Tag Archives: World Health Organization

WHO report takes aim at Grim Reaper of “lifestyle”

 

Photo by Robyn Lee via Flickr, Creative Commons

Some 16 million people die prematurely each year because of preventable, non-communicable diseases. So-called “lifestyle diseases” affecting the heart and lungs, and stroke, cancer and diabetes, are among humanity’s biggest threats, warns a new report by the World Health Organization. Photo by Robyn Lee via Flickr, Creative Commons

By Alessandro R Demaio, Harvard University 
January 19, 2015

The World Health Organization (WHO) has just released its Global Status Report on Noncommunicable Diseases, the second in a series tracking worldwide progress in the prevention and control of cancers, lung disease, diabetes and cardiovascular disease. It focuses on how to reach the internationally agreed overarching target of a 25% reduction of premature mortality from these four major non-communicable diseases by 2025.

Outlined in 2013, the target is to be reached via nine goals including reducing harmful use of alcohol, increasing physical activity and lowering salt or sodium intake as well as tobacco use. They also include halting the rise of diabetes and obesity and improving coverage of treatment and prevention of heart attacks and strokes. There’s also a goal for improving the availability and affordability of technologies and essential medicines for non-communicable diseases.

For those who don’t follow the machinations of the WHO, this may all seem a little confounding, or even esoteric. But don’t let the almost innocuous title fool you – non-communicable diseases are one of the biggest threats facing humanity today.

Non-communicable diseases, which are sometimes called “lifestyle” or “chronic diseases”, are caused by common risk factors. The good news is that they can also be prevented by largely shared strategies. Tobacco control, for example, helps reduce cancers, heart disease, stroke and lung diseases – all of which are non-communicable diseases. Improving the diet of populations will help avoid obesity, cancer, diabetes and heart attacks – also all non-communicable disease.

Non-communicable diseases were of little public health concern as recently as a couple of decades ago, but their burden has since skyrocketed. The prevalence of diabetes in Australia, for instance, has more than doubled in the last 25 years, from about 2% to 4%. In the United Kingdom and United States, the number of people living with diabetes has more than doubled and tripled, respectively.

The picture is even grimmer in the developing world. Over the same period as above, the prevalence of diabetes in China rose even more starkly, from 1% in 1980 to almost 12% today – or 114 million people.

Non-communicable diseases now kill more people than any other cause across the world; they were responsible for 38 million (68%) of the world’s 56 million deaths in 2012. More than 40% of them (16 million) were premature deaths – that is, the people who died were under the age of 70 years.

Almost three-quarters of all such deaths (28 million), and the majority of premature deaths (82%), occur in the world’s low- and middle-income countries.

Today’s WHO report aims to outline the how to for governments around the world, providing the most effective methods for achieving these goals. But for those of us not in positions to make decisions that could stop the wave of non-communicable diseases, here are seven key lessons from this latest update.

1. Bad news for the poor

Non-communicable diseases cause poverty and poverty causes non-communicable diseases. The burden of these diseases is concentrated in poor and sometimes the poorest populations. It acts as a barrier to economic development and has the potential to undo the progress of the past few decades.

Even in developed countries, such as the United States, research shows a strong link between poor counties and higher risk of obesity and related diseases.

2. Some countries are doing better

While some countries are doing well in the fight against these illnesses, many are not doing much to address their risk factors and impacts. The report urges governments to take heed of the growing evidence base and proven case studies from around the world in the fight against non-communicable diseases.

These include Australia’s efforts in plain packaging tobacco, the UK’s food labelling laws and the growing number of nations with childhood junk food advertising bans and taxes on junk food.

It also points to the many gaps in national policies globally. This is particularly an issue in low- and middle-income countries, which often face fierce opposition and even legal challenge from the private sector, just as Australia is facing the challenge to its plain packaging law in the World Trade Organisation.

3. Governments need to start acting

Government inaction is often not a matter of a lack of money, but money ill-spent, according to this report. Cost-effective interventions are available for avoiding a third of all cancers and 80% of heart disease and diabetes. Governments just have to choose and invest wisely – and we have to demand this of them.

This challenge is not just a risk to health either. Research reported in the American Diabetes Association journal states that the links between obesity, inactivity and poverty may be too costly to ignore. Non-communicable disease including obesity-associated chronic disease already account for 70% of all US health costs.

