Recent news from WHO

Bull World Health Organ 2010;88:568–569 | doi:10.2471/BLT.10.030810 569 News search infrastructure. Short-term project funding is not sufficient. Q: Where do a society’s values and beliefs fit into evidence-based decision-making? A: Policy should be informed by evidence, not dictated by it: values and beliefs are an essential part of the decision- making process. The key principle is transparency of decision-making: there is nothing wrong with saying that evidence alone is not enough. This means that more and better research is needed. It also helps to distinguish between broad and narrow areas of policy. For example, if we look at the question of whether we should use nuclear energy for power gen- eration, there are advantages and known risks – such as waste disposal – and there are suspected risks, but balancing the risks and benefits is not a scientific question: it is one of values and preferences. But when it comes to the evaluation of a specific drug, I find it hard to justify going beyond scientific arguments. Q: What can we offer patients who are not participating in research projects, but for whom the only options are new or unproven treatments? A: When you have a serious disease for which there are no effective treat- ments, you want to have a chance and so you are more interested in what might work than in what definitely works. A patient’s threshold for accepting that a treatment is worth trying is likely to be lower than the threshold of scientific proof. From a public health perspective, however, we do not want to pay for something that does not work when the money could be used for something that does work. We need to acknowledge that “works” is not a value-free term. To re- turn to the example of nuclear energy, it definitely “works” as a way of generating electricity, but that does not mean we are obliged to say it is something we want to use. It is also not a matter of say- ing that scientists are right about what counts as proof that something “works” and patients are wrong, but of fairly and transparently incorporating their differ- ent perspectives in decision-making. Q: You have said that it is not enough for research to be done: patients have to have access to the results in a form they can use. How might researchers do better when presenting their results to the public? A: We need to improve how sci- entists present results, how journalists address the public and how the public assesses what scientists tell them. People need a simple set of questions to ask every time results are presented; patients can ask their doctor these same questions. Scientists should understand that it is unethical to present the results for a treat- ment as relative risk reductions instead of absolute risk reductions because that misleads people into thinking the results are much better than they really are. ■ Recent news from WHO • The Adelaide Statement on Health in All Policies introduces a strategic approach for all sectors and levels of government to include health and well-being as a key component of policy development. Developed at an international meeting in April, in Adelaide, Australia, the Adelaide Statement outlines the need for a new social contract between all sectors because the determinants of health and well-being lie outside the health sector. Available at: http://www.who.int/social_determinants/hiap_statement_who_sa_final.pdf • Between 24 May and 2 June, WHO and other humanitarian health partners helped Zimbabwe’s Ministry of Public Health and Child Welfare immunize more than five million children against measles. The campaign was held in response to an outbreak that caused 517 deaths since September 2009. • On 18 June, WHO launched its Model Formulary for Children – a comprehensive guide to using more than 240 essential medicines in children up to 12 years of age. For the first time, medical practitioners worldwide have access to standardized information on the recommended use, dosage, adverse effects and contraindications of these medicines for use in children. • On 17 June, the global polio eradication initiative launched its Strategic Plan 2010–2012. Progress has been significant, particularly in Nigeria where case numbers have plummeted from 312 cases by mid-2009 to three to date in 2010. However, a US$ 1.3 billion funding shortfall (out of a budget of US$ 2.6 billion) for the next three years threatens this mission to eradicate polio. • World Breastfeeding Week is celebrated every year from 1 to 7 August in more than 120 countries to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made in August 1990 to protect, promote and support breastfeeding. WHO recommends exclusive breastfeeding until a baby is six months old and continued breastfeeding with the addition of nutritious complementary foods for up to two years or beyond. For more about these and other WHO news items please see: http://www.who.int/mediacentre “Every clinical encounter should be an occasion for contributing, in some way, to new knowledge.”