In Canada, there are about 100,000 abortions a year, most of them performed surgically in clinics or hospitals. Access to the procedure varies widely across the country. Wait times are short in the largest urban centres, though may still take several weeks, but options are extremely limited in Atlantic Canada and many rural communities. Even women in smaller cities must often travel hundreds of kilometres to access a clinic.

Medical abortions, experts suggest, are one way to improve earlier access to abortions, and protect privacy because patients could potentially go to their family doctors, and wouldn't need to visit a clinic – an important option for women from ethnic or religious groups that oppose abortion.

Currently, for medical abortions, Canadian women have access only to methotrexate, a chemotherapy drug, administered orally or by injection, that stops pregnancies. It can only be used in the first seven weeks of the pregnancy.

Another drug – Mifepristone – is considered the "gold standard" drug for medical abortion. The World Health Organization has declared it an "essential medicine" and, according to statistics cited in a recent editorial in the Canadian Medical Association Journal, it is now used in about 60 per cent of abortions in Europe and 20 per cent in the United States.

Taken orally, mifepristone blocks the production of progesterone which prevents the pregnancy from continuing. In other countries, it has been approved for use up to nine weeks.

Both drugs are taken with misoprostol, which causes contractions, and bleeding similar to a miscarriage. But having a medical abortion using methotrexate can involve a much longer process – patients typically wait three to seven days before taking the second drug. According to Dr. Wendy Norman, an assistant professor in the medical faculty at the University of British Columbia, who specializes in family planning, only about 60 per cent of women will have completed the abortion within a week, and some patients may wait several weeks. In up to 10 per cent of patients, women will have surgery – either because the pregnancy is still growing or to manage bleeding or because of the long wait.

By comparison, mifepristone usually works much faster, making it easier for physicians to monitor patients. The second drug, misoprostol, is usually taken within 48 hours, and research shows that two-thirds of women who have a medical abortion using mifepristrone will have a complete abortion within four hours after taking misoprostol, and 90 per cent within one day.

Mifepristone is the preferred option, medical experts say, because it works more quickly, has proven to be more effective and is less toxic. (In fact, as the CMAJ editorial pointed out, the World Health Organization does not recommend methotrexate for abortions because of the high risk of severe birth defects if the pregnancy continues.)

Concerns were raised about medical abortions around 2000, says Norman, when there was a cluster of cases in which women died from an infection – antibiotics are now prescribed as a precaution. Some groups have raised concerns about the use of medical abortion potentially isolating women when they have abortion, and preventing them from receiving counselling or support.

As the CMAJ reported, the issue is that Canadian women only have access to the second-best option. "There is no evidence to suggest that it isn't a very safe drug, and we have a lot of evidence to suggest that it is," says Dr. Sheila Dunn, research director of the Family Practice Health Centre at Women's College Hospital in Toronto and co-author of the CMAJ Editorial.

Norman agrees: "There is no scientific basis that can justify withholding the benefit of this medication from Canadian women. It's beyond logic and scientific evidence to try to explain the decisions that are being made."

According to Dunn, Health Canada received an application to approve mifepristone in October, 2012. "The results are pending," the editorial states. "It is important that this submission must not fail."

source: www.theglobeandmail.com

The battle against Aids is being won, with deaths down, record numbers of people being treated, and new cases among children down by more than half.

But ongoing discrimination against sufferers is the biggest obstacle to winning the war, according to the head of the United Nations Joint Programme on HIV/Aids (UNAIDS).

Speaking to The Independent on Sunday on the eve of World Aids Day, UNAIDS executive director Michel Sidibé said: "We are winning against this epidemic, we are seeing a decline in new infections, an increase in people treated... we have broken the conspiracy of silence."

For the first time, he said, authorities can see "an end to an epidemic that has wrought such staggering devastation around the world".

He added: "People living with HIV can live long and healthy lives, can now protect their partners from becoming infected, and can keep their children free from HIV."

But Mr Sidibé also warned: "We have not been able to change completely the perception of people against the most-at-risk populations. The stigma, discrimination and criminalisation of those people – sex workers, people who inject drugs, men who have sex with men – all those groups are mainly at risk of continuing to be completely forgotten."

There are more than 70 countries with "homophobic laws" – something which demonstrates "we still have a long way to go".

Discrimination remains a major obstacle in many parts of the world. One in seven people living with HIV has been denied access to healthcare and more than one in 10 has been refused employment. And while the global picture is good, austerity-stricken Europe is at risk of repeated outbreaks of HIV, warned the World Health Organization last night.

