New Delhi: Health issues in India are a highly debatable topic and one that needs urgent attention, primarily because of the way the problem is eating its way into the system.

The threat to health in India, in general, is devastating. Especially after the country has made such game-changing advancements in technology, it's a blow to see it go down in the health department.

The World Health Organisation (WHO) seems to have observed the downward trend too as it has emphasized the need to establish a national framework defining roles of the Centre and the states to address health issues and ensure convergence and portability.

This will also give the states the flexibility and freedom to choose their own path and progress at their own trajectory, says WHO Representative Dr Henk Bekedam.

"Diversity and equity are the two most crucial aspects of large economies like India. It is important to recognise diversity and also different health needs necessitate different approaches. Health is a state subject in India. As the Centre and states are at varying levels of development, there is a need to be cognisant of this reality," Bekedam told PTI.

"It will therefore be important to agree on a vision for the health sector and develop a national framework that defines roles of the Centre and the states. The agreed framework will help ensure convergence and portability. This will also give the states the flexibility and freedom to choose their own path and progress at their own trajectory," he elaborates.

Praising the Centre's role in adopting several policies such as the Draft National Health Policy 2016, the National Health Mission among others, the WHO official said it should focus on positioning health higher on its agenda with a greater investment in the public health sector.

The country should also accelerate effective financial protection, protection from diseases, fast-tracking the Sustainable Development Goal 3 (SDG3) agenda and a strong monitoring and evaluation (M&E) system, Bekedam, who took charge as the UN body's representative to India in 2015, said.

On whether the objectives of the National Health Mission pertaining to the Universal Access to Equitable, Affordable and Quality Healthcare Services was achievable or not, he sounded positive reiterating on the need a framework for it.

"The objectives are achievable but what is needed is a clear framework of accountability and programmatic adjustment based on progress made. The vision to achieve 'health for all' is possible - but for this, the process needs to be owned and led by the country."

On the WHO's role in helping India implement the Universal Health Coverage (UHC), Bekedam says, "UHC is an overarching umbrella and key to achievement of all SDG-3 targets and intrinsically linked to reducing poverty and inequities. We are working closely with the government in this area and will continue to share global best practices and lessons learnt from other countries."

He hails India's attainment of polio-free status as one of the biggest achievements in the annals of public health.

"While retaining the essential polio functions of surveillance, outbreak response and containment, we will, in consultation with the government, provide support to address new and emerging public health priorities," Bekedam says.

http://zeenews.india.com/

Dakar — Africa’s new continent-wide public health agency — the Africa Centres for Disease Control and Prevention (Africa CDC) — could help prevent a repeat of the disastrous ebola epidemic by monitoring diseases across country borders and deploying a rapid task force at the first signs of an outbreak, health experts say.

The African Union (AU) launched Africa CDC on January 31 at its headquarters in Ethiopia. Epidemiologists began disease surveillance work there this month. The agency will have regional centres equipped for lab testing in Egypt, Nigeria, Gabon, Zambia and Kenya, and will expand an emergency volunteer corps, created during the Ebola epidemic, to thousands of health workers across the continent.

"What the Africa CDC can truly contribute is to bring [international disease] response closer to the countries," said incoming director John Nkengasong, a virologist and senior official at the US CDC. The agency will focus on strengthening national health systems through its regional networks, Nkengasong said, making countries less reliant on overseas medical aid, staff and equipment during outbreaks.

Although the AU first proposed the idea for an African health agency in 2013, the ebola epidemic in 2014-2015 highlighted its urgency and accelerated the planning, according to people involved. International agencies, including the World Health Organisation (WHO), were widely criticised for taking too long to respond to the ebola outbreak, which killed more than 11,300 people in West Africa.

Creating a response mechanism within Africa was a logical next step, experts said. The director of disease control and prevention in Sierra Leone, one of the countries hit hardest by Ebola, said he thought the most important aspect of Africa CDC would be collaboration with other countries’ health agencies. "I think it’s a very good idea so we can share information and work together," Foday Dafae told the Thomson Reuters Foundation, adding that the biggest challenge would likely be co-ordination.

