Category: Berita Internasional

The World Health Organisation aims to reduce to zero by 2020 the number of children diagnosed with leprosy and related deformities.

The decision is part of a new strategy launched against leprosy by the global health body, which also called for stronger commitments and accelerated efforts to stop disease transmission and end associated discrimination and stigma, to achieve a world free of leprosy.

“The new global strategy is guided by the principles of initiating action, ensuring accountability and promoting inclusivity. These principles must be embedded in all aspects of leprosy control efforts,” Poonam Khetrapal, regional director for the World Health Organisation’s South-East Asia Region, said at the launch of the global strategy for 2016-2020 “Accelerating towards a leprosy-free world”.

The new strategy also aims to reduce the rate of newly-diagnosed leprosy patients with visible deformities to less than one per million; and ensure that all legislation that allows for discrimination on the basis of leprosy is overturned.

“The key interventions needed to achieve the targets include detecting cases early before visible disabilities occur, with a special focus on children as a way to reduce disabilities and reduce transmission, targeting detection among higher risk groups through campaigns in highly endemic areas or communities, and improving health care coverage and access for marginalised population,” said Ms Khetrapal.

She said screening all close contacts of leprosy affected people, promoting a shorter and uniform treatment regime, and incorporating specific interventions against stigma and discrimination are the other strategic interventions that endemic countries need to include in their national plans to meet the new targets.

“The new strategy builds on the success of previous leprosy control strategies. It has been developed in consultation with national leprosy programs, technical agencies and NGOs, as well as patients and communities affected by leprosy,” she said.

The strategy focuses on equity and universal health coverage which will contribute to reaching Sustainable Development Goals on health.

According to the health data, the main and continuing challenges to leprosy control have been the delay in detection of new patients and persisting discrimination against people affected by leprosy which has ensured continued transmission of the disease.

India, Brazil and Indonesia account for 81 percent of the newly diagnosed and reported cases globally.

Leprosy was eliminated globally in the year 2000 with the disease prevalence rate dropping to below one per 10,000 population.

Though all countries have achieved this rate at the national level, at the sub-national level, it remains an unfinished agenda.

Leprosy continues to afflict the vulnerable, causing life-long disabilities in many patients, subjecting them to discrimination, stigma and a life marred with social and economic hardships..

http://www.ndtv.com/

 

Spending on counseling or medication to treat mental health issues can be an expensive, but new research from the World Health Organization indicates that the global community cannot afford to not treat mental illnesses.

Every dollar invested in mental health treatment sees a $4 return based on better health and ability to work, according to a WHO study published on Tuesday. The first-of-its-kind study estimates the global cost of untreated mental health disorders to be $1 trillion a year.
“We know that treatment of depression and anxiety makes good sense for health and wellbeing; this new study confirms that it makes sound economic sense too,” Margaret Chan, the director-general of WHO, said in a statement.

The study’s release coincides with the 13th Annual World Health Care Congress, which began on Monday in Washington, D.C. Over the next two days, officials from WHO, the World Bank, and various aid organizations will develop an international agenda to expand mental health programs.

Researchers calculated treatment costs and health outcomes in 36 countries of varying wealth from 2016 to 2030. Applying a meta-analysis of past studies regarding depression and anxiety’s impact on workplace productivity and absenteeism, they estimated that a failure to scale up mental health programs would lead to 12 billion days (or 50 million years) of lost work annually over the next 15 years.

Rates of depression and anxiety have increased 50 percent (from 416 million to 615 million people) from 1990 to 2013. That figure will likely increase, given that nearly 20 percent of people involved in emergencies or humanitarian crises, such as the Syrian conflict, experience depression or anxiety.

Yet available treatment remains minimal. Governments spend an average of 3 percent of their health budget on mental health, according to WHO’s figures. That’s left a large number of people in need of services without help, especially in poor nations.

In some low-income countries in Africa, Asia, and Latin America, there are as few as a single mental health worker for a population of 1 million or more. Wealthy nations typically have one mental health worker for every 2,000 people.

To properly address mental health, governments in the 36 counties examined will need to invest $147 billion, primarily on counseling services and medication. WHO’s research found that an uptick in available services will lead to a 5 percent increase in work participation, which will in turn generate $399 billion. Increased mental health programs will also contribute to overall health, with researchers estimating the investment will translate to an additional 43 million years of healthy living, valued at $310 billion.

