New oncology imaging database promotes wider access to data

Curie-Cancer, the body responsible for developing Institut Curie’s industry partnership activity, and Strand Scientific Intelligence, (Strand) have launched the Curie Image Database (CID), a breakthrough image analysis and management platform that they developed jointly over the past two years at the Cell and Tissue Imaging Core Facility of the Institut Curie (PICT-IBiSA).

CID was created using Strand’s awardwinning Avadis platform. It now enables over 250 scientists at Institut Curie and 10 other collaborating institutions across Europe to effectively manage heterogeneous imaging data and complex analysis workflows. CID (or Avadis iMANAGE outside the Institut Curie network) provides shared, secure and open access to image life cycle data as well as image analysis algorithms.

“Institut Curie’s expertise in advanced imaging platforms and Strand’s ability to engineer superior scientific software have come together to create a scalable, secure and efficient ’open access‘ platform for microscopy images and analysis algorithms,” says Professor Vijay Chandru, cofounder and CEO of Strand.

“We are excited by the launch of this platform at the world’s leading cancer research institute. Strand has built an advanced genome sequencing-based diagnostic platform for oncology. Going forward we would like to explore with Institut Curie an advanced decision support platform for oncologists that integrates genomic signatures of cancers and imaging data towards better diagnosis and treatment of cancer patients.”

Jean Salamero, scientific director of Cell and Tissue Imaging Core Facility at Curie- Cancer, said: “Our goal was not only to provide an image ‘management’ system but also an interactive research tool that allows data and analysis sharing for distant and multidisciplinary projects between teams from different labs and institutes that is able to handle the exponential growth and complexity of scientific and biomedical images generated by advanced microscopy systems.

“Funding through the France Bio-Imaging program and Canceropole-IdF, a French network of institutions dedicated to oncology, allowed us to link CID to a new and secure storage infrastructure and to promote access to image processing on dedicated clusters.

Going forward, we would like to integrate this image database with other types of data, like genomic data or clinical and anatomy-pathological data related to clinical projects, resulting in an even more effective weapon in our fight against cancer.” Damien Salauze, director of Curie-Cancer, said: “Such a partnership project may ultimately help with the treatment of cancer. We are delighted to have contributed to the implementation of this technology developed by an international SME like Strand, whose roots are in India.

“This partnership embodies the principles of the Institut Carnot label which we were awarded by the French government in 2011 in recognition of our drive to provide genuine solutions for industry and ultimately for patients.”

Cell and Tissue Imaging

10 countries to benefit from GAVI Alliance HPV vaccination campaign

An estimated 206,000 girls in 10 developing countries are expected to benefit from the introduction of human papillomavirus (HPV) vaccine, which protects against the leading cause of cervical cancer, announced the GAVI Alliance on World Cancer Day.

The latest round of approved HPV vaccine introductions will see 10 countries begin targeted demonstration projects. The new approvals bring the total number of countries lined up to receive GAVI support for HPV vaccine to 21.

“HPV vaccine offers the best hope at protecting young girls from cervical cancer, one of the leading cancer killers of women in low-income countries,” said Dr Seth Berkley, GAVI Alliance CEO. “Current estimates show that by 2035 cervical cancer could claim the lives of 416,000 women each year, most of them living in developing countries.

The good news is that since GAVI began supporting HPV last year, there has been a real surge in demand for this vaccine. Our goal is to ensure that the vaccine reaches girls no matter where they live.” The ten countries planning to implement HPV vaccine demonstration projects over the next three years are Benin, Burundi, Cameroon, Cote d’Ivoire, Gambia, Liberia, Mali, Senegal, Solomon Islands, and Togo.

Three doses of the vaccine will be administered to girls in schools over a six month period while out-of-school girls will be reached through health facilities and community outreach programmes. The demonstration projects provide countries with an opportunity to gain experience in reaching girls with vaccines outside the usual routine immunisation schedule and to make informed decisions about whether to apply for a national introduction.

The wide reach of the immunisation programmes also provides an opportunity for countries to implement other health interventions that may benefit young adolescent girls. An estimated 266,000 women die every year from cervical cancer, of which more than 85% live in low-income countries, according to the latest statistics published by the International Agency for Research on Cancer (IARC).

Without changes in prevention and control, cervical cancer deaths are expected to rise to 416,000 by 2035, with over 95% expected to be women living in poor countries. Women in developing countries often lack access to cervical cancer screening and treatment, making HPV vaccine the best prevention tool against cervical cancer.

Unlike most other vaccines, which are administered to children under the age of five, HPV vaccines are given to girls aged nine to 13. Vaccination against HPV is more effective before a person is infected with the virus. Immunising girls before initiation of sexual activity, that is before exposure to HPV infection, is a key strategy to prevent cervical cancer.

The World Cancer Day campaign, organised by the Union for International Cancer Control (UICC), has the tagline “Debunk the Myths”.

The campaign is focusing on four general misconceptions around cancer which are common around the world, including the myth: “there is nothing I can do about cancer”. Several cancers are triggered by infections, including liver, cervical cancer, stomach and some lymphomas, some of which can currently be prevented with existing vaccines – hepatitis B vaccine against liver cancer and HPV vaccine against cervical cancer.

