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Preference: Infectious Diseases and Parasitology

434

Lymphatic filariasis eliminated in more nations

Three more countries have wiped out lymphatic filariasis as a public health problem.

Palau, Vietnam, and Wallis and Futuna have eliminated lymphatic filariasis as a public health problem, bringing to 11 the number of countries and areas validated since 2000 in the World Health Organisation (WHO) Western Pacific Region.

WHO Director-General Dr Tedros Adhanom Ghebreyesus and Regional Director Dr Shin Young-soo marked the accomplishment by presenting certificates to representatives from Palau, Vietnam, and Wallis and Futuna during the WHO Regional Committee for the Western Pacific held recently in Manila.

“We sincerely congratulate Palau, Vietnam, and Wallis and Futuna for eliminating lymphatic filariasis as a public health problem,” Dr Shin said.

“Decades of their effort with support from partners – including the governments of France, Japan, the Republic of Korea and the United States of America—as well as donations of medicines have enabled them to achieve this milestone and ensure future generations are safe from this dreadful disease.”

A mosquito-borne disease, lymphatic filariasis is one of 15 neglected tropical diseases that are endemic in the WHO Western Pacific Region. Also known as elephantiasis, the disease is painful and can lead to permanent disfigurement and disability, often causing people to lose their livelihood and suffer from stigma, depression and anxiety.

In 1997, the World Health Assembly resolved to eliminate lymphatic filariasis as a public health problem. In 2000, WHO launched the Global Program to Eliminate Lymphatic Filariasis by 2020. The program focuses on:

  • stopping the spread of infection through large-scale, annual treatment of all eligible people in affected areas; and
  • alleviating suffering by managing symptoms and preventing disability among people who are infected with lymphatic filariasis.

Since WHO launched program, a total of 11 countries and areas in the Western Pacific Region have been validated as having eliminated lymphatic filariasis as a public health problem: Cambodia, China, Cook Islands, Niue, the Marshall Islands, Palau, the Republic of Korea, Tonga, Vanuatu, Vietnam, and Wallis and Futuna.

Lymphatic filariasis remains endemic in 13 countries and areas in the Region: American Samoa, Brunei Darussalam, Fiji, French Polynesia, Kiribati, Lao People’s Democratic Republic, Malaysia, Federated States of Micronesia, New Caledonia, Papua New Guinea, Philippines, Samoa and Tuvalu.

 

[The Lancet Commissions] Alma-Ata at 40 years: reflections from the Lancet Commission on Investing in Health

In 2013, the Lancet Commission on Investing in Health published its report, “Global health 2035: a world converging within a generation” (GH2035). The report concluded that a grand convergence in health—a reduction in infectious, child, and maternal mortality to rates seen in the best-performing middle-income countries—is technically and financially feasible for all but the poorest countries by 2035. Mortality from non-communicable diseases could be reduced through inexpensive population-based and clinical interventions, especially fiscal policies such as heavy tobacco taxation.

[Comment] Primary health care for the 21st century, universal health coverage, and the Sustainable Development Goals

Good health and wellbeing are fundamental to the prosperity of societies. By many measures, modern humanity enjoys better health than earlier generations.1 But the benefits of modern health care are not accessible to all. Even as the incidence of infectious diseases such as HIV, tuberculosis, and malaria are reduced, many countries struggle to cope with the growing burden of non-communicable diseases, and the complex and growing health needs of ageing populations.2,3

[Articles] Efficacy and safety of ustekinumab, an IL-12 and IL-23 inhibitor, in patients with active systemic lupus erythematosus: results of a multicentre, double-blind, phase 2, randomised, controlled study

The addition of ustekinumab to standard-of-care treatment resulted in better efficacy in clinical and laboratory parameters than placebo in the treatment of active systemic lupus erythematosus and had a safety profile consistent with ustekinumab therapy in other diseases. The results of this study support further development of ustekinumab as a novel treatment in systemic lupus erythematosus.

[Correspondence] The Global Fund as an ATM plus

In his Comment, Richard Horton (July 7, p 14)1 advocates for an expanded mandate of the Global Fund, with the inclusion of Universal Health Coverage (UHC) in addition to its support for the three global high-burden diseases (HIV/AIDS, tuberculosis, and malaria). This notion is welcome in an era in which poor reproductive, neonatal, mother, adolescent, and child health and catastrophic health expenditure for chronic (non-communicable) diseases still create considerable anguish and hardships for people in many countries.

