WASHINGTON - Health authorities are finalizing a plan to end most cases of polio by late next year and eradicate the disease by 2018 -- if they can raise enough money to finish the work.

The six-year global strategy will cost $5.5 billion, and require increasing security for vaccine workers who have come under attack in hard-hit countries.

But with polio cases at a historic low -- 223 cases last year -- officials with the World Health Organization, Gates Foundation and other polio-fighting groups said Tuesday there's a chance of success. The disease was widespread in 125 countries back in 1988 when the global polio fight began. Today, it remains endemic in just three: Pakistan and Nigeria -- where those health workers were killed -- and Afghanistan.

(source: www.10news.com)

There are so many things we take for granted in America. One of them is that our children are not regularly infected by one of the tropical diseases so common among the world's poorest people.

When I was just starting my career in medicine, I worked for a year in Bangladesh studying the polio vaccine. I spent several months serving as the doctor in a clinic run by the Marist sisters. I kept a journal of my experiences that I came across when I was cleaning out my desk the other day.

Flipping through the pages reminded me why I went into public health in the first place: the opportunity to address some of the health inequity that I saw.

Join the ABC News Tweet Chat About Neglected Tropical Diseases Today at 1 p.m. ET

One of the diseases I treated while working at the clinic was ascaris, also known as roundworm infection. As many as one billion people around the world are infected with this parasite, according to the Center for Disease Control and Prevention.

Along with hookworm, trachoma, elephantiasis, whip worm, snail fever and river blindness, roundworm is considered one of the seven parasitic and bacterial infections that together have a higher health burden on the world's poor than malaria and tuberculosis.

In medicine, we refer to these as the "neglected tropical diseases." They infect nearly one in six people worldwide, including half a billion children, and lead to tremendous suffering and loss of life. Yet, the estimated cost to treat these diseases is less than 50 cents per person.

Roundworm is spread through contact with soil contaminated with feces containing eggs or early worm forms. Symptoms may be mild — but long-term infections with worms can cause micronutrient deficiencies that impair growth and stunt brain development.

Each year, an estimated 60,000 people die from roundworm infection. These are preventable deaths.

I am still haunted by one little boy I treated in Tuital, a rural village that is six hours by boat from Dhaka, the capital city of Bangladesh. He must have been 9 or 10 years old. Like most of the children I saw, his family brought him to the clinic as a last resort. Travel was difficult and local remedies were trusted more than conventional medicine.

Here is what I wrote in my journal at the time:

Jan. 28, 1990. "There is a little boy I'm caring for who has an intestinal obstruction from worms. I'm quite worried about him. After one enema, he passed a few worms. That was yesterday. I am afraid he will perforate his bowel and die. In the morning we may try again to convince the family to go to Dhaka. I would love to do an abdominal x-ray and then scope him. It is truly a cruel world if this child dies needlessly."

Jan. 30, 1990. "The little boy is hanging in there but in the morning we are sending him to Shishu Hospital in Dhaka......

March 5, 1990. "I met the family of the boy with worms that we sent to Dhaka. He died three days ago after two operations for resection of dead bowel. He was obstructed from worms as we thought. I can't help but wonder whether we had kept him here for too long....."

The World Health Organization has a plan for eliminating intestinal worms transmitted by contact with contaminated soil: treat all children with a cheap medication to "deworm" them; provide clean water and proper sanitation to prevent new infections.

Sounds pretty simple right? On my weekly tweet chat today, I'll explore why this hasn't happened yet and what it will take to get it done.

The one-hour chat takes place on Twitter today from 1-2 p.m. ET. This week, I'll be joined by the not-for-profit groups End 7, The Carter Center and Every Mother Counts, as well as the Center for Disease Control and Prevention, plus dozens of hospitals and caring citizens from around the globe.

I realize that the average American isn't likely to encounter a deadly tropical disease. But for the rest of the world, these diseases have devastating consequences. Won't you join me to learn more about this important issue and what you can do to get involved in the fight to the needless suffering caused by these diseases?

Participation is simple. Here's how. Follow the conversation or jump in with comments and questions of your own.

(source: abcnews.go.com )

SHANGHAI, CHINA (BNO NEWS) -- Two people in China's largest city of Shanghai died this month after contracting a strain of avian influenza that had never been transmitted to humans before, health authorities said on Sunday. A third victim in China is in a critical condition.