Health experts urge government action on obesity

The International Association for the Study of Obesity (IASO) in January published a 10-point action plan for governments to tackle obesity. The IASO Policy Briefing comes at a time when there is increasing need to tackle the rising levels of obesity and related non-communicable diseases (NCDs) in virtually all countries of the world.

“We’ve seen the evidence, we’ve got the strategies, now what we need is action,” said IASO Policy Director, Dr Tim Lobstein. The proposals come as governments prepare to report on their progress on tackling obesity and NCDs at the United Nations later this year. The Policy Briefing calls on governments to take a systems wide approach to tackling obesity and to work with civil society, especially to monitor the drivers of disease and to hold all stakeholders accountable for progress.

It also calls for further steps to be taken to strengthen nutrition security by protecting consumers, primarily children, from inducements to consume unhealthy products. In preparing their report, IASO gathered experts for a 2-day ‘meeting of the minds’ at the New York Academy of Medicine in September 2013 which brought together officials from the World Health Organization and the OECD, along with local and national government representatives and public health experts, advocacy groups, community activists and some private corporations.

Dr Lobstein, who convened the meeting, said: “The result of getting together such a wide group of people was explosive, with some radical proposals to tackle overconsumption, calls for stronger regulation through tough Public Health Acts, and calls for more transparent disclosures of agri-food company lobbying activities and their support for political parties.” The briefing recommendations include a strong emphasis on government leadership and action in order to reduce preventable deaths while improving economic performance.

“We call on governments to strengthen their legislative powers so they can intervene in markets for public health purposes. Failure to act will not be sustainable, especially in low-income countries,” said Dr Lobstein.

“We know that governments in lowincome countries have little control over the food supplies and trade and investment deals which destroy traditional, healthier diets.”

In isolation governments are reluctant to undertake market interventions as they don’t want to be seen to restrict people’s freedoms. However there is a good case for clear traffic light labelling on products, for banning junk food marketing to children, and for adjusting the existing subsidies and taxes to increase the consumption of healthier foods.”

“As obesity and consequent diseases put increasing strain on health services, governments will have no choice but to act,” he added. “The sooner they start, the cheaper and more effective their actions will be.” Professor Walter Ricciardi, President of the European Public Health Association, welcomed the report, commenting: “This report shows why governments must act against the drivers of the obesity epidemic, asserting their democratic mandate to defend the health of their populations against powerful vested interests.”

The prevention of obesity and NCDs: challenges and opportunities for governments

Deaths from measles reach historic low

New mortality estimates from WHO show that annual measles deaths have reached historic lows, dropping 78% from more than 562,000 in 2000 to 122,000 in 2012. During this time period, an estimated 13.8 million deaths have been prevented by measles vaccination and surveillance data showed that reported cases declined 77% from 853,480 to 226,722.

These gains are a result of global routine measles immunization coverage holding steady at 84% and 145 countries having introduced a routine second dose of measles vaccine to ensure immunity and prevent outbreaks. In addition to routine immunization, countries vaccinated 145 million children during mass campaigns against measles in 2012 and reached more than 1 billion since 2000, with the support of the Measles & Rubella Initiative.

Despite the impressive gains made, progress towards measles elimination remains uneven with some populations still unprotected. Measles continues to be a global threat, with five of six WHO regions still experiencing large outbreaks and with the Region of the Americas responding to many importations of measles cases. The African, Eastern Mediterranean and European regions are not likely to meet their measles elimination targets on time. The Region of the Americas has achieved measles elimination and continues to maintain this status while the Western Pacific region is approaching its target.

Routine measles vaccination coverage is an important progress indicator towards meeting Millennium Development Goal Four because of its potential to reduce child mortality and widely recognized as a marker of access to children’s health services.

Launched in 2001, the Measles & Rubella Initiative is a global partnership led by the American Red Cross, United Nations Foundation, U.S. Centers for Disease Control and Prevention (CDC), UNICEF and WHO.

The Measles & Rubella Initiative is committed to ensuring that no child dies from measles or is born with congenital rubella syndrome; reducing measles deaths by 95% by 2015; and achieving measles and rubella elimination in at least five regions by 2020. The WHO Region of the Americas has sustained measles elimination since 2002 and WHO Western Pacific Region is on track to reach its goal. All six regions have established measles elimination goals.

The Measles & Rubella Initiative join others in celebrating World Immunization Week, April 24-30 to promote one of the world’s most powerful tools for health – the use of vaccines to protect people of all ages against disease.

New Global Atlas calls for healthcare systems to implement palliative care

Only 1 in 10 people who need palliative care – that is medical care to relieve the pain, symptoms and stress of serious illness – is currently receiving it. This unmet need is mapped for the first time in the Global Atlas of Palliative Care at the End of Life, published jointly by the World Health Organization (WHO) and the Worldwide Palliative Care Alliance (WPCA). Palliative care is more than just pain relief. It includes addressing the physical, psychosocial and emotional suffering of patients with serious advanced illnesses and supporting family members providing care to a loved one.

