What the world can’t tell us about health care

It’s a simple truism, often repeated, that other developed nations achieve better health outcomes than the United States does despite spending less money on care.

A June 16 column in the New York Times was typical: “What Sweden can tell us about Obamacare.” Sweden spends less than half on health care per capita as the U.S., the author, Cornell University economist Robert Frank, points out, but achieves better outcomes by responding “efficiently” to treating illness, utilizing economies of scale for expensive procedures, and funding only treatments shown to be effective. To accomplish these objectives, he says, the Swedish model relies heavily on government authority and non-profit institutions — certainly far more than the U.S. Affordable Care Act does.

It’s all so obvious and widely agreed upon among health-care experts — and completely irrelevant.

Frank’s comparison reflects a common misunderstanding of the real relationships between health, health care and government policy in the U.S.

Yes, other nations do achieve better health outcomes, but this is almost entirely a matter of lifestyle (not “partly from lifestyle,” as Frank and so many others believe). Throughout the developed world, improvements in big things such as infant mortality, life span, even morbidity are almost completely attributable to diet; exercise; smoking, alcohol and drug usage; education; employment and income; family structure; environment; and community safety.

LESS IS MORE

Next to these determinants, the additional contribution of more health care — along with its policy cousin, “access” to health care — is almost insignificant. It may be more accurate to say that other developed countries achieve better health results not despite spending less on care, but because they spend less on care. In doing so, they free up resources — especially public resources — for the things that really matter: education, day care, recreation, even roads and bridges.

In the United States, our bloated health economy deprives other social needs of the resources required to genuinely improve and extend lives.

Of course, none of us personally finds health care or access to it insignificant. To us, any recommended treatment — even a “preventive” test — seems essential. Much of health care is useful, some of it even lifesaving, but few of us are aware of how many people need to have the latest screenings, pills and treatments for even one person to reap a benefit. (www.thennt.com shows these numbers for common treatments.)

Health care is personal, which is why it’s so powerful politically.

SAYING ‘NO’

Which brings us to the second fallacy in the conventional wisdom: that foreign health care is more efficient or better-regulated than American care. It often is, but the real difference is that in every other developed country’s system, someone actually has the authority and incentive to say “no.”

While these systems vary (even including one, Singapore, that relies heavily on consumer choice to control demand), in each there is an actual health-care budget somewhere that can’t be exceeded. It’s this effective limit on demand that allows, even causes, the other factors that health analysts credit with controlling cost: volume of care, prices, waste and overinvestment.

In contrast, the essential philosophy of U.S. policy is that no one should ever be denied any “needed” test, procedure or treatment. Obviously, this philosophy is imperfectly implemented: Many Americans remain outside the system and are harmed by the high prices that are the inevitable result of our unwillingness to control demand. Indeed, a desire to bring these people into the system underpins efforts to shift even more resources into health care.

What makes the U.S. unique is our refusal to empower anybody — the government, insurers or consumers — to say “no.” We don’t understand that there is no objective limitation on the need for health care; that unchecked, it will expand relentlessly no matter how healthy we get.

In debating everything from Medicaid to mortality, our health-care experts and policymakers ignore the data showing that most of our flood of care does little measurable good.

Medicare and Medicaid are essentially alone in the developed world as unbudgeted entitlements. Our tax subsidy for employer-provided health insurance has been essentially limitless. Strong new restrictions in the Affordable Care Act on private insurers’ ability to deny or cap claims extend this policy.

And hospitals’ obligation to treat indigent walk-ins is almost unlimited — the government compensates for this “uncompensated” care.

Senior-advocacy groups are surely aware of the overwhelming data on excess and the danger of unnecessary surgeries and prescription drugs, yet that hasn’t weakened their support for the Part D prescription drug entitlement nor their opposition to any Medicare spending controls.

For all the talk of the uninsured, it was the hospital and drug industries that paid for much of the campaign to pass the Affordable Care Act. And it’s the hospitals that are now lobbying for holdout governors to expand Medicaid, reminding politicians that hospitals are among their states’ largest employers.

