On April 7, World Health Day, India's Prime Minister Narendra Modi tweeted "Govt is working tirelessly to realise the dream of a Healthy India where every citizen has access to proper & affordable healthcare."

To back up that claim, India started its first national air quality index on Monday, belatedly following a World Health Organization (WHO) report last May that found 13 of the world's 20 most air-polluted cities are in India. Of the 1,600 cities studied, the Indian capital New Delhi had the world's dirtiest air with an annual average of 153 micrograms of small particulates (PM2.5) per cubic meter. According to the WHO, a shocking 627,000 Indians die each year due to pollution. The new index will initially cover ten cities and will subsequently be extended to 60. There are already around 247 Indian cities that have some air-quality monitoring mechanisms in place, including at least 16 with online real-time monitoring capabilities, but the "voluminous data" is often hard for people to understand. Government officials say the new index will track eight pollutants and then provide one consolidated number with color-coded associated health impacts, which will all be displayed online. The public can then see whether it would be safer to stay indoors or to refrain from strenuous activity outdoors, notes the BBC. But aside from issuing new rules on the disposal of waste from construction work (a major source of air pollution), the government has not done much to actually reduce air pollution.

More promising is Indradhanush, a massive immunization campaign aimed at inoculating 90% of the country's children against seven preventable diseases by 2020. It began on Tuesday and will run through July. Health officials said the campaign would focus on diseases for which vaccines are available, including diphtheria, whooping cough, tetanus, measles, hepatitis B, and Japanese encephalitis. The Indian government provides free immunizations through its national public health system, yet overall vaccination rates in the country remain frustratingly low. Only 44% of children aged 1 to 2 years have received basic inoculations, with significantly less in rural districts, according to a National Family Health survey. And while India has made enormous strides in the past few decades in reducing mortality from these diseases, there is still far more work to be done.

Another sector in which India lags behind is food safety – the theme of this year's World Health Day. The WHO has calculated that nearly 700,000 people die each year in South Asian countries alone from contaminated food and water. Toxic pesticides and antibiotics are the norm rather than the exception in food. The Centre for Science and Environment (CSE) said on Tuesday that pesticide use and management in India is largely unregulated, and food contaminated with pesticide residues is freely used by unsuspecting consumers. "Pesticides are linked to long-term health effects such as endocrine disruption, birth defects and cancer. Besides raw agriculture produce, pesticides have been found in packaged food products such as soft drinks, bottled water and in human tissues in India," CSE noted. And while street food's microbiological contamination is a concern, just as troubling is its most common replacement — processed and packaged food full of chemical additives whose long-term risks are unknown, as well as sky-high levels of salt, sugar, and fat.

Modi's "Make in India" campaign needs to be joined by a "Make India Healthy" campaign.

source: http://blogs.blouinnews.com/

World Health Day is April 7, and people around the globe are turning their attention to health issues. The global infant mortality rate of 33.6 deaths per 1,000 live births in 2013 has followed a long-term downward trend. Similarly, life expectancy has improved dramatically in recent decades. The improvements were uneven, however, and health conditions continue to vary widely between nations.

In order to assess the overall state of a country's health, 24/7 Wall St. reviewed a host of factors broadly categorized as health indicators, access measures, or the economy. The healthiest country, Qatar, led the countries reviewed with the highest overall score, while the least healthy country, Sudan, received the lowest score. These are the most and least healthy countries worldwide.

Negative health outcomes were far less common in the healthiest countries than in the least healthy ones. Chief among them, life expectancy, tended to be far higher in the nations with the strongest overall health measures. Life expectancy at birth in all of the healthiest countries exceeded the global expectancy of approximately 70 years. A child born in Iceland is expected to live longer than 80 years, the highest life expectancy in the world.

According to Gaetan Lafortune, senior economist at the OECD Health Division, life expectancy is perhaps the best way to measure the health of a nation. However, a range of indicators is necessary to capture the complex picture of a national population's health. Similarly, no single measure can explain a health outcome like life expectancy. Rather, only a wide range of behaviors, infrastructure characteristics, and economic factors can explain the strong or weak health outcomes in a nation.