China's National Health and Family Planning Commission said two men from Shanghai and a woman from another region in eastern China were diagnosed with avian influenza, better known as bird flu, after they became ill with coughs and fevers before developing pneumonia. Laboratory tests confirmed Saturday that they had contracted H7N9, a strain not seen in humans before.

The first known victim, an 87-year-old man from Shanghai, became ill on February 19 and passed away on March 4, according to the Commission. The second victim, a 27-year-old man who was also from Shanghai, began showing symptoms on February 27 and died at a local hospital on March 10.

A 35-year-old woman from Chuzhou, a city in Anhui province, some 320 kilometers (198 miles) northwest of Shanghai, became ill on March 15. The woman was later admitted to a hospital in Nanjing, a city in neighboring Jiangsu province, and remained in a critical condition on Sunday.

It is unclear how the virus infected the three victims, who do not appear to have any direct connections, but none of their relatives or friends are believed to have fallen ill. The Commission said the 27-year-old man was a butcher while the 35-year-old woman had been in contact with poultry before falling ill.

The Chinese government said it is closely following the situation and has informed the World Health Organization (WHO), Hong Kong, Macao, Taiwan, and a number of countries about the deaths. A WHO spokesman said the risk to public health appears to be low as there is no evidence of human-to-human transmission.

In Hong Kong, a spokesman for the Center for Health Protection said it would closely monitor the situation and urged members of the public to remain vigilant for possible cases of bird flu. "We will heighten our vigilance and continue to maintain stringent port health measures in connection with this development," he said.

There is no known vaccine for H7N9, but the strain is different from the well-known H5N1 variant. Since 2003, the H5N1 bird flu virus has killed or forced the culling of more than 400 million domestic poultry worldwide and caused an estimated $20 billion in economic damage before it was eliminated from most of the 63 infected countries.

According to the World Health Organization (WHO), the bird flu virus has infected at least 605 people since it first appeared, killing 357 of them. Most cases and deaths were recorded in Indonesia, Vietnam, Egypt and China. Vietnam, Indonesia, China and Cambodia all reported bird flu deaths last year.

(source; wireupdate.com)

Business research group Frost & Sullivan predicts Indonesia's health-care spending will reach $60.6 billion in 2018, more than double last year's estimate of $26.4 billion.

Nitin Dixit, a senior health-care industry analyst at Frost & Sullivan, said in Jakarta on Wednesday that health care spending in

Asia-Pacific countries was expected to double in line with increasing demand for quality health-care services and better life expectancies.

Dixit said the Indonesian market would be supported by government programs and policies resulting in increased spending and access to health services.

"In Indonesia, health care spending will reach $60.6 billion in 2018, assuming the average growth rate is 14.9 percent per annum from 2012 to 2018," Dixit was quoted as saying by Investor Daily.

During the same period, Dixit said per capita spending on health care would grow 13.8 percent a year, from $108.90 last year to $237.10 in 2018.

Frost & Sullivan also forecast that the private sector would play a greater role in the country's health-care sector and overtake spending sourced from the government. It estimated the private sector will account for 53 percent of health-care spending in 2018, up from 49 percent now.

Sutoto, the chairman of Indonesian Hospital Association, agreed with the assessment, adding that Indonesia's health-care industry would produce abundant opportunities for growth, particularly after the full implementation of universal health care in 2014.

The universal health-care scheme, written into law by the House of Representatives in 2011, aims to provide health insurance for 117 million Indonesian workers starting next year.

The current scheme, managed by state-owned insurer Jamsostek, only provides coverage to 11.5 million workers.

President Susilo Bambang Yudhoyono has called for an initial fund of Rp 25 trillion ($2.6 billion) for the program.

"Hospitals will be full when universal health care comes into effect due to the ease of access to health-care services. On the other hand, there will be more people demanding better-quality services," Sutoto added.

Hannah Nawi, associate director of health-care practice for the Asia Pacific at Frost & Sullivan, said the shift in people's lifestyles would also boost growth in health care.

