The Indonesian government has shared experiences with member states of Organization of Islamic Conference (OIC) in strengthening their national regulatory authority (NRA) functions in vaccine manufacturing for global markets.

"We are willing to share with all member states of OIC our experiences in strengthening national regulatory authority functions in vaccine manufacturing," said Lucky S. Slamet, head of Indonesian Agency for Food and Drug Control (BPOM), in a workshop held in conjuction with the 2nd meeting of OIC vaccine- and medicine-manufacturers in Bandung, West Java province, on Monday.

Delegates and experts from nine OIC countries that already have their vaccine making facilities out of the total 57 OIC member countries are attending the meeting which runs from 16 to 19 June, 2013.

In the workshop, Slamet told the workshop that NRAs hold a decisive role in guarranteeing the quality of vaccine supplied to the global markets. The World Health Organization (WHO), therefore, always evaluates the NRAs through capacity building efforts so as to ever strengthen them.

"The WHO has declared us, the Indonesian National Agency of Food and Drug Control, to have performed an internatonal standard control function, in particular, on vaccine. With this achievement, Indonesia now has a wide opportunity - through Bio Farma - to export its products to international markets," she pointed out.

Based on this experience, Slamet added, Indonesia is ready and willing to share with OIC member states the experience in strengthening their RNA functions in vaccine manufacturing.

"Out of the total 57 OIC member states only five countries having their vaccine manufacturers and out of this five only one that can export its products, namely Bio Farma," Slamet emphasized.

According to World Health Organization (WHO), NRAs are national regulatory agencies responsible for ensuring that products released for public distribution (normally pharmaceuticals and biological products, such as vaccines) are evaluated properly and meet international standards of quality and safety.

Countries producing vaccines need to exercise six critical control functions, and exercise them in a competent and independent manner, backed up with enforcement power. The six functions are a published set of requirements for licensing, surveillance of vaccine field performance, system of lot release, use of laboratory when needed, regular inspections for good manufacturing practices (GMP) and clinical performance evaluation.

Bio Farma Sales and Marketing Director Dr. Mahendra Suhardono also spoke in the workshop on quality management system (Manufacture, Pre Qualification of Vaccine) in a way to meeting the Good Manufacturing Practices (GMP as set out by the for WHO prequalification.

Bio Farma, he said, has been able to maintain an integrated system of quality control management as well as efforts on keeping it update with latest GMP requirements.

Bio Farma is Indonesia's only vaccine manufacturer whose products have been recognized by WHO since 1997 that the company can supply its products to over 120 countries.

Currently the needs for Expanded Program on Immunization (EPI) vaccines in Indonesia have been supplied solely by Bio Farma by producing and distributing over 1.7 billion doses of vaccine per year to meet the needs of EPI vaccine for national immunization program.

Bio Farma has an outstanding international reputation based on the WHO prequalification for all of its EPI vaccine products and has also implemented green industry and is environment friendly. WHO acknowledges that Bio Farma vaccine products are of high quality, efficacious, and affordable.

Bio Farma products are through the direct distribution or through various agencies such as UNICEF, PAHO. The company has obtained the Best Export Performance from the Indonesian Trade Ministry consecutively in 2010,2011, 2012 as an evidence of its consistent exceptional performance.

About OIC

The Organisation of Islamic Cooperation (OIC) is the second largest inter-governmental organization after the United Nations which has membership of 57 states spread over four continents. The Organization is the collective voice of the Muslim world and ensuring to safeguard and protect the interests of the Muslim world in the spirit of promoting international peace and harmony among various people of the world.

About PT Bio Farma (Persero)

Since its establishment in 1890, PT Bio Farma (Persero) has been active in supplying high quality vaccines and serum for people. Currently, Bio Farma is among the largest vaccines manufacturers and suppliers in the world. The need for EPI vaccines in Indonesia has been supplied solely by Bio Farma.

Bio Farma has existed for a century and proven its strength and experience world wide. The company has also grown and developed to become a vaccine and serum manufacturer of international reputation. This can be seen from its qualifications and ability to acquire WHO prequalification for all of its EPI Vaccine products. For more information, please visit http://www.biofarma.co.id/.

