E book: pandemics, global health and consumer choices

E book: pandemics, global health and consumer choices

E book: pandemics, global health and consumer choices

I want to share a resource prepared by Cynthia Schuck and Wladimir Alonso, two public health experts who are also passionate about the plight of farm animals. They’ve prepared a short free e-book to provide factual information on the connection between farm animals and pandemics to the general public.

Below are excertps from the E-book. All info in this post should be credited to the authors (Cynthia and Wladimir).

 A brief account of our history with animals

In our interactions with wild animals, companions, livestock and commensals, pathogens commonly known to us were imported: scavenging and hunting gave us tapeworms, and probably hepatitis and poliomyelitis through the hunting of our close relatives, primates; companion animals, rabies; livestock gave us measles, Salmonella, smallpox and anthrax (a disease that became famous for its potential use as a biological weapon); commensals, the plague, hantavirus and typhus. Of course, the reverse is also true: most human infectious diseases can also be transmitted to animals.

But the advancements in technology and the rapidly growing population were also catalysts of a massive increase of food animal populations and the intensification of farming practices, which accelerated sharply in the decades following World War II. As is discussed in the E-book, these conditions created efficient routes for the transmission of pathogens that gained, or re-gained, access to human populations. We are now in what scientists call the ‘third epidemiological transition’, characterized by a resurgence of familiar infections along with the emergence of new ones. Many have their origin in those animals we use as food.

With the human population approaching 8 billion people interconnected in a global village, where all forms of interactions with animals (from hunting to industrial complexes with enormous numbers of animals) are not only still present, but amplified (80 billion land animals are used for meat every year), new challenges are bound to happen in the form of local epidemics and global pandemics 6–9. These challenges will test not only our ability to react to these events appropriately, but also to identify (and rectify) the elements that most contribute to their emergence.

Direct contact with wild viruses

The brutality of Ebola (its death rate and the dreadful course of the illness on patients) is well known. Ebola is one among many other infectious diseases that find its way into humans when we expose ourselves to the large diversity of viruses that are tolerated by wild animals, but that can be harmful if they spill over to people. In the case of the Ebola outbreak in West Africa, such a jump was traced back to a two-year-old boy from Meliandou, a small village in Guinea. The boy used to play with other children in a hollow tree full of bats. According to the villagers, children would sometimes catch them, and perhaps even roast them on sticks to eat them. 

Eating wild animals is an important route of human exposure to pathogens harbored by wild animal species. Of course, it is not the only one: another popular means of human infection is through a vector, such as a mosquito or a tick, through which the pathogen makes its way from an animal to a person. Yet, because every infection transaction requires the intermediation of a middleman (the vector), the spread of the disease can be addressed more objectively by targeting the vector. In contrast, diseases that find their way to a person, and from that single human case (the ‘patient zero’) can be transmitted from human-to-human in a sustained way are more likely to become pandemic, especially if transmission occurs through behaviours that are common (such as physical greetings, sharing of objects, close proximity and sex).

There are many ways through which pathogens can find their way to human beings without the help of a vector. In the water, breathing dust from highly contaminated environments (such as caves), eating food chewed by infected animals or having close physical contact with those animals are among them. But one route that has been particularly important is the use of wild animal species as food. The origin of most Ebola outbreaks – which still happen, mainly in Central Africa – is believed to be associated with the consumption of bushmeat. It is not so much the consumption of a cooked animal that is risky, but the process of hunting and butchering the animal. In this (literally) bloody affair, plenty of opportunities exist for the direct exposure of vulnerable human tissues (skin wounds, mucosa) to the pathogens and for the cross-contamination of other food items with the bodily fluids of the infected animal. Humans were most likely infected with precursors of the human immunodeficiency virus (HIV) in this way, when hunting chimpanzees for meat. Interestingly, chimps got infected in the same way, when hunting two other smaller species of primates. HIV infection, which  leads to the acquired immunodeficiency syndrome (AIDS), has spread to all corners of the globe since the 1980s, with 39 million people killed of  HIV/AIDS-related complications as of 2018. 