International backing

Other health experts also praised the move, but said Africa CDC’s effectiveness could hinge on funding. "The AU initiative is evidence that countries have taken stock of the ebola crisis," said Mads Oyen, West and Central Africa emergency adviser for Unicef. "However, in order for Africa CDC to be a strong organisation, it will require long-term political will and financial commitment by national governments, as well as strong support from donor institutions."

The AU has allocated about 0.5% of its operating budget to Africa CDC; other funding will come from member states, partner countries and the private sector. The US and China are among those supporting the initiative.

The US CDC has advised the agency throughout its creation and will send two long-term advisors to the AU headquarters and support 10 African epidemiologists in the regional centres. The WHO has also provided technical assistance and will work closely with Africa CDC, said WHO Africa emergencies director Ibrahima Soce Fall, calling it a "very important step for the African region".

Experts said the agency’s relationship with the WHO will be critical to avoid being perceived as competition. Africa CDC will launch a five-year strategic plan in Addis Ababa at the end of March, and after that will build its staff. "There will be challenges," said director Nkengasong, "but the public health opportunities are huge."

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Asian countries are expected to face higher health care costs over the next 10 years.

The World Health Organization (WHO) says improvements in Asia’s economies have caused much lower levels of poverty. But this progress has caused changes in societies, lifestyles and the kind of food people eat. It has also caused an increase in urban pollution.

Conditions such as cancer, stroke and dementia are predicted to cause health care costs in the area to increase sharply.

The WHO says late treatment of cancer causes 1.3 million deaths a year in Southeast Asia. The UN organization says two thirds of the 8.8 million people who die of cancer worldwide each year are in Africa and Asia.

The WHO says cancers, diabetes, heart diseases and lung diseases caused 40 million deaths in 2015.

Cancer seen as a major health care cost in Asia

Costs to treat these diseases are increasing even as they become more common. In 2015, the cost of cancer drugs rose by 11.5 percent to $107 billion worldwide. Experts believe that will rise to $150 billion by 2020. They say the increase is mostly because of the cost of new drugs.

In a recent report, The Boston Consulting Group, a research organization, said the “cancer burden in developing countries is reaching pandemic proportions.” It notes that 2.5 million people die of cancer in India every year. It says the number of people with cancer in India could increase 500 percent by the year 2025.

China reported four million new cancer cases in 2016. The report noted that costs to care for people with cancer in China may increase 400 percent by 2025, to $1.84 trillion.

Gregory Winter is a professor at Cambridge University. He leads a team of researchers examining different ways to treat diseases like cancer. He reports some progress, but says the cost of treatment is too high for most people to pay.

He says, “in general we will be struggling with cost problems. The cost of antibody treatment can be in the order of $15,000 - $75,000 per year and that’s a lot for anybody.”

Some reports in China note that people with cancer, and family members who care for them, must pay a lot of money for cancer-fighting drugs. The report says some families buy drugs in unofficial markets. However, it warns that some of the drugs in these markets may be ineffective or fake.

Agencies in China that approve drugs work slowly. Some drugs are not available in China for as long as 10 years after they have been approved in the United States.

Professor Winter says such delays also take place in India. He says some Asian countries should “take more risks during the drug approval process.”

Strokes and dementia linked to pollution

Asian countries also are facing increasing costs for caring for the growing number of people affected by strokes and dementia.

In 2012, the WHO reported that 35.6 million people worldwide are living with dementia. It predicted that would increase to 65.7 million in 2030 and 115.4 million by 2050.

The report said almost 60 percent of those with dementia live in low- and middle-income countries. That percentage is expected to increase.

The WHO wrote that the huge cost of care drives millions of families into poverty. It says dealing with the increases should be a “public health priority.”

Valery Feigin is a director of the National Institute for Stroke and Applied Neurosciences at Auckland University of Technology. In 2016, his research showed a link between air pollution and strokes.

The researchers found that the harm air pollution causes to the lungs, heart and brain has been underestimated.

Vladimir Hachinski is an expert in stroke and dementia at the University of Western Ontario, in Canada. He said a growing amount of evidence links high levels of pollution with strokes and dementia.

Hachinski said, “This is a global problem because there are currents between the continents. There are currents in the atmosphere that carry air from one continent to another, and also within continents. So what happens in Beijing matters in Bangkok because the whole atmosphere is one in the biosphere.”

