Fw: Kaiser Daily Global Health Policy Report - Wednesday, July 1, 2009
Fw: Kaiser Daily Global Health Policy Report - Wednesday, July 1, 2009
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Subject: Kaiser Daily Global Health Policy Report - Wednesday, July 1, 2009
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Wednesday, July 01, 2009
1. Roche To Offer Developing Countries Discounted Tamiflu <>
2. Funding, Restrictions Keep WFP From Reaching Millions Of Hungry North Koreans <>
3. Kenya Malaria Study Shows One-Third Of Patients Receive ACTs <>
4. IPS Examines Obstetric Fistula In Southern Senegal <>
5. Study Examines PEPFAR Efforts In Zambia <>
6. PLoS Medicine Editorial Argues For Water Access To Be Considered Human Right <>
7. Also In Global Health News: HIV <> & TB; ITN Program; DRC's Health System
1. Roche To Offer Developing Countries Discounted Tamiflu <http://smtp01.kff.org/t/976/373649/431/0/>
The pharmaceutical company Roche on Wednesday announced a program to help ensure developing countries have access to its antiviral Tamiflu, for "the management of a novel influenza strain defined by the WHO as having significant and current pandemic potential," Reuters <http://www.reuters.com/article/GCA-SwineFlu/idUSTRE55S3UF20090701> reports (Egenter, 7/1). The program will make Tamiflu, which has been shown to be effective against the H1N1 (swine flu) virus, available to developing countries for "half the price normally charged," Dow Jones Newswires/Wall Street Journal <http://online.wsj.com/article/BT-CO-20090701-703586.html> reports (Mengewein, 7/1).
"Under the programme, which will take effect immediately, Roche will produce and store Tamiflu pandemic stockpiles for specified developing countries at a significantly reduced price with the cost spread over a number of years, the group said," Reuters writes. The stockpiles will be released if "an influenza pandemic has been announced, or in the event of a public health emergency, upon request from the governments concerned, it said" (7/1).
Dow Jones Newswires/Wall Street Journal writes, "Some 70 countries, which are members of the Global Alliance for Vaccines and Immunization, can take part in the program, [spokeswoman Martina Rupp] said." Roche is working with the WHO, U.N. and other agencies to see if they can step in to pay the costs of Tamiflu for countries that cannot afford the antiviral, even at a reduced rate (7/1).
Health Experts Recommend High-Risk Groups Skip Hajj To Avoid H1N1
On Tuesday, a group of international health experts recommended that those at greatest risks from the H1N1 virus -- children, patients with chronic diseases, pregnant women and the elderly -- "avoid making the annual hajj pilgrimage in Saudi Arabia to prevent catching swine flu," the AP/Washington Post <http://www.washingtonpost.com/wp-dyn/content/article/2009/06/30/AR2009063001732.html> reports. The announcement followed the conclusion of a four-day meeting between the WHO, CDC and Saudi health officials.
"The recommendations come as some in the Muslim world have raised questions about the risk posed by swine flu to the millions attending the annual Muslim pilgrimage, which takes place this year in December, with some even suggesting quarantining people returning from Saudi Arabia," the newspaper writes.
The groups also "urged that the kingdom maintain adequate screening for the virus at entry points used by pilgrims and that pilgrims receive flu shots at least two weeks before they travel to Mecca and Medina and the swine flu vaccine once it is available" (Abu-Nasr, 6/30).
U.S. Health Officials Credit H1N1 Preparedness To Lessons Learned From Previous Flu Outbreaks
U.S. public health officials said Tuesday that lessons learned from earlier flu outbreaks allowed for the country's swift response to the H1N1, CQ Politics <http://www.cqpolitics.com/wmspage.cfm?docID=news-000003156999> reports.
"The public health measures that were put in place [after the bird flu scare several years ago] were quite sensible," Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said during an H1N1 briefing, co-sponsored by the Kaiser Family Foundation, the Center for Strategic and International Studies, and the Congressional Global Health Caucus. Fauci and Harvey Fineberg, president of the Institute of Medicine spoke about how health experts continue to watch how the H1N1 virus is behaving during southern hemisphere's winter and discussed the preparations needed should the U.S. be faced with a mass immunization campaign (Robillard, 6/30). A webcast of the event is available online <http://globalhealth.kff.org/Multimedia/2009/June/30/gh063009video.aspx> .
Buenos Aires Declares Health Emergency In Response To H1N1
In response to a rising number of H1N1 cases in the city of Buenos Aires, Argentina, the government has declared a health emergency that will extend a school holiday that begins Monday by two weeks, the Wall Street Journal <http://online.wsj.com/article/SB124642190802178481.html> reports.
