The health-obsessed former Soviet republic Turkmenistan is the country with the world's lowest proportion of smokers, the World Health Organisation's director general, Margaret Chan, said during a visit to the isolated nation on Tuesday.

"Recently a WHO overview showed that in Turkmenistan only 8% of the population smokes," Chan told the country's authoritarian president, Gurbanguly Berdymukhamedov, at a health forum in the capital, Ashgabat.

"This is the lowest national indicator in the world. I congratulate you on this achievement."

Chan said the country had ratified the framework convention on tobacco control in 2011, by which time it had already banned smoking in public places.

Also speaking at the forum, was Vera Luiza da Costa e Silva, the head of the convention's secretariat, who challenged the central Asian state to drive smoking down to 5% in the coming years.

In 1990, 27% of Turkmen men over 15 and 1% of women smoked.

A decade later Turkmenistan banned smoking in public places, state buildings and the army, and all forms of tobacco advertising.

By comparison, 31.1% of the global male population over the age of 15 smoked in 2012, and 6.2% of women were smokers.

Berdymukhamedov, who trained as a dentist and is a keen horseman, has been in power since the death of his eccentric predecessor, Saparmurat Niyazov, in 2006. Niyazov campaigned against smoking and built a 36km "path of health" into the mountains surrounding Ashgabat which government officials were forced to walk.

In April, the gas-rich country of more than five million held a month of public exercises and sporting events under the slogan "health and happiness".

source: http://www.theguardian.com/

The World Health Organisation (WHO) is urging countries to move towards universal health coverage and to scale up international investment in catalytic development funding. The call comes as world leaders travel to the 3rd UN Financing for Development Conference in Addis Ababa to discuss ways to pay for the new Sustainable Development Goals (SDG), to be launched in New York in September 2015.

"The best way to assure meaningful progress towards the new global health goal is for countries to move closer to universal health coverage," says Dr Margaret Chan, WHO Director-General.

Progress towards the MDGs

By the end of this year, if current trends continue, the world will meet Millennium Development Goal (MDG) targets for turning around the epidemics of HIV, malaria and tuberculosis and increasing access to safe drinking water. It will also have made substantial progress in reducing child under-nutrition, maternal and child deaths, and increasing access to basic sanitation.

But wide gaps remain between and within countries. Much still needs to be done - particularly in the poorest countries and countries affected by conflict. And new health challenges have emerged, as highlighted by the Ebola crisis in West Africa and the rise of noncommunicable diseases. Within this context, countries have agreed a new global health goal with a strong focus on equity - to ensure healthy lives and promote well-being for all at all ages.

Moving towards universal health coverage

Universal health coverage, a major focus of WHO's work for the past 5 years, aims to redress those imbalances. As a first step, the Organisation recommends reducing the need for people to pay directly for services at the point of delivery – out of their own pockets. In countries that depend heavily on out-of-pocket payments, health bills push 100 million people into poverty each year.

Public funding is key to reducing out of pocket expenditure. As public spending on health goes up, dependence on out-of-pocket payments declines. Between 1995 to 2013, government spending on health increased from 3.4 to 4.1% of GDP - on average across 190 countries. The increase in low-income countries has been greater, from 1.7 to 2.6% of GDP.

Despite this improvement, there is a long way to go. The challenge for countries is twofold: to mobilise more domestic public resources for health, and to ensure health systems use resources more efficiently.

At the Addis Ababa conference, WHO will urge the international community to strengthen cooperation with low- and lower-middle income countries to combine domestic and external funding so they provide sufficient resources to build robust health systems.

The Organisation will also emphasise the importance of getting better results from the money spent by putting in place innovative service delivery arrangements, lowering prices of key inputs (e.g. medicines) procured internationally, and reducing fragmentation in aid flows to countries.

"If the world is serious about the health-related SDG targets, it needs to make serious investments – both at domestic and international levels," adds Dr Chan.

source: http://www.thedailystar.net/

LONDON: The World Health Organization (WHO) is unprepared to deal with crises like the Ebola outbreak and requires fundamental change, supported by an increase in funding, experts warned Tuesday.

More than 11,000 people have died from the highly infectious Ebola virus in the past 18 months, most of them in the west African countries of Sierra Leone, Liberia and Guinea, where it continues to claim lives.

In a critical report, a UN-appointed panel of independent experts said the WHO was too slow in declaring a global public health emergency on August 8, 2014, five months after the outbreak had taken hold.