A recent report by the environmental group Greenpeace said air pollution causes up to 1.2 million deaths every year in India. That is almost as many deaths as tobacco use causes.

In China, high levels of smog affect cities during the winter. Research shows the smog causes more than a million premature deaths in China each year. It reduces life expectancy by two to five years.

Hachinski said Asia must find a way to deal with the pollution.

“At the rate we are going, we cannot afford more patients having strokes, more patients having dementia -- particularly in Asia, (which has) 61 percent of the world’s population,” he said. “In some countries like China, stroke is the leading cause of death and in Japan, of course, you have an aging population (and) you have high rates of stroke and dementia.”

Hachinski said if countries in the area do not deal with pollution, they might have a sharp increase in strokes and dementia.

http://learningenglish.voanews.com/

Oncological diseases kill about 8.8 million people around the world every year, the World Health Organization said on its website on Saturday. According to the news release timed for World Cancer Day, observed on February 4, as a rule cancer is identified at late stages.

"New WHO figures released this week indicate that each year 8.8 million people die from cancer, mostly in low-and middle-income countries. One problem is that many cancer cases are diagnosed too late," the release says.

World Health Organization specialists pay special attention to early diagnosis of cancer, because most oncological diseases are curable, if identified at early stages. Under WHO criteria cancer is regarded curable if the patient lives for more than five years after the disease has been identified. High mortality rates are usually observed among third and fourth degree cancer patients.

"By taking the steps to implement WHO’s new guidance, healthcare planners can improve early diagnosis of cancer and ensure prompt treatment, especially for breast, cervical, and colorectal cancers. This will result in more people surviving cancer. It will also be less expensive to treat and cure cancer patients," says Dr. Etienne Krug, Director of WHO’s Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention.

Situation in Russia
Russian Health Minister Veronika Skvortsova has said Russia has shown a considerable improvement in terms of early cancer diagnosis and one-and five-year life expectancy among cancer patients over the past few years.

"The identification of cancer at early stages has shown noticeable improvement. More than 57% of oncological diseases in Russia are exposed at early stages," Skvortsova said.

The Health Ministry has developed new rules of comprehensive medical examination, which may take effect next year. Patients of certain age groups will enjoy the benefits of oncological screening programs.

A federal anti-cancer program is being drafted. The Russian Health Ministry’s leading outsourced cancer specialist, Mikhail Davydov, says the program will be presented at an oncological conference in Bashkortostan’s capital Ufa next summer. In fact, it will consist of individual sub-programs each region will devise for itself.

Cancer is Russia’s number two killer disease, accounting for about 14-15% of all deaths in the country, Skvortsova said.

More: http://tass.com/world/929030 

The World Health Organisation (WHO) says it has developed a guide to effectively address all barriers to early diagnosis of cancer.

In a message released in Commemoration of the 2017 World Cancer Day, on Saturday, WHO called for improved access to treatment of cancer.

The message read: “In anticipation of World Cancer Day, WHO has developed a Guide to Cancer Early Diagnosis, to help effectively address barriers to early cancer diagnosis.

“The guide aims to help policy-makers, programme managers and cancer advocates develop or strengthen programmes that improve early diagnosis and access to treatment.

“The consequences are more people surviving cancer, less morbidity and lower costs from treatment.”

WHO said it had provided guidance on how to address the cancer challenge through comprehensive cancer control, founded on global coordination and strong health systems.

The UN health agency added that it had helped lead engagement of partner UN agencies and entities, such as the UN Joint Global Programme on Cervical Cancer Prevention and Control.

According to WHO, collaboration is critical to producing a stronger response against the disease that needlessly claims the lives of millions around the world each year.

“New WHO figures released this week indicate that cancer deaths continue to increase.

“In 2015, 8.8 million people died from cancer, mostly in low- and middle-income countries,” it said.

WHO emphasised that globally, common challenges to cancer control are delays in cancer diagnosis and inaccessible treatment.

“Even in countries with strong health systems and services, many cancer cases are diagnosed at a late-stage, when they are harder to treat successfully.

“On World Cancer Day, WHO acknowledges the role of all stakeholders to strengthen coordination and health systems in cancer control, working toward a future of healthy lives for all,” it stated.