Based on those accounts, one could hope that the prevention of infectious diseases imported from wildlife would be just a matter of addressing these practices and the standards of life of populations on the fringes of urban societies. Unfortunately, the outbreaks of SARS in 2002-03 and the 2019 pandemic remind us that this is not the case.

SARS and COVID-19 outbreaks can be also traced back to the consumption of wild animals, but not in small villages from poor rural areas of developing countries. Both SARS and SARS-CoV-2 emerged in the wet markets of vibrant urban centers in China. In the case of SARS-CoV-2, the origin has been pinpointed to Wuhan, the most populous city in Central China, with approximately 11 million people . 

Wet markets are places where animals are sold for consumption, along with other perishable goods. Described this way, they would not be different from countless other grocery stores or street markets around the globe. What makes some of those places different is not only the large diversity of animal species that are sold, but also the way in which many are kept on display, to be butchered on site on the customers’ request. Cages and stand spaces are so limited that animals are mostly crammed into tight spaces, piles and shelves, where lower levels are constantly flooded with the droppings of upper ones. Wild animals (such as turtles, bamboo rats, badgers, hedgehogs, otters, civet cats, snakes, bats, pangolins) might have been taken directly from the wild, but more often they are raised in the numerous farms run by family enterprises. Many pathologists and virologists have warned authorities of the public health dangers that these conditions represent 6,7,25. The regular mixing of a high diversity of pathogens, from wild and domestic species, in an environment of acute stress for the animals and poor sanitary conditions, and where hosts from all species meet, creates the perfect conditions for the emergence of novel pathogens that can make their way to humans, be it through a wound, the cross-contamination of food or by the air, through the aerosolization of organic material.

Inconvenient truth  

We tend to approach each new epidemic and public health crisis independently, rather than recognizing their common drivers. Domesticated animals have served humanity for millenia, but in today’s modern societies we must be honest and admit that the way we commonly raise animals is a major threat for global health and the well-being of human populations. Moreover, the extensive human and financial losses associated with infectious disease outbreaks and drug resistance make this an enormous economic and social problem too. As global meat consumption continues to rise even further (it has doubled in the last 50 years, from a global average of 20 kilograms per person in 1961 to around 43 kilograms in 2014122), these risks and costs are expected to increase even further.  

The world spends billions every year in the design and control of measures to protect us against infectious diseases. In 2015, funding for the investigation of emerging and zoonotic diseases in a single US institution, the Centers for Disease Control, was nearly half a billion dollars 121. The annual cost of pandemic preparedness alone is estimated to lie somewhere within $ 3 billion to $ 5 billion 123. Yet it is disturbing that many of the most basic control policies supposed to be well established have failed when tested, even in high income countries such as the United States 121. Should we insist on making public health safety an exclusively reactive endeavor? 

While large investments are currently being poured into the development of vaccines and treatments to control the damage of the 2019 coronavirus outbreak, these (most needed and welcomed) developments are unlikely to shield us from a future epidemic. We must have this same sense of urgency to accelerate the development of modern methods of food production, which include the development of substitutes of animal protein. In fact, this is a revolution in the food sector that has already started, with a diverse range of products on that menu that include meat-like products made from plants or even grown in vats 124. Ultimately, however, the demand for alternative protein sources must come from the population, and the market will respond appropriately. Just as we exercise our citizenship by adopting the necessary measures to curb the advancement of COVID-19 and protect our communities, we must also exercise it with our wallets at the supermarket, and think how best our purchasing and dietary choices can build a safer future for generations to come.

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Wildlife markets are hotbeds of disease

Wildlife markets are hotbeds of disease

Wildlife markets are hotbeds of disease

Wildlife market

Wildlife market

In 2003, the world met SARS. The coronavirus wreaks havoc on a patient’s immune system, and even after treatment patients have gone on to suffer from long-term diseases like osteoporosis or lung disease. It’s thought that the virus jumped from animals to humans, facilitated by markets in southern China known for trading in wildlife and wildlife parts. The infection eventually spread to 29 countries on five continents. In all there were 8,098 human cases and 774 deaths. The outbreak cost China some $16.8 billion in lost tourism revenue.

