An Indonesian health official has acknowledged a shortage of intensive care units for babies, after the case of a new-born shocked the nation.

Five-day-old Dera Nur Anggraini died on Saturday due to breathing difficulties.

Her father said she was refused treatment by at least eight public and private hospitals.

Dien Emawati, head of Jakarta's public health office, said some of the hospitals had no neo-natal intensive care units or had been full.

The case of baby Dera has turned into a national media frenzy, with newspapers and television channels following it relentlessly, says the BBC's Karishma Vaswani in Jakarta.

She was born with a throat deformity and her family said all attempts to get her admitted to a bigger hospital for treatment failed.

Her father has also been quoted as saying that he could not afford to pay the fees requested at one private hospital.

Dera's twin sister, Dara, is reportedly being treated at a hospital in Jakarta, with her condition is improving.

Ms Emawati acknowledged that there was a shortage of facilities for new-borns requiring intensive care in the capital.

She said there are only 143 neo-natal ICU units in government and private hospitals in Jakarta, a city with a population of 10 million people.

In 2011, Indonesia passed an ambitious healthcare law pledging to provide health insurance to all of the country's 240 million citizens from January 2014, our correspondent adds.

But critics have questioned the sense of such a law when current healthcare facilities are already heavily over-burdened and under-resourced.

(source: www.bbc.co.uk)

GENEVA--The World Health Organization on Saturday urged countries to be vigilant over the spread of a potentially fatal SARS-like virus after a new case in Britain brought the global number to 12.

"Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns," the United Nations health agency said in a statement.

On Friday, British health authorities said that a third member of a family had been diagnosed with so-called novel coronavirus, but was not in danger.

"Although this new case offers further indications of person-to-person transmission, no sustained person-to-person transmission has been identified," said the WHO.

"Testing for the new coronavirus should be considered in patients with unexplained pneumonias, or in patients with unexplained severe, progressive or complicated respiratory illness not responding to treatment," it added.

Clusters of cases, and cases among health workers, should be thoroughly investigated wherever they occur, it underlined.

Britain's Health Protection Agency said the latest person to contract the virus was a relative of two other cases announced earlier this week.

The first member of the family, who was confirmed on Monday as having the virus, had recently traveled to the Middle East and Pakistan. The two relatives had no recent travel history.

A total of 12 cases have been reported to the WHO, with five of them fatal — three in Saudi Arabia and two in Jordan.

Coronaviruses are to blame for most common colds but can also cause SARS (severe acute respiratory syndrome).

A SARS epidemic killed more than 800 people when it swept out of China in 2003, sparking a major international health scare.

(source: www.chinapost.com.tw)

MANILA - The World Health Organization (WHO) issued a directive on Sunday for all health officials to find out if the novel coronavirus (NCoV) is spreading in countries aside from the United Kingdom (UK), where early cases have been reported.

It also advised countries to continue their surveillance efforts for severe acute respiratory infections (SARI).

"Testing for the new coronavirus should be considered in patients with unexplained pneumonias, or in patients with unexplained severe, progressive or complicated respiratory illness not responding to treatment," said the WHO.

The WHO added that new cases and clusters of the NCoV should be reported promptly to health authorities and them.

"Any clusters of SARI or SARI in healthcare workers should be thoroughly investigated, regardless of where in the world they occur," it said.

Last Wednesday, the UK government confirmed its first human to human transmission of the SARS-like virus.

The patient is believed to have caught the infection from a close family relative, who had travelled to the Middle East.

However, the WHO said it is not advising its member-states to issue a travel advisory since the confirmed victims in UK have no recent travel outside the country.

"WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied," said the WHO.

As of Saturday, the World Health Organization has recorded 12 cases of human infection with NCoV, including five deaths. (HDT/Sunnex)

(source: www.sunstar.com.ph)

HEALTH experts are urging the United States and other countries to boost their ability to identify fake or subpar medicines and close loopholes that allow products to be falsified or diluted.

In an international system in which different companies in many countries make ingredients for single treatments, no country alone can effectively enforce quality control on drugs that can be the fine line between life and death, stressed a report by the independent Institute of Medicine (IOM).

"Falsified and substandard medicines are a grave public health problem because they are ineffective, promote drug resistance, and even cause severe illness and death, particularly in developing countries where they regularly flood the market," said Lawrence Gostin, health law expert at Georgetown University Law Center who led the group of 12 experts who did the study.

"We're calling on WHO, in collaboration with regulators, companies, and civil society worldwide, to adopt a global code of practice, build national regulatory capabilities, and promote international cooperation," Gostin said.

Fake versions of the cancer drug Avastin were given to US patients in 2011 and 2012, for example, but similar problems occur even more frequently in poor countries, the committee found. Avastatin is made by Switzerland's Roche.

"Given the international nature of modern manufacturing and trade, every nation has a stake and a role to play in ensuring the production and sale of high-quality medications," said Gostin, who is director of the World Health Organization (WHO) Collaborating Center on Public Health Law and Human Rights.

