The World Health Organization (WHO) recently released new clinical guidelines for health care workers treating the mental health needs of people who have experienced trauma and loss. These guidelines are particularly significant because they reinforce the importance of including mental health care in humanitarian responses post-crisis.

As one of the largest torture survivor rehabilitation centers in the world, the Center for Victims of Torture provides mental health care to survivors of torture and war atrocities in areas of the world where few mental health resources are available.

Despite the widespread need for mental health services among populations coping with the aftermath of brutal conflicts, there are often few, if any, resources to address their complex needs. The psychological effects of torture and traumatic experiences during war can include anxiety, depression, and post-traumatic stress disorder. However, many primary care professionals are under-equipped to deal with these needs, leaving symptoms go untreated, and the increased potential that individuals, families, and communities are unable to rejoin society in a meaningful and productive way.

Fortunately, the WHO guidelines emphasize the need for integrating and understanding reactions to extreme stress and trauma in primary care. For survivors of psychological trauma and their mental health care providers, this increasingly comprehensive set of guidelines is essential.

The WHO guidelines are also an important next step in advancing access to mental health care in places of great need across the globe. Though this is an important step, it is not the final step. CVT joins WHO in the call for governments and donors to include funding for quality mental health interventions. Funding for training and supervision is essential in order to implement the guidelines, and further research is needed in order to expand the understanding of recommended effective interventions.

At a time when thousands of survivors of torture and war atrocities are waiting to receive the mental health care they so urgently need, increased financial support from the international community must be forthcoming.

source: www.huffingtonpost.com

A 9-year-old boy from northwestern Battambang province died of Avian Influenza H5N1 at Sunday night, bringing the death toll to ten and the number of the cases to 16 so far this year, a World Health Organization official confirmed Monday.

"The boy, contracted with H5N1 human avian influenza, passed away late last night in the Jayavarman VII Hospital in Siem Reap province," Sonny Inbaraj Krishnan, media relations officer at the World Health Organization-Cambodia, said Monday.

The boy was admitted to the hospital with fever, cough, vomit, abdominal pain and dyspnea and was confirmed positive for human H5N1 avian influenza on Aug. 9.

"On hospital admission, he was initially in a stable condition. However, his condition deteriorated on Sunday and he passed away last night," he said.

"There were recent deaths among chickens and ducks in the village. The boy carried dead and sick ducks and chickens from a cage for food preparation by his sister before he became sick," he added.

Cambodia sees the worst outbreak of the virus this year since the disease was first identified in 2004. To date, the country has recorded 37 human cases of the virus, killing 29 people.

H5N1 influenza is a flu that normally spreads between sick poultry, but it can sometimes spread from poultry to humans, the World Health Organization said, adding that it is a very serious disease that requires hospitalization.

source: www.globaltimes.cn

Somalia is suffering an "explosive" outbreak of polio and now has more cases than the rest of the world combined, an official said Friday.

Vaccine-wielding health workers face a daunting challenge: accessing areas of Somalia controlled by al-Qaida-linked militants, where 7 of 10 children aren't fully immunized.

Polio is mostly considered eliminated globally except mainly in three countries where it is considered endemic: Afghanistan, Nigeria and Pakistan. India marked a major success in February 2012 by being removed from the World Health Organization's list of countries plagued by the disease.

Somalia now has 105 cases, figures released Friday show, and another 10 cases have been confirmed across the border in a Kenyan refugee camp filled with Somalis. Globally there have been 181 cases of polio this year, including those in Somalia and Kenya.

Vaccination campaigns in Somalia have reached 4 million people since the outbreak began in May, but those health officials have limited access to about 600,000 children who live in areas of Somalia controlled by the armed Islamist group al-Shabab.

"It's very worrying because it's an explosive outbreak and of course polio is a disease that is slated for eradication," said Oliver Rosenbauer, a spokesman for the Global Polio Eradication Initiative at the World Health Organization in Geneva. "In fact we're seeing more cases in this area this year than in the three endemic countries worldwide."

In a bit of good news, Rosenbauer said in a phone interview with The Associated Press that polio numbers are down in the three remaining endemic countries.

"The only way to get rid of this risk is to eradicate in the endemic countries, and there the news is actually paradoxically very good," he said.

Somalia was removed from the list of endemic polio countries in 2001, and this year's outbreak is the second since then.

It began one month after Bill Gates helped unveil a six-year plan to eradicate polio at the Global Vaccine Summit. That effort will cost $5.5 billion, three-quarters of which has already been pledged, including $1.8 billion from the Bill and Melinda Gates Foundation.

The outbreak in Somalia does not set back the six-year plan, said Rosenbauer, because unpredictable and intermittent outbreaks were programmed into the timeline.

In al-Shabab controlled south-central Somalia, disease surveillance is functioning, but health officials are likely not able to detect all polio cases.