It "tends to adopt a reactive, rather than a proactive approach to emergencies" and failed to act on the warnings of experienced staff on the ground, the panel said.

In the early months of the crisis, Director-General Margaret Chan and senior staff also failed to show the "independent and courageous decision-making" required to deal with governments of the countries affected, it said.

The panel also criticised the WHO's early engagement with local communities about what could be done to reduce the spread of Ebola, and its failure to provide authoritative information on what was happening.

In Guinea, it said, communities are still not convinced of their own responsibilities with regard to declaring contact with infected patients and ensuring victims are safely buried, making it difficult to eliminate the virus.

"The panel is convinced that WHO must make fundamental changes, particularly in terms of leadership and decision-making processes, in order to deliver on this mandate," the report concluded.

"But it will also require the resources and political will of the member states to make WHO the agency that can fulfil this mandate in the 21st century. This transformation must be carried out urgently."

Short of funds

The panel declined to call for any resignations at the WHO, and warned that part of the problem was that its purchasing power had fallen by one third since 2000.

"You cannot expect an organisation to be taking on more and more of these global outbreaks and yet have a declining budget at the same time," said Barbara Stocking, the head of the panel and former head of development agency Oxfam.

Her team recommended that regular member state contributions be increased by 5% and called for a separate US$100 million (RM381 million) emergency contingency fund.

It said the WHO should set up a new emergency centre to respond to and manage global crises, a move that was preferable to creating a dedicated UN mission for each emergency, as occurred with Ebola.

The experts also welcomed plans to train more rapid response staff, which the WHO says are already underway.

Other factors also contributed to the slow global response, however, including the failure of countries to properly prepare for health outbreaks and their reluctance to declare possible epidemics.

The panel proposed some form of financial incentive for countries to declare health emergencies such as an insurance system to help with economic losses. – AFP

source: http://www.thesundaily.my/

Philippine authorities have confirmed the country's second case of Middle East Respiratory Syndrome (Mers), in a foreigner who arrived from Dubai.

Health officials said the 36-year-old man tested positive last Saturday and has been quarantined near Manila.
In February, a Filipino nurse who returned home after working in the Middle East was found with the virus, but later recovered.

Mers, which has no known cure, has killed nearly 500 people worldwide.

Asian countries have been on alert for cases of the flu-like virus since an outbreak in May in South Korea, where 33 people have now died.

South Korea has had 186 confirmed Mers cases, with 907 people under quarantine as of Monday, according to tYonhap news agency.

China, Malaysia and Thailand also have confirmed Mers cases, although these have been relatively more isolated. Last week, Thailand said a man who was its only Mers case so far had made a full recovery.

Contact tracing

Philippine health officials said in a televised press conference on Monday that the infected man was quarantined at the Research Institute of Tropical Medicine in Muntinlupa city, about 30km (18 miles) south of the capital, Manila.

He flew to Manila on a flight from Dubai, after making a stopover in Saudi Arabia. Officials declined to state the date of his arrival and his nationality, but said he was originally from the Middle East, reported GMA News.

He began showing symptoms last Thursday, and on Saturday he was admitted to the research facility where he tested positive.

Health Secretary Janette Garin said there were indications that the patient was already recovering, as he had low levels of the virus.

Authorities are now tracing 200 people who came into contact with the patient, and at least one person showing symptoms has already been quarantined.

Last week a man who was Thailand's first confirmed case of Mers was declared free of the virus and discharged from hospital.

The World Health Organization says that since September 2012, it has been notified of 1,365 confirmed cases of Mers worldwide, including Mers-related 487 related deaths.

Middle East Respiratory Syndrome (Mers)

• Mers is caused by a coronavirus, a type of virus which includes the common cold and Sars (severe acute respiratory syndrome).
• First cases emerged in the Middle East in 2012, and the first death in Saudi Arabia in June that year.
• It is not known for certain how it is transmitted. It is possible the virus is spread in droplets when an infected person coughs or sneezes.
• Patients have a fever, cough and breathing difficulties, but Mers can also cause pneumonia and kidney failure.
• Approximately 36% of reported patients with Mers have died globally - there is no vaccine or specific treatment.

source: http://www.bbc.com/

Dubai: Three years from now, hopefully, supermarket shelves around the world will be laden with good news.

