JOHANNESBURG, 30 October 2012 (IRIN) - Countries could save countless lives and greatly reduce health costs if forewarned about climate-sensitive infectious disease outbreaks months in advance: and that is becoming a possibility, according to the Atlas of Health and Climate, a report mapping the links between climate and diseases like cholera, malaria, dengue fever and diarrhoea.

These diseases take the heaviest toll, according to the Atlas, a collaborative effort between the UN's World Health Organization (WHO) and World Meteorological Organization (WMO), and real-time maps showing possible spread could help prevention and treatment efforts. Diarrhoea kills over two million people every year, for example, and malaria kills nearly a million; both are influenced by climate variability.

Data gathering

But the Atlas authors say they still have a long way to go to make such warnings global and reliable.

"We have good real-time weather data, but that is not the case with health data," said Geoff Love, WMO's director of weather and disaster risk reduction. Disease outbreak data in most developing countries is typically collected by hand and often updated weekly. "There are also issues of respecting the privacy of individuals," Love said.

Yet with improvements in computer access, internet connectivity and digital media, health data collectors in deep rural interiors could contribute to regional and global datasets.

The agencies are currently focusing on the health impact of short-term changes in the climate, but the Atlas opens the door to long-term forecasts linked to climate change.

Modest global warming, starting in the 1970s, was causing over 150,000 excess deaths every year by 2000, according to a WHO study looking at the impact of climate-sensitive illnesses like diarrhoeal disease.

Countries, mostly in the developing world, could spend from US$6 million to $18 billion a year by 2030 managing the additional health costs resulting from climate change, a study based on the WHO assessment noted.

The Intergovernmental Panel on Climate Change, an international scientific body, said rising temperatures and the increasing frequency of extreme events could exacerbate malaria, cholera, Rift Valley fever and dengue fever in developing countries.

Raising awareness

Diarmid Campbell-Lendrum, who leads the climate change and health team at WHO and is an author of the Atlas said, "One of the functions that we illustrate through the Atlas is that we can correlate climate and health information in places where we have both, and use the climate data to make health predictions, either for places where we have climate but not health information, or for the future."

Much of the information in the Atlas is not new, says Campbell-Lendrum, but "what we are doing is to connect it together, and make it as accessible and clear as possible to decision-makers, from heads of health and meteorological agencies to field staff in disease-control programmes.

"This also includes the general public, who we hope will become increasingly 'climate-aware' in regards to their health. This is going to become more important as issues such as heat waves become more frequent through climate change, and vulnerability to health impacts increases through ageing, chronic disease rates, etc."

For example, according to the Atlas, heat extremes currently expected to occur only once every 20 years may, by the middle of this century, occur on average every 2 to 5 years. At the same time, the number of older people living in cities - one of the groups most vulnerable to heat stress - will nearly quadruple globally, from 380 million in 2010 to 1.4 billion in 2050. The Atlas also shows seasonal linkages between diseases like meningitis and an increase in dust concentration and reduction in humidity levels in sub-Saharan Africa.

These and other findings make the case for more computer-generated climate models for tropical and waterborne disease outbreaks, says Campbell-Lendrum. There are very few, if any regional or country-level climate-change projections of possible diseases in developing countries.

"We already have many research studies in this area, but very few are converted into early warning systems or risk maps that are actually used for health decision-making," he added.

WMO's Love said, "The Atlas is more of an advocacy document at this stage."

(sumber: irinnews.org)

NEW DELHI: The warning is ominous — climate change and global warming will make vector-borne diseases like dengue and malaria - already causing havoc in the country more lethal.

A landmark report on climate change and health, published by the World Health Organization on Monday, said that in the last 100 years, the world has warmed by approximately 0.75 degree Celsius. Over the last 25 years, the rate of global warming has accelerated, at over 0.18 degree Celsius per decade.

Global health will suffer a loss of $2 billion-$4 billion per year by 2030 due to climate change.

Global warming, which has occurred since the 1970s, caused over 1.4 lakh excess deaths annually by 2004.

