News in Brief

US CDC recommends HPV vaccine for boys

US CDC’s Advisory Committee on Immunization Practices (ACIP) approved recommendations for routine vaccination of males 11 or 12 years old with 3 doses of HPV4 to protect against Human Papalloma Virus. The HPV vaccine will afford protection against certain HPV-related conditions and cancers in males, and vaccination of males with HPV may also provide indirect protection of women by reducing transmission of HPV.

Avian flu in Egypt

The latest case of avian flu in Egypt (before going to press) is that of a 31- year-old female from Meet Salseel district, Dakahlia governorate. She developed symptoms on 10 November 2011 and was hospitalised on 16 November. She was reported in critical condition. The source of infection is believed to be from exposure to sick and dead poultry in her backyard. Of the 153 cases confirmed by 1 December 2011 in Egypt, 52 have been fatal.

KHCC – MD Anderson Cancer Center partnership

The King Hussein Cancer Center in Amman, Jordan has signed a Sister Institution agreement with The University of Texas MD Anderson Cancer Center in the US. The agreement places KHCC within the largest global network of leading oncology research, education and clinical care centers.

WHO releases World Malaria Report

WHO released the World Malaria Report 2011 in December last year. The report carries the latest available data on malaria cases and deaths from around the world. It shows the most recent trends and also carries updated information about drug and insecticide resistance in malaria-endemic countries. For the first time, the report includes separate country profiles for all 99 countries with ongoing malaria transmission. See pg 134.

Stem Cells Translational Medicine journal launched

AlphaMed Press, publisher of Stem Cells, the oldest peer-reviewed journal solely dedicated to the field, has launched a new internationally peer-reviewed journal, Stem Cells Translational Medicine. The new journal answers an acknowledged need within the research and clinical communities for comprehensive coverage of stem cell science, stem cell-based regenerative medicine and tissue engineering, stem cell-based predictive toxicology, and cancer stem cell investigation. The inaugural issue’s articles are available at http://stemcellstm.alphamedpress.org

Global population reaches 7 billion

The global population has now reached 7 billion, according to the United Nations, which marked the occasion on 31 October last year, with a call to action to world leaders to meet the challenges that a growing population poses, from ensuring adequate food and clean water to guaranteeing equal access to healthcare. Ban Ki-moon, UN secretary-General said the world today is one of “terrible contradictions”. There is plenty of food but 1 billion people go hungry; lavish lifestyles for a few, but poverty for too many others; huge advances in medicine while mothers die everyday in childbirth; and billions spent on weapons to kill people instead of keeping them safe.

Polio reappears in Madagascar

While no cases of polio have been detected in Madagascar since 1997, the Ministry of Health announced in October that they had identified 6 new cases in the south of the country in the remote areas of Fort Dauphin and Tulear, raising fears of a new resurgence of the epidemic of polio. The low immunization rates combined with health problems and malnutrition may well contribute to a reoccurrence of this disease. A MoH report in 2010 showed that only 70% of Malagasy children were vaccinated against polio.

New disinfection system may change way hospital rooms are cleaned

A Queen’s University infectious disease expert has collaborated with Medizone International in the development of a disinfection system that may change the way hospital rooms all over the world are cleaned. The new technology involves pumping a Medizone-specific ozone and hydrogen peroxide vapour gas mixture into a room to completely sterilise everything – including floors, walls, curtains, mattresses, chairs and other surfaces. It is far more effective in killing bacteria than wiping down a room. Study results on the process are published in the December 2011 issue of the American Journal of Infection Control.

New funding for genome sequencing

A new funding plan by the US-based National Human Genome Research Institute (NHGRI) sharpens the focus of its flagship Genome Sequencing Program on medical applications. In addition to continuing on-going studies, the four-year, US$416 million plan launches new efforts to find causes of rare inherited diseases and accelerate the use of genome sequence information in the medical care of patients.

New consortium to ensure pandemic preparedness

A group of health organisations has launched a new international consortium to better prepare the clinical research community to respond to the next pandemic or other emerging health threats, according to CIDRAP News. The International Severe Acute Respiratory Infection Consortium (ISARIC) is a global collaboration of over 20 hospitalbased clinical research networks. The aim is to ensure the clinical researchers have in place the necessary open access protocols and datasharing processes and have considered the ethical issues that will allow them to respond to rapidly emerging diseases with epidemic or pandemic potential, such as the recent pandemic H1N1 influenza and SARS outbreaks.

