Health security effort to boost global disease response

Top administration officials joined representatives from federal agencies and 26 nations to launch an international effort that will help to boost the global capacity to prevent, detect and respond to disease outbreaks, Feb. 13.

At the Department of Health and Human Services headquarters, HHS Secretary Kathleen Sebelius and Lisa Monaco, assistant to the president for homeland security and counterterrorism, are speaking about the Global Health Security Agenda.

Joining them were officials from Finland, Germany, Canada, the United Kingdom, the Netherlands, Norway, Japan, South Korea China, India, Indonesia and other participating countries.

Representatives from three international organizations in Washington and Geneva, including the World Health Organization, were there, along with officials from the departments of State, Defense and Agriculture, and from the Centers for Disease Control and Prevention.

In advance of the international meeting, officials from the National Security Council, the Defense Department and CDC held a conference call with reporters to detail the U.S. plan to work even more closely with partners to strengthen the global disease response.

On the call were Laura Holgate, senior director for weapons of mass destruction, terrorism and threat reduction at the National Security Council; Andrew C. Weber, assistant secretary of defense for nuclear, chemical and biological defense programs; and CDC Director Dr. Tom Frieden.

“With the Global Health Security agreement, we’re talking about making the world safer and more secure by strengthening our ability as an international community to prevent, detect and respond to infectious disease outbreaks,” Holgate said.

Such diseases include Ebola and other hemorrhagic illnesses; flu; dengue fever; Middle East respiratory syndrome, or MERS; severe acute respiratory syndrome, or SARS; and other infectious diseases that arise in nature or that are accidentally or intentionally released, she added.

In 2007, most countries agreed to abide by updated International Health Regulations, or IHR, adopted two years earlier at the 58th World Health Assembly. The legally binding rules accepted country by country had been revised specifically to help in containing diseases that potentially could spread quickly worldwide.

The WHO set a five-year deadline for countries to ensure their national capacities to identify, investigate, assess and respond to such public health events. Continued…

source: www.dolphin-news.com

 

Revolutionary Vaccine Breaks Refrigeration Barrier in Africa

For decades, distribution of vaccines in Africa and other warm regions has been hampered by the need to keep the vaccines refrigerated – a major challenge in remote areas without electric power. But the World Health Organization says a new vaccine aimed at preventing meningitis A can withstand temperatures up to 40 degrees Celsius, and was found to be 100 percent effective during a trial study in Benin.

Researchers said that health workers in Benin have successfully immunized more than 155,000 people against meningitis A using the first vaccination to be approved for use without constant refrigeration, also known as the “cold chain.”

The World Health Organization (WHO) said the vaccine, which is known as MenAfriVac, can be stored for up to four days in temperatures up to 40 degrees Celsius.

PATH is a U.S.-based non-profit organization that partnered with the WHO on the Meningitis Vaccine Project. Dr. Marie-Pierre Preziosi, the project’s director, said the new breakthrough could revolutionize the way vaccination campaigns are conducted in developing countries. She spoke to VOA from Ouagadougou.

“As you know, vaccines are usually kept in cold chains, between 2 to 8 degrees Celsius. And so you have to have the whole capacity around the cold chain: that is freezers, ice packs, transportation fuel, electricity fuel, all of this. Sometimes, it is not only costly, but it is also very challenging to reach remote areas with such constraints,” said Preziosi.

Health experts said that because of the cold chain requirement, there is normally a lot of wasted vaccine vials during immunization campaigns, particularly during the “last mile” — the time from when the vaccine leaves the refrigerator at the district health center until it is injected into a person’s arm at the village level.

Many communities in Africa have no access to electricity and are often too remote to be reached before the ice packs in insulated coolers melt.

Preziosi said the flexibility of being able to transport the vaccine outside of the cold chain meant that only nine vaccine vials out of 15,000 had to be discarded during the trial study in Benin.