(source: www.newsmaker.com.au)

The World Health Organization evaluates international health care systems based on five criteria. Factors include the health of the overall population, care inequalities within the population and the responsiveness of the health system. The WHO additionally assesses heath care provided to the various economic levels of a population along with who covers the cost of the health system. The following countries offer some of the best health care on the planet.

Switzerland

The health care system of the country represents the Bismarck Model, named for its founder, Prussian Chancellor Otto von Bismarck. Recipients receive care under an insurance system financed by employees and employers. Approximately 95 percent of Switzerland's residents have private insurance policies. Impoverished citizens unable to afford a policy receive government help. The premiums of all policies cost the same amount and the companies cannot profit from basic health care treatment. The companies may however, receive monies for the costs associated with alternative medicine, dental care or for private hospital accommodations. Studies indicate that the government overall only spends a little over 11 percent on the system.

France

France also adopted the Bismarck Model with some variations.Residents obtain medical insurancethrough their place of work in addition to having private supplemental coverage. The government pays around 75 percent of the cost of medical care using the mandatory funds received from employees. Supplemental policies cover the remaining costs. Affluent citizens have the option of receiving elective procedures at their expense. All of the French citizens have the right to choose a health care provider and patients typically receive same day treatment.

Italy

According to infant mortality rates and life expectancies, Italy remains one of the countries providing the best health care. Employers provide and pay for the health insurance of employees, which features low-cost or no cost coverage regardless of the type of treatment. Unemployed individuals have the option of obtaining state operated medical coverage. Studies suggest that physicians remain dedicated to patients and receive exceptional training. Private hospitals receive glowing reports that rival any other country.

Taiwan

The country adopted the National Health Insurance Model in 1995, which combines the Beveridge and Bismarck systems. Private companies offer the policies that residents pay to the government who in turn covers the cost of medical treatment. The cost effective model does not allow profit by the insurance companies, preventing a motive for denying claims. However, the government only pays for a limited number of services or requires that patients wait a specific period of time for treatment. Individuals not able to afford private policies have the option of obtaining government assistance. Taiwan also implemented the "smart card." Each resident receives a card that contains a continuing medical history.

Australia

The country adopted the Douglas Model of healthcare that represents a dual system of private and public health insurance. Affluent residents must have private insurance or pay a specialized tax when using the Medicare public system. Employees pay an insurance premium through their paychecks that covers the cost of using the system. Physicians have private practices and receive wages when treating public patients. They also receive compensation when treating citizens with private policies. Two thirds of the country's hospital beds lie in public facilities. The remainder one third lies in private facilities. A drawback of the public system sometimes means patients wait for treatment.

(source: www.liveinsurancenews.com)

PHNOM PENH, June 12 (Xinhua) -- Hundreds of Cambodian citizens and dozens of foreigners working in Cambodia lined up to donate their blood on Wednesday during the celebrations of the 10th World Blood Donor Day.

Speaking at the event, Cambodian Minister of Heath Mam Bunheng expressed gratitude to all blood donors, saying that their donation was very valuable to save lives of the patients.

"I urge all of you to continue your donation," he said. " Blood transfusion will not harm your health; instead, your blood will save lives of people who are in need of blood."

Hok Kim Cheng, director of National Blood Transfusion Center, said the celebrations were to appeal to donors to donate blood in order to ensure the stability of supplying blood to hospitals and health centers throughout the nation.

He said last year, the center had received voluntary donations of 60,084 units of blood, up 28 percent from 46,690 units in a year earlier.

"More and more Cambodians are aware of the advantage of blood in saving lives," he said. "About 4.2 out of 1,000 people donate their blood last year, up from 4 out of 1,000 people in a year earlier."

He said all blood would be tested for four types of diseases, HIV, hepatitis B and C, syphilis, and malaria.

"The blood that contains any of these diseases will be destroyed," he said.

Dr. Pieter Van Maaren, representative of the World Health Organization to Cambodia, said a unit of blood could save up to three lives in low income countries including Cambodia.

