World Health Organization

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Find out more about the first-ever Universal Health Coverage Day


Universal Health Coverage Day

Universal Health Coverage Day

A new global coalition of more than 500 leading health and development organizations worldwide is urging governments to accelerate reforms that ensure everyone, everywhere, can access quality health services without being forced into poverty. The coalition was launched today, on the first-ever Universal Health Coverage Day, to stress the importance of universal access to health services for saving lives, ending extreme poverty, building resilience against the health effects of climate change and ending deadly epidemics such as Ebola.

Universal Health Coverage Day marks the two-year anniversary of a United Nations resolution, unanimously passed on 12 December 2012, which endorsed universal health coverage as a pillar of sustainable development and global security. Despite progress in combatting global killers such as HIV/AIDS and vaccine-preventable diseases such as measles, tetanus and diphtheria, the global gap between those who can access needed health services without fear of financial hardship and those who cannot is widening. Each year, 100 million people fall into poverty because they or a family member becomes seriously ill and they have to pay for care out of their own pockets. Around one billion people worldwide can’t even access the health care they need, paving the way for disease outbreaks to become catastrophic epidemics.

“The need for equitable access to quality health care has never been greater, and there is unprecedented demand for universal health coverage around the world,” said Michael Myers, Managing Director of The Rockefeller Foundation, which is spearheading Universal Health Coverage Day. “Universal health coverage is an idea whose time has come – because health for all saves lives, strengthens nations and is achievable and affordable for every country.”


For much of the 20th century, universal health coverage was limited to a few high-income countries, but in the past two decades, a number of lower- and middle-income countries have successfully embraced reforms to make quality health care universally available. Countries as diverse as Brazil, Ghana, Mexico, Rwanda, Turkey and Thailand have made tremendous progress toward universal health coverage in recent years. Today, the two most populous countries, India and China, are pursuing universal health coverage, and more than 80 countries have asked the World Health Organization for implementation assistance.

“Putting people’s health needs ahead of their ability to pay stems poverty and stimulates growth,” said Dr. Tim Evans, Senior Director for the Health, Nutrition and Population Global Practice at the World Bank Group. “Universal health coverage is an essential ingredient to end extreme poverty and boost shared prosperity within a generation.”

The 500+ organizations participating in the first-ever Universal Health Coverage Day coalition represent a diverse cross-section of global health and development issues, including infectious diseases, maternal and child health, non-communicable diseases and palliative care. Across these issues, knowledge and technologies exist to save and improve lives in significant numbers, but the impact of these tools is severely hampered by lack of equitable access to quality health services.

“Ebola is only the most recent example of why universal health coverage is the most powerful concept in public health,” said Dr. Marie-Paule Kieny, Assistant Director-General for Health Systems and Innovation at the World Health Organization. “Investing in strong, equitable health systems is the only way to truly protect and improve lives, particularly in the face of emerging threats like the global rise of non-communicable diseases and increasingly severe natural disasters.”

Events in 25 Countries Mark First-Ever Universal Health Coverage Day

Organizations around the world are calling on policymakers to prioritize universal health coverage, and are hosting events on 12 December to catalyze action, including:

  • New York, USA: High-level event on Ebola and resilience, organized by the Permanent Missions of France, Japan, Germany and Senegal to the United Nations, in collaboration with The Rockefeller Foundation and the Columbia University Mailman School of Public Health.
  • London, UK: Expert panel at the London School of Hygiene & Tropical Medicine on creating resilient, equitable health systems, organized in partnership with The Rockefeller Foundation and Action for Global Health.
  • New Delhi, India: High-level event on universal health coverage implementation in both India and the global context, convened by the Public Health Foundation of India, Oxfam India and the World Health Organization Country Office for India.
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Comprehensive cervical cancer control: a guide to essential practice – a New WHO guide to prevent and control cervical cancer


Comprehensive cervical cancer control: a guide to essential practice

Comprehensive cervical cancer control: a guide to essential practice

New guidance from the World Health Organization aims to help countries better prevent and control cervical cancer. The disease is one of the world’s deadliest – but most easily preventable – forms of cancer for women, responsible for more than 270 000 deaths annually, 85% of which occur in developing countries.

The new Comprehensive cervical cancer control: a guide to essential practice was launched at the World Cancer Leaders’ Summit in Melbourne, Australia today.

The main elements in the new guidance are:

• Vaccinate 9 to 13-year-old girls with two doses of HPV vaccine to prevent infection with the Human papillomavirus (HPV), the virus responsible for most cases of cervical cancer. The reduced, 2-dose schedule has been shown to be as effective as the current 3-dose schedule. The change will make it easier to administer the vaccine. In addition, it reduces the cost, which is particularly important for low- and middle-income countries where national health budgets are constrained but where the need for HPV vaccine is the greatest. Today, girls in more than 55 countries are protected by routine administration of HPV vaccine. Encouragingly, a growing number of low- and middle-income countries are introducing HPV vaccine in the routine schedule, with support from the GAVI Alliance.