Being able to work outside the cold chain also meant that health workers didn’t have to travel to and from the district health center each day to replenish vaccine supplies. This allowed them to vaccinate more people in a shorter amount of time.

PATH’s vice president for product development, Dr. David Kaslow, said that removing the refrigeration requirement for MenAfriVac could also reduce costs.

“The one study that was done with the WHO looked at the modeled scenario, which is: what are all the costs that are incurred in that last mile? And really, one of the major costs, obviously, are the cold chain costs themselves… And so the analysis was done as to what is the cost savings. And it’s about 50 percent,” he noted. “On average, from 24 cents per dose delivered to 12 cents per dose delivered.”

Meningitis, which is the inflammation of the protective tissue that covers the brain and spinal cord, can lead to severe brain damage if left untreated and results in death in about 50 percent of cases.

The WHO said that while meningitis can be prevented with vaccines, more than one million suspected cases have been reported by countries in Africa’s “meningitis belt” over the past 20 years.

The Meningitis Vaccine Project said that following the MenAfriVac vaccination campaign in Benin, there were no reported cases of Meningitis A in any of the 150 vaccinated communities.

Kaslow said that it is now up to individual countries to take advantage of this success and allow health workers to use MenAfriVac within the new temperature conditions.

He said the next step will be for pharmaceutical developers to see if the refrigeration requirements for other vaccines, such as cholera, can also be changed.

source: www.voanews.com

 

Rising costs, overprescription head list of setbacks in Asian health care

HONG KONG–Plagued by cost overruns and a US$4.2 billion deficit, Taiwan’s National Health Insurance set out in 2012 to find out what lay behind the problem.

The results were a mixture of the expected and unexpected. Other cities, it turned out, were not paying their fair share, so the entire cost fell on Taipei. At the same time, patients were visiting hospitals more than anywhere else in the world and being prescribed many more drugs than they needed or could ever take.

In one instance, a patient who suffered from a range of ailments from high blood pressure to heart disease and asthma was given enough pharmaceutical products to last him 22 years, said Lee Chun-fu, an official with the Bureau of National Health Insurance that runs Taiwan’s healthcare system.

The issue of over-prescription of pharmaceuticals is visible not only in Taiwan but around the world.

The World Health Organization (WHO) estimates that as many as half of all medicines are inappropriately prescribed, dispensed or sold. Overprescription of medicine and overtreatment is emerging as a significant problem across Asia, one that governments are working to address.

For the WHO, the concern is health related. Medicines that are not prescribed properly can lead to health problems. Take antibiotics, for example. If not properly prescribed and taken, they can lead to the emergence of resistant bacteria.

This is already a problem with diseases such as tuberculosis, of which there are resistant strains emerging globally.

“Antibiotic resistance is rising for many different pathogens that are threats to health,” said Tom Frieden, director of the U.S. Center for Disease Control and Prevention.

Another problem is fiscal. Improper or overprescription of drugs leads to huge cost overruns. This may be most visible in Taiwan.

Taiwan’s healthcare system operates through a national health insurance, which covers the entire population. Hospitals buy drugs directly from drug companies and sell them on to patients, although the National Health Insurance covers most of the cost.

The larger hospitals have the clout to negotiate steep discounts with the pharmaceutical companies and can make a tidy profit in the difference between what they pay for a drug and the fixed price that the government pays them.

It benefits doctors to prescribe as much as possible. A spokesperson for the National Health Insurance Civic Surveillance Alliance said the system puts a cap on prices for medicines but not on the quantities that are prescribed or distributed.

This “black hole” costs around US$340 million a year. In the last 15 years or so, Taiwan’s healthcare system has racked up some US$4.2 billion in deficits.

The problem is hardly unique to Taiwan.

Japan, which also has a well-established system of universal care under its national health insurance, has been under severe stress for several years, notes McKinsey & Co. Ltd., a management consulting firm.