The illegal trade in wildlife is not only devastating ecologically; it also has a real and measurable impact on human health and economics. And the problem is not just in China.

Laos, more properly known as the Lao People’s Democratic Republic or Lao PDR, is home to a stunning diversity of mammal, reptile, bird, and amphibian species. Many of them are endemic—animals found there and no place else—like the Phou Khao Khouay leaf-nosed bat, the Truong Son muntjac, and the critically endangered Saola. Like in China, there’s a tremendous amount of illegal trade in wildlife and wildlife parts in Laos. The extent of that trade, and its possible consequences for human health, were recently revealed in a study led by Zoe F. Greatorex and Sarah H. Olson of the Wildlife Conservation Society.

First, 375 basic surveys of 93 markets scattered across 15 of the 17 Laotian provinces were carried out over the course of three years. These surveys were simply to identify markets in which wildlife was sold, and they were carried out discretely by two Laotians who could blend in to the crowd.

Then, the researchers conducted detailed surveys in the winter and spring of 2012 at 44 markets. These surveys documented which species were being sold and how many individual animals per species were offered to buyers. In addition, researchers recorded the prices at which wildlife was sold, the origins of market visitors (information gleaned from license plates visible in the parking areas), and the hygiene of merchants and butchers. (For example: Did the butcher clean his or her equipment after every animal? Did the vendors wash their hands often enough?)

Finally, to assess the potential for the spread of zoonotic pathogens from wild animals to humans, the researchers focused on seven markets with a particularly high level of wildlife trade, using the data collected during the first two phases of the study. Each of these markets was observed selling more than 100 animals per day on at least four different days.

Nearly 7,000 animals were for sale for sale at these markets, weighing more than 2,000 kilograms combined. Across all 93 markets, they recorded 33,752 animals for sale, with nearly 7,000 of them belonging to species of conservation concern, including turtles, tortoises, deer, and lorises. This volume in wildlife trade is on par with some of the most prolific wildlife markets elsewhere, like in Equatorial Guinea, Myanmar, and China.

The mammals alone represented 12 taxonomic families ranging from rodents to primates, species previously documented to be capable of transmitting at least 36 pathogens, like Ebola, Lassa fever, Marburg virus, monkeypox, dengue, yellow fever, West Nile, and others. (Because their ability to transmit pathogens isn’t clear, carcasses that were smoked, dried, fermented, or frozen were omitted. The researchers concentrated instead on living animals or ones freshly slaughtered for this analysis.)

Though proper hygiene can limit the transmission of many of these pathogens, the researchers documented remarkable disregard for biosecurity. “In half-hour observations of 11 wildlife vendors in these seven markets, hand washing was only observed to be performed by one individual,” write the researchers. Only four of the markets even had running water available. And while five of the six markets that also sold domestic meat products had zoning regulations to keep livestock products and wildlife products separate, that didn’t seem to apply to poultry, fish, or produce—only to mammals. The possibility—likelihood, even—for cross-contamination in that sort of environment is mind-boggling.

To find out just who was purchasing all these wildlife products, the researchers compared the price of wild animals to that of fresh domestic pork. In most cases, wildlife generated a lot more revenue. In early 2012, one kilogram of pork could be sold for around 34,000 Kip, which is about $4. A kilogram of brush-tailed porcupine sold for four times as much. This suggests that urban consumers eat wildlife as a luxury, rather than for nutrition or subsistence. And since the average Laotian makes around $4 per day, there’s a high economic incentive to sell wildlife meat rather than livestock. A kilogram of pork represents around one day of income, while a kilogram of bat equates to three days’ worth of income.

The impacts of the Laotian wildlife trade are far-reaching. Not only does the study demonstrate the enormous potential for zoonotic spillover and the serious damage that the wildlife trade does to Laotian ecosystems, but it also reveals a challenge to food security to the poorest Laotians, who have historically relied on subsistence hunting for protein.