"The emergency declaration gives Buenos Aires city health authorities expanded power to cut through red tape to buy medical supplies or to take other measures they deem necessary," the Wall Street Journal writes, adding, "The announcement in the capital came one day after federal Health Minister Graciela Ocana resigned, under fire for the government's handling of swine flu and a previous outbreak of mosquito-borne dengue fever" (Moffett, 7/1).
20-Year-Old Becomes Spain's First H1N1 Fatality; H1N1 Reported In Mauritius
Spanish health authorities on Tuesday announced the country's first swine flu fatality, VOA News <http://www.voanews.com/english/2009-06-30-voa19.cfm> reports. The victim, a 20-year-old Moroccan woman, was seven months pregnant and had asthma when she succumbed to respiratory illness. "Earlier, doctors performed a Cesarean section to save her premature baby, who was in good health but on a respirator," VOA News writes.
Mauritius became the eighth African nation to report swine flu after health authorities confirmed the country's first case of swine flu on Monday. The patient, "a visiting French tourist" was "confined ... to his room for five days and released ... after treatment," VOA News writes (6/30).
More Labs In India To Diagnose H1N1
On Monday, Ghulam Nabi Azad, India's health minister, announced 16 new laboratories in the country will have the capacity to diagnose H1N1 within eight hours beginning July 1, the Telegraph <http://www.telegraphindia.com/1090630/jsp/nation/story_11176271.jsp> reports. "Sources said the move will save several hours in diagnosis," the newspaper writes (6/29).
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2. Funding, Restrictions Keep WFP From Reaching Millions Of Hungry North Koreans <http://smtp01.kff.org/t/976/373649/432/0/>
The U.N.'s World Food Programme (WFP) said Wednesday a "lack of international funding and new restrictions by North Korea on its staff and where it can operate has left it unable to reach millions of hungry women and children in the impoverished country," AP/Taiwan News <http://www.etaiwannews.com/etn/news_content.php?id=991413&lang=eng_news> reports. According to the WFP, it has received 15 percent of the $504 million it needs to feed 6.2 million North Koreans (Sanderson, 7/1). The agency has had to reduce its goal of reaching all 6.2 million, and is now targeting 2.27 million people, Torben Due, the WPF's country representative in North Korea.
"For adults, it doesn't mean a lot if you live for a few months on a diet of cereals and vegetables, but for children, it is critical," Due said, adding that anecdotally there appears to be "an increase in the number of children being admitted to hospitals with severe malnutrition," via AFP/Google.com <http://www.google.com/hostednews/afp/article/ALeqM5gk-78nhpZOYqK1_cRZloF3eHthWg> . He said the country's chronic food shortages have created a negative cycle in which malnourished children grow up stunted with weak immune systems, and, in turn, give birth to less-than-healthy babies.
According to SAPA/BusinessDay, the government told the WFP to "scale back its operations and get rid of its Korean-speaking staff, which reduced the number of workers to 16 last month from the 59 agreed upon last year" (7/1). According to Due, government leaders ordered the scale back without giving clear reasons why.
"A long-running international standoff over North Korea's nuclear programmes escalated on May 25 when Pyongyang carried out its second nuclear test, followed by further missile launches, which resulted in new U.N. sanctions," writes APF/Google.com. "We have not really received any contributions after the nuclear test was carried out," Due said (Martin, 7/1).
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3. Kenya Malaria Study Shows One-Third Of Patients Receive ACTs <http://smtp01.kff.org/t/976/373649/433/0/>
Just about one-third of people seeking malaria treatment in Kenya received the recommended artemisinin-based combination therapies (ACTs) and some people are being treated with ineffective drugs like chloroquine, which was phased out almost 10 years ago, according to the recently launched 2007 Kenya Malaria Indicator Survey -- the country's "first ever comprehensive malaria study," the Daily Nation <http://www.nation.co.ke/News/-/1056/617508/-/ukeiol/-/> reports (Gathura/Cheboi, 6/30).
Elizabeth Juma, the head of the Division for Malaria Control in the Ministry of Public Health and Sanitation, said the survey focused on children younger than age five because of their vulnerability to the transmission of malaria, Capital News <http://www.capitalfm.co.ke/news/Local/Bad-drugs-hurting-Kenya-malaria-fight-4940.html> reports. (Karong'o, 6/30).
