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Obesity-Related Diseases Among Top Three Killers in Most Countries: Since 1975 Obesity Has Nearly Tripled and Now Accounts For Four Million Deaths Worldwide Every Year: The World Bank Report on the Silent Epidemic of the World Death of Obesity



|| Tuesday: February 11: 2020 || ά.  Long believed to be a problem, exclusive to countries with high-income, evidence shows that over 70 percent of the world's two billion overweight and obese individuals live in countries with low or middle income. Faced with increasing disability, mortality, health care costs and lower productivity, obesity is a growing concern for all countries regardless of income level, according to a new World Bank Report launched on February 06.

Obesity has a major impact on national economies and on human capital by reducing productivity and life expectancy and increasing disability and healthcare costs. It is projected that in the next 15 years, the costs of obesity will total more than US$07 trillion in developing countries. The Report ‘Obesity: Health and Economic Consequences’ on an impending global challenge, states that obesity-related diseases are now among the top three killers across the globe, except in sub-saharan Africa. Recent data show that, since 1975 obesity has nearly tripled and now accounts for four million deaths worldwide every year.

The Report stresses that in order to avoid the rise of obesity in future generations, governments and development partners must adopt a comprehensive approach. Effective primary health systems will be crucial together with a strong focus on preventative measures, such as, mandating the labelling of processed foods; increasing consumer education; reducing salt and sugar-sweetened beverages; and investing in early childhood nutrition programmes. In other words, education is a must. Investing in education and life-long learning is vital. People need to have the knowledge in order to be able to not only becoming aware of all the vital issues of health, well-being, nutrition and healthy foods and drinks and equally the vital necessity of following a healthy, engaged and active life and living but, also, using that, being able to make informed choices and follow them through.

Factors, escalating the obesity epidemic include ultra-processed and sugary foods, reduced physical activity and higher incomes, which, often, go hand in hand with a higher consumption of unhealthy foods. “As countries grow economically and per capita income rise, the devastating impacts and burden of obesity will continue to shift toward the poor.” says Dr Meera Shekar, the Global Lead for Nutrition at the World Bank and Co-author of the Report along with Dr Barry Popkin from the University of North Carolina.

In China between 2000 and 2009, health care costs associated with obesity grew from half a percent to more than three percent of China’s annual health care expenditure. In Brazil, obesity-related health care costs are expected to double, from less than US$06 billion in 2010 to more than US$10 billion in 2050.

In addition to directly increased health care costs, there are, also, indirect costs, associated with, for example, reduced work productivity, absenteeism and early retirement, which affect individuals and societies. Many countries across the globe are, also, suffering from what is referred to as the ‘double burden of malnutrition’, high stunting and increasing obesity rates, further compromising their human capital.

“One of the most effective ways to address obesity and other non-communicable diseases is by ramping up investments in affordable, quality primary health care.” says Dr Muhammad Pate, the Global Director for Health, Nutrition and Population at the World Bank. “This makes sense both from a health and an economic perspective. Putting more resources on the frontlines to detect and treat conditions early, before they become more serious, saves lives, improves health outcomes, reduces health care costs and strengthens preparedness.”

The Report, also, highlights the importance of strong fiscal policies, such as, taxation of unhealthy foods; and enhancing urban design, such as, playgrounds in schools and walking and bicycle paths. Financial support for the preparation of the Report was provided by the Government of Japan through the Japan Trust Fund for Scaling Up Nutrition. 

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WHO Re-appoints Dr Matshidiso Moeti For Another Term As the Regional Director For Africa


|| Wednesday: February 05: 2020 || ά. The WHO Executive Board, currently holding its 146th session in Geneva, has re-appointed Dr Matshidiso Moeti for a second term as WHO Regional Director for Africa and Dr Hans Kluge as Regional Director for Europe in his first term. “I am greatly honoured to have been appointed to serve a second term as the WHO Regional Director for Africa and I would like to thank you for the trust you have shown.” said Dr Moeti.