If wildlife is to be harvested, conclude the researchers, it needs to be done with serious oversight and enforcement, as per the Lao PDR Wildlife and Aquatic Law. Because it poses risks both to public health and to biodiversity, they say this form of wildlife trade provides a unique opportunity for public health officials, conservationists, law enforcement, and other groups to collaborate on addressing the underlying economic realities that drive the sale of wild animals. – Jason G. Goldman | 06 April 2016

Source: Greatorex ZF, Olson SH, Singhalath S, Silithammavong S, Khammavong K, Fine AE, et al. (2016) Wildlife Trade and Human Health in Lao PDR: An Assessment of the Zoonotic Disease Risk in Markets. PLoS ONE 11(3): e0150666. DOI: 10.1371/ journal.pone.0150666.

This article originally appeared on teh university of Washington, Conservation page on 6th April , 2016. Available at: http://conservationmagazine.org/2016/04/wildlife-markets-spread-disease/

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Researchers confirm link between schistosomiasis and HIV acquisition

Researchers confirm link between schistosomiasis and HIV acquisition

Researchers confirm link between schistosomiasis and HIV acquisition

WWF

Photo by John Bett, WWF

A comprehensive review of secondary data sources has confirmed a long-suspected link between female genital schistosomiasis (FGS) and HIV infection for women in southern Africa. Researchers confirmed the link in Mozambique, finding that exposure to schistosomiasis, combined with HIV prevalence, increases the odds of HIV infection by three times. Researchers also conclude that treating young girls for schistosomiasis could avert millions of new cases of HIV infection at far less cost than treating HIV infection once it has occurred.

Schistosomiasis is a fresh water-borne parasitic infection, usually contracted in childhood through activities such as swimming, bathing, fishing, and fetching water. It affects 261 million people worldwide and is known to be highly endemic in sub-Saharan Africa. Domestic chores can place girls and women at greater risk of contracting FGS, which, the researchers say, may help explain the fact that only in sub-Saharan Africa are HIV infections higher among females than among males.

The authors, Paul Henry Brodish and Kavita Singh, conducted the study for MEASURE Evaluation, funded by the U.S. Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR), a project of the Carolina Population Center of the University of North Carolina at Chapel Hill (UNC).

Researchers confirmed the link in Mozambique by investigating two high-quality secondary data sources on HIV prevalence and FGS: the 2009 National Survey on Prevalence, Behavioral Risks, and Information about HIV and AIDS in Mozambique (INSIDA) and the Global Neglected Tropical Diseases (GNTD) open source database. Their results can reasonably be applied generally to sub-Saharan Africa and perhaps especially to South Africa, Tanzania, and Zimbabwe, where field studies showed woman whose vaginal mucosal barrier tissue was compromised due to FGS were three times as likely as their neighbors to be infected with HIV.

School children in Niger with gross hematuria (blood in urine) caused by schistosomiasis (photo by Jurg Utzinger)

School children in Niger with gross hematuria (blood in urine) caused by schistosomiasis (photo by Jurg Utzinger)

In fact, two decades of studies have indicated that HIV/AIDS can be exacerbated by co-infection with neglected tropical diseases (including schistosomiasis), which weaken immune systems, increase susceptibility to other infections, and lower the effectiveness of antiretroviral therapy (ART).

The study’s findings also offer a significant potential cost savings for governments and global donors, as treatment for FGS would cost significantly less than treating HIV infection. The authors cite estimates that de-worming 70 million African children twice a year for a decade would cost about $112 million, versus an estimated $38 billion PEPFAR would expend in the same period.

These results are additional evidence supporting the link between neglected tropical diseases (NTD) and HIV and the need to scale up treatment for NTD and for increased access to improved water sources. The authors suggest further studies are necessary in other locales where there is high HIV prevalence and endemic NTDs.

The researchers say the study is limited by its indirect assessment of exposure to FGS (S. haematobium) and that the availability of mass drug administration in various survey regions is not known. However, both of these limitations would tend to make it more difficult to draw an association between FGS and HIV infections.

The study is also significant on a global scale as the Sustainability Development Goals (SDG), USAID’s goal of an AIDS-free generation (AFG), and prevention of mother-to-child transmission of HIV (PMTCT), will be that much more attainable if HIV infection can be curtailed in sub-Saharan Africa—where 60 percent of new cases are female and mostly young.