• Use HPV tests to screen women for cervical cancer prevention. With HPV testing, the frequency of screening will decrease. Once a woman has been screened negative, she should not be rescreened for at least five years, but should be rescreened within 10. This represents a major cost saving for health systems, in comparison with other types of tests.
• Communicate more widely. Instead of focusing mostly on encouraging the screening of women aged over 29, the guide recommends communicating with a wider audience: adolescents, parents, educators, leaders and people working at all levels of the health system, to reach women throughout their lives.

Dr Nathalie Broutet, a leading WHO expert on cervical cancer prevention and control, says: “WHO’s updated cervical cancer guidance can be the difference between life and death for girls and women worldwide. There are no magic bullets, but the combination of more effective and affordable tools to prevent and treat cervical cancer will help release the strain on stretched health budgets, especially in low-income countries, and contribute drastically to the elimination of cervical cancer.”

An estimated one million-plus women worldwide are currently living with cervical cancer. Many have no access to health services for prevention, curative treatment or palliative care.

Cervical cancer rates have fallen in much of the developed world during the past 30 years, largely due to screening and treatment programs. During the same time, however, rates in most developing countries have risen or remain unchanged, often due to limited access to health services, lack of awareness and absence of screening and treatment programmes. Rural and poorer women living in developed countries are at increased risk of invasive cervical cancer.

The new guidance highlights the importance of addressing gender discrimination and other inequities in relation to a range of other social factors (such as wealth, class, education, religion and ethnicity), in the design of health policies and programmes.

“Unless we address gender inequality and ensure women’s right to health, the number of women dying from cervical cancer will continue to rise,” says Dr Marleen Temmerman, Director of WHO’s Department of Reproductive Health and Research.

The new WHO guidance provides a comprehensive cervical cancer control and prevention approach for governments and healthcare providers. Also known as the “Pink Book,” it underlines recent developments in technology and strategy for improving women’s access to health services to prevent and control cervical cancer.

The guidance identifies key opportunities and ages throughout a woman’s life when cervical control and prevention can be put into action, especially for:
• Primary prevention: human papillomavirus (HPV) vaccination targets girls aged 9 to 13 years, aiming to reach them before they become sexually active.
• Secondary prevention: access to technology for women over 30 years of age, such as VIA (visual inspection of the cervix with acetic acid) or HPV testing for screening, followed by treatment of detected precancerous lesions, which may develop into cervical cancer.
• Tertiary prevention: access to cancer treatment and management for women of any age, including surgery, chemotherapy and radiotherapy.
• When curative treatment is no longer an option, access to palliative care is crucial.
A variety of health services and programmes are needed to implement the different elements of these recommendations. The guidance underlines the importance of collaboration between sectors, between health programmes, and between professionals working at all levels of the health service, for the success of cervical cancer prevention.

The guidelines also show how cervical prevention and control can be integrated into existing health care delivery systems, including for family planning, postpartum care and HIV/AIDS. The delivery of vaccinations to adolescents for example, opens the door to reaching them with additional health information, sexual education and advice about healthy life styles.

A global opportunity to improve women’s health: Implementing cervical cancer prevention and control programmes supports the UN Secretary-General’s 2010 Global Strategy for Women’s and Children’s Health. Cervical cancer was identified in the 2011 Political Declaration of the High-level Meeting of the UN General Assembly on the Prevention and Control of Noncommunicable Diseases.

The 2013 World Health Assembly identified cervical cancer as among the priority interventions in the action plan for the prevention and control of NCDs 2013-2020, which was agreed by Member States, committing them to including cervical cancer and other NCD interventions in national health plans.

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Latest health and travel advice for Hajj and Umrah – well worth a read. And please share with all those making the pilgrimage.

Hajj and Umrah

Hajj and Umrah

Public Health England have just released their health advice for anyone making the Pilgrimage to Mecca this year. For non-Muslims the Hajj is the annual pilgrimage to Makkah (Mecca) in the Kingdom of Saudi Arabia is estimated to fall during early October 2014. Umrah is a shorter, non-compulsory pilgrimage for Muslims that can be performed at any time.

I’m sharing it here because well this is the kind of useful info some of my readers will need. Go here for any updates since this blog was posted.

“In response to international outbreaks of disease, the Kingdom of Saudi Arabia (KSA) Ministry of Health has recommended the following groups should postpone the performance of the Hajj and Umrah as a precautionary measure this year, for their own safety: elderly people, those with chronic diseases (heart disease, kidney disease, respiratory disease, nervous system disorders and diabetes), immunodeficient patients (congenital and acquired), pregnant women and children.

