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[Comment] The Lancet Commission on malaria eradication

20 years ago, infectious diseases dominated the global health agenda. Policy makers, researchers, implementers, and donors united in the fight against infectious diseases, creating the Millennium Development Goals, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the Vaccine Alliance, the US President’s Emergency Plan For AIDS Relief (PEPFAR), the Roll Back Malaria Partnership, the Multilateral Initiative on Malaria (MIM),1 and more. Tremendous progress was made. Malaria benefited spectacularly and there has been a 47% reduction in global deaths from the disease since 2000.

[Obituary] Robert Day

Public health expert who directed the US Fred Hutchinson Cancer Research Center. Born in Framingham, MA, USA, on Oct 22, 1930, he died from lung cancer on Jan 6, 2018, in Seattle, WA, USA, aged 87 years.

[Correspondence] mHealth and the legacy of John Snow

On Jan 14, 2018, during a tense final touchdown in a US National Football League playoff game, numerous Apple Watch users received an alert from their device telling them that they were having potentially harmful arrhythmias.1 Smartphones and wearable technology are increasingly used as public health tools because billions of people worldwide are digital users. In 2020, more than 6 billion people will have smartphone subscriptions.2 Clinicians and researchers can use these devices to effortlessly monitor patients’ health and behaviour indicators in real time.

[Perspectives] Guo-Qiang Chen: haematologist who risked all for research success

If determination is a predictor of future achievements in medical research, the likelihood that Professor Guo-Qiang Chen would have a flourishing career should have become apparent when he was still a very junior doctor. To leave the provincial medical school to which he was then contracted and relocate himself to a distant and more research-oriented institution, he had to find the money to take on a major debt. It was, as he himself admits, “a gamble”. Now, some 25 years later, Chen is a member of the Chinese Academy of Sciences, Chancellor of Shanghai Jiao Tong University School of Medicine, and Director of its Laboratory of Cell Differentiation and Apoptosis.

[World Report] Charles Perkins Centre

Obesity and the diseases that are related to it are at the core field of Sydney’s Charles Perkins Centre, led by a man whose first area of research was locust behaviour. Stephen Simpson says his own varied background shows why this research body is different.

[Comment] The social sciences, humanities, and health

Humanities and social sciences have had many positive influences on health experiences, care, and expenditure. These include on self-management for diabetes, provision of psychological therapy, handwashing, hospital checklists, the Scottish Government’s stroke guidelines, England’s tobacco control strategy, the response to the Ebola outbreak in west Africa and Zika virus in Brazil, and many more.1 Researchers have shown time and time again the political, practical, economic, and civic value of education and research in disciplines like anthropology, history, and philosophy.

[Comment] Public Health Science Conference: a call for abstracts

We are delighted to invite abstract submissions for Public Health Science: A National Conference Dedicated to New Research in UK Public Health, to be held in Belfast, UK, on Nov 23, 2018. This is our seventh annual conference to showcase the creativity of the public health research community in the UK and Ireland. The conference provides a forum for academics, practitioners, and policy makers to discuss important public health issues, and learn about the latest public health science and its role in advancing and supporting public health practice, policy, and health services.

[Obituary] John Sulston

Nobel Prize winner for work on Caenorhabditis elegans and a leader in human genome research. Born in Fulmer, UK, on March 27, 1942, he died on March 6, 2018, from complications of stomach cancer, aged 75 years.

Snippets

Get your flu shots … but not too early

The AMA has urged people to wait until at least mid-April before getting flu shots, following a push by some pharmacy chains to get the vaccinations too early.

Some big name pharmacies began advertising in March for people to get their shots to avoid a repeat of last year’s deadly influenza outbreak.

But AMA Vice President Dr Tony Bartone said getting vaccinated for the flu too early could be counterproductive.

He said the vaccine’s effectiveness begins to wear off after three or four months. With the flu’s peak season being from July to September, a March shot was too early.

“If we’re going to maximise our protection before that effectiveness starts to wane, we want to match the timing of the vaccination with the timing of the peak,” Dr Bartone said.

“And for that reason, mid-April onwards is a perfect time to start having your vaccination.”

 

Feed time at Federal Council

History was made when the AMA Federal Council met at Canberra in March.

For the first time ever (we think), a baby was breastfed during Council proceedings.

While it made no ripple at all, we here at Australian Medicine thought it was so cool that we wanted to let you all know about it.