"Many of the major killers such as diarrhoeal diseases, malnutrition, malaria and dengue are highly climate-sensitive and are expected to worsen as the climate changes," said WHO.

It added, "Malaria is strongly influenced by climate. Transmitted by Anopheles mosquitoes, malaria kills almost one million people every year. The Aedes mosquito vector of dengue is also highly sensitive to climate conditions. Studies suggest that climate change could expose an additional 2 billion people to dengue transmission by the 2080s."

WHO said over the last century, the surface area on which malaria remains a risk has been reduced from half to a quarter of the earth's landmass, but due to demographic changes the number of people exposed to malaria has increased substantially over the same period.

Estimates of cases and deaths differ greatly: the number of cases stands between 200 million and 500 million, while the death estimate is around one million per year.

Dengue has become the most rapidly spreading mosquito-borne viral disease in the world.

It is estimated to cause over 50 million infections and around 15,000 deaths annually in around 100 countries.

"Infection could range from a mild flu-like fever to the potentially fatal severe dengue, which particularly affects individuals who are exposed to one of the four different strains of the virus as a secondary infection. Heavy rainfall can cause standing water, while drought can encourage people to store more water around the home, both providing breeding sites for Aedes mosquitoes. Warm temperatures increase the development rates of both the mosquito vector and the virus, fuelling more intense transmission," the report said.

Extreme high air temperatures contribute directly to deaths from cardiovascular and respiratory disease, particularly among senior citizens.

High temperatures also raise the levels of ozone and other pollutants in the air that exacerbate cardiovascular and respiratory disease. Urban air pollution causes about 1.2 million deaths every year.

Pollen and other aeroallergen levels are also higher in extreme heat.

These can trigger asthma, which affects around 300 million people. Ongoing temperature increases are expected to increase this burden.

WHO added that globally, the number of reported weather-related natural disasters has more than tripled since the 1960s.

Every year, these disasters result in over 60,000 deaths, mainly in developing countries, it says.

In 2011, 332 disasters from natural hazards were recorded in 101 countries, causing more than 30,770 deaths, and affecting over 244 million people.

Recorded damages amounted to more than $ 366.1 billion. "Over the past 30 years the proportion of the world's popu-lation living in flood-prone river basins has increased by 114% and those living on cyclone-exposed coastlines by 192%. Reports of extreme weather events and disasters have more than tripled since the 1960s," it added.

(sumber: economictimes.indiatimes.com)

TB, which cannot be cured with conventional drugs, is spreading in Eastern Europe. So far, strategies to fight the disease have shown little success because it is closely linked to poverty and exclusion.

Two years ago, most addicts in Eastern Europe died from a overdose or committed suicide; today, more and more of them are dying from multi-resistant tuberculosis (TB).

"The leading cause of death for people we treat is TB," says Daria Ocheret, who has worked with addicts in the Lithuanian capital Vilnius for 10 years. "And most of the time, it is multi-resistant tuberculosis."

For many people, TB is a disease that was eradicated in the last century. But the fact is the disease has returned and is more dangerous than ever. Multi-drug resistant TB complicates the treatment of patients worldwide.

The past several years has seen the rise of strains that are resistant not only to conventional antibiotics but nearly to all medicines. The World Health Organization (WHO) estimates that more than 400,000 people are suffering from multi- or extremely-resistant TB.

Former Soviet states at high-risk

The former Soviet Union is especially at risk in Europe. Around 80,000 people with resistance to conventional TB medicines live in former Soviet states – a fifth of all cases worldwide, according to the WHO. A total of 15 European countries are considered high-risk, including Russia, Ukraine, Belarus, Bulgaria, and Moldavia as well as the Baltic states.

Germanyis interested in the situation in these countries, according to Barbara Hauer, an infections disease expert at the country's disease prevention and control authority Robert Koch Institute.

"We have to wait and see how the developments in other countries affect Germany in the long term," she says. "The rates are at a low-level, but we need to keep an eye on the number of cases.