“This is not just a public health issue—it’s a development issue,” Jim Yong Kim, president of the World Bank Group, said in a statement. “We need to act now because the lost productivity is something the global economy simply cannot afford.”

http://www.takepart.com/

 

The world celebrates World Health Day on Thursday and the WHO has decided to put diabetes in the spotlight for this year’s theme. Diabetes, along with other non-communicable diseases (NCDs), is the leading cause of death in Southeast Asia, taking the lives of up to 8.5 million people each year, one-third of whom are under 70 years old, leading to productivity losses.

As a developing country, Indonesia is facing a double burden of diseases. We are still fighting infectious diseases, without realizing that NCDs have grown silently to become the top killer.

In 2014, approximately 71 percent of deaths were attributed to NCDs and 6 percent of the total were due to diabetes. Yet, most of the population is still not aware of the urgency of combatting this disease.

Researchers have identified modifiable risk factors to prevent diabetes, i.e. maintaining normal body weight, eating a healthy diet and engaging in adequate physical activity.

The 2014 Global Status Report on NCDs revealed that 84 percent of Indonesian adolescents were physically inactive. The percentage of the Indonesian population that is overweight steadily increased from 2010 to 2014, from 17.2 to 20.7 percent and 24.4 to 28.1 percent for men and women, respectively.

Obesity also showed an increasing trend over recent decades and obesity prevalence in women has roughly doubled compared to that of men (7.8 percent vs 3.6 percent). Statistics showed a similar pattern in all other countries, which is why halting the epidemic should be our overarching goal now.

How did we end up like this?

First and foremost, this happened because of a lack of education. People still strongly believe that diabetes is a genetic disease; hence they embrace the diagnosis as part of inevitable heritage from their ancestors. Yes, genetic abnormality comes into play in type 1 diabetes. And yes, genetic hereditary may contribute to predisposition for type 2 diabetes, but the disease itself develops throughout one’s lifespan due to multifactorial causes.

People are also unaware of the early symptoms of diabetes, which usually include constant fatigue, thirst and cravings.

When you have a family predisposition to diabetes, it is better to get regular checkups and to start paying attention to your lifestyle.

Second, it is because we live in what public health experts call an obesogenic environment — an environment that promotes gaining weight and one that is not conducive to weight loss. Jakarta is a perfect example.

We have all gone through the phase of making life goals to work out more and eat healthily. But many of us have failed. Staying outdoors is out of the question as the air is severely polluted, sidewalks are crowded with vendors and using private vehicle is much more comfortable than sharing public transportation.

All these things beyond our personal choice that directly — or indirectly — affect our population’s health are called social determinants of health.

Over time, governments have made tremendous efforts to create a less obesogenic environment for us. We have seen an amazing transformation in Bandung, as well as improvement in public transportation and investment in green spaces in Jakarta.

What can we do to curb the epidemic?

We can start with ourselves and families, with good intentions to live long and healthy lives.

New research in India shows that consumption of white rice is the main culprit of the high prevalence of diabetes in India and more generally Southeast Asia. Nutritionists recommend red or brown rice.

The WHO has also released new recommendations for daily sugar intake of a maximum of 25 grams (six teaspoons) and integrating more than 400 grams of vegetables and fruits daily into the diet.

It is always better to avoid processed foods as they usually contain high salt, high sugar and high fat. Physical activity should be at least 150 minutes per week of moderate intensity exercise.

Or there is always the choice of taking the stairs, campaigned a few months ago at the WHO headquarters as #WalkTheTalk #StepUp.

Although the social determinants of our health mostly rely on policymakers and governments, we have the power to put pressure on this matter and urge them to address the problem. Governments must understand that globalization and urbanization play major roles in shaping our society.

Therefore, they need to work beyond health sectors intertwined with this problem.

Collaboration between transportation, urban planning, sport and education departments is necessary to reach physical activity targets. Amsterdam has not always been the cycling-friendly city we all know today, but people advocated for their rights and the transformation has been nothing short of great.

Multisectoral population-based action related to the production, distribution and marketing of food is also needed to protect our consumption patterns.

The UK recently undertook new measures in tackling childhood obesity by implementing a sugar tax on high-sugar drinks and allocating the surplus to fund sports programs in elementary school.

All in all, population health should be the priority in every process of creating new policies.

Time is pressing and the burden is growing. If we continue with business as usual, we know where this epidemic curve is heading.

As public health expert Majid Ezzati said regarding obesity: “Unless we make healthy food options like fresh fruits and vegetables affordable for everyone, and increase the price of unhealthy processed foods, the situation is unlikely to change.”

