29 January 2013 – The United Nations Food and Agriculture Organization (FAO) today warned that the world is at risk of a repeat of the disastrous bird flu outbreak seen six years ago unless countries step up global health measures to monitor and control this and other dangerous animal diseases.

"The continuing international economic downturn means less money is available for prevention of H5N1 bird flu and other threats of animal origin. This is not only true for international organizations but also countries themselves," said FAO Chief Veterinary Officer Juan Lubroth.

"Even though everyone knows that prevention is better than cure, I am worried because in the current climate governments are unable to keep up their guard."

Since 2003, the H5N1 Highly Pathogenic Avian Influenza virus has killed or forced the culling of more than 400 million domestic poultry and caused an estimated $20 billion in economic damage. Although it does not infect humans often, about 60 per cent of those infected with the virus die. Between 2003 and 2011, it infected over 500 people and killed more than 300, according to the World Health Organization (WHO).

Large reservoirs of the H5N1 virus still exist in some countries in Asia and the Middle East, in which the disease has become endemic. Without adequate controls, it could easily spread as it did in 2006, when 63 countries were infected, FAO said in a news release.

"I see inaction in the face of very real threats to the health of animals and people," Mr. Lubroth said, adding that in spite of budget restrictions, countries must invest in preventing the disease to avoid further economic damages.

Appropriate measures can completely eliminate H5N1 from the poultry sector. Domestic poultry are now virus-free in most of the places infected in 2006, including Turkey, Hong Kong, Thailand and Nigeria. In addition, substantial headway has been made against bird flu in Indonesia, after many years of work and international financial commitment.

FAO warned that another growing threat is Peste des Petits Ruminants, or PPR, a highly contagious disease that can decimate flocks of sheep and goats.

"It is currently expanding in sub-Saharan Africa – causing havoc in the Democratic Republic of Congo among other countries – and is just starting to spill over into southern Africa," Mr. Lubroth said. "The irony is that a perfectly good vaccine exists for PPR, but few people are using it."

Some of the reasons for not using the vaccine include tight finances, lack of political will, and poor planning and coordination. To address these, governments must invest in prevention means such as improving hygiene practices, market and border controls, and health security in farms and markets. Countries must also equip laboratories, train staff to diagnose the disease and respond to outbreaks, and organize efficient extension services to serve farmers' needs.

"We need to come together to find ways to ensure the safety of the global food chain," Mr. Lubroth said. "The costs – and the dangers – of not acting are just too high."

(source: www.un.org)

IN 1978, 134 countries, 67 international organizations and many non-governmental organizations participated in an international conference at Alma-Ata, now Almaty, in Kazakhstan, and came up with the Declaration of Alma-Ata.

The declaration reaffirmed the World Health Organization (WHO) definition of health—a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity. This argued that attainment of the highest possible level of health requires the action of socioeconomic sectors, in addition to the health sector.

The Alma-Ata declaration deemed inequity as unacceptable and health as a human right, thus called for "Health for All." From a limited perspective of service delivery—a world only of doctors and hospitals—health was now viewed as an outcome borne out of systematic actions from several actors and stakeholders. Just as it takes a village to raise a child, it takes a health system to ensure health for all.

The WHO defines a health system to consist of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence socioeconomic determinants of health, as well as more direct health-improving activities. It is more than just public hospitals and health-care facilities delivering personal health services. It includes mothers taking care of their sick children, indigenous peoples seeking treatment from traditional healers, and private hospitals and health-care professionals, private and government health-insurance organizations. It includes the Department of Social Welfare and Development making vaccinations and facility-based deliveries as conditions for cash transfers and the Department of Education promoting oral hygiene and hand washing.

The World Bank (WB) states that individuals and organizations, whether public or private, who are regulators, recipients, purchasers, or providers of services and supplies, are all parts of the health system. These many parts are always inter-connected by the key functions of the health system, which are oversight of the whole health system, health-service provision and promotion, health financing, and management of health-related resources, such as pharmaceuticals, medical equipment and health information.

The attainment of health for all, or universal health coverage, thus requires transformation of all the parts of the health system. The WHO explains this as working on the six building blocks, which are as follows: improving health-service delivery; ensuring responsive health work force; setting up functional health-information systems; expanding access to essential medicines; appropriate health financing; and instituting strong leadership and governance.

Similarly, the WB talks about health-system control knobs, and that transformation of health systems would entail finding the right balance of up to where to move each of the control knobs. It means actions on the five control knobs of organization, financing, provider payment, regulation and persuasion.