Part of the problem is that rising wealth across the country encourages people to seek more care that combines with a lack of centralized controls over the allocation of resources.

Japan’s system of healthcare, known as kaihoken, was established in 1961. But in the past few years, a shortage of doctors has emerged. McKinsey’s 2011 findings note that some doctors see as many as 100 patients in a single day. Under such high levels of turnover, they tend to overprescribe drugs. This also helps the clinics that own in-house pharmacies.

Limit Services to Reduce Cost in Japan

source: www.chinapost.com.tw

 

How Pakistan’s polio strain could affect world health

Just a few weeks ago, 11-month-old Shaista was pulling herself up, giggling as she took her first wobbly steps with the helping hand of her teenage mother.

Then the polio virus struck and Shaista was no longer able to stand, her legs buckling beneath her weight. Today, her mother cries a lot and wonders what will become of her daughter in Pakistan’s male-dominated society, where a woman’s value is often measured by the quality of her husband.

“It is not a hardship just for the child, but for the whole family,” said the child’s 18-year-old mother, Samia Gul. “It is very difficult for a poor family like us. She will be dependent on us for the rest of her life.”

Shaista is one of five new polio cases to surface in Pakistan in just the first month of this year. Last year, Pakistan recorded 92 new cases, beating Nigeria and Afghanistan — the only other polio-endemic countries — by almost 2 to 1, the World Health Organization said.

Pakistan’s beleaguered battle to eradicate polio is threatening a global, multi-billion-dollar campaign to wipe out the disease worldwide. Because of Pakistan, the virus is spreading to countries that were previously polio-free, U.N officials say.

“The largest polio virus reservoir of the world,” is in Peshawar, in northwestern Pakistan near the border with Afghanistan, according to WHO.

Shaista and her parents share a two-room mud house with a couple of goats, a half-dozen squawking chickens and 10 other relatives in Pakistan’s western Khyber Pukhtunkhwa, or KPK, province, where Islamic militants often gun down health workers distributing vaccines and send suicide bombers to blow up police vehicles that protect them.

Fresh cases of polio — traced through genetic sequencing to the Pakistani strain of the disease — are showing up in countries that were previously polio-free, including Syria and Egypt, as well as in the Gaza Strip, said Ban Khalid Al-Dhayi, the spokeswoman for UNICEF in Pakistan. UNICEF is tasked with persuading a reluctant tribal population that lives along Pakistan’s border with Afghanistan — perhaps one of the most dangerous places on the planet — to vaccinate their children.

“A lot of countries that spent so much money and resources eradicating polio are worried,” Al-Dhayi said in an interview.

It wasn’t so long ago — 1988 — that more than 350,000 people, most of them children under 5, were afflicted by polio in 125 countries where the disease was endemic. Today the disease is endemic in only three.

Last year, the Bill and Melinda Gates Foundation, a multi-billion-dollar charity that funds polio vaccinations, vowed to wipe out the crippling disease by 2018.

Underlining the danger that Pakistan poses to achieving that goal, Al-Dhayi said there are 350,000 Pakistani children in just one small area of the country who have not been vaccinated.

The area — North and South Waziristan — is too dangerous for health workers to venture. Islamic militants, many with ties to al-Qaida, banned polio vaccinations there in 2012 to press their demand that the United States end its use of drones to target their hideouts.

Militants have also created suspicion among ultraconservative parents in Pakistan’s deeply religious northwest, saying the polio vaccine will make their children impotent. The vaccine, they claim, is a ploy by the West to limit the world’s Muslim population.

But health workers and militants alike agree the biggest setback was the highly publicized use of a Pakistani doctor and a vaccination ruse to ferret out al-Qaida chief Osama bin Laden in May 2011. Dr. Shakil Afridi is in jail in Pakistan for his role in the CIA operation that uncovered bin Laden’s hideout.

