Global charter calls for action on Alzheimer’s emergency
Alzheimer’s Disease International (ADI) has launched to global call for action to address the growing public health and social care emergency posed by Alzheimer’s disease and related dementias.
The worldwide effort focuses on a new Global Alzheimer's Disease Charter urgently calling upon all governments and stakeholders to act now to make Alzheimer's disease and other dementias a priority.
“With 4.6 million new cases of dementia being reported each year, the potential impact on current and future generations is overwhelming. There are currently 30 million people with dementia worldwide; by 2050 it is projected that the figure will be 100 million. We are facing a public health and social care emergency, which requires immediate attention from governments and healthcare policy makers. No country is currently prepared to deal with a crisis of this magnitude,” said Daisy Acosta, Chairman of ADI.
Promotion of the Charter aims to increase respect for people with dementia as members of the community and argues for appropriate access to health and social care. The plan recognises that the role of family carers is key and that families must be supported.
The members of Alzheimer's Disease International (ADI) representing 77 Alzheimer and dementia associations around the world urgently call for the following six principles to be adopted to make this devastating disease a global priority:
1. Promote awareness and understanding of the disease
2. Respect the human rights of people with the disease
3. Recognize the key role of families and carers
4. Provide access to health and social care
5. Stress the importance of optimal treatment after diagnosis
6. Take action to prevent the disease, through improvements in public health
Alzheimer’s Disease International aims to collect 10,000 signatures of support by March 2009 and is encouraging people from all over the world to visit www.globalcharter.org, sign the petition to show their support for the Charter.
Ethics of screening for Down’s questioned
A new analysis in England shows that more people are being born with Down syndrome compared to 15 years ago despite universally available genetic screening.
However, Down syndrome people are achieving more and living longer and richer lives, which raises questions regarding the ethics of screening, according to the report – Wrongful deaths and rightful lives – screening for Down syndrome by Frank Buckley and Sue Buckley. The report is published in Down Syndrome Research and Practice and online at Down Syndrome Online: www.down-syndrome.org/editorials/2087
“It is often assumed that fewer babies are now born with Down syndrome. This is not true – births of babies with Down syndrome have risen 25% in 15 years in England. At the same time, life expectancy and quality of life continue to improve,” says Frank Buckley, the charity’s Chief Executive and co-author of the report. “More people are living with Down syndrome than ever before with more than 600,000 across Europe and North America and maybe 4 million worldwide. There is still much more to do, but people with Down syndrome are achieving more thanks to better healthcare, better opportunities and more effective teaching approaches.”
In England 700,000 pregnancies are at risk each year from screening. Around 95% of all ‘positive’ screening results are wrong, according to Down Syndrome Education International. Women who receive these results are encouraged to consider invasive tests. Between 1 in 100 and 1 in 50 pregnancies tested in this way are miscarried as a result of the tests.
Down Syndrome Education International is calling for further research and better support for people living with Down syndrome. The charity is also calling for reviews of screening policies and wider debate about the acceptability of genetic screening for mental and physical abilities during pregnancy. For more information visit: www.downsed.org
Philips leads innovative euHeart initiative
Philips Elelctronics announced late August that it will lead a European Union (EU) funded research project called ‘euHeart’, which is aimed at improving the diagnosis, therapy planning and treatment of cardiovascular disease – one of the biggest causes of mortality in the Western world.
The euHeart consortium aims to develop advanced computer models of the human heart that can be personalised to patient-specific conditions using clinical data from various sources, such as CT and MRI scans, measurements of blood flow and blood pressure in the coronary arteries and ECGs.
These computer models will integrate the behaviour of the heart and the aorta at molecular, cellular, tissue and organlevel. They will also incorporate clinical knowledge about how cardiovascular disease disturbs the correct functioning of the heart at these levels. As a result, it may be possible to develop simulation tools that doctors can use to predict the outcome of different types of therapy, and because the models will be personalised to individual patients, the therapy could be equally personalised.
The euHeart consortium comprises public and private partners from 16 research, academic, industrial and medical organisations from six European countries. It will run for four years and has a budget of approximately EUR 19 million (about US$26 million), of which approximately EUR 14 million will be provided by the European Union as part of the EU 7th Framework Program. The project forms part of the Virtual Physiological Human (VPH) initiative – a collaborative effort that aims to produce a computer model of the entire human body so that it can be investigated as a single complex system.