***
The writer is a general practitioner at the Indonesian Red Cross (PMI) Hospital in Bogor, West Java, who graduated from the School of Medicine at the University of Indonesia. She obtained her Master’s of Health Science in public health from Erasmus University in Rotterdam, the Netherlands, and was an intern at the WHO headquarters in Geneva, Switzerland.

http://www.thejakartapost.com/

 

“This year the theme of World Health Day is diabetes, a potentially fatal disease that is constantly and dramatically increasing. If the trend continues it will reach epidemic proportions without making headlines. It is now time to put the evidence into practice. My deepest wish is to see a radical shift from treatment of diseases towards promotion of good health. We have solid evidence that this works.”

Currently in the EU, 32 million people are living with diabetes. Furthermore, one in five school children is obese or overweight already (a major risk factor for developing type 2 diabetes), and this number is on the rise. Globally, the number of adults living with diabetes rose from 153 million to 415 million from 1980 to 2015. By 2030, diabetes is expected to be the 7th cause of death worldwide.

The silver lining is that in many cases, type 2 diabetes is preventable and in some cases it is also possible to reverse it. As with other chronic diseases, risk factors include an unhealthy diet, being overweight and lack of physical activity. Experience has shown that simple changes in lifestyle can be effective in preventing or delaying type 2 diabetes. These include maintaining a normal weight, regular physical exercise and a healthy diet.

All policy tools, from education to awareness campaigns and from advertising to taxation, should be mobilised. Measures to trigger and accompany these changes should particularly focus on the younger generation and on providing healthy food in schools, replacing vending machines selling sweets or sugary drinks in schools with healthy alternatives, and making food low in salt, sugar and fat available and affordable for all.

As for type 1 diabetes, actions to improve the lives of people living with diabetes could include the further development of eHealth solutions enabling diabetic patients to monitor their own blood glucose and transmit the information electronically to their healthcare specialist. More broadly, increasing patient access to quality care across Europe and supporting research for finding new and more effective treatments will remain key objectives of health policy.

In the fight against diabetes and other preventable diseases, the most important remaining question is this: What will it take to truly start focusing on the promotion of good health and disease prevention? The challenge is to start seriously tackling the risk factors – not only obesity, poor nutrition, lack of exercise, tobacco, alcohol misuse and stress, but also wider social inequalities that amplify the risks for our most vulnerable citizens.

http://europa.eu/

 

The World Health Organization (WHO) said on Wednesday the number of adults with diabetes has almost quadrupled worldwide since 1980 to 422 million, mainly in developing countries, driven by a rise in overweight and obese people, a UN spokesman said.

On the eve of World Health Day, which falls on Thursday, the WHO published its first “Global report on diabetes,” which highlighted the need to step up prevention and treatment of the disease.

Margaret Chan, WHO director-general, stressed that “if we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain.”

She added that even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.

WHO notes that diabetes is a chronic, progressive noncommunicable disease characterized by elevated levels of blood glucose.

It occurs either when the pancreas does not produce enough of the insulin hormone, which regulates blood sugar, or when the body cannot effectively use the insulin it produces.

Among the key findings from the report are:

— The number of people living with diabetes and its prevalence are growing in all regions of the world. In 2014, 422 million adults (or 8.5 percent of the population) had diabetes, compared with 108 million (4.7 percent) in 1980.

— The epidemic of diabetes has major health and socioeconomic impacts, especially in developing countries.

— In 2014, more than 1 in 3 adults aged over 18 years were overweight and more than one in 10 were obese.

— The complications of diabetes can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation. For example, rates of lower limb amputation are 10 to 20 times higher for people with diabetes.

— Diabetes caused 1.5 million deaths in 2012. Higher-than-optimal blood glucose caused an additional 2.2 million deaths by increasing the risks of cardiovascular and other diseases.

“Many cases of diabetes can be prevented, and measures exist to detect and manage the condition, improving the odds that people with diabetes live long and healthy lives,” said Oleg Chestnov, WHO’s assistant director-general for NCDs and Mental Health.

“But change greatly depends on governments doing more, including by implementing global commitments to address diabetes and other (noncommunicable diseases).”

These include meeting Sustainable Development Goals (SDGs) target 3.4, which calls for reducing premature death from noncommunicable diseases (NCDs), including diabetes, by 30 percent by 2030.

Governments have also committed to achieving four time-bound national commitments set out in the 2014 UN General Assembly “Outcome Document on Noncommunicable Diseases,” and attaining the nine global targets laid out in the WHO “Global Action Plan for the Prevention and Control of NCDs,” which include halting the rise in diabetes and obesity.

