift even more resources into health care.

What makes the U.S. unique is our refusal to empower anybody — the government, insurers or consumers — to say "no." We don't understand that there is no objective limitation on the need for health care; that unchecked, it will expand relentlessly no matter how healthy we get.

In debating everything from Medicaid to mortality, our health-care experts and policymakers ignore the data showing that most of our flood of care does little measurable good.

Medicare and Medicaid are essentially alone in the developed world as unbudgeted entitlements. Our tax subsidy for employer-provided health insurance has been essentially limitless. Strong new restrictions in the Affordable Care Act on private insurers' ability to deny or cap claims extend this policy.

And hospitals' obligation to treat indigent walk-ins is almost unlimited — the government compensates for this "uncompensated" care.

Senior-advocacy groups are surely aware of the overwhelming data on excess and the danger of unnecessary surgeries and prescription drugs, yet that hasn't weakened their support for the Part D prescription drug entitlement nor their opposition to any Medicare spending controls.

For all the talk of the uninsured, it was the hospital and drug industries that paid for much of the campaign to pass the Affordable Care Act. And it's the hospitals that are now lobbying for holdout governors to expand Medicaid, reminding politicians that hospitals are among their states' largest employers.

HEALTH-CARE MONSTER

The American health-care monster rests on a powerful political coalition of seniors groups, ideological liberals and what is by far the country's largest industry. That influence is felt at every stage of policy-making and administration, impeding the government's existing ample authority to drive quality, value and even safety. Their shared opposition to any attempt to control demand through government, or even private, action leaves us stuck with industrial policy posing as a public safety net — and not a very strong one.

Unless we find the political will to ever say "no" (or at least assign that capacity to insurers or consumers), we have little to learn from the health systems of Sweden, or Canada, Britain or any other developed country where care seems more efficient. Our mess is uniquely American; difficult though it may be, we need to find a uniquely American solution.

(source: thegazette.com)

For many years, the World Health Organization (WHO) has reported problems with high pesticide levels and industrial contaminants in some herbs. Over the past couple of years, both the American Botanical Council and the American Herbal products Association have identified ongoing problems with contamination. Much of the scrutiny of herbs focuses on those from India and China, where environmental safety laws are lax – and where contamination is sadly common.

Now a new study, entitled Chinese Herbs: Elixir of Health or Pesticide Cocktail continues this scrutiny. Sponsored by the environmental group Greenpeace, the report exposes unsafe practices of overuse of pesticides, use of banned pesticides, and high levels of these toxic agents in many Chinese herbs. The report stands to damage trade in Chinese herbs, which have repeatedly come under fire for safety concerns due to contamination.

As the world's largest supplier of herbs, China has a lot to lose. Revenues from Chinese herbal exports total in the hundreds of millions of dollars. And given that Chinese people rely heavily on herbs for health, the Chinese population is at risk as a result of significant health problems arising from poisons in their natural medicines.

Traditional Chinese Medicine – also known as TCM – is one of the oldest systems of health care in the world. Some TCM texts date back to over 3,000 years ago. At the heart of TCM is the use of over 11,000 herbs. Employed almost always in formulas of several herbs at a time and typically boiled into concentrated teas, herbs are essential to the practice of TCM. Apothecaries in China and in Chinatown areas in Europe and the United States carry a plethora of Chinese-grown or wild-harvested herbs.

According to the study, Greenpeace sampled 65 batches of herbs, finding pesticide residues in 48 of the samples. In six samples, researchers found highly toxic banned pesticides. In over 30 samples, 3 or more pesticides were discovered. One widely used herb, Sanqi flower, had residues of 39 pesticides. Wolfberry, otherwise known as Goji, contained residues of 25 pesticides. Widely regarded as a superfood and a healthy snack, the high levels and broad variety of pesticides in Goji diminish that berry's lustre as a health enhancer. Chrysanthemum, widely used in tea, was also heavily contaminated.

China is the world's largest user of agricultural pesticides. Application of pesticides directly onto herbal crops, as well as contamination of soil and water by pesticides used on other crops, adds up to a dangerous environmental and health situation. China's 600 million farmers use over two million tons of pesticides per year. Most of that use goes entirely unregulated, and oversight of the country's guidelines concerning pesticides is scant.

The country has a history of food-related scandals, such as the melamine poisoning of milk, toxic levels of pesticides in ginseng, and other problems. Pesticides used in China regularly contaminate water supplies, running into rivers, lakes and streams. In recent years the country has had poisoning problems with contaminated ginger, chives and cowpeas.

At a time when acceptance of herbal medicine is high, the presence of toxic agents in herbs creates anxiety and concern among those who seek natural remedies. And the contamination problem isn't limited to bulk herbs from China. Many prepared Chinese herbal formulas in tablets, capsules and other forms also contain highly toxic pesticides, casting doubt on the entire category of Chinese herbal remedies. How do you know which Chinese herbs are safe? You don't. Until Chinese health authorities and environmental officials begin to take this matter seriously, the best advice you can follow is to seek your remedies elsewhere.

(source: www.foxnews.com)

Representatives of the Secretariat of the Pacific Community (SPC) and Pacific Island countries and territories were very proud to hear an international expert recognising the value of the long-established Pacific Public Health Surveillance Network (PPHSN) ...The Pacific Region's Public Health Surveillance Network Praised

Wednesday 26 June 2013, Secretariat of the Pacific Community (SPC), Noumea, New Caledonia –

Representatives of the Secretariat of the Pacific Community (SPC) and Pacific Island countries and territories were very proud to hear an international expert recognising the value of the long-established Pacific Public Health Surveillance Network (PPHSN) during an international Forum that took place earlier this month in La Reunion.

