Global Health Events (May – October 2008)

May

1st With the Big 3 diseases (HIV/AIDS, tuberculosis, and malaria) receiving the majority of global attention, the May edition of the Bulletin of the World Health Organization calls for renewed advocacy and focus on pneumonia, in particular childhood pneumonia. As reported previously, fairly accurate estimates of pneumonia morbidity and mortality in children less than five (5) years old is 150 million and 2 million respectively.

28th Bangladesh confirms its first human case of H5N1 Avian Influenza. The patient is a 16-month old male who developed symptoms on January 27, 2008 and later recovered. Identification was conducted by the WHO H5 Reference Laboratory, U.S. CDC.

30th Copenhagen Consensus 2008, which comprised a panel of eight distinguished economic experts, prioritized a series of proposals to respond to ten global challenges including diseases and malnutrition & hunger. Five of the top ten proposals addressed malnutrition and disease: micronutrient supplements and fortification, expanded immunization coverage for children, biofortification, and community-based nutrition promotion.

June

1st Child injuries and violence is a focus of the June edition of the Bulletin of the World Health Organization. An editorial highlighted the high level of injuries and violence affecting children and youth and the inequity between high- and low- and middle-income countries. Violence kills approximately 875,000 children and youth (aged less than 18 years) and injures tens of millions. Violence and injuries are not only an increasing cause of child death and injury but has other health consequences e.g. mental health and reproductive health. Global health inequities reveal child-injury mortality rates are four times higher in low- and middle-income countries compared to high-income countries.

9th The first HIV/TB Global Leaders’ Forum held prior to the UN High Level Meeting called for efforts to strengthen the response to HIV/TB co-infection.

10th UN High Level Meeting on HIV/AIDS took place on June 10-11 in New York City to review progress in achieving the 2001 Declaration on HIV/AIDS and the 2006 Political Declaration on HIV/AIDS. Key themes within government and civil society presentations were: (1) HIV as both a public health and development issue, (2) need to scale up and increase access to prevention, treatment, care, and support services, (3) human rights and gender as core components of an effective response, and (4) promote an inclusive response. Two findings (universal access and scaling up HIV services) indicate challenges for the global community to reach by 2010. A recommendation is the strengthening and integration of health systems.

11th The U.S. Department of Agriculture (USDA) scientists in collaboration with government, industry, and academic researchers released the genomes of 150 different avian influenza (AI) viruses to the NIH GenBank. This release is part of a special sequencing project supported by the U.S. presidential initiative on AI and aims to sequence 900 AI viruses.

July

1st WHO Director-General Margaret Chan, Norwegian Minister of Foreign Affairs Jonas Gahr Støre, and French Minister of Foreign Affairs Bernard Kouchner co-authored an editorial in the July edition of the Bulletin of the World Health Organization on foreign policy and global public health. Health crises such as bioterrorism or pandemic influenza are understood as threats to national/global security; however, the authors contend there must be more integration and understanding between foreign policy and global public health prior to crises to create a more sustainable relationship. The editorial highlighted the efforts of the Foreign Policy and Global Health (FPGH) initiative launched by Brazil, France, Indonesia, Norway, Senegal, South Africa, and Thailand in 2007.

9th At the annual G8 Summit held in Hokkaido, Japan on July 7 – 9, the G8 leaders renewed their commitment to improve global health and indicated they would submit to annual progress measurements to determine progress to achieving global health objectives. In regards to recruitment of healthcare workers, the G8 detailed a voluntary system for the ethical recruitment of health personnel.
30th President Bush signed into law The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (commonly known as PEPFAR). Funding has been increased to $48 billion over fiver years and has lifted the travel ban on non-U.S. citizens living with HIV and AIDS. Some previous earmarks on prevention and treatment have been eliminated or revised.