Mohamud Yasin, a retired doctor who has treated polio throughout his career, said: "It's indeed worrying because this comes at a time when the country is still hugely affected by the raging fighting, which prevents volunteers from accessing people in need of vaccines. It may take time before we can confidently say we have universal coverage of the immunization."

In a sign of how difficult it is for medical providers to operate in Somalia, the aid group Doctors Without Borders announced this week it was pulling out of the country after 22 years because of attacks on its staff members. MSF, as the group is also known, was not taking part in the polio vaccination campaign.

Somalia shares one significant trait with the three endemic countries: pockets of severe violence where populations can be hostile to health care workers. In February, gunmen believed to belong to a radical Islamic sect known as Boko Haram shot and killed at least nine women taking part in a polio vaccination drive in northern Nigeria.

Polio, for the moment, has been defeated in two areas of Pakistan. But in one region where the disease persists — the dangerous North and South Waziristan region near the Afghanistan border — local authorities have banned immunization campaigns since mid-2012. Vaccination programs, especially those with international links, have come under suspicion since a Pakistani doctor ran a fake vaccination program to help the CIA track down Osama bin Laden.

"So no immunizations are taking place, and sure that's a challenge and that has to be addressed," said Rosenbauer. Still, he noted that nine times out of 10 when a child isn't immunized in Pakistan it's because of operational issues, not social resistance.

Southern Afghanistan hasn't recorded any polio cases since November, a story of success after years of failure there. Afghanistan saw 37 polio cases last year but only four so far this year. Polio cases are also down in Nigeria year-over-year, but about the same in Pakistan.

When the Global Polio Eradication Initiative was launched in 1988, the disease was endemic in 125 countries and paralyzed about 1,000 children per day. Since then the incidence of polio has decreased by more than 99 percent. Five children have been paralyzed in Somalia's recent outbreak.

At the April summit, Gates talked about the need to vaccinate the hardest-to-reach children in the endemic countries.

Eradicating the last cases has proved difficult. The World Health Organization knows the Somalia outbreak came from West Africa but can't say exactly where. In 2011, the virus jumped from Pakistan to China, and the year before that to Tajikistan. There have been more than 50 outbreaks in the last decade.

Poliovirus is very contagious. The virus lives in an infected person's throat and intestines. It spreads through contact with the feces of an infected person and through droplets from a sneeze or cough.

source: www.trivalleycentral.com

Healthcare-associated infections (HAIs) are costly and deadly and becoming a national crisis, according to the Alliance for Aging Research.

Some 1.7 million Americans develop hospital-acquired HAIs each year at a cost ranging from $28.4 billion to $5 billion, the Washington nonprofit noted in a fact sheet released Monday.

And roughly 45% of hospital-acquired HAIs are in patients older than 65, according to Thomas File, MD, president of the National Foundation for Infectious Diseases.

"I think there's a huge emphasis on prevention and control of healthcare-associated infections and antimicrobial resistance among the infectious disease physician and nurse community," Victoria Fraser, MD, a professor of infectious disease at the Washington University School of Medicine in St. Louis, said. "I think the importance of this fact sheet is making it more broadly emphasized across other industries and other populations."

File and Fraser spoke Monday on a call with reporters about the fact sheet, the latest addition to the Alliance's "Silver Book," a searchable database.

"When infections do occur in the older population, the burden of illness is high and often the outcome is less favorable," File added.

With 10,000 baby boomers turning 65 every day, there are more opportunities to increase prevention efforts and research activities, they said.

For example, more work is needed to understand HAIs outside the intensive care unit, in long-term care, rehab and dialysis facilities, and ambulatory surgical centers, Fraser said.

"We also need specific research programs focused on cancer patients and the elderly that will deal with how to improve our environmental decontamination, cleaning, and disinfecting to reduce the burden of antimicrobial organisms," Fraser said.

Aging contributes to decreased protections from infections such as changes to the skin and lungs. Immune response is weakened by more chronic conditions such as heart disease which accumulate through time. As a result, older patients are two to five times more likely to develop a HAI.

The most common types of HAIs are bloodstream infections related to central lines, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections. Clostridium difficile infections are another common HAI -- and 75% of those start outside the hospital, in nursing homes and physician offices.

The rise in antibiotic resistance just adds to the problem -- about 70% of hospital-acquired HAIs are resistant to at least one drug.

The Alliance for Aging Research hopes release of the fact sheet will spur activity in fields beyond infectious disease.

"I think we're trying to ramp up interest and emphasis in geriatrics, in endocrinology, in cardiology, among multiple subspecialties, not just infectious disease about this important problem," Fraser said.

The six-page fact sheet compiles information from previous reports such as the number of hospital-linked infections.

