NEW YORK, 12 December 2014 / PRN Africa / — A new global coalition of more than 500 leading health and development organizations worldwide is urging governments to accelerate reforms that ensure everyone, everywhere, can access quality health services without being forced into poverty. The coalition was launched today, on the first-ever Universal Health Coverage Day, to stress the importance of universal access to health services for saving lives, ending extreme poverty, building resilience against the health effects of climate change and ending deadly epidemics such as Ebola.

Universal Health Coverage Day marks the two-year anniversary of a United Nations resolution, unanimously passed on 12 December 2012, which endorsed universal health coverage as a pillar of sustainable development and global security. Despite progress in combatting global killers such as HIV/AIDS and vaccine-preventable diseases such as measles, tetanus and diphtheria, the global gap between those who can access needed health services without fear of financial hardship and those who cannot is widening. Each year, 100 million people fall into poverty because they or a family member becomes seriously ill and they have to pay for care out of their own pockets. Around one billion people worldwide can't even access the health care they need, paving the way for disease outbreaks to become catastrophic epidemics.

"The need for equitable access to quality health care has never been greater, and there is unprecedented demand for universal health coverage around the world," said Michael Myers, Managing Director of The Rockefeller Foundation, which is spearheading Universal Health Coverage Day. "Universal health coverage is an idea whose time has come – because health for all saves lives, strengthens nations and is achievable and affordable for every country."

For much of the 20th century, universal health coverage was limited to a few high-income countries, but in the past two decades, a number of lower- and middle-income countries have successfully embraced reforms to make quality health care universally available. Countries as diverse as Brazil, Ghana, Mexico, Rwanda, Turkey and Thailand have made tremendous progress toward universal health coverage in recent years. Today, the two most populous countries, India and China, are pursuing universal health coverage, and more than 80 countries have asked the World Health Organization for implementation assistance.

"Putting people's health needs ahead of their ability to pay stems poverty and stimulates growth," said Dr. Tim Evans, Senior Director for the Health, Nutrition and Population Global Practice at the World Bank Group. "Universal health coverage is an essential ingredient to end extreme poverty and boost shared prosperity within a generation."

The 500+ organizations participating in the first-ever Universal Health Coverage Day coalition represent a diverse cross-section of global health and development issues, including infectious diseases, maternal and child health, non-communicable diseases and palliative care. Across these issues, knowledge and technologies exist to save and improve lives in significant numbers, but the impact of these tools is severely hampered by lack of equitable access to quality health services.

"Ebola is only the most recent example of why universal health coverage is the most powerful concept in public health," said Dr. Marie-Paule Kieny, Assistant Director-General for Health Systems and Innovation at the World Health Organization. "Investing in strong, equitable health systems is the only way to truly protect and improve lives, particularly in the face of emerging threats like the global rise of non-communicable diseases and increasingly severe natural disasters."

Events in 25 Countries Mark First-Ever Universal Health Coverage Day
Organizations around the world are calling on policymakers to prioritize universal health coverage, and are hosting events on 12 December to catalyze action, including:
New York, USA: High-level event on Ebola and resilience, organized by the Permanent Missions of France, Japan, Germany and Senegal to the United Nations, in collaboration with The Rockefeller Foundation and the Columbia University Mailman School of Public Health.
London, UK: Expert panel at the London School of Hygiene & Tropical Medicine on creating resilient, equitable health systems, organized in partnership with The Rockefeller Foundation and Action for Global Health.

New Delhi, India: High-level event on universal health coverage implementation in both India and the global context, convened by the Public Health Foundation of India, Oxfam India and the World Health Organization Country Office for India.
SOURCE World Health Organization (WHO)

http://en.starafrica.com/

In the United States, there can be no question as to whether or not Obamacare is controversial. It's been the subject of so much gridlock and partisanship at this point that no matter how it's reformed or changed or improved, there will likely be some that hate it. The push back against Obama's Affordable Care Act has, predictably, garnered some attention from other countries, and there's been a great deal of talk about how other nations feel about Obamacare and their impressions of how Americans have reacted to it.