August

3rd The 2008 International AIDS Conference held in Mexico City on August 3 – 8 brought together thousands of policymakers, civil society, private sector, and people living with HIV/AIDS to discuss the progress on achieving universal access, share best practices, and respond to ongoing barriers to achieve access for all. Key issues that were addressed in the 2008 AIDS conference included: health systems strengthening, integration of treatment and prevention, promotion of human rights & gender equality, and specific regional issues e.g. stigma, South-South collaborations.

23rd The U.S. Department of Health and Human Services (DHHS) and Department of Homeland Security (DHS) announced guidance on the allocation of pandemic influenza vaccine. The guidance serves as a framework to assist state, tribal, and community leaders to ensure proper allocation of vaccine to (1) reduce the impact of pandemic influenza on public health and (2) to minimize disruption to society and the economy. Allocation guidance relies upon categories (homeland & national security, healthcare & community support services, critical infrastructure, and general population), target groups & tiers (1 – 5), and Pandemic Severity Index (PSI) to depict various vaccination strategies.

27th WHO Director-General Margaret Chan spoke on “the face of cancer is changing” at the opening of the UICC World Cancer Congress. Dr. Chan underscored the shifting disease burden from high-income to middle- and low-income countries which account for 72% of cancer-related deaths; current estimates indicate that cancer causes 7.9 million deaths annually. A higher disease burden in less affluent countries strains already weak health systems and burdens individual households facing significantly higher out-of-pocket payments. Dr. Chan stated that “For cancer, out-of-pocket payment is a double-edged sword. It discourages people from seeking treatment early, when the chances of cure are greatest. And it deepens household and community poverty.”

September

17th The number of children who became ill in China due to baby formula/milk powder contaminated with melamine, an industrial chemical, increased to more than 6,200 with 158 infants diagnosed with acute kidney failure. Other food producers have been implicated and melamine contamination has been found in yogurt and fresh milk products.

25th The Global Malaria Action Plan (GMAP) was released by the Roll Back Malaria Partnership which outlines a roadmap to eliminate malaria. The GMAP calls for a malaria control scale-up across 109 countries and 65 international institutions. A key objective of GMAP is to avert 4 million deaths by 2015 and is estimated to cost below the amount currently spent in malaria endemic countries. The key tools for malaria prevention and treatment includes: long-lasting insecticidal  nets, indoor residual spraying, intermittent preventive treatment during pregnancy, other vector controls, diagnosis, and treatment.

October

3rd A study published in Nature suggested that human immunodeficiency virus (HIV) may have crossed from animal to human between 1884 and 1924. Furthermore, the researchers postulate that colonialism and newly-built cities contributed to the transmission or spread of HIV subtypes. In 2007, researchers found a viral ancestor of an HIV subtype in Leopoldville, the Belgian Congo capital.

6th The 2008 Nobel Prize in Physiology and Medicine was awarded to three scientists involved in the discovery of human papilloma virus (HPV) and human immunodeficiency virus (HIV). Harald zur Haussen was credited for his discovery of HPV while Françoise Barré-Sinoussi and Luc Montagnier for their discovery of HIV.

6th The UN System Influenza Coordinator (UNSIC) and the World Bank released the Fourth Global Progress Report on “Responses to Avian Influenza and State of Pandemic Readiness.” This report examines the country responses to avian influenza and pandemic preparedness between June 2007 and June 2008; notably, there have been fewer outbreaks of highly pathogenic avian influenza (HPAI) and fewer infected countries. Between January – September 2008, there were zero (0) newly infected countries and only 20 countries that have experienced outbreaks to date. In regards to human morbidity and mortality, to date there have only been 36 human cases and 28 deaths.

27th The WHO published a report assessing the global burden of disease that drew together data from across the WHO programs. It conducts a comparative assessment between deaths, diseases, and injuries by region, age, sex and country income for 2004 as well as projecting deaths and disease burden by cause and region to 2030. Globally, Africa accounts for 90% of child deaths due to malaria, AIDS, and for half of child deaths due to pneumonia or diarrheal diseases.

Sources: Pandemicflu.gov, the World Health Organization (WHO), the United Nations (UN), BBC News, Nature, Global Health Council