HEALTH-CARE MONSTER

The American health-care monster rests on a powerful political coalition of seniors groups, ideological liberals and what is by far the country’s largest industry. That influence is felt at every stage of policy-making and administration, impeding the government’s existing ample authority to drive quality, value and even safety. Their shared opposition to any attempt to control demand through government, or even private, action leaves us stuck with industrial policy posing as a public safety net — and not a very strong one.

Unless we find the political will to ever say “no” (or at least assign that capacity to insurers or consumers), we have little to learn from the health systems of Sweden, or Canada, Britain or any other developed country where care seems more efficient. Our mess is uniquely American; difficult though it may be, we need to find a uniquely American solution.

(source: thegazette.com)

 

Atasi DBD, Indonesia Bisa Mencontoh Singapura

Dalam mengendalikan kasus penyakit demam berdarah dengue (DBD), Indonesia sebaiknya mengadopsi langkah yang dilakukan Singapura dan beberapa negara lainnya di dunia. Dari Singapura misalnya, yang berhasil mengatasi penyebaran DBD dalam satu tahun, Indonesia dapat belajar bagaimana melakukan fogging yang tepat.

“Indonesia dapat mencontoh pada Singapura, Brasil, dan Kuba. Ketiga negara tersebut berhasil menurunkan angka penderita DBD. Kita bisa belajar dari Singapura, bagaimana fogging yang efektif. Hal ini bisa kita lakukan di Indonesia,” kata peneliti dari Departemen Kesehatan Lingkungan Fakultas Kesehatan Masyarakat Universitas Indonesia (FKM UI) Budi Haryanto.

Di Singapura, kata Budi, penyakit DBD tidak lagi dilaporkan sejak 2005. Menurut Budi, pemberantasan virus dengue berhasil karena fogging yang berjalan efektif. Fogging dilakukan dengan dosis, radius, dan timing yang tepat.

Di negara tetangga tersebut, fogging dilakukan serentak di seluruh wilayah tanpa didasarkan kasus. Hal dilakukan guna mencegah nyamuk dewasa berpindah mencari lokasi sasaran lain. Fogging melibatkan 240 ribu relawan dan dilakukan satu bulan sekali terus-menerus, selama setahun.

Selain itu, Pemerintah Singapura juga menerapkan denda bagi pemilik tempat tinggal yang ditemukan jentik nyamuk. Denda menuntut warga untuk selalu menjaga kebersihan dan peraturan ini terbukti mampu menhhindarkan warga dari ancaman DBD.

Di Indonesia, penyakit DBD masih menjadi ancaman. Hasil Riskesdas 2007 menunjukkan, DBD menjadi penyebab kematian nomor 5 pada balita setelah diare, pneumonia, dan meningitis, dengan jumlah kematian 6,8 persen.

Jumlah kasus DBD di Indonesia saat ini mencapa sekitar 160 ribu per tahun sedangkan di dunia rata-rata ada sekitar 925.896 setiap tahunnya. Indonesia juga pernah menempati posisi tertinggi kasus DBD di dunia pada 2006, 2007, dan 2008.

(sumber: health.kompas.com)

 

Panduan baru dalam pengobatan HIV

Sebuah panduan baru dalam perawatan HIV diperkirakan akan memberikan jutaan orang di negara berkembang berkesempatan mendapatkan obat yang bisa menyelamatkan hidup mereka.

Badan Kesehatan Dunia, WHO merekomendasikan kepada pasien untuk mulai melakukan perawatan pada tahap awal penyakit yang dideritanya itu.

WHO mengatakan panduan yang diluncurkan pada Konferensi Internasional AIDS di Kuala Lumpur ini akan mampu membantu menghindari jumlah tambahan kematian sebanyak 3 juta orang akibat AIDS pada 2025 mendatang.

Lembaga sosial bernama MSF menyambut baik langkah tersebut tapi mereka mengatakan langkah ini harus dibarengi dengan investasi lebih banyak.