In particular, criticism from our closest neighbor, Canada, has been interesting to watch. Salon offers just one sample of Canadian health care discourse when pitted against a member of the GOP, quoting Dr. Danielle Martin from Women's College Hospital in Toronto and her opponent, Sen. Richard Burr (R-N.C.). Martin also admits downfalls of Canadian public health and where the solution may lie. "The solution to the wait-time challenge that we have in Canada ... does not lie in moving away from our single-payer system to a multi-payer system," she said, pointing to Australia as an example.

I point this out, not in support or opposition of either system, but rather because this admission of problems alongside praising the aspects that work is what I'd like to focus on. Because indeed, every health care system around the world has its pros and cons; even ones with clear advantages over America's past and present system have faults, and it's useful to consider what they are. So rather than rehash what is at this point a very tired argument over health care reform and the Affordable Care Act, I'd like to look internationally.

Canada
First, let's start with Canada; it seems an appropriate first stop on our list given the above context. Canada has universal health care and has government sponsored health care for all citizens. Each of the 13 provinces has some degree of power, but must meet national standards in order to be eligible for funding. Perhaps the most notable and obvious advantage to Canada's health care is that it is so universally available and affordable. And the most obvious disadvantage, at least based on the majority of rhetoric discussing Canadian health care, has to do with extreme wait times — consider our VA scandal earlier this year and what wait times can mean for patients.

Going back to Martin and Burr's discussion, Martin basically pitted these two items against each other, when asked how many patients die while waiting to be treated. "I don't [know], sir, but I know that there are 45,000 in America who die waiting because they don't have insurance at all," she said, "we believe that when you try to address wait times, you should do it in a way that benefits everyone, not just people who can afford to pay."

The United Kingdom
According to a health care ranking report from the Commonwealth Fund, the United Kingdom has itself a place on the top of the list for having the best health care out of 11 studied and ranked — with the U.S. falling last on the list. The U.K., on the other hand, ranked very well on a number of criteria. In particular, it did well in terms of the quality of its care and the access people had to the care based on cost. Like Canada, timeliness of care was listed as a bit of a problem, but nothing compared to our neighbor to the north, which was ranked last for timeliness, while the U.K. managed a third place ranking. However, the absolute worst score it received was actually near dead last, in terms of how healthy civilians lives were. Indicators for this were "mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60." Another critique offered has been that the National Health Service caters to immigrants and visitors in the country as well as citizens, and that this complicates costs and wait times.

France
The World Health Organization places France at the top of a list of the World Health Systems — and notes that neither Canada or the U.S. even makes the top 25. France, like Canada, has universal health coverage. It has both private (mutuelle) and public aspects to its system, with a great deal of the cost covered by the government, making medical care much more available and much more affordable in France than in the U.S. Costs are also much more predictable in France than in the U.S.

According to Slate, 53% of France's Gross Domestic Product is funneled to public spending. The wait times in France are considerable, as with Canada, and constitute a serious problem. Cost coverage in France has its advantages and its disadvantages. Some things are very well covered, but certain aspects of treatment and coverage can get pricey depending on your needs. Pharmaceutical expenditure per capita, for example, is much higher in the U.S. — $983 per capita in 2010, according to the Huffington Post — but it's still comparably quite high in France as well, at $634 per capita.

source: http://wallstcheatsheet.com/

about 1 in 13 Americans was suffering from depression at some point between 2009 and 2012, yet only 35% of people with severe depression and 20% of those with moderate depression said they had sought help from a mental health professional, according to a new report from the U.S. Centers for Disease Control and Prevention.

That's troubling, the report authors write, because therapy combined with medication is "the most effective treatment for depression, especially for severe depression." Drugs might be prescribed by a primary care doctor, but only a mental health specialist would conduct the type of therapy needed to get well.

The report, from the CDC's National Center for Health Statistics, offers a snapshot of the nation's mental state during recent years.

