Category: Berita

The World Health Assembly continued progress Friday, approving plans to better incorporate palliative care, expand inclusion of the needs of those affected by autism, improve access to health care for those with disabilities, better integrate the use of traditional medicine and raise awareness of psoriasis.

Traditional medicine

The Health Assembly approved WHO’s traditional medicine strategy 2014–2023. Traditional medicine covers a wide variety of therapies and practices which vary from country to country and region to region. The strategy aims to build the knowledge base for national policies and strengthen quality assurance, safety, proper use and effectiveness of traditional and complementary medicine through regulation. It also aims to promote universal health coverage by integrating traditional and complementary medicine services into health care service delivery and home care.

Disability action plan

A new WHO global disability action plan 2014–2021 aims to improve the health and quality of life of the one billion people around the world with disabilities by improving their access to health care and creating new and strengthening existing services and technologies that help them acquire or restore skills and functions. It also aims to strengthen data and research.

People with disabilities have the same general health care needs as others, but are three times more likely to be denied health care and four times more likely to be treated badly in health facilities. One in seven people worldwide has a disability. As people live longer and chronic diseases increase, more people are likely to develop disabilities. Road traffic crashes, falls, violence, natural disasters and conflict, unhealthy diet and substance abuse can also lead to disability.

Autism spectrum disorders

The Health Assembly urged Member States to include the needs of individuals affected by autism spectrum and other developmental disorders in policies and programmes related to child and adolescent health and development and mental health. This means increasing the capacity of health and social care systems to provide services for individuals with autism spectrum disorders and for their families and shifting the focus of care from long-stay health facilities towards non-residential services in the community. It also means improving health surveillance systems to capture data on autism spectrum disorders and ensuring countries are better able to diagnose and treat autism spectrum disorders.

The resolution highlights the need for the WHO Secretariat to help strengthen countries’ capacities to address autism spectrum and other developmental disorders; facilitate resource mobilization; engage with autism-related networks; and monitor progress. All efforts will be conducted in alignment with the WHO Mental health action plan 2013–2020.

Autism spectrum disorders comprise a range of development disorders which include autism, childhood disintegrative disorder and Asperger syndrome. Worldwide, most people with autism spectrum disorders and their families do not receive any care from health and social care systems.

Psoriasis

A resolution on psoriasis encourages Member States to raise awareness about the disease and to advocate against the stigma experienced by so many people who suffer from it. It requests the WHO Secretariat to draw attention to the public health impact of psoriasis and publish a global report on the disease, emphasizing the need for greater research and identifying successful strategies for integrating the management of psoriasis into existing services for noncommunicable diseases by the end of 2015.

Psoriasis is a chronic inflammatory disease characterised by scaly, red skin lesions. People with psoriasis have relatively higher risks of heart disease, stroke, hypertension and diabetes. Studies have documented higher rates of depression and anxiety compared with the general population.

Strengthening palliative care as a component of comprehensive care

Today’s resolution emphasizes that the need for palliative care services will continue to grow – partly because of the rising prevalence of noncommunicable diseases and the ageing of populations everywhere. The WHO global action plan for the prevention and control of noncommunicable diseases 2013–2020, endorsed by the Health Assembly in May 2013, includes palliative care among the policy options proposed to Member States and in its global monitoring framework.

source: www.who.int

 

The World Health Organization opened its 67th annual assembly on Monday in Geneva.

The event is expected to draw more than 3,000 delegates from WHO’s 194 member states for six days of discussion on key global issues.

A recent survey by Gallup showed that 72 percent of the public has a good opinion of WHO and its partner UNICEF.

The event will cover efforts for preventing and controlling noncommunicable diseases such as heart disease, diabetes, cancer and chronic lung disease. The participants will also discuss a new global strategy for preventing and controlling tuberculosis and propose efforts for improving the health of patients with viral hepatitis.

The assembly will also work on drafting an action plan for newborn health. The WHO’s global strategy for maternal and young child nutrition will also be reviewed.

The assembly will also be making efforts toward the Millennium Development Goals and a post-2015 agenda.

The tackling of antimicrobial drug resistance, access to essential medicines, medicine regulation, the management of autism and protection against vaccine-preventable diseases are also on the agenda.

Shigeru Omi, the president of the 66th World Health Assembly, will open the meeting, at which delegates will elect a new president and officers.

source: vaccinenewsdaily.com

 

The US government has told a group of local health educators that it will no longer use immunisation programs as a cover for espionage.