Panduan pengobatan baru ini akan mengharuskan seorang pasien mengkonsumsi sebuah pil beserta tiga jenis obat-obatan lain saat dia dinyatakan positif mengidap HIV.

Konsumsi obatan-obatan ini dilakukan pada tahap yang sangat dini saat sistem kekebalan tubuh mereka masih kuat.

Sejumlah negara seperti Algeria, Argentina dan Brasil telah menjalani pengobatan yang didasari atas panduan baru dari WHO.

Konsultasi panjang

Saat ini tidak semua orang yang membutuhkan bisa mendapatkan pengobatan secara dini meskipun sejumlah kebijakan untuk membantu para pasien telah dibuat dalam beberapa tahun terakhir agar mereka bisa memperoleh akses lebih luas dalam pengobatan HIV.

WHO menyebut panduan ini merupakan bentuk dari wujud perubahan besar dalam kebijakan mereka.

Mereka berharap dari perubahan kebijakan ini akan menghasilkan peningkatan akses pasien dengan HIV terhadap obat-obatan di negara berkembang.

Mereka memperkirakan jumlah pasien yang bisa mengakses obat-obatan dengan cara ini akan meningkat dari 16 juta orang menjadi 26 juta orang atau 80 persen dari total orang dengan HIV yang ada di dunia saat ini.

Diperkirakan panduan ini akan memunculkan tambahan anggaran sebesar 10 persen dari biaya keseluruhan dalam menangani HIV/AIDS di seluruh negara berkembang.

WHO merasa bahwa negera donor dan negara berkembang akan bisa diyakinkan bahwa usulan tentang pengobatan dini ini jauh lebih efektif secara biaya.

Kebijakan ini sendiri disetujui dalam konfrensi di Kuala Lumpur setelah melalui konsultasi selama satu tahun lebih dengan menunjukan adanya bukti-bukti yang telah dipertimbangkan bahwa pengobatan dini berperan dalam mengurangi penyebaran virus.

(sumber: www.bbc.co.uk)

 

Menjadikan Indonesia Tuan Rumah Pengobatan Herbal

INDONESIA tak hanya terkenal sebagai negeri yang kaya akan sumber daya alamnya saja, tapi juga kaya potensi tanaman obat untuk penyembuhan berbagai penyakit.

Indonesia merupakan rumah dari 30.000 jenis dari 40.000 jenis tanaman obat yang tersebar di seluruh Indonesia. Potensi tersebut merupakan lahan yang bisa dimanfaatkan untuk menjaga kesehatan atau mengobati beragam penyakit di masyarakat. Apalagi, tanaman obat pun tak kalah efektif untuk mengobati beragam penyakit. Terbukti, saat ini banyak produksi obat-obatan yang menggunakan material tanaman obat.

Kombinasi antara pengobatan modern yang memanfaatkan bahan alami ialah terobosan inovasi yang perkembangannya harus didukung oleh berbagai lapisan masyarakat.

Perkembangan industri farmasi ini bertujuan untuk mencapai tingkat kesehatan dan kesejahteraan masyarakat yang lebih baik.

“Banyak yang sudah mulai menyadari pentingnya pemanfaatan bahan-bahan alami untuk kesehatan dan pengobatan penyakit. Untuk mencapai hasil yang maksimal, diperlukan usaha berkesinambungan antara penelitian yang dilaksanakan, edukasi berkelanjutan pada masyarakat dan tentunya dukungan dari pemerintah,”ungkap Indah Yuning Prapti, SKM, M.Kes, Kepala Balai Besar Penelitian dan Pengembangan Tanaman Obat dan Obat Tradisional (B2P2TO-OT) dalam acara bertema Menyingkap Kebaikan Alam untuk Indonesia Sehat, Four Seasons Hotel, Tapis Room, H.R Rasuna Said, Jakarta, Rabu 26 Juni 2013.

Pengobatan herbal dan pemanfaatan bahan alami untuk obat sudah memberikan kontribusi nyata bagi industri farmasi Indonesia. Tren penggunaan obat dengan bahan alami, baik untuk peningkatan kesehatan maupun pengobatan penyakit, cenderung meningkat di negara berkembang, termasuk Indonesia.