While Afridi never got DNA samples from the bin Laden family, his involvement in the covert operation that led to bin Laden’s death caused residents to look with suspicion on many vaccination programs. Devastating for the polio campaign were the images of Afridi standing beside a banner promoting polio vaccinations as television commentators told of his collusion with the CIA.

“We have deep sensitivity about the polio vaccination after the martyrdom of the great mujahed and leader of Muslims, Sheikh Osama bin Laden,” Taliban spokesman Ehsanullah Ehsan told The Associated Press. “We still have strong suspicions that the vaccination campaign could be used again and again to spy on Muslims and the mujahedeen.”

UNICEF is trying to get Pakistan’s senior Islamic clergy to support the polio campaign, with some success, according to Al-Dhayi. Among those recruited is the so-called father of Afghanistan’s Taliban movement, Maulana Sami-ul-Haq.

“The effort is really intensive and proving positive,” she said, but the clock is ticking. “Pakistan is the worst of the three (polio-endemic countries) in terms of the number of cases and the complexity.”

source: www.dailytribune.com

 

Kalbe Farma Sets Aside $41m to Finance Acquisition of a Health-Food Producer

Kalbe Farma, a local pharmaceutical firm, sets aside Rp 500 billion ($41.3 million) to finance its planned acquisition of a health-food producer this year.

The company will fund the acquisition from its own funds.

“The acquisition fund doesn’t come from our capital expenditure this year,” said Vidjongtius, finance director at Kalbe Farma as quoted by the Investor Daily.

Kalbe has been scouting the market and been in talks with more than 10 companies in Indonesia. The report did not identify the potential acquisition targets.

Unilever Indonesia is one of the listed food companies in the country.

Kalbe Farma said on Wednesday that it has allocated between Rp 1 trillion and Rp 1.2 trillion for capital expenditure this year to boost its production capacity.

The company also aims its sales growth and net income to reach 14 percent and 16 percent, respectively, supported by the development of each division.

“Kalbe plans to introduce three to five products of each division this year,” said Irawati Setiady, president director at Kalbe Farma, as quoted by the Investor Daily.

The company will keep on developing its unbranded generic medicines, which it has been producing in Cikarang, West Java, since 2012. It has also completed its oncology production facility in Pulogadung, East Jakarta, on Jan. 23, it said in the press release.

In its fast-food division, Kalbe plans to continue the construction of a production facility for nutritional drinks, which is expected to be completed in mid-2015.

The company seeks to develop into a global brand with a presence in countries such as the Philippines, Vietnam, Myanmar, and Nigeria.

It will expand its sales area and boost its export to 5 percent from below 4 percent previously.

“We usually work together with local companies to help distribution,” Kalbe said as quoted by Investor Daily.

The company has built a plant in Nigeria, which focuses on medicine and food production.

The company reported a 17.4 percent increase in revenue to Rp 16.01 trillion last year compared to the year before. Its net income rose 10.8 percent last year from the previous year.

Shares of Kalbe Farma rose 0.7 percent to Rp 1,410 on the Indonesia Stock Exchange on Wednesday.

source: www.thejakartaglobe.com

 

Poor Nations Seek New Hepatitis C Drug

Now that wealthy nations have a simple pill regimen that can cure hepatitis C, calls are mounting from representatives of poor nations for the same drugs.

In December, the Food and Drug Administration approved sofosbuvir, from Gilead Sciences. Under the brand name Sovaldi in the United States, it is expected to cost $84,000 per treatment. Four other companies are developing similar pills expected to reach the market in the next three years, with similarly high price tags.

Worldwide, at least 150 million people — nearly five times the number with H.I.V. — are believed to have hepatitis C, which can cause liver damage and cancer.

The Access Campaign of Doctors Without Borders has estimated that cocktails of sofosbuvir and similar drugs can be made for $250 or less, and it is lobbying to make that possible, said Rohit Malpani, the campaign’s policy chief.