This article originally appeared on the Measure Evaluation website, authored by WWF CHAPEL HILL, NC. Available at: http://www.cpc.unc.edu/measure/news/schistosomiasis-and-hiv-acquisition

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‘Here And Now’: Tracing The Wisconsin Elizabethkingia Outbreak

‘Here And Now’: Tracing The Wisconsin Elizabethkingia Outbreak

‘Here And Now’: Tracing The Wisconsin Elizabethkingia Outbreak

Federal, State Officials Work To Pinpoint Source Of Rare Disease

As tracked by the Wisconsin Department of Health Services, cases of Elizabethkingia have been reported in Columbia, Dane, Dodge, Fond du Lac, Jefferson, Milwaukee, Ozaukee, Racine, Sauk, Sheboygan, Washington and Waukesha counties. Most of the victims have been older than 65, and all were dealing with a serious illness of some kind at the time.

In a March 11, 2016 interview on Wisconsin Public Television’s “Here And Now,” Michael Bell, deputy director for the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention in Atlanta, shared what federal health officials know about the outbreak so far. He also explained why epidemiologists are having trouble determining its source.

Over a typical year, health officials generally report a half dozen or more Elizabethkingia infections in each state, Bell told host Frederica Freyberg, so it’s unusual to see so many cases concentrated in one geographic area within a few months.

“We don’t see 48 of the identical organism causing an outbreak like this very often,” he said. “In fact, this is probably the largest one we’ve seen.”

Bell explained that it can take about two weeks in the lab to determine whether or not a sample is contaminated with a specific bacteria. CDC and state officials have examined potential sources — including drinking water, medical products, healthcare facilities, and patients’ homes — but have yet to find a smoking gun. The best lead so far is that all of the Elizabethkingia anophelis specimens identified so far turned out to have the same genetic “fingerprint,” or marker of variation within its species — akin to genetic similarities among people born from the same mother.

“The fact that they all have one fingerprint makes us think that it could be one isolated source,” Bell said.

Bell also pointed out the upsides: Elizabethkingia is not contagious, people with healthy immune systems can easily avoid infection, and medical providers have identified some antibiotics that work against the strain found in Wisconsin.

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Is there rationale for WHO shifting investment from infectious to NCDs?

Is there rationale for WHO shifting investment from infectious to NCDs?

Is there rationale for WHO shifting investment from infectious to NCDs?

 Introduction

This blog entry will try and elucidate the shift in investment from infectious to non-communicable diseases by the World Health Organisation (WHO) drawing successes from the Millennium Development Goals 6: “To combat HIV/AIDS, malaria, and other diseases”. Initially this blog entry will provide an overview of the management strategies and progress that has been made in addressing infectious diseases (using the “big three diseases” of the MDG 6 as examples). It will then highlight the financial investment from the different Global Health Actors towards these ‘big 3 diseases’ as compared to the other diseases and in conclusion determine if the WHO shift in investment is justifiable or not.

The term ‘infectious diseases’ (IDs) does not refer to a homogeneous set of illnesses but rather to a broad group of widely varying conditions (Saker, Lee, Cannito, Gilmore, & Campbell-Lendrum, 2004) that are transmitted from a person, animal or inanimate source to another person either directly, with the assistance of a vector or by other means, while non-communicable diseases (NCDs) are diseases or conditions that affect individuals over an extensive period of time and for which there are no known causative agents that are transmitted from one affected individual to another (Daar et al., 2007). If diseases are infectious, then they present in a pandemic (e.g. H1N1 influenza), epidemic (e.g. measles), or endemic (e.g. malaria) form, while if non-communicable as acute (e.g. accidents) or chronic (e.g. cancer) form (Roger, 2005).

For the purpose of this blog entry infectious diseases will be classified according to the causative agent, namely: Bacterial (e.g. Tuberculosis), parasitic (e.g. Malaria) and viral (e.g. HIV/AIDS).

Management strategies and progress against infectious diseases

Generally, control of infectious diseases can be directed either at the agent, the route of transmission, the host or the environment and sometimes a combination of the control strategies (Roger, 2005). The general methods of control are summarized in Figure 1 below.

