Category: Berita Internasional

To the editor:
The outbreak of the Ebola virus in the West African nations of Guinea, Liberia, Sierra Leone, and Nigeria has brought into sharp focus the importance of the United Nations global health affiliate the World Health Organization (WHO). With respect to matters of global health, no other organization is capable of mobilizing the resources, responding to, and combatting threats to public health. It is a vital actor on the world stage as it must confront some of the deadliest diseases known to man.

The WHO is guided by six main roles as stipulated by the organization’s Eleventh General Programme of Work 2006-2015. The roles are:

1. Providing leadership on matters critical to health and engaging in partnerships where joint action is needed;
2. Shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge;
3. Setting norms and standards and promoting and monitoring their implementation;
4. Articulating ethical and evidence-based policy options;
5. Providing technical support, catalyzing change, and building sustainable institutional capacity;
6. Monitoring the health situation and addressing health trends.

Precision Response is Key

How WHO responds to public health threats, such as disease outbreaks or natural disasters, requires a precise and coordinated plan. The disproportionate share of the affected people WHO serves reside in the developing world. They are the poorest and most vulnerable individuals. Any delay in responding to their needs can mean the difference between life and death, particularly as it relates to a virus like Ebola. As a result, WHO set forth a “roadmap” this past week to put an end to any further transmission of Ebola in the next 6-9 months. In addition the global health body plans to minimize its spread, while also focusing on the larger societal and economic consequences as a result of the outbreak. WHO knows time is of the essence, and there is no entity better equipped to handle this crisis than them.

No End in Sight

According to Margaret Chan, director-general of WHO, writing in the New England Journal of Medicine, “No one is talking about an early end to the outbreak.” She added that she anticipates Ebola continuing for “many more months.” There is one issue that the director-general believes has exacerbated the problem – poverty. These West African nations of Guinea, Sierra Leone, and Liberia rank well below the poverty line. These countries have had to endure years of conflict and civil war that has decimated their ability to combat this virus. The health infrastructure is essentially non-existent; it is estimated that there are one or two doctors per 100,000 people in West Africa, according to Dr. Chan.
Poverty forces individuals to flee their homeland in search of work. This migration causes a spread of the virus that threatens areas not previously inflicted. Liberia recently closed many of its borders to prevent such an occurrence from happening. However, this is not something that is easily accomplished. As the death toll continues to mount, the challenges for the health professionals on the ground becomes greater every day.

U.N. Broadens Its Efforts

In an effort to assist in stemming the tide of the Ebola virus, U.N. Secretary-General Ban Ki-moon last week appointed Dr. David Nabarro as Senior U.N. System Coordinator in charge of Ebola. Dr. Nabarro will work closely with Dr. Chan of WHO in coordinating their efforts. Dr. Nabarro, in an interview with UN News Centre, indicated that WHO’s primary responsibility is to diagnose and treat those who may be infected. This is a massive undertaking and an important reason why we need WHO. In his interview, Dr. Nabarro noted that when he met with the leadership of the various nations affected by Ebola he noted that they said to him they wanted WHO to take the lead to assist them in treating their respective citizens. In order to properly inform the public and to avoid widespread panic, the health professional remarked that social media has a crucial role to play in getting the right message out to people. If the public receives incorrect information, this will only complicate an already dangerous situation.

Unmatched Success

The accomplishments of WHO in the area of global health is unrivaled. The most notable achievement came in 1950 when the eradication of smallpox was realized. As a result, life expectancy in the developing world has seen a 60% rise. Furthermore, according to the Center for Global Development, children under the age of five now have a greater chance of survival. WHO has largely been responsible for controlling tuberculosis in China; eliminating childhood polio in Latin America; many regions on the continent of Africa have experienced the containment of river blindness; and Sri Lankan women do not fear dying during childbirth all as a result of the efforts of WHO.

Should the U.S. be worried?