4. Talk is cheap

The nine voluntary global targets for the prevention and mitigation of non-communicable diseases are an important start, but the WHO is calling on governments to also set local targets and ways of monitoring their achievements. This would allow countries to tailor their efforts and interventions for greater effectiveness. It would also help them target the non-communicable disease most affecting their populations.

5. Not just health

Non-communicable diseases are caused – and so can be solved – by collaboration across traditionally divided actors and sectors, including agriculture and food production, urban planning, water and air management, transport and engineering, among others.

For a new challenge, we need new platforms for change. Consider the EAT Stockholm Food Forum, which is a multilateral platform convening leading scientific, policy, private sector and civil society thinkers on the interrelated challenges of non-communicable diseases, food systems and climate change.

6. Investing in health systems

The report is a reminder that spending on health is an investment – both economic and social – and that it must be seen as such. Even countries with strong health-care systems can do better, and the key is prevention.

Investing in cost-effective strategies that will nip non-communicable diseases in the proverbial bud is our only hope if we are to afford an ageing population, the rising obesity burden and the greater expected burdens of chronic disease.

7. A new type of health worker

The report reinforces the idea that, as the major diseases affecting the population change, so too must the skills of doctors, nurses and other health staff.

Prevention, public health and public policies are the most effective responses to reducing non-communicable diseases without blowing health-care budgets, so we need to start teaching talking about them in courses that are not related to health. We need to start talking about the causes and ways to prevent these diseases with urban planners, food experts, agriculturalists and agronomists, and economists, to name just a few related professions.

Non-communicable diseases are a growing, urgent and universal health challenge affecting almost every one of us. These diseases and their environmental, commercial and social drivers are here to stay, unless we take local and international action. The WHO is urging governments – and those who vote them in – to prioritise action on this rising global burden.

Creative CommonsThe Conversation

Alessandro R Demaio

Alessandro R Demaio

Dr Alessandro Demaio is a Postdoctoral Fellow in Global Health and NCDs at Harvard Medical School and an Assistant Professor at the Copenhagen School of Global Health.

Click here for his website

This article was originally published on The Conversation. Read the original article.

 

 

 

 

 

 

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Rethinking Cancer: non-sexy, low-cost therapies

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Vikas Sukhatme, a Harvard Medical School professor, and his wife, Vidula, co-founded the nonprofit Global Cures to promote research of cost-effective cancer treatments. (Photo by Matthew Healey for ProPublica)

Increasingly, Big Pharma is betting on new blockbuster cancer drugs that cost billions to develop and can be sold for thousands of dollars a dose. In 2010, each of the top 10 cancer drugs topped more than $1 billion in sales, according to Campbell Alliance, a health-care consulting firm. A decade earlier, only two of them did. Left behind are low-cost alternatives — therapies like off-label medications, including generics — that have shown some merit but don’t have enough profit potential for drug companies to invest in researching them.

Read the free, in-depth, investigation in Think, Magazine, by ProPublica’s Jake Bernstein:

Cancer: Where Are The Low-Cost Treatments?

Excerpt:

Michael Retsky awoke from surgery to bad news. The tumor in his colon had spread to four of his lymph nodes and penetrated the bowel wall. When Retsky showed the pathology report to William Hrushesky, his treating oncologist, the doctor exclaimed, “Mamma mia.”

“Michael had a mean looking cancer,” Hrushesky remembers.

Retsky didn’t need anyone to tell him his prognosis. Although trained as a physicist, he had switched careers to cancer research in the early 1980s and spent more than a decade modeling the growth of breast cancer tumors. During his treatment, he joined the staff of one of the most prestigious cancer research labs in the country.

In the absence of chemotherapy, there was an 80 percent chance of relapse. Even with therapy, there was a 50 percent chance the cancer would return. The standard treatment was brutal. Six months of the highest dose of chemotherapy his body could withstand and, after that, nothing but hope.

 

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Dirty air kills twice as many as previously thought: WHO

Air pollution is now the world’s largest single environmental health risk, prematurely killing some seven million people in 2012 alone, said the World Health Organization.

People die prematurely of pollution-linked strokes, ischaemic heart disease, cancer, respiratory infections and chronic obstructive pulmonary diseases (COPD), said WHO in estimates released in Geneva on March 25.