Both frameworks are consistent with each other, as both challenges countries to do systematic reforms and not just piecemeal, silo-based and limited changes. Until countries start fully realizing that health system matters, the reforms will not be transformational.

In the next months, I will be describing how the Philippines and other countries in Southeast and East Asia and probably the rest of the world are reforming their respective health systems. We will look into how the Philippines and other countries are working to strengthen the building blocks and to find the appropriate mix of the control knobs.

We will look into where we are as to addressing the traditional public-health diseases of tuberculosis and malaria and the other emerging disease, such as dengue and HIV/AIDS. But beyond the usual number of cases, we will assess how various health-system interventions have contributed (or not) to addressing these public-health problems.

We will explore the role of the private sector—from hospitals to ambulatory health facilities, private physicians, pharmaceutical companies and health maintenance organizations in the reforms. We will delve into the role of development partners, bilateral and multilateral agencies in the reforms. We will discuss how public financing, be it from budget or health insurance, is changing behaviors and practices; look into how primary and preventive care and devolution are ensuring access and affordability of services; and many other stories of health system reforms.

Alma Ata correctly diagnosed that health for all needs changes from all of us. And for us to attain the dream of "Health for All," we need all parts of the health system to be transformed.

(source: businessmirror.com.ph)

Britain's National Health Service (NHS) is suffering death by a thousand cuts and faces wholesale privatisation.

The Conservative-Liberal Democrat coalition has demanded a £20 billion cut by 2015 from an overall budget of £108 billion—a reduction that is impossible without slashing essential life-saving services.

So far, only £6 billion in cuts have been made—mostly one-off savings. Much worse is to follow. But staff levels are already being cut by as much as 20 percent and new labour contracts are being imposed with lower wages and higher workloads.

Accident and Emergency departments (over 30 nationally), children's units and other wards and facilities are closing—justified by claims that services and medical procedures can be better provided in specialised units. There are no guarantees that such specialised units will not be swamped by demand, or that lives will not be lost due to the distances involved. Yet the medical director of the NHS, Sir Bruce Keogh, dismisses broad opposition to these changes as pressure to "inhibit excellence" and "perpetuate mediocrity."

The Health and Social Care Act allows private companies to provide health care under the auspices of the NHS and comes in to effect in April 2013. However, this will only escalate a process already underway. The NHS is being bled dry by innumerable private corporations that are fleecing the taxpayer while care is either rationed or denied outright to the chronically ill and the most vulnerable members of society.

On November 13, 2011, Circle Health became the first private corporation to run an NHS hospital. In October 2012, a Freedom of Information request found that in one week alone contracts were signed taking more than 400 community services out of the NHS, including ambulance services, diagnostic testing, podiatry and adult hearing.

Doctors warned that the NHS was being "atomised", with over 100 health care firms now providing basic care under Any Qualified Provider rules. Some private companies already earn up to £200 million a year each from NHS-funded work.

Sixty NHS Trusts face being declared bankrupt in the next four years, threatening hospitals with "rationalisation" or closure. To fend off this threat, trusts must cut budgets and ration or deny treatments declared to be "of limited clinical value". Nearly one in five hip replacements and hernia repairs are already handled by private companies. Soon they will have to be paid for.

Cold hard cash is a major factor in the drive to first gut and then privatise the NHS. It will open up massive revenue streams for private medicine, which previously made up just 8 percent of the health sector and was for decades almost entirely parasitic—a form of glorified queue-jumping for the better-off, using NHS taxpayer-funded facilities and doctors trained at public expense.

The NHS is hated by the ruling class as a symbol of everything they were forced to grant the working class in Britain in the post-war period—the "cradle to grave" welfare reforms—in order to placate demands for social change.

It is even now an object of hatred for the political and business elite in the United States, where bitter denunciations of "socialised medicine" conceal the fact that the NHS is still, thanks to being free at the point of delivery and based on clinical need and not the ability to pay, one of the best in the world for the standard of care provided, while America is one of the worst. This is despite spending nearly £5,000 per capita in the US, compared with just over £2,000 in the UK.

These figures provide some indication of the quality of health care that could be provided under a truly socialist health system, integrated into a socialist economy in which the corporations and banks were publicly owned and democratically controlled.

Working people depend on the NHS for their lives and health and want to fight for it. But, as with all fundamental tasks workers face—the defence of jobs, wages, essential services and benefits—this desire is thwarted at every turn by the trade unions and parties once associated with such struggles.