AIDS activists welcome Obama’s pledge on antiretroviral supply

AIDS activists have welcomed a pledge by US President Barack Obama to provide antiretroviral treatment to some six million people globally by 2013, an increase of two million on the previous target. In 2010, some 3.2 million people were accessing ARVs through the US President's Emergency Plan for AIDS Relief (PEPFAR); globally, some 6.6 million people have access to HIV treatment out of an estimated 15 million who need it. According to an IRIN PlusNews report, the pledge, however, does not come with an increase in PEPFAR funding from the US$48 billion pledged in 2008 for five years.

Insomnia drug approved

The US FDA has approved Intermezzo (zolpidem tartrate sublingual tablets) for use as needed to treat insomnia characterised by middle-of-the-night waking followed by difficulty returning to sleep. This is the first time the FDA has approved a drug for this condition. Intermezzo should only be used when a person has at least four hours of bedtime remaining. It should not be taken if alcohol has been consumed or with any other sleep aid.

Smoke-free workplace reduces cardiac death

Mayo Clinic researchers have amassed additional evidence that secondhand smoke kills and smoke-free workplace laws save lives. The study was presented to the American Heart Association's Scientific Sessions in November last year. This study adds to the observation that smoke-free workplace laws help reduce the chances of having a heart attack, but for the first time it is reported that these laws also reduce the chances of sudden cardiac death.

Meningitis vaccine rolled out in Africa

Three more countries – Nigeria, Cameroon and Chad – in the so-called “meningitis belt” stretching across Africa introduced a new vaccine in December designed to eliminate Group A meningitis, the WHO reported. Around 22 million people were expected to be vaccinated with MenAfriVac in the three countries. The campaign will be extended to 19 other countries in the belt by 2016.

Cherry juice may help improve sleep

Drinking cherry juice significantly improves both the quality and duration of sleep, according to new findings from Northumbria University. Researchers from the School of Life Sciences have found that Montmorency cherry juice significantly increases the levels of melatonin in the body, the hormone which regulates sleep, and could benefit those who have difficulty sleeping due to insomnia, shift work or jet lag. 
 

Polio eradication more difficult than smallpox

Declaring the eradication of polio will be far more difficult than it was for smallpox, according to a review published in the Journal of General Virology. Further research into the complex virus – host interactions and how the vaccine is used in the final stages of the eradication programme is crucial to its success.

Poliomyelitis, also known as infantile paralysis, was one of the most feared diseases of the 1950s. By the mid 1970s, thanks to vaccination, the viral disease had been controlled and eradicated from the developed world, including the UK, US and most of Europe. In 1988, the World Health Organisation launched a global eradication programme which is now near completion.

By the end of 2000, the only countries where polio was still endemic were those in the Indian subcontinent and central Africa. This year, for the first time, India has had no cases of polio. There are now just three countries where the virus is still circulating: Nigeria, Pakistan and Afghanistan. As the programme draws ever closer to its goal, there are new challenges and issues to be faced, these are explored by Dr Philip Minor from the UKbased National Institute for Biological Standards and Control, a centre of the Health Protection Agency, in the review.

As many polio infections do not cause symptoms, strong evidence is needed to show that not only the disease, but the virus that causes it, has disappeared completely.

“There are three strains of virus that cause polio – some more easily detectable than others,” explained Dr Minor. “There have been examples where disease has been undetectable but the virus continues to be found circulating in the environment, e.g. sewage. This obviously raises questions about the confidence with which polio can be said to be eradicated when the time comes.”

Dr Minor believes that ridding the world of polio is more challenging than it was for smallpox. “The effort to eradicate polio is very close to success. If it gets there it will be a colossal technical achievement – arguably greater than putting a man on the moon – and will be among the greatest public health achievements of all time,” said Dr Minor. “However, polio is different from smallpox as most infections are asymptomatic and the live vaccine – which requires sophisticated technology to make – can, in rare cases, cause the disease.

