Transcript of WHO podcast - 26 March 2007
WHO reports on the latest avian influenza news from Jakarta; the role of male circumcision in HIV prevention
Christine McNab: You’re listening to the WHO podcast for the week of 26 March 2007. I'm Christine McNab.
In this episode:
- at a breakthrough meeting this week, Indonesia announced it will resume sharing avian influenza virus samples with WHO;
- WHO and UNAIDS have new recommendations about male circumcision and HIV prevention;
- as World Health Day nears, WHO urges the international community to invest in health for a safer future; and
- WHO and the public health community mourn the loss of a pioneer.
This week, influenza experts gathered in Jakarta to find a solution to a difficult issue - how to ensure developing countries benefit when they share influenza viruses. Earlier this year, the Minister of Health of Indonesia brought the world's attention to something she called "unfair", that while poor countries were sharing influenza viruses for analysis and vaccine development, they might not have access to the resulting vaccine. She announced that Indonesia would stop sharing influenza virus samples with WHO. Some considered this a threat to global public health security, because, without these samples, experts could not analyse the virus to see if it was changing into a more dangerous form, develop diagnostics, or test it for sensitivity to medicines. At the same time, WHO fully recognized that Indonesia and other developing countries must have access to pandemic influenza vaccines. Following the two-day technical meeting, WHO welcomed an announcement from the Indonesian Minister of Health, Siti Fadilah Supari, that she would resume sharing samples.
Siti Fadilah Supari: We have now agreed with WHO and other Member States on a timetable to make the changes necessary to accomplish our objective of achieving equitable and affordable access to vaccines to developing countries around the world.
Christine McNab: Dr David Heymann, WHO's head of Infectious Diseases, said, "We have struck a balance between the need to continue the sharing of influenza viruses for risk assessment and for vaccine development and the need to help ensure that developing countries benefit from sharing without compromising global public health security."
Christine McNab: This week also marks an announcement of another health issue: how and when should male circumcision be used to prevent the spread of HIV. Randomized controlled trials in Kenya, South Africa and Uganda demonstrated that male circumcision reduces the risk of the man being infected during heterosexual sex by about 60%. WHO and UNAIDS recently held an expert consultation on the topic and have just announced the recommendations. Dr Kevin De Cock is the director of WHO's HIV department.
Dr Kevin De Cock: The implications are really quite major because what this represents is the WHO and UNAIDS and the scientific community saying that male circumcision is an effective prevention strategy for the prevention of the acquisition of HIV in heterosexual men. This really needs to be considered as an additional prevention strategy.
Christine McNab: De Cock warns, however, that male circumcision in no way provides complete protection. It is critical that circumcised men and their sexual partners receive quality counselling so there is no false sense of security.
Dr Kevin De Cock: Male circumcision should not be viewed as a stand alone intervention. It is an additional prevention strategy, rather than a replacement of any other prevention interventions. Men must be advised that this offers only partial protection and other prevention measures are required, and we must guard against a sort of relaxation of behavioural and preventive measures.
Christine McNab: Bearing that in mind, the consultation recommended that countries with high prevalence of HIV, a generalized heterosexual epidemic where rates of male circumcision are low, consider dramatically increasing access to male circumcision. The challenge now is for these countries, primarily in southern and to some extent eastern Africa, to consider how to implement this safely as part of a comprehensive HIV prevention package.
Christine McNab: HIV is one of the issues in the spotlight for World Health Day on April 7. The theme this year is international health security. Recent outbreaks of new diseases, such as avian influenza and SARS, natural disasters, the threat of chemical and radiation spills, climate change combined with globalization mean national health events can quickly threaten international health. This year, Dr Margaret Chan, WHO's Director-General, will debate the issues on April 2 in Singapore with the Foreign Minister of Norway, the Senior Minister of State for Foreign Affairs of Singapore, and the Chief Executive of Cathay Pacific. Dr Chan has repeatedly stressed the need to take collective action and responsibility to reduce the global risks.
Dr Margaret Chan: We must act with a common purpose to address a fundamental issue - strengthening our collective global public health security. We must work together to decrease our vulnerability.
Christine McNab: For more on World Health Day, including an issues paper, visit www.who.int and link to the World Health Day pages. We'll have more from the day itself including events from around the world in the next WHO podcast.
Christine McNab: Finally, this week, the global public health community lost a leader, mentor, and for many, a hero. Dr Aileen Plant of Australia was a renowned medical epidemiologist and was considered an outstanding public health expert. She died suddenly this week in Jakarta where she had led important discussions at the influenza virus sharing meeting. WHO colleagues called Dr Plant "the best", "the beating heart", and a "true servant of public health". When SARS was a new disease in Viet Nam, Dr Plant immediately jumped on a plane to lead the investigation there knowing the disease was killing health workers. Her analysis helped the world to better understand and, therefore, to stop SARS. Here she is reporting back on her Viet Nam experience to an expert meeting in Malaysia in 2003.
Dr Aileen Plant: But really we end up with good news. And that is we don't have to wait for perfect answers to control SARS. We can actually do it now. Thank you very much.
Christine McNab: This week, WHO's Director-General, Dr Margaret Chan, offered her deepest condolences to Dr Plant's family, friends and colleagues.
Thanks for listening to the WHO podcast. For the latest public health news and more information about WHO’s work, visit our website at www.who.int.