It will ask the World Health Organization to put sofosbuvir on its list of drugs the agency tests for countries too poor to have their own drug regulatory agencies.

It is opposing Gilead’s patent application for sofosbuvir in India. Gilead, meanwhile, hopes to license Indian drug companies to make a $2,000-per-treatment version.

The campaign also plans to ask the three top funders of the war on AIDS — the Global Fund to Fight AIDS, Tuberculosis and Malaria; the President’s Emergency Plan for AIDS Relief; and Unitaid — to agree to pay for hepatitis drugs too if the prices become affordable, which will let Doctors Without Borders start pilot treatment projects in several countries.

source: www.nytimes.com


 

Riyadh, Dhaka to sign health pact

The Kingdom and Bangladesh will soon sign a Memorandum-of-Understanding (MoU) to strengthen their mutual cooperation in various functions in the health sector.

The decision to draft a MOU was taken on Sunday during a meeting held here between Health Minister Dr. Abdullah Al-Rabeeah and his Bangladesh counterpart Mohammed Nasim.

Areas of the proposed agreement would include medical collaboration for training, research, exchange of experts, recruitment of doctors and health professionals from Bangladesh and medical education.

The visiting minister sought the Kingdom’s help to secure accreditation for different post-graduate medical education degrees (MD, MS, and FCPS) awarded by Bangladesh, which are yet to be recognized by the Saudi government. “The existing limitations bar the Bangladeshi post-graduate doctors from being accepted as specialist doctors, and force them to accept lower salaries than doctors with similar qualifications from other countries,” the minister noted.

During the bilateral meeting, both ministers agreed to enhance cooperation in the health sector through sharing experiences, training and research collaboration of medical practitioners of both countries for the improvement of the citizens of both nations. Explaining the recent initiatives taken for the improvement in the health sector in Bangladesh under the leadership of Prime Minister Sheikh Hasina, the Bangladesh health minister sought the support of the government of Saudi Arabia to recruit more doctors, nurses and other health professionals from Bangladesh.

Agreeing to consider these proposals by the Bangladesh health minister, the Saudi health minister underlined the need for regular and increased interaction between health professionals of both countries to enhance better understanding about the need for health services.

The Saudi side also expressed willingness to receive medical doctors for training modules in Saudi hospitals while they are pursuing a higher degree in Bangladesh. “This would improve understanding and collaboration between the two countries and benefit Bangladesh doctors who may pursue future careers in Saudi Arabia subsequently to gain experience,” the visiting minister said.

Informing of the massive health reforms undertaken in the Kingdom in an expansion program, Health Minister Al-Rabeeah expressed interest in hiring qualified graduate nurses under the new programs.

Al-Rabeeah hoped to visit Bangladesh at a convenient time in response to the invitation of Bangladesh health minister. A luncheon was hosted by Saudi health minister in honor of the Bangladesh health minister.

Before the bilateral meeting, the Bangladesh health minister also had a meeting with Dr. Sulaiman Al-Emran, acting secretary general of Saudi Commission of Health Specialties, sole body for accreditation and licensing of medical doctors and other health professionals in the Kingdom.

The Saudi Commission agreed to send its doctors as external examiners of Bangladesh medical degrees such as MS and MD as well as for the attachment in premier medical institutions in Bangladesh. The commission’s officials also agreed to undertake a visit to Dhaka soon to see for themselves the medical education, training and services facilities.

The visiting minister attended a reception hosted in his honor by the expatriate Bangladesh community at the Riyadh Palace Hotel here on Saturday.

In the afternoon, Nasim left for Geneva to attend a two-day meeting on e-health standardization at the World Health Organization (WHO).

According to Deputy Health Secretary Sayedul Islam Bangladesh would highlight the successful introduction of e-health services in the country. Bangladesh has been successfully using different software to collect use and store data, Sayedul said, adding that WHO officials will be shown how the Bangladeshi system would be helpful for other countries to exchange data. Seeking anonymity, a ministry official said Bangladesh would get a prize and official recognition from the WHO for successfully introducing e-health in the country.

