Cambodia leads the way in the protection of children against worms.

635Bulletin of the World Health Organization | August 2004, 82 (8) WHO News WHO tobacco convention set to become law by year’s end One of the most rapidly embraced UN conventions — the WHO Framework Convention on Tobacco Control — is set to become binding international law by the end of 2004, just one year after the landmark document originally opened for signature in Geneva. The Convention closed at the end of June with signatures from 167 WHO Member States as well as the European Community and 23 ratifications or equivalent — over half the number required to make it a legal instrument. Adopted unanimously by all WHO Member States in May last year, it is the first public health treaty negotiated under the auspices of WHO. Whilst the rapid response to the Convention demonstrates increasing commitment by governments in con- trolling the epidemic of tobacco-related diseases, WHO Director-General, Dr LEE Jong-wook, said yet more action was needed. “Although we have good reason to be confident, a relentless effort will still be needed for the foreseeable future. Current projections show a rise of 31% in tobacco-related deaths during the next twenty years, which will double the current death toll, bringing it to almost ten million a year,” said Lee during a meeting of the Intergovernmental Working Group in Geneva which took place between 21 and 25 June. “When the treaty comes into force, national and local activities aimed at reversing these trends will be enormously strengthened. The result will be improved public health and reduced poverty.” WHO has urged signatory coun- tries to ratify the Convention as soon as possible and is currently helping gov- ernments to prepare for the moment the Convention is brought into force. “The sooner the 40 ratifications are in place, the sooner effective and coor- dinated actions within the Framework Convention at country level can begin,” said Dr Catherine Le Galès-Camus, Assistant Director-General from WHO’s department of Noncommunicable Diseases and Mental Health. “Countries can rely on WHO for continued sup- port,” she added. The WHO Framework Conven- tion on Tobacco Control was designed as a tool to manage what WHO describes as the single biggest prevent- able cause of death. There are currently 1.3 billion smokers worldwide. Half of them — some 650 million people — are expected to die prematurely of a tobacco-related disease. Containing provisions that set inter- national standards on tobacco price and tax increases, advertising and sponsorship, labelling, illicit trade and passive smok- ing, the Convention will become law for those countries which have ratified it (or adopted an equivalent instrument) 90 days after the fortieth ratification. The parties to the WHO Frame- work Convention on Tobacco Control — those who had ratified it or adopted an equivalent instrument as of 30 June 2004, are Bangladesh, Brunei Darus- salam, Cook Islands, Fiji, Hungary, Iceland, India, Japan, Kenya, Maldives, Malta, Mauritius, Mexico, Mongolia, Myanmar, Nauru, New Zealand, Norway, Palau, Seychelles, Singapore, Slovakia and Sri Lanka. O New alternative medicine guide launched amidst increasing reports of adverse reactions Reports of adverse reactions to alterna- tive or traditional medicines have more than doubled in three years, according to WHO which released a new set of guidelines on 22 June. The document, Developing information on proper use of traditional, complementary and alterna- tive medicine, is intended to help national authorities develop context-specific and reliable information for consumers who are considering using such medicines. “WHO supports traditional and alternative medicines when these have demonstrated benefits for the patient and minimal risks,” said WHO Director- General, Dr LEE Jong-wook. “But as more people use these medicines, govern- ments should have the tools to ensure all stakeholders have the best information about their benefits and their risks.” Up to 80% of developing country populations rely on traditional medicine for their primary health care, due to cultural tradition or lack of alternatives. In wealthy countries on the other hand, the increasing popularity of natural medicines is based on the sometimes dangerous assumption that natural means safe. According to WHO, the global increase in the use of traditional and alternative medicines has been accompa- nied by an increase in reports of adverse reactions. In China, a country where traditional therapies and products are widely used in parallel with con- ventional medicine, there were 9854 reported cases of adverse drug reactions in 2002 alone, up from 4000 between 1990 and 1999. According to a WHO survey, 99 out of 142 countries said that the ma- jority of traditional or alternative medi- cines in their country could be bought without prescription. In 39 countries, many traditional remedies were used for self-medication, bought or prepared by friends or acquaintances of the patient. These trends have raised concerns over the quality of the products used, their appropriateness for the condition and the lack of medical follow-up. It is hoped that the guidelines will go some way in addressing these concerns. They include, for example, a quick checklist of basic questions to help facili- tate proper medicine use. Advice is also provided to government authorities on preparing easy-to-access information and working with the mass media to sensitize and educate the population. Suggestions are given for several health system struc- tures and processes needed to promote proper medicine use. The guidelines do not however, address the problem of poor quality traditional or alternative medicines or inappropriate practices. The development of the guide- lines was carried out with the financial and technical support of the Regional Government of Lombardy, in collabora- tion with the State University of Milan. The guidelines are based on evidence and 636 Bulletin of the World Health Organization | August 2004, 82 (8) WHO News Call for papers on Human Resources and Health Workforce Constraints The Bulletin of the World Health Organization is seeking original research papers dealing with human resources for health care, to accompany commissioned Policy and Practice papers in a theme issue on this subject in the first quarter of 2005. Papers should cover aspects of current shortfalls in specific health service delivery, particularly