Prevention principles

We will now focus on the progress and management efforts that have been used to combat infectious diseases but mainly drawing management strategies from HIV/AIDS, Malaria and Tuberculosis.

HIV/AIDS

Progress

On the global context the annual number of people newly infected and dying from HIV has greatly reduced, see Figure 2 below.

HIV progress

Based on the MDG Report 2015 (UNDP, 2015), in the last 15 years, Africa has made significant strides in combating HIV/AIDS. The progress in reducing the mortality rate and the pandemic status of HIV/AIDS has encompassed all five of Africa’s geographical sub-regions, see Table 1 below.

HIV in Africa progress

Management

Progress in HIV/AIDS rests on a number of factors including: improvement in testing, counselling and access to antiretroviral therapy; the reduction in mother-to-child transmission; the increase in prevention through the use of condoms and treatment as prevention; and the improvement in the general awareness and knowledge of the disease, including a better understanding of the link between HIV and tuberculosis. Engaging men in the fight against HIV also proved a winning strategy (UNDP, 2015).

Malaria

Progress

In the World Malaria Report 2015 (WHO, 2015f) it is highlighted that there has been a dramatic decline in the global malaria burden over the past 15 years (2000-2015) whereby 57 countries have reduced their malaria cases by 75%, with the global incidence and mortality rate reducing by 37% and 60%, respectively, see figure 3 below.

Malaria incidence

Management

Progress was made possible through the massive rollout of effective prevention and treatment tools: Vector control interventions, use of insecticide-treated bed-nets, quality-assured artemisinin-based combination therapy and rapid diagnostic tests have expanded in Africa over the past 10 years. However, specific efforts to protect pregnant women and children against malaria are progressing rather slowly (WHO, 2015f).

Tuberculosis

Progress

The MDG target of halting and reversing TB incidence by 2015 was achieved globally, in all six WHO regions and in 16 of the 22 high TB burden countries (WHO, 2015b). Since 2000, the global community has experienced a downward trend in tuberculosis prevalence, incidence and death rates (WHO, 2015b) see Figure 5 below.

TB trends

Management

The changes in tuberculosis prevalence and death rates mirror the rate of detection and treatment success under the DOTS approach which remains at the heart of Stop TB strategy which entails: Political commitment with increased and sustained financing; Case detection through quality-assured bacteriology; standardized treatment, with supervision and patient support; an effective drug supply and management system and Monitoring and evaluation system, and impact measurement (WHO, 2015d). Between 2000 and 2014, TB treatment alone saved 35 million lives among HIV-negative people; TB treatment and antiretroviral therapy saved an additional 8 million lives among HIV-positive people (WHO, 2015b).

Investment in infectious and non-communicable diseases 2000-2014

Development assistance for health (DAH) Disbursement

In 2000, the international community put global health high on the development agenda. Three distinct Millennium Development Goals focused on health issues in the developing world. At the forefront was the fight against child mortality, maternal mortality, and three infectious diseases: HIV/AIDS, malaria, and tuberculosis (TB). The formation of the MDGs was followed by major increases in global health financing flows. Rapid growth took hold from 2000 to 2010, following the launch of the MDGs. From 2013 to 2014, Development assistance for health (DAH) dropped by 1.6% (IHME, 2014). From the purchase of antiretroviral drugs and long-lasting insecticide-treated nets to support for disease-specific planning and programming, DAH has funded an array of activities in pursuit of MDGs 4, 5, and 6  with the very least proportion (1.48% of total) directed towards the non-communicable diseases.

Figure 8 below shows that UN agencies, including UNICEF, WHO, and UNAIDS, concentrated their DAH contributions most substantially on Maternal, newborn and child health (43.6%), but also supported work on other infectious diseases (11.3%), HIV/AIDS (6.6%), and Sector wide approaches/health sector support (5.3%), and to a minor extent non-communicable disease (1.8%), tuberculosis (1.1%), and malaria (0.9%). The investment on non-communicable diseases is generally low across all funding sources as compared to the MDG focus areas diseases.