We have all seen the images of the doctor and aid worker be transported back to the U.S. from the region after contracting Ebola. Thankfully they both appear to be doing well at this point and time. However in an era of globalization where people, goods, and services move about so freely, how can one say we will ever be truly free from these epidemics? No one can, but what is known is that there are many dedicated professionals from WHO giving their very best each day in an attempt to manage this crisis. They are essential players in bringing this matter under control. There will always be naysayers who will try to dispute why we need the U.N., or WHO for that matter; but to all those opposed to the U.N. and its agencies think about this question for a moment: If you were ever to find yourself in a country where you were threatened by such a crisis, would you not want the assistance of a global health organization like WHO to assist you? Of course you would! For you to say otherwise would simply be foolish. There is no disputing the fact that their work is crucial to the survivability of many around the world today.

MICHAEL CURTIN
Editorial Chair and Blogger
United Nations Association of the USA (UNAUSA-NNJ)
unausannj.com

source http://www.nj.com/

 

President-elect Joko “Jokowi” Widodo may rename the existing national health insurance (JKN) program the Healthy Indonesia Card (KIS) program, as both health programs share a similar purpose, observers have said.

Hasbullah Thabrany, professor at the University of Indonesia’s School of Public Health, said that if the KIS, a free health-care program promoted by Jokowi during his presidential campaign, were to stand on its own, it would require new legislation that would consume too much time and resources.

If Jokowi decides to continue or expand the current nationwide JKN program, which is run by the Social Security Management Agency (BPJS), it would save time and it would be faster in reaching those people who are still waiting for better quality health care.

“Replacing the [JKN] cards with KIS cards is a very practical thing to do, by allowing the new president to focus on improving the program’s quality,” Hasbullah said during a discussion on the two health programs on Tuesday.

During the presidential campaign, Jokowi said he would implement the KIS as a national program.

Few details about the program have been made available but many consider it to be similar to the Healthy Jakarta Card (KJS) program, which Jokowi implemented in the capital during his two years as governor.

The KJS essentially expanded existing health-care programs, namely Gakin and SKTM, with the Jakarta administration issuing cards and providing health care, not only to those people who were considered poor, but to anyone with a Jakarta identity card who applied to join the program.

Hasbullah said that expanding the JKN would require more work, including a possible revision of the current framework for the insurance, and the BPJS as its provider.

“For example, the new government should be aware that only marginalized people are entitled to free health coverage under the JKN program. Even if it is good, if everyone ends up being covered, that would contravene our regulation,” he said.

Article 14 of the National Social Security System (SJSN) Law stipulates that the government is obligated to pay premiums for medical treatment for impoverished people.

The health coverage for the poor, once known as Jamkesmas, is one of the programs currently provided by the BPJS.

The non-profit body also manages health insurance offered by PT Askes (a former entity that became the BPJS), PT Jamsostek and PT Asabri.

Based on BPJS data, as of Aug. 8, the program covered 126.4 million people in total and cooperated with 1,551 hospitals nationwide. The program aims to cover the entire Indonesian population by 2019.

Rieke Diah Pitaloka, a member of the House of Representatives’ Commission IX overseeing health and manpower, emphasized that KIS was initiated as a refinement to the BPJS’ national health insurance program.

Rieke, who is also a politician with the Indonesian Democratic Party of Struggle (PDI-P), said the current JKN program had yet to reach many marginalized people.

“We even see in the news that sometimes people are rejected treatment by hospitals due to financial issues,” she said.

Hasto Kristiyanto, deputy head of Jokowi’s transition team, said they were optimistic that the KIS would be approved by House lawmakers.

source http://www.thejakartapost.com

 

 

When Indonesian president-elect Joko Widodo takes power in October, he will be confronted by a laundry list of pressing issues, ranging from budget-sapping energy subsidies and urgently needed infrastructure projects to figuring out why heavy spending on education does not seem to be paying off.

Then, there is health. After making steady progress through the 1990s in lowering the country’s infant mortality rate, Indonesia has stagnated and will probably fail to meet next year’s Millennium Development Goal (MDG) of 28 deaths per 1,000 live births.

According to the United Nations Children’s Fund (Unicef), a child below the age of five dies somewhere in Indonesia every three minutes. That is about 150,000 a year, with many of those deaths due to a lack of simple sanitation and hygiene.

