Beat Diabetes: WHO call to action

It’s World Health Day today and the WHO has issued a call to action to “Beat Diabetes”.

World Health Day 2016 poster: Halt the rise in diabetes

Source: World health day

Diabetes is  a set of diseases that result in excessive amounts of sugar in the blood a.k.a high blood glucose. Type 2 diabetes is among the most common types of diabetes and it occurs when the body stops using insulin properly ultimately leading to “insulin resistance”. The other common types are

  1. Type 1 diabetes
  • occurs due to lack of insulin production
  • poorly understood form of diabetes

2. Gestational diabetes

  • occurs during pregnancy
  • risk factor for pregnancy related complications
  • increased risk of Type 2 diabetes for both the mothers and their children.

Diabetes is a metabolic disorder and its long term complications include heart disease, strokes, diabetic retinopathies, kidney failure  and poor blood flow to the limbs that could result in amputations. It is also among the leading cause of death. In 2012 nearly 1.5 million deaths were directly attributed to diabetes. Early diagnosis, management of blood glucose levels through diet, physical activity and medication when necessary and routine screenings are not only cost-effective but are effective interventions to prevent diabetes-related complications from occurring or worsening.

A new study published in The Lancet this month has raised the alarm by showing that there has been quadrupling of the number of people with diabetes since 1980. The pooled analysis of 751 population-based studies involving nearly 4.4 million participants from 146 countries shows increasing burden of diabetes, more so in low and middle income countries than in high-income countries. This number is startling and is  a wake up call to public health and health care professionals.

World Health Day 2016 banner

Image Source: World health day

 

Diabetes is a treatable disease and efforts to prevent/treat it, will help achieve MDG 3 target of preventing premature mortality from noncommunicable diseases by one-third by 2030. We should be working together to raise awareness about diabetes with a particular focus on low and middle income countries, scale up prevention strategies that are specific, effective and affordable.

For this campaign, WHO has created a quiz-take it to test your knowledge!

Together we can Beat Diabetes!

Note: This was cross-posted to my blog

Global News Round-Up

Politics & Policies

A report by The Johns Hopkins – Lancet Commission on Public Health and International Drug Policy calls for governments to reevaluate policies on the global war on drugs.  The report argues the policies have negatively contributed to public health, human rights, and development, while minimally impacting the drug markets or drug use among drug offenders.  It calls for a focus on scientifically based evidence and public health during policy discussions.

Programs

The 21st International AIDS Conference will be held from July 18-22 in Durban, South Africa.  This year’s theme: Access Equity Rights Now.

Research

A new PLOS (Public Library of Science) collection named “Grand Convergence: Aligning Technologies and Realities in Global Health” argues that we may be able to save  10 million lives per year in one generation from HIV/AIDS, tuberculosis, malaria, maternal and infant deaths, and neglected tropical diseases, which are conditions that disproportionately affect the world’s poorest.

The Zika virus, which was first detected in Brazil in 2013, may have been brought by visitors to the country during the 2013 Confederations Cup soccer tournament, according to a paper published in Science.  The researchers sequenced the genome of the virus samples taken from infected patients in an attempt to retrace the virus’ route.

A study published in Science Translational Medicine has shown promise for a new experimental dengue vaccine called TV003.  Because dengue is caused by the same family of viruses that cause Zika, the success of TV003 may translate to a Zika virus vaccine.

Diseases & Disasters

The worst yellow fever outbreak in 30 years in the African country of Angola has infected more than 450 people and caused 178 deaths.  Yellow fever is caused by the same Aedes aegypti mosquito that transmits the Zika virus.  Symptoms include fever, headache, muscle pain, nausea, vomiting, and fatigue.  Vaccination is recommended and although the World Health Organization (WHO) has vaccinated 5.7 million people in the capital city of Luanda, vaccines are still in short supply.  Angola is one of 34 African countries where yellow fever is present.

March 24 is World Tuberculosis (TB) Day.  Although TB is treatable and preventable, it infects almost a third of the world population and it kills about 1.5 million people annually.  A century has passed since the scientific discovery of the bacterium that causes TB, but it remains one of the world’s most deadliest infectious disease. The global health community has called for the eradication of TB by 2035.

Middle East respiratory syndrome coronavirus (MERS-CoV), which was first reported in Saudi Arabia in 2012, has infected 4 more individuals, with 1 death reported. There has been 1,698 confirmed infections and 609 deaths, with 26 countries reporting cases of infection.   Symptoms include fever, cough and shortness of breath. Pneumonia is common, but not always present. Gastrointestinal symptoms, including diarrhea, have also been reported.  About 36% of patients have died from MERS-CoV and there is currently no vaccine.  Treatment is supportive based on clinical findings and camels may play role in the disease process.

Technology

In an effort to explore cost effective ways of reducing waiting times for HIV testing of infants, the Government of Malawi and UNICEF have started testing the use of Unmanned Aerial Vehicles (UAVs or drones). UAVs have been previously used in surveillance and assessments during disasters.