Besides senior officials from the MOH, Bangladesh Ambassador Mohammed Shahidul Islam, Neazuddin Miah, Secretary, Ministry of Health and Family Welfare, Professor Pran Gopal Datta, Vice Chancellor of Bangabandhu Sheikh Mujib Medical University, Professor Abu Shafi Ahemd Amin, President of Bangladesh Medical and Dental Council (BMDC) and Nazrul Islam, Director General (West Asia) of the Ministry of Foreign Affairs were also present.

sumber: www.arabnews.com

 

Egypt Confirms 38 Swine Flu Deaths

Egypt confirmed Sunday 38 death cases of A/H1N1 virus, known as swine flu, since the beginning of last December, the Egyptian Health Ministry said in a statement.

“The ministry has detected 339,483 cases with 318 diagnosed as carrying the virus since last Dec. 1, and 38 of them died,” health minister Maha al-Rabat said in the statement.

The ministry will announce twice a week on the new developments, the statement added.

The statement also warned susceptible population which includes those younger than two years and above 65 years, patients suffering respiratory diseases, diabetes and pregnant women to make urgent test once they feel the symptoms of the ordinary flu.

A/H1N1 has become so common that it has been categorized under the seasonal influenza by the World Health Organization since 2010, according to the statement.

Former health minister Mohamed Awad Tag-Eddin said at a press conference last week that the virus is growing increasingly active in the northern Hemisphere including Egypt.

source: english.cri.cn

 

Drug-resistant diseases grow as threat to public health

(RNN) – An increasing risk from drug-resistant diseases threatens to wipe out decades of medical progress, according to a study by the Centers for Disease Control and Prevention.

The study showed that resistant microbes kill at least 23,000 people each year and complicate treatment and recovery for 2 million more.

Health professionals characterize the threat as the largest challenge facing modern medicine.

“We are approaching a cliff,” said Michael Bell, deputy director of CDC’s Division of Healthcare Quality Promotion in a news release. “If we don’t take steps to slow or stop drug resistance, we will fall back to a time when simple infections killed people.”

When faced with “superbugs,” physicians must resort to second- and third-line treatments, which may be more expensive or toxic for patients.

Resistant infections are also costly to the healthcare system. The CDC estimates the care costs from these diseases are as high as $20 billion a year and lost productivity as high as $35 billion a year.

The rise of resistant infections also threatens patients who receive advanced therapies, such as joint replacements, organ transplants and cancer treatments. Antibiotics are key to fighting their infections.

“If the ability to effectively treat those infections is lost, the ability to safely offer people many of the life-saving and life-improving modern medical advances will be lost with it,” the CDC stated.

Plan of attack

Bacteria naturally develop resistance to antibiotics over time through use – and misuse – of antibiotics, CDC researchers noted.

“Every time antibiotics are used in any setting, bacteria evolve by developing resistance. This process can happen with alarming speed,” said Dr. Steve Solomon, director of CDC’s Office of Antimicrobial Resistance.

The agency said as many as 50 percent of the antibiotics prescribed for humans are not needed or misused. Much of the antibiotics used in farm animals are also unnecessary.

Drug-resistant microbes can be traced to the 1940s, according to the World Health Organization. The first one, staphylococcus aureus, was discovered four years after the mass production of penicillin in 1943.

Superbugs are a worldwide problem. For instance, a resistant tuberculosis strain is gaining ground, particularly in areas of the former Soviet Union, according to the WHO.

The CDC has developed four plans of attack to fight these diseases: preventing the spread of resistant infections, tracking resistance patterns, improving the use of current antibiotics and developing new antibiotics and tests.

“Because antibiotic resistance occurs as part of a natural process in which bacteria evolve, it can be slowed but not completely stopped,” the CDC stated. “Therefore, new antibiotics always will be needed to keep up with resistant bacteria, as will new tests to track the development of resistance.”