This is because, last month, the US Food and Drug Administration (FDA) finally ruled that Partially Hydrogenated Oils (PHOs), the primary dietary source of artificial trans fats in processed foods, are not "generally recognised as safe" (GRAS) for use in food and has given the food industry a compliance window of three years to reformulate products with other permissible food additives.

Clearly, it was a triumph of sorts for the campaigners against the use of PHOs in the food industry.

This means that by 2018, we might find food products in supermarket aisles that may be free of trans fats. But will this really happen? The truth is, given the decades of food economics and consumer food habits, it seems to be a tall order to completely eliminate PHOs from our foods.

However, we also need to recognise a stark reality: trans fats are one of the main causes of the staggering rise in lifestyle diseases. These stealthy compounds raise triglyceride levels, trigger inflammation in the body and clog arteries with 'bad' cholesterol, a triple whammy that has helped cardiovascular disease (CVD) become the number one killer in the world after road accidents.

Seen in this light, the FDA ruling comes as a much-needed reversal of the dark tide of lifestyle diseases that has created a health crisis of unprecedented proportions for the world's population over the last 50 years.

First, do you, as a consumer, know where trans fats lurk? Well, in just about every packaged food you eat. In all the lip-smacking cookies, chips, sauces, ketchups, frozen meals (heat-and-eat variety, including frozen pizzas), ice-cream, cakes and sausages, among many other foods. All these goodies have trans fats in them, and consuming them fast tracks you to cardiovascular diseases.

Dr Nasim Ashraf, American Board-certified Internal and Integrative Medicine specialist and CEO of the Abu Dhabi-based DNA Health Corp, told Gulf News: "Basically, trans fats also called trans fatty acids. These are created when vegetable cooking oils are partially hydrogenated. [Hydrogenation is a process in which liquid oils are put through a chemical procedure that enables them to stay hard at room temperature.] These are called artificial trans fats."

Why is this done?

"Because the oil is then easy to use and reuse," says Dr Ashraf. It becomes an economically viable commodity. Hydrogenation also helps the oil make the food it is cooked in or added to have a desirable taste and texture.

The FDA's main fight is against the artificial trans fatty acids that the PHOs contain and that are known to cause considerable harm due to overuse. "What we need to guard against is the PHOs [from both cottonseed and soybean oils] the food manufactures use widely and these are not generally recognised as safe (GRAS) for consumption," says Dr Ashraf.

Why are trans fats likened to a slow poison?

Dr Ashraf explains: "[Due to the change in their chemical structure] trans fats are bad for our health as they raise the levels of LDL (Low Density Lipoprotein) Cholesterol — the bad cholesterol and lower the level of HDL (High Density Lipoprotein) cholesterol, which is the good cholesterol. This can increase the risk of heart attacks, strokes and diabetes. The American Heart Association (AHA) recommends limiting your consumption of saturated fats to less than 10 per cent of your daily calories. A new study indicates that trans fats are also known to cause memory decline and cognitive impairment."

Instead of oils and fats which are partially hydrogenated, it is better to use olive oil and peanut oil as they have mono unsaturated fats which are healthier. Traditional ghee (clarified butter) is also much better in small quantities compared to margarine and partially hydrogenated cooking oils.

"In general, we should reduce and limit intake of saturated fats and partially hydrogenated fats and use more mono and poly unsaturated fats," said Dr Ashraf.

Are trans fats a necessary evil?

Beyond the world of hydrogenated oil-based foods, the fact is that trans fats are also found to occur naturally in the intestines of certain animals such as bovine animals and sheep. Compounds such as vaccenyl and conjugated linoleyl acid are produced in very small quantities in the intestines of these animals and are, therefore, found in their meat and milk. But the quantity is so small that it's insignificant.

Juilot Vinolia, clinical nutritionist at Medeor 24/7 hospital in Dubai, explained why it is a challenging task to escape the trans fatty acid trap. "Traditionally, fat and sugar are used as a preservative in the food industry for many years as this is what gives these products a long shelf life. Some brands of meat burgers, for instance, can be preserved in the frozen state for up to four years. Any processed or packaged food with a shelf life of more than three months is likely to have trans fat in it. The worst kind of product that contains trans fat are processed sausages, which mothers lovingly feed their children [as a snack or part of a meal]. They have a good percentage of trans fatty acids and as a staple food for children are highly avoidable."

Other ways people can cut down on trans fats in their diet is by minimising barbecues, as the meat and chicken cooked over open wood and charcoal fires can transform the naturally occurring trans fats in animal products and make them more harmful to your health."