For example, seven of the healthiest nations reported less than 10 incidents of tuberculosis per 100,000 people in 2013, a fraction of the global rate of 126 incidents of tuberculosis per 100,000 people. While lung diseases and other poor health outcomes were far less common in these nations, risk factors such as smoking were not necessarily less prevalent. The residents of the healthiest nations were actually more likely than most nations reviewed to report a smoking habit.

The quality of a nation's infrastructure and health system are closely related to a low prevalence of disease. Doctors were far more available in the healthiest countries than in the least healthy ones, for example. The prevalence of physicians in seven of the healthiest countries was at least double the global ratio of 1.52 physicians per 1,000 people. In all of the least healthy countries, on the other hand, there was less than one doctor per 1,000 people.

The quality of infrastructure is also very important for the health of a country's residents. "Access to clean water in particular is absolutely crucial to avoid all sorts of diseases that lead to death for children and adults," Lafortune said. In all of the healthiest countries, drinking water is treated before it reaches residents' homes In half of the least healthy countries, less than half of the drinking water consumed in rural areas was treated.

Health care spending and the availability of resources are also major determining factors of nationwide health. As Lafortune noted, "It is not too good for your health to be poor." Poor people — in any country — will be in worse health and live shorter lives than rich people.

All of the healthiest nations spent more than $2,000 per capita on health annually, versus the global expenditure of just over $1,000 per capita. With only one exception — Equatorial Guinea — the least healthy nations spent far less than the global figure. In fact, health care expenditures in seven of the least healthy countries was less than $100 per capita.

Of course, high spending does not guarantee strong health outcomes. Annual health spending in the United States totalled $8,895 per capita, more than the spending of all but two other countries reviewed. Yet, the health of U.S. residents was rated worse than 33 other nations.

As Lafortune explained, the return from health spending is far higher in countries already spending very little. For example, immunization rates — which were as low as 25% in the Central African Republic for measles — can be increased dramatically with little resources. "As spending goes up, what becomes more important is the efficiency of the spending," Lafortune said.

In many of the least healthy countries, living conditions are so poor that "unhealthy" may actually be an understatement. Recent regional violent conflicts may account for a country's exceptionally low life expectancy much more than other unhealthy behaviors, for example. Four of the least healthy countries — Mozambique, Guinea-Bissau, Yemen, and Sudan — have all been through at least one civil war since 1990. Haiti, while not exactly war torn, is still recovering from a devastating earthquake in 2010 as well as a cholera epidemic that emerged in the aftermath of the natural disaster.

These are the most healthy countries in the world.

10. Australia

> Life expectancy: 79.9 (5th highest)
> Infant mortality rate (per 1,000 live births): 3.4 (21st lowest)
> Health expenditure per capita: $6,140 (6th highest)
> Unemployment rate: 5.7% (58th lowest)

Based on an assessment of healthy behaviors and outcomes, access to health services, and various economic factors, Australia is the 10th healthiest country in the world. The country's strong national health care system compared to most countries largely explains its ranking. There were about 3.3 physicians per 1,000 Australians in 2011, the 26th highest such ratio out of the 174 nations reviewed, and well more than twice the global prevalence of just over 1.5 physicians per 1,000 people. In addition, annual health spending totalled $6,140 per capita, sixth highest of all countries reviewed and nearly six times the global expenditure of $1,030 per capita. Partly as a result, country residents had among the world's longest life expectancies at nearly 80 years in 2012. However, Australia also had a relatively high obesity rate, at 28.6%, and a relatively high alcohol consumption rate.

9. Sweden

> Life expectancy: 79.9 (5th highest)
> Infant mortality rate (per 1,000 live births): 2.4 (8th lowest)
> Health expenditure per capita: $5,319 (10th highest)
> Unemployment rate: 8.1% (62nd highest)

Like in most of the healthiest countries, Sweden has universal health coverage, with patient fees covering only a very small percentage of health costs. The country's annual health expenditures totalled $5,319 per capita, the 10th highest spending worldwide. The high health care spending and strong coverage have resulted in good health outcomes compared to most countries. There were just two infant mortalities per 1,000 live births and four maternal deaths per 100,000 live births in Sweden, both nearly the lowest such rates worldwide. Swedes also live longer than most people, with a life expectancy at birth of roughly 80 years. Compared to other healthy countries, however, Sweden's 2013 unemployment rate of 8.1% was relatively high.

