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Welcome to The Lancet Global Health Network. As a leading independent journal of global medicine, The Lancet is committed to advancing health for all people around the world. We publish research aimed at changing medical practice and adding informed analysis and opinion to scientific and policy debates. The aim of this site is to bring together international scientific and public-health experts. The network is an official publishing partner of International Health, a journal of the Royal Society of Tropical Medicine and Hygiene.

May 19th 2010

This week in medicine

The following will be published in the May 22 issue of The Lancet:

Childhood obesity As part of US First Lady Michelle Obama’s Let’s Move campaign, President Barack Obama established the Task Force on Childhood Obesity, which has now released a report outlining action plans and identifying key bench­marks. Recommendations include encouraging breastfeeding, reducing children’s “screen time”, and improving nutritional labelling of foods.

Research crisis After two decades of financial neglect, clinical research in South Africa is in serious decline, according to the country’s Academy of Science. The lack of government funding is driving researchers towards more lucrative options and the pharmaceutical industry. The Academy is calling for a national funding scheme with 2% of gross domestic product going towards research.

CVD differences In recognising health inequalities as a “key challenge in the battle against cardiovascular disease”, the British Heart Foundation has released a report on ethnic differences in the disorder in the UK today. Salient findings include the fact that the risk of myocardial infarction is highest for people of south Asian origin, and that as many as 40% of Bangladeshi men smoke (compared with 25% overall).

HIV blood screening In China, the Ministry of Health plans to tighten blood screening for HIV, including introducing RNA tests, which will cost up to an extra 1 billion yuan (US$146 million), and expanding the current 7335 voluntary clinics for HIV testing and counselling. Each year, around ten people contract HIV through blood transfusion in China.

French food The French Ministry of Health has announced some positive results from its healthy eating and living programme. Since 2000, the population has reduced its sugar intake and followed advice on healthier eating habits. A new plan focuses on further action in disadvantaged areas, promotion of physical activity, and undernutrition in older people.

Caribbean pact Last week saw the signing of phase II of an AIDS response partnership agreement between the USA and the Caribbean Community. Over the next 5 years, 14 Caribbean states will receive up to US$25 million from the President’s Emergency Plan for AIDS Relief towards prevention, laboratory strengthening, strategy, capacity building, and sustainability.

Commemorative chapel The Nurses’ Chapel in Westminster Abbey, Lon­don, UK, has been renamed the Nightingale Chapel after “exemplary Christian” and iconic figure of nursing, Florence Night­ingale. The dedication took place as part of a ceremony to mark the centenary of her death. This is the first chapel within the abbey to be named after an individual who is not a saint or member of Royalty.

Reproductive health The World Bank has released a new 5-year Reproductive Health Action Plan to help 58 countries with high maternal mortality and fertility rates achieve Millennium Development Goal 5. The Bank will increase funding and focus on promoting contraception, increasing access to antenatal care, educating women about prevention, and training new health-care workers.

Bad ads The US Food and Drug Ad­ministration has launched a campaign to encourage doctors to blow the whistle on inappropriate drug mar­keting. The Bad Ad Program aims to help doctors recognise and report advertisements that are inaccurate, unbalanced in terms of risks and benefits, inconsistent with prescribing information, or that are not supported by evidence from clinical studies.

Rights move The UN High Com­mis­sioner for Human Rights, Navi Pillay, has expressed her en­couragement at Japan’s recent moves towards a more rights-based society. After a 3-day visit to the country, she praised the Government’s com­mitment to improving the treatment of people with leprosy, and its intention to set up an independent national human rights institution.

Anti-violence law Timor-Leste has passed a law against domestic violence, which calls for police to investigate domestic violence crimes and provides victims with emergency medical treatment, shelter, psychosocial support, and legal services. Domestic violence has been a crime in the country since 2009 but the existing legislation failed to define the crime and call for the provision of support services.