In a bid to end the persecution of people with HIV/Aids, UNAIDS is launching a "zero discrimination" campaign, backed by Nobel Peace Prize Winner Daw Aung San Suu Kyi, to mark World Aids Day.

Speaking at today's launch of the campaign to launch a Zero Discrimination Day on 1 March 2014, she said: "We can all make a difference by reaching out and letting people lead a life of dignity, irrespective of who they are."

North America and Caribbean

Aids-related deaths in the Caribbean dropped 50 per cent between 2001 and 2012 (falling from 24,000 to 11,000), but in Jamaica 37 per cent of gay men are HIV positive. Mexico has an HIV rate among gay men of 17 per cent; Guyana 19 per cent. Meanwhile, 17 per cent of Guyanese sex workers are HIV positive, against 1 per cent in Mexico.

South America

Across Latin America there was a 37 per cent drop in Aids deaths between 2001 and 2012 – from 82,000 to 52,000. With its high deprivation and population density, Brazil's HIV rate is among the highest; 10 per cent of gay men, and 5 per cent of sex workers, are HIV positive. In Peru, where less than 0.4 per cent of the population is HIV positive, 12 per cent of gay men are infected.

Africa

In sub-Saharan countries the number of new cases of HIV was 40 per cent less last year than in 2001 – almost a million fewer cases. But with some 1.6 million people infected last year, the continent's struggle with Aids and HIV continues. In Swaziland, one in four adults (26 per cent) is HIV positive. Across the continent there were 1.2 million Aids-related deaths last year. The majority of those infected with HIV were sex workers and gay men. In Ivory Coast half of "men who sleep with men" are HIV positive. By contrast, in developed Middle East and North Africa, numbers acquiring HIV rose by more than 50 per cent, but still remained at just 32,000 people in 2012.

Europe and Central Asia

HIV infections have increased by 13 per cent, or 100,000 people, since 2006. The majority of people diagnosed with HIV were those who inject drugs, and gay men. Across the continent, less than 1 per cent of the population was HIV positive. The Ukraine, Belarus and Spain had the highest HIV rates among needle users, with 21, 17 and 16 per cent respectively. The number of Aids-related deaths in the region has increased from 36,000 in 2001 to 91,000 people last year. New infections among drug users in Greece have risen, despite a general decline elsewhere in Europe, with authorities blaming funding cuts in treatment centres.

East and South-east Asia

Aids deaths were on the rise in East Asia last year, increasing from 18,000 in 2001 to 41,000. A fifth of Thailand's gay men and needle users were HIV positive, compared with 0.6 per cent of the general population. In the Philippines only 1 per cent of gay men had been infected, but 14 per cent of drug users were positive. In Indonesia 9 per cent of sex workers were HIV positive.

source: www.independent.co.uk

Geneva, Nov 28.- The human immunodeficiency Virus (HIV) remains a major public health problem worldwide, and has killed 36 million people to date, according to the World Health Organization.

In 2012, there were 35.3 million people infected with HIV (the figures range between 32.2 and 38.8 million), the WHO said on its website.

Sub-Saharan Africa, where one out of 20 adults is infected with HIV, is the area of the world most affected, with 69 percent of the world's HIV-positive population.

In late 2012, nearly 10 million people received antiretroviral therapy in low or middle income countries, although more than 19 million people need those treatments and have no access to them.(Prensa Latina)

source : www.cadenagramonte.cu

by Claire Bolderson

Marketplace Morning Report for Tuesday, November 26, 2013

As the Obama administration continues its erratic roll out of health care reform, halfway around the world in Indonesia, authorities are getting ready to introduce the world's biggest universal health care program. It will cover all 240 million citizens and go into effect in 2014.

It will take five years to roll out completely but eventually the idea is that everyone will be able to get health care that is free at the point of use. It's an ambitious plan for a middle income country.

But as the BBC's Claire Bolderson found on the Island of Sulewesi -- one of the biggest in the Indonesian archipelago -- the country's health care system is already under strain.

source: www.marketplace.org

A 31-year-old Indonesian woman has died of bird flu, bringing the death toll to 163 in the country hardest-hit by the virus, the Health Ministry said Monday.

The housewife from Bekasi Timur, a West Java district just east of Jakarta, died last week from the H5N1 bird flu virus, the ministry said in a statement on its website.

