Bulletin of the World Health Organization

Public health round-up

Asia takes the reins

WHO/Chadin Tephaval

More than 89% of all people affected by emergencies worldwide live in Asia. Recent disasters, including the 2004 Indian Ocean tsunami and Cyclone Nargis in 2009, have been the catalyst for Asian States to demand a more active role in coordinating the response to disasters. The Association of South-east Asian Nations Coordinating Centre for Humanitarian Assistance on Disaster Management, was inaugurated in Jakarta, Indonesia, in November. It has been established to form a central point of information for tracking and preparing for potential disasters and allocating resources, including international assistance, for a coordinated response.

Towards elimination

The WHO Region of the Americas has committed to eliminating mother-to-child transmission of HIV and syphilis by 2015. A report published in December shows some countries have already reached target transmission levels: Antigua and Barbuda, Canada, Cuba and the United States of America have reduced mother-to-child transmission of HIV to less than 0.3 cases per 1000 births and to 0.5 per 1000 births for congenital syphilis. Other countries including El Salvador and Guatemala have a lot of work to do to increase low rates of diagnosis and treatment of HIV and syphilis in pregnant women. Around 5000 children become infected with HIV and more than 3000 babies are born with syphilis in this region each year.

20 million by 2015

A plan to circumcise 20 million African men is expected to prevent 3.4 million new HIV infections by 2025. The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States President's Emergency Plan for AIDS Relief (PEPFAR) aim to fund the circumcision of 80% of men aged 15–49 years in 14 priority African countries by 2015. While the plan will cost an estimated US$ 1.5 billion, the future savings are expected to be around US$ 16.5 billion in HIV treatment and care costs. The plan also aims to establish long-term national circumcision programmes in these countries for infant boys and adolescents. “It is time we closed the gap between scientific evidence and implementation,” says Michel Sidibe, executive director of UNAIDS.

Vaccinate in time

European countries need to take action to increase their measles vaccination coverage following several outbreaks in the region in 2011. According to WHO, there were more than 26 000 cases of measles in 36 European countries from January to October 2011, with more than 14 000 in France alone. About 83% of these cases were in western European countries in spite of their strong health systems. These outbreaks caused nine deaths, including six in France, and more than 7000 hospitalizations. “The increase in measles in European countries reveals a serious challenge to achieving the regional measles elimination goal by 2015,” says Zsuzsanna Jakab, WHO Regional Director for Europe. The majority of cases were in non-vaccinated adolescents and adults or in people for whom vaccination history was not known. Peak months for measles outbreaks in Europe are typically from February to May.

Research under threat

Research and development for neglected diseases is under threat with a 6% (US$ 125 million) drop in public funding from high-income countries in 2010, according to a report published by research analysis organization, Policy Cures, in December. Mary Moran, director of Policy Cures, says “It’s time for governments to step up to the plate, otherwise we risk losing a decade of investment that is on the verge of delivering badly needed new medicines and vaccines for the developing world.” The report, the G-FINDER survey of global R&D funding for neglected diseases, collects data on public and private funding for 31 diseases mainly found in developing countries. Access the report at: http://www.policycures.org

Celebrating World Braille Day

Taha Hussein library

Worldwide, 285 million people are visually impaired, more than one-third of these cases are due to cataracts; 39 million are blind. World Braille Day is celebrated every year on 4 January, the birthday of Louis Braille, who invented a system of reading and writing for people who are blind or visually impaired. Braille was once the only accessible format for the visually impaired. Today, there are other options. This girl is using a handheld device to read a book in the Digital Accessible Information SYstem (DAISY) format. More needs to be done though to expand access: according to the World Intellectual Property Organization, less than 5% of books are made available in accessible formats within the first year of publication.