The News Agency of Nigeria (NAN) reports that the World Cancer Day, organised by the Union for International Cancer Control and celebrated each year on Feb. 4, is an opportunity to rally the international community to end the injustice of preventable suffering from cancer.

NAN also reported that the theme of World Cancer Day 2017 is ‘We can, I can.’

http://tribuneonlineng.com/

As the World Health Organization Board prepares to consider candidate institutions to be admitted into official relations with the UN agency, some health and public interest groups are raising alarm at what they see as a seeming lack of safeguard against conflicts of interest. Particular concern has been raised over admitting the Bill & Melinda Gates Foundation as an observer because of the Foundation trust’s investments in business ventures such as Coca-Cola, which they see as contrary to health goals. But the Gates Foundation, which is the biggest private donor of the WHO, said the trust is a separate entity from the foundation, and refutes any conflicts of interest.

The WHO Executive Board, meeting from 23 January to 1 February, is expected to consider [pdf] the following candidates: the Bill & Melinda Gates Foundation, Grand Challenges Canada, International Rescue Committee, Knowledge Ecology International and The Fred Hollows Foundation for admission into official relations with WHO.

In May 2016, the WHO adopted a Framework of Engagement with Non-State Actors (FENSA), which is aimed at reducing the risk of conflicts. Non-state actors are non-government organisations, private sector entities, philanthropic foundations, and academic institutions.

A number of public interest, health, and citizens’ groups sent a letter [pdf] to the Executive Board calling the attention of the Board to the weakness of conflict of interest safeguards to protect WHO from influence of industry.

In the letter, the groups detail the example of the Gates Foundation, which is seeking to be admitted as an external actor in “official relations” with the WHO and as a non-voting member of the World Health Assembly. The Gates Foundation is the largest non-governmental donor of the WHO.

According to the letter, citing the United States Government’s Securities and Exchange Commission, “the Bill and Melinda Gates Foundation Trust endowment—the source of revenue for the Foundation—is heavily invested in many of the food, alcohol, and physical inactivity related consumer products that cause or treat the current crisis of preventable heart disease, stroke, cancer, and diabetes.”

In particular, “Gates Foundation Trust direct investments include: Coca-Cola regional company that operates in the Americas south of the U.S. ($466 million), Walmart ($837 million), the largest food retailer in the U.S. and a leading retailer of pharmaceutical drugs and alcoholic beverages, Walgreen-Boots Alliance ($280 million), a large multinational pharmaceutical drug retailer, and two of the world’s largest TV companies (screen-time): Group Televisa ($433 million) and Liberty Global PLC ($221 million),” the letter said.

The signatories belong to institutions such as Alcohol Justice (USA), Baby Milk Action (United Kingdom), Centre for Health Science and Law (Canada), FIAN International (Germany), Foundation for Alcohol Research and Education (Australia), Health Innovation in Practice (Switzerland), International Baby Food Action Network (Brazil) People’s Health Movement (Global), and World Public Health Nutrition Association (United Kingdom).

The letter notes that what they see as conflicts of interest are not acknowledged in the WHO budget’s financial contributor database, and only partially noted in the WHO’s Register of Non-State Actors.

The signatories called for member states to fund the WHO more adequately so it does not have to rely on funding from major investors in food, drug, and alcohol companies, and compromises the independence of the WHO.

They asked the Executive Board this week to “defer the decision to accept the Gates Foundation and any other new and legacy applicants for Official Relations status for which there has been no conflict of interest safeguard review on the record for consideration” by member states of the EB.

Gates Foundation Clarifies Independence

Meanwhile, according to Chris Elias, president of Global Development at the Gates Foundation, “The Gates Foundation provides the World Health Organization with funding to help it achieve global health goals that have been approved by its member states. These include global polio eradication and ending preventable child deaths. Formalizing our relationship with WHO under the framework that it has adopted for working with NGOs creates clear norms and guidelines for our ongoing support.”

“In this and all our work, the foundation operates as a separate entity from the Bill & Melinda Gates Foundation Trust,” he told Intellectual Property Watch in an email.