“Around 100 years after the insulin hormone was discovered, the ‘Global report on diabetes’ shows that essential diabetes medicines and technologies, including insulin, needed for treatment are generally available in only one in three of the world’s poorest countries,” said Etienne Krug, director of WHO’s Department for the Management of NCDs, Disability, Violence and Injury Prevention.

“Access to insulin is a matter of life or death for many people with diabetes. Improving access to insulin and NCD medicines in general should be a priority,” Krug said.

World Health Day is a global health awareness day celebrated every year on April 7, under the sponsorship of WHO.

In 1948, the WHO held the First World Health Assembly which decided to celebrate April 7 of each year, with effect from 1950, as the World Health Day.

The World Health Day is held to mark WHO’s founding, and is seen as an opportunity by the organization to draw worldwide attention to a subject of major importance to global health each year.

http://www.shanghaidaily.com/

 

 

More than 125 million people are living in crisis-affected countries, the World Health Organization reports, saying the three greatest emergencies are Syria, Yemen and Iraq.

The agency is appealing for $2.2 billion to come to terms with the escalating health crisis, in an effort to provide life-saving health care to 87 million people in more than 30 countries.

In Syria, the agency says 11.5 million people need essential medicines and primary health care, as well as trauma care and mental health care.

WHO says special care for mothers and children, as well as essential medicine and other health care, are needed by more than seven million people in Iraq and 10.6 million in Yemen.

In South Sudan, the focus of aid for 2.3 million people will be on combating child mortality by preventing and treating malaria, diarrhea and pneumonia, according to WHO.

Health care threatened

War and violence have wreaked havoc on these countries, says Rick Brennan, WHO’s director of emergency risk management and humanitarian response. The destruction has been felt in the loss of health infrastructure, the loss of staff, and the disruption of health programs like vaccination programs, according to Brennan.

“I think the other issue is that none of these emergencies is going away any time soon,” he said. “So, we have to shift the way that we think about providing assistance there — not only to meeting acute needs, but working with partners on the ground to increase their resilience and their capacity to provide assistance.”

Brennan says natural disasters also are of concern. He cites the health consequences of the El Nino weather phenomenon on countries such as Ethiopia, where some 400,000 children are suffering acute malnutrition.

In addition, the U.N. agency and its partners are responding to sudden onset emergencies such as Cyclone Winston that hit Fiji in February, epidemics such as the Zika virus in Brazil, a severe outbreak of yellow fever in Angola — the worst in 30 years — and the remaining risks of Ebola in West Africa.

http://www.voanews.com/

 

New data on the health of city-dwellers in almost 100 countries show that as the world’s urban population continues to grow, health inequities – especially between the richest and poorest urban populations – are a persistent challenge, according to a report by WHO and the United Nations Human Settlements Programme (UN-Habitat).

For example, only half of households in urban areas of 91 countries with comparable data have access to piped water, with the richest 20% of households being 2.7 times more likely to have access to piped water than the poorest 20%. In Africa, this ratio is closer to 17 times.

About 3.7 billion people live in cities today. A further 1 billion people will be added by 2030, with 90% of the growth being in low- and middle-income countries. This intensifies the need to realize the Sustainable Development Goal (SDG) target of ensuring universal health coverage (UHC): that all people obtain the health services they need without suffering financial hardship when paying for them, by 2030.

Health inequalities undermine progress

The report finds that in 79 low- and middle-income countries, children in the poorest one fifth of urban households are twice as likely on average to die before their fifth birthday compared with children in the richest fifth. In nearly 9 of 10 countries for which comparable data was available, the urban poor did not achieve the Millennium Development Goal target for reducing under-five mortality.

The report emphasizes the urgency of addressing health disparities and their determinants in cities as countries strive to achieve the SDGs and identifies innovative ways to achieve UHC that are emerging in such diverse cities as Guangzhou and Lagos, Lima and San Francisco, among many others.

“There is an urgent need to identify and reduce health inequities, particularly for the most vulnerable populations, such as the nearly 1 billion people living in urban slums or informal settlements today,” said Dr Marie-Paule Kieny, WHO Assistant-Director General for Health Systems and Innovation. “This report gives countries and cities practical tools to reduce health inequities and achieve the SDGs.”

While a number of urban areas have improved health coverage, the report finds that coverage for the poor still lags behind. Currently, at least 400 million women, men and children around the world are excluded from what is a basic human right: access to affordable health care. They have little or no access or to health services, and health insurance that is inadequate or non-existent. The report includes a new Urban UHC Dashboard– an analysis of nine indicators for 94 countries– which shows that vast inequalities in health service coverage persist, despite urban areas reporting higher coverage of services than their respective national average levels.