“We must also think carefully how these vaccines are used, in the final stages of the eradication programme. We need to look more closely into the behaviour of the virus – including the wild-type and the virus used in vaccines – and how they interact with their hosts. These lessons are important for future disease eradication efforts,” he said.



GE, Microsoft to form joint venture to improve healthcare IT

GE, through its healthcare IT business, and Microsoft will establish a joint venture aimed at helping healthcare organisations and professionals use real-time, systemwide intelligence to improve healthcare quality and the patient experience. Upon formation, the new company will develop and market an open, interoperable technology platform and innovative clinical applications focused on enabling better population health management to improve outcomes and the overall economics of health and wellness.

As healthcare providers and payers around the globe shift from episodic single-patient care to continuous population management, new requirements have emerged for integrated care processes, greater insight and engaging patient experiences, GE said in a press statement. These delivery system reforms, including a shift toward new payment models, require healthcare providers to address gaps and integrate data across areas of care delivery to help enable better care coordination and performance improvement.

This new venture will combine Microsoft’s expertise in building platforms and ecosystems with GE Healthcare’s experience in clinical and administrative workflow solutions, empowering healthcare professionals and organisations with the intelligence and capabilities to respond to the rapidly evolving and complex healthcare landscape.

“The complementary nature of GE Healthcare’s and Microsoft’s individual expertise will drive new insights, solutions and efficiencies to further advance the two companies’ shared vision of a connected, patient-centric healthcare system, ” said Jeffrey R. Immelt, Chairman and CEO of GE. “The global healthcare challenges of access, cost and quality of care delivery are creating a new focus on the performance and accountability of healthcare delivery systems – in every country, at every level of care. This venture will demonstrate what is possible when leading companies with complementary capabilities work together to meet a common goal.”

The new company will deliver a distinctive, open platform that will give healthcare providers and independent software vendors the ability to develop a new generation of clinical applications. The venture will develop healthcare applications on the platform using in-house developers and the platform will connect with a wide range of healthcare IT products. GE Healthcare IT will immediately be able to connect existing products to the platform, helping current customers to derive new insights. “High quality affordable healthcare is one of the biggest challenges facing every nation, but it’s also an area where technology can make a huge difference,” said Steve Ballmer, CEO of Microsoft. “Combining Microsoft’s open, interoperable health platforms and software expertise with GE’s experience and healthcare solutions will create exciting opportunities for patients and healthcare providers alike. Working together, GE and Microsoft can help make healthcare systems more intelligent and cost efficient while improving patient care.”

The two parent companies bring complementary expertise to this new venture and will contribute substantial intellectual property, including: Microsoft Amalga, an enterprise health intelligence platform Microsoft Vergence, a single sign-on and context management solution Microsoft expreSSO, an enterprise single sign-on solution GE Healthcare eHealth, a Health Information Exchange GE Healthcare Qualibria, a clinical knowledge application environment being developed in cooperation with Intermountain Healthcare (Salt Lake City, Utah) and Mayo Clinic

The long-term vision of the venture is to create new value by offering a healthcare performance management suite that includes many of these products. The two companies will each maintain a strong presence in the healthcare IT industry, as both parent organisations will continue to sell other products and services to healthcare organisations around the globe.

The new company, which has yet to be named, will be headquartered near the Microsoft campus in Redmond, Washington. Michael J. Simpson, vice president and general manager at GE Healthcare IT, will serve as the company’s CEO. EU funds project to research immunisation technologies

A new EU-funded project set to speed up the development of novel and powerful immunisation technologies for the next generation of human vaccines got under way recently. The ADITEC (Advanced immunization technologies) project is funded in part by €30 million as part of the ‘Health’ theme of the Seventh Framework Programme (FP7); it will bring together scientists from 42 research and industry bodies across 12 countries. The aim is to establish a strong platform for innovation in a crucial area for human health and to highlight the importance of the vaccine sector in effective health care. The project partners will work on a wide range of vital aspects of vaccination, from basic research and new technologies to clinical trials and public health.

Máire Geoghegan-Quinn, EU Commissioner for Research, Innovation and Science explains: “New technologies are opening the door to fight those diseases for which vaccines could not be developed so far. However, researchers in a single laboratory cannot tackle modern vaccine science in isolation, which is why we are bringing together some of Europe's top researchers in this area. By joining forces and pooling knowledge and expertise, we can take a big step towards transforming the medicine of the future.”