8. Singapore

> Life expectancy: 79.9 (5th highest)
> Infant mortality rate (per 1,000 live births): 2.2 (5th lowest)
> Health expenditure per capita: $2,426 (22nd highest)
> Unemployment rate: 2.8% (13th lowest)

The small island nation of Singapore has a remarkably strong economy. Less than 3% of Singapore's workforce was unemployed in 2013, one of the lowest unemployment rates worldwide. Also, Singapore's GDP per capita of $55,182 in 2013 was one of the higher economic outputs worldwide. In addition to a strong economy, Singapore fares especially well in health measures. The nation's obesity rate of 6.2% was among the lower rates worldwide, and especially low compared to the healthiest countries. A child born in 2013 was also expected to live roughly 80 years, tied for the fifth highest life expectancy worldwide. While the city-state's health care system is universal, like many other especially healthy countries, it is a unique system. Residents are subject to a forced savings rate, and funds for medical expenses are saved in a Medisave Account. Catastrophic health insurance enrollment is automatic for all residents as well, although people can opt out.

7. Austria

> Life expectancy: 78.4 (20th highest)
> Infant mortality rate (per 1,000 live births): 3.2 (15th lowest)
> Health expenditure per capita: $5,407 (9th highest)
> Unemployment rate: 4.9% (45th lowest)

Health care spending in Austria totalled about $5,400 per capita annually, ninth highest out of all countries reviewed. Like many other healthy countries, the relatively high level of health care expenditure helps increase the number of physicians and quality of health care. There were nearly five doctors per 1,000 Austrians in 2011, the fourth highest ratio globally. As in most of the healthiest nations, the Austrian government controls most functions of the country's health care system. While Austria is one of the healthiest countries, nearly half of adult Austrians reported a smoking habit in 2011, one of the higher smoking rates worldwide.

6. Iceland

> Life expectancy: 81.6 (the highest)
> Infant mortality rate (per 1,000 live births): 1.6 (tied-the lowest)
> Health expenditure per capita: $3,872 (16th highest)
> Unemployment rate: 5.6% (56th lowest)

Iceland, by population, is the smallest of the 10 healthiest countries. Iceland is the sixth healthiest country worldwide partly because it had the highest life expectancy, which at 81.6 years was also a full year longer than Switzerland, the country with the second highest life expectancy. About 18% of adult Iceland women smoked, the 88th highest rate of all countries, while 19% of all adult males smoked, 17th highest of all countries. Iceland also had the lowest infant mortality rate, at just 1.6 deaths per 1,000 live births. Iceland's low infant mortality rate came even though a relatively low 91% of children aged 12 to 23 months received DPT — diphtheria, pertussis (whooping cough), and tetanus — and measles vaccines.

5. Japan

> Life expectancy: 79.9 (4th highest)
> Infant mortality rate (per 1,000 live births): 2.1 (3rd lowest)
> Health expenditure per capita: $4,752 (11th highest)
> Unemployment rate: 4.0% (32nd lowest)

With 127 million people, Japan is the most populous of the 10 healthiest countries in the world. Ironically, it had the highest death rate of the top 10 countries, at 10 per 1,000 people. About one quarter of the nation's population was over 65 last year, a testament to the longevity and health of Japanese people. One factor contributing to the strong overall health rating is Japan's adult obesity rate of 3.3%, which was seventh best in the world and the best out of the 10 healthiest countries. Despite its high ranking, Japan has relatively high smoking rates for both males and females and one of the higher rates of CO2 emissions, at 9.2 metric tons per capita, almost twice the global average of 4.9 metric tons per capita. Japan's tuberculosis rate of 18 per 100,000 people was far below the global rate of 126 per 100,000 people.

4. Luxembourg

> Life expectancy: 79.1 (16th highest)
> Infant mortality rate (per 1,000 live births): 1.6 (tied-the lowest)
> Health expenditure per capita: $7,452 (4th highest)
> Unemployment rate: 5.9% (63rd lowest)

With the fourth highest per capita health care spending, Luxembourg, the only grand duchy in the world also has the fourth best health results, suggesting a link between health spending and outcomes. Luxembourg had the lowest mortality rates for both infants and children under five years old. But like most of the 10 healthiest countries, Luxembourg has a relatively high death rate. Though it is reasonably strong, the country's overall health ranking is likely held back by its residents' relatively high alcohol consumption of 11.9 liters per capita, and relatively high obesity rate of 23.1%.