Poppy blight A fungus that destroys poppy plants has infected about half of Afghanistan’s crop, according to Antonio Costa, head of the UN Office on Drugs and Crime. Poppies are used for opium production, to which Afghanistan contributes 92% worldwide. The reduced yield this year could cause opium prices to go up by 50%, Costa said.

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May 12th 2010

This week in medicine

The following will appear in the May 15 issue of The Lancet:

New at UNICEF Anthony Lake has been sworn in as the sixth Executive Director of UNICEF. Lake started his career in foreign policies in 1962 and has had extensive experience in international development since. He played an important part in policies that led to peace in Bosnia and Herzegovina and was a senior foreign policy adviser to Barack Obama’s presidential campaign in 2008.

Undernutrition crisis 7·2 million people in Yemen are suffering from chronic undernutrition; yet despite 3·4 million of those people requiring food aid, only 475 000 are receiving it, according to UN aid agencies. These statistics are a result of a slash in food rations because of a drop in donor funding. The agencies warn that increasing food shortages could lead to social unrest and mass migration.

Templeton winner On May 6, Francisco J Ayala–an evolutionary geneticist at the University of California and former Dominican priest–was awarded the £1 million Templeton Prize for entrepreneurs of the human spirit at Buckingham Palace in London, UK. Ayala believes that science and religion are often complementary. He donated the prize money to his university’s graduate education programme.

Mental health China is to establish its first electronic mental health records for the survivors traumatised by the earthquake in Sichuan province in 2008. Local doctors are receiving training so that they can diagnose and treat mental illnesses in the simplest and most practical ways.

Indigenous progress Economic growth and poverty reduction in some countries has helped their Indigenous people to achieve better outcomes in terms of poverty, health, and education, according to a World Bank report. However, there is still a poverty gap between Indigenous and non-Indigenous people, and whereas the gap is narrowing in China, it is stable or widening elsewhere.

Men’s health The Australian Govern­ment has launched its first National Men’s Health Policy. Australian men have one of the highest life expectancies in the world, but are more likely to die from chronic diseases than are Australian women. The policy’s priorities include health equity within the male popu­lation, preventive health, and access to health care.

Violence victim support The US President’s Emergency Plan for AIDS Relief (PEPFAR) has committed to pro­vide US$30 million to Mozambique, Tanzania, and the Democratic Republic of Congo  to support victims of sex-based violence. PEPFAR hopes to see these countries set up further prevention programmes, make them more accessible to the population, and increase their efficacy.

Orphan birthday On May 3–4, the European Medicines Agency held a meeting at its London offices to celebrate 10 years of orphan drug regulation in Europe. Since the legislation was passed in 2000, 62 orphan drugs (ie, those designed for diseases that affect fewer than five people per 10 000) have been approved in the European Union.

Measles support Zimbabwe is to receive US$5·6 million from the UN Central Emergency Response Fund to protect 5 million children from the measles epidemic. UNICEF will use $3·5 million to provide logistical support to the nationwide campaign, and $2·1 million will go to WHO to support microplanning activities and refresher training.

Paediatric drugs recalled The US Food and Drug Administration has reported serious quality-control concerns at a plant producing common paedi­atric medicines. The McNeil plant had used contaminated raw materials and had not investigated customers’ complaints about foreign matter in its drugs. The company has voluntarily recalled 43 over-the-counter drugs, including Tylenol and Benadryl.

Snakebite guidelines WHO has released new guidelines on snake antivenoms. The guidelines are aimed at helping public health officials decide what antivenoms are needed in their country and in drafting relevant national public health policies. An associated database for the global distribution of venomous snakes is aimed at increasing awareness among the general population.

Foundation fraud The Prince’s Found­ation for Integrated Health, a comple­mentary health charity supported by the UK’s Prince of Wales, has been shut down in the wake of fraud and money-laundering allegations. Although a spokesperson said that closure was planned, since the foundation had met its main aim to promote integrated health, the scandal charges had expedited its dissolution.