'For me, PPHSN is the first network that worked and it inspired us when forming the Global Outbreak Alert and Response Network,' said Dr Mike Ryan, Former Director of WHO Global Alert and Response Team, Professor of International Health at University College Dublin and one of the keynote speakers at the Forum.

The 1st International Forum on Public Health Surveillance and Response in island territories and countries gathered over 300 actors of health surveillance in human and animal health from the Indian Ocean, the Caribbean, the Pacific and the French Mediterranean regions.

'We were very pleased to hear Dr Ryan's statement and all PPHSN members from Pacific Island ministries of health, regional organisations and training institutions can be very proud as well,' said Dr Yvan Souarès, Deputy Director of SPC's Public Health Division and one of the founders of PPHSN.

'PPHSN, which was created in 1996, has established robust services to support national and regional surveillance and response to epidemics and other public health emergencies that are really up to date, according to our exchanges with our counterparts working in the other island regions.'

During the three days (from 11–13 June), 70 oral presentations and 60 posters created the opportunity to discuss many topics: different forms of surveillance, early warning and response systems, the development of e-health tools, emerging diseases, new challenges and opportunities in the field of vector control, and the One Health concept, combining animal health and human health.

'All the presentations were of high scientific level and it was very interesting to share our knowledge, experience and views with those of our counterparts from the Indian Ocean and the Caribbean, as they face similar problems specific to an island context,' said Dr Salanieta Saketa from Fiji, who was part of the Pacific delegation.

This Forum has been a real success, both for the participants and the organisers: Agence de Santé Océan Indien, the Indian Ocean Commission, and the French Institute for Public Health Surveillance, with the support of the French Development Agency.

SPC's Public Health Division is committed to pursue the collaboration, and build up on commonalities (for economies of scale) and differences (expert resources) among Islands' public health networks, and has expressed an interest in hosting the second edition of the Forum in 2015.

Background information:

The PPHSN is a voluntary network of countries and organisations dedicated to the promotion of public health surveillance and appropriate response to the health challenges of 22 Pacific Island countries and territories. Its first priorities are outbreak-prone diseases and public health emergencies in general. It was created in 1996 under the joint auspices of SPC and WHO. SPC is the focal point of the PPHSN Coordinating Body.

PPHSN comprises five essential service networks to monitor and respond to public health emergencies occurring or threatening the region: (1) the Pacific Syndromic Surveillance System for outbreak detection, (2) PacNet for alert and communication, (3) LabNet for verification and identification of pathogens, (4) EpiNet, multi-disciplinary national and regional teams for preparedness and response to epidemics, and (5) PICNet for infection control.

The Global Outbreak Alert and Response Network (GOARN) is a technical collaboration of existing institutions and networks who pool human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance. It was created in 2000 by the World Health Organization.

(source: pacific.scoop.co.nz)

Malaysia has declared a state of emergency in two regions of Johor, a state in the southern part of the country, on Sunday as smoke from fires has caused a spike in air pollution levels that specialists believe are hazardous to citizens. The cause behind this air pollution is the illegal burning of forests on Indonesia's island of Sumatra, which creates a "haze" in many parts of the country and even Singapore.

"Prime Minister Najib Razak has agreed to declare emergency status in Muar and Ledang with immediate effect," Malaysian Natural Resources and Environment Minister G. Palanivel said in a Facebook post, according to Reuters.

Reuters reports:

Domestic media quoted the minister as saying cloud seeding would be carried out in the affected areas.

All 211 schools in the area are to be closed until further notice, residents have been advised to stay indoors and face masks have been distributed, Khaled Nordin, chief minister of the state, said, also via posts on Facebook.

Schools have been ordered shut in the neighbouring state of Malacca, where pollution has also reached hazardous levels. Schools were also ordered to close in one district in Pahang state.

All domestic airports managed by Malaysia Airports Holdings Berhad (MAHB) are operating as usual despite the haze, the national news agency quoted the airport operator as saying.

The current visibility level of 1 km was still safe, but runways would have to close if visibility fell under 300 m, it quoted Malaysian airports official Azmi Murad as saying.

Indonesian officials have deflected blame by suggesting companies based in Malaysia and Singapore may be partly responsible. Malaysia-listed Sime Darby and Singapore's Wilmar Group both deny the charge.

Earlier this year, China's air pollution levels were breaking records and reaching dangerous levels. So much so that the Chinese media had taken a stand on air pollution in China by calling on the government to take action against pollution, which according to the media, had reached dangerous levels in the capital city, which is home to around 20 million people.

According to the media, the air quality in Beijing reached 755 on an index measuring particulates of matter in the air. For an idea of how bad 755 is, know that the World Health Organization recommends a daily level no higher than 20 and a level of 300 is deemed to be dangerous. According to Zhou Rong, climate and energy campaigner at Greenpeace, 755 is the worst recorded air pollution in Beijing.

"How can we get out of this suffocating siege of pollution?" asked the People's Daily, the official newspaper of the Communist Party, in a front-page editorial, according to Reuters. "Let us clearly view managing environmental pollution with a sense of urgency."

The media's sense of urgency at the time (and currently) is apt, as the the Journal of Toxicology and Environmental Health found that a particulate matter with a diameter of 2.5 micrometers can cause cardiopulmonary disease, lung cancer and acute respiratory infection.

What's more, the capital of China was forced to cancel flights due to poor visibility and temporarily shut down factories due to the high levels of smog. The Associated Press wrote: "The capital was a colorless scene. Street lamps and the outlines of buildings receded into a white haze as pedestrians donned face masks to guard against the caustic air. The flight cancellations stranded passengers during the first week of the country's peak, six-week period for travel surrounding the Chinese New Year on Feb. 10."