Hauer estimates that Germany has around 50 cases a year.

Inadequate diagnosis

Normally, TB patients receive four to five antibiotics, which they have to take for six months. Resistance develops when patients don't take their medicine or the treatment ends earlier. Up to 17 tablets can be required to treat resistant TB, which can lead to deafness. And the costs can exceed normal TB treatment by more than a hundred times. If multi-resistant TB is not treated properly, there is a danger of extremely resistant strains.

That's why it's necessary to carefully monitor current and former patients, according to Andrei Dadu from WHO's European office.

But the actual number of known cases of resistant TB is "still at a very low level," he says, adding that "if we don't find the number of infected people, others could get infected."

Dadu believes more money should be invested in diagnostic techniques in high-risk countries.

Last year, the WHO allocated more than $400 million (309 million euros) alone for countries in Europe at risk of TB. The money is to be used, among other things, for producing diagnosis equipment designed to identify strains within an hour through DNA analysis. By 2015, the WHO budget could rise to almost $2 billion. The Global Fund to Fight AIDS, Tuberculosis and Malaria has set aside a similar amount of money.

Despite the funding, less than a third of suspected cases of multi-drug resistant TB are found and only two-thirds of the discovered cases are treated adequately. Plenty of necessary infrastructure is also lacking, such as hospital beds and labs, in addition to diagnostic equipment.

Lack of understanding

There is often a lack of understanding for TB in society, such as a willingness to accept HIV-positive prisoners and drug addicts, according Daria Ocheret.

"Almost every person who died from TB in Russia over the past 10 years was HIV positive and addicted to drugs," she says.

There is a simple reason, she adds, why these people have not been diagnosed or treated – drugs are illegal and addicts fear being sent to prison or a long stay in the hospital without drugs or substitutes, as is the case in Russia.

"A lot of them leave," Ocheret says. "Or they are thrown out after being caught with drugs. So they stop the treatment and increase the chances of developing and spreading multi-resistant TB."

The solution, she believes, would be to link help for addicts to TB treatment. Those who receive anti-addiction drug methadone must also be given TB drugs regularly.

But a joint proposal of initiatives for drug prevention has failed, partly due to the public health structures in Ukraine, Russia, and Belarus. And the WHO argues Central Asian countries like Azerbaijan and Kazakhstan lack a political will to take action.

At the end of this year, the Global Funds wants to base the allocation of funds on a country's TB burden and the average per capita income.

(sumber: www.dw.de)

A senior official at the Indonesian health ministry said that the government has requested a two-year extension to allow it to implement an international health regulation previously agreed with member states of the World Health Organization (WHO), local media reported on Wednesday.

On June 15, 2007, Indonesia adopted the 2005 International Health Regulation (IHR) and agreed to a five-year timeframe to implement the regulation.

Under the agreement, governments are required to take steps to strengthen their core capacity to detect and prevent the potential for the rapid, global spread of disease and chemical and radioactive contamination.

"We need more time to prepare the full implementation of the IHR 2005 partly due to lack of human resources with broad technical expertise in surveillance and response," said Deputy Health Minister Ali Ghufron Mukti.

The 2005 agreement is binding to all WHO member countries, including Indonesia.

The agreement requires that each protection effort should be based on the principle of "maximum protection with minimum restriction both on trade and international travel."

"The expanded 2005 IHR mandate not only measures the prevention of the global spread of infectious disease, chemical and radioactive contamination, but also coordination and information sharing in detecting risks that may lead to public health emergencies of international concern," Ali said, quoted by the Jakarta Post.

To support the implementation of the 2005 IHR, he said, the government established the National Commission for the 2005 IHR Implementation, with representatives from relevant ministries and institutions as members.

The 2005 IHR was set up following the outbreak of Severe Acute Respiratory Syndrome (SARS) in February 2003. The SARS pandemic prompted the revision of the IHR as it caused deaths and significant economic losses.