May 5th 2010

This week in medicine

The following will appear in the May 8 issue of The Lancet:

Free health care Sierra Leone is seek­ing to improve maternal and child health by providing free health care to pregnant and lactating women and to children younger than 5 years. The government has increased the number of nurses trained per year, and improved health workers’ salaries in preparation for the increased numbers of patients seeking health care.

Resuscitation risk The UK’s National Patient Safety Agency (NPSA) has issued a “signal” about incidents in which newborn babies who required resusci­tation after birth had been at risk either because resuscitation equip­ment or the correct drugs in the right dose were unavailable. The NPSA has received 622 such incident reports since 2003, 11 of which resulted in serious harm or death of the newborn baby.

HIV/AIDS campaign The South African Government has launched its eagerly anticipated expansion of HIV/AIDS testing, treatment, manage­ment, and prevention services in a new campaign. By June, 2011, the aim will be to test 15 million residents. With more people in South Africa being infected by HIV/AIDS than in any other country, the increased efforts by the government are much needed.

Kickbacks kicked back AstraZeneca has agreed to pay US$520 million after federal investigations into whether they had paid doctors to promote Seroquel (quetiapine), a schizophrenia drug, for use in children, elderly people, veterans, and prisoners. AstraZeneca reported Seroquel sales of more than $4·9 billion last year, and the drug is the fifth best-selling worldwide.

Compulsory licensing The Govern­ment of Ecuador has ordered the compulsory licensing of the currently patented antiretroviral Kaletra (lopin­avir plus ritonavir). The move, which has been praised by civil society organisations and recommended to other Latin American governments, is expected to improve access to the drug and to generate savings for expanding HIV prevention and testing.

Asthma device A new device that uses radiofrequency energy to treat severe asthma has been approved by the US Food and Drug Administration for use in adults whose disorder is not adequately controlled with conventional drugs. The Alair Bronchial Thermoplasty system uses heat from radiofrequency energy to reduce the thickness of smooth muscle that narrows the airways.

Migrant abuse Amnesty Inter­national has urged the Mexican authorities to prevent, halt, and punish those involved in the abuse of migrants who pass through Mexico every year to reach the US border. The organisation reports that six of ten migrant women and girls have experienced sexual violence and that 10 000 migrants were abducted during a 6-month period in 2009.

Biotech and global health South Africa’s newly created Technology Innovation Agency will be the first African governmental agency, and Massachusetts Institute of Technology the first University, to join the Pool for Open Innovation against neglected tropical diseases (NTDs) created by GlaxoSmithKline to aid in the discovery and develop­ment of new medicines for the treat­ment of 16 NTDs in developing countries.

AIDS funding gap The global shortfall in funding for HIV/AIDS programmes is causing antiretroviral stocks to run out in several countries, according to a report by the International Treatment Preparedness Coalition. The report assesses the AIDS situation in India, Kenya, Latvia, Malawi, Swaziland, and Venezuela and finds that patients are being turned away from treatment programmes owing to lack of drugs.

Prison health The appalling conditions in Zambia’s prisons are highlighted in a new report by Human Rights Watch and others. Inmates are often malnourished, face overcrowding, and are at risk of rape or torture, according to the report. The authors state that minimal medical care provided to prisoners also puts them at serious risk of HIV and tuberculosis.

Jerry Morris remembered On May 12, the UK’s London School of Hygiene and Tropical Medicine is holding a meeting in memory of Jerry Morris, a public health physician who worked at the school for most of his career and who died last year at the age of 99 years. Morris was one of the first to show a link between exercise and health, and was dedicated to improving health inequalities.

More sex please With nearly 25% of Brazilian citizens having hypertension, Health Minister José Temporão has introduced an unconventional national campaign that aims to reduce soaring blood pressure levels with safe sex. More incentive than political policy, it has been noted that “sexercise” will bring with it a string of additional health benefits, including the alleviation of stress.