The World Health Organization (WHO) does not currently advise any travel restrictions to KSA in relation to the outbreak of Middle East Respiratory Syndrome coronavirus (MERS-CoV), and overall the risk of UK residents travelling to the Middle East contracting the virus remains low. However, cases reported from KSA continue to increase, to 846 by September 2014, and there have now been 298 deaths, occurring mainly among residents.

Professor Nick Phin, head of respiratory diseases at PHE said: “With growing evidence indicating the role of camels in transmitting MERS-CoV to humans, we’re advising all travellers to the Middle East, particularly those with underlying or chronic medical conditions, to avoid contact with camels and camel products, and to practise good hand and respiratory hygiene to reduce the risk of respiratory illnesses.

MERS-CoV is a new type of coronavirus first identified in a Middle Eastern citizen in 2012. Although cases continue to be reported from the Middle East, no new cases of MERS have been detected in the UK since the cases linked to the Middle East in February 2013.

“Pilgrims returning from Hajj and Umrah with flu-like symptoms including fever and cough, or shortness of breath within 14 days of being in the Middle East, should contact their GP without delay and inform them of their travel.”

Pilgrims should also be aware this year that due to the Ebola outbreak in West Africa, visas will not be issued to individuals who have travelled or lived in Ebola affected countries within the three weeks before their applications. All visitors to the KSA will be required to complete an Ebola screening card before being allowed to enter the country.

In addition, the declaration by WHO of polio as a Public Health Emergency of International Concern has also led to additional vaccination requirements for arrivals in KSA from particular countries.

Dr Dipti Patel, joint director of NaTHNaC, said: “Our updated health information sheet for pilgrims includes information on health regulations, vaccine requirements, recommendations and general health advice for those planning to travel for the Hajj and Umrah. Pilgrims are strongly advised to follow our specific guidance about staying safe and healthy when travelling.”

Dr Brian McCloskey, director of global health at PHE, said: “The Hajj is the largest annual international gathering, with more than two million Muslims travelling from around the world, including thousands from the UK. A large population in one confined area has historically increased the risk of infectious disease outbreaks, which is why it is important to get the relevant vaccinations and to get travel advice from your GP or travel health clinic.”

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WORLD HEART DAY 2014: SALT REDUCTION SAVES LIVES


World Heart Day 2014

World Heart Day 2014

As regular readers of this blog know I am rather skeptical about of lot of MedEd (medical education for those not in the in crowd). Actually much of it is total rubbish. And it strikes me the bigger the organisation the more rubbish it tends to produce. You know who you are! But no names no pack drill!

So you can imagine my delighted when an email about World Heart Day dropped into my inbox. One of those great occasions when I’m sent something which is actually useful. Mainly about salt reduction it does not just say why but much more importantly it says how.

On World Heart Day, which takes  place on 29 September, the World Health Organization (WHO) is asking us to take action on the overuse of salt.  They feel we can do this  by implementing their sodium (the main source our diets is salt)  reduction recommendations.   This they say reduce the number of people experiencing heart disease and strokes.


In fact noncommunicable diseases, including heart disease and stroke, are now the main causes of premature death .

“If the target to reduce salt by 30% globally by 2025 is achieved, millions of lives can be saved from heart disease, stroke and related conditions,” shares Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health.

As we noted above main source of sodium in our diet is salt. But it also come from  from sodium glutamate and sodium chloride, and is used as a condiment in many parts of the world. In the developed world WHO claim 80% of salt intake comes from processed foods such as bread, cheese, bottled sauces, cured meats and ready-made meals.

Too much sodium to hypertension, or high blood pressure, and there or up the risk of things like  heart disease and stroke.

On average, people consume around 10 grams of salt per day which is twice as much as we should.

“Salt is in almost everything we eat, either because high levels of salt are found in most

Salt reduction boost health

Salt reduction boost health

processed and prepared foods, or because we are adding salt when we prepare food at home,” adds Dr Chestnov.

Government and NGos wouldn’t be government or NGOs if they did not call for greater regulation.  So they kick off with:-

  • regulations and policies to ensure that food manufacturers and retailers reduce the levels of salt in food and beverage products;
  • agreements with the industry to ensure that manufacturers and retailers make healthy food (with low salt) available and affordable;
  • fostering healthy eating environments (that promote salt reduction) in public places such as schools, hospitals, workplaces and public institutions;
  • ensuring clear food labelling so consumers can easily understand the level of salt in products;


But what about us.  Because that is where it really counts as we all know.