The findings are based on interviews with a nationally representative group of American adults and teenagers who participated in the federal government's ongoing National Health and Nutrition Examination Survey. These volunteers answered a range of questions that assessed a variety of physical, cognitive and mood symptoms that are related to depression. Responses from people 12 years old and older were used to compile the report.

Overall, 2.9% of the participants had suffered "severe depressive symptoms" in the two weeks before they were interviewed, and another 4.7% had "moderate depressive symptoms," the researchers found. Americans in their 40s and 50s were the most likely to be depressed, with 9.8% having moderate or severe depression. They were followed by Americans between the ages of 18 and 39, with a 7.4% depression rate. The oldest (ages 60 and over) and the youngest (ages 12 to 17) people in the survey were the least likely to be depressed, with rates of 5.4% and 5.7% respectively.

African Americans (9.7%) and Latinos (9.4%) had higher rates of moderate and severe depression than whites (6.9%), according to the report. (No data were reported for Asian Americans.) However, after the researchers adjusted their findings to take poverty status into account, there were no significant differences based on race or ethnicity.

Gender, on the other hand, had a large effect, with women experiencing higher levels of depression than men in all age groups. The biggest gap was among people in their 40s and 50s -- 12.3% of women in this age group were moderately or severely depressed, compared with 7.2% of men. That 5.1-point difference was 30% bigger than the 3.9-point difference for the entire study population. Overall, 9.5% of women were depressed, along with 5.6% of men.

Depression took a meaningful toll on people's lives, the researchers discovered. About 43% of those with severe depression said they had "serious difficulty" managing their work, home and social activities, and another 45% had "some difficulty." For people with moderate depression, the corresponding figures were 16% and 58%. Even for people with mild depressive symptoms, 4% had serious difficulty with their daily activities and 42% had some difficulty.

Despite these problems, only 35% of people suffering severe depression and 20% of those with moderate depression told interviewers they had seen a mental health specialist, such as a psychologist, psychiatrist, psychiatric nurse or clinical social worker. (The researchers couldn't verify whether these people actually began treatment for their depression.) Latinos were the least likely group to seek professional help from a mental health specialist -- only 28% of those with severe depression and 17% of those with moderate depression did so, according to the report.

source: http://www.latimes.com/

Community groups in the Asia-Pacific are taking the lead on prevention initiatives for cancer, diabetes, heart disease and other non-communicable diseases which cause 36 million deaths globally. This APEC project helps counter the rise of these diseases by conducting outreach and education on the risk factors and preventive lifestyle changes at the local community level. Following a successful trial across Indonesia, the project developed a framework and guidebook for other APEC economies to replicate this grassroots approach over the next few years.

Led by the APEC Health Working Group, the project comes as the incidence of death through non-communicable diseases such as cancer, diabetes and heart disease continues to rise, especially in the Asia-Pacific region. According to the World Health Organisation (WHO), deaths from these diseases in Southeast Asia alone will grow by 15 per cent over the next decade, reaching 10.4 million per year by 2020. In many cases, these diseases are detected at a later stage, resulting in higher economic cost for treatment.

"Non-communicable diseases are now the leading cause of death in many APEC economies," says Dr Ekowati Rahajeng, Director of Non-communicable Diseases at the Indonesian Ministry of Health, who leads the project. "Cardiovascular disease accounts for about one-third of all deaths in Asia, with mortality rates, on average, 70 per cent higher than in OECD countries. Cancer alone causes an estimated 13 per cent of deaths in Asian economies."

According to Dr Ekowati, raising awareness of the risk factors associated with these diseases—such as obesity, lack of exercise and smoking—is the most effective way to overcome the fatalities. "Our community-based approach has huge potential, because it teaches people how to protect themselves," she says. "Without action, non-communicable diseases could have a catastrophic impact on health budgets."