JCI makes primary health standards publicly available
Recognising the importance of primary care in promoting patient health, Joint Commission International (JCI) has decided to make the standards for its new primary healthcare accreditation programme publicly available.
Primary healthcare is a main strategy of the World Health Organisation (WHO) for achieving its goal of “health for all”, and the WHO definition of primary healthcare provided guidance for the content and focus of these new standards.
The standards were developed by an international panel of primary care experts and have been extensively reviewed by primary care providers in countries around the globe. The standards introduce the most important elements of patient safety to an organisation and create the capacity for the primary care organisation to continually improve its quality of services to benefit patients.
The new standards join the suite of JCI standards related to hospital care, ambulatory care, the care continuum, clinical laboratories, medical transport, and the certification of disease or condition-specific programmes.
“In addition to impacting care in individual primary care organizations, the standards will be useful to Departments or Ministries of Health for building up the capacity of their primary care delivery system to deliver uniform, safe, quality care to patients. Uniform access to quality services at the community level is one of the greatest challenges in public health,” says Karen H. Timmons, president and CEO, JCI.
For more information visit: www.jointcommissioninternational.org
Medtronic set to acquire Cryocath
Medtronic and CryoCath Technologies announced they have entered into an agreement whereby Medtronic will takeover CryoCath in a deal valued at about US$380 million.
The CryoCath board of directors has unanimously recommended that CryoCath shareholders accept the offer, and the acquisition is expected to close in the fourth quarter 2008.
Canadian-based CryoCath is a medical technology company that leads the world in cryotherapy products to treat cardiac arrhythmias.
“Medtronic estimates that up to five million patients worldwide are impacted by atrial fibrillation,” said Pat Mackin, president of the Cardiac Rhythm Disease Management business and senior vice president at Medtronic. “Medtronic and physicians are interested in procedures that are safer, faster and less complex so that more patients can benefit from treatment.”
Jan Keltjens, president and CEO of CryoCath, said: “Medtronic’s offer reflects its endorsement of our cryoablation technology and the role that our flagship product, Arctic Front, will play in treating atrial fibrillation patients around the world. This offer delivers significant value. Joining forces with Medtronic at this stage in our development will dramatically expand our reach and accelerate innovation to the benefit of patients today and tomorrow.”
Massive meningitis vaccine programme agreed for Africa
Health ministers from countries of the African meningitis belt in September committed themselves to introduce a highly promising candidate meningitis vaccine. The vaccine is designed to prevent periodic epidemics of the deadly disease in these countries.
Meeting at the 58th session of the WHO Regional Committee for Africa, held in Yaoundé from 1 to 5 September, the ministers adopted the Yaoundé Declaration, committing themselves to several actions. They agreed to prepare comprehensive meningitis control plans, including the introduction of the new vaccine once available; to implement meningitis control strategies; to undertake joint action vis-à-vis the threat; to improve information exchange for epidemic response; and to contribute financially to epidemic control activities.
The meningitis prevention and control strategy that these countries will implement entails introducing the new vaccine to immunise – between 2009 and 2015 – a population of approximately 250 million people aged 1 to 29 years and 23 million infants living in 25 African countries.
“Several hundred million people are at risk of meningitis in 25 African countries. Many generations have suffered,” said Professor Avocksouma Djona, Minister of Public Health, Chad. “On behalf of all affected countries in Africa, we are collectively committing ourselves to put an end to devastating outbreaks of this disease. We will ensure that this effective new vaccine is made available to populations throughout the Meningitis belt,” he said.
The new product, conjugate meningococcal A vaccine (MenAfriVac), was developed through the Meningitis Vaccine Project, a product development partnership between WHO and the Program for Appropriate Technology in Health (PATH), a non-governmental organisation. The project was set up in 2001 with core funding from the Bill & Melinda Gates Foundation.
The new vaccine is the result of a deliberate effort to get ahead of these epidemics, at a price affordable in Africa. With this vaccine, countries can move away from a reactive response to emergencies towards elimination of the epidemic threat,” said WHO Director- General, Dr Margaret Chan.