“As Africa increasingly faces the double burden of diseases, the next five years in public health will be crucial in laying a strong foundation to reverse this burden.” Dr Moeti, who is from Botswana, said that she would accelerate action towards attaining universal health coverage so that everyone can access care without financial hardship. Despite significant health challenges in the African region, which serves 47 countries, progress is being made in strengthening health systems, combating diseases and improving people’s health. Recent efforts by Member States include policies to tackle tobacco use, vaccines for cervical cancer and Malaria prevention, as well as, joint initiatives to procure medicines affordably.

As the first woman WHO Regional Director for Africa, Dr Moeti was elected as WHO Regional Director for Africa on February 01, 2015. In 1999, she joined the WHO Regional Office for Africa and has served as Deputy Regional Director, Assistant Regional Director, Director of Non-communicable Diseases, WHO Representative for Malawi, Co-ordinator of the Inter-Country Support Team for the South and East African countries and Regional Advisor for HIV:AIDS.

Before joining WHO, Dr Moeti worked as Team Leader of the Africa and Middle East Desk in Geneva, 1997-1999 with the Joint United Nations Programme on HIV:AIDS:UNAIDS. She, also, worked with the United Nations Children's Fund:UNICEF as Regional Health Advisor for East and Southern Africa and with Botswana’s Ministry of Health as a clinician and public health specialist.

Dr Moeti holds a degree in Medicine, M.B.B.S and a Master’s degree in Public Health, MSc in Community Health for Developing Countries, from the Royal Free Hospital School of Medicine, University of London and the London School of Hygiene and Tropical Medicine, respectively. She was awarded an Honorary Fellowship of the London School of Hygiene and Tropical Medicine and an Honorary Doctorate from the University of Health and Allied Sciences, Ghana.

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Tackle the Unacceptable Inequalities Between Cancer Services in Rich and Poor Countries: This Could Save Seven Million Lives: When Will the World Accept That Without Universal Healthcare There’s No Other Way to Get Health Equality So That Diseases Like Cancer Does Not Become a Death Sentence to the Poor Millions in the Poorer Countries Which Is What It Is Now


|| Tuesday: February 04: 2020 || ά. Global cancer rates could rise by 60 per cent over the next 20 years unless cancer care is ramped up in countries with low and middle income, the World Health Organisation:WHO has warned. Less than 15 per cent of these nations offer comprehensive cancer treatment services through their public health systems, compared with more than 90 per cent among their richer counterparts, according WHO.

“At least seven million lives could be saved over the next decade, by identifying the most appropriate science for each country situation, by basing strong cancer responses on universal health coverage and by mobilising different stake-holders to work together.” said Dr Tedros Adhanom Ghebreyesus. WHO Director-General. Seven million lives: how massive a number of human lives can be saved from death! Only, if, there’s Universal Health Coverage, that has the required investment for the level and degree of challenge!

Coinciding with the World Cancer Day, Tuesday, February 04, WHO and it’s specialised International Agency for Research on Cancer:IARC have released two Reports: one aimed at setting the global agenda on the disease; the other focused on research and prevention. The Reports highlight numerous proven interventions, such as, controlling tobacco use, which is responsible for a quarter of all cancer deaths, vaccinating against hepatitis B to prevent liver cancer and eliminating cervical cancer by vaccinating against HPV.

“This is a wake-up call to all of us to tackle the unacceptable inequalities between cancer services in rich and poor countries.” said Dr Ren Minghui, the WHO’s Assistant Director-General, overseeing Universal Health Coverage policy, as well as, communicable and non-communicable diseases.

“If, people have access to primary care and referral systems, then, cancer can be detected early, treated effectively and cured. Cancer should not be a death sentence for anyone, anywhere.”

While the Reports show that progress can be achieved, the challenge will be for countries to select cancer treatments taking into consideration cost, feasibility and effectiveness. Dr Elisabete Weiderpass, the IARC Director, said that there had been tremendous advances in cancer research over the past five decades, leading to a reduction in deaths.

She said, ‘’High-income countries have adopted prevention, early diagnosis and screening programmes, which together with better treatment, have contributed to an estimated 20 per cent reduction in the probability of premature mortality between 2000 and 2015 but, low-income countries only saw a reduction of five per cent. We need to see everyone benefitting equally.”

