The following will be published in the March 13 issue of The Lancet:

Testing times The UK’s General Medi­cal Council has launched a public consultation on the long-discussed proposal for a new licensing procedure for doctors. The process, known as revalidation, would involve a yearly appraisal of a doctor’s fitness to practise, supported by feedback from colleagues and patients. The consultation closes on June 4.

Doctors come home Authorities in Wasit Province, central Iraq, are offer­ing financial incentives, a car, and housing allowances to specialists such as anaesthetists, cardiologists, and gynaecologists to try to get them to return to local health facilities. Many doctors have fled to the more peaceful northern parts of Iraq or abroad because of violent conflict and crime.

Nutrition claim slap Ahead of plans to tighten up the labelling of foods, the US Food and Drug Administration has made public dozens of stiff warning letters that it issued recently to several foodmakers with respect to “unauthorized nutrient content claims” on product labels and websites. Some claims about health benefits were so extreme as to count some products as drugs.

Ecuadorian achievement Ecuador has become the second nation in the Americas to stop the transmission of onchocerciasis, according to the country’s Ministry of Health and the Onchocerciasis Elimination Program in the Americas (OEPA). Colombia interrupted transmission in 2008, and now only four nations in the region—Brazil, Guatemala, Mexico, and Venezuela—remain endemic. The OEPA seeks to stop transmission in these countries by 2012.

Mongolia winter crisis As heavy snow and temperatures of –50°C con­tinue to affect Mongolia, aid efforts have been redoubled. UNICEF and the government have airlifted emergency and edu­cational supplies to schoolchildren, while mobile medi­cal teams supported by WHO and UN agencies have been delivering support to pregnant women and newborn babies in remote areas.

Migrant health How to improve access to health care for hundreds of millions of international and inter­nal migrants was addressed last week at a meeting in Madrid, Spain. Convened by WHO, the International Organization for Migration, and the Spanish Govern­ment, the meeting called for more partnerships across sectors and be­tween countries affected by migration.

Child marriage UNICEF is supporting a new movement against child mar­riage, launched by children in West Bengal, India. Amar Shaishab Amar Adhikar (My Childhood, My Right), has released a manifesto, which for the first time collected children’s views on child marriage and suggested points of action for parents, teachers, and communities.

Prostate cancer screening In the wake of controversy about the benefit of screening strategies in reducing the burden of prostate cancer, the American Cancer Society’s new guide­lines, released on March 3, emphasise the importance of involving men in the decision to be tested. The guidelines suggest starting the screening discussion at different ages, dependent on the man’s risk.

Mudslide deaths Mudslides in eastern Uganda have left 80 people dead; hundreds more are missing after several days of torrential rains. The UN Office for the Coordination of Humanitarian Affairs, which has dispatched two teams to assess the situation, stated that immediate health needs include first aid and support in accessing medical facilities.

Environmental health European government ministers met in Parma, Italy, this week to discuss emerging environmental health challenges, with a focus on children. Four general areas—water and sanitation, physical activity, air quality, and protection from chemicals—were discussed in the broader context of socioeconomic and gender inequalities, extreme weather events, and the financial downturn.

Kenya health insurance Social health insurance in Kenya could be reality this year after the National Economic and Social Council accepted a proposal to transform the National Hospital Insurance Fund into a National Social Health Insurance Scheme for outpatient treatment. This reform could help millions of Kenyans who are currently only covered for in-patient treatment costs.

Pill power Could a glowing pill-bottle lid be a solution to the problem of  non-compliance? One such product is about to be tested in a small trial. When it is time to take a tablet, the top of the bottle glows orange. Pro­crastinate, and it will beep with in­creasing urgency. Ignore, and a wireless transmitter could inform your doctor.

The following will appear in the March 6 issue of The Lancet:

Earthquake hits Chile One of the biggest earthquakes in a century, measuring 8·8 on the Richter scale, hit Chile last week, killing at least 708 people, destroying buildings, and triggering a tsunami that threatened Pacific coastlines. President Michelle Bachelet estimated that the economic damage could be up to US$30 billion, equivalent to about 15% of Chile’s gross domestic product.

Road safety On March 2, the UN General Assembly met to discuss a new resolution on road safety. A proposed plan of action called on member states to tackle rising trends in road traffic deaths and injuries worldwide by increasing resources for road safety, targeting the most common causes of road traffic crashes, and setting targets for reduction of fatalities.

Prescription placebos The formal licensing and government fund­ing of homoeopathic treatments has been denounced by the UK’s Science and Technology Committee. Lack of evidence of the efficacy of homoeopathic treatments means that they should not be labelled as medicines, the Committee declared. Such actions “lend a spurious medical legitimacy to homeopathic products”.

India’s health budget In its 2010–11 budget, the Indian Government has earmarked US$4·82 billion for health (an increase of 8·3% from 2009). An annual health survey will be done to map the district health profile of the rural population. AIDS control, mental health programmes, prevention of diabetes and heart disease, and the shortage of health-care workers were all allocated increased funds.