Community-based intervention: a different approach

The successful model for community-based intervention began in Indonesia over a decade ago, with a single pilot study. It involved experienced, local health workers partnering with community leaders to explain the risk factors that contribute to diabetes, cancer and heart disease, clearly and directly to groups of citizens.

"What makes this approach different is that activities take place in community areas such as schools or religious centres, rather than clinics," says Dr Ekowati. "Also, activities are driven by local community members, who know how to stimulate attendance and participation."

The initial pilot was soon replicated in four other provinces in Indonesia. The Community Co-ordinator for West Jakarta, Ms Joko, explains how the program works: "I am one of a group of eight friends, which includes a senior nurse, and through the community-based intervention project, we received training in non-communicable diseases at local health centres."

Each month, Ms. Joko organises a consultation for between 50 and 70 people, which is supervised by a public health service official. A local doctor measures each individual's vital signs as well as weight, and then tests blood sugar, and levels of cholesterol and uric acid.

"The sessions allows us to do three things: clearly explain the risks factors that contribute to cancer, diabetes and heart disease, assist with early detection, and then observe changes in behaviour over time," she says.

Proven results, and expansion across Indonesia

The community approach enabled Dr. Ekowati's project to closely monitor its effectiveness, and the results proved impressive. Between 2003 and 2006, the prevalence of high cholesterol among target groups in one district—Depok, West Jakarta—reduced by a third, from 31.65 per cent to 19.6 per cent; the prevalence of high blood pressure halved, from 9 per cent to 4.5 per cent, and mean body mass index (BMI) measurements fell for both men and women.

With clear evidence that the project's unique community-based intervention approach had a concrete impact, the project gained acclaim. In 2012, the community-based model for non-communicable disease reduction was formally incorporated in Indonesia's health strategy. Community programs were implemented in all 34 provinces in Indonesia, with approximately 11,000 community groups delivering risk-factor programs in each of 500 local districts.

Gaining traction across the APEC region

In 2013, the APEC Health Working Group funded the project to expand the approach in the region— recognising that Indonesia's model could help member economies take practical steps to respond to two key international health initiatives: the WHO Global Action Plan on non-communicable diseases 2013–2020, and the 2011 declaration on non-communicable diseases by the United Nations General Assembly.

Dr Ekowati proposed using the Indonesian community-based intervention experience to design and develop a comprehensive community program that could be used by multiple economies—right across the Asia-Pacific region. It would include guidelines for community health discussions, and a framework to help community workers set up each local project.

With funding from the APEC Support Fund, Dr Ekowati convened a landmark workshop in April 2014 in Bali, Indonesia. The prospect of adopting a tried and tested strategy for non-communicable diseases prevention drew health experts, academics, and policy makers from Chile, Japan, Malaysia, Peru, the Philippines, Russia, South Korea, Thailand and the USA.

Input from these specialists resulted in an APEC guidebook for implementing the approach in other economies which was published in August 2014. The framework on community-based intervention explains how the concept works in practice, examines the challenges involved and provides recommendations to help APEC economies learn from Indonesia's experience.

APEC member economies such as the Philippines and Thailand now intend to use this guidebook to help implement community-based prevention programs of their own.

The bigger economic picture

As the program readies for APEC-wide rollout, its sponsor is quick to point out that the goal of containing and reducing these non-communicable diseases is inseparable from wider social and economic objectives.

"Cancer, diabetes, heart disease and other non-communicable disease are chronic illnesses that require long-term treatment," Dr Ekowati says. "The costs of treatment and healthcare lead to higher health expenditure and lower productivity—and remember these diseases are the biggest cause of premature death."

According to the World Health Organization, non-communicable diseases cause an estimated 63 per cent of global fatalities every year.

"Without these social programs, there will be an inevitable decline in the economic status of many people—in particular those on middle or low incomes. This program has huge potential, not just to limit the impact these diseases have on prosperity today, but to prevent non-communicable diseases from dominating health budgets in the future."

source: http://www.webwire.com/

The World Health Organization (WHO) has announced plans to focus on food safety for World Health Day––April, 7, 2015. WHO has pinpointed this particular topic due to the increasing globalization of our food supply, which requires additional and improved systems both in and between all countries.