The public can help by getting immunized, handling food safely, using antibiotics as prescribed and practicing basic hygiene such as washing hands.

Patients should dispose of any antibiotic remnants properly, with the best option being taking unwanted medicine to a drug take-back program. The Drug Enforcement Administration’s Drug Take-Back Day is April 1.

The FDA also has developed advice for how to best dispose of an assortment of drugs.

Food supply issues

Animals used in food are given antibiotics to prevent and treat disease, as well as make these animals gain weight faster with less feed.

According to a PBS report, “small doses of antibiotics administered daily would make most animals gain as much as 3 percent more weight than they otherwise would.”

The drugs are added to the animals’ feed and sometimes to the drinking water. But their overuse, experts say, is likely compromising human health, as drug-resistant microbes can be transferred from animals to the humans who eat them.

The countries of the European Union have forbidden the use of antibiotics to promote animal growth.

The U.S. Food and Drug Administration has released a voluntary plan, along with industry, to phase out antibiotic use in farm animals to bolster production.

Some question whether the FDA is doing enough to protect the food supply.

The Natural Resources Defense Council noted that a decade-long FDA assessment classified 18 of the 30 feed additives as having a “high risk” of exposing the public to drug-resistant bacteria through the food supply, in a report the environmental advocacy group released late last month.

“The FDA concluded in their review that at least 26 of the reviewed feed additives do not satisfy even the safety standards set by FDA in 1973,” the report stated.

The NRDC, which based its report on data the FDA released as part of a Freedom of Information Act request, also criticized the agency for making its antibiotics reduction voluntary.

A coalition of meat producers, however, questions the danger of antibiotics use.

It characterizes the health risks of antibiotics in meat as “negligible,” according to a 2012 news release from the National Chicken Council. They claim that antibiotics are needed, and the restrictions of the drugs’ use is more stringent that the use of antibiotics in humans.

source: www.live5news.com

 

WHO: Imminent global cancer ‘disaster’ reflects aging, lifestyle factors

Cancer cases are expected to surge 57% worldwide in the next 20 years, an imminent “human disaster” that will require a renewed focus on prevention to combat, according to the World Health Organization.

The World Cancer Report, produced by the WHO’s specialized cancer agency and released on World Cancer Day, predicts new cancer cases will rise from an estimated 14 million annually in 2012 to 22 million within two decades. Over the same period, cancer deaths are predicted to rise from 8.2 million a year to 13 million.

The rising incidence of cancer, brought about chiefly by growing, aging populations worldwide, will require a heavier focus on preventive public health policies, said Christopher Wild, director of the International Agency for Research on Cancer.

“We cannot treat our way out of the cancer problem,” he said. “More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally.”

The report notes that the rocketing cost of responding to the “cancer burden” — in 2010, the economic cost of the disease worldwide was estimated at $1.16 trillion — is hurting the economies of rich countries and beyond the means of poor ones.

The report said about half of all cancers were preventable and could have been avoided if current medical knowledge was acted upon. The disease could be tackled by addressing lifestyle factors, such as smoking, alcohol consumption, diet and exercise; adopting screening programs; or, in the case of infection-triggered cancers such as cervical and liver cancers, through vaccines.

“I know the report said we can’t treat our way out of (the cancer problem) but there are major things we can do,” said Dr. David Decker who works in oncology at Florida Hospital in Orlando. “Virtually 80 or 90 percent of lung cancers are caused by smoking. I know stopping smoking is not easy for people, but it does seem like a pretty simple way to reduce the numbers.”

“The cancer rates are not going up for shocking reasons, but for reasons that are easier to understand, and if we improve overall health, there are things we can do to prevent this from happening,” Decker said.