It also pays to assess the amount of food you are consuming that comes in tetra packs.

Much of what is packaged or put into tetra-packs contains trans fats in some amount, says Vinolia. "People switch from normal milk to creamers which contain a certain percentage of trans fats. Just consider the number of cups of tea and coffee you might be having in a day and the amount of trans fats you are adding to your food even while you think you are drinking healthy. Take the low-calorie crackers which we presume are healthy. They contain 0.5gm per serving of trans fat. If you were to have more than two or three, you would be consuming too much trans fat. The biggest culprits are the zero-fat, zero-sugar products. When they remove the natural fat, they add trans fat and they add artificial sweeteners to enhance taste, chemically altering the nutrition of a product. You need to read labels and make sure that trans fat in any product is less than 5-7 per cent per serving of the product. So, if a product contains 5gm of trans fat, per 100gm of the product will have 0.5 per cent of trans fat. In a day, we often reach out for biscuits, chips, ice-cream and increase our consumption of this harmful additive to more than 10 per cent of our daily calorie intake."

Will the FDA ruling have a legal implication?

The FDA has given the food industry a three-year window for compliance. However, when it comes into effect, it will have a bearing on the food industry. Dr Ashraf said: "The FDA's final ruling on trans fats means, within three years, all artificial trans fats will have to be totally removed from all products and in the preparation of food reusing old oil in restaurants. In 2013, FDA had issued a preliminary determination that trans fats were not generally regarded as safe. This had a loophole. If concentration of trans fats was up to 0.5gm per serving, manufacturers could still label it as zero. And restaurants could use and reuse cooking oils with trans fats. Now, all this will stop by 2018."

Will it really?

Cynics say it is not really possible to make any of the packaged food without PHOs (Partially Hydrogetaed Oils) in small amounts. When the order is enforced, the food industry willl have to make the paradigm shift and look for healthier alternatives. For one, it will have to get over its fixation for food that has a shelf life of beyond three months and use other food additives that are GRAS, such as permissible PHOs made from rape seed and menhaden oil that the FDA says can be used in small amounts. The decision of the US food industry to make this switch is likely to have a worldwide impact as many countries follow FDA guidelines. Besides, in countries like the UAE, many US food products are imported and consumers here have direct access to them in supermarkets. Any healthy change in the food product will impact UAE consumers who habitually consume US proucts. Despite all the checks and balances in place, as consumers, we need to be more aware and minimise consumption of packaged food, opt for fresh food items, avoid foodstuff with a long shelf life and cut down on eating out in restaurants.

source: http://gulfnews.com/

Women face both physical and sexual abuse in health facilities during childbirth, a study by the World Health Organisation (WHO) shows.The authors assessed 65 published studies undertaken in 34 countries and identified seven areas of mistreatment and abuse.

The mistreatment included physical (such as slapping), sexual, verbal, stigma and discrimination, a failure to meet professional standards of care and poor rapport between women and providers and health system constraints (such as a lack of resources to provide women with privacy), the study said.

"The rates of skilled birth attendance and of facility-based childbirth have risen in resource-limited countries over the past two decades, but almost a third of women in these countries still deliver without a skilled birth attendant," the study said.Among the obstacles likely to prevent further increase in the proportion of women delivering in a health facility is women's fear of mistreatment during delivery.

"Women need to be sure that they will receive dignified and respectful care during childbirth," said the study by Meghan Bohren and colleagues of the WHO Department of Reproductive Health and Research.One of the United Nations Millennium Development Goals is to bring about a 75 percent reduction in the maternal mortality ratio.In 2010, some 289,000 maternal deaths occurred worldwide, many in low and middle income countries.

While these numbers explain why attention is focused on a reduction in maternal deaths, attention is also needed to defining and measuring the extent of problems around childbirth, such as mistreatment, to better inform constructive changes in policies and practices, the study emphasised.

The results indicate that, although the mistreatment of women during delivery in health facilities often occurs at the level of the interaction between women and healthcare providers, systemic failures at the levels of the health facility and the health system also contribute to its occurrence.The results appeared in the journal PLOS Medicine.

source; http://www.india.com/

While the Supreme Court's ruling last week on same-sex marriage was a victory for gay rights, it could lead to some fallout when it comes to benefits for both gay and heterosexual couples.