But the damage from previous such programs is difficult to undo, and distaste for the US, exacerbated by drone strikes, means the announcement has more symbolic value for Western audiences than impact on the ground. Luckily, local efforts and leadership in affected areas are making progress.

Three regions – Somalia, Nigeria and Pakistan – have armed groups openly hostile to public health efforts, especially immunisation. But only in the latter is this due to the CIA’s actions.

Radical groups in Pakistan

The most radical threat to public health by armed extremists is by anti-government elements in north-west Pakistan. Attacks on health workers and security personnel protecting them have led to more than 60 deaths over the past three years.

The escalation in assaults and murders of vaccinators can be traced directly to the May 2011 U.S. Special Forces assault on the Abbottabad compound inhabited by Osama bin Laden and his family. Three months after the raid, in which bin Laden was killed, the Guardian revealed the CIA had used a Pakistani doctor to carry out a fake hepatitis B vaccine effort to get DNA samples from children living in the compound.

Combined with anger about continuing drone attacks, this episode led to a ban by the Pakistan Taliban in July 2012 on all forms of immunisation in areas they control in the Federally Administered Tribal Areas (affecting mainly North and South Waziristan districts).

Around 350,000 children in contested areas are unable to access immunisation and other public health services. And there’s been a spike in paralytic polio cases in Pakistan this year, with 66 cases reported so far (compared with only 14 in the same period last year).

But this spike is merely the most visible impact of the Pakistan Taliban’s ban on vaccinations; polio surveillance is very effective compared with surveillance for other diseases.

Other negative health impacts include women health workers (the bedrock of Pakistan’s community health services) being unable to work for fear of violence. This means the coverage of health programs for women and children is now very low. And the government has closed 450 community health centres in FATA since 2010 due to the unwillingness of personnel (especially women) to work in the region.

What is being done?

Bans on vaccination and other public health programs are fuelled by a mix of political, tactical, and quasi-religious motives. The link made by the Pakistan Taliban between drone attacks and child immunisation programs, for instance, is spurious but holds the international health community to hostage.

Many in the global Islamic community have been active in countering claims that the polio vaccination, for instance, is “anti-Islam”. The Islamic Advisory Group on Polio, based at Al-Azhar University in Cairo, has been the most active.

At a meeting in Jeddah this year, the chairman emphatically denounced what he termed “fallacious and distorted fatwas (edicts) and claims” against polio vaccines and strongly condemned violent attacks against polio vaccinators. The IAG has developed pro-vaccination fatwas and disseminated them to local Islamic leaders in the hope of countering the radicals’ propaganda.

Another approach has been the use of innovative communication strategies to mobilise community demand for vaccination. Messages are being transmitted by respected community leaders, mullahs and teachers.

Local political leadership is vital because it can be transformative. In the state of Peshawar in Pakistan, where violence had disrupted many immunisation campaigns, Imran Khan’s government deployed 4,000 security personnel and banned motorcycles on 12 consecutive Sundays to vaccinate more than seven million children against nine diseases without any violent incidents.

Likewise, discrete negotiations between the governor of Kandahar province in Afghanistan with local Taliban leaders led to high vaccination rates and the elimination of polio from the province in late 2012.

Local power

The important lesson from Afghanistan is the importance of keeping polio prevention and other life-saving public health programs politically neutral.

While former president Hamid Karzai demanded high performance and accountability from provincial governors, he maintained a low public profile and avoided politicising the polio vaccination program.

The White House announcement will contribute to building that neutrality in challenging settings such as north-west Pakistan. What’s now needed is a concerted campaign by communications specialists and religious scholars to convince communities that vaccinating children is not just “a good idea” but an obligation.

Hostile militant groups elsewhere

In south and central Somalia, Al Shabaab has banned all humanitarian agencies, including Islamic Relief access to territories it controls, leading to the cessation of all child health programs.

More than 300,000 children were un-vaccinated for over three years, resulting in a 2013 polio outbreak that paralysed 194 children and spilt into the neighbouring countries of Ethiopia and Kenya. Al Shabaab’s ban on vaccination also led to widespread measles epidemics throughout the Horn of Africa.

In north-east Nigeria, the extreme militant group Boko Haram has attacked health facilities that provide immunisation and killed health workers, claiming that vaccination is a Western plot to sterilise girls and infect them with AIDS.