Every hour, a mother dies because of complications related to pregnancy or during child birth.

More bad news, this time on the HIV front. Bucking a worldwide downward trend in deaths related to acquired immune deficiency syndrome (Aids), a new United Nations report says Indonesia is one of six countries being left behind, with a massive 427 per cent increase in cases between 2005 and 2013.

Tuberculosis (TB) is another priority. With 91,000 deaths among the 528,000 cases of the disease recorded each year, Indonesia has the third highest TB rate in the world, behind China and India.

That is a troubling 6.3 per cent of total recorded diseases, compared with 3.2 per cent across the rest of the South-east Asian region.

Poor health-care system

Healthy economic growth is supposed to bring equivalent dividends in the quality of health care. Yet despite this year’s promising roll-out of Universal Health Care (UHC) for 86.4 million of the nation’s poor, the 1 per cent of GDP invested in health remains one of the lowest in the world.

That leaves it on a par with neighbouring countries like Laos, Cambodia and the Philippines, but behind Malaysia and Brunei on 2 per cent, and Vietnam and Thailand, both on 3 per cent.

Neo-natal deaths – when a baby dies within 28 days of birth – point to flaws in the efficient and effective delivery of quality round-the-clock mid-wifery and referral services, which in turn are often related to larger health system issues.

Infant deaths may have been reduced from 97 to 31 (per 1,000 live births) since 1990, but the rate has plateaued now that the large-scale introduction of immunisation, vitamin A distribution and what health professionals call other so-called “low-hanging” fruit has run its course.

Of course, there are much bigger geographic and demographic challenges for a sprawling archipelago of 250 million people, but, all the same, compare that 31 figure to the Philippines (30), Vietnam (23), Thailand (13) and Malaysia (nine).

But even today, in a country where a surprising number of urban dwellers prefer going to a traditional healer rather than a real doctor, Indonesia has the third highest number of non-immunised children. As a result, it still experiences outbreaks of vaccine-preventable diseases like measles and diphtheria.

While president Susilo Bambang Yudhoyono’s government may have increased access to health services over the past decade, better-quality advice is needed when it comes to such things as swaddling and longer-term breast-feeding.

Malnutrition and poor water and sanitation are major contributors to child mortality. It is sobering to read that Indonesia has the fifth highest number of stunted children in the world and the second highest number of people – 52 million – practising open defecation.

Frustratingly, increasing coverage on interventions is not translating into reduced mortality. The same lack of progress applies in a different way to education, despite the fact that public spending absorbs 3 per cent of GDP.

Outer Islands

While rates of mortality soar in less populated parts of Indonesia, it is the high population pockets that contribute to the greatest numbers in terms of morbidity and deaths. Health experts say both require radically different approaches.

Isolated groups of small islands and parts of Papua require more “waiting homes” so expectant mothers have somewhere to go to await birth. It has taken time to explain to husbands why this is necessary, particularly in Papua where under-five mortality rates stand at 90 per 1,000 live births.

In many parts of less-developed eastern Indonesia which, along with Kalimantan, accounts for 15 per cent of the total population, a 24/7 service just is not there. There may be health clinics dating back to president Suharto’s days, but they often do not have proper facilities or even basic medicines.

The reason seems obvious. Decentralisation may have been politically crucial when it was launched in 2001, but it has also blurred the lines of authority and impacted negatively on accountability.

The lack of a regular mechanism to track progress masks serious regional inequalities. What is needed is a systems approach to health service delivery, such as the better distribution of skilled health-care providers and the identification of bottlenecks.

The challenge of HIV

Indonesia’s HIV epidemic is a related threat. About 10 people die of Aids-related illnesses every day. Six years ago, an estimated 200,000 children and young people under 25 were living with HIV. Today, they are now believed to be responsible for a fifth of new cases, or at least seven a day.

Along with the Central African Republic, the Democratic Republic of the Congo, Nigeria, Russia and South Sudan, Indonesia faces the triple threat of a high HIV burden, low treatment coverage and little if any decline in new HIV infections.

