New report on global TB control
20 March 2008 -- New report on global TB control; emergency vaccination in Iraq; new edition of medical guide for ships.
Transcript of WHO podcast
Chris Powell: You’re listening to the WHO podcast. My name is Chris Powell, and this is episode 29.
In this edition,
- the Global Tuberculosis Control 2008 report is launched;
- an emergency vaccination campaign in Iraq;
- and a new edition of the International Medical Guide for Ships is published.
Chris Powell: The World Health Organization this week released its annual report on tuberculosis. The report says that the pace of progress to control the TB epidemic slowed in 2006. That is the most recent year for which data were available. Dr Marcos Espinal of the Stop TB Partnership explains:
Dr Marcos Espinal: The epidemic is slowing down but it's not enough. It's very modest what we are seeing in terms of decline. …What we need to do is basically to ensure the finding of more and more cases to control this disease.
Chris Powell: New data used in the report show a reduction in the progress in diagnosing people with TB. WHO Director-General Dr Margaret Chan talks about the risks:
Dr Margaret Chan: Too many TB cases are not being diagnosed. This robs patients of the benefits of treatment, but it also means that the potential of infectious individuals to spread the disease in communities to others is not being checked…. Poor management of TB cases has dire consequences. Inadequate treatment drives the development of multi-drug resistant TB, in short MDR-TB, which is much more difficult, and 100-times more costly, to treat.
Chris Powell: There were 9.2 million new cases of TB in 2006. This number included 700 000 people living with HIV, and 500 000 people with multi-drug resistant TB.
Chris Powell: Following a recent measles outbreak in the province of Anbar in Iraq, the Ministry of Health, WHO and UNICEF recently launched a campaign to deliver the MMR vaccine to about 200 000 children under five years old. The combined MMR vaccine protects children from measles, mumps and rubella. Dr Naeema Al Gasseer, WHO Representative for Iraq, talks about how the 10-day immunization drive is going:
Dr Naeema Al Gasseer: We recruited 600 ministry of health personnel and vaccinators to be moving from house to house using various means and vaccinating each child. So far the reports have been very good. There has been a very very encouraging response from the families and the communities. They actually have been supporting the vaccinators to move from one place to another. In Anbar we have stories of people moving not only by cars, but also by bikes, donkey, horses and all means of communications to reach the children.
Chris Powell: The ongoing conflict not only poses risks to the vaccination teams; it also puts burdens on the “cold chain” network, the system which stores vaccines at the right temperature to keep them effective.
Dr Naeema Al Gasseer: Cold chain is a problem. There is a big support from UNICEF and WHO in using all the means to ensure the vaccine is safe and that the vaccine that the children are getting are not ruined and there are several technical measures that the health professionals use to make sure that the vaccine that they give to the children has actually been kept at the right temperature.
Chris Powell: Dr Naeema Al Gasseer, WHO Representative for Iraq, talking about the challenge of keeping vaccines safe and effective in difficult areas.
Chris Powell: Seafaring has always been a dangerous occupation. Long voyages, extreme weather conditions and accidents can take a heavy toll on the health of crew members. Seafarers face bigger health risks and often they are cut off from medical care and help available to people on the shore. WHO has recently published a new edition of the International Medical Guide for Ships -- the most authoritative guide to medical and health care at sea. Since it first came out in 1967, the book has been a standard reference for medical care on ships. Dr Laragh Gollogly from WHO Press edited the latest edition of this book and came into the studio to tell us more:
Dr Laragh Gollogly: Things have changed luckily in the last 20 years and some of the recommendations and guidance given in the previous edition was no longer in line with medical practice. There are more women working as seafarers, so pregnancy, delivery and childbirth needs to be properly addressed in the book.
There is less, luckily, of yellow fever and plague which was addressed in there previous book. And there is more of other diseases, such as HIV, which weren't in existence when the last edition was published. So it has really been a major revision both in content and in presentation.
Q: What range of emergencies are faced on a ship?
Dr Laragh Gollogly: Most ships in fact do not have medical personnel on board, and as ship crews are getting progressively smaller, they are less likely to have medically trained personnel on board. But all ships have obligations to train a named first responder to any medical emergency on board, and this book is used for the training of those people. In order to fulfil the ship-owners' obligations in terms of providing care to the crew, this book is essential.
Q: Not all ships have medical personnel on board. So in a situation where people are at sea, and there is a problem, how would people use this book?
Dr Laragh Gollogly: Well, the same things happen to people on board a ship that happen on land. Because of the dangerous environment in which they are working a lot of other things that don't happen on land. So you have every gamut of problems you would see in an emergency room, from violent crime, to poisoning, to suicide attempts, to heart attacks, to falls from a height, with the addition of cold water exposure, drunkenness, diabetic crisis...everything you could imagine. And this book covers everything, essentially, it really does.
Chris Powell: Dr Laragh Gollogly from WHO Press, telling us about the new edition of the International Medical Guide for Ships.
That's all for this WHO podcast. Thanks for listening. You can read more about these stories, and get more public health information at www.who.int