Planning cities for people and health

Increasing urbanization poses a unique set of health challenges, including the double burden of non-communicable and infectious diseases, air pollution, access to water and sanitation, and the need to improve nutrition, increase physical activity, and build resilience to health emergencies. Meeting those challenges will require countries and cities to take bold steps towards UHC.

The ways that cities are planned, today and for the future, can profoundly affect the ability of their residents to live long, healthy and productive lives. The report presents solutions for ensuring accessibility to water and sanitation, reducing urban sprawl while developing new transport options, increasing road safety, making cities age-friendly and accessible for persons with disabilities, managing urban health emergencies and increasing resiliency, while also improving healthier homes, particularly for those living in urban slums.

The report further presents a comprehensive set of interventions that can reduce the urban burden of non-communicable diseases. These include smoke-free city ordinances and enforcement; altering the built environment and promoting alternative transport options to foster greater physical activity and reduce air pollution; new approaches to urban food environment to reduce malnutrition and obesity; affordable and healthy housing conditions, and safety-related efforts.

Together, these have tremendous impact on reducing diarrheal diseases, indoor and ambient air pollution, non-communicable diseases, and other diseases saving millions of lives and increasing quality of life. A variety of examples from New York City and China to Mexico City, Barcelona, and South Africa illustrate these impacts, particularly using multiple interventions.

“In cities, progress in health depends not only on the strength of health systems, but also on shaping urban environments. Capitalizing on such interdependent factors leads to efficiency, synergies and co-benefits, and is essential to attaining the SDGs,” said Alex Ross, Director of the WHO Centre for Health Development in Kobe, Japan, which led and wrote the report.

“A healthy population is essential for creating economically competitive and inclusive cities,” said Joan Clos, Executive Director of the United Nations Human Settlements Programme (UN-Habitat). “This new report documents opportunities for joint action to implement the SDGs, and is an important contribution to the Third United Nations Conference on Housing and Sustainable Urban Development to take place in Quito in October 2016 and to the realisation of the New Urban Agenda.”

Note to editors:

This report:

• updates the 2010 joint WHO/UN-Habitat global report “Hidden Cities: Unmasking and Overcoming Urban Health Inequities”, with the latest evidence on urban health inequity patterns and their social, economic and environmental determinants. Without addressing these issues, the SDGs will not be fully achieved.
• Systematically synthesises evidence for various inter-sectoral actions and impacts on health for issues such as noncommunicable diseases, infectious diseases, health emergencies, nutrition, environmental health (air pollution, water and sanitation), transport, housing, energy and safety.
• Introduces the need for enhanced governance and leadership to realize results, including achieving UHC, and a number of SDG Targets. A healthy population is the basis of a city’s, and ultimately a nation’s and the world’s, sustainable economic growth, social stability, and full realization of human potential.
• Highlights areas for immediate intervention, as well as gaps in knowledge, particularly to document the impact of various interventions on urban health, and means to reduce health inequities.
• Emphasizes health inequities and vulnerable populations, particularly the nearly 1 billion people living in urban slums and informal settlements today, which are projected to double by 2050.

http://www.who.int/

 

The World Health Organization says there is now scientific consensus that the Zika virus is connected with microcephaly — a condition in which babies are born with very small heads and brain damage.

Scientists have been working for months to confirm a link between Zika and microcephaly, ever since Brazil reported a startling increase in cases last fall.

Zika infection during pregnancy appears to increase the risk for several types of birth defects and miscarriages, a recent study found. And scientists have found the virus in the brains of affected babies.

But all this evidence is circumstantial. So the big question has been: Is Zika really the culprit?

Now WHO and the Centers for Disease Control and Prevention agree there’s enough evidence to say, yes, Zika is linked to microcephaly.

“At this point the most pressing question people want answered is, ‘If I get a Zika infection during pregnancy what are the chances my baby is going to be affected?’ ” says Dr. Anne Schuchat, the deputy director of the CDC. “We really feel a sense of urgency to both answer that question and to help stop the spread of the virus.”

Currently the Zika virus is circulating in 33 countries in the Americas and has sickened hundreds of thousands of people.

http://www.npr.org/

 

Tuberculosis surpassed HIV as the leading cause of death from infectious disease in the world in 2014, according to a report released Wednesday by the World Health Organization.