Experts attribute the increase to the high number of people from traditionally low-risk population groups contracting HIV and to the government’s failure to ensure access to anti-retroviral therapy for those already living with the disease.

About 3 per cent of those infected with HIV also have active tuberculosis. This prevents people from earning wages and leads many already-poor families ever deeper into poverty because of the high cost of sustained treatment.

Mostly, the disease preys on those living in rural areas, those with weak immune systems and those seeking health services from centres that do not treat the disease in the directly-observed, low-cost way recommended by the World Health Organisation.

Joko has some major challenges ahead. But given the huge toll that preventable and curable disease is taking on the nation’s children, it is hoped health will become as much a priority as education.

source http://www.thejakartapost.com

 

Indonesia’s conditional cash transfer program, Program Keluarga Harapan (PKH), provides cash to poor households in exchange for meeting specified health targets. It aims to reduce poverty and improve maternal and child health. But does it work?

After the success of Mexico’s social assistance program PROGRESA (now Oportunidades), Indonesia followed suit in 2007 with the implementation of a pilot program, PKH. PKH set out to speed up the attainment of the Millennium Development Goals, especially poverty reduction and improved maternal and child health. Indonesia’s PKH targets the poorest households with children or expectant mothers. The requirements typically include prenatal and postnatal checks, vaccinations and school enrolment and attendance.

Under PKH, program participants are required to have four prenatal visits; facility-based delivery (the original requirement was childbirth assisted by a trained health care provider); two postnatal visits; monthly weighing; vaccinations and vitamin A for children under five; and enrolment in primary and junior high school with a minimum of 85 per cent attendance for school-aged children.

To the government’s credit, PKH has been more successful than other social assistance programs in identifying and enrolling poor households. The impact evaluation finds that the program has increased participants’ utilisation of primary health care services, which suggests that the program has improved health care access for the poor. Unfortunately, the program has no effect on education. This is not surprising, however, since primary school enrolment is already high (greater than 80 per cent) and the transition rate to junior high school is fairly high (roughly 75 per cent).

Even though the program is successful in getting participants to ‘show up’ to meet the health requirements, participants’ health-seeking behaviour unfortunately has not translated to improvements in long-term outcomes — such as reductions in the incidence of low birth weight and mortality. The lack of impact here is partly related to the supply side of the health care market.

Conditional cash transfer (CCT) programs operate best when the health care system has adequate supply to absorb the additional demand stemming from the program requirements. In some places, there is insufficient supply or no excess capacity in the health care system, so there is a change in price, quantity or quality from the supply side — which can dampen the effects of the program. In particular, higher prices are expected in the short term, before new health care providers can enter the market to increase supply. This increase in demand may also reduce quality of care as providers see more patients.

Indonesia’s public providers are also allowed to hold private practice part-time, and this potentially impacts on the program. As the CCT increases demand for health care — for providers with both public and private practices — they can respond with higher prices in private practice, thereby increasing average prices.

Also, public providers may opt to pursue their more lucrative private practice. This could strain the public system and quality of care would suffer. The combination of lower quality and higher prices could limit health care access, thereby defeating the purpose of the program. This possibility is a particular concern for households that just miss the CCT cut-off.

PKH is planned to go national this year. It will be interesting to analyse the long-term effects and how the effects change as the program expands. The supply of health care will become an even more important issue with the implementation of the national health insurance system, Jaminan Kesehatan Nasional.

The Indonesian government is continuing to seek better ways of delivering health care services to the public and to the poor. As the government is taking steps to strengthen the health care system — through efforts such as PKH — we can be cautiously optimistic for what the future holds.

source: http://www.eastasiaforum.org

 

Indonesia’s conditional cash transfer program, Program Keluarga Harapan (PKH), provides cash to poor households in exchange for meeting specified health targets. It aims to reduce poverty and improve maternal and child health. But does it work?

After the success of Mexico’s social assistance program PROGRESA (now Oportunidades), Indonesia followed suit in 2007 with the implementation of a pilot program, PKH. PKH set out to speed up the attainment of the Millennium Development Goals, especially poverty reduction and improved maternal and child health. Indonesia’s PKH targets the poorest households with children or expectant mothers. The requirements typically include prenatal and postnatal checks, vaccinations and school enrollment and attendance.