"The event is very important to encourage people to donate blood and to thank donors for their blood donation," he said.

One of the blood donors is a Buddhist monk who has donated blood to the center for 31 times.

"I have donated blood in every three months, there is no any harm to my health," said Svay Sophea, a Buddhist monk at Botum Vatey pagoda in Phnom Penh. "This is the way I can do to save lives of people who are in need in blood."

(source: news.xinhuanet.com)

SANTO DOMINGO, Dominican Republic – The counter-narcotics fight is fueling an international hepatitis C epidemic, according to a new report, leading prominent world and Latin American figures to call on countries to decriminalize drug use and focus on treatment.

"The Negative Impact of the War on Drugs on Public Health: the Hidden Hepatitis C Epidemic," produced by Global Commission on Drug Policy, stated that about five of every eight intravenous drug users are living with the disease.

The World Health Organization (WHO) estimates that about 150 million people are chronically infected with hepatitis C, which kills about 350,000 people a year – most of whom develop cirrhosis or cancer.

In the Americas, between seven and nine million are infected with the disease, according to the Pan American Health Organization (PAHO). The organization doesn't estimate the number of deaths specifically caused by the disease, but according to PAHO statistics about 16,500 people die of related disease – such as cirrhosis – annually.

About 10 million people living with the disease are intravenous drug users. But the Global Commission on Drug Policy said the disease is needlessly spread due to outdated laws and policies that target drug users.

Hepatitis C, one of the five types of viral hepatitis diseases that affect the liver, is contracted through contact with the blood of infected persons, meaning intravenous drug users run a high risk of contracting the disease. It is a leading cause of liver transplants.

Infection rates are highest in countries in Central Asia and Eastern Europe, where as many as 90% of intravenous drug users are infected.

The commission carries the weight of several prominent figures. Former United Nations Secretary-General Kofi Annan, seven former presidents and Virgin Group founder Richard Branson are among the commission's members.

Former Brazilian President Fernando Henrique Cardoso, the commission's chairman, said hepatitis C is "both preventable and curable when public health is at the core of drug response."

With the report, "we are exposing the links between repressive drug policies and the spread of hepatitis C, another massive and deadly global epidemic," Cardoso said in a video message introducing the study. "This is another concrete example of the failure and negative impacts of repressive drug policies around the world."

The commission previously had warned of the link between criminalized drug use and the spread of HIV/AIDS. By linking drug use to hepatitis C, the commission hopes to provide another example in the argument that drug use should be decriminalized.

Cardoso also said it's a human rights issue.

"Though human rights abuses are widespread in most parts of the world, they come about in different ways," he said. "In Latin America, the main issue is mass incarceration, violence and corruption and the strengthening of organized crime."

Specifically, the commission is recommending governments:

1. End criminalization and mass incarceration of drug users;
2. Redirect money currently dedicated to the counter-narcotics fight toward public health projects aimed at drug users;
3. Make sterile syringes available and offer treatment programs, such as opioid substitution therapy for heroin users;
4. Better report hepatitis C cases by improving surveillance systems and other measures;
5. Reduce the cost of medicines that can treat hepatitis C by negotiating with pharmaceutical companies and making the drugs more widely available.

The report was released in advance of the International Harm Reduction Conference in Lithuania, which began June 9.

Meantime, last week's 43rd General Assembly of the OAS ended with foreign ministers' creating a roadmap they hope leads to long-term renewal of their regional drug policy in 2016.

Officials at the General Assembly, which was held in the Guatemalan city of Antigua, said they will convene a special meeting during the first half of 2014 to outline the counter-narcotics strategy that will be discussed when the OAS holds its 44th General Assembly in June 2014 in Paraguay.

"We have already reached a consensus and agreed that our final declaration will include changes to the current anti-drug model," Guatemalan Foreign Minister Fernando Carrera told reporters. "We already have some ideas on how to change drug-fighting policies."

(source: infosurhoy.com)

Social and structural factors – such as poverty, marginalisation and stigma – and not just individual behaviours are shaping the HIV epidemic in Europe and central Asia.