Dr Jill Tomlinson introduced daughter Anna to the Council on March 16. “She is four weeks old today,” proud Mum told AusMed.

We are not a hundred per cent sure that Anna didn’t vote during the Bupa motions.

PICTURE: Dr Jill Tomlinson and daughter Anna

 

Culturally safe waiting rooms

The promotion of designated waiting rooms for Aboriginal people in NSW hospitals has been met with a mixed reaction.

The State’s health department undertook research into why Indigenous patients are more likely than non-Indigenous patients to leave waiting rooms without receiving treatment.

The research found that some Aboriginal patients did not feel safe in waiting rooms, sparking calls for “designated Aboriginal waiting rooms” or “culturally appropriate space” for Indigenous patients.

Hanging Aboriginal artwork on waiting room walls could also help, the study concluded.

The recommendations have been both applauded and criticised.

AMA President Dr Michael Gannon said it was good that the concept of cultural safety is entering the popular narrative.

“The truth is that health outcomes for Indigenous Australians are significantly worse than non-Indigenous Australians according to just about every possible metric,” he said.

“The AMA strongly supports Aboriginal control when it comes to primary care and when it comes to Aboriginal and Torres Strait Islanders being in larger health facilities like our hospitals, I think we need to do everything we can to make them the appropriate settings for them to seek care.”

 

Doctors have role to play in drug-free sport

To coincide with the XXI Commonwealth Games, played on the Gold Coast this month, the AMA released its revised Position Statement on Drugs in Sport, and called on both doctors and athletes to ensure the event was free from any banned performance-enhancing drugs.

AMA President Dr Michael Gannon said the Games provided an opportunity to uphold Australia’s reputation for drug-free competition at all levels.

“While some athletes deliberately use prohibited substances to improve their performance, others may inadvertently ingest a banned substance in a prescription or over-the-counter medication,” he said.

“Doctors have an important role to play in reducing the use of performance-enhancing drugs in sport, and in helping athletes to avoid unwittingly taking banned substances in otherwise legal medications.”

The AMA Position Statement on Drugs in Sport – 2018 can be read in full at:

position-statement/drugs-sport-2018

CHRIS JOHNSON

Tuberculosis continues to threaten regional health security

During a World Tuberculosis Day speech delivered in the Senate in March, International Development Minister Concetta Fierravanti-Wells sought to highlight the devastating outcomes tuberculosis is still having globally, including in Australia’s region.

TB is the world’s top infectious disease killer. In 2016, 1.7 million people died from TB – almost 4,700 each day.

Twelve of the world’s 30 highest TB burden countries are located in our region, accounting for nearly half of all cases of drug-resistant TB and TB deaths worldwide.

“Turning the page on TB – once and for all” is a Federal Government priority, Senator Fierravanti-Wells said.

In the 12 months to December last year, there were 10 million movements out of Australia. Two million Australians visited Pacific island countries and Oceania and another 3.1 million Australians visited South-East Asian countries.

“Thirty highest TB-burden countries are located in our region and account for nearly half of all cases of drug-resistant TB and TB deaths worldwide,” the Minister said.

“Papua New Guinea, which is four kilometres to our north, has a major TB problem and, in particular, a drug-resistant TB problem. That not only puts PNG at risk; it also puts Australians at risk.”

In 2014, Australia’s National Notifiable Diseases Surveillance System received 1,339 TB notifications, representing a rate of 5.7 per 100,000 population

However, the Department of Health notes Australia’s overseas-born population continued to represent the majority (86 per cent) of TB notifications and Australia’s Aboriginal and Torres Strait Islander population continue to record TB rates about six times higher than the Australian born non-Indigenous population. 

The Department estimates the cost of treating a single patient with drug resistant TB can be up to $260,000 in Australia.

“TB not only affects individuals, but it also cripples communities; disrupts tourism, trade and investment and sets back regional economic growth and development,” Senator Fierravanti-Wells said.

The Minister said that in June last year, the Government announced a new partnership with the World Bank, targeting drug resistant TB in vulnerable communities in PNG.

Another way that Australia is contributing to the fight to end TB is through research.

With one in four people with TB not getting treatment through public health programs, WHO Regional Director for the Western Pacific, Dr Shin Young-soo, continues to urge Governments to do more.

“The TB rate is coming down in the region, but it’s not happening fast enough. We need to do much more to achieve our goal of ending the epidemic once and for all,” he said

 MEREDITH HORNE