Under PKH, program participants are required to have four prenatal visits; facility-based delivery (the original requirement was childbirth assisted by a trained health care provider); two postnatal visits; monthly weighing; vaccinations and vitamin A for children under five; and enrollment in primary and junior high school with a minimum of 85 percent attendance for school-aged children.

To the government’s credit, PKH has been more successful than other social assistance programs in identifying and enrolling poor households. The impact evaluation finds that the program has increased participants’ utilization of primary health care services, which suggests that the program has improved health care access for the poor. Unfortunately, the program has no effect on education. This is not surprising, however, since primary school enrollment is already high (greater than 80 percent) and the transition rate to junior high school is fairly high (roughly 75 percent).

Even though the program is successful in getting participants to ‘show up’ to meet the health requirements, participants’ health-seeking behavior unfortunately has not translated to improvements in long-term outcomes—such as reductions in the incidence of low birth weight and mortality. The lack of impact here is partly related to the supply side of the health care market.

Conditional cash transfer (CCT) programs operate best when the health care system has adequate supply to absorb the additional demand stemming from the program requirements. In some places, there is insufficient supply or no excess capacity in the health care system, so there is a change in price, quantity or quality from the supply side—which can dampen the effects of the program. In particular, higher prices are expected in the short term, before new health care providers can enter the market to increase supply. This increase in demand may also reduce quality of care as providers see more patients.

Indonesia’s public providers are also allowed to hold private practice part-time, and this potentially impacts on the program. As the CCT increases demand for health care—for providers with both public and private practices—they can respond with higher prices in private practice, thereby increasing average prices.

Also, public providers may opt to pursue their more lucrative private practice. This could strain the public system and quality of care would suffer. The combination of lower quality and higher prices could limit health care access, thereby defeating the purpose of the program. This possibility is a particular concern for households that just miss the CCT cut-off.

PKH is planned to go national this year. It will be interesting to analyse the long-term effects and how the effects change as the program expands. The supply of health care will become an even more important issue with the implementation of the national health insurance system, Jaminan Kesehatan Nasional.

The Indonesian government is continuing to seek better ways of delivering health care services to the public and to the poor. As the government is taking steps to strengthen the health care system—through efforts such as PKH—we can be cautiously optimistic for what the future holds.

source: http://www.asianscientist.com

 

 

The World Health Organisation (WHO) says it is finalising a plan to stop the spread of the deadly Ebola virus, with details to be released early next week.

The death toll from the Ebola outbreak in West Africa has risen to 1,427, according to the latest figures released by the WHO.

Liberia remains the worst-affected country with 624 deaths. Guinea has seen 406 people die while the disease has killed 392 in Sierra Leone and five in Nigeria.

The UN agency says it has drawn up a draft strategy to combat the disease over the next six to nine months.

David Nabarro, senior United Nations system coordinator for Ebola, who was travelling with the WHO’s Dr Keiji Fukuda in Liberia, said the strategy would involve ramping up the number of health workers fighting the disease.

“It means more doctors, Liberian doctors, more nurses, Liberian nurses, and more equipment,” he said.

“But it also means, of course, more international staff.”

The announcement comes after aid agency Medecins Sans Frontieres (MSF), which has urged the WHO to do more, said that the speed of the crisis was outstripping the ability of authorities to cope.

The affected West African countries were already struggling with few doctors and fragile healthcare systems before the Ebola outbreak was first identified in March.

Health workers have been among the hardest hit by the disease.

The head of MSF, Joanne Liu, told Reuters that the fight against Ebola was being undermined by a lack of international leadership and emergency management skills.

In a sign of spreading regional alarm, Senegal, West Africa’s humanitarian hub, said it had blocked a UN aid plane from landing and was banning all further flights to and from countries affected by Ebola.

The WHO has repeatedly said it does not recommend travel or trade restrictions for countries affected by Ebola, saying such measures could heighten food and supply shortages.