April 28th 2010

This week in medicine

The following will be published in the May 1 issue of The Lancet:

Paying organ donors “Should more people be expected to donate organs, eggs and sperm and, if so, how far can we ethically go in encouraging them to donate?” asks the UK’s Nuffield Council on Bioethics at the launch of a public consultation. Ideas under consideration include payment and priority for an organ in the future. The consultation is open until July 13.

Vaccines for all The Pan American Health Organization last week launched its eighth Vaccine Week in the Americas (VWA). Started in 2003 in response to a measles outbreak in Colombia and Venezuela, VWA hopes to reach more than 42 million children and adults, especially those with limited access to health care. Similar campaigns are running in the eastern Mediterranean and Europe.

GP specialists French President Nicolas Sarkozy has announced that the price of general practitioners’ consultations will be increased to the amount a specialist would charge—ie, from €22 to €23 from January, 2011. The union of general practitioners, MG France, has been demanding this recognition for years, especially since universities recognised their status as specialists in medical practice in 2007.

Restriction removal China is con­sider­ing the removal of travel restrictions on people with HIV, acknowledging that the policy is outdated and discriminatory. “As HIV/AIDS cases have been seen in all provinces in China, a travel ban on foreigners will not help local public health”, admitted He Xiong, deputy director of the Beijing Centre for Disease Prevention and Control.

Salt reduction The US Institute of Medicine has released a consensus report on the reduction of salt intake in the country. It recommends that the national guideline daily amount of sodium be reduced from 2400 mg to 1500 mg per day, and that the Food and Drug Administration enacts legislation to gradually reduce the amount allowed in foodstuffs.

DRC warning Margot Wallström, the UN special representative on sexual violence in conflict, has warned that withdrawal of UN peacekeepers from the Democratic Republic of Congo could increase the already high rates of rape and violence against women in the country. The government wants the UN’s peacekeepers to start scaling back in the coming months, with complete withdrawal by next year.

Kinderpalliativzentrum On the grounds of the Vest Children’s Hospital in Datteln, Germany, the country’s first children’s palliative care centre has opened. The centre includes ‘’Station Lichtblicke’’—eight rooms tailored to the specific needs of seriously ill children and young people. Also on offer are educational and training workshops in paediatric palliative care.

Drug addiction Addiction to heroin, opium, and hashish is on the increase in Afghanistan, according to the country’s Ministry of Counter-Narcotics. Afghanistan produces more of these drugs than any other country, but addiction has not been seen as a domestic problem. However, figures show an increase in the number of Afghan drug users from 920 000 to 1·5 million in the past 5 years.

Rights of indigenous people Susan Rice, US ambassador to the UN, has announced a review of her country’s position on the rights of indigenous people, which could affect native Americans living in reservations. The 2007 UN Declaration on the Rights of Indigenous Peoples was rejected by the USA, Canada, Australia, and New Zealand, although Australia and New Zealand have since recanted.

Funds for food crisis Oxfam and the Government of Mali have warned that they are short of funding to launch an emergency response for 629 000 people who face food insecurity in western, northern, and north­eastern parts of the country. The govern­ment needs US$59 million to launch its response, while Oxfam needs to raise $4·5 million for its plans to dis­tri­bute food to vulnerable families.

Heatwave hell Extreme temperatures of up to 47°C contributed to the deaths of 80 people in India during the month of April, according to news reports. The continued heatwave, which has seen temperatures 4–6°C higher than average for the time of year, is also expected to take a toll on the country’s wheat harvest. Rice production had already been damaged by a fiercer than usual monsoon.

Animal action Animal protection groups in the USA have filed a law­suit against the Food and Drug Admini­stration. The groups assert that, by failing to provide legislation on the adoption of alternatives to animal testing, such as those used in the EU for the past 23 years, the agency has neglected its obligations under the Administrative Procedure Act.