Nigeria has long been a stronghold of anti-vaccination propaganda. In 2003, the political and religious leaders of three northern states called on parents not to allow their children to be immunised. They argued vaccines could be contaminated with anti-fertility agents, HIV, and cancerous agents.

The result was thousands of children getting of new infections, and the outbreak of polio eventually spread abroad as far as Indonesia.

source: theconversation.com

 

The 67th World Health Assembly is happening this week in Geneva, and one of the key issues on the agenda is noncommunicable diseases.

NCDs — cardiovascular disease, cancer, diabetes and chronic respiratory disease — result in more than 36 million deaths each year, and 80 percent of these occur in low- and middle-income countries. In Africa, deaths from NCDs are expected to outpace those stemming from infectious, maternal, prenatal and nutritious diseases by 2030.

The World Economic Forum estimates NCDs can cost the global economy more than $30 trillion — or 48 percent of the world’s gross domestic product in 2010 — in the next two decades.

But perhaps because the development community is more focused on addressing health issues covered by the Millennium Development Goals — HIV and AIDS, malaria, tuberculosis, and maternal and child health — funding to prevent the spread of NCDs has been minuscule. The latest available sectoral data on development assistance for health indicate NCDs received $377 million, or just 1.2 percent of health funding, in 2011. While this represented a 4.6 percent increase from 2010 allocations, it pales in comparison to what other subsectors are receiving. Development assistance for HIV and AIDS, for instance, is 20 times higher than that for NCDs.

NCDs — which are caused by either genetic or lifestyle factors — are preventable and less costly to combat. According to the World Health Organization, cost-effective interventions in low-income countries would only amount to 4 percent of current global health funding. That figure drops to 2 percent in lower-middle-income countries and 1 percent in upper-middle-income nations.

Collaboration: ‘The only way to go’

Community-level outreach is one of the most effective low-cost interventions to prevent and control NCDs. And to implement such programs effectively, partnerships and a multistakeholder approach are vital.

“No one organization has the solution,” Dr. Ayham Alomari, senior health officer for community health and noncommunicable diseases at the International Federation of Red Cross and Red Crescent Societies, told Devex.

To change the behavior of members of at-risk communities and encourage them to adopt healthy lifestyles, Alomari said the environment plays a very critical role. By “walking the talk,” volunteers can help communities understand the risks associated with unhealthy habits and the benefits of healthy living. The academic community, meanwhile, can provide empirical data on which community-level approaches work, how, why and where.

For many of these health issues, collaboration “is the only way to go,” Mario Ottiglio, public affairs and global health policy director at the International Federation of Pharmaceutical Manufacturers & Associations, affirmed. With NCDs, one has to go beyond the health dimensions and look at the messaging and marketing as well.

IFPMA is an international group based in Geneva, Switzerland. Its members include R&D companies and national pharmaceutical associations in developed and developing countries.

“You can’t escape the way of partnerships because there are too many interlinked dimensions [in addressing NCDs],” Ottiglio told Devex. “You can conceivably have a partnership between the food sector, the government [and the information technology] industry, and you will have a stake for everybody there.”

Last year, IFPMA forged a two-year partnership with the IFRC, which entailed having to design a behavioral change-based toolkit for community-based outreach. The toolkit aims to promote four healthy habits — eat healthy, be physically active, reduce alcohol intake and quit smoking — as a way to prevent and control NCDs.

IFPMA provided in-kind and modest financial contributions to kick-start the program and make sure the basics the volunteers will need are in place. The group is also helping with the messaging and advocacy, according to Ottiglio.

“The plan in the future,” Alomari said, is for IFPMA to “be the bridge between IFRC and the private sector.” IFPMA will identify potential partnerships and develop the framework for collaboration.

“Our member companies have been traditionally involved in this field,” Ottiglio said. “One-quarter of our partnerships focus on NCDs.” At present, IFPMA members have been involved in building capacity, raising awareness, devising strategies to facilitate access to medicines, and strengthening and securing the supply chain.

IFPMA and IFRC have trained volunteers in 20 countries in Asia and the Pacific and 13 in Europe, and are planning to conduct training in some 40 countries in the Americas and Africa by the end of the year. Volunteers in the initial 33 countries are now ready to implement the “4 Healthy Habits” initiative, which will be formally launched at a side event on the first day of the World Health Assembly.

Beyond financing and behavior change

Changing the behavior of communities is a key challenge the “4 Healthy Habits” initiative aims to address.

“[The] key for the success of the program is the uptake at the local level, in the sense that those that will be trained will be proactive and can explain the value of the program to the community. Messaging is key,” Ottiglio stressed.