Counterfeit and substandard medications with little or no active ingredients can hasten drug resistance, do not treat disease, and boost health care costs. In addition, products that contain dangerous ingredients have sickened and killed people around the world, the report explains.

It urges the WHO to increase its cooperation with regulators worldwide.

"What we're seeing in the United States - and doubly so in developing countries - is a race to the bottom," Gostin said. "Unscrupulous drug suppliers seek the state or country with the weakest regulatory and law enforcement standards. We need to encourage a status competition for the finest regulatory oversight."

So the report urges a mandatory drug tracking system.

US "agreement on a federally mandated tracking system has been slowed by costs associated with changing drugs' primary packaging and labels as well as wholesale repackaging, the report found. "Without a national system, however, companies face the burden of meeting competing state demands. For example, California will require unique serial numbers on bottles and vials by 2015," it said.

The report also urges adoption of the terms "substandard" and "falsified" to refer to products that pose a public health risk, asking parties to refrain from using the term "counterfeit" except in trademark infringement cases.

"Consistent use of terms would improve nations' abilities to document the extent of the problem, determine causes, and discuss possible solutions," it added.

(source: www.theaustralian.com.au)

In order to cut premature death rates, the world's politicians need to focus on "simple measures" like anti-tobacco policies, cutting salt levels in food, and improving access to affordable heart disease drugs, according to experts writing in The Lancet today.

The report focuses on preventing 'non-communicable' diseases, or NCDs – i.e. cancers, heart disease, strokes, chronic lung diseases, and diabetes.

Rates of these diseases – which are often linked to lifestyle – are set to soar across the developing world in coming decades.

According to recent estimates, 34.5 million people died from NCDs in 2010, representing two-thirds of the 52.8 million deaths worldwide that year.

In May 2012, the World Health Organisation (WHO) committed to reducing preventable NCD deaths by 25 per cent by 2025.

But in order to make this reality urgent action is needed, the panel of international experts said.

The key is to regard health not as a "goal" of development, but "an instrument to bring it about," according to Sir George Alleyne, Emeritus Director of the Pan American Health Organization and contributor to the report.

"Any realistic attempt to make human development sustainable must take NCDs into account."

That means regulating the marketing of tobacco, alcohol, and 'ultra-processed' food and drinks, said Professor Rob Moodie from the University of Melbourne.

"These companies say they're part of the solution, but the evidence says otherwise. They should have no role in formulating health policy. Put it this way – you wouldn't let a burglar change your locks," he added.

According to the report, there is growing evidence that multinational food, drink and alcohol manufacturers are adopting similar strategies to tobacco industry to undermine public health policies. They should thus be similarly regulated, argue the authors.

Tobacco is the most important preventable cause of cancer, but the disease is also linked to obesity, high alcohol consumption and poor diet.

Policymakers also need to focus on equal access to healthcare, including vaccines and drugs – particularly cheaper generic drugs which could "prevent or treat most NCDs".

Hazel Nunn, Cancer Research UK's head of evidence and information, welcomed the report.

"Cancer is often seen as a disease of the richer world, but just over half of the 12.7 million people diagnosed every year live in less developed countries, and this proportion is rising fast," she said.

"This new report is an important and timely reminder to keep non-communicable diseases high on the global political agenda. Just like the other major NCDs, cancer is a social and economic issue as well as a health issue, and requires strong and joined-up action."

"The Framework Convention on Tobacco Control has given policymakers much-needed guidance in setting national anti-tobacco agendas. This new report suggests that the time may be right to mirror this approach in other areas, particularly alcohol and 'ultra-processed' food and drinks," she added.

(source: www.cancerresearchuk.org)

The three tiers of government in the country have been advised to enroll their citizens into the National Health Insurance Scheme (NHIS) as a means of improving access to quality care in hospital, Senator Isa Zarewa, chairman of a health organization has said.

Senator Isa Zarewa, chairman of the International United Health Care, a Health Maintenance Organisation (HMO) told Daily Trust that most developed countries who are presently medical tourist centres and raking in millions for their countries are able to attend such status because they have well established health insurances.

Speaking during a training organized by the organization to update its staff on best practices abroad on how to provide better services to their client at the Reiz Hotel, Zarewa said that the HMO was looking at cascading into community health insurances to assist those at the rural areas.

He added that if the NHIS is adequate financed by the government, or even people it would go along way to do away with out of pocket spending, which is gradually collapsing the system

He however warned that the HMO would always put their client's health first and deal with hospitals that fail to compel with the terms of agreement and mis management the needs of the patients.

Earlier the managing director of International United Health Care, Dr Kolawole Owoka said that though the health sector is fragmented, with the rich travelling abroad for medical treatment, with the poor making do with what the country has to provide, NHIS according to him can bridge the wide gap in accessing health care.

He added that the organization is bracing up to assist the government achieve universal coverage which he said would improve the health indices.

He advised that to achieve universal coverage, Nigeria as a developing nation has to borrow a leaf out of great developed countries and look at how they operate their health insurances, with minority group subsiding the bills of the majority.

(source: allafrica.com)

A website providing a directory of medical services and other resources for people living with HIV/AIDS in Indonesia was recently set up to help patients more easily access treatment and information about the disease.