[Perspectives] The business of academic publishing: “a catastrophe”

As I watched Paywall: The Business of Scholarship, I was taken back 30 years to when I thought for the first time about the business aspects of academic publishing. I was an assistant editor at the BMJ, and the editor asked me to join a meeting with a group of rheumatologists who wanted a share in the Annals of Rheumatic Diseases, a journal we owned. “We do the research published in the journal”, said one of the rheumatologists. “We do the peer review, we edit the journal, we read it, and we store it in our libraries.

Act now on climate change and health

 

Act now on climate change and health

The AMA has warned the Government not to ignore the future health implications of climate change.

Describing some details in the latest report from the Intergovernmental Panel on Climate Change (IPCC) as “worrying predictions for human health,” AMA President Dr Tony Bartone they simply must not be dismissed.

The just released report – Global Warming of 1.5°C, an IPCC special report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty – highlights the scientifically-based threats to human health that could occur if governments do not act to tackle climate change.

It states that limiting global warming to 1.5°C would require rapid, far-reaching changes in all aspects of society.

But limiting global warming to 1.5°C compared to 2°C could go hand in hand with ensuring a more sustainable and equitable society.

Dr Bartone said the report was consistent with AMA policy.

He added that it reiterated the scientific reality that climate change affects health and wellbeing by increasing the environment and situations in which infectious diseases can be transmitted, and through more extreme weather events, particularly heatwaves.

The IPCC has previously concluded that there is high to very high confidence that climate change will lead to greater risks of injuries, disease, and death due to more intense heatwaves and fires; increased risks of undernutrition; and consequences of reduced labour productivity in vulnerable populations.

“The 2018 report shows that the magnitude of projected heat-related morbidity and mortality would be even greater with global warming at 2°C than by limiting global warming at 1.5°C,” Dr Bartone said.

“The impact on human life is significant. The AMA urges the Government to seriously consider these predictions, and act accordingly.”

According to the Appendix of the 2018 IPCC Report:

  • Years of life lost due to heat-related illness in Brisbane are projected to increase from 616 in 2000, to 1178 at 1.5°C, and then to 2845 at 2°C.
  • In Australia’s five largest cities, with estimated population change, heat-related deaths are projected to increase from a baseline of 214 per year, to 475 per year at 1.5°C, and to 970 per year at 2°C.

Other impacts at 1.5°C compared to 2°C include:

  • A higher increase in ozone-related mortality.
  • A higher risk of malaria due to an expanded geographic range and season of the anopheles mosquito.
  • A higher risk of dengue, yellow fever, and Zika virus due to an increased number and range of the aedes mosquito.
  • A more significant increase in vector-borne disease transmission in North America and Europe, including West Nile Virus and tick-borne diseases.

The IPCC report cites 6,000 scientific references, includes the contribution of thousands of expert and government reviewers worldwide, and was prepared by 91 authors and review editors from 40 countries.

 

JOHN FLANNERY and CHRIS JOHNSON

 

The AMA Position Statement on Climate Change and Human Health is at position-statement/ama-position-statement-climate-change-and-human-health-2004-revised-2015

 

[Comment] Reduce air pollution to beat NCDs: from recognition to action

Air pollution is now recognised as the second leading cause of non-communicable disease (NCD) deaths after tobacco smoking, causing more than 5 million such deaths each year, and 7 million deaths in total, including communicable diseases.1 NCDs caused by air pollution include heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer. The health impacts of air pollution may be even higher than 5 million NCD deaths per year,1 given recent evidence indicating even larger health impacts for those diseases at current exposures.

WMA calls for stronger physician-led health care systems worldwide

World Medical Association President Dr Yoshitake Yokokura has called on world leaders to strengthen healthcare systems based on physician-led primary care.

Using a United Nations General Assembly meeting in New York discussing non-communicable diseases (NCDs), Dr Yokokura welcomed the Political Declaration on the prevention and control of NCDs.

The emphasis of the declaration is on strengthening the link between NCDs and the social-economic and environmental determinants of health.

Dr Yokokura added, however, that he regretted the declaration does not include clear and measurable commitments.

He said the WMA is particularly concerned by the lack of specific commitments and targets for funding. The WMA is advocating for the inclusion of more NCDs to avoid a silo approach.

“Health care professionals see first-hand the devastating impact of NCDs on patients and their families,” Dr Yokokura said.

“Physicians are treating an increasing number of cases and are seeing more and more complex cases. NCDs are increasing the bill and burden on already under-resourced health care systems. 

“In the light of the expected increased demand for 18 million more health workers, primarily in low and lower middle-income countries by 2030, healthcare system strengthening is of the utmost importance to reduce the growing burden of NCDs.”

The WMA called for UN member states to use the momentum of the declaration to set ambitious country targets, to commit to additional funding for NCDs and to draw up policies and measures in country action plans which aim to support.

CHRIS JOHNSON