Gabon has also announced its suspension of air and sea links to the four affected countries, following the lead of a number of regional nations who have defied WHO advice in an attempt to isolate themselves from the disease.

Families hiding infected loved ones

The WHO said the scale of the outbreak has been underestimated and that many cases have probably gone unreported, especially in Liberia and Sierra Leone.

Families hiding infected loved ones and the existence of “shadow zones” where medics cannot go mean the Ebola epidemic is even bigger than thought, the agency said.

The WHO said it is now working with the MSF and the US Centers for Disease Control and Prevention to produce “more realistic estimates”.

The stigma surrounding Ebola poses a serious obstacle to efforts to contain the virus, which causes regular outbreaks in the forests of Central Africa but is striking for the first time in the continent’s western nations and their heavily populated capitals.

“As Ebola has no cure, some believe infected loved ones will be more comfortable dying at home,” the WHO said in a statement detailing why the outbreak had been underestimated.

“Others deny that a patient has Ebola and believe that care in an isolation ward – viewed as an incubator of the disease – will lead to infection and certain death.”

In other cases health centres are being suddenly overwhelmed with patients, suggesting there is an invisible caseload of patients not on the radar of official surveillance systems.

US experts have played down hopes of a cure for Ebola after two American health workers were sent home from hospital after being cleared of the virus.

source: http://www.abc.net.au

 

 

 

The World Health Organization (WHO) has warned that the global fight against HIV risks stalling without stronger preventative treatments for transgender people and gay and bisexual men.

As well as offering medical advice, WHO has recommended that countries “remove the legal and social barriers that prevent many people from accessing services”. In countries which do not prevent discrimination against groups such as transgender people and gay men, seeking healthcare often carries severe risks which render treatment inaccessible.

The message comes as WHO issues new “guidelines on HIV prevention, diagnosis, treatment and care for key populations”, ahead of an International AIDS Conference to be held in Australia later this month.

In a press release, WHO noted that transgender women are at particularly high risk, being “almost 50 times more likely to have HIV than other adults”. Men who have sex with men (MSM) are “19 times more likely to have HIV than the general population”.

Other key risk groups are sex workers, people in prison, and people who inject drugs.

Dr Gottfried Hirnschall, Direction of the HIV Department at WHO, said: “Failure to provide services to the people who are at greatest risk of HIV jeopardizes further progress against the global epidemic and threatens the health and wellbeing of individuals, their families and the broader community.”

The announcement marks the first time that WHO has strongly recommended pre-exposure prophylaxis (PrEP) for MSM “as an additional method of preventing HIV infection”, to be used in conjunction with condoms.

“Modelling estimates that, globally, 20-25% reductions in HIV incidence among men who have sex with men could be achieved through pre-exposure prophylaxis, averting up to 1 million new infections among this group over 10 years,” WHO states.

PrEP is a preventative treatment for people who are HIV-negative, but at high risk of contracting the infection. The treatment involves taking one anti-retroviral pill daily and, if used consistently, has been shown to reduce the risk of infection by up to 92%.

Guidelances released at last year’s International AIDS Conference recommended that antiretroviral treatment should be offered to HIV-positive patients at an earlier stage in the progression of the infection.

Earlier this year, the U.S. Centre for Disease Control (CDC) extended its own recommendations on the preventative usage of the PrEP drug Truvada to new groups.

Results of another study released this week showed that the use of Truvada as PrEP also lowers inflectional rates of genital herpes by 30%.

In the UK, the drug is currently still in its experimental trial period, but some campaigners are already calling for it to be made available on the NHS.

source: www.pinknews.co.uk

 

Over the last five years, World Health Partners (WHP) has worked to develop a system of healthcare delivery that meets the needs of those most vulnerable in India: rural communities who constitute three-fourths of the population. Last month, with the launch of a new collaborative project in Kisumu, western Kenya, WHP took the first step in realizing a foundational goal for the organization: expansion into Africa.