Selama ini, pengobatan bahan alami sendiri digunakan berdasarkan praktis empiris, yaitu pencegahan penyakit, meningkatkan kesehatan, penyembuhan penyakit dan sebagai kosmetik. Contohnya tanaman brotowali, kumis kucing, buah merah, dan temulawak merupakan sedikit dari beragam jenis tumbuhan asli Indonesia yang diketahui dapat menyembuhkan berbagai macam penyakit seperti diare, darah tinggi, diabetes, hiperkolesterorl, hepatitis, asam urat, asma, batu ginjal, reumatik, batu empedu, keputihan, hingga obesitas.

Kendati demikian, agar produk obat dengan bahan alami Indonesia dapat menjadi produk yang diandalkan dan diterima di semua kalangan. Maka mutunya harus ditingkatkan, keamanannya harus dibuktikan, serta khasiatnya pun harus diteliti dan dapat dibuktikan secara ilmiah.

“Pemanfaatan tanaman asli Indonesia sebagai bahan pengobatan modern merupakan usaha yang terus harus dilanjutkan guna menjadikan Indonesia tuan rumah dari pengobatan herbal,” jelas dr. Pangestu Adi, SpPD-KGEH, Staf Senior Penyakit Dalam, Fakultas Kedokteran Universitas Airlangga, Rumah Sakit Umum Dr. Soetomo Surabaya.

Saat ini, banyak pihak termasuk kalangan perusahaan farmasi modern telah memanfaatkan berbagai potensi keanekaragaman hayati tanaman di Indonesia untuk menciptakan berbagai produk kesehatan, baik yang bersifat pengobatan preventif maupun kuratif.

“Hal ini merupakan hal yang positif untuk mengembangankan dan melestarikan tanaman obat di Tanah Air,”imbuhnya.

Terlepas dari itu, pemerintah telah mengatur pemanfaatan herbal medik dalam fasilitas kesehatan melalui beberapa peraturan pemerintah, keputusan menteri, maupun peraturan perundang-undangan. Pemanfaatan bahan alami yang dapat digunakan sebagai bahan untuk obat pun sudah diatur dalam Peraturan Badan Pengawas Obat dan Makanan (BPOM) tentang pengawasan pemasukan bahan baku obat tradisional. (ind) (tty)

(sumber: health.okezone.com)

 

Are Chinese herbs safe to use?

For many years, the World Health Organization (WHO) has reported problems with high pesticide levels and industrial contaminants in some herbs. Over the past couple of years, both the American Botanical Council and the American Herbal products Association have identified ongoing problems with contamination. Much of the scrutiny of herbs focuses on those from India and China, where environmental safety laws are lax – and where contamination is sadly common.

Now a new study, entitled Chinese Herbs: Elixir of Health or Pesticide Cocktail continues this scrutiny. Sponsored by the environmental group Greenpeace, the report exposes unsafe practices of overuse of pesticides, use of banned pesticides, and high levels of these toxic agents in many Chinese herbs. The report stands to damage trade in Chinese herbs, which have repeatedly come under fire for safety concerns due to contamination.

As the world’s largest supplier of herbs, China has a lot to lose. Revenues from Chinese herbal exports total in the hundreds of millions of dollars. And given that Chinese people rely heavily on herbs for health, the Chinese population is at risk as a result of significant health problems arising from poisons in their natural medicines.

Traditional Chinese Medicine – also known as TCM – is one of the oldest systems of health care in the world. Some TCM texts date back to over 3,000 years ago. At the heart of TCM is the use of over 11,000 herbs. Employed almost always in formulas of several herbs at a time and typically boiled into concentrated teas, herbs are essential to the practice of TCM. Apothecaries in China and in Chinatown areas in Europe and the United States carry a plethora of Chinese-grown or wild-harvested herbs.