The project will focus on improved potency and safety of vaccines and their components, novel routes and devices for administration of vaccines, optimised vaccination strategies and optimised formulations and vaccination methods for different age groups. It will also enhance our insight into the effects of gender, chronic diseases and genetic variation on vaccination.



Mouth cancer cases forecast to rise

The International Agency for Research on Cancer predicts that over 790,000 people will be diagnosed with mouth cancer globally by 2030 – an increase of over 63% compared to 2008.

Mortality rates for mouth cancer are predicted to be even higher with over 460,000 deaths forecast by 2030 – more than two thirds higher than 2008 rates (67.6%).

Many of the risks for mouth cancer are lifestyle related. Tobacco use is by far the biggest cause of mouth cancer. Alcohol abuse is also a major cause and drinking to excess can increase the risk of mouth cancer by up to four times. People who smoke and drink are up to 30 times more likely to develop mouth cancer.

Smokeless or chewing tobacco like Gutka, Khaini, and Pan Masala also pose a major risk for mouth cancer, especially among South East Asian countries and communities. The Human Papilloma Virus (HPV), usually transmitted through oral sex, is another risk factor for mouth cancer.

The World Health Organisation believes ‘modifying and avoiding’ risk factors could result in up to 30% of cancers being avoided and Chief Executive of the International Dental Health Foundation, Dr Nigel Carter, believes greater worldwide knowledge on mouth cancer and associated risk factors could have a major influence on the lives of millions.

Dr Carter said: “Although cancer is not wholly preventable, mouth cancer is very closely related to lifestyle choices. Making more people aware of the risks and symptoms for mouth cancer will undoubtedly save lives.

“In the UK, Mouth Cancer Action Month is run each year to help raise awareness. We know that early detection can transform survival rates from 50% to 90% and simple campaigns like these – supported by health professionals – can make a real difference.

“Forecasts for the incidence and mortality of mouth cancer are very grim. We hope more countries will develop their own mouth cancer action campaigns to raise awareness and invite anyone who wishes to do so to contact the Foundation for advice.

“Something that everyone can do is to routinely check for warning signs. These include ulcers which do not heal within three weeks, red and white patches in the mouth, and unusual lumps or swellings in the mouth.”



Syphilis resurgence puts pregnant women and their babies at risk

Syphilis is re-emerging as a common sexually transmitted infection in many developing economies, putting pregnant women and their babies at risk.

A study published recently in the Bulletin of the World Health Organization highlights a lack of syphilis testing of pregnant women in rural communities of southern China, where this largely forgotten infection has seen a recent resurgence.

Syphilis infection in pregnant women can cause foetal and infant deaths, and irreversible birth defects including blindness and brain damage. But, if diagnosed early, the infection can be treated effectively with penicillin.

The WHO estimates that almost 2 million pregnant women worldwide are infected with syphilis every year and half of these women transmit the infection to their baby if they are not treated. The disease has been around for many centuries but some countries are experiencing a resurgence in cases, particularly among female sex workers and men who have sex with men. In China, there were almost 300,000 reported cases of syphilis in 2008, a tenfold increase on the previous decade.

“Mother-to-child syphilis transmission is an important public health concern in areas with high incidence of syphilis,” says Dr Li-Gang Yang, from the Guangdong Provincial Center for Sexually Transmitted Infection Control & Prevention. “Our study of almost 500,000 pregnant women in Guangdong Province found that more than 40% of pregnant women in poor areas were missing out on a syphilis test, in most cases because health clinics lack testing facilities.”

“Since we did the study in 2008, the Chinese government has responded to this problem by integrating rapid tests into the national programme for prevention of mother-to-child transmission of HIV, syphilis and hepatitis B in China,” says another author of the study, Rosanna Peeling of the London School of Hygiene and Tropical Medicine. “This timely translation of evidence to policy can serve as a model for other countries.”



UK conducts largest home telehealth study

Philips has welcomed the initial results of a home healthcare clinical study in the UK of which it was one of three telehealth technology providers.

The study, published 6 December 2011 by the UK’s Department of Health, involved approximately 6,000 patients at three sites across the UK. It was carried out over two years and is believed to be the world’s largest of its kind.