The Labour Party presided over the creation of the NHS in 1948, but spent 13 years in office from 1997 on undermining it. Privatisation by stealth first began in 1989 with the introduction of the "internal market" by Margaret Thatcher. However, it was the last Labour government that encouraged outsourcing of medical services and used the Private Finance Initiative to build hospitals that cost multiple times their initial outlay, saddling these institutions with massive debts for facilities that often had up to 28 percent fewer beds. Labour is now seeking to pose once again as the friend of the NHS, but this is a worthless fraud.

As for the trade unions, none of them has lifted a finger in defence of jobs and services—confining workers to signing petitions, writing letters to MPs, and participating in campaigns to keep open this or that hospital or unit so that the axe falls somewhere else.

How could it be otherwise? The universal experience of workers the world over is that social democratic parties have become indistinguishable from their conservative counterparts, while the trade unions stifle and betray any and all expressions of resistance to government austerity measures, corporate downsizing and speed-up.

In Greece, the social democratic PSAOK and the Democratic Left sit in government with the conservative New Democracy, presiding over austerity measures that include the near-total collapse of public health care.

The Socialist Equality Party in the UK has initiated the NHS FightBack Campaign, based upon the independent political mobilisation of the working class. The SEP campaign insists:

"The defence of health care and every other basic social right can be taken forward only through a break from the unions and the Labour Party. Action committees must be formed by patients, hospital staff and the workers and youth whose lives and health are being jeopardised. The problem is not a lack of funds or resources, but the monopoly of wealth by the super-rich. This monopoly can be broken only by a mass movement of the working class to bring down the coalition government and replace it by a workers' government based on socialist policies.

"Such a government would carry through a radical redistribution of wealth in favour of working people, which would include ending the obscenity of medicine-for-profit and restoring the health service as a free, high quality state-run facility for all."

This is the basic perspective upon which every fight by the working class in every country must now proceed.

(source: www.wsws.org)

International scientists have declared an end to a moratorium on research into mutant forms of the deadly H5N1 bird flu. Since influenza viruses are constantly changing, research is crucial, WHO's Gregory Härtl told DW.

DW: There has been this open letter in the journal Science and Nature that international scientists are going to lift their voluntary moratorium on certain research. First of all, what's the reaction from the World Health Organization (WHO)? Is this a good or a bad thing?

Gregory Härtl: Well, certainly it's to be expected. We convened a meeting with Dr Fouchier and Dr Kawaoka and others directly involved in this research a year ago, right at the time when this moratorium was announced. And the fact that they have desisted from doing any research on H5N1 for a year now - so twice as long as originally envisaged - has given the influenza and virology world a lot of time to sit back and look at what needs to be done in order to do this research in a surer environment and to do things that can help raise confidence all around.

The moratorium was imposed because of fears that terrorists could get access to what was being researched. Is there any proof to say that the moratorium has worked in that sense - that it's stopped those sorts of things happening?

What basically is at issue here is understanding the benefits and risks of what we call dual-use research. So obviously with something like H5N1 and working to make it more transmissible among mammals, which is what these two studies did, it helps us understand much better how the virus might become more transmissible. And we can maybe develop a better vaccine or we can see markers developing in the environment when we do our studies that will help us to take precautionary and preventative actions beforehand.

Certainly, yes, in the wrong hands, the fear was that this could have been used as a terrorist instrument and this is why a lot of people were looking at it. In the interim there's been a lot of work done on developing laboratory guidelines. There's also been a lot of discussion about what's happened, and the year has given us a lot of breathing space. And it's to be expected that the researchers would start the research again and from a public health point of view it's necessary that they do this.

This open letter is signed by scientists around the world - the US, China, Japan, the UK, the Netherlands, Canada, Hong Kong, Italy and Germany - is there an issue at stake here in terms of the security in laboratories? Has that issue been resolved?

There are guidelines by WHO on how to make laboratories secure and what constitutes a secure laboratory. These regulations are implemented nationally, not by WHO.

But are we seeing cases where those guidelines are not being adhered to? Let's just take the European countries for now.

I would say not - the guidelines certainly would be stuck to.

Foto

So European laboratories are secure. And what we're hearing is that now with the moratorium lifted, we can expect some very creative experiments and creative research. What do you think we can expect?

Let's be realistic here. First of all, laboratory security is very good, it has always been very good. And there will not be anything done overnight which radically changes the way a virus works, so be reasonable.

Be reasonable? But still, what can we expect? There is an expectation still that it's very likely that flu pandemics will break out and that we are still at risk and we still do not have an entirely steadfast resolution for this issue, given that it does always mutate and change. So what would be fair to expect?

