Six candidates compete to be WHO Director-General

Six health experts — including four from Europe, one from Africa and one from Asia — are “seeking to win the top post in what is billed as the most transparent, and democratic, race” in the history of the World Health Organization (WHO), according to The Lancet. This list will be narrowed down to five in January 2017, and the WHO’s 34-member country Executive Board will then decide on the names of three nominees to be sent forward to the World Health Assembly (WHA) in May 2017. The WHA will vote for a new Director-General by secret ballot. The six candidates are Tedros Adhanom Ghebreyesus, Ethiopia’s Minister of Foreign Affairs and a former Minister of Health; Philippe Douste-Blazy, a former French Foreign Minister and Minister of Health; Sania Nishtar, a former Minister of Health in Pakistan; David Nabarro, the United Nations Special Envoy for Ebola in 2014–15 and a former senior WHO official, supported by the UK; Flavia Bustreo, WHO Assistant Director-General for Family, Women’s, and Children’s Health, nominated by Italy; and Miklós Szócska, a former Minister of Health of Hungary. James Love, director of the non-profit organisation Knowledge Ecology International, which works on knowledge management, including innovation and access to knowledge goods, said of the candidates: “WHO member states should pick the candidate who can maintain independence from influence from corporate interests and manage the relationship with the Bill and Melinda Gates Foundation with dignity and wisdom.”

New bowel cancer DNA blood test “twice as sensitive” to recurrence

Researchers from Flinders University have found that a new blood test targeting tumour DNA in patients with colorectal cancer (CRC) detects early signs of recurrence of the disease at twice the rate of the standard test currently used. The two-gene test found methylated BCAT1 and IKZF1 DNA in blood in almost 70% of patients with recurrence, while only 32.1% tested positive for carcinoembryonic antigens (CEA). CEA monitoring is often used in practice for CRC patients who have undergone surgery. Flinders University’s Professor Graeme Young, one of the authors of a study involving 122 cancer survivors post-surgery, said that the high recurrence of colorectal cancer, which kills 600 000 people worldwide every year, meant that such an improvement in early and effective detection of recurrence could save more lives. He said that the new test had the potential to “fill an urgent and unmet clinical need”. Professor Young and his colleague, Flinders University’s Dr Erin Symonds, will present their findings at the Australian Gastroenterological Week Conference, which starts today in Adelaide and runs until Wednesday 12 October. The study compared the sensitivity and specificity of the two-gene blood test for tumour-derived methylated BCAT1 and IKZF1 with those of CEA in patients undergoing surveillance for recurrent CRC following induction of remission. Recurrence was assessed by clinical findings, blood testing and periodic computed tomographic surveillance scans. Of the 122 participants evaluated, 28 had recurrence and 94 had no clinically-detectable disease. Among those with recurrent disease, 67.9% were positive for methylated BCAT1 and IKZF1 (ie, the marker was detectable), while only 32.1% were positive for CEA (> 5 microg/L), representing a significant two-fold sensitivity improvement with the two-gene test. Sensitivity estimates of the methylated BCAT1 and IKZF1 test were 75% and 66.7% for local and distant recurrence respectively, compared with 50% and 29.2% for CEA.

The Lancet releases global health check series

According to a new series published by The Lancet, life expectancy has risen, but seven out of ten deaths are now due to non-communicable diseases. Other results from the Global Burden of Disease, Injuries, and Risk Factors 2015 study (GBD) include that headaches, tooth cavities, and hearing and vision loss each affect more than one in 10 people; there has been progress on reducing unsafe water and sanitation, but diet, obesity and drug misuse are increasing threats; more than 275 000 women died in pregnancy or childbirth in 2015, most from preventable causes; and deaths of children under the age of 5 years have halved since 1990, but there has been slower progress on reducing newborn deaths. For the first time, GBD 2015 included a measure of development (the socio-demographic index, or SDI, which is based on income per capita, educational attainment and total fertility rate) in order to assess a country’s observed performance compared to their expected performance based on their stage of development. GBD 2015 analysed 249 causes of death, 315 diseases and injuries, and 79 risk factors in 195 countries and territories between 1990 and 2015. The world population gained more than a decade of life expectancy since 1980, rising to 69.0 years in men and 74.8 years in women in 2015. An important contributor to this has been a large fall in the death rates for many communicable diseases, particularly in the past 10 years, including HIV and AIDS, malaria and diarrhoea. The rate of people dying from cardiovascular disease and cancers has also fallen, although at a slower pace. The number of annual deaths has increased from roughly 48 million in 1990 to almost 56 million in 2015. Around 70% (40 million) of global deaths in 2015 were due to non-communicable diseases, including ischaemic heart disease, stroke, diabetes, chronic kidney disease, Alzheimer’s disease and other dementias, and drug misuse disorders. In 2015, an estimated 1.2 million deaths were due to HIV and AIDS (down 33.5% since 2005), and 730 500 were due to malaria (down 37% since 2005).

Limit to human lifespan

Human lifespan may have a natural limit that is unlikely to be exceeded, according to an analysis of global demographic data published online in Nature. The maximum age of death ever documented for humans is 122 years, and the odds that this record will be broken appear small. Using data from the Human Mortality Database, the authors from the Albert Einstein College of Medicine in the US, showed that the age with the greatest improvement in survival plateaued around 1980. The authors then focused on the maximum reported age at death in France, Japan, the United Kingdom and the US, as reported in the International Database on Longevity. This analysis revealed that age at death plateaued close to the time of death of Jeanne Calment — the oldest person ever documented — in 1997. The authors suggested that this could represent a natural limit of human lifespan. Their model predicted that the likelihood of a person exceeding the age of 125 years in any given year is less than 1 in 10 000.


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