Tuberculosis Caused More Deaths than HIV in 2014

But it’s not because more people are getting infected. Global health officials said on Wednesday that they are able to better track cases to report more accurate numbers. This year, 1 million new cases were reported in Indonesia, significantly revising data from last year, which showed half that number.

Cases also were higher among children than previously thought – nearly double the number reported last year. Data show 140,000 children died from TB and 1 million were infected.

WHO estimates overall totals could be even higher, with nearly 40 percent of cases undiagnosed worldwide.

Still, global health efforts have greatly reduced the incidence of the disease since the 1990s, shows the report, the 20th annual Tuberculosis Report.

TB mortality has fallen by nearly half since 1990, with nearly all improvement taking place since 2000, when the United Nations set Millennium Development Goals for reducing the incidence of the disease. From 2000 to 2014, about 43 million lives were saved because of better diagnosis and treatment.

“We can now begin to imagine the end of tuberculosis,” said Dr. Ariel Pablos-Mendez, assistant administrator for global health at USAID, at a news conference Wednesday held in the District of Columbia at the National Press Club. “We never imagined we would be at this stage.”

TB is caused by airborne bacteria that damage the lungs, resulting in fever and coughing up blood or mucus. It is curable through medication, but easily can be transmitted from one person to another.

Of the new TB cases in 2014, 58 percent were in the Southeast Asia and Western Pacific regions, with India having the largest percentage of cases at 23 percent. The African region had 28 percent of the world’s cases in 2014, but the most severe burden relative to population: 281 cases for every 100,000 people – more than double the global average of 133. More than half of the world’s TB cases (54 percent) occurred in China, India, Indonesia, Nigeria and Pakistan.

Despite advances, TB killed more than 1.5 million people in 2014.

This is slightly higher than HIV’s death toll, estimated at 1.2 million, which included 400,000 deaths among people who had both TB and HIV, which is also treatable, through the use of antiretroviral drugs. People who are HIV-positive are more susceptible to TB because they have a weakened immune system. Worldwide, 9.6 million people contracted TB in 2014, 12 percent of whom were HIV positive.

Dr. Eric Goosby, United Nations special envoy on TB, called for more funding so that global health officials could reach their goals to reduce TB deaths by 90 percent and TB cases by 80 percent by 2030.

To do so, the report says, better detection systems need to be in place and tools developed to better diagnose people, and a vaccine should be developed. This will require more funding. WHO estimated a funding gap of $1.4 billion for interventions in 2015. For research, WHO estimates it is short $1.3 billion.

Dr. Mario Raviglione, director for WHO’s global TB program, noted during the news conference that the U.S. had given the highest investment to combating TB. “Despite the gains, the progress is far from sufficient,” he said.

Even with adequate investment, the world faces another looming threat: TB that has become resistant to the drugs used to treat it. The WHO report noted that about half of people who are infected with this type are effectively treated.

TB Is Now The Top Infectious Killer (Even Though Deaths Are Down)

Tuberculosis is now killing more people each year than HIV, according to new data from the World Health Organization.

WHO estimates there were almost 10 million new cases of TB last year; the disease caused 1.5 million deaths. By comparison, 1.2 million lives were claimed by HIV.

That makes TB the number one infectious killer.

But dig into the numbers and you’ll find some surprises. TB deaths have actually been going down in recent years. The number of deaths from the disease each year has dropped by nearly half since 1990.

HIV deaths, however, are falling far faster.

And these death numbers are a bit complicated. Some 400,000 fatalities were double-counted — included under each disease — because the deceased had both infections.

There’s another TB statistic that’s particularly worrisome. The new report estimates that there were roughly half a million cases of multi-drug resistant TB last year, double the number from the year 2000. Conventional antibiotics can’t cure MDR-TB. Treatment can take 2 years or more with drugs that cause severe side-effects; some patients are left completely deaf.

“MDR-TB is rampant in some parts of the world such as the former Soviet Union, where up to a third of all [TB] cases are MDR,” says Dr. Mario Raviglione, the director of WHO’s global TB program. “Something is not going well there.”

Much of the rise in regular TB cases is the result of new diagnostic tools that make the disease far easier to diagnose and of better reporting. Those are the reasons behind an increase of hundreds of thousands of “new” cases from Indonesia and India. Indonesia’s reported incidents of TB doubled last year to 1 million cases. India’s tally was up 29 percent.