::: Caption: A Research Assistant, left, receives training from a Biologist at the National Cancer Institute of Columbia: Image: PAHO:Jane Dempster :::

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The Chinese Novel Corona Virus 2019: The Facts and Evidence So Far


|| Monday: February 03: 2020 || ά. A new strain of corona virus, officially, named, 2019-nCoV, which has caused respiratory diseases in China and spread to, at least, 23 other countries, has been declared a Public Health Emergency of International Concern:PHEIC by the World Health Organisation:WHO. Here are the basic facts about the virus for people to know. At least, 361 people have died from the Novel Corona Virus, which first appeared in the Chinese city of Wuhan in December 2019.

More than 17,200 cases have been confirmed in China and according to experts, the numbers of people being infected by the virus is expected to rise in the coming weeks. Although, the vast majority of cases have been in China, the virus, which can cause Pneumonia, is worrying global health authorities. Some 151 cases have been confirmed in 23 countries and the first death outside of China was recorded in The Philippines. Most of those, affected by the virus had travelled from Wuhan, the epicentre of the outbreak.

A public health emergency of international concern is declared by the WHO, which is declared in cases of ‘an extraordinary event’, which constitutes ‘a public health risk to other States through the international spread of disease’ and ‘potentially, requires a co-ordinated international response’. This definition implies a situation, that is ‘serious, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action’.

Speaking at a meeting of the WHO Executive Board on Monday, the Agency’s Director-General, Dr Tedros Adhanom Gebreyesus, explained that the decision to announce a PHEIC was made because of signs of human to human transmission outside China and WHO’s concern regarding what might happen, if, the virus were to spread in a country with a weaker health system.

Dr Ghebreyesus, also, noted the importance of containing the virus in China. He said, “If, we invest in fighting at the source, then, the spread to other countries is minimal and, also, slow. If, it’s minimal and slow, what is going outside can, also, be controlled easily. It can get even, worse. But, if, we give it our best, the outcome could be, even, better.”

Several countries have, already, put travel restrictions in place but, Dr Ghebreyesus pointed out that WHO is not recommending measures, that unnecessarily interfere with travel and commerce.  

What is a Corona Virus: Corona Viruses consist of a core of genetic material, enclosed within an envelope of protein spikes, which resembles a crown or, in Latin, corona. They are a large group of viruses, that cause respiratory diseases and, sometimes, gastrointestinal symptoms.

Diseases can range from the common cold to Pneumonia, which can be fatal. In most people symptoms are mild but, some types can cause severe disease. These include Severe Acute Respiratory Syndrome:SARS, first discovered in China in 2003 or Middle East Respiratory Syndrome:MERS, which originated in Saudi Arabia in 2012. MERS caused more than 2,400 cases and 850 deaths and more than 800 people were killed by SARS.

It has been estimated that 20 per cent of patients, infected with the novel corona virus 2019-nCoV have severe symptoms. People, who have other health problems, such as, Asthma, Diabetes and cardiovascular disease are, particularly, vulnerable.

How deadly is Novel Corona Virus: As of Monday February 03, 361 people had died from Novel Corona Virus:2019-nCoV. This represents about two per cent of cases. By comparison, around 25 per cent of MERS cases resulted in the death of the patient.

However, at this stage, it is still too early to determine how deadly the virus is: thousands of patients are being tested, with around 2,110 in a serious condition and it is not yet known how these cases will evolve.

Where does the virus come from: The first cases of Novel Corona Virus occurred in a group of people with Pneumonia, linked to a seafood and live animal market in Wuhan, where many fish, reptiles, bats and other live and dead animals were traded. The disease, then, spread from those, who were sick, to family members and healthcare workers.

Corona Viruses circulate in a range of animals and can, sometimes, make the jump from animals to humans, via a process known as, a ‘spill-over’, which can occur due to a mutation in the virus or increased contact between animals and humans.

It is not yet known how Novel Corona Virus was first transmitted to humans: in the case of MERS, it is known that people caught the virus via direct or indirect contact with infected camels and SARS originated in civet cats.

Is the virus transmitted from person to person: The transmission of the virus from person to person has occurred mainly in the city of Wuhan, the epicentre of the outbreak but it occurred in other parts of China and outside the country as well.