in developing countries, with evidence of the implications to the relevant burden of disease. We would like to encourage authors to submit original research, done to find ways of improving equitable access and referral systems, through better use of existing human resources, or sustainable increases in the local workforce. We will also consider related submissions to the other sections of the Bulletin: Perspectives, Round Tables, and Public Health Reviews. Manuscripts should be submitted to http://submit.bwho.org by 1 October 2004, following the usual Guidelines for Contributors, with a cover letter mentioning this call for papers. experiences collected from 102 countries representing all WHO regions. The guidelines are available from: http://www.who.int/medicines/library/ trm/Consumer.pdf O Cambodia leads the way in the protection of children against worms Cambodia has become the first country to protect three out of four school-aged children against intestinal worms since the global anthelminthic control target was established at the World Health Assembly in 2001. The recent comple- tion of Cambodia’s latest treatment campaign, involving more than 6500 schools, saw the country become the first of 105 endemic countries to reach the global target — six years ahead of schedule. Only five years ago, more than 70% of Cambodian children were infected with intestinal worms. Now the situa- tion is reversed with 75% of Cambodia’s nearly three million school-aged children protected. “This is a huge step forward not only for Cambodia, but for all countries working to control intestinal parasitic diseases,” said Dr Lorenzo Savioli, WHO’s Coordinator of Parasitic Diseases Control. “Cambodia’s experience provides hard evidence that it is completely within the realm of possibility to pro- tect the vast majority of children against parasites. Cambodia has done it, and so can other countries.” Weighing as much as 2 kg less than healthy children, those who are infected have a much higher chance of becoming anaemic. Anti-parasite treatment has led to a dramatic increase in short- and long-term memory among affected children, as well as an improvement in their reading capacity and compre- hension. The intervention, therefore, represents a powerful tool for combating school absenteeism which can drop by as much as 25% as a result of a treat- ment campaign. Schistosomiasis and intestinal worm infections affect at least two billion people worldwide and are a significant public health threat in regions where sanitation and hygiene levels are inade- quate. Infection occurs when skin comes into contact with contaminated water or soil through ingestion. Heavy infec- tion can result in retarded growth and intellectual and physical development. If left untreated, progressively severe organ damage occurs which becomes irreversible. Despite the potentially serious consequences of carrying intestinal worms, treatment is cheap — costing only US$ 0.02 per tablet — and simple to administer. Cambodia’s success follows the pro- gressive expansion of intestinal parasite control to the national level involving a twice-yearly anti-parasite campaign. Drugs are administered across all 24 provinces by thousands of teachers, who distribute the pills to students in class- rooms. The campaigns were conducted by the Cambodian Ministry of Health, Education and Sport, with the support of WHO, UNICEF, the Japanese Em- bassy in Cambodia and the Sasakawa Memorial Health Foundation. “This clearly wouldn’t have been possible without the strong commitment of Cambodia’s Ministry of Health,” said Dr Kevin Palmer, Regional Adviser in Parasitic Diseases for the Western Pacific Regional Office of WHO. “Reaching the target this early wasn’t accidental. It demonstrates what can be achieved when the political will is there together with financial support from donors and partners.” O WHO announces “River of Life” winners The winners of the WHO “River of Life” international photo competition were announced on 17 May to coincide with the presentation of WHO’s first global strategy on reproductive health during the 57th World Health Assembly. The competition title originated from the idea that the best way to show how reproductive and sexual health impacts all people was to invite photogra- phers from around the world to capture the four key stages in the course of an individual’s lifetime or “River of Life”: Love, Life, Illness and Death. There were seventeen winners overall comprising three winners per category and a Special Award for Out- standing Contribution to each category. A Special Award from the Assistant Director-General of WHO’s department of Family and Community Health was given to a photograph entitled “Happi- ness Family” by A.K. Moe from Yangon, Myanmar (see overleaf ). The photographers were asked to use their cameras to bring to life success stories in sexual and reproductive health and also to focus on the health inequities that exist in many countries. The compe- tition is part of a broader effort on behalf of WHO to raise public awareness of the importance of sexual and reproductive health and the challenges faced by the international community in this area. According to WHO, over half a mil- lion women die during pregnancy and childbirth every year. Unsafe abortions alone leave a further 70 000 women dead every year. In 2003, five million new cases of HIV infection occurred, 600 000 of which were infants infected due to mother-to-child transmission. A panel of four expert photographers from England, South Africa, the United States and Switzerland, judged nearly 800 submissions from both amateurs and professionals. The seventeen winning shots (four of which are printed overleaf) by photographers from ten countries can be viewed at th e following URL: http:// www.who.int/reproductive-health/ results_photo_competition.html. O 637Bulletin of the World Health Organization | August 2004, 82 (8) WHO News River of Life “Happiness Family” by A.K. Moe from Yangon in Myanmar received the Special Award from the Assistant Director-General from WHO’s department of Family and Community Health. “Generations” by Marko Kokic from Canada — a winner in the Life category. 638 Bulletin of the World Health Organization | August 2004, 82 (8) WHO News River of Life “Child on Windowsill” by Natalie Behring-Chrisholm from Beijing, China — a winner in the Death category. “Gang Funeral” by Douglas Engle from Rio de Janeiro, Brazil — a winner in the Death category.