According to the study, Greenpeace sampled 65 batches of herbs, finding pesticide residues in 48 of the samples. In six samples, researchers found highly toxic banned pesticides. In over 30 samples, 3 or more pesticides were discovered. One widely used herb, Sanqi flower, had residues of 39 pesticides. Wolfberry, otherwise known as Goji, contained residues of 25 pesticides. Widely regarded as a superfood and a healthy snack, the high levels and broad variety of pesticides in Goji diminish that berry’s lustre as a health enhancer. Chrysanthemum, widely used in tea, was also heavily contaminated.

China is the world’s largest user of agricultural pesticides. Application of pesticides directly onto herbal crops, as well as contamination of soil and water by pesticides used on other crops, adds up to a dangerous environmental and health situation. China’s 600 million farmers use over two million tons of pesticides per year. Most of that use goes entirely unregulated, and oversight of the country’s guidelines concerning pesticides is scant.

The country has a history of food-related scandals, such as the melamine poisoning of milk, toxic levels of pesticides in ginseng, and other problems. Pesticides used in China regularly contaminate water supplies, running into rivers, lakes and streams. In recent years the country has had poisoning problems with contaminated ginger, chives and cowpeas.

At a time when acceptance of herbal medicine is high, the presence of toxic agents in herbs creates anxiety and concern among those who seek natural remedies. And the contamination problem isn’t limited to bulk herbs from China. Many prepared Chinese herbal formulas in tablets, capsules and other forms also contain highly toxic pesticides, casting doubt on the entire category of Chinese herbal remedies. How do you know which Chinese herbs are safe? You don’t. Until Chinese health authorities and environmental officials begin to take this matter seriously, the best advice you can follow is to seek your remedies elsewhere.

(source: www.foxnews.com)

 

Produsen Rokok Perangi Aturan Baru di Thailand

BANGKOK — Raksasa tembakau Philip Morris dan lebih dari 1.400 peritel Thailand akan menuntut kementerian kesehatan negara itu terkait aturan yang akan menutupi hampir semua kemasan rokok dengan peringatan bahaya merokok, menurut seorang perwakilan perdagangan tembakau, Rabu (26/6).

Aturan yang dijadwalkan mulai berlaku 2 Oktober mewajibkan 85 persen kemasan depan dan belakang rokok untuk pesan-pesan dan gambar peringatan tentang bahaya merokok, beberapa diantaranya mengandung foto-foto gamblang dari pasien-pasien kanker paru-paru.

Varaporn Namatra, direktur eksekutif Asosiasi Perdagangan Tembakau Thailand (TTTA), mengatakan organisasi tersebut dan Philip Morris (Thailand) akan mengajukan tuntutan ke Pengadilan Administrasi untuk membatalkan keputusan tersebut pada 4 Juli.

“Faktanya adalah bahwa Thailand sudah memiliki beberapa peringatan kesehatan terbesar di dunia, sehingga TTTA tidak melihat mengapa perlu ada kewajiban baru, terutama karena itu hanya akan mempersulit pekerjaan dan menimbulkan masalah baru bagi banyak sekali peritel pekerja keras,” ujar Varaporn.

Ia mengatakan bahwa biaya-biaya yang lebih tinggi dapat membuat para konsumen beralih ke tembakau yang lebih murah yang tidak disasar oleh peraturan-peraturan baru tersebut.

Thailand dan Australia adalah di antara negara-negara dengan gambar peringatakan bahaya kesehatan merokok terbesar di dunia. Australia baru saja melarang tampilnya logo dan warna khas perusahaan rokok di kemasan produknya. Badan Administrasi Pangan dan Obat-obatan AS (FDA) telah berencana mewajibkan label yang besar dan seringkali gamblang pada kemasan rokok, namun label-label itu dirancang ulang setelah sebuah pengadilan menolak permintaannya.

Di bawah aturan-aturan Kementerian Kesehatan Publik Thailand, pesan-pesan peringatan menempati 55 persen bungkus rokok bagian depan dan belakang.

Wakil Menteri Kesehatan Publik Cholnan Srikaew mengatakan bahwa peringatan-peringatan yang lebih besar akan lebih efektif dalam menghambat perokok.