DAH for health focus

Interestingly, the WHO programme budget allocation for communicable/infectious diseases has been declining for the past 2 financial years while the programme budget for non-communicable has been increasing see Table 2 below.

WHO budeget

Change in disease burden from infectious to non-communicable diseases?

Historically, infectious diseases (IDs) have been the most important contributor to human morbidity and mortality (WHO, 2002) until recent times, when dominance has shifted to non-communicable diseases (Beaglehole & Bonita, 2008) as shown in Figure 9 below. This dominance of NCDs could be as a result of low investment as we have established from the previous section above.

Projected deaths

Non-communicable diseases (NCDs) are one of the major health and development challenges of the 21st century, in terms of both the human suffering they cause and the harm they inflict on the socioeconomic  fabric of countries (Suhrcke, Nugent, Stuckler, & Rocco, 2006), particularly low-and middle-income countries (WHO, 2014), see Figure 10.

Chronic diseases

The number of deaths from non-communicable diseases is double the number of deaths that result from a combination of infectious diseases (including HIV/AIDS, tuberculosis and malaria), maternal and perinatal conditions, and nutritional deficiencies (Daar et al., 2007). Over the coming decades the burden from NCDs is projected to rise particularly fast in the developing world (WHO, 2005a). Non-communicable diseases (NCDs) are now recognized as a development issue.

Conclusion: Is there a necessity for WHO to shift from infectious diseases?

This far we can actually conclusively agree that the success in the progress of the MDG diseases (HIV/AIDS, Malaria and Tuberculosis) was as a result of heavy financial investment from several sources as development assistance for health (DAH) (IHME, 2014). This clearly confirms the fact that health interventions are largely based around economics; disease with the greatest perceived burden tend to be where most resources are targeted. This clearly affirms the statement, “Many may suggest that infectious diseases are suitably managed in terms of financial investment

The huge emphasis placed on the burden created by HIV/AIDS, Malaria and Tuberculosis in the original 1990 Global Burden of disease study by (Murray & Lopez, 1996) had the unintended consequence, over the last two decades, of committing the majority of resources towards combating these three diseases, “ignoring” investment in the other diseases and of major concern resulting to the rising trend in non-communicable diseases.

The increased investment in non-communicable diseases by the World Health Organisation and statement by Dr. Margaret Chan (Director General of WHO) which stated, “Worldwide, NCDs have overtaken infectious diseases as the leading cause of mortality. This shift challenges traditional development thinking, which has long focused primarily on infectious diseases and maternal and child mortality as priorities for international action. We continue to support this focus, but need to make space for additional challenges” (WHO, 2015e); certainly informs us that the shift in focus is a timely investment to address the rising challenge of non-communicable diseases but what is required of the WHO is to develop a balanced approach of tackling both infectious and non-communicable diseases.

References

Beaglehole, R., & Bonita, R. (2008). Global public health: a scorecard. Lancet, 372, 1988–1996. doi:DOI:10.1016/S0140-6736(08)61558-5

Daar, A. S., Singer, P. A., Leah Persad, D., Pramming, S. K., Matthews, D. R., Beaglehole, R., . . . Bell, J. (2007). Grand challenges in chronic non-communicable diseases. Nature, 450(7169), 494-496.  Retrieved from http://dx.doi.org/10.1038/450494a

IHME. (2014). Financing Global Health 2014: Shifts in Funding as the MDG Era Closes. Retrieved from Seattle, WA: http://www.healthdata.org/policy-report/financing-global-health-2014-shifts-funding-mdg-era-closes

Murray, C. A., & Lopez, A. D. (1996). The Global Burden of Disease: The Havard School of Public Health on behalf of The World Health Organisation and The World bank.

Roger, W. (2005). Communicable Disease Epidemiology and Control: A Global Perspective (Second ed.): Oxfordshire, U.K. ; Cambridge, Mass. : CABI Pub. .