The vaccine produces in both adults and toddlers a higher immune response than the currently available vaccines. In addition, the new vaccine confers long-term protection and induces immunity in certain non-vaccinated persons who live in proximity of those who are immunised, leading to broad community protection.
Funding for development of molecular probes
The US National Institutes of Health (NIH) will fund a network of nine centres across the United States that will use high tech screening methods to identify small molecules for use as probes to investigate the diverse functions of cells.
Approximately US$70 million annually will be awarded to the network over a four year period to speed up the development and use of molecular probes, which have become invaluable tools for exploring biologic processes and for developing new therapies for disease.
“This network marks a new era in academic and government research as NIH-funded scientists will have access to the tools for rapidly screening hundreds of thousands of small molecules against many novel biological assays at lower costs than previously possible,” said Elias A. Zerhouni, MD, NIH director.
“The information generated by this network will be important to developing a greater understanding of biology and its complexity, while hopefully discovering novel approaches to therapies and prevention, especially for rare or neglected diseases.”
As genomics research reveals more about the enormous complexity of cell function, new approaches are needed to understand the details. Small molecule probes can be minutely targeted to interact with one site of a cell’s chemical machinery, thus providing information on a specific step in a cascade of cell functions. In some cases, small molecules may have activity that gives them potential for eventual therapeutic as well as research use; or, they may identify targets in the cell for the design of future therapies.
Using assays-laboratory tests used to screen for specific types of probes-solicited by NIH from the research community, the network will screen a library of more than 300,000 small molecules maintained in the programme’s Molecular Libraries Small Molecule Repository – http://mlsmr.glpg.com/MLSMR_HomePage
Oxford to launch neuroethics centre
Oxford University is to launch the UK’s first neuroethics centre following an award of more than £800,000 (about US$1.38 million) from the Wellcome Trust.
The grant has been awarded to Professor Julian Savulescu, a member of the philosophy faculty and director of the Oxford Uehiro Centre for Practical Ethics. It will help support the best research in biomedical ethics and will be used to strengthen collaboration and support new research fellowships and studentships.
“Research will focus on questions about the enhancement of cognition and mood; borderline consciousness and severe brain impairment; free will, criminal responsibility, and addiction; and the neural basis of moral decision-making,” said Prof Savulescu.
The award will fund the establishment of the Oxford Centre for Neuroethics. The Centre will bring together researchers from a wide range of disciplines and address current advances in neurosciences and other areas of related clinical medicine.
“Neuroscience studies the brain and mind, and thereby some of the most profound aspects of human existence. In the last decade, advances in imaging and manipulating the brain have raised ethical challenges, particularly about the moral limits of the use of such technology, leading to the new discipline of neuroethics,” said Prof Savulescu.
“The Oxford Centre for Neuroethics, led by experts from ethics, philosophy of mind, neuroscience, neurology, psychiatry and legal theory, will be the first international centre in the UK dedicated to neuroethical research.”
The Centre for Neuroethics will be located within the existing Oxford Uehiro Centre for Practical Ethics. The Uehiro Centre is one of the world’s leading centres for work in applied ethics. Prof Savulescu is internationally recognised as a world-class bioethicist and his work is highly influential around the world.
Head of Humanities at Oxford University, Professor Sally Shuttleworth, said: “The award is a tribute to the work of Prof Savulescu and his colleagues, and will establish Oxford as a world-leading centre in the rapidly emerging field of neuroethics.
“The Centre will bring together researchers from Europe, Australia and USA, across a wide range of disciplines, from ethics, philosophy of mind, law, psychiatry, and neurosciences to address current advances in neurosciences and other areas of related clinical medicine. It will link relevant research groups around the world and seek to engage policy makers and the general public.”
For more information visit www.practicalethics.ox.ac.uk
Pharmaceutical pollution in the water supply
The Environmental News Network (ENN) reported in August on an Associated Press (AP) study in the United States that indicates that the drinking water of at least 41 million people in the US is contaminated with pharmaceutical drugs.
The report notes that while sewage is treated before being released back into the environment and water from reservoirs and rivers is treated before making its way to the drinking water supply, these treatments do not remove all traces of medications. It also notes that medications from animals are entering the water supply.