“Peringatan yang ada tidak terlalu terlihat hasilnya dalam menurunkan jumlah perokok, jadi kita perlu membuatnya lebih besar,” ujar Cholnan.

Kementerian Kesehatan Publik mengatakan bahwa sekitar 50.000 orang meninggal karena penyakit terkait merokok setiap tahun di negara Asia Tenggara berpenduduk 65 juta itu. (AP)

(sumber: www.voaindonesia.com)

 

Tanpa Apoteker, Sistem Jaminan Sosial Tak akan Sukses

JAKARTA–Pelaksanaan Sistem Jaminan Sosial Nasional (SJSN) akan gagal jika tidak melibatkan apoteker. Sebab akan mendongkrak biaya obat hingga 40 persen. Itu sebabnya Ikatan Apoteker Indonesia (IAI) berharap pemerintah mengajak pihaknya terlibat dalam sistem agar masyarakat tidak terbebani harga obat yang mahal.

Aspirasi ini disampaikan Ketua IAI Dani Pratomo saat rapat dengar pendapat umum Komisi IX DPR RI, Rabu (26/6). Dani yang mewakili 45 ribu apoteker di seluruh Indonesia sangat berharap kepada anggota DPR bisa menegur pemerintah karena tidak konsisten melaksanakan aturan.

“Kami ingin proses penegakan hukum tentang UU Badan Penyelenggara Jaminan Sosial (BPJS). Percuma kalau Indonesia mempunyai begitu banyak lulusan-lulusan apoteker terbaik namun tidak dimanfaatkan ketika momentum BPJS digelar,” keluh Dani.

Sikap ini disampaikan karena pemerintah telah menelurkan Peraturan Presiden Nomor 12 tahun 2013 tentang Jaminan Kesehatan. Namun dalam beleid tersebut, jasa apoteker tidak masuk dalam sistem reimbursement klaim pelayanan kesehatan. Hanya terdapat harga obat, alat medis dan jasa dokter saja.

“Padahal dalam UU Kesehatan pasal 108 apoteker adalah salah satu tenaga kesehatan. Harusnya dalam pelaksanaan UU, apoteker masuk ke dalam sistem. Artinya pemerintah tidak konsiten melaksanakan program ini,” ungkapnya.

Dani melanjutkan, tujuan BPJS adalah agar masyarakat bisa menjangkau harga obat. Jika hanya mengandalkan dokter dalam menentukan jenis obat, maka belum tentu tercipta harga yang ekonomis.

“Dokter bukan ahli di bidang obat-obatan. Pelayanan kesehatan menggunakan sistem out of pocket, dimana pasien membayar langsung. Karena dokter tidak pernah terpikir farmako ekonomi, maka pasien bisa menerima obat yang sangat mahal dari dokter, ” ungkapnya.

Ia mencontohkan, obat-obatan yang memiliki harga Rp 300-400 memiliki kualitas yang sama dengan harga obat Rp 4.000-5000. Namun karena pengetahuan obat dari dokter terbatas, maka pasien bisa diberikan harga yang lebih mahal.

Akibatnya, banyak rumah sakit yang baru-baru ini mengajukan klaim obat pasien yang sangat mahal sekali. “Karena itu, ditengah persaingan industri farmasi yang ketat dibutuhkan peran apoteker yang bisa membantu memberikan jalan tengah agar obat bisa efektif dan ekonomis,” tandasnya. (Esy/jpnn).

(sumber: www.jpnn.com)

 

Pacific Region’s Public Health Surveillance Network Praised

Representatives of the Secretariat of the Pacific Community (SPC) and Pacific Island countries and territories were very proud to hear an international expert recognising the value of the long-established Pacific Public Health Surveillance Network (PPHSN) …The Pacific Region’s Public Health Surveillance Network Praised

Wednesday 26 June 2013, Secretariat of the Pacific Community (SPC), Noumea, New Caledonia –

Representatives of the Secretariat of the Pacific Community (SPC) and Pacific Island countries and territories were very proud to hear an international expert recognising the value of the long-established Pacific Public Health Surveillance Network (PPHSN) during an international Forum that took place earlier this month in La Reunion.