According to WHO, food safety is increasingly threatened by a number of factors––food production, distribution and consumption; changes to the environment; new and emerging pathogens and antimicrobial resistance. The spread of contamination is also made possible with increases in travel and trade.

In conjunction with their food safety campaign, WHO will also release estimates of how much foodborne diseases––the cause of 2 million deaths annually, mostly children––cost on a global scale. This will be the first time such numbers are published.

WHO's overarching goal is to provide various sectors within the food industry––farmers, health practitioners, farmers, government agencies––with the food safety knowledge they need in order to ensure safe food for all. In fact, WHO developed its own Five Keys to Safer Food for both vendors and consumers:

Key 1: Keep clean

Key 2: Separate raw and cooked food

Key 3: Cook food thoroughly

Key 4: Keep food at safe temperatures

Key 5: Use safe water and raw materials

Visit WHO.int for more information.

source: http://www.foodsafetymagazine.com

HIV/AIDS knows no boundaries. The virus spreads to every corner of the country, including Aceh, where sharia law takes effect and gives no room for promiscuity. It has infected people from all walks of life, including loyal housewives.

The constant rise of the number of people in Aceh infected with the virus over the past 10 years to a current total of 272 has shocked Hayati, a local female politician from the Muslim-based Prosperous Justice Party (PKS). We will all closely watch the statistics for HIV infections every time we commemorate the World AIDS Day on Dec. 1.

As of Sept. 30 of this year, HIV has infected 150,296 people in Indonesia, including 55,800 with AIDS, according to the Health Ministry. The virus has killed nearly 9,800 people since April 1, 1987.

What should give us cause for concern is the fact that citizens of productive age between 19 and 40 years old make up the majority of people with HIV/AIDS. More worryingly, though, there is a phenomenon in the pattern of the global spread of HIV that youths are becoming easy prey.

UNICEF data revealed that the virus claimed the lives of about 110,000 young people aged between 10 and 19 years old in 2012, up by 50 percent within only seven years. Indonesia must not be complacent about the trend, given a finding that the young generation in the country is mostly uninformed and, hence, unaware of HIV/AIDS despite a widespread campaign.

A Health Ministry study in 2010 discovered young people's poor understanding of reproductive health, especially when it comes to risky sexual behavior, prevention of unwanted pregnancy, perceptions about the dangers of the virus and stigmas embedded about people with HIV.

Such lack of knowledge, if not ignorance, comes on the heels of the mushrooming new values and easy access to drugs, which have given a boost to HIV spread. Without knowledge, youth are more vulnerable to HIV.

Youths account for one-fourth of the Indonesian population today and their bill of health will determine whether the country will profit from its demographic bonus in the next few decades.

It is therefore the responsibility of the state and society, including parents and NGOs, to protect the young generation. The initiative of the National Population and Family Planning Board (BKKBN) to join the fight against HIV through educating youths is therefore worth merit.

No less challenging is the fact that many people with HIV live in destitution and therefore are deprived of access to antiretroviral medication, which has proven to improve the quality of life of those infected and help curb virus infection.

The Indonesia Health Card (KIS), launched by President Joko "Jokowi" Widodo, should and could include poor people with HIV among its beneficiaries. There will be a question of moral hazard if the national medical program also covers people with HIV, but for the sake of our as well as our children's future, such a move will do more good than harm.

This is an editorial published by The Jakarta Post on Dec. 1.

source: http://www.chinapost.com.tw/

Primary health centres are the most basic unit of the public healthcare network. Jakarta's open dataset on its primary health centres can uncover a host of services for Indonesians and benefits for the government. This is why FutureGov has chosen this dataset as its open dataset of the week.

The dataset lists the names, addresses and contact details of 394 clinics across Jakarta. It also indicates a breakdown of staff and the state of infrastructure in each of these clinics, including the condition of the buildings, ambulances, internet connections.