What would be fair to expect in Europe is that there are very secure laboratories from which the risk would be extremely small that any virus would escape or get out. So from that point of view laboratory security in Europe is very high. From the point of view of doing research on influenza viruses, it is extremely important to do this research from a public health point of view, because influenza viruses do constantly mutate and we need to know how they mutate and in what way those mutations might make these viruses more transmissible between humans.

Gregory Härtl is with the Director-General's office at the World Health Organization (WHO) in Geneva.

(source: www.dw.de)

22 JANUARY 2013 | GENEVA - The WHO Executive Board, currently holding its 132nd session in Geneva, has appointed Dr Carissa Etienne as the new Regional Director for WHO's Americas Region (WHO/AMRO), following her nomination by the Regional Committee for the Americas in September 2012. Dr Etienne will take up her appointment for a five-year term on 1 February 2013, succeeding Dr Mirta Roses Periago of Argentina.

"I believe strongly that good health is rooted in equity, universality, solidarity and inclusiveness," said Dr Etienne in her acceptance speech. "I have learned that Universal Health Coverage is not only the best way to improve the health of every citizen in a country – but that it is entirely feasible."

Dr Etienne, from Dominica, holds degrees in medicine and surgery from the University of the West Indies as well as a master's in community health and an honorary diploma in public health from the London School of Hygiene and Tropical Medicine.

In her native country she served twice as Chief Medical Officer (in 2000-2002 and 1995-1996), Director of Primary Health Care Services, Disaster Coordinator, and National Epidemiologist in the Ministry of Health. She also served as Coordinator of the National AIDS Programme, Chairperson of the National AIDS Committee, and Medical Director of the Princess Margaret Hospital, and was an Associate Professor at the Ross University School of Medicine.

From 2003-2008, Dr Etienne served as Assistant Director of the Pan American Health Organization, WHO's Regional Office for the Americas, and from 2008-2012 she was Assistant Director-General, Health Systems and Services, at WHO headquarters in Geneva.

In Geneva, Dr Etienne led efforts to renew primary health care (PHC) at the global level and to strengthen health systems based on PHC, promoting integration and improved functioning of health systems. She has also promoted policy directions to reduce health inequalities and advance health for all through universal coverage, people-centred care, the access to safe and effective medical products and technology, the integration of health into broader public policies, and inclusive and participatory health leadership.

The Regional Office for the Americas comprises 38 Member States stretching from the Arctic to the Tierra del Fuego: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Brazil, Canada, Chile, Columbia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, France, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Netherlands, Nicaragua, Panama, Paraguay, Peru, Saint Lucia, St. Vincent and the Grenadines, St. Kitts and Nevis, Suriname, Trinidad and Tobago, United Kingdom, United States of America, Uruguay and Venezuela (Bolivarian Republic of). In addition, Puerto Rico is an Associate Member, while Spain and Portugal are Observer States in the Region.

(source: www.who.int)

21 January 2013 – International cooperation on health is delivering positive results at a time when the world is dealing with multiple challenges such as difficult weather conditions, conflict and economic austerity, a senior United Nations official said today, calling on countries to continue their efforts to improve public health.

"The climate is changing. Antibiotics are failing. The world population keeps getting bigger and older [...] costs are soaring at a time of nearly universal austerity," the Director-General of the World Health Organization (WHO), Margaret Chan, said in her report to the agency's Executive Board in Geneva. "The challenges facing public health are big and increasingly universal, but they are not insurmountable."

Dr. Chan stressed that new challenges need new instruments and approaches, and noted how innovation has allowed for significant progress, reducing the spread of diseases such as meningitis.

As of December, 100 million Africans had received a new conjugate vaccine to protect them from meningitis through a joint WHO project, leading to a dramatic drop in cases in 10 countries, Dr. Chan noted, and a new diagnostic tool for tuberculosis has been made more affordable through financial support from WHO partners, allowing it to be used in more than 70 countries.

Economic uncertainty has led to new health programmes that are equally ambitious while being more mindful of costs to affected countries and the international donor community, she said.

"At a time when funding is precarious, it is particularly encouraging to see how programmes are using new research to set ever higher goals," she said. In particular, she pointed to scientific breakthroughs for HIV, which are more accessible to larger numbers of people at lower costs.

"The range of interventions has expanded dramatically. Safer, more robust antiretroviral therapy is now available even in the world's poorest countries."

WHO is also working with countries to help them make better use of their legislation and regulations to reduce the source of health threats, through treaties such as the first protocol to the WHO Framework Convention on Tobacco Control that was adopted in November and aims to eliminate illicit trade in tobacco products.

