Bulletin of the World Health Organization

Public health round-up

WHO/Dag Rekve

Kjell Magne Bondevik, former Prime Minister of Norway (pictured on right), suffered a bout of depression during his first term in office in August 1998. His honesty and willingness to speak openly received strong public support and helped to combat the stigma of mental illness. However, more than three quarters of people with mental illness living in low- and middle-income countries do not have access even to basic care that could help them recover from or manage their illness. In some countries, expenditure for mental health services is as low as US$ 0.25 per person per year. WHO estimates that one in four people will require mental health care at some point in their lives. Bondevik was in Geneva on 10 October, World Mental Health Day, for the launch of WHO’s Mental Health Atlas 2011 with Shekhar Saxena (pictured on left), director of the department of Mental Health and Substance Abuse at WHO. Access the report at: http://www.who.int/mental_health/publications/mental_health_atlas_2011

The Republic of South Sudan officially became WHO’s 194th Member State in late September 2011, having gained independence as a country and joined the United Nations in July. After decades of civil war, South Sudan faces many development challenges. The majority of its 8 million people are aged less than 30 and live in poverty in rural areas. Only 55% of them have access to safe drinking water.

Dracunculiasis, also known as guinea-worm disease, is on the verge of eradication, according to WHO. Worldwide cases have dropped from an estimated 3.5 million in 20 countries in the mid-1980s to fewer than 1800 in 2010. The new state of South Sudan had 97% of cases in 2010; other cases were reported in Chad, Ethiopia and Mali. However, WHO says that obstacles such as lack of funding and poor access to disease-endemic areas are preventing eradication. The disease is transmitted when people drink water contaminated with parasite-infected water fleas. Prevention is possible by filtering drinking water and keeping infected people from contaminating the water supply.

Air pollution in many cities is reaching health-threatening levels and takes the lives of more than two million people every year, according to new data on air pollution from WHO. The data, the most comprehensive compilation ever done, includes air quality measurements from almost 1100 cities in 91 countries. It shows that some cities exceed WHO safe air quality levels by up to 15 times. The main causes of outdoor air pollution are motor transport, small-scale manufacturing and other industries, burning of biomass and coal for cooking and heating, as well as coal-fired power plants. Residential wood and coal burning for space heating is also an important contributor to air pollution. Access the data at: http://www.who.int//phe

Around 700 million children, about half the world’s total child population, breathe air polluted by tobacco smoke, mainly in the home. Last month at the World Medical Association General Assembly in Uruguay, delegates from almost 50 national medical associations called for stronger action to protect children from the effects of smoking. This includes banning the sale and accessibility of tobacco products to children and adolescents, as well as banning candy products that resemble tobacco products.

World Diabetes Day

WHO/Chris de Bode

Salima Tumlo from the United Republic of Tanzania is one of an estimated 220 million people with diabetes in the world. WHO estimates this number is likely to more than double by 2030 if there is no intervention. World Diabetes Day on 14 November aims to raise global awareness of the disease with the slogan “Act on Diabetes. Now”. All over the world, from Bishkek to Hong Kong to Zagazig, hundreds of buildings and monuments will be lit in blue to mark the occasion.

A new therapy is helping east Africa fight its worst outbreak of the deadly parasitic disease kala azar (also known as visceral leishmaniasis) in more than a decade. The new combination therapy is cheaper than previous ones and nearly halves the length of treatment from a 30-day course of injections to 17 days. The combination of drugs sodium stibogluconate and paromomycin helps to reduce risk of drug resistance and is now the WHO-recommended first-line treatment in Africa. Kala azar is spread through the bite of a sandfly and can be fatal without treatment. Each year up to two million people are newly infected with the disease and 50–60 000 die from it.

The number of tuberculosis (TB) deaths has fallen to its lowest level in a decade, according to a new report. The numbers of people falling ill with TB each year are also dropping for the first time, according to the WHO 2011 global tuberculosis control report, published on 11 October. In 2009, 47 million people were successfully treated and 7 million lives saved. However, current progress could be at risk as countries have reported a funding shortfall of US$ 1 billion for TB treatment implementation in 2012.

Healthy men (without symptoms) should no longer receive a prostate-specific antigen (PSA) blood test to screen for prostate cancer because the test does not save lives, according to a statement made in October by the United States Preventive Services Task Force. This decision is based on the results of five well-controlled clinical trials and could change the existing practice of routine screening of American men aged 50 to 75 years. The Task Force found that the PSA test detects prostate cancer in 25% of men, but that this cancer never progresses in the majority of men. This “overdiagnosis” often leads to costly and harmful treatment that causes pain, impotence and incontinence. Even among men who have fast-growing prostate cancer, screening using the PSA test has not been shown to have saved lives.

Sex selection, including prenatal testing and infanticide in favour of male children, is damaging the development of countries in Asia, says Nobuko Horibe, director of the Asia-Pacific office of the United Nations Population Fund. At a conference held last month in Viet Nam, Horibe called for stronger action to tackle gender imbalances caused by sex selection. “Sex selection is discrimination against women and girls and should end”, she says. A gender imbalance can threaten social stability and lead to increased sexual violence and trafficking of women, says Horibe.

Looking ahead

  • 14 November: World Diabetes Day
  • 16 November: World Chronic Obstructive Pulmonary Disease Day
  • 20 November: Universal Children’s Day
  • 20 November: World Day of Remembrance for Road Traffic Victims
  • 25 November: International Day for the Elimination of Violence against Women
  • 1 December: World AIDS Day
  • 3 December: International Day of Persons with Disabilities http://www.idpwd.com.au
  • 10 December: International Human Rights Day http://www.ohchr.org
  • 18 December: International Migrants Day
  • 20 December: International Human Solidarity Day
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