The locations and names of clinics in the city can be mapped out if combined with their geographic coordinates. This could be turned into a handy application for residents which lights up the nearest clinics on a map.

The government can use the information on the staff and the condition of infrastructure to create a dashboard of its primary health network. It could use this to plan when a clinic needs a new ambulance or when it's time for an internet connection.

Both of these ideas can be improved if the government can combine the existing data with the number of patients visiting each of these clinics. The app could then show residents the closest clinic with the shortest queue, so that patients can plan their visits better. The dashboard could predict more accurately how resources should be allocated across the clinics based on the number of patients they receive.

Some rows in the dataset are still incomplete and the latest data is from 2012, so there is potential for the data to be more accurate and comprehensive.

FutureGov also loved the graph and map tools built into Indonesia's open data portal, so you can have a peek at how a visualisation might look without even downloading the dataset. However, this doesn't seem to be available for all of the datasets and it would surely be useful to make that happen.

source: http://www.futuregov.asia

The country of Madagascar is known for its tranquil beaches, exotic wildlife and rich culture. But something else also inhabits the island that is now making headlines: The Black Death.

Perhaps best known as the Bubonic Plague that is generally associated with the Middle Ages when rats, fleas and poor hygiene resulted in the deaths of approximately 200 million people, the disease remains an enduring threat in third-world nations.

Madagascar has been one of the world's last remaining hotspots for the plague but the illness has been mostly isolated in rural villages and self-contained... until now.

On Friday, Nov. 21, the World Health Organization announced an "outbreak of the plague" in Madagascar, with two people in the country's capital being infected and one having died from the disease.

Cases have been reported in 16 districts of the seven regions, according to WHO, and the health ministry said there had been 138 suspected cases since the beginning of the year and warned that the death toll was likely to rise in the coming months.

Now that the disease has made it to a densely populated area, a major outbreak seems inevitable. The capital of Madagascar, Antananarivo, houses the prime conditions for a disease such as the plague to spread, similar to those in 14th century Europe – garbage is dumped in the streets and public restroom conditions are terrible. Black rats, which were the primary vector for the disease in the Middle Ages, also roam freely between buildings.

"There is now a risk of a rapid spread of the disease due to the city's high population density and the weakness of the health care system," the WHO said in its report, while noting that a national task force has been activated to manage the outbreak.

Contraction of the bubonic plague results in the swelling of the lymph nodes, but can be treated with antibiotics. The pneumonic version, affecting the lungs, can be spread from person to person through coughing. Death can result in as little as 24 hours. The third form of the disease, septicemic plague, is the rarest form and occurs when the blood is directly infected.

Whichever variety of the plague, as the disease progresses its victim lapses into recurrent seizures, Alzheimic confusion, coma and internal hemorrhaging.

The plague is almost impossible to eradicate from Madagascar, due to interaction of natural and sociocultural factors. According to a 2013 report by the US National Library of Medicine, the high percentage of animals carrying the disease lays the foundation for transmission, and social and economic conditions further encourage the periodic leap to humans.

Outbreaks of the plague usually occur in villages at high altitudes in the northern region of Madagascar, spiking between October and April when the warm rainy season keeps temperatures well above 70 degrees day and night.

Without funds coming in from developed nations, the country doesn't have much to work with to fight the plague. The African Development Bank is allocating $200,000 however, but those resources could quickly dwindle in the coming months. All of these conditions leading up the outbreak mirror those that caused the Ebola virus to spread throughout West Africa.

"Belief in old practices, rampant misinformation, and apathetic, corrupt politicians have combined to make the current outbreak much more widespread than it should be," VICE correspondent Ben Shapiro said in a documentary that was released in September where he helicoptered into a village about 1,000 kilometers north of the capital that was considered a hot zone. "For Madagascar, though, it's unclear how many more people will die of plague before things start to change."

For now, the World Health Organization does not recommend any travel or trade restriction based on the current information available.

source: http://www.healthcareglobal.com