3. Switzerland

> Life expectancy: 80.6 (2nd highest)
> Infant mortality rate (per 1,000 live births): 3.6 (24th lowest)
> Health expenditure per capita: $8,980 (2nd highest)
> Unemployment rate: 4.4% (40th lowest)

With the second highest life expectancy of all nations, Switzerland is the third healthiest country in the world. Switzerland had 3.9 physicians per 1,000 people, the ninth highest ratio of the 172 nations reviewed. The country ranked high overall despite a relatively high death rate of nine deaths per 1,000 people as well as prevalent risk factors. The per capita alcohol consumption in Switzerland of 10.7 liters was almost 73% higher than the global average. Also, an estimated 22% of adult females and 31% of adult males smoked. The incidence of tuberculosis in Switzerland of 6.5 cases per 100,000 people was 16th highest in the world. Despite these habits, Switzerland's population remains very healthy, perhaps due to its health care expenditure. An annual $8,980 per capita was spent on health in the country, the second highest globally.

2. Norway

> Life expectancy: 79.5 (9th highest)
> Infant mortality rate (per 1,000 live births): 2.3 (6th lowest)
> Health expenditure per capita: $9,055 (the highest)
> Unemployment rate: 3.5% (22nd lowest)

Norway spends more on health care per capita than any other country. The country's annual health care spending totalled $9,055, ahead of Switzerland's $8,980 and the United States' $8,895. Norway had a relatively high death rate of 8.4 deaths per 1,000 people, six times that of Qatar. Norway's infant mortality rate, its mortality rate for those under five, and life expectancy rate at birth all ranked within the top 10 of all nations, however. While the country fared relatively poorly on health measures, its economy is very strong, and residents have some of the best access to health professionals and facilities in the world. Norway had the second best access to services, reflecting clean water and that its entire population had access to electricity. There were also nearly four physicians per 1,000 people in the country, one of the highest shares.

1. Qatar

> Life expectancy: 77.6 (28th highest)
> Infant mortality rate (per 1,000 live births): 7.0 (44th lowest)
> Health expenditure per capita: $2,029 (25th highest)
> Unemployment rate: 0.5% (2nd lowest)

While Qatar topped 24/7 Wall St.'s health rankings, it was the only country of the 10 healthiest not to have a national health care system. As the emirate is transitioning to a universal system, however, the health of its population may become even better. Qatar plans to have its entire population covered by the end of this year. With 7.7 physicians per 1,000 people, more than any other country, the country's health system is already very good. Qatar fared very well in health, access, and economic measures, largely on the strength of its relatively low overall death rate of 1.4 deaths per 1,000 people and relatively low maternal mortality rate. The small Middle Eastern country, which is about the size of Connecticut, took steps to protect its citizens from diseases with 99% of children receiving the DPT and measles vaccines. As in several other prosperous and healthy nations, Qatar had the second-highest obesity rate in the world.

Methodology

To determine the most and least healthy countries, 24/7 Wall St. collected data on 21 measures on more than 170 countries. These measures were grouped into three categories: health, access, and economy.

While our index aspires to be comprehensive, many measures are also interrelated. To account for interdependence, our index was created using a geometric mean rather than the traditional arithmetic mean. We then used the geometric mean of each index to calculate a country's overall score. Potential scores ranged from one to 172, with lower values indicating better scores.

One challenge was data availability for all 172 countries. We addressed this challenge in two ways. The data is for the most recent year available but also needed to be no older than 2010. Secondly, data had to be available for at least 75% of countries. In addition, we only considered countries with at least 150,000 people.

The health category captured both outcomes and residents' behaviors in each country. Infant mortality, fertility, maternal mortality, and the incidence of various diseases came from the World Bank. We used the World Bank's life expectancy figure for males as a proxy for life expectancies for all people because it is much more widely available in the countries reviewed. Smoking rates and the percentage of children with certain immunizations also came come the World Bank. Lastly, we considered per capita alcohol consumption and adult obesity rates from the World Health Organization (WHO).