The international community has used the 2005 IHR to deal with the H1N1 virus, or swine flu outbreak in 2009 and other public health emergencies that occurred afterward.

Providing KKP (Port Health Agency) officers with leadership and technical training was included in the 2005 IHR's plan of action.

"KKP officers working at sea ports, airports and cross border posts are at the front of efforts to protect the country from any threats of infectious disease and chemical and radioactive contamination coming from outside. So, it's important to empower them," said Ali.

(sumber: globaltimes.cn)

Indonesia's Minister of Health, Nafsiah Mboi, pledged to scale up HIV testing and treatment programmes, leading to zero new HIV infections and zero AIDS-related deaths. Minister Mboi met with UNAIDS Executive Director, Michel Sidibé on Tuesday, on the first day of his two day trip to Indonesia.

Indonesia is one of several countries in Asia where new HIV infections are growing. The Ministry of Health estimates that more than 600 000 people are living with HIV and that there are more than 76 000 new HIV infections each year. Currently HIV treatment coverage is at less than 20%.

But, Minister Mboi promised a new approach to the country's AIDS response. She said she will ensure that everyone will know their HIV status and have access to HIV treatment. Health authorities will focus on 141 districts where key affected populations are the highest. Indonesia's epidemic is concentrated on key populations at higher risk such as drug users, sex workers and their clients and men who have sex with men.

Indonesia is taking an active role in the AIDS response in Asia. As chair of the last year's ASEAN (Association of South East Asian Nations) summit the country pushed for the adoption of the ASEAN Declaration of Commitment in Getting to Zero New HIV Infections, Zero Discrimination and Zero AIDS-related deaths.

Indonesia also plans to become one of three countries in the region to offer universal health care by 2014. The Ministry of Health says that HIV treatment will be included in the health coverage.

"Indonesia is a key partner in the drive to end the AIDS epidemic," said Mr Sidibé. "Universal health coverage is a game changer for Indonesia. I am delighted to know that HIV treatment will be included in this national programme. This sets the stage for sustainable funding of HIV programmes."

Domestic investments in the HIV response have been increasing significantly in Indonesia since 2010, but there still is a large funding gap and in 2015 Indonesia will no longer be eligible for funding from the Global Fund to Fight AIDS, Malaria and Tuberculosis.

"Indonesia is trying to ensure the sustainability of HIV care for people living with HIV once donor countries stop giving funds," said Minister Mboi. "The Ministry of Health is preparing an exit strategy. We plan to cover 100% of the HIV treatment by the national government budget," she added.

Health authorities are increasing efforts to focus HIV programmes on communities that need the most attention. The sharing of needles among people who use drugs has been one of the drivers of the HIV epidemic in Indonesia. Since 2009, the Directorate General of Corrections says it has scaled up its HIV programmes at 149 corrections facilities in 25 provinces.

Mr Sidibé toured the Narcotics Prison Cipinang in East Jakarta, which is one of eleven model prisons implementing a comprehensive AIDS programme. He met with prison authorities and then went on a tour of the prison, visiting the clinic where antiretroviral treatment and methadone services are provided. He also toured the occupational training centre where inmates learn new skills including baking, sewing and handicrafts.

"My visit today shows that even in prisons we can restore the dignity of people," said Mr Sidibé. "Prison can be a transformative experience. The Indonesian government is showing great innovation and courage with its remarkable harm reduction and HIV programme in prisons. I hope the programme inspires other countries to show the same entrepreneurship," he added.

On Tuesday, the Ministry of Health hosted a dialogue between Mr Sidibé and faith based organizations, including Islamic, Christian, Hindu, Buddhist and Confucian religious groups. Religious leaders are important community members and their cooperation is key to ensuring support for HIV prevention, treatment and care. The leaders agreed that faith based organizations need more education and training in HIV issues, so that they can help their communities.

Anggia Ermarini, Health Unit Secretary of Indonesia's Ulama Council, the country's Muslim clerical body said, "Many religious leaders do not understand about AIDS. We want the United Nationsto to tell us about the situation in our country."