The protocol treaty, Dr. Chan underlined, "is a watershed event in its own right. It is also a model of what can be achieved when multiple sectors of government, including trade, finance, the environment, customs, law enforcement, and the judicial system, collaborate in the name of health."

Collaboration from the private sector and non-governmental organizations is also necessary, as they help to increase accessibility and affordability of vaccines and medicines, and raise awareness of health measures, Dr. Chan said.

Private companies have so far committed more than $18 million to strengthen pandemic preparedness and in December one of the three largest manufacturers of influenza vaccines, GlaxoSmithKline signed an agreement with WHO to give the agency access to 10 per cent of its total production of pandemic vaccines, in real time. This means that, as the vaccines roll out of production, every 10th dose goes to WHO for distribution to countries most in need. The company has further agreed to give WHO up to 10 million treatment courses of antiviral medicine.

"These are truly first-time, breakthrough achievements," Dr. Chan said. "They mark the beginning of a new approach to establishing a structured and predictable process for ensuring fair access to medical products during an emergency, and strengthening preparedness."

While much progress has been made, there remains a lot to be done to eliminate diseases such as malaria and polio, and address other pressing health issues, including non-communicable diseases such as diabetes. Commitment, accountability, transparency and continuous engagement are required from Member States to achieve this, Dr. Chan stated, as she asked Member States to continue supporting the agency this year.

"International health cooperation is doing much good, despite a world climate of austerity and adversity. A WHO that performs with greater efficiency and effectiveness will make that good even better."

(source: www.un.org)

The World Health Organization has advised the Jakarta administration to monitor cases of water-borne communicable diseases among flood-affected victims, warning that a delay in treatment could pose more serious health risks.

While the international health body praised the city's quick reaction to set up more than 60 emergency health posts following the intense flooding on Thursday, the WHO reminded officials to ensure people had access to clean water and essential medicines to prevent any possible health outbreaks such as dengue fever.

"Floods do not necessarily lead to an immediate major increase in mosquito numbers, however it is important to track weekly case numbers and provide laboratory-based diagnosis to pick up the early stages of an epidemic," WHO representative to Indonesia Khanchit Limpakarnjanarat told the Jakarta Globe on Saturday.

At least 17 people were reportedly killed during the floods, which displaced 18,000 people from their homes at its peak.

On Friday, the Jakarta Health Agency chief Dien Emawati said up to 8,000 flood victims in Jakarta had complained about a number of flood-related diseases, mainly coughs and colds, muscle aches and skin rashes.

The WHO, which cited diarrhea, skin infections, influenza, conjunctivitis and leptospirosis as common illnesses among flood victims, suggested the Jakarta administration distribute leaflets informing people about how to avoid these diseases.

"It is highly important to inform people that they have to seek medical help or go to the nearest clinic as soon as possible when they or someone around them develops any symptoms like a fever, cough, diarrhea, red eyes, or jaundice," Limpakarnjanarat explained.

As of Sunday, floods receded in most areas, except for places such as Grogol in West Jakarta, Prapanca in South Jakarta and Pluit in North Jakarta.

The National Disaster Mitigation Agency (BNPB) has warned that flooding in the capital could continue until mid-February.

(source: www.thejakartaglobe.com)

The World Health Organization (WHO) 2012 Global Report for Research on Infectious Diseases of Poverty says infectious diseases remain key agents of the debilitating poverty afflicting so much of the world today.

The report, which was made available to the Ghana News Agency on Thursday says, each year these diseases kill almost nine million people, many of them children under five, and they also cause enormous burdens through life-long disability.

It notes that stepping up research into their causes and how to effectively treat them and prevent them from spreading can have an enormous impact on efforts to lift people out of poverty and to build a better world for future generations.

The report outlines ten areas where research on infectious diseases of poverty can make major improvements; these form the framework for the rest of the report.

It also focuses on specific themes: the environment, health systems, and innovation and technology.

Implementation of the actions proposed in this report should help improve current research prioritization processes, guide investment strategies and enhance commitment to using research to promote global health equity.

Like the Millennium Development Goals, these options for action are focused on by policy-makers, funders and researchers, they should lead to well-planned, effective, and powerful health interventions and have a real chance of saving millions of lives in years to come.

The global report for research on infectious diseases of poverty is an independent publication comprising different viewpoints written by expert authors.

It was initiated and facilitated by the Special Programme for Research and Training in Tropical Diseases, supported by the European Commission, and based on wide contributions from stakeholders at various stages of the work.

It offers new ways of improving public health in low and middle income countries, with research as the compelling foundation and driver for policies. GNA

(source: vibeghana.com)