There is also a large section devoted to proven prevention efforts.

source: www.medpagetoday.com

The World Health Organization says everybody should have access to the health care services they need without risking financial ruin. This year's World Health Report urges countries to provide universal health coverage tailored to their peoples' specific needs.

In 2005, all 194 member states of the World Health Organization committed themselves to achieving universal health coverage. However, relatively few countries have achieved this goal and most people in the world have to pay out of pocket for the health care they need.

WHO says services provided by universal health coverage should include prevention, treatment, rehabilitation and palliative care. Coverage should encompass health care in communities, health centers and hospitals.

Since health needs differ from one country to another, the report says each nation must create a system of universal health coverage specifically tailored to its needs.

Christopher Dye, lead author of the report, is director of WHO's Office of Health Information, HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases.

He said countries must invest in local research to know what kind of universal health coverage would work best for them. For example, he said nearly half of all HIV-infected people eligible for anti-retroviral therapy are receiving it. But, he said research is needed to determine how the other half will be eligible to receive this life-saving treatment.

"Let me give you another example with respect to the way in which people pay for health care," he said. "Every year approximately 150 million people in the world suffer catastrophic health expenditure. That is they have to pay out of their own pockets for health care to a degree that they cannot possibly afford. So, how do we put in place mechanisms for financial risk protection, which will ensure that catastrophic health expenditures are reduced to a minimum?"

The report shows how research can help countries develop a system of universal health coverage that addresses their health issues and ensures their citizens can obtain the services they need without suffering financial hardship.

The U.N. health agency said research should be done in low- and high-income countries because the poorer countries have special problems they have to work out for themselves. It says answering these questions is not a luxury but a necessity.

The thorny question of how countries can finance universal health coverage, especially during a time of economic austerity, runs throughout this report.

Dr. Dye noted a number of northern European countries have made the decision to continue supporting their social and health services during this period of financial distress. He said this decision is paying off in better health for their people.

"Saving money on health care is often a false kind of economy. If you save money on health care in the short term, you may end up spending more in the long term. So, cutting the cost of health budgets is not an enlightened policy," he said.

Acknowledging escalating costs, Dr. Dye said provisions for health care must be made within a limited budget during times of relative financial stability, as well as of economic austerity. He said governments need to make greater effort to reign in run-away expenses and make health care services more cost-effective and beneficial.

source: www.voanews.com

An article by Scientific American.

Global eradication of polio has been the ultimate game of Whack-a-Mole for the past decade; when it seems the virus has been beaten into submission in a final refuge, up it pops in a new region. Now, as vanquishing polio worldwide appears again within reach, another insidious threat may be in store from infection sources hidden in plain view.

Polio's latest redoubts are "chronic excreters," people with compromised immune systems who, having swallowed weakened polioviruses in an oral vaccine as children, generate and shed live viruses from their intestines and upper respiratory tracts for years. Healthy children react to the vaccine by developing antibodies that shut down viral replication, thus gaining immunity to infection. But chronic excreters cannot quite complete that process and instead churn out a steady supply of viruses. The oral vaccine's weakened viruses can mutate and regain wild polio's hallmark ability to paralyze the people it infects. After coming into wider awareness in the mid-1990s, the condition shocked researchers.

Philip Minor, deputy director of the U.K.'s National Institute for Biological Standards and Control, describes the biomedical nightmare: Wild polioviruses stop circulating. Countries cut back on vaccination efforts. A chronic excreter kisses an unvaccinated baby, and the baby goes to day care. "And zappo," he adds, "it's all over the place, with babies drooling all over each other. So you could see a scenario where polio would come back from a developed country." It could happen in the developing world as well. Although it was once thought that immunocompromised individuals could not survive for long in lower-income countries, circumstances are changing as those countries improve their health care systems. In 2009 an immunodeficient 11-year-old Indian boy was paralyzed by polio, five years after swallowing a dose of oral vaccine. It was only then that researchers recognized him as a chronic excreter.

Chronic excreters are generally only discovered when they develop polio after years of surreptitiously spreading the virus. Thankfully, such cases are rare. According to Roland W. Sutter, the World Health Organization scientist who heads research policy for the Global Polio Eradication Initiative, the initiative is pushing for the development of drugs that could turn off vaccine virus shedding. A few promising options are in the pipeline.

Drugs can only solve the problem if chronic excreters are identified, and that's no easy task. For years scientists in Finland, Estonia and Israel monitored city sewers, watching for signs of shedders' presence. In many samples, they have found the telltale viruses from chronic excreters, but they have failed to locate any of the individuals. These stealthy shedders may not be classic immunodeficient patients traceable through visits to immunologists. Instead they may be people who do not know they have an immunity problem at all and are under no specialized medical care. "We know that there's really a Damocles sword hanging over them," Sutter says. It hangs over the rest of us as well.

source: www.nature.com

'United Nations agencies like the World Health Organization are constantly painted in a bad light by the more extreme conservative elements of the Catholic Church here in the Philippines.'