Closing the gap

More than 80 million people live in poverty in the European Union and health inequalities are widening both between and within European countries. A new internet resource aims to help countries to share practical information on ways they are tackling this problem. The European Portal for Action on Health Inequalities provides more than 300 examples of policies and practices that European countries are using to reduce poverty and social exclusion. It is available at: http://bit.ly/u19qI2

Connecting nurses

Nurses from all over the world are being called upon to contribute innovative ideas to the Care Challenge initiative. This online programme provides a space where nurses can submit their ideas and projects and discuss them with other nurses and caregivers. It was developed through a collaboration of nursing organizations, including the International Council of Nurses, and funded by Sanofi. A total of 20 awards are on offer, including ten prizes each worth approximately US$ 4000. Submissions at: http://www.care-challenge.com by 31 March 2012.

Greener and healthier

School crossing guards, such as this girl from Banareng Primary School in South Africa, are important to safe networks for walking to school – one very low-cost means identified in the report for reducing transport’s climate change emissions while supporting healthy physical activity in children
Brett Eloff
School crossing guards, such as this girl from Banareng Primary School in South Africa, are important to safe networks for walking to school – one very low-cost means identified in the report for reducing transport’s climate change emissions while supporting healthy physical activity in children

Improved rapid transit, pedestrian and cycle networks can boost public health and reduce climate change emissions from transport at the same time. A report launched in December at the United Nations climate change conference in Durban, South Africa, highlights the strong association between well designed transit and nonmotorized transport, and evidence of better population health outcomes in more than 300 peerreviewed studies. Part of WHO’s Health in the Green Economy series, the report calls for policy-makers in climate, transport and land-use to consider the impact of their policies on health and equity. Access the report series at: http://www.who.int/hia

Research scan

Treat them at home

Pneumonia is the single biggest killer of children aged less than five years worldwide. A study in Pakistan shows that community health workers can successfully treat these children at home with oral antibiotics, even in cases of severe pneumonia. The study, published in November in the Lancet, found that the children treated at home for severe pneumonia even had better outcomes than those referred to a health clinic or hospital. “If this is confirmed in other settings, we can make treatment much more accessible for families, help governments make the most of limited resources and save more children’s lives,” said Shamim Qazi from WHO. http://www.thelancet. com/journals/lancet/article/PIIS0140-6736(11)61140-9/abstract.

When to wash?

Hand hygiene is crucial for preventing hospital infections but a survey of German medical students has revealed very poor knowledge of when they should wash their hands at work. Only 21% of the third-year medical students surveyed could identify correctly from a list the following scenarios when doctors must wash their hands: before contact with a patient, before preparation of intravenous fluids, after removal of gloves, after contact with a patient and after contact with vomit. Published last month in the American Journal of Infection Control, the study also found that the students rated their own hand hygiene practices as “good” and rated nurses as less compliant. Other published studies have shown that nursing students have significantly better hand hygiene practices than medical students.

Eat your veggies

Eating foods rich in antioxidants – such as fruit and vegetables, whole grains and tea – may reduce the risk of stroke in women, even among women with a history of cardiovascular disease. More than 30 000 Swedish women aged 49–83 years were tracked for an average of 10 years. Each woman filled in a diet questionnaire which was used to determine her total consumption of antioxidants, which include vitamins C and E, carotenoids and flavenoids. The study found that women with a history of cardiovascular disease who also had an antioxidant-rich diet reduced their risk of stroke by more than 50%. Study published online in Stroke: Journal of the American Heart Association: http://stroke.ahajournals.org ■

Looking ahead

  • 4 January: World Braille Day
  • 3 December: International Day of Persons with Disabilities http://www.idpwd.com.au
  • 16–23 January: 129th meeting of the Executive Board of the World Health Organization
  • 25 January: World Leprosy Day
  • 4 February: World Cancer Day http://www.uicc.org/world-cancer-day-2012
  • 6 February: International Day of Zero Tolerance to Female Genital Mutilation
  • 14 February: Congenital Heart Defect Awareness Day
  • 19–22 March: World Congress on Health Ageing, Kuala Lumpur, Malaysia http://www.who.int/ageing/events/1st_world_congress
  • 22 March: World Water Day
  • 24 March: World Tuberculosis Day