Maria Carmen Castro, 46, of Lima, Peru, is a survivor of MDR-TB — multidrug-resistant tuberculosis. Partners In Health treated her and loaned her money to open a small store. “Because of my TB and thanks to God and Partners In Health, now I have my own business,” she says.
GOATS AND SODA
TB Patients That The World Writes Off Are Getting Cured In Peru
Jenny Tenorio Gallegos, 35, in Lima, Peru, is being treated for drug-resistant TB. The treatment lasts two years and may rob her of her hearing.
GOATS AND SODA
She’s Got One Of The Toughest Diseases To Cure. And She’s Hopeful
So public health officials are worried. Progress against TB is not moving as fast as progress against some other diseases — and not as fast as they’d like.

“The number of deaths caused by TB and HIV are pretty similar,” says Raviglione. But he says TB doesn’t attract nearly the funding for research or treatment that goes to HIV.

According to data gathered by WHO, roughly $6.6 billion was spent fighting TB last year compared to $20.2 billion invested to fight HIV/AIDS in low- and middle-income countries.

“Our point is that we should have the same type of investment going to TB and as of yet that hasn’t been achieved,” Raviglione says.

Patient advocates are not as diplomatic.

“We’re in this dire situation because the vigorous community response, massive research effort and political leadership that distinguished the response to HIV are utterly absent from TB,” said Mark Harrington, executive director of Treatment Action Group, in a statement.

Raviglione stresses that the world neglects TB at its peril: “After all it’s airborne and can spread fairly easily.”

Global fight against TB advancing, but disease still a leading cause of death

The global fight against tuberculosis is advancing, with this year’s death rate nearly half of what it was in 1990. However, the disease is still a public health concern, ranking alongside HIV/AIDS as a major cause of global death, according to the World Health Organization.

The WHO released the Global Tuberculosis Report 2015 on Wednesday, giving a snapshot of how far the international health community has come in combating TB.

According to the report, close to 1.5 million people died from TB in 2014. By comparison, HIV’s death toll in 2014 was estimated at 1.2 million, according to the WHO.

The report found that most of the gains in combating TB have come since 2000, the year the UN’s Millennium Development Goals were established.

Between 2000 and 2015, effective diagnosis and treatment of TB resulted in 43 million lives saved, the report says. Globally, TB incidence has fallen 1.5 per cent per year since 2000, equalling a total reduction of 18 per cent.

But despite these advances, TB continues to be a major cause of death, says Dr. Mario Raviglione, director of WHO’s Global TB Programme.

“We are still facing a burden of 4,400 people dying every day, which is unacceptable in an era when you can diagnose and cure nearly every person with TB,” he said in a statement.

TB is an infectious disease caused by mycobacterium. The disease typically effects the lungs, and is spread through the air when infected patients transmit bodily fluids from their throat and lungs through coughing or sneezing.

Symptoms of active TB include a chronic cough, chest pains, weakness, fever, night sweats and weight loss. The disease is treatable with a course of antibiotics, however, if left untreated it can result in death.

This year’s report found the global total for new TB cases to be 9.6 million cases. This is higher than in previous years, but it may reflect improvements in data collection rather than an actual increase, the WHO said.

Addressing treatment gaps and multi-drug resistant TB
The report shows the need to improve TB detection, close “treatment gaps,” boost funding, and develop new drugs and vaccines, the WHO said.

Detection in particular remains a problem, with the WHO finding that about 37.5 per cent of the new TB cases in 2014 went undiagnosed or were not reported to national authorities.

This is especially serious for patients with multidrug-resistant TB (MDR-TB). The WHO estimates that 3.3 per cent of the new patients have MDR-TB, a level that has not changed over the years. MDR-TB is a form of TB infection caused by bacteria that are resistant to common drug treatments.

“Detection and treatment gaps are especially serious among people with MDR-TB, which remains a public health crisis,” the WHO said in a statement. “Of the 480, 000 cases estimated to have occurred in 2014, only about a quarter – 123 000 – were detected and reported to national authorities.”

The WHO report found that fewer people were diagnosed with MDR-TB globally in 2014 than in 2013, although the total estimated number of people who developed MDR-TB remained the same.

The WHO said 43 countries reported cure rates for MDR-TB patients of more than 75 per cent. However, global data shows an average cure rate of only 50 per cent for treated MDR-TB patients.

Dr. Grania Brigden, interim medical director from Doctors Without Borders Access Campaign, said the overall picture is “disheartening,” and is particularly bleak when it comes to MDR-TB.

“We’re losing ground in the battle to control drug-resistant forms of TB, and without considerable corrective action, the vast majority of people with MDR-TB won’t ever be diagnosed, put on treatment, or cured,” she said.
“Drug-resistant forms of TB will continue to spread unless the gap is narrowed between people with undiagnosed TB disease and people who are diagnosed.”