The access category was designed to measure the availability of specific resources that are critical to the health of a nation's people. We looked at the share of a country's population with access to clean water, clean air, and electricity — all data from the World Bank. Additionally, we looked at the concentration of physicians in each country as a proxy for how easily residents can access health care.

Economic conditions also have an impact on health and health outcomes. The economy category included per capita health expenditure by public and private sources, as well as poverty and unemployment rates. All economic data came from the World Bank.

source: http://www.usatoday.com/

The House of Representatives is investigating the performance of the Healthcare and Social Security Agency (BPJS Kesehatan) as the agency has run into financial difficulties as a result of soaring insurance claims.

House Commission IX overseeing health and welfare said that it had set up a working committee that would assess BPJS Kesehatan in order to decide whether it would allow the agency to hike premiums for subscribers. "We will form a working committee on BPJS Kesehatan that will be ready later this month," Commission IX head Dede Yusuf told The Jakarta Post on Thursday.

The commission decided to set up the committee after BPJS Kesehatan asked for House approval for its request to raise the premiums of the National Health Insurance (JKN) program.

Dede said there were measures that the government should take before it increased the premiums.

"We have to evaluate the numbers because when I checked with hospitals, it turns out that most of patients covered by the BPJS are not those subsidized by the government. It means many poor patients are unaware of the program," he said.

Low-income patients, known as Contribution Assistance Recipients (PBI) have a proportion of their premiums paid by the government and together with disabled people, they make up the first category of BPJS Kesehatan participants.

The second group are the Non-PBI participants, consisting of wage-earning workers and their family members, as well as unemployed workers and their family members. They have to pay for their own premiums ranging from Rp 25,500 (US$1.96) per month to get healthcare services in third-class facilities, to Rp 42,500 for second class and Rp 59,500 for first class.

Dede said the House also found irregularities in the data on participants. "Much data doesn't make sense. A small businessman who has two motorcycles is registered as a PBI participant, while those truly in need are not registered," he said.

"So our point is not to totally reject the rise in premiums, but to fix the data first," he added.

Taking the irregularities into account, the House working committee would look at problems with BPJS Kesehatan management and see if it could be fixed without having to resort to hiking premiums.

"With such an audit, hopefully BPJS Kesehatan can save up to 10 percent. I know that because I heard from regional branches of BPJS Kesehatan that they could save more money if they could prevent wasteful spending made by health-service providers and patients themselves," Dede said.

BPJS Kesehatan expects to remain in the red throughout this year, with its claim ratio expected to hover around 100 percent. The claim ratio is the difference between the hospitals' bills for health services provided and the premiums collected by the agency from participants registered in the program.

The agency receives premiums from tax funds to finance low-income people in the scheme, as well as premiums paid by employees and their employers, and those individually registered with the program.

The agency has reported a deficit between claims it has paid and the premiums it has received. In 2014, the deficit stood at Rp 1.54 trillion, with Rp 42.6 trillion paid out in claims and Rp 41.06 trillion received in premium payments.

The agency also suffers from low compliance among premium payers, where they only pay the premiums when they are sick and stop paying once they have recovered.

BPJS Kesehatan finance director Riduan said that the agency could suffer a deficit of Rp 11.71 trillion if it did not raise the premiums it charged to subscribers.

The agency has proposed raising the premiums for PBI participants from Rp 19,225 per month to Rp 27,500 per person per month in 2016.

Some lawmakers in Commission IX flatly rejected the premium rise as they believed it would make it harder for non-PBI participants to pay their premiums.

However, Bambang Purwoko of the National Social Security Board (DJSN), tasked with monitoring the JKN program, said that if Indonesian people could afford to buy cigarettes regularly, then surely they would be able to afford a rise in premiums for something as important as health insurance.

"We have no trouble in buying cigarettes regularly. So it's strange if we complain [about paying health insurance premiums],". he told the Post.

source: http://www.thejakartapost.com

The scientists behind a recent World Health Organization study which concluded the herbicide glyphosate "probably" causes cancer, say they stand behind their assessment. The comments come in response to criticisms from Monsanto Co., who said the study was based on "junk science". The main ingredient in Monsanto's Round Up product is glyphosate. Monsanto executives said they are reviewing their options as they move forward.