(source: www.thejakartaglobe.com)

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Indonesia's healthcare expenditure is predicted to reach US$60.6 billion in 2018 with a growth of 14.9 percent over the 2012-2018 period on account of faster growth in age groups above 35 years, urbanization and an increase of lifestyle-related diseases such as cancer and diabetes, says research and consulting firm Frost & Sullivan.

Hannah Nawi, Frost & Sullivan's Healthcare Practice Associate Director for Asia Pacific, said Indonesia's median age was 28 years and that age groups beyond 35 years were projected to grow faster than the average from 2010 to 2014.

"Urbanization and a slowly aging population will the drive demand for healthcare in Indonesia," Hannah said recently.

She added that increasing chronic and lifestyle-related diseases, including cancer and diabetes, especially in big cities in the country, would also play a large role in the increasing public demand for healthcare services in the next few years.

"In terms of the healthcare burden, once you are a cancer patient, you'll be in treatment for life. The same goes for diabetes," Hannah said, adding that it could put a strain on healthcare institutions.

Separately, the head of the Indonesian Hospital Association (PERSI), Sutoto said that the national healthcare system under the Social Security Providers (BPJS) Law would also play a significant role in increasing the country's total healthcare expenditure.

The health insurance, which will cover 121.6 million people as of Jan. 1, 2014, will be made available in stages for all eligible Indonesians through 2019.

"Many hospitals questioned their readiness ahead of the implementation of the BPJS next year, when in fact it actually opens more opportunities for the healthcare industry, especially for private hospitals," Sutoto said. "Around 86 million low-income people who have no access to healthcare services, will be able to receive hospital services by the time it is implemented, and the government will pay their premiums," he added.

The country, however, still faced a lot of challenges in fulfilling the increasing demand for healthcare services, Nitin Dixit, Frost & Sullivan's healthcare senior industry analyst, said.

"The first challenge is the uneven distribution of resources. The hospital, the doctors, the entire healthcare infrastructure is unevenly distributed," Nitin said.

Sutoto said that the country's doctor-to-people ratio was only 3 doctors per 10,000 people, much less than Malaysia, which has 9 doctors for every 10,000 people and Cuba, which has 64 doctors for 10,000 people.

"We have a total of 73 medical faculties across the country, but yet we are still lacking doctors, especially specialist doctors," he said.

He also said that hospitals should start recalculating their service costs and make it more efficient ahead of the BPJS, as the government would apply an equal healthcare tariff across all healthcare institutions to ease insurance claims.

"We urge all hospitals to reduce their costs and make it more efficient ahead of the BPJS," Sutoto said. "At the same time, we hope the government assists us and lowers taxes, as well as electricity and water tariffs for hospitals, as we will have to provide more third class rooms for low-income people," he said. (nad)

(source:  www.thejakartapost.com)

The Indonesian government hopes to implement one of the largest ever examples of "compulsory licensing", which will enable the generic manufacture of drugs still under patent.

Advocates of the move say the reduced drug costs achieved through compulsory licensing have been instrumental in reducing HIV mortality rates in Indonesia.

"One of the major reasons for decreased HIV mortality rates is the provision of anti-retroviral [ARV] treatment, and if [Indonesia] can't afford the anti-retroviral treatment, the mortality rate will return" to the higher levels of previous years, Samsuridjal Djauzi, chairman of the Association of Indonesian Physicians Concerned about HIV/AIDS, told IRIN.

The latest use of compulsory licensing – Indonesia's third to date – will allow the government to expand its access to the second-line ARVs, he said, including tenofovir, emtricitabine, and lopinavir/ritonavir.

Under the World Trade Organization's Trade Related Aspects of Intellectual Property Rights (TRIPS), countries can override patents for public health purposes by issuing compulsory licenses that enable the generic manufacture of drugs still under patent.

"Urgent need"

In this latest move, a September 2012 presidential decree announced the government would procure generic equivalents of the international patents for seven HIV/AIDS and hepatitis B medicines, citing the "urgent need" to control these diseases.

"The implementation of the third compulsory licensing depends on the capability/readiness of the manufacturer [Kimia Farma]. I estimate efavirenz [another HIV medication on the list] will be available in the next three to six months. For other drugs, [we] will need more time," Djauzi said.