The exact way that the disease is transmitted is yet to be determined but, in general, respiratory diseases are spread via drops of fluids when someone coughs or sneezes or by touching a surface infected with the virus. According to Chinese scientists, people, who get the virus are contagious, even, before they show symptoms. The incubation period, the period from when the infection occurs until symptoms develop, is between one and 14 days.

How fast is the virus spreading: A large number of new cases are being reported on a daily basis, in the 24 hours period between February 01 and February 02, for example, over 2,590 new cases were confirmed in China but, this is not surprising, as more and more controls are being put in place to detect and confirm infections.

The total number of cases is expected to be much greater in the coming weeks.

What can I do to protect myself: There is no vaccine currently available to treat Novel Corona Virus but, WHO is recommending several precautionary and hygienic measures.

For example:

::: Avoid direct contact with people, suffering from acute respiratory infections,

::: Wash your hands frequently, especially, after direct contact with sick people or their surroundings,

::: Avoid direct contact with farm animals or wild animals, living or dead,

::: People with symptoms of a severe respiratory infection should try to keep their distance from other people and cover their nose and mouth when sneezing or coughing.

Detailed information on Novel Corona Virus, including, daily situation reports, can be found on the WHO website.

The best advice is to seek, find and read information from bona fide agencies and organisations, such as, the World Health Organisation about any of the issues, relating to the development of this virus.

::: Caption: A digital illustration of the Corona Virus shows the crown-like appearance of the virus: Image: Centres for Disease Control and Prevention :::

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Urgent Need For Immediate Solutions to Combat Drug-Resistant Infections: WHO



|| Wednesday: January 22: 2020 || ά. Drug-resistant infections are on the rise as private investment in new antibiotic development declines, the World Health Organisation:WHOsaid on Friday. Two new WHO reports show that, while some 50 new antibiotics and 10 biologics are under development, only 32 of the total target WHO-priority pathogens and the majority have very limited benefits when compared to existing antibiotics.

The reports, further, found that antibiotics research and development was, primarily, driven by small or medium-sized enterprises, as large pharmaceutical companies continue to exit the field. “Never has the threat of anti-microbial resistance been more immediate and the need for solutions more urgent.” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Numerous initiatives are underway to reduce resistance but, we, also, need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”

With the aim of encouraging the medical research community to develop treatments for resistant bacteria, in 2017, WHO published a list of 12 classes of bacteria, added with these are tuberculosis, that were resistant to most existing treatments and, thus, increasingly, jeopardise human health.

Of the antibiotic agents in the pipeline, only, a precious few target the rapidly spreading, multi-drug resistant Gram-negative bacteria. Gram-negative bacteria, such as, E-coli, can cause severe and, often, deadly infections, that, particularly, threaten people with weak or not-yet-fully-developed immune systems, including, the new-borns, the elderly and people undergoing cancer treatment.

“It’s important to focus public and private investment on the development of treatments, that are effective against the highly resistant bacteria because we are running out of options.” says Mr Hanan Balkhy, WHO Assistant Director-General for Antimicrobial Resistance.  “And we need to ensure that once we have these new treatments, they will be available to all, who need them.”

The pre-clinical pipeline shows more innovation and diversity, with 252 agents under development to treat WHO-priority pathogens. However, these products are in the very early stages and still need to be proven safe and effective. Forecasts suggest the first two to five products will not become available for another 10 years, according to the report.

On a more positive note, the pipeline for anti-bacterial agents to treat Tuberculosis and Clostridium Difficile, which causes diarrhoea, is more promising, saying that more than half of the treatments fulfil all WHO-defined innovation criteria.

However, WHO makes clear that new treatments alone will not be sufficient to combat the threat of anti-microbial resistance and its scientists are working with countries and partners to improve infection prevention and control.

With the goal of delivering five new treatments by 2025, WHO and the Drugs for Neglected Diseases Initiative have established a non-profit research and development organisation, called, the Global Antibiotic Research and Development Partnership, to develop new and improved antibiotics, that tackle drug-resistant infections.

The enterprise is currently working with more than 50 public and private sector partners in 20 countries to develop and ensure sustainable access to treatments.

::: Caption: A medical illustration depicts the drug-resistant, Mycobacterium Tuberculosis Bacteria: Image: CDC:Alissa Eckert and James Archer ::: .