Environmental Health

Environmental factors associated with industrialization may play a role in the rise of inflammatory bowel disease (IBD) or Crohn’s disease in parts of Asia, where the disease has been virtually nonexistent.  Both the Asia-Pacific Crohn’s and Colitis Epidemiology Study (ACCESS) and the Genetics, Environmental, Microbial (GEM) Project aims to study the factors that may contribute to the development of Crohn’s disease. The complex nature of the disease has left researchers with many unanswered questions.

Although 195 nations agreed on a climate change deal in December to reduce  greenhouse gas emissions, a paper in the Atmospheric Chemistry and Physics outlines a much sooner prediction of catastrophic effects due to global warming such as rising global sea levels due to large-scale melting of polar ice sheets, flooding of coastal cities, such as New York, London, Rio de Janeiro, Shanghai, and storms of great magnitude not seen before, unless there is significant cuts in greenhouse gas emissions soon across the globe.  Mainstream climatologists disagree with the timeline.

In order to stop the spread of spruce bark beetle, Poland has approved a large-scale logging in the Białowieża forest, despite opposition from scientists, ecologists, and the European Union.  The Białowieża forest spans 150,000 hectares (2.47 acres) and is home to 20,000 animal species and has been untouched for more than 10,000 years.

A study by the Nanyang Technological University’s S. Rajaratnam School of International Studies (RSIS) noted that variations in food production around the world due to climate events are likely to become more intense and frequent, which could impact food supply in countries like Singapore that imports most of their food from other countries.

The findings published in the annual report by the UN Environment Program, the Frankfurt School, and the Bloomberg New Energy Finance states that nations in the world invested a record $286 billion in renewable energy development in 2015.  China led in the amount invested at $103 billion, while other developing countries, including India and Brazil, invested $156 billion.

Malaria-2015 and beyond

One of the mosquito-borne illness (we have been hearing about these a lot lately in the news, heard of Zika virus anyone?) that the global community has been trying to eradicate for a long time now is malaria. Malaria is caused by Plasmodium, a parasitic protozoan, that is transmitted from the bites of infected female anopheles mosquitoes.

Early this month, the WHO released a video describing the progress that has been made toward reducing/eradicating malaria globally and the challenges that exist in the fight against malaria. The disease is widespread in Sub-Saharan Africa, Asia and Latin America. 214 million cases were reported in 2015. A multi-pronged approach of coordinated responses that include timely diagnosis through Rapid Diagnostic Testing (RDT), treatment using artemisinin-based combination therapy (ACT), distribution of long-lasting insecticide-treated bed nets (LLIN) and targeted insecticide spraying, the global mortality rates have decreased by 60% between 2000-2015. The malaria incidence rates also fell by 37% between 2000 and 2015.

Childhood mortality due to malaria fell by 65% worldwide and by 71% in Africa. This is particularly impressive and an important win since children under five years of age are highly susceptible to malaria infection and death.

In 2015, the global burden of malaria is highly concentrated in 17 countries, mostly in Africa and progress in reducing malaria incidence in these high burden countries has lagged behind other countries.
These data thus far are dramatic and encouraging but given the many challenges including poorly functioning health systems, climate change and global economy, a coordinated, multi-pronged global response with continued investment is needed. The Global Technical Strategy for Malaria was approved by the WHO in 2015. This strategy follows the timeline of the sustainable development goals and aims to reduce both malaria incidence and mortality by 90%. The framework provided in the technical strategy consists of 3 pillars, that could be used as a foundation for anti-malaria strategies and programs. The three pillars are a) ensure universal access to malaria prevention, diagnosis and treatment; b) accelerate efforts towards elimination and attainment of malaria-free status; and c) transform malaria surveillance into a core intervention. The framework aims to provide clear defined paths to achieve the lofty goals of malaria reduction and elimination.

Now is the time for consistent financial support from national governments and other donors to keep the momentum going in our fight against malaria. Together we can end malaria!

Global News Round Up

Politics & Policies

The American Public Health Association (APHA) supports the President’s request for funding to combat the spread of the Zika virus, both domestically and abroad.  The request to Congress includes more than $1.8 billion in emergency funds.

Programs

Malaria results in more than 400,000 deaths each year.  The President’s Malaria Initiative (PMI) is working hard to eliminate the devastating effects of the disease.  The program’s expansion means more people in endemic areas will benefit from the program.

Research

A paper presented at the Conference on Retroviruses and Opportunistic Infections by the Centers for Disease Control and Prevention (CDC) scientists has shown promising results in the global response to AIDS.  Malawi, for example, through its 2011 policy and Option B+ implementation, is showing success on the path towards the UNAIDS goal of less than 5% mother-to-child transmission rate.

A recent review published in Epidemiology Reviews by Santaella-Tenorio et al examines evidence on gun laws and gun violence from 130 studies that had been conducted in 10 countries. The authors found that new restrictions on gun purchasing and ownership was associated with reduction in gun-related deaths. But, they did point out that their study does not conclusively prove that gun restrictions reduce gun-related deaths.

