Public health round-up

232 Bull World Health Organ 2014;92:232–233 | doi: http://dx.doi.org/10.2471/BLT.14.010414 News Contraception and human rights WHO has launched new guidance to help countries ensure that human rights are respected in the provision of contra- ceptive information and services. Universal access to reproductive health by 2015 is part of Millennium Development Goal 5 and one of the in- dicators for measuring progress towards this goal is the extent to which the need for contraception has been met. The prevention of unwanted preg- nancies results in a decrease in maternal and infant deaths and disease. But this unmet need is great: an estimated 222 million girls and women who do not want to get pregnant, or who want to delay their next pregnancy, are not using a modern method of contra- ception, the guidance notes. The 26-page guidance document that was released last month recom- mends that everyone who wants contra- ception should be able to obtain detailed and scientifically accurate information, and that a variety of services, such as counselling as well as contraceptive products should be made freely available. The guidance stresses that age-ap- propriate sex education programmes for young people, including information on how to use and acquire contraceptives, should be based on sound scientific evidence. Adolescents should be able to seek contraceptive services without having to obtain permission from par- ents or guardians, and women should be able to request services without hav- ing to obtain authorization from their husbands. http://www.who.int/reproductivee- health/publications/family_planning/ human-rights-contraception WHO finalizes guideline on “free sugars” This month WHO finalizes revised rec- ommendations on the intake of what are known as “free sugars”, following peer- review by an external expert group and a public consultation last month. The guideline will provide coun- tries with recommendations on limit- ing the consumption of free sugars to reduce diet-related noncommunicable diseases, such as obesity and dental caries (tooth decay). Free sugars include monosaccha- rides (such as glucose and fructose) and disaccharides (such as sucrose – commonly known as table sugar – and lactose) that are added to foodstuffs by manufacturers, cooks and consumers. Free sugars also include the types of sugar that are naturally present in honey, syrups, fruit juices and fruit con- centrates, but do not include the sugars found in non-refined foodstuffs, such as brown rice or fruit. Once finalized, the document will be cleared by WHO’s Guidelines Review Committee before its official release later this year. WHO’s current recommendation, from 2002, is that free sugars should make up less than 10% of total energy intake per day. The new draft guideline recom- mends that free sugars should make up less than 10% of total energy intake per day, while a reduction to below 5% of total energy intake per day would have additional health benefits. In an average adult of normal body mass index and light activity pattern the five per cent of total energy intake is roughly equivalent to 25 grams – or about six teaspoons – of sugar per day. Many of the sugars consumed today are “hidden” in processed foods. For example, one tablespoon of ketchup contains around 4 grams (around one teaspoon) of sugar and a can of a sugar-sweetened soda drink contains up to 40 grams (around 10 teaspoons) of sugar. The draft guideline is based on an analysis of all the available scientific studies on the human consumption of free sugars and the effect of reducing or increasing this on weight gain and dental decay in adults and children. http://www.who.int/mediacentre/ news/notes/2014/consultation-sugar- guideline New WHO standards for influenza surveillance WHO has released a new set of stan- dards for the surveillance of influenza and other respiratory illnesses for public health authorities. Global epidemiological surveillance standards for influenza provides new guidance on the collection, reporting and analysis of epidemiological surveil- Public health round-up N s The small organisms that carry serious diseases This year’s World Health Day on 7 April is devoted to vector-borne diseases. This poster, developed for the campaign, shows three common vectors – mosquitoes, sandflies and tics. W H O Bull World Health Organ 2014;92:232–233| doi: http://dx.doi.org/10.2471/BLT.14.010414 233 News lance data on seasonal influenza, along with new case definitions for influenza- like illness (ILI) and severe acute respi- ratory infections (SARI). Influenza surveillance has tradi- tionally focused on monitoring viruses and collecting specimens