"We decided to set up this portal and mobile application we call 'AIDS Digital' because there has not been a comprehensive service that could facilitate the AIDS-affected community or the public in general who want to know more about HIV testing, antiretroviral [therapy and drugs], reference hospitals or any other sexual transmitted disease," Aditya Wardhana, the executive director of the Indonesia AIDS Coalition, told the Jakarta Globe on Saturday.

Aditya said even with the growth of the Internet and access to it, proper information about HIV/AIDS in Indonesia was scarce. Even those able to access the information found it difficult to ask further questions because few websites providing information about HIV/AIDS were interactive.

Users are able to submit questions about HIV/AIDS and receive responses via the website.

"Most of the time the dissemination of information about HIV/AIDS was done from mouth to mouth," Aditya said. "This method has failed to break the negative stigma and taboo surrounding the infection itself."

AIDS Digital, which can be accessed at www.aidsdigital.net, offers directories of health facilities providing sterile needles, methadone therapy and antiretroviral drugs, as well as the addresses of reference hospitals and nongovernmental organizations that provide counseling and advocacy for HIV/AIDS patients. It also contains comprehensive information about HIV/AIDS, prevention programs and discussions aimed at debunking myths about the disease.

The website also allows users to rate the services provided by health facilities.

"With the satisfaction survey, we hope we can push the health service in Indonesia to improve," Aditya said.

"We hope AIDS Digital can be a private space for the AIDS-affected community so they can access the service they need without having to be burdened by shame or fear of people finding out about their status," he added.

The number of Indonesians living with HIV was around 370,000 in 2011, according to UNAIDS.

About $69 million was spent in 2010 to prevent and treat AIDS in Indonesia, according to the National AIDS Commission, an increase of around $13 million since 2006. More than half of that comes from international sources of funding.

(source; www.thejakartaglobe.com)

More coherence is needed between public health, intellectual property (IP), and trade policies in order to advance innovation and improve access to medicines, according to a joint report released by the WTO, the World Health Organization (WHO) and the World Intellectual Property Organization (WIPO) on Tuesday.

The study, entitled "Promoting Access to Medical Technologies and Innovation: Intersections between Public Health, Intellectual Property, and Trade," was designed to bring together the three organisations' respective areas of expertise with the goal of better informing policy-making decisions, especially in developing countries.

Coherence is key, WTO, WIPO, WHO chiefs say

In recent years, the role of the IP system in fostering medical innovation and its potential impact on medicines' availability have been the subject of extensive discussions - and controversy - at the different organisations.

"The IP system is not an isolated specialist domain, nor yet a monolithic barrier to public health; instead, IP is an element of a complex set of policy tools required to resolve global problems," WTO Director-General Pascal Lamy explained.

Coherence between health policies, IP rules, and trade policy is therefore "key" toward ensuring that sustainable solutions are found for issues involving access to medicines and medical technologies, the WTO chief added. Along with medicines, medical technologies can also include vaccines and medical devices.

Indeed, the mission of IP is to find an equilibrium point among all interests that surround the process of knowledge production and distribution, as well as "translating intellectual assets into productive assets," WIPO Director-General Francis Gurry told the audience.

Developed countries have traditionally argued that making patent laws less stringent could hinder innovation on developing medicines and medical technologies; meanwhile, developing countries have long called for more flexibilities and exceptions to have more policy options available in this area.

The study therefore calls for appropriate and creative patent licensing strategies to ensure that drugs and medical technologies are made both affordable and available in poorer countries. While the study also points out the importance of the patent system for the pharmaceutical sector, it identifies alternative incentive mechanisms that seek to enable the development of new products for treating neglected diseases.

The organisations also list various flexibilities aimed at safeguarding the public interest that are already available in the international IP regime. In this regard, WHO Director-General Margaret Chan indicated the need to discuss ways to promote drug availability for treating non-communicable diseases - such as anti-cancer medicines - specifically mentioning the recent trend of issuing compulsory licenses to allow the production of life-saving generics. Chan stressed that generics must be brought quickly into the market, as delaying their entry "hurts public health."

She also suggested that attention should be given to the request by least developed countries (LDCs) to extend the transition period for applying the WTO's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), which is set to expire in July 2013. (See Bridges Weekly, 14 November 2012)

"I fully respect the sovereignty of the multilateral systems in WTO and WIPO. From a public health perspective, an extension of the transition period is worth consideration," Chan said.

Impact of trade policies on access to medicines

The study also highlights trends in trade of health-related products, and how certain trade policies can help or hinder access to medicines. For instance, high tariffs in some countries can have negative implications for this area.

The study also considers competition and procurement policies that could be beneficial in promoting innovation and availability of medical technologies. For instance, competition policies "can serve as a corrective tool if and when IP rights hinder competition and thus constitute a potential barrier to innovation and access."

With regard to procurement policies, the study indicates that open and competitive tendering - such as what the WTO's plurilateral Government Procurement Agreement aims to ensure among its parties - is particularly important in increasing access to medical technologies at a time when governments are facing intense budget constraints.

(source: ictsd.org)