Aaron Blair, a scientist emeritus at the National Cancer Institute and lead author of the study, told Reuters,"There was sufficient evidence in animals, limited evidence in humans and strong supporting evidence showing DNA mutations and damaged chromosomes." The WHO's International Agency for Research on Cancer (IARC) published their study of glyphosate on March 20, finding that the popular herbicide may contribute to non-hodgkins lymphoma.

IARC report was published in The Lancet Oncology detailing evaluations of organophosphate pesticides and herbicides. The report concluded that there was "limited evidence of carcinogenicity in humans for non-Hodgkin lymphoma." The evidence for this conclusion was pulled from studies of exposure to the chemical in the US, Canada and Sweden published since 2001.

The researchers found "convincing evidence that glyphosate can also cause cancer in laboratory animals." The report points out that the United States Environmental Protection Agency (US EPA) had originally classified glyphosate as possibly carcinogenic to humans in 1985. The IARC Working Group evaluated the original EPA findings and more recent reports before concluding "there is sufficient evidence of carcinogenicity in experimental animals." Despite the WHO's findings, the EPA approved Monsanto's use of glyphosate as recently as 2013.

The battle around glyphosate is also closely linked to the debate around Genetically Engineered or Modified foods. The herbicide is typically used on GM crops such as corn and soybeans that have been specifically modified to survive the harmful effects of the herbicide. Corporations like Monsanto are heavily invested in the success of the chemical. The herbicide has been found in food, water, and in the air in areas where it has been sprayed.

In 2014 Anti-Media reported on a study published in the International Journal of Environmental Research and Public Health which claims to have found a link between glyphosate and the fatal Chronic Kidney Disease of Unknown origin (CKDu), which largely affects rice farmers in Sri Lanka and other nations. In response Sri Lanka has banned glyphosate and Brazil is considering doing the same.

Sri Lanka's Minister of Special Projects S.M. Chandrasena stated that President Mahinda Rajapaksa issued a directive to ban glyphosate sales in the country. "An investigation carried out by medical specialists and scientists have revealed that kidney disease was mainly caused by glyphosate. President Mahinda Rajapaksa has ordered the immediate removal of glyphosate from the local market soon after he was told of the contents of the report."

The researchers believe glyphosate could be helping carry toxic heavy metals present in certain agri-chemicals to the kidneys. Chronic kidney disease of unknown etiology (CKDu) was first seen in the north central areas of Sri Lanka in the 1990s and has taken an estimated 20,000 lives. Before being pushed by Monsanto for use as herbicide, glyphosate was a de-scaling agent to clean mineral deposits in hot water systems.

Although the paper did not offer new scientific evidence, the researchers proposed a theory for how CKDu is spread. The researchers believe that glyphosate is contributing to a rise of heavy metals in drinking water. Dr. Channa Jayasumana, lead author of the study said, "glyphosate acts as a carrier or a vector of these heavy metals to the kidney." Glyphosate itself is not the toxic agent, however when combined with metals in the ground water the herbicide becomes extremely toxic to the kidneys.

In recent years there has been a spike in CKDu patients in farming areas of El Salvador, Nicaragua, and Costa Rica.

The Minister stated that a new national program would be launched encouraging Sri Lankan farmers to use organic fertilizer. The Ministry of Agriculture is hoping to plant 100,000 acres of land throughout the country using organic methods.

Monsanto spokesman Thomas Helscher stated,"There are no epidemiologic studies suggesting that exposures to glyphosate-based products are associated with renal disorders either in Sri Lanka or elsewhere. The paper presents a theory, the theory has not been tested, and there are a significant number of publications supported by data that make the Jayasumana hypothesis quite unlikely to be correct." Despite promises from Monsanto, the evidence indicating dangers related to glyphosate continue to pile up.

With the USDA's decision late last year to approve a new batch of genetically modified corn and soybean seeds designed to be resistant to glyphosate, we should expect to see an increase in herbicide use overall, and with it, many disastrous health effects. In fact, the approval by the USDA now partners DOW Chemical and Monsanto together, a move which will only further entrench the control that corporate entities have over governments.

source: http://www.globalresearch.ca/

World TB Day, March 24, marks the day in 1882 when German microbiologist Robert Koch announced his discovery of the bacterium that causes tuberculosis (TB). Despite the considerable progress made since that discovery, TB remains one of the world's deadliest diseases. In 2013, an estimated 9 million people became ill with TB, and 1.5 million people died, according to the World Health Organization (WHO). This airborne disease is a leading killer of women and children worldwide. TB co-infection is the major cause of death among HIV-infected people killing roughly 1 in 4 who are co-infected. The growing problems of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB further intensify the TB crisis.