The survey also found that prescription drugs were being sold over the counter, and it calls on the Pharmacy and Poisons Board to ensure medicines are regulated, according to the Daily Nation. The report also recommends that children presenting with fever be tested for malaria and treated accordingly, "which is bound to raise debate given that most health clinics do not have the facilities and equipment to undertake such tests," writes the Daily Nation (6/30).
According to Capital News, "[t]he report further indicated that at least 61 percent of Kenyan children do not sleep under Insecticide Treated Nets (ITNs), which are recommended for preventing malaria spread." Juma said efforts to promote the use of bed nets must be scaled up (6/30).
Kenya Broadcasting Corporation <http://www.kbc.co.ke/story.asp?ID=58303> reports that Kenya National Bureau of Statistics Director Anthony Kilele said the country needs to increase ITN usage by pregnant women to reach a 60 percent coverage target. "The survey results indicate that areas where two mass net distribution campaigns were conducted reported a higher ITN usage among children under five than areas in which there were no such campaigns," he said.
Kikele also said the survey showed that up to 30 percent of outpatient health facility visits and 19 percent of admissions to health facilities in Kenya are due to malaria (Kamau/KNA, 6/30).
"The delay in releasing the report was blamed on the post 2007 election crisis," Capital News writes (6/30).
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4. IPS Examines Obstetric Fistula In Southern Senegal <http://smtp01.kff.org/t/976/373649/434/0/>
Inter Press Service News Agency <http://www.ipsnews.net/africa/nota.asp?idnews=47474> examines the prevalence of obstetric fistula in the southern region of Senegal. According to state reproductive health officials in the town of Kolda, 58 percent of births take place at home without medical assistance. "Women in the region suffer from exceptionally high rates of fistula," which "occurs when extended pressure damages the soft tissue in a woman's pelvis during the process of giving birth" and can lead to debilitating complications and ostracization from their families, IPS writes.
For every 20 deliveries at the Kolda's regional hospital, at least nine women develop fistula, said the hospital's medical commission President Charles Antoine Diatta. He said it is the result of inadequate monitoring during pregnancy.
"In our southern regions, girls are married off between the ages of 13 and 15. They are right in the middle of adolescence and from a morphological perspective, their pelvic girdles are not yet fully developed. This is one of the causes of fistula because at delivery, labour is prolonged," Diatta said, adding that the cost of medical care for a woman who has a fistula is between 70,000 and 150,000 CFA francs, about $320.
"The extreme poverty in these communities means that fistula sufferers stay away from health facilities and often do not return after a consultation. Being ashamed of their condition also keeps them away, as well as their awareness of the odour they give off," according to Diatta, because the condition can cause leakage of urine or feces.
A shortage of health workers and equipment also contributes to the pervasiveness of fistula, according to Jacques Diam Ndour, head doctor in Kolda district. According to the WHO, there are seven doctors in Senegal for every 100,000 people, and one midwife for every 400,000 people. The article includes additional comments from a local religious leader, a UNPFA worker, a Kolda high school student and a public health leader in the area (Adigbli, 6/30).
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5. Study Examines PEPFAR Efforts In Zambia <http://smtp01.kff.org/t/976/373649/435/0/>
A report <http://www.siecus.org/index.cfm?fuseaction=Feature.showFeature&FeatureID=1767> from researchers at the Sexuality Information and Education Council of the United States examines how $577 million in PEPFAR funding between 2004 and 2008 was used in Zambia, PlusNews/IRIN <http://www.plusnews.org/Report.aspx?ReportId=85076> reports. According to the findings, the authors write, "we observed and documented some impressive prevention programming funded through PEPFAR ... Nonetheless, when stepping back and observing the whole picture, it becomes apparent that the overall approach of PEPFAR dollars to HIV prevention is far from comprehensive. Instead, it is overly restrictive, adhering to a narrow vision of a moralistic ideal, rather than responding to the reality of the epidemic and the needs of the entire population."
The report found $20.5 million of PEPFAR funds in 2008 were spent on programs focused on promoting "abstinence and being faithful" compared to $12.4 million on "other approaches, including the use of condoms," IRIN writes. "The disproportionate emphasis on abstinence-until-marriage ... has created a distinctly anti-condom atmosphere," according to the authors.
For instance, "Researchers visited one of Zambia's major trucking routes, where high rates of poverty have caused the commercial sex trade to flourish, and found that only one of three organizations distributing condoms to sex workers received PEPFAR funding, and that the supply of condoms constantly ran out," IRIN writes. The article also documents the confusion organizations on the ground have over PEPFAR requirements on how money is spent.