An investigation by the ministry found that the woman, who first developed symptoms of fever and nausea on Nov. 1, had possible contact with poultry around her house.

The woman died Nov. 11 when she was about to be transferred to special hospital assigned to treat bird flu, the ministry said.

She is the third Indonesian to die this year from the virus. The first two were a 2-year-old boy and a 28-year-old man, who died in June and September respectively in other districts of Bekasi.

A total of 195 people are known to have been sickened by bird flu in Indonesia since 2005.

Bird flu typically flares during the cooler winter months.

There have been more than 646 confirmed H5N1 cases worldwide since 2003, about 60 percent of them fatal.

source: abcnews.go.com

By a News Reporter-Staff News Editor at Vaccine Weekly -- A new study on Biotechnology is now available. According to news reporting originating from Geneva, Switzerland, by NewsRx correspondents, research stated, "Typhoid fever is a gastrointestinal disease transmitted through the ingestion of contaminated water or food. The bacterium, Salmonella enterica subspecies enterica serovar Typhi is an important cause of illness and death in many poor countries where access to safe water and basic sanitation is limited."

Our news editors obtained a quote from the research from World Health Organization, "Humans are the only natural host and reservoir of S. Typhi. Typhoid fever causes around 21 million cases and at least 200,000 deaths per year. Currently, several groups are developing typhoid conjugate vaccines that are expected to be safe and effective in infancy or early childhood. The World Health Organization convened a meeting, in collaboration with the Korea Food and Drug Administration, with experts group in September 2012 to develop guidelines for regulatory evaluation of the quality, safety and efficacy of typhoid conjugate vaccines."

According to the news editors, the research concluded: "This report summarizes collective views on scientific and technical issues that need to be considered in the guidelines."

For more information on this research see: Working Group on quality, safety and efficacy of typhoid Vi capsular polysaccharide conjugate, vaccines, Jeju, Republic of Korea, 5-7 September 2012. Vaccine, 2013;31(41): 4466-4469. Vaccine can be contacted at: Elsevier Sci Ltd, The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, Oxon, England. (Elsevier - www.elsevier.com ; Vaccine - www.journals.elsevier.com/vaccine )

The news editors report that additional information may be obtained by contacting C. Jones, WHO, Dept. of Essential Med & Hlth Prod, CH-1211 Geneva, Switzerland. Additional authors for this research include C.K. Lee, C. Ahn, J. Shin and I. Knezevic (see also technology.html Biotechnology).

Keywords for this news article include: Biotechnology, Geneva, Europe, Switzerland, Conjugate Vaccines, Synthetic Vaccines, Biological Products

Our reports deliver fact-based news of research and discoveries from around the world. Copyright 2013, NewsRx LLC

source: www.hispanicbusiness.com

Risky behaviour – smoking, illegal drug use, excessive drinking, unhealthy eating and unsafe sex – is on the rise worldwide and poses a growing threat to health, particularly in poorer countries, according to a World Bank report.

Smoking exacts a particularly high toll. Nearly 80% of the 6.3m deaths from smoking in 2010 occurred in middle- and low-income countries, says the Risking Your Health report.

Smoking is decreasing in richer countries but increasing in parts of the developing world. The Bank says low- and middle-income countries are in the grip of a tobacco epidemic, characterised by a sharp rise in smoking, particularly among men, after it peaked in rich countries in the 1960s and 70s.

In China, where smoking accounts for 1.2m deaths a year, it is the number one killer. In 2009, the country consumed more than 38% of the world's cigarettes, followed by Russia, the US, Indonesia and Japan.

The report finds that tobacco-related illnesses place a considerable financial burden on countries. The bank cites a study in Bangladesh that found families with at least one member afflicted by a tobacco-related illness, such as heart disease, lung cancer and oral cancer, spent 5.1% of their household monthly expenditure on tobacco and 10.2% on treating their illnesses.

In Vietnam, even after accounting for government subsidies, the out-of-pocket expenses for each hospital admission of lung cancer, chronic obstructive pulmonary disease and heart disease amounted to $285, or about 34%, of per capita gross domestic product.

In an area of Tanzania, health spending triggered by HIV and Aids was more than 70% greater than for other diseases over a two-year period. Together with funeral costs, this amounted to more than the annual household income.

"Individuals' risky behaviours that cluster among the poor ripple throughout entire populations, crippling families' potential and undermining the great health and economic progress we've seen in low- and middle-income countries in recent years," said Tim Evans, director of health, nutrition and population at the World Bank.