Franz Magnis Suseno, a Jesuit priest from the Institute of Philosophy Driyakara said that he thought that religious organizations needed to start to educate people about sexuality. He said there was a high resistance to sex education but that it was necessary.

Mr Sidibé is in Indonesia at the start of a three country trip to Asia, where he will also visit Myanmar and Thailand.

(sumber: unaids.org)

Starting with Malaysia in 2003, many Asian countries are now taking action to promote cheaper medicines through compulsory licensing, with Indonesia being the latest case.

RECENT government actions by Indonesia and India to issue compulsory licences is extending the trend in Asia to increase access to cheaper medicines to treat serious ailments, especially HIV/AIDS, cancer and Hepatitis B.

The supply of generic medicines, either through import or local production, has been the major method of reducing prices and making the drugs affordable to more people.

When the required medicines are patented, which usually results in high prices, governments are allowed by the WTO rules to issue a compulsory licence to enable themselves or private companies to import or produce generic versions, which usually cost much less.

In 2003, Malaysia became the first developing country to issue a compulsory licence to a local firm to import drugs to treat HIV/AIDS from India.

Following this, Indonesia in 2004 issued a presidential decree enabling the production of some HIV/AIDS drugs while Thailand in 2007 issued compulsory licences for several HIV/AIDS and cancer drugs.

In March, India approved its first compulsory licence enabling a local company to produce a generic version of an anti-cancer drug, which could reduce the price of treating kidney and liver cancer from US$5,200 (RM15,600) a month (the price of the branded product) to US$160 a month (RM480) (the price of the generic product).

The latest measure was taken on Sept 3 by Indonesian President Susilo Bambang Yudhoyono who issued a decree which has the effect of a compulsory licence.

It enables local manufacturers to make, import and sell generic versions of seven patented drugs used for treating HIV/AIDS and Hepatitis B.

The decree said that in line with the urgent need to control HIV/AIDS and Hepatitis B in Indonesia, "it is necessary to continue and expand the access policies to provide access to anti-viral and anti-retroviral medicines still protected by patent".

This is the third time Indonesia has issued a set of compulsory licences.

The latest decree stated that the 2004 and 2007 decrees were no longer sufficient to implement the policies.

The compulsory licence is aimed at significantly reducing the prices of these life-saving medicines and making them accessible to thousands more Indonesian patients.

"We will ensure the availability of good quality, safe and effective generic versions of anti-retroviral and anti-viral drugs," said HM Subuh, infectious disease control director at the Indonesian Health Ministry, as quoted in The Jakarta Post on Oct 19.

According to the decree, the generic companies would have to pay a royalty of 0.5% of the net sales value of the generic drugs to the companies that own the patents such as Merck, Glaxo SmithKline, Bristol Myers Squibb, Abbott and Gilead.

The latest decree enables the supply of generic anti-retroviral products for not only better first but also second-line anti-retroviral therapy.

"With the 2012 regulation, we obviously can improve access to quality but affordable drugs," Maura Linda Sitanggang, the Health Ministry's director-general for pharmaceuticals and medical equipment, told The Jakarta Post.

"We're using this mechanism concerning public interest on the production of quality but affordable medicines to treat HIV and HBV."

The seven medicines which are the subject of the compulsory licence (known in this case as for "government use") are efavirenz, abacavir, didanosin, lopinavir+ritonavir combination, tenofovir, tenofovir+emtricitabine and tenofovir+emtricitabine+efavirenz. All the drugs are used to treat HIV/AIDS.

The drug tenofovir (brand name Viread produced by patent holder Gilead) is also used to treat Hepatitis B, which affects 13 million people in Indonesia.

It had been approved in the United States for treating HIV/AIDS in 2001 and for treating chronic Hepatitis B in 2008.

The combination drug tenofovir+emtricitabine (brand name Truvada, produced by Abbot) is taken in a single dose once a day.