In a new study published in The Lancet Global Health, Tarsicio Uribe-Leitz and colleagues report great discrepancies in surgical outcomes across different regions in the world. They examined the three surgical procedures, for which reporting should be uniform, since the procedures have been standardized (caesarean delivery, appendectomy, and groin hernia repair). Their systematic review shows that quality of surgical outcome data from LMICs is poor, and in most cases, LMICs are not even reporting the surgical data.

Diseases & Disasters

Researchers at the University of California, San Diego have published a paper in Nature describing how rock formations under the sea may have played a role in the 2011 Tohoku-oki magnitude 9 mega earthquake in Japan, which resulted in almost 16,000 deaths.

Technology

An effective experimental vaginal ring that can help prevent HIV transmission has been tested by the International Partnership for Microbicides (IPM), according to USAID.  The ring slowly releases an antiretroviral drug reducing the chances of infection by some women, who are at an increased risk of getting infected.

The Paul G. Allen Foundation, the largest private donor in the response of the Ebola outbreak in West Africa, and the US Department of State have teamed up to create a better and cost-effective airborne medical evacuation system to deal with a future outbreak.  The solution is the Containerized Bio-Containment System (CBCS).

Environmental Health

Many regions in northeast Mongolia have been severely affected by a phenomenon called dzud, whereby large numbers of livestock die due to extremely harsh winter conditions. This phenomenon that used to occur about once every 10 years, has now been occurring more frequently. This devastating trend seems to be the result of overgrazing in combination with climate change.

Five Epidemics to Watch for

As the World Health Organization executive board met in January 2016, Médecins Sans Frontières (MSF) highlighted five diseases that had the potential to become epidemics this year.

The 5 epidemics to watch for this year are:

Cholera is the infection of the intestine caused due to the rod-shaped Vibrio cholerae. It spreads through water and food that has been contaminated by human feces. While in the US and other developed countries, it is deemed as a rare disease, but it is a huge issue in many parts of the developing world. In 2014 the WHO reported a 47% increase in the number of cholera cases compared to 2013. Cholera can be prevented by improving sanitation, especially by the provision of clean drinking water.

L0032154 Unhygienic practices which lead to death from cholera. Colou
L0032154 Unhygienic practices which lead to death from cholera. Colou Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Unhygienic practices which lead to death from cholera. Colour lithograph by S. Pogorelskii, 192-. 1920-1929 By: S. PogorelskiiPublished: [ca. 1920?] Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/
Image Source: Unhygenic practices which lead to death from cholera,  Wellcome Images

Measles, yet another infection that is considered rare in the US, is among the leading causes of death among children worldwide. It is a highly contagious disease caused by the measles virus. Measles vaccination is the most effective prevention method. There has been a 75% decrease in deaths due to measles between 2000 and 2013.

Measles

                            Image Source: A global partnership to stop measles and rubella, CDC

Malaria is caused by the plasmodium parasite and is transmitted from person to person by the female anopheles mosquito. Of more than 100 species of the malarial parasite, the most deadly is Plasmodium falciparum, which is also the most common in Africa. About 3.2 billion people are at risk for malaria, with young children and pregnant mothers being particularly vulnerable. There have been increased efforts in curbing this life-threatening disease. Malaria incidence fell by 37% globally between 2000 and 2015.

malaria_lifecycle

                                                                Image Source:Malaria Biology, CDC

Meningitis, an inflammation of the protective linings (meninges) around the brain and spinal cord, is often caused by infection. Bacterial meningitis caused by Meningococcal meningitis affects more than 400 million people each year in the African meningitis belt that runs east-west from Senegal to Ethiopia. While the number of cases has been decreasing steadily (24,000 in 2010 to 11,500 in 2014), the most recent outbreak occurred in 2009 with over 80,000 cases in Nigeria and Niger.

extra-meningitisbelt-map-0216

                                           Image Source: Map of Africa’s meningitis belt,  PATH

Emerging and Re-emerging viruses and parasites have already been causing some serious worry among the health professionals. Who could forget the Ebola outbreak in 2015, and we are all already well aware of the Zika virus. But a few other infectious diseases that did not receive too much of a media coverage in the US this past year were outbreaks of dengue, Chikungunya, Middle Eastern Respiratory Syndrome. Visceral leishmaniasis,a parasitic infection that has been under control for so long, is also on the rise.

In addition to prevention measures and rapid emergency alert systems, MSF has emphasized the necessity of broadening efforts to help countries strengthen their national health care systems (infrastructure and capabilities). MSF said that individual health security, including health security for vulnerable populations is the first step to achieve global health security.

Dr. Rull said that “Current outbreak response strategies are failing the very people they are designed to help”. “If we don’t make significant changes, we will be doomed to repeat past mistakes, and must take responsibility for the consequences.”