Domestic-partner benefits may decline as employers reassess their human-resources (HR) plans following the ruling, according to Aon Hewitt, which estimates that 77 percent of employers currently offer same-sex domestic partner health care coverage. Many employers extended these benefits because gay couples often didn't have the right to marry, but now that marriage is legal for them nationwide, HR experts say some of those companies may drop domestic partner benefits.

Even before the Supreme Court made its ruling, some companies were already tweaking their benefits, given that 37 states and the District of Columbia had legalized gay marriage. Verizon (VZ) and Delta Air Lines (DAL) were among those that gave ultimatums to their employees: Get hitched, or lose your partner's health care coverage.

Verizon gave same-sex couples in states where it was legal six months to get married, or else forfeit the benefits. The company said its reasoning was to level the playing field for both gay and straight couples.

Domestic same-sex partner benefits were created "to equalize benefits for spouses and same-sex couples who couldn't get married," said J.D. Piro, senior vice president and national practice leader in the Aon Hewitt Health Law Group. "The question is if it's still needed. The answer for every employer will be different."

About 22 percent of companies polled by The Erisa Industry Committee earlier this year said they would drop benefits offered to domestic partners if the Supreme Court ruled in favor of gay marriage. The good news for domestic partners who rely on these benefits is that more than two-thirds of companies said they would keep them if the Supreme Court legalized gay marriage.

Companies most likely to drop health care coverage might be those that offer domestic benefits only to same-sex couples, given that the reason for doing so was to provide benefits to people who weren't legally able to get married, said Lenny Sanicola, senior practice leader at WorldatWork, a nonprofit HR association. Companies that offer benefits to domestic partners, regardless of gender, may be more likely to keep those benefits.

"There are many couples who choose not to get married for various reasons," Sanicola said. "Companies realize there is a lot of talent out there, including people who are in a relationship and committed, but not in a marriage situation."

If a company phases out same-sex domestic partner benefits, couples who aren't prepared to tie the knot still have options, noted Scott Belsky, government relations manager at GoHealth, an online health insurance exchange.

Under the Affordable Care Act, individuals who get dropped from a partner's health insurance plan can enroll through what's called a "qualifying life event," Belsky noted. These events allow individuals to buy health insurance through the state or federally run exchanges outside of the annual enrollment period.

But even before the Supreme Court ruling, some people had moved off their domestic partner's insurance plan in favor of buying an individual plan through Obamacare, Belsky said. "They are often getting tax credits or were finding plans that were cheaper than through" their partner's workplace, he said. "That will be accelerated by the Supreme Court ruling."

Even though gay couples can now get married across the country, other issues are at stake. Some states don't have antidiscrimination laws, so gay couples there may be wary about getting married in case they "out" themselves and suffer negative consequences, such as being denied services or housing, according to the Human Rights Campaign, which is urging employers to maintain their domestic-partner benefits.

"If an LGBT employee is, in effect, 'outed' by being required to obtain a public marriage license in a state that doesn't provide explicit non-discrimination protections, it could place that employee and their family at risk of being denied credit, housing and public accommodation," said HRC legal director Sarah Warbelow in a statement. "These core elements of daily life could be compromised for LGBT families, even in states that might honor their marriage license."

source: http://www.cbsnews.com/

Indonesia, the world's biggest Muslim-majority country, is at high risk of Middle East Respiratory Syndrome (MERS) virus spreading with at least 1 million of its citizens going to the Middle East for religious trips annually.

The Health Ministry general director for disease control and environmental health, Muhammad Subuh, said on Friday that Indonesia was prone to MERS virus outbreaks because of the high number of Indonesians traveling for hajj pilgrimage and umrah (minor pilgrimage) to Saudi Arabia, where the virus originated.

He said there were 250,000 hajj pilgrims and 750,000 religious travelers travelling to Saudi Arabia every year.

"There is no country as big as Indonesia, whose citizens go in huge number to a MERS-infected country for a long time," he said as quoted by kompas.com.

Hajj and minor pilgrimages require Muslims to stay in Saudi Arabia for at least two weeks.

In 2014, Subuh said two Indonesians were infected by MERS with one of them infected during an umrah trip. Both of them were hospitalized in Saudi Arabia and returned to Indonesia after they recovered.

The head of the Health Ministry's research and development body, Tjandra Yoga Aditama, meanwhile, reminded travelers that MERS virus was still active in its point of origin.

He said there were three new MERS cases in Saudi Arabia, bringing the total to 1,038 people with 459 dead, 573 recovered and six were hospitalized. (ika)(+++)

source at: http://www.thejakartapost.com/