Public Health Round-up

732 Bull World Health Organ 2018;96:732–733 | doi: http://dx.doi.org/10.2471/BLT.18.011118 News Indonesia emergency The World Health Organization (WHO) is working with the Ministry of Health and other partners in Indonesia to provide support following the earthquake and tsunami that occurred in September. WHO specialists have been help- ing to restore surveillance systems to ensure early detection of outbreak-prone diseases. WHO is also supporting primary health organizations to ensure con- tinuation of the national tuberculosis programme, including monitoring of drug-resistant tuberculosis patients and conducting inventory assessments for all districts in Central Sulawesi. Immunization experts from WHO have been conducting cold chain assess- ments in three districts. Other specialists are coordinating and supporting Ministry of Health surveillance on water, sanitation and hygiene assessment and WHO is also advising on the provision of mental health and psychosocial support. On 28 September, a 7.7 magnitude earthquake hit Central Sulawesi Province, affecting mainly Donggala district, Parigi Mountong district and Palu city. Fifteen minutes later, a tsunami hit Palu City. As of 12 October, 2073 people were reported dead, 2549 were severely injured and 87 775 were displaced. Some 20 health-care facilities have been affected, including one hospital. http://bit.ly/2yhCQNx Vaccines prequalified WHO prequalified a seventh inactivated polio vaccine (IPV), ShanIPV™ on 1 October. WHO prequalification means that these vaccines are of acceptable quality, safe and efficacy, and thus recommended for bulk purchase by United Nations agencies and Gavi, the Global Vaccine Alliance, for eligible low and middle- income countries. Since it is not a live virus, IPV carries no risk of vaccine-produced infection, unlike oral polio vaccine, which can give rise to vaccine-derived polio. The use of IPV is recommended by the WHO Strategic Advisory Group of Experts (SAGE) for vaccines as part of the effort to eradicate all forms of polio. Countries that have reached full immunization coverage with the oral vaccine are therefore encouraged to transition to IVP. On 25 September, WHO prequali- fied Rotasil, an oral rotavirus vaccine, produced by Serum Institute of India. Rotasil is the first rotavirus vaccine that is stable in higher temperatures, making it suitable for use in low-income countries, where infrastructure and electricity sup- plies make refrigeration difficult. Rotavirus is responsible for about 37% of deaths from diarrhoea among children younger than 5 years of age worldwide. WHO recommends that rota- virus vaccines be included in all national immunization programmes. bit.ly/2CFf69N Air pollution conference Government ministers, mayors, health and environment professionals and representatives of intergovernmental agencies gathered at the first Global Con- ference on Air Pollution and Health at the World Health Organization (WHO) headquarters in Geneva. The event, from 30 October to 1 No- vember, was organized by WHO in collab- oration with United Nations Environment Programme, the World Meteorological Organization, the Climate and Clean Air Coalition World Bank, the United Nations Economic Commission for Europe, and the United Nations Framework Conven- tion on Climate Change. On the first two days of the con- ference, experts presented evidence, reviewed global progress and identified gaps and solutions. On the third day, participants aimed to develop a global goal and set of recommendations for an action agenda to reduce deaths due to air pollution as a contribution to achieving the sustainable development goals and the Paris Agreement. Ambient air pollution in most cities exceeds WHO-recommended levels, in some cities by a factor of 10 or more, while household air pollution is a lead- ing killer in low- and middle-income countries. Government officials, urban mayors and representatives from civil society were invited to make commitments to the global advocacy campaign, Breathe Life, to meet WHO’s Air Quality Guidelines and to reduce climate emissions. bit.ly/2yldEGb Public Health Round-up Tackling air pollution, tackling noncommunicable diseases W H O /A . M w au ra Air pollution air pollution is estimated to cause 7 million deaths per year, including 5.6 million deaths from noncommunicable diseases. This picture shows teenagers burning E-waste, imported from Europe, at a dump in Accra, Ghana. Waste burning is one of the causes of outdoor air pollution. (WHO/ Abraham Mwaura) N s 733Bull World Health Organ 2018;96:732–733| doi: http://dx.doi.org/10.2471/BLT.18.011118 News WHO investment case WHO Director General, Tedros Adha- nom Ghebreyesus, presented the Orga- nization’s first-ever investment case at WHO headquarters on 19 September. Based on WHO’s new five-year General Programme of Work, the case argues for US$ 14.1 billion over the next five years, or about US$ 2.8 billion per year, 14% above the WHO’s current base budget over a 5-year