This is the main conclusion of a new report released by the London School of Hygiene & Tropical Medicine, the World Bank Group and WHO/Europe. The study systematically reviews evidence on HIV vulnerability and response in all countries of the WHO European Region.

The report, HIV in the European Region: vulnerability and response, focuses on key populations most at risk of HIV infection: people who inject drugs, sex workers and men who have sex with men. It confirms that they are disproportionately affected by the growing HIV epidemic in Europe, where the number of reported HIV cases reached over 1.5 million in 2011.

HIV cases in these three groups account for about 50% of total diagnoses. Economic volatility and recession risks are increasing vulnerability to HIV and infections.

Key findings in the report include the following.

• 25% of HIV diagnoses in Europe were associated with injecting drug use, with much higher proportions in eastern Europe (33%) than in western Europe (5%) and central Europe (7%).
• HIV remains relatively low among female sex workers in Europe who do not inject drugs (less than 1%), but higher among those who inject drugs (over 10%) as well as among male and transgender sex workers.
• Sex between men accounted for 10% of all HIV diagnoses in Europe, with higher rates reported in western Europe (36%), followed by central Europe (22%) and eastern Europe (0.5%). The increase was higher, however, in central and eastern Europe.

The analysis highlights the pivotal role of environmental factors in shaping HIV epidemics and HIV prevention responses. Barriers to successful HIV responses include the criminalisation of sex work, of sex between men, and of drug use, combined with social stigmatisation, violence and rights violations.

Co-author of the report, Professor Tim Rhodes from the London School of Hygiene & Tropical Medicine, said: "We need to maintain the momentum of HIV prevention for vulnerable populations in Europe. The need for scaling-up HIV prevention for people who inject drugs remains most urgent in the east of Europe. Not only do we need to promote treatment interventions tailored to individuals, we need to strengthen efforts to bring about social, structural and political changes".

The report calls for policy-makers and HIV programme implementers to target the right policies and programmes to maximise the health and social impacts of Europe's HIV responses and get higher returns on HIV-related investments

Professor Peter Piot, Director of the London School of Hygiene & Tropical Medicine, added: "Now is an important time for Europe. The momentum of HIV prevention must be maintained in a climate of economic and funding uncertainty. The evidence gathered through our collaborations with the World Bank Group and the World Health Organization show how institutions can work together to generate the evidence and the policy to do this."

(source: www.healthcanal.com)

The Ministry of Health partnered with 10 telecommunication service providers to launch a national health emergency hotline similar to the United States government's 911 emergency hotline number.

According to Akmal Taher, the Health Ministry's director general for health development, the hotline number, 119, would allow the public to obtain information regarding the availability of hospital rooms as well as make emergency requests for an ambulance.

"In the future, we will no longer see patients being rejected by hospitals when they are in dire need of health assistance. They can simply dial the number to get information about the nearest available hospitals," Akmal told reporters on Monday. The 119 emergency hotline was first launched in Jakarta early this year, in cooperation with PT Telkom Indonesia. The service is now being expanded nationwide as part of the Ministry's Memorandum of Understanding with the following key stakeholders: PT Telekomunikasi Indonesia; PT Telekomunikasi Selular; PT Indosat; PT XL Axiata; PT Smartfren Telecom; PT Bakrie Telecom; PT Axis Telekom Indonesia; PT Sampoerna Telekomunikasi Indonesia; PT Smart Telecom and PT Hutchison 3 Indonesia.

Meanwhile, Chairul Rajab Nasution, the ministry's health referral system director, estimated the service to be ready for full implementation across all provinces by 2014.

Nasution added that they hope address certain drawbacks such as the need to key in the area code when dialling the 119 hotline number.

(source: www.futuregov.asia)

The World Bank (WB) on Monday approved an assistance package of US $ 100 million for the Punjab Health Sector Reform Project's implementation. It would focus on enhancing the number of people with access to basic health services, particularly in the low performing districts of Punjab.

"Punjab holds the key to Pakistan's progress towards attaining the Millenium Development Goals (MDGs) as it constitutes 60 percent of Pakistan's population", said Pakistan World Bank Country Director Rachid Benmessaoud.