At first glance, expansion into Africa seems a counterintuitive step for WHP. Our expertise is in India. We have spent half a decade navigating challenges unique to the Indian health system. And, though we are proud of our progress, there remains no shortage of work in rural India. Yet, WHP’s mission has always been to deliver health services to those in need, a philosophy that is agnostic to country or region, and one that means working where the needs are greatest.

In my 25+ years of working in global health, I have seen countless programs take root and grow only to wither and fade – programs filled with great ideas that failed to adapt to local contexts, or programs with great promise that failed to innovate in the face of the uncertainties of low resource, weak infrastructure settings. Our experience working in rural Uttar Pradesh and Bihar, two of India’s largest and poorest states, has been a crucible of learning and innovation for us, and we relish the challenge of applying these lessons to a new country.

After over 120,000 successful telemedicine consultations in India, and having served millions of patients through our 6,000 rural Sky franchisees, we trust that our model is making a difference in the lives of those we reach.

Our new project in Kenya, implemented in collaboration with Kisumu Medical and Educational Trust (KMET), was born from a mutual desire to improve health services for rural Kenyans, many of whom remain underserved by the existing health system.

Kenya, like most countries in the developing world, has struggled to relocate doctors, nurses, and clinical services close to the rural communities that need them the most, communities in which nearly 75% of Kenya’s population still lives. In the face of an underdeveloped rural infrastructure and insufficient human resources for health, we believe our Sky network can be a catalyst for achieving universal health coverage.

For many rural communities of western Kenya, the first point of medical care is the local community health worker (CHW). The Sky franchise network transforms rural CHWs into sources and conduits for affordable and timely medical services through a combination of training, reliable supply of medicines and diagnostics, and telemedicine links to qualified doctors in urban centers.

This is a small beginning for WHP’s efforts in Africa. Existing human resources like CHWs in rural Kenya are present in every community; the native sense of entrepreneurship is a universal resource and the lynchpin of human ingenuity. We are confident that the linkages we help form, along with our micro-franchising approach, will not only empower local health workers, but give them the ownership necessary to truly bridge, sustainably and at scale, the access challenges that exist in much of Africa.

source: www.huffingtonpost.com

 

Posing serious threat to global health, two forms of tuberculosis (TB) have become resistant to rifampicin, regarded the most effective drug against TB, researchers from India and the US say.

The two forms are multi-drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB).

Scientists from the two countries have found that a new compound – 24-desmethylrifampicin – has much better anti-bacterial activity than rifampicin against multi-drug-resistant strains of the bacteria that cause TB.

This is an important step toward development of new drugs that can transcend antibiotic resistance issues.

‘We believe these findings are an important new avenue toward treatment of multi-drug-resistant TB,’ said Taifo Mahmud, professor at Oregon State University in the US.

‘The approach we are using should be able to create one or more analogs that could help take the place of rifampicin in TB therapy,’ Mahmud added.

A combination of genetic modification and synthetic drug development was used to create the new compound.

Further development and testing will be necessary before it is ready for human use, researchers said.

‘Drug resistance in rifampicin and related antibiotics has occurred when their bacterial RNA (Ribonucleic acid) polymerase enzymes mutate,’ Mahmud said, ‘leaving them largely unaffected by antibiotics that work by inhibiting RNA synthesis.’

The new approach works by modifying the drug so that it can effectively bind to this mutated enzyme and again achieve its effectiveness.

‘We found out how the antibiotic-producing bacteria make this compound, and then genetically modified that system to remove one part of the backbone of the molecule,’ Mahmud added.

Collaborators on this research were from the University of Delhi and the Institute of Genomics and Integrative Biology in New Delhi.

In 1993, resurging levels of TB due to this antibiotic resistance led the World Health Organization to declare it a global health emergency.

Today more than a million people around the world are dying each year from TB. After AIDS, it remains the second most common cause of death by infectious disease.

The study appeared in the Journal of Biological Chemistry.

What is TB?