WHO

A woman cooks over an open fire in her kitchen in India. Smoke from such fires causes millions of deaths annually, said the World Health Organization. © WHO/TDR /Andy Crump 2001

The organization’s new estimates are double the numbers of people previously suspected killed by dirty air, both indoor and outdoor, and WHO announced a  program to better track information and advise and inform countries of health gains from reducing pollution.

The problem is global. In France this month an environmental agency, Ecologie Sans Frontiere, filed a criminal complaint of “endangering others” over the recent extreme smog in Paris. On Monday the European Union’s environmental agency announced that 11 EU countries exceed pollution limits. China, especially affected by thick smog, has begun using drones to inspect polluting factories, said the state-run news outlet China Daily.

WHO said the countries most affected by air pollution are in South-East Asia and the Western Pacific Regions where, said WHO’s Dr. Flavia Bustreo in a statement, “Poor women and children pay a heavy price from indoor air pollution since they spend more time at home breathing in smoke and soot from leaky coal and wood cook stoves.”

The causes of indoor pollution are mostly cooking over coal, wood and biomass (dung) stoves — and they especially affect women and children, said WHO. In a WHO feature accompanying the report it quoted Dr Kirk Smith of the University of California at Berkeley, an expert in pollution from biomass stoves: “Having an open fire in your kitchen is like burning 400 cigarettes an hour.”

Outdoors, WHO laid the blame for pollution on transport, energy, waste management and industry.

“The risks from air pollution are now far greater than previously thought or understood, particularly for heart disease and strokes,” said Dr Maria Neira, Director of WHO’s Department for Public Health, Environmental and Social Determinants of Health, in the WHO statement. “Few risks have a greater impact on global health today than air pollution; the evidence signals the need for concerted action to clean up the air we all breathe.”

The WHO report said ischaemic heart disease and stroke kill the greatest numbers of people, with COPD a close third.

Copyright Deborah Jones 2014

 Independent, non-partisan and employee-owned, F&O serves, and is funded by, readers. We do not carry advertising or solicit donations from foundations or causes. Our original work in Dispatches, Think and Photo-Essays is available for a $1 site day pass or at a modest subscription price. Use the SUBSCRIBE  form, right, to receive our free Frontlines stories and notices of new work.

 

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Polio and progress

In most of the world polio is a mere bogeyman, a shadow that drifts through our awareness every October 24, the day global health agencies call World Polio Day. Few suffered, or now recall, the polio epidemics that menaced cities from the late 1800s until 1952, when Jonas Salk invented a vaccine. 

Scientists like Salk, politicians, public health agencies and Rotary International made it a global mission to wipe out poliovirus: they cooperated globally and aggressively attacked a scourge that causes muscle weakness, paralysis and sometimes death. Most of us are lucky today because of them: they were smart.

Lately we haven’t been so smart – and now the bogeyman is becoming a real threat.

Earlier this year health authorities thought poliomyelitis had almost entirely vanished except in Nigeria, Afghanistan and Pakistan – and in those countries, there were 40 per cent fewer cases in 2013 than in 2012, said the Global Polio Eradication Initiative.

Because the virus only lives in humans, it was hoped that immunization through global cooperation would finish polio off within a generation, and that poliomyelitis would join smallpox as an extinct human disease.

But this month polio surfaced again in war-torn Syria for the first time since 1999, and more than 20 cases have been confirmed, reported the World Health Organization. It was reported again in the Horn of Africa, and a few cases were reported in China.

Meanwhile efforts to stop it elsewhere are being hindered by religious fundamentalists – and the rule of unintended consequences.

America’s “war on terror” coincidentally sparked opposition to vaccines in Taliban territory, after a Pakistani doctor working with the United States reportedly used a fake vaccination campaign to get information from Osama bin Laden’s family.

Pakistani physician Shakil Afridi told a court he used the ruse  of a hepatitis-B vaccination campaign to try and get DNA from Osama bin Laden’s children, in Peshawar. The U.S. said it killed bin Laden in 2011, and last year a Pakistan court sentenced Afridi to 33 years in jail for treason.

Since Afridi’s admission, the Taliban has targeted health care workers delivering vaccines. The latest in some two dozen deaths were from bombings in Peshawar this month, reported the BBC.

Disease control is an example of human “progress,” a disputed and contentious word that’s fallen out of fashion lately. In addition to being out of fashion, “progress” has taken several steps backward.

Copyright © 2013 Deborah Jones

 

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