Saker, L., Lee, K., Cannito, B., Gilmore, A., & Campbell-Lendrum, D. (2004). Globalization and infectious diseases: A review of the linkages. Retrieved from http://www.who.int/tdr/publications/documents/seb_topic3.pdf

Suhrcke, M., Nugent, R. A., Stuckler, D., & Rocco, L. (2006). Chronic Disease: An Economic Perspective. Retrieved from London: http://www.nature.com/nature/journal/v450/n7169/full/450494a.html

UNDP. (2015). MDG Report 2015: Lessons learned in implementing the MDGS. Retrieved from http://www.undp.org/content/dam/rba/docs/Reports/MDG%20Report%202015_ENG.pdf

WHO. (2002). World health report 2002. Retrieved from Geneva,: http://www.who.int/whr/2002/en/whr02_en.pdf?ua=1

WHO. (2005a). Preventing Chronic Diseases: A Vital Investment. Retrieved from Geneva: http://www.who.int/chp/chronic_disease_report/contents/en/

WHO. (2005b). Preventing Chronic diseases: a vital investment-Part one. Retrieved from http://www.who.int/chp/chronic_disease_report/contents/part1.pdf?ua=1

WHO. (2013). Proposed Programme Budget 2014-2015. Retrieved from http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_7-en.pdf

WHO. (2014). Global status report on noncommunicable diseases 2014.  Retrieved from http://www.who.int/nmh/publications/ncd-status-report-2014/en/

WHO. (2015a). Global health sector response to HIV, 2000-2015: Focus on innovations in Africa. Retrieved from Geneva: http://apps.who.int/iris/bitstream/10665/198148/1/WHO_HIV_2015.40_eng.pdf

WHO. (2015b). Global tuberculosis report 2015. Retrieved from France: http://apps.who.int/iris/bitstream/10665/191102/1/9789241565059_eng.pdf?ua=1

WHO. (2015c). Proposed programme budget 2016-2017. Retrieved from http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_7-en.pdf

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Pregnant women advised to avoid animals that are giving birth

Pregnant women advised to avoid animals that are giving birth

Pregnant women advised to avoid animals that are giving birth

Public Health Wales is reminding pregnant women to avoid close contact with animals that are giving birth.
Pregnant women who come into close contact with sheep during lambing or other farm animals that are giving birth may risk their own health, and that of their unborn child, from infections that such animals can carry.
Therefore Public Health England, the Department of Health, the Department for Environment, Food and Rural Affairs, the Animal and Plant Health Agency and the Health and Safety Executive, in association with the Welsh Government and Public Health Wales, the Scottish Government and Health Protection Scotland and the Departments of Agriculture and Rural Development (DARD) and of Health, Social Services and Public Safety (DHSSPS) in Northern Ireland have issued annual advice for a number of years that women who are or may be pregnant should avoid animals that are giving, or have recently given, birth.
Although the number of human pregnancies affected by contact with an infected animal is extremely small, it is important that pregnant women are aware of the potential risks and take appropriate precautions.
These risks are not only associated with sheep, nor confined only to the spring (when the majority of lambs are born). Cattle and goats that have recently given birth can also carry similar infections.
To avoid the possible risk of infection, pregnant women should:
  • not help ewes to lamb, or provide assistance to a cow that is calving or a nanny goat that is kidding;
  • avoid contact with aborted or new-born lambs, calves or kids or with the afterbirth, birthing fluids or materials (e.g. bedding) contaminated by such birth products;
  • avoid handling (including washing) clothing, boots or any materials  that may have come into contact with animals that have recently given birth, their young or afterbirths. Potentially contaminated clothing will be safe to handle after being washed on a hot cycle;
  • ensure contacts or partners who have attended lambing ewes or other animals giving birth take appropriate health and hygiene precautions, including the wearing of personal protective equipment and clothing and adequate washing to remove any potential contamination.
Pregnant women should seek medical advice if they experience fever or influenza-like symptoms, or if concerned that they could have acquired infection from a farm environment.
Farmers and livestock keepers have a responsibility to minimise the risks to pregnant women, including members of their family, the public and professional staff visiting farms.
Further advice is available to download from the document: More information on the following document... Q&A for pregnant women during lambing season

Source

Article originally appeared on the Public Health Wales Health Protection Division website on 11th January available at: http://www.wales.nhs.uk/sites3/news.cfm?orgid=457&contentid=39978

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