Science lessons A report by the UK’s Science and Learning Expert Group has called for school science lessons to be made more exciting by adding more experiments to the classrooms. The report, commissioned by ministers, also advises the government to increase the salaries of science and mathematics teachers to attract more specialists into teaching.

Child poverty The number of Egypt­ian children living in poverty is increasing, according to UNICEF and the Egyptian Govern­ment. The country’s economic growth is failing to keep up with the rapidly rising population, leaving 23% of children younger than 15 years with less than US$1 per day. The report calls on Egypt to invest in education and to introduce special laws for the protection of children.

Misuse control Misuse of prescription drugs is on the increase, according to the International Narcotics Con­trol Board. Public ignorance about the risks associated with misuse of pain medication, and the distribution of drugs via illegal internet pharmacies, were highlighted. However, the danger that patients could be denied legitimate pain relief by overly rigorous policies was also recognised.

Drug R&D in Africa African policy makers were urged to improve drug research, production, and access to essential medicines at the African Expert Meeting on Pharmaceutical Innovation in Africa, which took place in South Africa on Feb 18–20. Although around 120 proposals for research and development are in place, initiatives are uncoordinated and long-term plans are scarce.

Going too far? A series of sexually suggestive anti­smoking posters by pressure group Les Droits des Non-fumeurs has sparked controversy in France. The posters, which have been circulated to the press, depict teen­agers in sub­missive sexual positions, and bear the slogan “Smoking is to be a slave to tobacco”. Smoking in 13–15-year-olds increased by 66% in France during 2004–08.

Dengue alert At least 20 years after its last registered case of dengue fever, Queensland, Australia, has announced its first locally acquired case. In an effort to contain the disease within one town, a team of mosquito controllers has been called and the population has been advised to thoroughly clean in and around their homes to reduce mosquito breeding sites.

Lobbying rules The Danish pharma­ceutical industry association, Lif, has issued a new code of conduct for its members to follow when lobbying decision makers such as health technology appraisal bodies. Stakeholders will be encouraged to learn that Lif members must not provide incorrect or misleading infor­mation nor use personal issues to exert pressure.

Round hole, square peg? The Ameri­can Academy of Pediatrics has recom­mended a redesign of the humble hot dog. The fast food results in the choking-related treatment of 15 000 youngsters in the USA every year. Experts say square-shaped hot dogs could save lives. But other foods, such as grapes, also pose a risk, according to the Academy. Sadly, their redesign might prove more difficult.

The following will be published in the February 27 issue of The Lancet:

More broken promises Last week the Organisation for Economic Co-operation and Development released a review of aid performance of its member countries for 2010. Although overall aid will reach a record high of US$107·4 billion, it is $21 billion short of the amount originally pledged in 2004. Countries not reaching their projected goals include France, Germany, Austria, Italy, Greece, and Portugal.

Organ awareness In an attempt to overcome the shortage of compatible donors in the UK, a campaign to raise awareness about organ donation in black and south Asian communities has been launched by NHS Blood and Transplant. Currently, black and south Asian patients wait nearly twice as long as does a white person for a compatible organ.

Niger famine 5 years ago, an extreme famine in Niger was largely ignored by the international community (despite pleas from aid agencies) until the media got involved. Worryingly, 7·8 million people—two-thirds of Niger’s population—are now facing extreme food insecurity. This time, pleas for international help should not be ignored.

Syrian seizure Syria has shut down a group of counterfeit drug manu­facturers and traders operating in the country and exporting fake drugs to Iraq, Turkey, Lebanon, Iran, and Egypt. Syrian officials also seized fake medicines and equipment used to produce the counterfeits. 65 people, including smugglers and pharmacists, have been arrested in connection with the case and await trial.

Waste disposal The UN Industrial Development Organization (UNIDO) and the Government of India have teamed up to help to improve disposal of hazardous medical waste in India. The 5-year, US$40-million project will use environmentally friendly methods such as microwave and autoclave to reduce persistent organic pollutants. UNIDO’s Director-General also appealed to the private sector to reduce the burden on hospitals.

Info or ad? An opinion from an Advocate General of the European Court of Justice might mean that the Information to Patients strand of the EC’s Pharmaceutical Package (which some have regarded as direct-to-consumer drug advertising by another name) might now become law. But the ruling is vague, relying on the “deliberate and direct intention” of drug companies to give information versus advertising.

Extreme poverty A joint report by the UN Economic and Social Commission for Asia and the Pacific and the UN Development Programme states that the global economic downturn could push 21 million people in the Asia-Pacific region into extreme poverty.  Asia has weaker social protection programmes in place than do other regions such as Latin America and eastern Europe.