“Foundation staff have no influence on the trust’s investment decisions and no visibility into its investment strategies or holdings, other than through what is publicly available. This two-entity structure ensures that the foundation’s work remains independent from the trust’s investments, and focused solely on fulfilling our mission to improve quality of life for the world’s poorest,” he said.

Other Candidates

Grand Challenges Canada is funded by the government of Canada and fund innovators in low- and middle-income countries and Canada.

The United States-based International Rescue Committee specialises in relief during humanitarian crisis.

The Fred Hollows Foundation based in Australia works to restore sight to people in developing countries.

US-based Knowledge Ecology International has a focus on social justice.

Draft Decision Calls for Postponing Review of Some, Dropping Others

The draft decision to the agenda item on non-state actors calls for the Board to approve maintaining official relations with 58 non-state actors whose names are listed in Annex 2 of the document. This includes the Drugs for Neglected Diseases initiative, International Baby Food Action Network, International Federation on Ageing, Medicines Patent Pool, Médecins Sans Frontières (MSF, Doctors Without Borders), and the International Society for Biomedical Research on Alcoholism.

The draft decision also asks to defer the review of relations with a number of non-state actors until the 142nd session of the EB in January 2018. The list includes the European Generic Medicines Association, the International Union for Health Promotion and Education, and the World Federation of the Deaf.

Among the institutions with which the WHO suggested discontinued relations are the Inter-African Committee on Traditional Practices affecting the Health of Women and Children, the International Centre for Trade and Sustainable Development, and the World Association for Sexual Health.

http://www.ip-watch.org/

The list of candidates to become director-general of the World Health Organization was whittled to three Wednesday, with a final choice due in May.

The U.N. agency said those left in the running were Ethiopian Foreign Minister Tedros Adhanom Ghebreyesus; medical doctor David Nabarro, who served as U.N. envoy on Ebola; and Sania Nishtar, the Pakistani founder of a health think tank, Heartfelt, who served one year as a federal minister.

The next WHO chief will replace Margaret Chan, who took over its reins 10 years ago and came under fire for the agency's sluggish reaction to the Ebola epidemic, which spread across West Africa, one of the world's poorest regions, and killed of thousands of people. Chan's second five-year term ends June 30.

The final choice is to be made by the World Health Assembly, the annual ministerial gathering of WHO's 194 member states, held May 22-31.

Some public health policy experts called for a leader with political experience to revive the WHO's international standing and bring in funding for flagship programs.

"International organizations like WHO have lost lots of luster," Lawrence Gostin, professor of global health law at Georgetown University Law School, told Reuters. "WHO was wounded very badly with Ebola, and now even its new emergencies program is underfunded. It should be easy to fund. That is why somebody who has a lot of political stature has to direct it."

http://www.voanews.com/

The process of choosing the next director-general of the World Health Organization starts in earnest this week. While the final selection won’t be made until May, the current field of six will shrink to five, then no more than three before the week is out.

If you haven’t been paying much attention up until now, you’re not alone. With Brexit and the US election, this campaign has been getting little attention.

So let’s explore the three Ps — the people, the process, and the predictions.

Who wants to lead the WHO?

Four Europeans, one African, and one South Asian are vying to succeed Dr. Margaret Chan, whose second term as WHO director-general ends on June 30. (Directors-general can only serve two five-year terms. Chan, who was nominated by China, served a little longer because her predecessor, J.W. Lee of South Korea, died before his term ended.)

All but one of this year’s candidates is a medical doctor. Four have served as health minister for their respective countries and two of those four have also served as foreign minister. Two have had extensive WHO experience. Most have done work for global institutions — the United Nations, the World Bank, UNICEF, or prominent players in the global health sector such as Roll Back Malaria and Gavi, the Vaccine Alliance.