‘For me, PPHSN is the first network that worked and it inspired us when forming the Global Outbreak Alert and Response Network,’ said Dr Mike Ryan, Former Director of WHO Global Alert and Response Team, Professor of International Health at University College Dublin and one of the keynote speakers at the Forum.

The 1st International Forum on Public Health Surveillance and Response in island territories and countries gathered over 300 actors of health surveillance in human and animal health from the Indian Ocean, the Caribbean, the Pacific and the French Mediterranean regions.

‘We were very pleased to hear Dr Ryan’s statement and all PPHSN members from Pacific Island ministries of health, regional organisations and training institutions can be very proud as well,’ said Dr Yvan Souarès, Deputy Director of SPC’s Public Health Division and one of the founders of PPHSN.

‘PPHSN, which was created in 1996, has established robust services to support national and regional surveillance and response to epidemics and other public health emergencies that are really up to date, according to our exchanges with our counterparts working in the other island regions.’

During the three days (from 11–13 June), 70 oral presentations and 60 posters created the opportunity to discuss many topics: different forms of surveillance, early warning and response systems, the development of e-health tools, emerging diseases, new challenges and opportunities in the field of vector control, and the One Health concept, combining animal health and human health.

‘All the presentations were of high scientific level and it was very interesting to share our knowledge, experience and views with those of our counterparts from the Indian Ocean and the Caribbean, as they face similar problems specific to an island context,’ said Dr Salanieta Saketa from Fiji, who was part of the Pacific delegation.

This Forum has been a real success, both for the participants and the organisers: Agence de Santé Océan Indien, the Indian Ocean Commission, and the French Institute for Public Health Surveillance, with the support of the French Development Agency.

SPC’s Public Health Division is committed to pursue the collaboration, and build up on commonalities (for economies of scale) and differences (expert resources) among Islands’ public health networks, and has expressed an interest in hosting the second edition of the Forum in 2015.

Background information:

The PPHSN is a voluntary network of countries and organisations dedicated to the promotion of public health surveillance and appropriate response to the health challenges of 22 Pacific Island countries and territories. Its first priorities are outbreak-prone diseases and public health emergencies in general. It was created in 1996 under the joint auspices of SPC and WHO. SPC is the focal point of the PPHSN Coordinating Body.

PPHSN comprises five essential service networks to monitor and respond to public health emergencies occurring or threatening the region: (1) the Pacific Syndromic Surveillance System for outbreak detection, (2) PacNet for alert and communication, (3) LabNet for verification and identification of pathogens, (4) EpiNet, multi-disciplinary national and regional teams for preparedness and response to epidemics, and (5) PICNet for infection control.

The Global Outbreak Alert and Response Network (GOARN) is a technical collaboration of existing institutions and networks who pool human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance. It was created in 2000 by the World Health Organization.

(source: pacific.scoop.co.nz)

 

State of Emergency Declared by Malaysia Due to Air Pollution

Malaysia has declared a state of emergency in two regions of Johor, a state in the southern part of the country, on Sunday as smoke from fires has caused a spike in air pollution levels that specialists believe are hazardous to citizens. The cause behind this air pollution is the illegal burning of forests on Indonesia’s island of Sumatra, which creates a “haze” in many parts of the country and even Singapore.

“Prime Minister Najib Razak has agreed to declare emergency status in Muar and Ledang with immediate effect,” Malaysian Natural Resources and Environment Minister G. Palanivel said in a Facebook post, according to Reuters.

Reuters reports:

Domestic media quoted the minister as saying cloud seeding would be carried out in the affected areas.

All 211 schools in the area are to be closed until further notice, residents have been advised to stay indoors and face masks have been distributed, Khaled Nordin, chief minister of the state, said, also via posts on Facebook.

Schools have been ordered shut in the neighbouring state of Malacca, where pollution has also reached hazardous levels. Schools were also ordered to close in one district in Pahang state.