While the concentration of drugs in drinking water tends to be low, some medications, like hormones are highly efficacious at very low concentrations, warn the researchers.
ENN says that while little research has been carried out about the effects on health of these traces of medications in the water supply, the few studies that have been undertaken show cause for alarm.
“Contamination of environmental water sources has caused male fish to exhibit female traits and led to damaging effects on other wildlife species. Laboratory research indicates that small levels of drugs can cause cancer cells to proliferate faster, slow kidney cell growth and cause inflammation in blood cells,” ENN says in its report.
The report comments that “at a time when the American population is suffering from skyrocketing infertility and hormone imbalances, it seems outrageous that health authorities would not be looking more closely at this issue and working on ways to protect the public from pharmaceutical pollution.”
There is no law in the US regulating the screening of water for pharmaceuticals.
The Associated Press investigative team surveyed the water providers of the 50 largest cities in the United States and 52 smaller communities, analysed federal databases and scientific reports, and interviewed government and corporate officials.
According to ENN, the investigation found widespread evidence of drinking water contaminated with both over-the-counter and prescription drugs, including painkillers, hormones, antibiotics, anti-convulsants, antidepressants, and drugs for cancer or heart disease. Of the 28 major cities that tested their water supplies for pharmaceuticals, only two said those tests showed no pharmaceutical contamination.
According to the AP report a total of over 100 pharmaceutical products have been detected in water supplies in North America, Europe and Asia, including remote regions such as Swiss lakes and the North Sea. It adds that bottled water is not safer as “the filters used in homes or bottling plants are rarely designed to remove pharmaceutical residue”.
ENN criticises drug companies for not accepting responsibility, saying “Big Pharma hasn’t even yet acknowledged the fact that their products are ‘pollutants’ in any way. Like most pharmaceutical consumers, the drug companies hope to just flush this issue down the toilet and pretend it never existed.”
Poorer countries face heavy burden from cancer
Speaking at the opening of the UICC World Cancer Congress Dr Margaret Chan WHO Director-General said outlined how the shift in the burden of cancer from wealthy to less affluent countries will have an enormous impact on the health budgets of these health systems.
“For public health, the complexity of cancer control has increased enormously following the shift of the disease burden from wealthy to less affluent countries. Cancer causes around 7.9 million deaths worldwide each year. Of these deaths, more than 72% are now occurring in low- and middle-income countries. This is a shocking statistic, with huge implications for human suffering, health systems, health budgets, and the drive to reduce poverty,” Dr Chan said.
“Diseases like cancer are a leading cause of so-called catastrophic health expenditure. This is especially true in lowand middle-income countries, where most people rely on outof- pocket payments for health care. WHO estimates that catastrophic payments for health care push an estimated 100 million people below the poverty line each year. For cancer, out-of-pocket payment is a double-edged sword. It discourages people from seeking treatment early, when the chances of cure are greatest. And it deepens household and community poverty.
“Health systems in developing countries can usually cope with the intermittent emergencies caused by infectious diseases. The patient either survives or dies. In contrast, the demands of chronic care can push a fragile health system to the breaking point. First-rate interventions – and the money to buy them – will have little impact in the absence of systems for their delivery.”
She said that for cancer control in low- and middle-income countries, breakthroughs do not come in the form of spectacular new drugs for cure, but when research shows how existing tools can be adapted to work well in resource-poor settings.
“Developing countries are now face-to-face with problems that affluent countries confronted decades ago. Policies were devised. Lessons were learned. Clinical advances raced ahead. Incidence rates for some cancers dropped, while survival rates dramatically improved. These experiences need to be shared as urgently as possible. We are not starting from scratch. Screening programmes, diagnostic tests, and treatments are costly. But with the shift in the cancer burden, a nation’s resource level can no longer be viewed as a barrier to cancer control,” she said.
“There is too much at stake – for health and economic development, for equity and social justice, for human suffering, and for the dignity of human life.”
The Congress issued the World Cancer Declaration 2008 as a tool to help cancer advocates bring the growing cancer crisis to the attention of health policymakers at national, regional and global levels. Add you voice by signing the declaration online at: www.worldcancercongress.org
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