Global Health News Last Week

May 12 was International Nurses Day.
USAID’s Frontlines magazine is running an exclusive interview with Dr.

Margaret Chan, the WHO Director-General, in which she discusses current global health priorities and systems strengthening.

Peoples-uni, an open-access education initiative, offers open-access resource and online learning materials for capacity-building in low- and middle-income countries.

POLICY

  • Excessive bleeding following childbirth is the leading cause of maternal deaths in the developing world, but the World Health Organization (WHO) has now approved the use of misoprostol, a drug that considerably reduces this risk.
  • Shanghai’s health authority and local hospitals are seeking to reduce the rate of births by cesarean section this year after a recent report showed that far more Shanghai women are undergoing the procedure than is recommended by the World Health Organization (WHO).
  • For the fifth time, at next week’s WHO General Assembly, countries will debate whether or not to destroy the last two known stockpiles of smallpox.
  • The Director General of Nigeria’s drug and food regulator, Dr. Paul Orhii, was in London last week where he lodged a strong case before members states of the World Health Assembly to institute a legal platform to combat the spread of counterfeit drugs.

PROGRAMS

  • Humanosphere’s Tom Paulson writes that funding for childhood vaccinations is not keeping up with the need and is struggling to compete with more high-profile priorities.
  • The phenomenon of “poverty tourism” – in which charities and aid organizations take donors on trips to “experience poverty” and meet their beneficiary – is coming under increased scrutiny and generating controversy.
  • John Donnelly, writing in GlobalPost, characterizes the Obama Administration’s Global Health Initiative as off to “a slow, stumbling start” in a short series called “Healing the World.”
  • Last Wednesday, the WHO launched a campaign to reduce the huge but largely unrecognized burden of traffic deaths and injuries over the next decade.

RESEARCH

  • An HIV-positive person who takes anti-retroviral drugs after diagnosis, rather than when their health declines, can cut the risk of spreading the virus to uninfected partners by 96%, according to a study.
  • New research has revealed that a bacteria present in the gut of mosquitos may be another tool to fight the spread of malaria.
  • An experimental drug helped monkeys with a form of the Aids virus control the infection for more than a year, suggesting it may lead to a vaccine for people, or even a cure.
  • A study by US scientists, published in the American Journal of Public Health, found that 400,000 females aged 15-49 were raped over a 12-month period in the DRC 2006 and 2007. That comes out to an average of 48 women and girls being raped every hour.
  • A new report by MSF argues that switching from using quinine to artesunate to treat malaria could save up to 200,000 lives a year.
  • A US study has suggested that homosexual men are more likely to have had cancer than heterosexual men.
  • According to the findings of the last Pakistan Demographic and Health Survey, getting pregnant soon after childbearing, miscarriage or abortion places mothers and newborns at a higher risk of health complications or even death.
  • Results announced today by the United States National Institutes of Health show that if an HIV-positive person adheres to an effective antiretroviral therapy regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%.

DISEASES AND DISASTERS

  • According to statistics released by the National Coordinator of the Nigeria’s National Malaria Control Program (NMCP), Dr. Babajide Coker, Nigeria contributes a quarter of the malaria burden in Africa, and a staggering 90 per cent of its citizens are at risk for contracting the disease.
  • Johnson & Johnson’s recalled at least 11,700 bottles of HIV/AIDS drug Prezista in several countries, after discovering trace amounts of a chemical emitting offensive odors in five batches of products sold in the U.K., Ireland, Germany, Austria and Canada.
  • In China, around 1.5 million people require organ transplants, but just 10,000 receive them each year, as few Chinese agree to donate their organs upon death. Illegal organ traffickers have stepped in to fill that gap.

TOTALLY UNRELATED TO ANYTHING ELSE: Princess Beatrice’s atrocious weird attention-grabbing hat, worn to the royal wedding, is now being auctioned on eBay for UNICEF and Children in Crisis. Um, yay?

Cancer: the Next Challenge for Global Health

Guest blogger: Dr. Isobel Hoskins

We think of cancer as a disease of affluent countries. That may have been true in the 1970s, but since then, cancer levels in developing countries have risen alarmingly. This massive rise in cancer is one reason why a UN summit in June is addressing chronic diseases, including cancer, with the aim of kickstarting the fight against these illnesses.

Some figures: 5.5 million of the nearly 8 million deaths from cancer in 2008 happened in the developing world. Back in 1970 only 15% of cancers were found in the developing world. However, by 2008, according to the World Cancer Report, more than half of cases were in developing countries. These numbers hide a burden of misery – cancers in developing countries are often detected at a late stage – too late for many treatments. These patients often don’t even have access to pain medications.

What drove this increase? The WHO Director General, in a recent address to the IAEA, cited ageing, urbanization and the globalisation of unhealthy lifestyles. Population growth has also driven the numbers up. Isn’t it ironic that improved life expectancy leads to increased cancer burdens?

Many papers can be found indicating the enormous problem that cancer is for developing countries. Given the expense of treatment is there anything that can be done to reduce the cancer burden? Fortunately there is – I read a paper in the Lancet that gives a ray of hope…

Farmer et al. say that we shouldn’t accept that cancers in developing countries will remain untreated. Instead, we should make cancer prevention and treatment broadly available as rapidly as possible. We should consider the example of HIV and TB a decade ago: critics asserted that HIV and TB treatments were too complex and long term for weak health systems. These arguments proved unfounded. Farmer et al. point out examples of successful treatment and prevention of cancer in low resource settings that we can build on.

The approach should concentrate on curable and preventable cancers. Farmer et al. have come up with a list. These cancers can be prevented by reducing risk factors such as tobacco use or infection, or they can be cured by early detection and surgery methods or specific low cost systemic drugs. It includes some very common cancers: lung cancer, breast cancer, cervical cancer and liver cancer.

Many problems posed by cancer care, including cost of drugs and lack of infrastructure and specialists, was a big obstacle for HIV, too. The solutions could be similar: Farmer et al. suggest reducing drug cost by drug purchasing and production negotiations, as well as the use of primary and secondary caregivers to deliver services. The paper cites an example of cancer care in Malawi that uses such workers with remote support from specialists.

And if there is no suitable treatment, pain control is low cost, and the paper asserts that all should have access to that as a human right.

Farmer and co-authors have formed the Global Taskforce on Expanded Access to Cancer Care and Control in Developing Countries to address cancer care worldwide. I for one hope this taskforce prospers!

Dr Isobel Hoskins is Co-Editor of the bibliographic database Global Health which covers public health research worldwide. Global Health is produced by CABI, an international not-for-profit information provider. She’s usually found blogging on the Global Health Knowledge Base and on Twitter here: @CABI_Health.

Global Health News Last Week

December 9 was Anti-Corruption Day.
December 10 was Human Rights Day.

A recently published research study reveals that aspirin can prevent cancer – to very little acclaim.

There is a new rapid diagnostic test for TB, though some argue that it may not be the best idea for developing countries.

There is a polio outbreak in the Congo, and cholera rages on in Haiti and the Dominican Repubic.