Bulletin of the World Health Organization

Public health round-up

Bulletin of the World Health Organization 2011;89:548–549. doi:10.2471/BLT.11.010811

Worst drought in 50 years

IRIN/Mohamed Gaarane

In the drought-ravaged Gedo region of Somalia, obtaining water can involve treks of 20 km. Somalia is one of eight countries in Africa hit by the worst drought in 50 years. Around 10 million people need humanitarian assistance. Thousands fled conflict in Somalia to Ethiopia and Kenya and are living in camps without adequate health care, clean water or proper sanitation. WHO is working with ministries of health and other partners to deliver health services, including treatment for severe malnutrition. It is also helping to scale up disease surveillance systems.

Promising progress

The world is on track to reduce poverty to less than 15% of the population by 2015 – well below the 23% target, according to the Millennium Development Goals report 2011. Launched on 7 July by United Nations Secretary-General Ban Ki-Moon, the report found that significant progress has been made in reducing poverty. In other areas such as child mortality, illiteracy and some infectious diseases countries are lagging. www.un.org/millenniumgoals

Adolescents at risk

Every day, around 2500 young people become infected with HIV. For the first time a United Nations publication, Opportunity in crisis: preventing HIV from early adolescence to young adulthood, presents global data on adolescents and HIV. The report reveals stark gender inequalities, particularly in sub-Saharan Africa where 72% of young people (aged 15–24) living with HIV are women. Young women and girls face a disproportionately high risk of infection due to biological vulnerability, social inequality and exclusion. http://www.who.int/hiv/pub/opportunity_in_crisis

Affordable HIV drugs

Poor countries often wait years before they can afford new medicines for HIV. This is set to change. The Medicines Patent Pool, developed by global health initiative UNITAID, announced on 12 July an agreement with Gilead Sciences, its first to date with a pharmaceutical company. The Pool seeks to stimulate innovation and improve access to HIV medicines through the negotiation of voluntary licences on medicine patents. The aim is to enable generic production and development of new formulations including for children. “I welcome this first important step by Gilead and urge other pharmaceutical companies to place their intellectual property at the service of global public health,” said Philippe Douste-Blazy, chair of the UNITAID Executive Board.

Safe water

Every year an estimated two million people die from waterborne diseases and many more suffer illness from drinking unsafe or contaminated water. On 4 July, during International Water Week in Singapore, WHO released new Guidelines for drinking-water quality, calling on governments to adopt a primary prevention approach in their water safety management. The new guidelines recommend that water suppliers systematically assess the risk of contaminants entering the water supply, and that they take action based on their findings and document the process. “If we look at the most recent waterborne disease outbreaks, both in developing and developed countries, it is clear that most of these could have been prevented through the proactive implementation of water-safety plans,” said Robert Bos, coordinator for Water, Sanitation, Hygiene and Health at WHO. http://www.who.int/water_sanitation_health/publications/2011/dwq_guidelines

Stigma stands in the way

WHO has launched the first public health guidelines on HIV services for men who have sex with men and transgender people. Men who have sex with men are nearly 20 times more likely to be HIV positive than the general population. But often they are reluctant to approach HIV prevention and treatment services due to the stigma and discrimination they face and, in some countries, because same-sex relationships are illegal. The guidelines suggest practical ways to improve access to such services. http://www.who.int/hiv/pub/guidelines/msm_guidelines2011

Research scan

Screening for syphilis

More than 50% of newborn deaths and stillbirths related to syphilis could be prevented with low-cost screening and treatment during pregnancy, according to research published in The Lancet Infectious Diseases. Around 2.1 million pregnant women are estimated to have active syphilis. Without screening and treatment, 69% of these women will have an adverse outcome of pregnancy. Nearly 500 000 babies die of congenital syphilis every year in sub-Saharan Africa alone. http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70104-9/abstract

Does cutting salt help?

Reducing salt intake is commonly recommended to reduce the risk of cardiovascular disease, such as stroke and heart attacks. But a new study has found that there is no clear evidence to support this. A Cochrane review published in July in the American Journal of Hypertension analysed seven randomized controlled trials covering more than 6500 participants. Although cutting down on salt reduced blood pressure after six months, the study did not find enough evidence to show that sodium intake affected the participants’ cardiovascular disease and deaths. It concluded that more research is needed on the effects of reducing salt intake, including “hidden salt” in processed foods. http://onlinelibrary.wiley.com/o/ cochrane/clsysrev/articles/CD009217/ frame.html

Cooking ups blood pressure

An estimated two billion people in the world cook with a biomass fuel, such as wood, exposing themselves to high doses of pollution. A study published last month in Environmental Health Perspectives has linked indoor air pollution with increased blood pressure among women aged 50–59. The study of 280 women in a remote part of China found that a reduction in this kind of pollution was linked to a drop in systolic blood pressure. “We have known for years that unvented cooking indoors causes respiratory damage, but now that we have documented cardiovascular effects as well, the rationale for cleaner stoves and better fuels becomes that much stronger,” said co-author Jonathan Patz from the Nelson Institute for Environmental Studies, United States of America. http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1003371

The cost of cancer

If Canada's average smoking rates were cut by half, i.e. to 11% of the population within five years, there would be 36 000 fewer cases of lung cancer by 2030, which could save about US$ 670 million in treatment costs alone. New cancer projection technology was launched last month in Amsterdam at the 14th World Conference on Lung Cancer. The tool, developed for the Canadian Partnership Against Cancer, uses demographic data to project cancer occurrences and explore the impact of smoking cessation and screening programmes on treatment costs, life-years gained and tax revenue.

The world needs more midwives

WHO/C Black

A midwife in Nepal helps a new mother learn to breastfeed. Nepal is one of 58 countries with high rates of maternal, fetal and newborn deaths highlighted in the first State of the world’s midwifery report. The report, which was published in June, shows that the world lacks some 350 000 skilled midwives and that 38 countries have a severe shortage of midwives. The recommended minimum number of skilled birth attendants required for every 1000 births is six. In Nepal that rate is 0.7.

Looking ahead

1–7 August: World Breastfeeding Week http://worldbreastfeedingweek.org

9 August: International Day of the World’s Indigenous People http://www.un.org/en/events/indigenousday

19 August: World Humanitarian Day http://ochaonline.un.org/whd

10 September: World Suicide Prevention Day http://www.iasp.info/wspd

19–23 September: United Nations Summit on Chronic Diseases (High-level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases) http://www.who.int/nmh/events/2011/ncd_summit

21 September: International Day of Peace http://www.internationaldayofpeace.org

24 September: World Heart Day http://www.world-heart-federation.org

1 October: International Day of Older Persons http://www.un.org/en/events/olderpersonsday

4 October: World Habitat Day http://www.unhabitat.org/categories.asp?catid=669

10 October: World Mental Health Day http://www.wfmh.org/00WorldMentalHealthDay.htm

14 October: World Sight Day http://www.vision2020.org

15 October: Global Handwashing Day http://www.globalhandwashingday.org

16 October: World Food Day http://www.fao.org/getinvolved/worldfoodday

17 October: International Day for the Eradication of Poverty http://www.oct17.org/en

20 October: World Statistics Day http://unstats.un.org/unsd/wsd

19–21 October: World Conference on Social Determinants of Health. Rio de Janeiro, Brazil.