But there are key concerns surrounding NCD prevention that are beyond the scope of the initiative. Among these, Alomari noted, is the need to have legislation that can help promote healthy behavior.

“The challenge is for countries to adopt and enforce clear policies that work,” Alomari said.

Financing is an issue as well. Early diagnosis is a vital component of preventing deaths from NCDs. But diagnosis is a problem in communities where health centers are ill-equipped or do not have the necessary equipment at all.

Alomari is hopeful global spending on NCDs will pick up in 2016, after the end of the MDG period. And some developments support this optimistic view.

At last year’s meeting, the World Health Assembly approved a 20.5 percent increase in WHO’s 2014-2015 budget for noncommunicable diseases — from $264 million to $318 million. This is in stark contrast to the $72 million cut in the allocation for infectious diseases. In 2013, WHO also released a $940.3 million, eight-year action plan to prevent and control NCDs.

Alomari is hoping for more than increased financing for NCDs at this year’s World Health Assembly.

“We would want to see that NCD prevention would be included in the agenda of donors and policy makers. We would like to see there is a fund and promotion of community health workforce, including volunteers, as integral components of the health system. See more practical, easy-to-use toolkits and learn from them. We would like to see more programs in the field happening.”

Devex is in Geneva to cover the 67th World Health Assembly. Check back in the next few days to see video interviews and more of our coverage from Switzerland. Join the Devex community and gain access to more in-depth analysis, breaking news and business advice — and a host of other services — on international development, humanitarian aid and global health.

source: www.devex.com

 

Alcohol kills 3.3 million people worldwide each year, more than AIDS, tuberculosis and violence combined, the World Health Organisation said on Monday, warning that booze consumption was on the rise.

Including drink driving, alcohol-induced violence and abuse, and a multitude of diseases and disorders, alcohol causes one in 20 deaths globally every year, the UN health agency said.

“This actually translates into one death every 10 seconds,” Shekhar Saxena, who heads the WHO’s Mental Health and Substance Abuse department, told reporters in Geneva.

Alcohol caused some 3.3 million deaths in 2012, WHO said, equivalent to 5.9 per cent of global deaths (7.6 per cent for men and 4.0 per cent for women).

In comparison, HIV/AIDS is responsible for 2.8 per cent, tuberculosis causes 1.7 per cent of deaths and violence is responsible for just 0.9 per cent, the study showed.

More people in countries where alcohol consumption has traditionally been low, like China and India, are also increasingly taking up the habit as their wealth increases, it said.

“More needs to be done to protect populations from the negative health consequences of alcohol consumption,” Oleg Chestnov of the WHO’s Noncommunicable Diseases and Mental Health unit said in a statement launching a massive report on global alcohol consumption and its impact on public health.

Drinking is linked to more than 200 health conditions, including liver cirrhosis and some cancers. Alcohol abuse also makes people more susceptible to infectious diseases like tuberculosis, HIV and pneumonia, the report found.

Most deaths attributed to alcohol, around a third, are caused by associated cardiovascular diseases and diabetes.

Alcohol-related accidents, such as car crashes, were the second-highest killer, accounting for around 17.1 per cent of all alcohol-related deaths.

China, India drinking more

Binge drinking is especially damaging to health, the WHO pointed out, estimating that 16 per cent of the world’s drinkers abuse alcohol to excess.

While people in the world’s wealthiest nations, in Europe and the Americas especially, are boozier than people in poorer countries, rising wealth in emerging economies is also driving up alcohol consumption.

Drinking in populous China and India is rising particularly fast as people earn more money, the WHO said, warning that the average annual intake in China was likely to swell by 1.5 litres of pure alcohol by 2025.

Still, Eastern Europe and Russia are home to the world’s biggest drinkers.

Russian men who drink consumed an average of 32 litres of pure alcohol a year, according to 2010 statistics, followed by other Western countries including Europe, Canada, the United States, Australia and South Africa.

On average, every person above the age of 15 worldwide drinks 6.2 litres of pure alcohol in a year, according to the report.

Counting only those who drink though, that rises to 17 litres of pure alcohol each year.

But far from everyone indulges. Nearly half of all adults worldwide have never touched alcohol, and nearly 62 per cent say they have not touched a drink in the past year, the report showed.

Abstinence especially among women, is most common in low-income countries, while religious belief and social norms mean many Muslim countries are virtually alcohol free.

source: www.smh.com.au