for the devel- opment of seasonal influenza vaccines – ever since WHO established the Global Influenza Surveillance and Response System, formerly known as the Global Influenza Surveillance Network, in 1952. But in recent years, countries have called on WHO to expand influenza surveillance to include more epide- miological data, in line with resolution WHA 64.5 to adopt and implement the Pandemic Influenza Preparedness Framework at the World Health As- sembly in May 2011. The new standards address gaps in global influenza surveillance, including the lack of established surveillance for severe disease in most countries and of an international mechanism for sharing epidemiological data. The standards were developed fol- lowing a global consultation in Geneva in March 2011 and subsequent review by surveillance experts and WHO regional offices, followed by a six-month public consultation on the WHO web site. They have also undergone field testing. http://www.who.int/influenza/ree- sources/documents/influenza_surveil- lance_manual http://www.who.int/influenza/surr- veillance_monitoring/ili_sari_surveil- lance_case_definition Vaccines for sexually transmitted infections More investment is needed in research and development for new vaccines to stop the spread of genital herpes, gonorrhoea, chlamydia, syphilis and trichomoniasis, according to a special issue of the journal Vaccine. The special issue of the journal ap- peared last month. It was co-edited by WHO, the United States’ National Insti- tute of Allergy and Infectious Diseases and the United States National Institutes of Health. “Sexually transmitted infections are a massive health challenge,” said Dr Marleen Temmerman, director of the Department of Reproductive Health and Research at WHO. “First, they are extremely common – more than a mil- lion new infections occur every day. Second, most infections don’t show any symptoms so people don’t know they are infected. Third, gonorrhoea, one of the major diseases, is becoming increas- ingly resistant to the medicines currently available to treat it.” For example, sexually transmitted infections, such as herpes, can increase the risk of HIV infection threefold or more while mother-to-child transmis- sion of syphilis can result in stillbirth, neonatal death, low birth weight and prematurity, and congenital defects. Infection with the human papilloma virus contributes to some 530 000 cases of cervical cancer each year, although a vaccine for this has been introduced in some countries, and sexually transmit- ted infections, such as gonorrhoea and chlamydia, are major causes of pelvic in- flammatory disease, adverse pregnancy outcomes and infertility. “Widespread immunization with safe and effective vaccines could revolu- tionize the way we tackle sexually trans- mitted infections,” said Dr Jean-Marie Okwo-Bele, director of the Department of Immunization Vaccines and Biologi- cals at WHO. “The good news is that the introduction of vaccines to prevent both hepatitis B and human papillomavirus infections shows that it can be done.” http://www.sciencedirect.com/scii- ence/journal/0264410X/32/14 New guidance on health and climate change A new WHO guidance document, entitled Protecting health from climate change: vulnerability and adaptation as- sessment, advises countries on what they can do to avoid or lessen the negative health effects of climate change. These health effects are many. Stud- ies show that climate change alters the number of people affected by malnutri- tion and vector-borne diseases, and that it alters the nature of some extreme forms of weather, such as heatwaves, floods, droughts and windstorms. The document explains how countries can conduct a national or sub-national assessment of their current and future vulnerability to the health risks that are associated with climate change. http://www.who.int/globalchange/ publications/vulnerability-adaptation http://apps.who.int/bookorders/ anglais/detart1.jsp?sesslan=1&codlan= 1&codcol=15&codcch=864 ■ Looking ahead 25 April – World Malaria Day 23–30 April – World Immunization Week 17–18 May – Conference hosted by the World Health Professions Alliance entitled Health professional regulation – facing challenges to acting in the public interest, Geneva, Switzerland 19–24 May – Sixty-seventh World Health Assembly 31 May – World No Tobacco Day Cover photo Some countries are rolling out the human papilloma virus (HPV) vaccine against a sexually-transmitted infection that can cause cervical cancer (see on this page “Vaccines for sexually transmitted infections”. This month’s cover photo shows a school girl in Ghana registering to get the jab. GA VI /2 01 3/ Ev el yn H oc ks te in