Cutting smoking rates would have a significant impact, as lung cancer remained the most commonly diagnosed cancer (1.8 million cases a year, or 13% of total cancer diagnoses) and the deadliest, accounting for about one-fifth (1.6 million) of all cancer deaths worldwide.

There is a silver lining to the report, some experts said: It may lend urgency to the fight against cancer. Countries such as the United States present examples of success stories stemming from legislation and financial resources devoted to cancer prevention.

“The good news is, in (the United States), cancer mortality is trending downward, and that would be more true if you make an age adjustment,” said Dr. Walter Curran, chairman of the Department of Radiation Oncology at Emory University’s School of Medicine in Atlanta.

“Since we have an aging population, the cancer rate increases, and if you adjust for the aging of America, the cancer rate is declining notably.”

Curran said a typical 20-year-old American who doesn’t smoke, “who has a good diet and a healthy lifestyle, someone with moderate alcohol consumption and who takes preventive health measures like regularly seeing a doctor and getting exercise — their chance of cancer is significantly less than someone who for example lives in a developing country in Africa right now.”

However, the United States is dealing with an obesity epidemic — the rates of adults who are considered obese has doubled since the 1970s — and drinking excessively is still the No.3 cause of lifestyle-related death.

Smoking is still the leading cause of preventable death in the United States. However, when the U.S. Surgeon General linked tobacco to lung cancer 50 years ago, more than 40% of the adult population smoked; now it’s about 19%.

Public health initiatives have also made a difference in smoking rates. The report eventually spurred local governments to make it harder for a smoker to find a place to practice their habit. Many restaurants, bars, and even public parks ban smoking.

National leadership gave state governments license to raise taxes on cigarettes so much that people quit because they could no longer afford their habit.

Money from the federal tobacco lawsuit settlement went into smoking cessation programs and gave farmers incentives to grow crops other than tobacco. The FCC banned persuasive cigarette ads that may have encouraged young people to smoke.

Smoking rates remain high in Asia and Africa. China — where one-third of the world’s cigarettes are smoked, according to the World Health Organization — only recently moved to ban indoor public smoking.

The report’s authors suggested governments take similar legislative approaches to those they had taken against tobacco in attempting to reduce consumption of alcohol and sugary drinks, and in limiting exposure to occupational and environmental carcinogens, including air pollution.

According to the report, the next two most common diagnoses were for breast (1.7 million, 11.9%) and large bowel cancer (1.4 million, 9.7%). Liver (800,000 or 9.1%) and stomach cancer (700,000 or 8.8%) were responsible for the most deaths after lung cancer.

“The rise of cancer worldwide is a major obstacle to human development and well-being,” said Wild, the International Agency for Research on Cancer director. “These new figures and projections send a strong signal that immediate action is needed to confront this human disaster, which touches every community worldwide.”

The report said the growing cancer burden would disproportionately hit developing countries — which had the least resources to deal with the problem — due to their populations growing, living longer and becoming increasingly susceptible to cancers associated with industrialized lifestyles.

More than 60% of the world’s cases and about 70% of the world’s cancer deaths occurred in Africa, Asia, and Central and South America.

“In the developing world, we are really at the beginning of understanding how serious the cancer problem is in these countries,” said Emory School of Medicine’s Curran.

Cancers related to the HIV epidemic in developing countries and the spread of Hepatitis C are also on the rise, but so too is the general age of the population in developing counties. When you now have the potential to live long enough to see your grandchildren — something that was not true even a decade ago in many developing countries — your risk of having cancer is going to go up.

“When life expectancy get better, cancer rates will go up and so will cancer fatalities,” Curran said.

Governments needed to appreciate that screening and early detection programs were “an investment rather than a cost,” said Bernard Stewart, co-editor of the report — and low-tech approaches had proven successful in some developing countries.

The World Cancer Report, which is published about once every five years, involved a collaboration of around 250 scientists from more than 40 countries. Tuesday is World Cancer Day.

source: edition.cnn.com