It has been used to treat HIV/AIDS and in July 2012 it also became the first drug approved by the US Food and Drug Administration for use as a preventive measure, to reduce the risk of HIV infection for people at high risk, including those who may engage in sex with HIV infected patients.

In India, the patent office in March approved the country's first compulsory licence to local firm Natco Pharma to make a generic version of the cancer drug sorofenib tosylate (brand name Nexavar, produced by Bayer).

The drug is used to treat advanced kidney and liver cancer.

According to the terms of the licence, Natco would pay Bayer royalties of 6% of its net sales.

Bayer challenged the compulsory licence and on Sept 16 the Intellectual Property Appellate Board rejected its petition, ruling that "if a stay is granted it will jeopardise the interests of the public who are in need of the drug".

Other developing regions have also been making use of the compulsory licence option in the WTO's intellectual property treaty known as TRIPS.

They include Brazil and Ecuador in Latin America and Kenya, Zambia and Zimbabwe in Africa.

In 2001, the WTO's Ministerial Conference in Doha adopted a TRIPS and Public Health Declaration that asserted that the TRIPS Agreement does not and should not prevent members from taking measures to protect public health.

(sumber: thestar.com.my)

Washington, D.C., 18 October 2012 (PAHO/WHO)--Professionals in the fields of health and information sciences will participate in the Ninth Regional Congress on Health Sciences Information (CRICS9), organized by the Pan American Health Organization/World Health Organization (PAHO/WHO) and their affiliated Latin American and Caribbean Center on Health Sciences Information (BIREME), this coming October 22 to 24 in Washington, D.C.

Focusing on the theme "e-Health: Reaching Universal Access to Health, " the participants will share experiences and updates on current programs, projects, and health science information and communication systems and networks in the Region. Topics relevant to public health will also be considered in the keynote address and other speeches, as well as at round tables, on panels, and in tutorials based on the meeting's five thematic tracks: information for decision-making in health, strategies and public policies, information and communication technologies, telehealth, and capacity-building.

eHealth can contribute to the sustainable development of health systems, better access to services, and improved service quality through the use of information and communication technologies (ICT), training in computer and ICT literacy, access to evidence-based information, and continuing and distance education.

The opening ceremony, to be chaired by Dr. Mirta Roses Periago, Director of PAHO, will take place on 22 October at 9:00 a.m. The speakers at this session will be Marcelo D' Agostino, Manager of Knowledge Management and Communications at PAHO; Adalberto Tardelli, Director of BIREME and Chair of CRICS9; Francis Collins, Director of the United States National Institutes of Health; and Georges Benjamin, Executive Director of the American Public Health Association.

The sessions will be held at the headquarters of the Pan American Health Organization in Washington, D.C., and include presentations on the PAHO/WHO eHealth strategy approved by the Member States of the Organization in 2011; information management in emergencies and disasters; Public eHealth, Innovation, and Equity in Latin America and the Caribbean (eSAC Project); and telehealth applied to primary health care in Brazil.

CRICS9 will be preceded on 20-21 October by the 6th Meeting of Regional Coordination of the Virtual Health Library (BVS6), which will also focus on the theme of eHealth. This event will be an in-person forum for sharing experiences and knowledge among members of the network of health-providing institutions, intermediaries, and users of scientific and technical health information from the Virtual Health Library (VHL). The participants, to be divided into three working groups, will discuss management and collaborative networks, information products and services available on the VHL, and technology and interfaces.

The concept "eHealth" encompasses electronic medical records (or electronic clinical histories), telehealth (including telemedicine), mHealth (health via mobile devices), eLearning (including distance training or learning), continuing education in information technology and communication, and standardization and interoperability between different technologies and software applications to allow data to be exchanged effectively, accurately, and reliably.

The CRICS series was initiated in 1992 during the meeting of the then representatives of the 37 countries that comprised the Latin American Health Information System, known today as the VHL Network. It was intended to be an innovative encounter bringing together experts in the fields of scientific information and communication, knowledge management, information methodologies and technologies, and their applications for the development of health research, education, and service delivery systems. Brazil, Costa Rica, Cuba, and Mexico have been host countries of CRICS in the past.