Brigden called for a widespread rollout of existing rapid tests and drug-resistance testing.

The WHO said that in 2016, the global community’s goal will shift from controlling TB to ending the epidemic. Its “End TB Strategy,” adopted by all WHO member states, will aim to reduce TB incidence by 80 per cent and TB deaths by 90 per cent by 2030.

source: http://www.albanydailystar.com/

 

Christine Sow is President and Executive Director of Global Health Council, and Susan Barnett is Founder of Faiths for Safe Water.

‘This is not an expensive, high-tech problem; it’s a problem of prioritization’

The world reacted in horror and indignation this week when a reporter posted a photo of a Syrian woman forced to bath her 20-day-old newborn in a puddle in a refugee camp on the Greek-Macedonian border. The plight of this family is clearly unacceptable; lacking access to a safe water source puts every family member at risk, but especially the children. Today is World Water Day, but for much of the world, you wouldn’t know it.

There are 663 million people around the world live without access to safe water. And about 2.2 billion people—one sixth of the world’s population—live without the dignity and safety of adequate sanitation. Many are trapped in the cycle of poverty, and without water and sanitation, there is no way out.

Even more surprising, healthcare institutions fair little better. In the U.S. we take for granted that an expectant mother will be admitted to a hospital with running water and sanitation. However, a report published last year by the World Health Organization revealed that almost 40% of healthcare facilities around the world do not have access to safe water and almost 20% do not have even basic sanitation.

This wide-reaching study looked at 54 low- and middle-income countries, and found that even soap for hand-washing, one of the most effective and cost-effective ways to prevent infection, was absent from more than one-third of the facilities. The study’s authors note that this “lack of services compromises the ability to provide basic, routine services, and compromises the ability to prevent and control infections.” The direct and dire consequences of these conditions were clearly seen during the recent Ebola crisis in West Africa, where the high mortality toll of the disease among health workers has been attributed in part to the lack of adequate water sources and sanitation in healthcare facilities.

Ebola is not a highly contagious disease; it can only be spread by direct contact with infected bodily fluids. However health workers were obliged to work in inhuman conditions where they routinely came in contact with infectious matter and were unable to properly protect and disinfect themselves, their gear, or their physical surroundings. It is estimated that nearly 1 in 12 health workers in Liberia died during the epidemic. The loss of doctors, nurses and midwives was tragic, and it has led to a deadly ripple effect on the health of the population, especially mothers and children. Maternal mortality was estimated to have increased by 111% in Liberia and child mortality by 28% across the three Ebola-hit countries.

The ongoing cholera crisis in Haiti is another example of how the lack of adequate water supplies has led to a deadly water-borne disease traveling across borders to infect a population where it had not been seen for more than 100 years. It’s estimated that 8,600 Haitians have died of cholera, brought into Haiti by U.N. peacekeepers from Nepal. Litigation is ongoing around the responsibility of the UN to have prevented this senseless tragedy.

In 2014, during the Haiti cholera crisis and before Ebola became a household name, President Barack Obama launched the Global Health Security Agenda as a partnership of international organizations, non-governmental organizations and some 50 nations, to strengthen the capacity to prevent, detect and rapidly respond to infectious disease threats. The administration’s recognition of the global threat posed by infectious disease was timely but has fallen short in addressing the root causes of the spread of infectious disease.

The agenda focuses on strengthening laboratory capacity, surveillance systems and global cooperation in order to ensure health security. All good ideas, however a provision for basic water and sanitation within health facilities and communities does not explicitly appear in any of the its 11 “action packages.” The absence of this basic component represents a significant missed opportunity to rally global leaders and policymakers around this immediate—and obvious—need. To put a further point on it, in a recent WHO survey, only 21 out of 86 countries surveyed report having a plan in place to install safe drinking water and sanitation in their health facilities.

This situation is made all the more infuriating because unlike so many crises facing our planet, the lack of access to safe water, soap and sanitation, is solvable. Basic, sustainable, cost-effective approaches abound. This is not an expensive, high-tech problem; it’s a problem of prioritization.

Every global health and development policy and piece of legislation must contain provisions for sustainable water and sanitation. Anything less is a plan that is guaranteed to fall short of its goals. At a time of tight budgets, it’s smart, logical and cost-effective. But it’s also a matter of who lives, and who dies, and who is forced to bath her newborn baby in a mud puddle.

source: http://time.com/