The candidates are:

• Tedros Adhanom Ghebreyesus, 51, from Ethiopia. Tedros (he goes by his first name), who was until recently foreign affairs minister, and health minister earlier in his career, is the only non-physician; he has a PhD in community health.
• Dr. Flavia Bustreo, 55, from Italy. Bustreo is WHO’s assistant director-general for family, women’s, and children’s health (on leave while she campaigns). She has also worked at UNICEF and the World Bank.
• Dr. Philippe Douste-Blazy, 64, of France. A former health and foreign affairs minister, he founded UNITAID, which works to prevent, diagnose, and treat HIV.
• Dr. David Nabarro, 67, of Britain. Nabarro has spent much of his career at the WHO and then the UN. He is currently the special adviser to the UN secretary general on sustainable development and climate change.
• Dr. Sania Nishtar, 53, of Pakistan. A former health minister, Nishtar has extensive experience both nationally and internationally in the civil society sector.
• Dr. Miklós Szócska, 56, from Hungary. Szócska is a former health minister, and a professor in the Health Services Management Training Centre, at Semmelweis University in Budapest.

How does this election work?

The first few steps in this process are taken by the WHO’s executive board, which holds its annual meeting in Geneva this week. It is composed of representatives from 34 countries who are elected to serve on the board for three-year terms.

The United States currently has a seat on the executive board, held by Dr. Tom Frieden, who until Friday was director of the Centers for Disease Control and Prevention. He was not asked to stay on by the incoming Trump administration.

The US government has not made public who it is backing in this race and Frieden will not say for whom he’s been instructed to vote. “That is confidential,” he told STAT in an email.

Voting throughout this process will be done by secret ballot, a decision some observers have criticized.

On Tuesday, the executive board will vote to select a short list of five candidates who will be interviewed Wednesday. The interviews — one hour per candidate — will be held behind closed doors. Canada and Colombia have put forward a motion to make the interviews public, but it was not accepted.

After the interviews, executive board members will pare the list of candidates down to no more than three. The finalists will continue to campaign until the World Health Assembly — the WHO’s annual general meeting — in May, when the 194 member states will elect Chan’s successor. He or she will take office July 1.

Anyone want to place a bet?

If you’re tempted, you may not find someone to take it.

“I do think the outcome is going to be unpredictable,” Suerie Moon, director of research at the global health center of the Graduate Institute of International and Development Studies in Geneva, told STAT. “Everybody has their hunch. But I haven’t spoken to a single person who thinks they know or will admit that they know.”

Many observers are skeptical that Szócska will make it to the interview stage. His CV is thinner than those of his rivals.

After that, it becomes much harder to forecast. Voting for a position like this involves backroom diplomacy and often, frankly, horse-trading — things that are impossible to track with secret ballots and when few if any countries openly declare their preference.

Another factor adds to the opacity: When voting on the final three, board members will have three votes apiece. The system may have been devised to try to ensure that the three strongest candidates go forward to the final round, but observers are not so sure things will work that way.

Some countries may choose to cast one vote for the person they hope will win, and use the other two to strengthen his or her chances by supporting weaker candidates to knock out their favorite’s strongest rivals. Or the executive board as a body might favor a candidate, and nominate that person plus two weaker candidates — putting its thumb on the scale, essentially.

Who would be best for WHO may not be top of mind. “I would be highly skeptical that that is the driving force behind voting decisions,” said Moon. “I think countries will vote based on strategic calculations.”

While the outcome is uncertain, there are a few tea leaves in the bottom of the cup.

For a while, the word in international circles was that it was Africa’s turn; an African has never led the WHO. And though a number of potential African candidates tested the waters early on, only one emerged. Early last year, the African Union said all African countries were supporting Tedros. That would make a 54-country bloc for him if he makes it to the final three. But only eight African Union countries are on the executive board. And rumors have swirled for months that France has pried away some African support for Douste-Blazy, for whom France has been campaigning hard.

Having four candidates from Europe doesn’t help any of them, as it likely splits what might otherwise might have been a significant bloc. Likewise, Britain’s departure from the European Union may cost Nabarro — who on experience alone would appear to be one of the strongest candidates. “I imagine that Brexit isn’t helping David Nabarro,” Moon said.

It’s also not clear, given the appetite for change manifested in the Brexit vote and the US election, whether being a WHO insider is an advantage at this point. That said, Moon noted that none of the five expected to go through to the interview round could be seen as a true outsider.

She wouldn’t make a prediction on who will win this race — or even who will be in the final three. But Dr. Ashish Jha, director of the Harvard Global Health Institute, said he thought Douste-Blazy, Tedros, and either Nishtar or Bustreo would be the candidates who make it through to the final voting round.

Watch this space.

https://www.statnews.com/