"Reversing the tide of these pernicious behaviours by promoting societal conditions for better health choices will pay dividends for families and countries across the globe, ultimately helping us end extreme poverty and promote inclusive and healthy growth."

Legislation and taxation, for example, tend to be effective, the report concludes, especially when combined with strong enforcement. Cash transfers have also proved to be promising in some settings. Behaviour change campaigns, such as school-based sex education and calorie-labelling laws, are often less effective on their own. Instead they benefit from being part of broader programmes to change risky behaviour.

Repeated messaging is effective, as with the case of graphic labelling on cigarette packets that reinforce the message to smokers each time they reach for a cigarette. Comprehensive advertising bans on cigarettes are more effective than partial bans.

While taxes on tobacco and alcohol can be shown to reduce consumption, particularly in richer countries, the evidence on behaviour change from tax on unhealthy foods is more mixed. A recent attempt by Denmark to tax high-fat food products increased prices by 9%, but the attempt failed, in part because consumers shopped across the border.

The report also notes fundamental differences in being able to change behaviour relating to alcohol, tobacco and food.

"People need to eat to survive, while they can abstain from tobacco and alcohol without health consequences," the report says. "Many unhealthy foods are inexpensive, while healthier foods are more expensive and require more time for shopping and cooking (cheap doughnut compared to expensive broccoli, for example) ... Differentiated taxes could modify relative prices, but the broad range of healthy and unhealthy foods makes it difficult to avoid substitution among unhealthy foods."

Programmes tend to be more successful if they take into account local culture. Brazil successfully carried out a tobacco substitution programme as it involved the community in the choice of the substitute crop and method of farming. In contrast, Bolivia's coca substitution initiative met with less success as it was imposed on the community.

On HIV prevention, the report says the evidence on the efficacy of conditional cash transfers remains limited, but there have been some encouraging results. In Malawi, small financial incentives have been shown to increase the uptake of HIV testing and counselling. Another study in Malawi conducted similar transfers for adolescents in which cash was conditional on school attendance – in addition to increased enrolment and attendance, the programme caused a reduction in HIV and HSV-2 (herpes simplex virus–type 2, the common cause of genital herpes) incidence.

source: www.theguardian.com

An Indonesian boy, who made headlines for smoking since he was two years old, has finally kicked the habit. However, Aldi Rizaln, now aged five, has switched to gorging on junk food.

Aldi, a native of Sumatra in Indonesia, was pushed in the spotlight in 2010, when he was seen puffing on a cigarette while riding his tricycle. His habit of smoking 40 cigarettes a day led the Indonesian government to launch an anti-smoking campaign for children, Daily Mail reported. The toddler was soon shifted to a rehabilitation centre and was enrolled in play therapy sessions for some time.

A recent investigation showed that the boy hasn't smoked for more than a year, but has developed an unusual craving for unhealthy foods, making him overweight compared to other children of his age.

Nutritionist Fransisca Dewi told Daily Mail that the boy consumes nearly three cans of condensed milk every day, in addition to "too many carbohydrates."

"Aldi is very overweight, his weight doesn't match his age. His ideal weight is 17kg to 19kg. He's 24kg already," he said.

According to doctors, smoking has played a major role in increasing the boy's appetite. "Nicotine can increase the endocrine hormone in the body. This condition can cause resistance to insulin," Paediatric specialist Dr William Nawawi, told Daily Mail. "The blood will not be able to break glucose from food. This will make Aldi become bigger and bigger."

Though Aldi's case appears to be a rare case, smoking at a young age is not completely new in Indonesia, where there are no strict rules to prevent youngsters from buying cigarettes.

According to Mirror, a six-year-old boy named Maulana Susanto started smoking when he was just two years old. "He's been smoking since he was two. He was on a pack a day. Now he goes to school just one or two cigarettes are enough," Maulana's mom told the tabloid. "Yes I want him to stop but nobody comes to help me."

Indonesia is one of the few countries which are yet to sign the UN Tobacco Control Agreement that imposes strict restrictions on marketing cigarettes to a country. Indonesian health officials attributed this reason as a contributing factor to the rise in the number of children smoking cigarettes. "I think the tobacco industry have used all their skills and resources to get hold of these kids. The number of people who have started smoking between five and nine years of age has increased sevenfold," said health minister Dr Nafsiah Mboi.

source: www.ibtimes.co.in