(sumber: www.thebahamasweekly.com)

Did it surprise anyone when in handling the Influenza A H1N1 crisis in 2009, the World Health Organization limited itself to informing us about what stage the outbreak was reaching until it became a full-blown pandemic? Does it surprise anyone today that the WHO does not recommend travel restrictions to Madeira, where a Dengue Fever epidemic is in full swing?

Remember Swine Flu (Influenza A H1N1)? It was first reported in Mexico in April 2009, received a World Health Organization Phase 5 label within a week, by early May had passed all the criteria to receive a Phase Six alert (Pandemic) but this was only announced on June 11. Why? Why were travel restrictions not set in place from the outset? By the time the WHO made its tardy announcement, there were laboratory-confirmed infections in 74 countries in all the WHO Regions.

Nice for whom? Why the Pharma lobbies, of course, eager to sell their (hastily-put-together) vaccines, the results of which are still hotly debated. The Surge Response Capacity, at the WHO level, which should have been the highest, appeared to be, on the contrary, the lowest, if not totally invisible. And this, despite the WHO's own guidelines that containment is the best policy to follow through Phases one to three, and mitigation after phase four (because the disease has already spread so widely that containment is no longer effective, and the approach is replaced by early detection and treatment).

The WHO Phases

Phase 1: A virus in animals has caused no known infections in humans.

Phase 2: An animal flu virus has caused infection in humans.

Phase 3: Sporadic cases or small clusters of disease occur in humans. Human-to-human transmission, if any, is insufficient to cause community-level outbreaks.

Phase 4: The risk for a pandemic is greatly increased but not certain.

Phase 5: Spread of disease between humans is occurring in more than one country of one WHO region.

Phase 6: Community-level outbreaks are in at least one additional country in a different WHO region from phase 5. A global pandemic is under way. (*)

In the case of A H1N1, the WHO announced already on April 27, 2009, that the outbreak had reached levels that no longer justified containment (Phase 4). The question remains, had proper containment policies been put into place from the beginning of the outbreak, would A H1N1 have ever become a pandemic? Let us add a tag to the same question, would Glaxo-Smith-Kline's Relenza (zanamivir) and Roche Holdings' Tamiflu (oseltamivir) have sold so many millions of doses of their medication to limit symptoms (not infections)?

The side effects of these medicines are well documented, giving rise to another question: was their distribution hastily implemented, inadequately researched and hurried through from the laboratory to the doctors' surgeries without the proper systems of control? Why were billions of dollars spent in obtaining these medicines, only for up to half the stocks in some countries to have been destroyed (in 2012)?

It therefore comes as no surprise that the World Health Organization, today, does not recommend any travel restrictions to the Isle of Madeira, where Dengue Fever is endemic and has manifested itself in dozens of cases in recent weeks.

One wonders what the WHO will do when a new strain of flu, such as A H5N1, Avian Flu, finally manages to make the species leap and become transmitted from human to human. This highly pathogenic strain of the Influenza A virus has a mortality rate of up to 50 per cent, making it far worse than the Black Death.

May we postulate a scenario? The World Health Organization will inform us that a novel human-to-human transmitted strain of A H5N1 has appeared in (Laos) and will post symptoms on its website, along with the sentence "There is to date no vaccine or treatment for this strain, apart from the normal healthcare procedures implemented when treating Influenza". Phase 2 and Phase 3 will be announced within three days, within a week we will receive a shrug and a gesture of hopelessness with outstretched arms and the admission that the virus has spread so widely (Phase 4) that containment is no longer effective (when containment was never properly implemented).

Two major Pharmaceutical companies will announce that they have developed not only vaccines but also medication to reduce the severity of the symptoms, only this time we might not be so lucky. Half the world's population may die and a global economic crisis such as never been seen before may make the market-oriented capitalist model's banking and economic crises look like child's play.

(sumber: english.pravda.ru)