Patent care The US Patent and Trademark office has upheld a previous decision that an element of Pfizer’s Viagra (sildenafil) is not a new invention and so cannot be patented. Seemingly sildenafil works in a similar way to the Chinese herb yin yang huo, otherwise known as horny goat weed, which is sold via the internet.

Pay for performance The World Bank has released the results of a study on the use of pay-for-performance (P4P) medicine in low-income countries. The study examined the effect of P4P on maternal and child health services such as facility-based childbirth and scheduled vaccination in Rwanda, and concluded that financial performance incentives are capable of improving both the quantity and quality of health services.

Nurse prescribing Finnish nurses could soon be able to prescribe drugs for the specific medical conditions in which they have been trained, with authorisation from a supervising doctor. The bill, currently being con­sidered by the Finnish Parliament, is expected to improve the efficiency of services in health centres and to slow down the increasing demand for physicians.

New drug registration A report by the Drugs for Neglected Diseases Initiative outlines recommendations to improve registration of new drugs in Africa. These include closer collaboration between high-income and low-income countries, further involvement of WHO, and the establishment of regional centres of excellence to assess the safety, efficacy, and quality of new drugs for the specific populations most affected by neglected diseases.

Medical drama Canadian researchers have revealed the shocking fact that medical dramas on television are not the best source of information about first aid, especially when it comes to seizures. The researchers spent many a gruelling hour watching episodes of House MD, ER, Grey’s Anatomy, and Private Practice, and found that 46% of depictions of seizure care involved inappropriate actions such as putting something into the patient’s mouth.

Human-rights groups are concerned for the welfare of 43 Filipino health workers who were arrested by government forces while attending a training seminar. Margaret Harris Cheng reports.

Typhoon Ketsana, the massive storm that wreaked havoc in the Philippines, continues to have consequences. But for a group of 43 community health workers, nurses, and doctors now languishing in a military prison, the consequences were way beyond their worst nightmares.

The group was taking part in a week-long training seminar organised by the Community Medicine Foundation, to build first-responders capacity at provincial level, so the effects of disasters like Ketsana could be mitigated.

Participants had come from all parts of the Philippines to a farm in Rizal, east of Manila, owned by Melecia Velmonte, a leading infectious diseases specialist who regularly lends her farm to medical organisations for conferences, training sessions, and meetings.

But the Armed Forces of the Philippines, viewed the seminar as something entirely different. They insist that what was going on was a terrorist training camp where participants were being trained to make explosives. At first light on Feb 6 they swooped on the farm to achieve what they described as their biggest-ever mass arrest of insurgents.

“Around 6.15 am, 300 heavily armed elements of the military and police forced their way into the farm”, says a report released by the human rights Karapatan (whose deputy general secretary is married to one of the doctors arrested during the raid).

“At gunpoint, the military forced the caretaker to open the gates. Inside, the soldiers fanned out to different directions. They also kicked the main door to get into the building.”

“When Dr Velmonte and her son, Bob demanded for a search warrant, they were merely brushed aside by the military. All medical practitioners and health workers, were ordered to line up at the garage, frisked, and handcuffed…The male victims were then blindfolded with old shirts brought in by the soldiers and secured with packaging tape. All of the personal belongings of the victims were also taken by the military.”

While the medical workers waited outside, cuffed and blindfolded, wondering what would happen next, the soldiers searched their sleeping quarters. There they found, according to an official announcement made later that day, C4 (composition 4) explosives, a gun with seven bullets, and three hand grenades. One of the grenades was allegedly found under someone’s pillow.

“Would you hide a grenade under your pillow?” asked Roneo Clamor, husband of one of the detainees, Mary Mia-Clamor, during a press conference held by relatives and friends to demand that the 43 individuals be freed immediately.

Their demands fell on deaf ears. The health workers remain locked up in a military camp in Rizal—the women all in one room, the men in smaller cells in ones and twos. Relatives who have been able to see them for short periods say they have been tortured, and subjected to lengthy interrogation, sleep deprivation, and, in some instances, sexual abuse.

Their military captors say the interrogations have yielded evidence that some were involved in attempts to abduct senior commanders involved in counter-insurgency operations. However, this has yet to be tested legally. The Philippines’ supreme court issued a writ of habeas corpus commanding the military to produce the 43 in court on Feb 12, but they did not, citing a “lack of resources”. They eventually produced the health workers in court on Feb 15.

To outsiders the two versions—a disaster medicine training seminar and a terrorist training camp—are so far apart, the arrests seem absurd. But those familiar with the extrajudicial arrests, detentions, and killings often done in the name of counter-insurgency by a powerful, well funded military poorly controlled by the judiciary or the elected government, are not surprised.

Doctors who choose to become community health specialists and work with poor people in the provinces, are automatically considered leftists and targeted. “It’s sending a really bad message—not only to the health sector…we already have problems with our health-care delivery and now doctors are frightened of going to the provinces”, said Gene Nisperos of the Health Alliance for Democracy.

Margaret Harris Cheng