ANTI-RH fundamentalists appear to be schizophrenic about international scientific bodies and their role in assessing evidence on biological processes and their effects on health.

This was apparent during the legislative debates as well as in the third RH hearing of the Supreme Court last week.

On the one hand they repeatedly cited a World Health Organization (WHO) body, the International Agency for Research on Cancer (IARC), to warn about the harmful effects of contraceptives. On the other, they constantly downplayed WHO opinions about the safety and efficacy of contraceptive devices and pills.

The likely explanation for such confusion is a lack of knowledge concerning the origins, history, and roles of international agencies in the conduct of international activities.

WHO for example is a specialized agency of the United Nations with technical authority on international health matters. While it functions as a part of the United Nations System, as an intergovernmental agency, WHO has a separate charter with its own set of governing bodies.

The World Health Assembly that meets annually in Geneva is WHO's highest governing body. It is composed of the Ministers of Health or their representatives of the organization's more than 190 Member States. The Assembly exercises its authority through an Executive Board comprising 36 public health or biomedical experts nominated on a rotating basis by the Member States themselves.

Day to day operations are carried out by a Secretariat of technical and health management experts supported by general service staff stationed at headquarters in Geneva, the six Regional Offices, and at country offices.

The main source of WHO's technical strength is its access to international technical bodies (such as IARC) and the health expertise of its Member States' health authorities as well as their academic and science institutions in all areas relevant to its mandate.

From time to time and for special purposes, WHO convenes expert panels drawn from the global scientific community to supplement in-house capacities. Thus, WHO opinions on specific issues are distillations of the consensus of such bodies and reflect views from a broad range of public, biomedical, social, and other highly specialized disciplines.

WHO's regular budget is funded through assessed contributions of Member States pro-rated according to the member's population and level of socio-economic development. Some countries also make contributions to special extra-budgetary programs. The funding arrangements render it improbable that financial pressure can be brought to bear on its scientific decision making processes.

Although agencies like WHO are sensitive to political and even religious sensibilities of its Member States, its structure and manner of working make it highly unlikely that its conclusions can be biased in favor of any one member or group of members.

The Organization's position on reproductive health for example has been consistent with all the global consensus-driven declarations particularly the International Conference on Population and Development in Cairo in 1994 where the term reproductive health was first introduced.

The Vatican's status in the World Health Assembly is that of "observer" - meaning it has no vote but can participate in debates and discussions. However, it influences international health policy through its political leverage in countries with predominantly Catholic populations. Historically, the Vatican strongly resisted incorporating population and family planning issues in the Organization's agenda from its inception in 1947. Nevertheless, the Vatican supports WHO initiatives in other areas such as addressing children's health problems in poor countries.

The WHO Regional Office for the Western Pacific was established here in Manila in 1949. The majority of its general service staff is Filipino. A number of Filipino health experts have served in high-ranking technical and administrative posts in the Secretariat here, in other Regional Offices, and in Geneva. Additionally, Filipinos have participated extensively in special panels, technical working groups, and scientific working groups - making significant contributions to WHO achievements such as the global eradication of smallpox and the more recent eradication of polio in the Western Pacific.

It is unfortunate that United Nations agencies like the World Health Organization are constantly painted in a bad light by the more extreme conservative elements of the Catholic Church here in the Philippines. What is even more regrettable is that, as a result, even some educated Filipinos are not informed about the important role that agencies such as WHO, UNFPA, and UNICEF play to improve health conditions in developing countries like the Philippines.

Hopefully, as the heated debates on reproductive health are gradually replaced by more rational sober discussions on universal health care for all Filipinos, there will be broader cooperation between secular health institutions and the more enlightened elements of the Catholic Church in the Philippines.

source: www.malaya.com.ph

The United Kingdom recently announced that it will donate £10 million to the United Nation's World Health Organization to vaccinate more than 6 million people in response to recent outbreaks of poliovirus in Somalia and Kenya.

"While the world has almost eradicated polio, this new outbreak shows that we cannot rest until we have stamped it out completely," U.K. International Development Secretary Justine Greening said.

The outbreak in Somalia is its first since 2007; Kenya's outbreak is its first since 2011. The U.N. said in a statement that if the disease is not controlled, it can become an epidemic across East Africa, where many rates of polio vaccination are extremely low.

"There is a very real risk that this outbreak could quickly become a problem across the entire region," Greening said. "We must act now to stop this deadly and debilitating disease from spreading further."

The contribution from the U.K. will fund the immunization of 6.1 million people at the highest risk of infection in Somalia, northern Kenya and other countries in the region. Confirmed cases of the disease were reported in Mogasdishu, Somalia and the Dadaab refugee camp in Kenya in May.

There is no cure for the disease, but it is preventable through immunization.

source: vaccinenewsdaily.com