WHO's theme for World TB Day 2015, Reach, Treat, Cure Everyone, highlights the continued need to effectively diagnose, treat, and cure those afflicted with the disease — many of whom live in the world's poorest, most vulnerable communities. NIAID remains committed in its broad research efforts to gain a better understanding of the disease and to find new ways to diagnose, treat and prevent TB.

Through innovative approaches, such as mathematical modeling and genome mapping of complex biological structures, scientists are developing a greater understanding of how Mycobacterium tuberculosis (Mtb) causes disease, as well as the various stages of Mtb infection and TB disease. With NIAID's support, scientists have sequenced the genomes of approximately 2,000 Mtb strains to gain a deeper knowledge of the bacterium's genetic diversity and patterns of drug resistance — information that will contribute to the development of new diagnostics and other rapid tests for identifying patients with MDR-TB and XDR-TB.

New diagnostics and indicators, or markers, of disease to identify patients who harbor TB bacteria but do not have symptoms is a key research focus. In this regard, NIAID recently expanded its Tuberculosis Research Units program, which integrates epidemiology, immunology and microbiology to focus on TB latency and persistence and their connection to active TB disease. Additionally, the NIAID-supported TB Clinical Diagnostic Research Consortium is evaluating several investigational diagnostics and their impact on TB management in endemic countries. NIAID supports the development of the WHO-endorsed GeneXpert MTB/RIF TB diagnostic test, which detects Mtb and drug resistance in sputum samples within two hours. Development efforts are aimed at increasing the sensitivity of Mtb detection, expanding the drug resistance markers to detect XDR-TB, as well as using non-sputum samples to facilitate diagnosis of TB in children.

Finding new TB treatments is also a major research focus at NIH. Adherence to current therapy can be difficult given that regimens require daily medications for at least six months and potentially up to two years. Moreover, with the growing threats of MDR-TB and XDR-TB, effective new medicines to overcome drug resistance are critically needed. NIAID support has contributed to more than two-thirds of the roughly 20 investigational TB drugs and drug combinations currently in clinical testing. Additionally, NIAID scientists working as part of an innovative, collaborative public-private partnership helped to identify 3,200 promising compounds for further development. In 2014, NIAID scientists and other researchers helped to identify a new type of TB treatment, called host-directed therapy, which involves manipulating the body's response to TB bacteria rather than targeting the bacteria itself.

Controlling TB infection ultimately depends on effective prevention strategies, including a vaccine. NIAID supports basic and preclinical research on new candidate TB vaccines to prevent infection or disease, as well as to help shorten the duration of TB drug treatment regimens. Several candidate vaccines have demonstrated protective effects in animal models and are now being tested in humans. Through its HIV/AIDS clinical trials networks, NIAID also evaluates preventive TB treatments for people infected with HIV.

Last year, WHO announced the goal of completely eliminating TB by 2050. NIAID remains committed to supporting and conducting the necessary research and leveraging resources with other funding agencies and organizations to reach that target. Although the challenges ahead are daunting, our resolve to end the plague of this ancient disease is steady. With continued scientific progress, we look forward to the day when World TB Day becomes a thing of the past.

Anthony S. Fauci, M.D., is the director of NIAID. Richard Hafner, M.D., is chief of the TB Clinical Research Branch in the NIAID Division of AIDS; Christine F. Sizemore, Ph.D., is chief of the Tuberculosis and Other Mycobacterial Diseases Section in the NIAID Division of Microbiology and Infectious Diseases.

NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available at http://www.niaid.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

source: http://www.nih.gov/news/health/mar2015/niaid-24.htm

A 2010 graduate of the University of Alabama at Birmingham has been selected by the World Health Organization to a six-person committee tasked with evaluating the global response to the Ebola epidemic.

Dr. Faisal Shuaib received his degree from the School of Public Health's international health program and was recently commissioned by WHO Director General Dr. Margaret Chan to be part of the team that will lead WHO's Ebola strategy.