All domestic airports managed by Malaysia Airports Holdings Berhad (MAHB) are operating as usual despite the haze, the national news agency quoted the airport operator as saying.

The current visibility level of 1 km was still safe, but runways would have to close if visibility fell under 300 m, it quoted Malaysian airports official Azmi Murad as saying.

Indonesian officials have deflected blame by suggesting companies based in Malaysia and Singapore may be partly responsible. Malaysia-listed Sime Darby and Singapore’s Wilmar Group both deny the charge.

Earlier this year, China’s air pollution levels were breaking records and reaching dangerous levels. So much so that the Chinese media had taken a stand on air pollution in China by calling on the government to take action against pollution, which according to the media, had reached dangerous levels in the capital city, which is home to around 20 million people.

According to the media, the air quality in Beijing reached 755 on an index measuring particulates of matter in the air. For an idea of how bad 755 is, know that the World Health Organization recommends a daily level no higher than 20 and a level of 300 is deemed to be dangerous. According to Zhou Rong, climate and energy campaigner at Greenpeace, 755 is the worst recorded air pollution in Beijing.

“How can we get out of this suffocating siege of pollution?” asked the People’s Daily, the official newspaper of the Communist Party, in a front-page editorial, according to Reuters. “Let us clearly view managing environmental pollution with a sense of urgency.”

The media’s sense of urgency at the time (and currently) is apt, as the the Journal of Toxicology and Environmental Health found that a particulate matter with a diameter of 2.5 micrometers can cause cardiopulmonary disease, lung cancer and acute respiratory infection.

What’s more, the capital of China was forced to cancel flights due to poor visibility and temporarily shut down factories due to the high levels of smog. The Associated Press wrote: “The capital was a colorless scene. Street lamps and the outlines of buildings receded into a white haze as pedestrians donned face masks to guard against the caustic air. The flight cancellations stranded passengers during the first week of the country’s peak, six-week period for travel surrounding the Chinese New Year on Feb. 10.”

Kemenkes: Dokter Banyak tapi Formasi CPNS-nya Terbatas

JAKARTA – Kementerian Kesehatan (Kemenkes) kesulitan menyalurkan dokter umum di wilayah-wilayah yang membutuhkan tenaga kesehatan. Pasalnya, jumlah formasi CPNS sangat terbatas dan tidak sebanding dengan dokter yang dihasilkan.

Kepala Badan Pengembangan dan Pemberdayaan Sumber Daya Manusia (PPSDM) Kemenkes Untung Suseno Sutarjo mengungkapkan, saat ini ada 8.075 dokter yang ikut program internship atau pemahiran di rumah sakit pemerintah dan puskesmas. Yang sudah selesai internshipnya 3.026 dokter.

“Jadi kita punya tenaga dokter 8.075 yang siap terjun ke masyarakat. Namun, formasi dokter dan tenaga kesehatan lainnya untuk CPNS masih terbatas. Itu sebabnya lagi kami upayakan meminta tambahan formasi dokter dan tenaga kesehatan,” kata Untung di Jakarta, Selasa (25/6).

Selain itu, lanjutnya, pemerintah pusat tengah berkoordinasi dengan daerah yang membutuhkan tenaga dokter agar siap memberikan insentif bagi para tenaga medis tersebut. Sebab di lapangan, banyak daerah yang belum siap memberikan insentif bagi para dokter.

“Intinya, Kemenkes siap menempatkan dokter di daerah mana saja. Apalagi tenaga dokter kita cukup banyak. Sekarang tinggal kemampuan daerah saja untuk menyiapkan insentif bagi para dokter tersebut,” terangnya.

Ia menambahkan, dengan adanya program internship kebutuhan dokter untuk daerah-daerah tertentu bisa terpenuhi. Karena setelah lulus dan diambil sumpah, mereka diwajibkan ikut internship setahun agar lebih mahir melayani pasien.

“Meski sudah diambil sumpah, kalau belum ikut internship maka dilarang melayani pasien sendiri karena yang bersangkutan belum ada izin dokter,” tandasnya.(esy/jpnn)

(sumber: www.jpnn.com)