"This programme would help the Punjab government implement its Health Sector Strategy by building the capacity and systems to strengthen accountability and stewardship in the Health Department," Rachid added.

Punjab's overall health outcomes are comparable to the national average, and slightly better than other provinces, but the pace of change remains slow and uneven with significant disparities among regions, rural and urban areas, and by economic status.

For example, the average exclusive breast-feeding duration is only 0.9 months in Punjab, compared to the national average of 3.2 months. Immunization coverage also remains low; only one in three children aged 12-23 months are fully immunized (34.6%).

The Punjab government is keen towards human development for a productive workforce due to its increasing youth population. It said it had included health in a holistic Punjab Health Sector Strategy 2012-2020, which involves governance, accountability reforms and strengthening health systems.

"Punjab has gradually improved maternal and child-outcomes and for further improvement, addressing the huge burden of malnutrition among women and children is crucial. Stunting occurs among 39 percent children under five", said Dr. Inaam-Ul-Haq, the project's task team leader, adding that the project would aim "to improve the health service providers' capacity to deliver nutrition interventions at the facility and community level."

The project comprises four components and its results would specifically measure improvements in three health service indicators: fully immunized children 12-23 months of age; use of skilled birth attendants and use of modern birth-spacing methods. 

(source: www.pakistantoday.com.pk)

There needs to be international agreement on when and how death is diagnosed, two leading doctors suggest.

At a European meeting of anaesthetists they said improvements in technology mean the line between life and death is less clear.

They called for precise guidelines and more research to prevent the rare occasions when people are pronounced dead but are later found to be alive.

The World Health Organisation has begun work to develop a global consensus.

In the majority of cases in hospitals, people are pronounced dead only after doctors have examined their heart, lungs and responsiveness, determining there are no longer any heart and breath sounds and no obvious reaction to the outside world.

'Permanent damage to brain'

But Dr Alex Manara, a consultant anaesthetist at Frenchay Hospital in Bristol, said more than 30 reports in medical literature, describing people who had been determined dead but later found to be alive, had driven scientists to question whether the diagnosis of death can be improved.

At a meeting of the European Society for Anaesthesiology he said that on some occasions doctors do not observe the body for long enough before someone is declared dead.

Dr Manara called for internationally agreed guidelines to ensure doctors observe the body for five minutes, in order not to miss anyone whose heart and lungs spontaneously recover.

Many institutions in the US and Australia have adopted two minutes as the minimum observation period, while the UK and Canada recommend five minutes. Germany currently has no guidelines and Italy proposes that physicians wait 20 minutes before declaring death, particularly when organ donation is being considered.

Dr Jerry Nolan, consultant in intensive care at the Royal United Hospital in Bath, who is not involved in the conference, said: "In hospitals, where patients are monitored closely, and after the appropriate resuscitation has taken place, waiting five minutes to observe the body is a good idea.

"There is evidence to show that once you start going beyond five minutes without a circulation or oxygen to the brain you start seeing permanent damage to brain cells."

At the conference, Ricard Valero, professor of anaesthesia at the University of Barcelona, considered the rarer scenario of patients in intensive care units whose hearts and lungs are kept functioning by machines.

In such scenarios, doctors use the concept of brain death - often conducting neurological tests to monitor any brain activity in the patient.

'Variations don't seem logical'

But the criteria used to establish brain death have slight variations across the globe.

In Canada, for example, one doctor is needed to diagnose brain death; in the UK, two doctors are recommended; and in Spain three doctors are required. The number of neurological tests that have to be performed vary too, as does the time the body is observed before death is declared.

"These variations in practice just do not seem logical," Prof Valero said.

He proposed further research to support a global consensus on the most appropriate criteria to diagnose brain death.

Dr Nolan said: "In principle an international guideline on death is a very good idea. It is likely to help in terms of the movement of doctors between countries and, importantly, with public confidence.

"Italians and Brits are probably built in the same way. It makes sense to have the same criteria for death for both."

(source: www.bbc.co.uk)