TB or Tuberculosis is an infectious disease caused by a bacterium called mycobacterium tuberculosis. TB most often affects the lungs, but contrary to popular belief, it can affect almost all other organs such as the uterus, fallopian tubes, intestine, kidney, bones, meninges (lining around the brain and spinal cord). It is no wonder that during the early days of this disease it was commonly called ‘consumption’, because the bacterium would infiltrate almost all parts of the human body. Read ten facts you didn’t know about TB.

source: www.thehealthsite.com

 

Indonesia became the newest country to mandate graphic photo warnings on cigarette packs Tuesday, joining more than 40 other nations or territories that have adopted similar regulations in recent years.

The warnings, which showcase gruesome close-up images ranging from rotting teeth and cancerous lungs to open tracheotomy holes and corpses, are an effort to highlight the risks of health problems related to smoking.

Research suggests these images have prompted people to quit, but the World Health Organization estimates nearly 6 million people continue to die globally each year from smoking-related causes. The tobacco industry has fought government efforts to introduce or increase the size of graphic warnings in some countries.

Here are a few places where pictorial health warnings have made headlines:

Indonesia

The law: 40 percent of pack covered by graphic photos.

Timing: Deadline to be on shelves was June 24.

Background: Many tobacco companies missed Tuesday’s deadline to comply with the new law requiring all cigarette packs in stores to carry graphic warning photos. Indonesia, a country of around 240 million, has the world’s highest rate of male smokers at 67 percent and the second-highest rate overall. Its government is among the few that has yet to sign a World Health Organization treaty on tobacco control.

Thailand

The law: Portion of cigarette packs that must be covered with graphic health warnings rising from 55 percent to 85 percent.

Timing: Change will take effect in September.

Background: Last year, the Public Health Ministry issued a regulation increasing the level of coverage to 85 percent. Tobacco giant Philip Morris and more than 1,400 Thai retailers sued, and a court temporarily suspended the order. On Thursday, the Supreme Administrative Court ruled that the regulation can take effect before a lower court reaches a final verdict in the lawsuit.

Australia

The law: No cigarette brand logos permitted; graphic health warnings required on 75 percent of front and 90 percent of back.

Timing: Plain packaging law went into effect in 2012.

Background: Australia became the first country in the world to mandate plain cigarette packs with no brand logo or colors permitted. Instead, the packs are solid brown and covered in large graphic warnings. Tobacco companies fought the law, saying it violated intellectual property rights and devalued their trademarks, but the country’s highest court upheld it. Figures released this month by the country’s Bureau of Statistics found that cigarette consumption fell about 5 percent from March 2013 to the same period this year. The World Trade Organization has agreed to hear complaints filed by several tobacco-growing countries, but other governments have expressed interest in passing similar laws. Smokers make up 17 percent of Australia’s population.

United States

The law: No graphic pictures on packs.

Timing: The government stepped away from a legal battle with tobacco companies in March 2013.

Background: There are currently no pictorial warnings on cigarette packs in the U.S. After the tobacco industry sued, a Food and Drug Administration order to include the graphic labels was blocked last year by an appeals court, which ruled that the photos violated First Amendment free speech protections. The government opted not to take the case to the U.S. Supreme Court, but will instead develop new warnings. About 18 percent of adult Americans smoke.

Philippines

The law: Graphic warning legislation approved this month requires 50 percent of bottom of the pack to be covered by graphic warnings.

Timing: Legislation awaits president’s signature.

Background: The Philippines is expected to join a handful of other countries that put graphic warnings at the bottom of their packs, meaning they are not visible when displayed on store shelves. Anti-smoking advocates say labels on the bottom of the packs are less effective, and have denounced tobacco industry involvement in the implementation process. Health officials said around 17 million people in the country of 96 million, or 18 percent, smoked in 2012.

Uruguay

The law: Graphic warnings cover 80 percent of packs.

Timing: Regulations implemented in 2010.

Background: Uruguay, a leader in strict tobacco controls, mandated what were the largest graphic warnings ever in 2010. Eighty percent of packs must be covered by the labels, including one depicting a person smoking a battery to show that cigarettes contain the toxic metal cadmium. Uruguay has backed Australia at the WTO, telling the trade body that smoking is “the most serious pandemic confronting humanity.” Philip Morris International sued Uruguay over the law; the case is still pending

source: www.poconorecord.com