Bulletin of the World Health Organization

Public health round-up

Bulletin of the World Health Organization 2013;91:316-317. doi: http://dx.doi.org/10.2471/BLT.13.010513

Moving target: the influenza A(H7N9) virus in China

WHO/KC Cabali

WHO experts follow the situation in China, where 31 cases of human infection with the influenza A(H7N9) virus, including six deaths, had been confirmed by 10 April. The new emergency operations centre (pictured) opened in March at WHO’s Regional Office for the Western Pacific in Manila, the Philippines.

After the MDGs

A report published last month praises the achievements of the Millennium Development Goals (MDGs) and calls for a new approach to health and development that emphasizes “sustainable well-being”.

The 104-page report, entitled Health in the post-2015 agenda: report of the global thematic consultation on health April 2013, contains proposals for the health component of a new development agenda.

The proposals are based on a six-month consultation of some 150 000 people and many organizations from all regions, co-led by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), in collaboration with the governments of Botswana and Sweden.

“The health sector has led the development success of the MDG era and created an unprecedented opportunity to achieve even more after 2015,” the report says, adding that the health MDGs raised the profile of global health “to the highest political level,” mobilized civil society, increased health aid and helped to improve health in developing countries.

But, according to the report, “the MDGs do not fully address the broader concept of development enshrined in the Millennium Declaration, which includes human rights, equity, democracy and governance… The MDGs have also contributed to fragmented approaches to development.”

“Further progress in improving health and well-being can only be made by reducing inequities,” it says. “This requires not only health system strengthening and financial protection but also political and social mobilization to overcome gender inequalities, all forms of discrimination and human rights violations that impede the achievement of all the MDGs.”

A post-2015 development agenda is emerging. The report proposes “sustainable well-being” as an “overarching goal” and that the specific health goal, in which the health sector would play a large part, be called “maximizing healthy lives”.

It proposes that countries build on the existing health-related MDGs to speed progress in reducing child and maternal deaths and controlling HIV infection, tuberculosis, malaria and neglected tropical diseases and to set new targets to reduce the burden of the four groups of noncommunicable diseases causing the most deaths (cardiovascular diseases, cancers, chronic respiratory diseases and diabetes) and mental illness.

Universal health coverage is proposed as the key contribution of the health sector to achieve these health goals and targets. Health is one of 11 topics selected by the UN Secretariat for “global thematic consultations”. The report on health and other topics will be discussed at the UN General Assembly in September. www.worldwewant2015.org/health

Dot health at the Assembly

WHO’s Member States gathered at the World Health Assembly this month are due to consider the role the global public health community should play in the internet domain name “.health”.

Last year the Internet Corporation for Assigned Names and Numbers (ICANN), a US-based non-profit corporation, invited applications for new names to be added to the current system of generic internet names, e.g. “.com”.

Of a total of 1930 applications, it received four for “.health” from commercial companies. These applications are under review in a process involving technical evaluation and stakeholder input.

Last year, WHO and several nongovernmental organizations raised concerns that these applications may not adequately protect consumers, and requested a delay in the attribution of the domain name until the global health community has been fully consulted.

A report (EB132/24) submitted to the WHO Executive Board in January highlighted the need for better regulation of health on the internet, saying that the “lack of an overarching international legal framework for the internet hinders an effective response to fraud and crime, such as identity theft and the illegal promotion and sale of medicines.”

“Quality seals and voluntary codes of conduct are still ineffective after a decade of use. Efforts to educate consumers are insufficient and government actions, such as accreditation schemes, have had limited impact on a global medium,” the report said.

Cover photo

© The Global Fund/John Rae

Illegal immigrants are often excluded from health-care services and are at higher risk of infection with HIV. This month’s cover photo shows children from Myanmar at a school for illegal immigrants in Kanchanaburi, Thailand, as part of an HIV prevention programme.

Call to help Syrians

WHO called on donors to provide US$ 39.8 million by June 2013 to respond to the acute health needs of people affected by the crisis in the Syrian Arab Republic, estimated at almost four million, including internally displaced persons and returnees.

In its most recent update on the health sector situation in the country, WHO said that the health system had been severely disrupted with 57% of public hospitals damaged, 37% of which are out of service and 20% partially damaged. Many of the hospitals that continue to operate do so at reduced capacity, owing to the lack of fuel and electricity.

The health workforce has been severely reduced as many health professionals have fled the country and there is now a shortage of qualified medical staff particularly for trauma, anaesthesia and laboratories.

The update described shortages of life-saving medicines, including anaesthesia, analgesics, antibiotics, sera and intravenous fluids as “critical” and lamented also the shortages of medicines for the treatment of chronic diseases in a country where noncommunicable diseases are the leading cause of death and disease. http://www.who.int/hac

Preventing child deaths

The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have launched a global plan to prevent the deaths of some two million children every year, caused by pneumonia and diarrhoea, by increasing access to life-saving treatment and care.

The Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea calls for a 75% reduction globally in the incidence of severe pneumonia and diarrhoea among children aged under five years from 2010 levels and the virtual elimination of deaths from both diseases in this age-group.

The plan calls on governments and other decision-makers to increase investment in services to prevent and treat these health problems in children living in the poorest parts of the world. Pneumonia and diarrhoea are two of the leading killers of children aged under five globally. Most of these deaths occur in sub-Saharan Africa and South Asia.

“If, in the 75 countries with the highest death rates, we apply to the entire population the same coverage of essential interventions enjoyed by the richest 20% of households, we can prevent the deaths of two million children even as soon as 2015, the deadline for the Millennium Development Goals,” said Micky Chopra, global head of UNICEF’s health programmes.

The plan calls for 90% of all children to have access to antibiotics for pneumonia and oral rehydration salts for diarrhoea, up from current levels of 31% and 35% respectively. As an interim target, at least half of all children under six months should be exclusively breastfed, against 2012 levels of 39%, which helps to prevent diarrhoea.

Building on progress made in some countries in introducing new vaccines against pneumococcal bacteria, a major cause of pneumonia, and rotavirus, a major cause of diarrhoea, the plan aims for 90% coverage by the target date.

Well-being on the agenda

A new report on the health of nearly 900 million inhabitants in WHO’s European Region puts well-being at the centre of its overview of health in these 53 countries.

The report, entitled: The European health report 2012: charting the way to well-being says that while maintaining traditional targets of reducing premature mortality and inequities in health, increasing life expectancy and providing universal health coverage, the region is setting a new target – that of enhancing the well-being of its population.

It describes a common health information system for the whole WHO region that is expected to result, later this year, in proposed indicators that governments can use to assess the level of well-being and other aspects of health. The target year to achieve the goals is 2020.

“To incorporate well-being in [the] Health 2020 [agenda] and to quantify a European target and relevant indicators, it is essential to develop a common concept and approach to well-being that allow for valid measurement and yield information that is useful to policy-makers and for programme evaluation,” the report says.

The report provides an update on health in this diverse WHO region, ranging from Portugal in the west to Kazakhstan in the east. http://www.euro.who.int/en/what-we-do/data-and-evidence/european-health-report-2012

Looking ahead

14 June: World Blood Donor Day

1–5 July: 50th anniversary of the Codex Alimentarius for food safety and nutrition

28 July: World Hepatitis Day