According to UNAIDS, an estimated 380,000 people are living with HIV/AIDS in Indonesia. The number may not appear alarming considering that Indonesia is a developing country with nearly 250 million people, but the prevalence rate is now 25 percent higher than it was a decade ago.

The spread of HIV is attributed to low condom use and epidemic-level infection rates – 36.4 percent – among injecting drug users, experts say.

The cost of normal treatment is around US$90 per person per month, Usep Solehudin, who coordinates free distribution of ARVs for some 120 patients at a clinic in Jakarta called Yayasan Pelita Ilmu (YPI), told IRIN. This is beyond the means of most of his patients, whose incomes are generally $100 to $200 per month.

"The patients would not otherwise be able to buy it [the ARVs] because they cannot afford it," he said. "They would just ignore their health."

Jakarta first used compulsory licensing in 2004, ushering in increased medication access.

The number of Indonesians receiving ARVs has quadrupled since 2008, to 30,000 today, and the government is looking to maintain this rate of expansion, said Cho Kah Sin, country director of UNAIDS in Indonesia.

The latest government license focuses on second-line ARVs, which are prescribed to patients who have developed resistance to first-line treatment. Resistance in a population tends to develop within several years of a drug's introduction. The government is therefore expecting that increasing numbers of Indonesians with HIV will require second-line treatment, said Cho Kah Sin.

Innovation at risk?

Critics of compulsory licensing say its usage undermines medical innovation.

"Systematic issuance of compulsory licenses sets a negative precedent and can reduce the incentive to invest in the research and development of new medicines that address unmet medical needs," said Andrew Jenner, director of innovation, intellectual property and trade at the Switzerland-based International Federation of Pharmaceutical Manufacturers and Associations, in a written statement to IRIN.

"We believe that negotiated approaches, such as tiered pricing and voluntary licensing, are generally more effective and sustainable, both medically and economically," said Jenner, whose organization represents four pharmaceutical companies whose medicines are to be generically replicated by Indonesia. Tiered pricing is the practice of setting different prices for different markets.

Others studies , however, argue there is no empirical evidence that patents increase innovation and productivity.

Peter Maybarduk, who directs the Global Access to Medicines Programme for Public Citizen, a US-based NGO, advocates wider use of "compulsory licensing" by developing countries. "We don't think compulsory licensing should only be used in the most dire scenarios," he said.

Switzerland-based Michelle Childs, who heads the Campaign for Access to Essential Medicine for Médecins Sans Frontières, agrees: "If there is a clash between access to [essential] medicines and patent rights... the primacy of access should be promoted," she said.

Maura Linda Sitanggang, director-general of the pharmaceutical department at Indonesia's Ministry of Health, did not respond to requests for an interview.

(source: gantdaily.com)

KUALA LUMPUR: The Health Ministry is committed to eliminating tuberculosis (TB) by 2050 as envisaged under the Strategic Plan for TB Control 2011-2015.

Director-general of Health Datuk Dr Noor Hisham Abdullah said the TB detection rate had surpassed dengue, putting the disease at the top of the infectious disease list in the country.

"Controlling and eliminating TB is our main agenda as it has become the most common infectious disease with the highest number of deaths."

He said this at the launching of the Clinical Practice Guidelines on Management of Tuberculosis (3rd Edition) and World TB Day 2013 with the theme "Stop TB in my lifetime".

The World Health Organisation Global Tuberculosis Report 2012 reported that there were 8.7 million new TB cases, 1.4 million deaths because of the disease in 2011 and 500,000 new cases with 64,000 deaths among children around the globe.

In Malaysia last year, 22,710 cases were detected and treated, with an increase in case detection from 81 per cent in 2010 to 98 per cent last year.

It was reported that there were about 1,600 deaths last year because of this infection.

Selangor, Sarawak and Sabah recorded the highest number of cases.

Noor Hisham said the plan would strengthen the TB control programme with new approaches, such as providing TB drugs in private healthcare facilities for free.

"We want to ensure TB patients get access to treatment easier and nearer to their homes."

He added that other strategies, such as education and creating awareness of TB in health facilities, were ongoing.

He said the ministry was committed to controlling TB.

March 24 is celebrated every year as World TB Day.

It was when the germ causing TB was announced to the world by Dr Robert Koch in Berlin, Germany.