"It is an honor to be part of this prestigious assembly of experts commissioned to do this important piece of work," Shuaib said. "The panel's report will hopefully add to the growing body of knowledge on how we can do a better job of confronting disease-causing agents that have proved to be tenacious, efficient and unforgiving."

Shuaib is currently the incident manager and head of the National Ebola Emergency Operations Center in Nigeria, where he played a major role in containing and ultimately dispelling the virus outbreak.

The first case of Ebola in Nigeria came into Lagos state by flight on July 20 when an ill traveler arrived from Liberia, according to UAB. During the course of the disease, Shuaib said the country recorded 19 confirmed cases, but within a month the country reported no more cases and the WHO declared Nigeria Ebola-free on Nov. 7, 2014.

As part of the WHO team, Shuaib will be monitoring other West African countries and submit a report to the 68th World Health Assembly in May.
"We still maintain a focus on the Ebola outbreak in other West African countries," Shuaib said. "We continue to conduct active surveillance, perform screenings at our ports, and continually increase awareness about this disease."

source: http://www.bizjournals.com/

Billionaire philanthropist Bill Gates is issuing a call to action for countries around the world to create an international response system for future outbreaks, which he said would address the "global failure" to combat Ebola.

As the death toll for Ebola continues to rise, Gates is urging governments and international organizations like the United Nations and NATO to seize the momentum and adopt a new global health strategy.

Gates laid out a blueprint for the global response system Wednesday in the New England Journal of Medicine. His plan focuses on creating a central international institution and building up the basic health systems in poor countries – an ambitious and costly plan that he says would take years of work.

"As the Ebola epidemic fades from the world's attention, we risk missing the opportunity to learn from it," Gates wrote. "There is a significant chance that an epidemic of a substantially more infectious disease will occur sometime in the next 20 years."

A central part of the strategy is a "global institution" to coordinate all outbreak-related efforts. This body would must be "given enough authority and funding to be effective," Gates wrote.

That organization would assume many the roles of the United Nations' health arm, the World Health Organization (WHO), which has faced heavy criticism for its sometimes lagging response to Ebola. Gates describe the WHO's current response network as "severely understaffed and underfunded."

His plan would also increase disease-surveillance abilities and laboratory capacity in poor countries, as well as create a stockpile of needed supplies. He also called for countries to maintain a "pool of volunteers" who can be immediately brought in to deal with an outbreak, as well as a trained group of military personnel.

Gates also stresses the need for more research to create new vaccines and treatments. He specifically points to the lack of universal vaccine for influenza, which he said needs a far larger INVESTMENT.

"There is work being done toward this goal, but it has garnered nowhere near the resources that it deserves," he said.

He said the response network could also address a potential biothreat.

source: http://thehill.com

The European Society for Clinical Microbiology and Infectious Diseases (ESCMID) has been joined by the World Health Organization (WHO) to launch the 7th annual International Day for Fighting Infection, April 24, 2015. This year's event sees the European society exploring vaccines as a possible solution in the global, cross-border fight against antimicrobial resistance.

The event is free for anyone to attend and coincides with the ESCMID annual congress (ECCMID) in Copenhagen and the WHO's World Immunization Week. The overall mission of the day is to increase international collaboration and to highlight cutting-edge methods in the battle against infectious disease. The WHO will be providing an update from its European office across Ebola, extensively drug-resistant tuberculosis and polio, while ESCMID will explore how nations can start harnessing the potential of vaccines in the intensifying battle against antimicrobial resistance.

Following International Day for Fighting Infection will be the 25th European Congress of Clinical Microbiology and Infectious Diseases, which will be held April 25-28, 2015.

Murat Akova, ESCMID president, says, "Our annual 'International Day for Fighting Infection' has traditionally been held on or around St George's day, and it seems very fitting as the war against antimicrobial resistance can now be fought with a needle rather than a sword - vaccines have huge potential to help combat this growing problem. This event is designed specifically with the goal of spreading the word throughout the medical community of the society's mission and solutions we are exploring. For instance, the ESCMID guidelines on antimicrobial resistance should be the basis of all healthcare professions' response. Moreover, this year the WHO has expanded its collaboration with us, recognising our excellent work and is throwing its full support behind the campaign."

source: http://www.infectioncontroltoday.com