About one third of those needing palliative care suffer from cancer. Others have progressive illnesses affecting their heart, lung, liver, kidney, brain, or chronic, lifethreatening diseases including HIV and drug-resistant tuberculosis.

It is estimated that every year more than 20 million patients need palliative care at the end of life. Some 6% of these are children. The number of people requiring this care rises to at least 40 million if all those that could benefit from palliative care at an earlier stage of their illness are included. Hospice and palliative care often encompasses some support to family members, which would more than double care needs.

In 2011, approximately 3 million patients received palliative care, the vast majority at the end of their life. Although most palliative care is provided in high-income countries, almost 80% of the global need for palliative care is in low- and middle-income countries. Only 20 countries worldwide have palliative care well integrated into their healthcare systems.

“The Atlas shows that the great majority of the global need of end-of-life care is associated with noncommunicable diseases such as cancer, heart disease, stroke and lung diseases,” says Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. “While we strengthen efforts to reduce the burden of the biggest killers in the world today, we must also alleviate the suffering of those with progressive illness who do not respond to curative treatment.”

The Atlas calls on all countries to include palliative care as an essential component to every modern healthcare system in their moves towards universal health coverage. This means addressing barriers such as: 1) lack of policies recognizing palliative care and the need for care both at the end of life and during progressive illnesses; 2) lack of resources to implement services, including access to essential medicines, especially pain relievers; 3) lack of knowledge of health care professionals, community volunteers and members of the public about the benefits of palliative care.

“Our efforts to expand palliative care need to focus on bringing relief of suffering and the benefits of palliative care to those with the least resources,” adds David Praill, Co-Chair of the WPCA. “This will take courage and creativity as we learn from each other how to integrate palliative care into existing but very limited healthcare systems.”

The importance of palliative care is being emphasized by the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 and the most recent WHO essential medicines list that includes a specific section on medicines for palliative care.

Global Atlas of Palliative Care at the End of Life

Philips sets up Healthcare Informatics Solutions and Services group

Philips announced in January the formation of Healthcare Informatics Solutions and Services, a new business group within Philips’ Healthcare sector that offers hospitals and health systems the customized clinical programs, advanced data analytics and interoperable, cloudbased platforms necessary to implement new models of care.

Building off a proven track record in improving the health of aging and at-risk populations, Healthcare Informatics Solutions and Services will partner with healthcare providers to improve access, lower cost and enhance quality across the continuum of care, from screening and diagnosis, to treatment and monitoring, and after care at home.

“Healthcare systems today are changing the way they operate, how decisions are made and how patients receive care,” said Deborah DiSanzo, chief executive officer, Philips Healthcare. “This requires a significant overhaul of complex organizations, as well as the associated actionable data about each patient population they serve. As we continue to expand the tools, analytics, consulting and support, we are paving the way for providers to transition into more integrated, collaborative care.”

World Health Day puts focus on vector-borne diseases

World Health Day is celebrated on 7 April every year to mark the anniversary of the founding of WHO in 1948. Each year a theme is selected that highlights a priority area of public health. The day provides an opportunity for individuals in every community to get involved in activities that can lead to better health. The topic for 2014 is vector-borne diseases.

Vectors are organisms that transmit pathogens and parasites from one infected person (or animal) to another. Vectorborne diseases are illnesses caused by these pathogens and parasites in human populations. They are most commonly found in tropical areas and places where access to safe drinking-water and sanitation systems is problematic.

The most deadly vector-borne disease, malaria, caused an estimated 660,000 deaths in 2010. Most of these were African children. However, the world’s fastest growing vector-borne disease is dengue, with a 30-fold increase in disease incidence over the past 50 years. Globalization of trade and travel and environmental challenges such as climate change and urbanization are having an impact on transmission of vector-borne diseases, and causing their appearance in countries where they were previously unknown.

In recent years, renewed commitments from ministries of health, regional and global health initiatives – with the support of foundations, nongovernmental organizations, the private sector and the scientific community – have helped to lower the incidence and death rates from some vector-borne diseases.

World Health Day 2014 will spotlight some of the most commonly known vectors – such as mosquitoes, sandflies, bugs, ticks and snails – responsible for transmitting a wide range of parasites and pathogens that attack humans or animals. Mosquitoes, for example, not only transmit malaria and dengue, but also lymphatic filariasis, chikungunya, Japanese encephalitis and yellow fever.

The campaign aims to raise awareness about the threat posed by vectors and vector-borne diseases and to stimulate families and communities to take action to protect themselves. A core element of the campaign will be to provide communities with information. As vector-borne diseases begin to spread beyond their traditional boundaries, action needs to be expanded beyond the countries where these diseases currently thrive.

More broadly, through the campaign, the WHO is aims to assist: l families living in areas where diseases are transmitted by vectors know how to protect themselves; l travellers know how to protect themselves from vectors and vector-borne diseases when travelling to countries where these pose a health threat; l in countries where vector-borne diseases are a public health problem, ministries of health put in place measures to improve the protection of their populations; and l in countries where vector-borne diseases are an emerging threat, health authorities work with environmental and relevant authorities locally and in neighbouring countries to improve integrated surveillance of vectors and to take measures to prevent their proliferation.


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