Bulletin of the World Health Organization

Public health round-up

Bulletin of the World Health Organization 2013;91:624-625. doi: http://dx.doi.org/10.2471/BLT.13.010913

Research for universal health coverage

WHO/Chris Black

A field worker interviews a girl near Bala Kot, Pakistan. Research is essential to find out how to make health care accessible and affordable for people in need. Research for universal health coverage is the subject of the World health report 2013, which was released on 15 August. http://www.who.int/whr

WHO to lead NCD task force

The World Health Organization (WHO) will convene a formal meeting with its Member States on 13 November to complete the work on a draft terms of reference for a new United Nations (UN) task force on the prevention and control of noncommunicable diseases (NCDs) to be led by WHO.

In July the UN Economic and Social Council adopted a resolution in Geneva to establish the task force.

The move comes two years after heads of state and government gathered at the UN General Assembly in September 2011 committed to take action to address NCDs.

This year, WHO’s 194 Member States agreed on a WHO Global NCD Action Plan 2013–2020 at the World Health Assembly in May.

The plan aims to achieve nine voluntary global targets, including a 25% reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2025.

The purpose of the task force is to coordinate the activities of the UN system and other intergovernmental organizations in this regard, in particular through the implementation of the WHO Global NCD Action Plan 2013–2020 (see editorial on page 623).


UN to debate disability and post-MDG agenda

Member States will gather on 23 September at the UN General Assembly in New York to discuss including people with disabilities in greater efforts to achieve the Millennium Development Goals (MDGs) by 2015 as well as in other development projects, including the post-MDG agenda.

Some progress has been made since 2006, when the Convention on the Rights of Persons with Disabilities was adopted. However, people with disabilities make up an estimated 15% of the world’s population, of whom 80% live in developing countries and that is why the MDGs and other development goals cannot be achieved unless development processes reach and benefit them equally.

Member States will also discuss proposals for the post-2015 development agenda contained in the final report.

http://www.un.org/disabilities/default.asp?id=1590; http://www.post2015hlp.org/the-report/

More support for breastfeeding needed

Only 37 (19%) of the 199 countries reporting to WHO have fully implemented the recommendations of the International Code of Marketing of Breast-milk Substitutes, according to a new WHO report.

WHO recommends that mothers exclusively breastfeed infants for the child's first six months to achieve optimal growth, development and health. After that, they should give their infants nutritious complementary foods and continue breastfeeding up to the age of two years or beyond.

In 1981, the International Code of Marketing of Breast-milk Substitutes was adopted by countries to address concerns that breast-milk substitutes were being marketed to mothers too aggressively. Thirty years later this is still the case in many countries.

The report found that only 69 countries (35%) fully prohibit advertising of breast-milk substitutes while only 62 (31%) completely prohibit free samples or low-cost supplies for health services. Meanwhile, 64 (32%) completely prohibit gifts of any kind from relevant manufacturers to health workers and 83 (42%) require a message about the superiority of breastfeeding on breast-milk substitute labels.

“Nearly all mothers are physically able to breastfeed and will do so if they have accurate information and support,” said Dr Carmen Casanovas, breastfeeding expert with WHO’s Department of Nutrition for Health and Development. “But in many cases women are discouraged from doing so and are misled to believe that they are giving their children a better start in life by buying commercial substitutes.”

The report was released to mark World Breastfeeding Week 1–7 August.

MERS-CoV update

An emergency committee of international experts reviewed all available information on the Middle East respiratory syndrome coronavirus (MERS-CoV) and agreed unanimously that the current situation did not meet conditions for a public health emergency of international concern.

The committee was convened on 9 and 17 July under the International Health Regulations to advise the Director-General of WHO. So far, the only time it has deemed a situation to be a public health emergency of international concern was during the A (H1N1) influenza pandemic in 2009.

From September 2012 to date, WHO has received reports of a total of 94 laboratory-confirmed cases of infection with MERS-CoV, including 47 deaths. A recent study suggests that MERS-CoV, or a virus very similar to it, has been circulating recently among camels. This is the first study identifying the animal that could be a reservoir for the virus and more structured investigations are needed including on exposures in humans.

WHO is encouraging all Member States to continue their surveillance for severe acute respiratory infections and to review any unusual patterns.

Health-care workers are advised to maintain vigilance, while recent travellers returning from the Middle East who develop severe acute respiratory infections should be tested for MERS-CoV as advised in the current surveillance recommendations.


Cover photo

WHO/Anna Kari

The September issue of the Bulletin of the World Health Organization is devoted to the topic of women’s health beyond reproduction and highlights the neglected but growing burden of chronic diseases among women particularly in developing countries.

Medicines gap

A new WHO report calls on pharmaceutical researchers to take account of the ageing of populations all over the world in their research and development work.

The report, Priority medicines for Europe and the world: 2013 update, highlights pharmaceutical gaps, where more effective targeted treatments are needed.

The ageing of populations leads to a greater prevalence of diseases and conditions associated with ageing, such as heart disease, stroke, cancer, diabetes, osteoarthritis, low back pain, hearing loss and Alzheimer disease, the report notes.

In combination with health promotion and disease prevention initiatives, these conditions require more investment in research and innovation to bridge these pharmaceutical gaps. Since the original priority medicines report was published in 2004, progress has been mixed.

“Multiple small-scale trials of combination therapy have been undertaken, but no large-scale studies have been initiated. One such example is fixed-dose polypills for ischaemic heart disease,” says Kees De Joncheere, director of the Essential Medicines and Products Department at WHO headquarters.


New WHO guidelines

Tuberculosis screening

WHO has developed guidelines on systematic screening for active tuberculosis based on a thorough review of available evidence.

Early detection of tuberculosis is essential to further improve health outcomes for people with the disease and to reduce transmission more effectively. Systematic screening in high-risk groups is a possible complement to efforts to improve the patient-initiated pathway to tuberculosis diagnosis.


Mental health

WHO has released new clinical protocols and guidelines for health-care workers to use when treating the mental health consequences of trauma and loss.

Using the new protocol, which was co-published with the United Nations High Commissioner for Refugees, primary health care workers can offer basic psychosocial support to people exposed to trauma or loss.

Types of support offered can include psychological first aid and stress management. Referral for advanced treatments such as cognitive-behavioural therapy or a new technique called eye movement desensitization and reprocessing should be considered for people with post-traumatic stress disorder.


Looking ahead

8–11 October: Budapest Water Summit, Hungary http://www.budapestwatersummit.hu/budapest-water-summit/overview

10 October: World Mental Health Day http://www.who.int/mental_health/world_mental_health_day

14 November: World Diabetes Day

1 December: World AIDS Day http://www.who.int/campaigns/aids-day/2013/event

3 December: International Day of Disabled Persons