The report appeals for PEPFAR "to develop the capacity of local NGOs to make more substantial contributions to HIV prevention in their country, provide greater transparency about how PEPFAR funds were spent, shift away from the ideological emphasis on abstinence-until-marriage, and invest more in comprehensive sex education," IRIN writes (6/30).
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6. PLoS Medicine Editorial Argues For Water Access To Be Considered Human Right <http://smtp01.kff.org/t/976/373649/436/0/>
"As scientists warn that the world's fresh water supplies will soon run critically short, and companies scramble to privatize them, some researchers and activists say water should be considered a basic human right," Wired's blog, "Wired Science <http://www.wired.com/wiredscience/2009/06/waterright/> " writes of an editorial <http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000102> published in PLoS Medicine Tuesday (Keim, 6/30).
While the WHO currently estimates 1.2 billion people worldwide are without access to clean drinking water, and an additional 2.6 billion lack adequate sanitation services, "[t]he U.N. has estimated that 2.8 billion people in 48 countries will be living in conditions of water stress or scarcity by 2025," the authors write in the PLoS Medicine editorial.
Responding to recent opposition by Canada, Russia and the U.S., the editorial authors outline three main arguments for why water should be declared a human right, pointing to the fact that: access to clean water has the potential to reduce the global burden of disease caused by water-borne infections; privatization of water has failed to serve those suffering most from water shortages; and the existence of climate change is increasing the prospects of global water scarcity.
Pointing to the failure of reaching previous clean water access goals and the slim prospects of attaining related U.N. Millennium Development Goals, the authors write, "Critics have called inadequate access to water and sanitation a 'silent emergency' that has yet to command sufficient attention from the international community or from health professionals. Clearly we need a more radical approach" (6/30).
Wired Science writes: "In terms of intellectual coherency, the idea [that water be considered a human right] passes muster. Water's just as essential to life as food, which makes an appearance in Article 25 of the United Nations' Universal Declaration of Human Rights."
"Of course, it's a lot easier to declare a right than to enforce it. ... But as the PLoS Medicine editors point out, recognizing water as a human right would at least provide a framework for dealing with water privatization" (6/30).
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7. Also In Global Health News: HIV <http://smtp01.kff.org/t/976/373649/437/0/> & TB; ITN Program; DRC's Health System
HIV-Positive Babies More Likely To Contract Deadly TB If Given BCG
A three-year study <http://www.who.int/bulletin/volumes/87/7/08-055657/en/index.html> in South Africa found that babies who were born HIV-positive had a higher risk of contracting a deadly form of tuberculosis if given the widely used BCG vaccine, the AP/Seattle Post-Intelligencer <http://www.seattlepi.com/national/1103ap_un_med_who_tb_vaccine.html> reports. The study, which was published Wednesday in the Bulletin of the World Health Organization, recommends "not vaccinating babies with HIV and delaying vaccination for those babies whose HIV status is unknown," writes the AP/Seattle Post-Intelligencer (7/1).
Research Identifies Why People With HIV Are More Likely To Develop TB
Researchers recently identified why people who have HIV/AIDS are more susceptible to getting tuberculosis, the ANI/Times of India <http://timesofindia.indiatimes.com/Lifestyle/Why-HIV-patients-are-vulnerable-to-TB/articleshow/4723834.cms> reports. The research, which is published in the Journal of Leukocyte Biology, explains how HIV interferes with the lungs' cellular and molecular mechanisms used to fight TB. According to one of the scientists, this new information could lead to the development of new drugs to treat or prevent TB in HIV-positive people (7/1).
VOA News Examines Nothing But Nets Campaign
VOA News <http://www.voanews.com/english/AmericanLife/2009-06-30-voa17.cfm> examines the U.N. Foundation's campaign Nothing But Nets that is "devoted entirely to raising money to purchase bed nets." The "widespread use" of long-lasting, insecticide-treated nets (ITNs) can reduce transmission of malaria by up to 90 percent, VOA News writes. Recently, the campaign partnered with the U.N. High Commission on Refugees to distribute ITNs in refugee camps. In addition, Nothing But Nets "has remained strong, even in a troubled economy," writes VOA News (Hegg, 6/30).
BMJ Examines Health Care System Of DRC, Estimates Of 1,500 Deaths Daily
British Medical Journal <http://www.bmj.com/cgi/content/full/338/jun30_3/b2652> examines how a broken health system is exacerbating the health conditions of vulnerable people living in war-torn Democratic Republic of Congo, leading to the deaths of some 1,500 people per day. The article also explores the recent efforts of the U.N. to make health services in the region free (Zarocostas, 6/30).
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