October 23rd 2008
This week in medicine
The following will appear in the Oct 25 issue of The Lancet:
Infant deaths The US infant mortality rate fell by 2% between 2005 and 2006, according to the US Centers for Disease Control and Prevention, but is still 50% higher than the national goal of 4·5 deaths per 1000 births. The decline is the first since 2000, a delay which is attributed to increased preterm births and associated complications. Infant mortality rates were substantially higher (2·4-fold) in non-Hispanic black women, than in non-Hispanic white women.
Praise Uganda Female genital mutilation (FGM) has been banned by the Sabiny, the only remaining community in Uganda still practising the act. The local Kapchorwa district council is lobbying parliament to make the ban part of national law. The ban, encouraged by last year’s UN resolution against FGM, has been enforced just before the start of the seasonal tribal ritual of the procedure.
Vitamin D The American Academy of Pediatrics now recommends doubling its previously recommended dose of vitamin D for infants, children, and adolescents. New clinical trials show that 400 IU daily can prevent and treat rickets and could boost immunity and reduce risk of osteoporosis later in life.
HIV in Iran The number of people infected with HIV/AIDS in Iran has reached 18 320-a 30% increase on the 2007 figure. So far, 1592 of those infected with HIV have developed AIDS and 2800 have died. 93·7% of infections were in men. Intravenous drug use is believed to be responsible for the increase.
European care Inequalities in cancer care are common across Europe, according to a survey released by the European Society for Medical Oncology. Icelanders have access to 35 medical oncology facilities whereas Belgians have only one. Less than a third of European countries require cancer specialists to continue their medical education after graduation. Undergraduate teaching of palliative care now takes place in just over half of countries, compared with 28% in 2006.
Food prices In a report released on Oct 16, World Food Day, Oxfam announced that small farmers in developing countries have not benefited from increased food prices as they should. The report, Double Edged Prices, places the blame on flawed trade and agricultural policies that have weakened the position of these farmers in international markets, allowing large traders to profit from rising food prices while small farmers miss out.
Strike in Kosovo Thousands of doctors are on strike in Kosovan state hospitals after failing to reach an agreement with the government about better working conditions and pay. The Health Trade Union claims that the strike will continue until demands are met, including a 50% pay rise and the introduction of health insurance laws by parliament.
NIH freezes grant The US National Institutes of Health has frozen a US$9·3 million research grant to Emory University psychiatrist Charles B Nemeroff, for research involving drugs made by GlaxoSmithKline (GSK). A Congressional inquiry claims that Nemeroff failed to report $500000 in payments from GSK.
Anthrax outbreak 37 people have been infected with anthrax in northern Iraq. As yet, there have been no resulting deaths from what is the first outbreak of the disease in Iraq since the 1980s. Experts believe that the infection was passed to people via livestock, and the authorities have ordered that all affected animals be killed.
Global Health Watch The new alternative to WHO’s World Health Report, Global Health Watch 2, was launched in London on Oct 16, followed by launches in around 20 other countries. The report calls for radical moves to address climate change, growing poverty, and poor health. The first edition of Global Health Watch, published in 2005, was hailed for its ground-breaking analysis and mobilising call to action.
World Bank reform The USA will no longer be solely able to appoint the next president of the World Bank after a deal brokered by the UK’s development secretary Douglas Alexander secured a fairer appointment system. Candidates from any country can now be selected for the post at the world’s leading global health and development institute-a reform for which developing countries have long been calling.
Managing waste Medical waste from private and government hospitals in the Afghan capital Kabul is being left in dumps and open dustbins where poor children often scavenge, posing a serious threat of infection. Regulation is scarce and there is no practical method of disposal in place. Over 60 hospitals have no incinerator, and Kabul Municipality, which already struggles to manage the city’s volume of waste, has no specialised equipment to handle disposal.
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