period. The US$ 14.1 billion estimate in- cludes a US$ 10 billion base budget, US$ 2.5 billion for humanitarian response and US$ 1.6 billion for polio eradication. The 14% increase refers to the increase in the base budget only, not the overall budget. The investment case also stressed the importance of changing the way WHO is financed. Currently, more than 70% of the Organization’s budget is earmarked, leaving WHO with discretion on less than 30% of its financing. This creates silos and internal com- petition for funds that makes it more difficult to deliver results. The Director-General asked Member States and other donors to increase the proportion of discretionary funding. “We need all countries to commit to flexible funding,” he said. bit.ly/2RHcjBo Unnecessary caesareans WHO issued new guidance on 11 Oc- tober on non-clinical interventions designed to reduce unnecessary caesar- ean sections, the estimated incidence of which increased from 12% to 21% of all births globally between 2000 and 2015. The new guideline, entitled WHO recommendations on non-clinical inter- ventions to reduce unnecessary caesarean sections, recommends that health pro- fessionals use evidence-based clinical guidelines and regular audits of caesarean section practices in health facilities, and introduce financing arrangements that remove the incentive for over-prescrip- tion of caesarean sections. The guidelines also recommend the provision of educational interventions to inform a meaningful dialogue with women and help women make informed decisions about mode of birth. These include counselling for women feeling excessive anxiety about giving birth. A caesarean section can save the life of a woman and her baby. However, the procedure entails risks and should only be used when absolutely necessary. bit.ly/2CGXgDJ Children with cancer WHO launched the Global Initiative for Childhood Cancer on 28 Septem- ber, aiming to reach 60% survival for children with cancer by 2030, thereby saving an additional one million lives annually. The initiative seeks to increase pri- oritization of childhood cancer through awareness–raising at global and national levels and to expand the capacity of coun- tries to deliver best practice in childhood cancer care. WHO will support governments to assess current capacities in cancer diag- nosis and treatment including the avail- ability of medicines and technologies; to set and cost priority cancer diagnosis and treatment programmes; and to integrate childhood cancer into national strate- gies, health benefits packages and social insurance schemes. http://bit.ly/2PvMItF UN high-level meeting on tuberculosis World leaders pledged to ensure that 40 million people with tuberculosis receive the care they need by end –2022 on 26 September at the United Nations General Assembly in New York. Governments also agreed to provide 30 million people with preventive treat- ment to protect them from developing tuberculosis. Heads of state and government representatives attending this first-ever United Nations high-level meeting on tuberculosis agreed to mobilize US$ 13 billion a year by 2022 to implement tuberculosis prevention and care, and US$ 2 billion for tuberculosis research. They also committed to take action against drug-resistant forms of the bac- teria and prioritize human rights issues, such as stigma surrounding the disease. The political declaration is the culmination of recent leadership com- mitments at global and regional level – including the 2017 Moscow Declaration to End Tuberculosis – to drive universal access, sufficient and sustainable financ- ing, intensified research and innovation, and accountability across all sectors. bit.ly/2IQrjJh Adolescents and alcohol Adolescents in WHO’s European Region are consuming less alcohol than 12 years ago, according to a WHO report released on 26 September. Despite the reductions, however, lev- els of consumption remain dangerously high and continue to be a major public health concern, according to Adolescent alcohol-related behaviours: trends and inequalities in the WHO European Region, 2002–2014. Overall reductions in harmful drinking were the greatest in countries that traditionally have had higher preva- lence, such as the United Kingdom of Northern Ireland and Great Britain and Scandinavian countries. On 28 September WHO launched an alcohol control initiative to support a global target of reducing harmful use of alcohol by 10% by 2025. http://bit.ly/2ydZOoK ■ Looking ahead 1 December – World AIDS Day marks its 30th anniversary with the theme “Know your status” 2 8 J a n u a r y – 5 F e b r u a r y - 144th session of the Executive Board WHO headquarters 29 January – 3 February - The Prince Mahidol Award Conference, Bangkok, Thailand. Theme: The Political Economy of NCDs: A Whole of Society Approach Cover photo Air pollution from homes using coal stoves in Datong, Shanxi Province, China.air pollution from homes using coal stoves in Datong, Shanxi Province, China. So vf ot o/ U IG v ia G et ty Im ag es