April 7th 2010

This week in medicine

The following will be published in the April 10 issue of The Lancet:

Help for Haiti Nearly US$10 billion have been pledged by donors in aid to Haiti, which is more than double the amount requested by President René Préval after the devastating earthquake in January. Most of these funds are likely to flow through the Haitian state government’s budget to rebuild infrastructure after the earthquake, with monitoring to help minimise corruption and waste.

Social care levy The UK’s Labour Party has proposed a compulsory levy to fund social care for all adults in England. If introduced, eligible adults would be entitled to financial support to provide residential care or home help. Currently, many vulnerable adults rely on support from family and friends, or have to sell their homes to pay for care.

New meningitis vaccine A new con­jugate vaccine for meningococcal meningitis has been launched in Europe by Novartis. A study by the company found that two-thirds of people who had visited the so-called meningitis belt (the strip of sub-Saharan Africa between Senegal and Ethiopia) had not been vaccinated. The vaccine protects against the four major strains of Neisseria meningitidis: A, C, W-135, and Y.

Driving with disabilities In China, newly revised regulations on drivers’ licences will allow more people with disabilities to drive motor vehicles, as of April 1.  They are those who are able to sit by themselves despite having paralysed limbs, hearing-impaired people who use a hearing aid, and those with incomplete fingers or missing right thumbs.

Drug-resistant gonorrhoea Public health experts attended a meeting in the Philippines last week to discuss the spectre of drug-resistant gonorrhoea. Strains of Neisseria gonorrhoeae resist­ant to either cefixime or ceftriaxone have been reported in Australia and Hong Kong, and multidrug resistance has been noted in Japan. The meeting highlighted the urgent need for new drugs to treat the disease.

CT scan hearing The US Food and Drug Administration (FDA) held a 2-day meeting last week to discuss the risks of exposing healthy individuals to CT radiation during routine screening for cancer. At the hearing, a former FDA scientist alleged that the agency ignored his objection, and that of colleagues, to the approval of CT scanning for colon cancer screening.

Rift Valley fever An outbreak of Rift Valley fever has affected dozens of farmers, veterinarians, and farm workers in South Africa, at least two of whom have died. Up to 80 farms have reported laboratory-confirmed cases of the zoonosis in animals, with extensive deaths. The government is continuing to investigate the outbreak and is taking steps to develop disease-surveillance systems in cattle.

H1N1 vaccine surplus An estimated 71·5 million doses of influenza A H1N1 vaccine might have to be discarded in the USA, according to figures obtained from the Centers for Disease Control and Prevention. Of the 229 million doses purchased, only 91 million have been used. Much of the bulk surplus will be stored or donated to other countries, but doses that have been made up in vials will expire too soon.

Afghan poverty Most people in Afghanistan live in dire poverty, despite receipt of US$35 billion in aid between 2002 and 2009, according to a UN report by the UN Office of the High Commissioner for Human Rights. The report criticises donors for putting security before long-term development, noting that child and maternal mortality rates in Afghanistan are among the worst in the world.

Deadly delivery An Amnesty International report has concluded that about half the deaths attributable to complications of pregnancy and childbirth in the USA could be prevented if maternal health care were available, accessible, and of good quality for all women. The report draws attention to racial disparities in care, poor insurance coverage, and availability of family planning services.

Under fire The Canadian Government has attracted criticism for failing to include safe access to abortion in its G8 maternal health funding initiative. At a G8 foreign ministers’ meeting, US Secretary of State Hillary Clinton argued that “contraception and family planning and access to safe, legal abortions” are essential parts of any maternal health initiative.

Monkey business Long the nemesis of western medical practitioners, traditional folk medicine has a new opponent: zoologists. A global survey has shown that, of 101 species of primate whose body parts are commonly used in traditional folk medicine, magic, or religious rituals, 23 are classified as being endangered and 12 as critically endangered.