The clinical study – known as the Whole System Demonstrator (WSD) program – aimed to provide an evidence base for the adoption of telemonitoring technologies, which could alleviate the mounting financial burden of institutional care for the chronically ill.

The early findings of the WSD program show that if used correctly TeleHealth can deliver a 15% reduction in accident & emergency (A&E) department visits, a 20% reduction in emergency admissions, a 14% reduction in elective admissions, a 14% reduction in bed days and an 8% reduction in tariff costs. More strikingly, they also demonstrate a 45% reduction in mortality rates.

Philips was selected as one of only three TeleHealth technology providers for the WSD program, offering its remote patient management system – called Motiva – to approximately 550 heart failure, COPD (chronic obstructive pulmonary disease) and diabetes patients in the London borough of Newham. Newham is challenged with providing long-term healthcare for more than 17% of its population as well as being ranked as having the highest diabetes rate and death rate from stroke in the UK, thus reflecting the current pressures facing the NHS. Philips further contributed to the WSD study by designing the so-called ‘care pathways’, i.e. the plan that defines how the patient is monitored, provides information and receives information.

Philips’s Motiva remote patient management system analyses a patient’s vital signs (blood pressure, weight, and blood sugar levels) via home monitoring devices wirelessly linked to a patient’s television at home. Anomalies in vital signs are transmitted via secure broadband to healthcare professionals for remote analysis. Through Motiva, patients receive early alerts related to their health condition so that they can take steps at home to improve their health rather than waiting for their condition to worsen resulting in a trip to emergency or a possible hospital admission.

Unlike traditional home monitoring technologies, Motiva delivers educational healthcare content – videos, medication reminders, health tips – based on the remote assessment healthcare professionals make of the patient’s regularly monitored vital signs. The educational content aims to “motivate” patients to adapt their dayto- day routine – their nutrition, exercise, medications – to improve the management of their chronic condition.

“The encouraging initial results of the WSD study validate our strategy and will drive continued collaboration with health care providers and home care providers in order to provide meaningful innovations that will address clinical needs and help improve patient lives,” said Steve Rusckowski, CEO, Philips Healthcare.



WHO members agree on proposals for reform

The Executive Board of the World Health Organisation (WHO) ended a three-day special session with Member States in November last year expressing strong support for WHO’s work and reaching agreement on broad proposals for reform, which aim to better position WHO to improve health outcomes, create a greater coherence in global health and exercise its leadership functions as a more efficient, effective and transparent organisation.

“We organised this meeting to discuss the key elements of the proposed reforms,” says Rahhal El Makkaoui, Chair of the WHO Executive Board. “Our discussions have been positive. These are ambitious reforms, designed to build on the Organisation’s already strong foundations and better equip it to respond to public health challenges in the 21st century.”

The Board welcomed many of the proposals put forward by Member States and the Director-General, including agreement that WHO’s five core areas of work should concentrate on health development, health security, strengthening health systems and institutions, generating evidence on health trends and determinants, and convening for better health.

In their regular meeting in January this year, the Executive Board will review, among other things, a proposed mechanism to increase predictability and flexibility of financing for the Organisation.

The Board emphasised the intergovernmental nature of WHO and its unique mandate as the directing and coordinating authority for work in global public health. In addition, they welcomed proposals to strengthen the governance of WHO, improve financing of the Organisation, strengthen country offices, facilitate collaboration across the Organisation, improve human resource policies, and increase accountability, to better measure the impact of health investments on health outcomes within countries.

The historical special session of the WHO Executive Board, repeatedly echoed the value of WHO’s unique mandate as the directing and coordinating authority for work in international health and agreed to proposals which include:

- developing criteria for priority setting of WHO’s work in global public health;

- how to engage an increasing number of public health actors, including foundations, civil society organisations, partnerships and the private sector. The Board felt strongly that in any opportunity for engagement, WHO’s independence and integrity must be protected from undue influence by those with vested interests;

- establishment of a contingency fund for the work of WHO in public health emergencies;

- clarification of roles and responsibilities between the three levels of the WHO – country offices, regional offices and headquarters – to create a tightly networked, leaner and streamlined Organisation;

- development of an approach to independent evaluation.


 

                                  
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