(source: www.nst.com.my)

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For Indonesia, World Tuberculosis Day, which falls on March 24, is an event of great relevance due to the fact that the country ranks fifth on the list of 22 high-burden Tuberculosis (TB) countries in the world.

According to the World Health Organization's (WHO) Global Tuberculosis Control Report in 2012, an estimated 528,063 new TB cases or approximately 256 cases per 100,000 of the population were found in Indonesia in 2010. Based on WHO disability-adjusted life-year (DALY) calculations, TB alone is responsible for 6.3 percent of the total disease burden in Indonesia, almost twice the figure in Southeast Asia.

In addition, as in many other developing countries, coinfection or co-morbidity of TB and HIV is a common phenonemenon in Indonesia. Put differently, in many places in developing and low-income countries, including Indonesia, the TB epidemic has become intertwined with the HIV epidemic. On the one hand, HIV infection greatly increases the risk of TB infection; on the other hand, TB infection exacerbates the suffering of people living with HIV. Therefore, the current world TB commemoration once again empahasizes the urgent need to combat not just TB but also TB-HIV coinfection.

The Health Ministry states that as of March 2012 there were 20,564 reported cases of people living with HIV in the country. Considering the tendency of underreporting of HIV cases in Indonesia, the Indonesian National AIDS Commission (2010) estimates the number of people living with HIV and AIDS in the country ranges from 200,000 to 270,000. The United Nations Joint Commission on AIDS (UNAIDS) has identified a shift of HIV epidemics in Indonesia since early 2000 from "low prevalence" to "concentrated prevalence", implying that HIV prevalence is less than 1 percent in the general population but more than 5 percent among vulnerable groups such as injecting drug users, female sex workers and their clients, as well as homosexuals.

TB-HIV coinfection is common among these HIV high-risk groups, In addition, it is noteworthy that these high-risk groups tend to be socially and economically marginalized. They usually suffer from the so called cluster of disadvantages e.g. generally having low educational attainment, low levels of skill and employability, low levels of income, low food and nutrition intake, low levels of physical fitness and immunity, and live with poor housing and sanitation.

Moreover, many of them are involved in high-risk behavior such as smoking, alcohol and drug abuse, as well as high-risk sexual practices. In these circumstances, it is not surprising that many of them are susceptible to infectious diseases, including TB and HIV.

Abundant studies indicate that because of their social and economic marginalization the presence of ignorance, lay beliefs and misconceptions about TB and TB/HIV coinfection are common among these high-risk groups. These beliefs and misconceptions influence their health-seeking behavior and frequently hinder their access to adequate treatment.

Moreover, the stigma and discrimination commonly attached to TB and HIV as well as to people living with TB and HIV further exacerbates their suffering and hinders their access to adequate medical treatment. As an example, the level of adherence to TB medication among the members of the above groups who suffer from TB is so low as to render them susceptible to TB multi-drug resistance.

Numerous studies indicate that to control TB-HIV coinfection, concerted efforts (not limited to biomedical and public health interventions) are needed. In other words, while educating people, particularly vulnerable groups, about the risks and the ways to prevent TB and HIV infection is necessary, it is not sufficient to reduce TB-HIV coinfection if they continue to live with high-risk factors such as poor housing, poor sanitation and poor nutrition.

An increasing number of studies maintain that there is a strong link between poverty, economic inequality and TB, HIV and TB-HIV coinfections. On the one hand, poverty and economic inequality lead to people living with TB-related high-risk factors (poor housing, poor sanitation and poor nutrition) as well as indulging in HIV-related high-risk behavior (having multiple sex partners, low levels of condom use and the sharing of needles and other injecting equipment).TB and HIV coinfection further exacerbate poverty, economic inequality, individual as well as social suffering among the members of these vulnerable groups.

Therefore, concerted efforts in the forms of increased access by vulnerable groups to knowledge and prevention skills, access to TB-HIV medication as well as social and economic interventions to improve access to sufficient educational attainment, employability, income, housing and nutrition are urgently needed. However, many of the above requirements are beyond the control of health authorities.

Thus, active engagement by multiple government agencies, not limited to the health sector, as well as the involvement of the community and civil society is crucial.

(source: www.thejakartapost.com)