  • reading food labels when buying processed food to check salt levels; (or of course you can give process food a miss)
  • asking for products with less salt when buying prepared food in restaurants etc
  • removing salt dispensers and bottled sauces from dining tables;
  • limiting the amount of salt added in cooking to a total maximum amount a fifth of a teaspoon over the course of a day;
  • limiting frequent consumption of high salt products;
  • guiding children’s taste buds through a diet of mostly unprocessed foods without adding salt.

 

They also gave us a few links so please check them out!

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Study warns swift action needed to curb exponential climb in Ebola outbreak – says New England Journal of Medicine


Ebola Outbreak News

Ebola Outbreak News

Like many of my readers I have been following the recent Ebola outbreak with some concern. I was send the following information this morning which I thought would be useful to share.

Unless Ebola control measures in West Africa are enhanced quickly, experts from the World Health Organization (WHO) and Imperial College, London, predict numbers will continue to climb exponentially, and more than 20,000 people will have been infected by early November, according to a new article in the New England Journal of Medicine released six months after WHO was first notified of the outbreak in West Africa.

In the article, public health epidemiologists and statisticians reviewed data since the beginning of the outbreak in December 2013 to determine the scale of the epidemic, better understand the spread of the disease, and what it will take to reverse the trend of infections.

Scale of epidemic

Although WHO was first notified of the outbreak on 23 March 2014, investigations retroactively revealed the outbreak started in December 2013. Between 30 December 2013 and 14 September 2014, a total of 4507 cases were reported to WHO.


The data in the study help clarify some details of who is most affected by this outbreak. For example, there have been mixed reports on whether women might be harder hit because they are more likely to care for sick, or whether it would be men who might be more likely to bury the highly-infectious dead bodies.

“This study gave us some real insight into how this outbreak was working, for example, we learned there is no significant difference among the different countries in the total numbers of male and female case patients,” says Dr Christopher Dye, Director of Strategy for WHO, and co-author of the study. “There may be differences in some communities, but when we actually looked at all the data combined, we saw it was really almost split 50-50.”

The extensive review of data also allowed for a closer look at case fatality rate.

“Assessing the case fatality rate during this epidemic is complicated by incomplete information on the clinical outcomes of many cases, both detected and undetected,” says Dye. “This analysis shows that by 14 September, a total of 70.8% of patients with definitive outcomes have died. This rate was consistent among Guinea, Liberia and Sierra Leone.”

But the case fatality rate was lower when only hospitalized patients were considered, supporting evidence that getting patients to good, supportive health care quickly makes a difference.

Spread of infection

The examination of the data also showed the spread more clearly. In late December, the first cases were reported in the forest areas of Guinea. By March, when the government sounded the alarm to WHO, cases had already spread from the forest area to the capital of Conakry. In May, the focus of the outbreak in Guinea expanded strongly to Sierra Leone and in June it really took hold in Liberia. From July onward, there were sharp increases in case numbers in all three countries.

Projections

Although the current epidemic in West Africa is unprecedented in scale, the clinical course of infection and the transmissibility of the virus are similar to those in previous Ebola outbreaks.
“We infer that the present epidemic is exceptionally large, not primarily because of biologic characteristics of the virus, but in part because of the attributes of the affected populations, the condition of the health systems, and because control efforts have been insufficient to halt the spread of infection,” says Dye.

There are challenges in this region that exacerbate the struggles to contain the virus quickly. Most importantly the health systems in all three countries were shattered after years of conflict and there was a significant shortage of health workers, leaving the system weaker than in other countries with Ebola outbreaks. In addition, certain characteristics of the population may have led to the rapid spread of the disease, for example, the populations of Guinea, Liberia, and Sierra Leone are highly interconnected, with extensive cross-border traffic at the epicentre and relatively easy connections by road between rural towns and villages and the densely populated capital cities.
“The large intermixing population has facilitated the spread of infection, but a large outbreak was not inevitable,” says Professor Christl Donnelly, Professor of Statistical Epidemiology, Imperial College and the MRC Centre for Outbreak Analysis and Modelling. “In Nigeria, for example, where health systems are stronger, the number of cases has so far been limited, despite the introduction of infection into the large cities of Lagos and Port Harcourt.“

The critical determinant of outbreak size appears to be the speed of implementation of rigorous control measures.

“Forward projections suggest that unless control measures – including improvements in contract tracing, adequate case isolation, increased quality of care and capacity for clinical management, greater community engagement, and support from international partners – improve quickly, these three countries will soon be reporting thousands of cases and deaths each week,” says Dye.
Experimental therapeutics and vaccines offer promise for the future, but are unlikely to be available in the quantities needed to make a substantial difference in control efforts for many months, even if they are proved to be safe and effective.

The risk of continued expansion of the Ebola outbreak is real. This study provides the evidence needed for an urgent wakeup call requiring intensive scaling up of control measures while working towards rapid development and deployment of new medicines and vaccines.