n/a World Health Day 2007: International Health Security
"Invest in health, build a safer future"
High-level debate tackles need for improved international health security
29 MARCH 2007 | GENEVA/SINGAPORE -- Political, business and opinion leaders are gathering in Singapore on 2 April for a global debate that will focus on the urgent need to improve international health security. The high-level debate, hosted by the World Health Organization (WHO) and the Government of Singapore, will launch the World Health Day 2007 theme of international health security and send a global message to "Invest in health, build a safer future."
n/a World Health Day debate on international health security
Dr Margaret Chan
Director-General of the World Health Organization
A foreign agent that invades sovereign territory, evades detection, kills civilians, and disrupts the economy is a security threat by most definitions. Not all new diseases are highly lethal, contagious, and able to spread internationally, inciting panic as they do. But those that can are international threats to health security.
We live in a world where threats to health arise from the speed and volume of air travel, the way we produce and trade food, the way we use and misuse antibiotics, and the way we manage the environment.
All of these activities affect one of the greatest direct threats to health security: outbreaks of emerging and epidemic-prone diseases.
Outbreaks are unique public health events because of their ability to cross national borders, undetected and undeterred. Traditional defences at national borders are no protection against a microbe incubating in an unsuspecting traveller or an insect hiding in a cargo hold.
All nations are at risk. This universal vulnerability creates a need for collective defences and for shared responsibility in making these defences work.
Outbreaks are a much larger menace today than they were just three decades ago. They are larger in two ways.
First, changes in the way humanity inhabits the planet have led to the emergence of new diseases in unprecedented numbers. In the thirty years from 1973 to 2003, when SARS appeared, 39 pathogenic agents capable of causing human disease were newly identified.
The names of some are notoriously well-known: Ebola, HIV/AIDS, and the organisms responsible for toxic shock syndrome and legionnaire’s disease. Others include new forms of epidemic cholera and meningitis, Hanta virus, Hendra virus, Nipah virus, and H5N1 avian influenza.
This is an ominous trend. It is historically unprecedented, and it is certain to continue.
Second, the unique conditions of the 21st century have amplified the invasive and disruptive power of outbreaks. We are highly mobile. Airlines now carry almost 2 billion passengers a year. SARS taught us how quickly a new disease can spread along the routes of international air travel. Financial markets are closely intertwined. Businesses use global sourcing and just-in-time production. These trends mean that the disruption caused by an outbreak in one part of the world can quickly ricochet throughout the global financial and business systems. Finally, our electronic interconnectedness spreads panic just as far and just as fast.
This has made all nations vulnerable – not just to invasion of their territories by pathogens, but also to the economic and social shocks of outbreaks elsewhere. Some experts have gone so far as to state that there is no such thing as a “localized” outbreak anymore. If the disease is lethal, frightening, or spreading in an explosive way, there will always be international repercussions.
On the positive side, our world’s electronic transparency has made it difficult for any country to hide an outbreak. News will always seep out and be picked up. Last year, media reports were the first alert to more than 52% of the 197 outbreaks verified – in just that year – by WHO.
In June of this year, the revised International Health Regulations will come into force. For the first time, WHO is authorized to act on media reports to request verification and offer collaboration to an affected country. If this offer is refused, WHO can alert the world to an emergency of international concern using information other than official government notifications. This is a significant step forward for our collective security.
The best defence against emerging and epidemic-prone diseases is not passive barriers at borders, airports and seaports. It is proactive risk management that seeks to detect an outbreak early and stop it at source – before it has a chance to become an international threat. We are now in a good position to act in this pre-emptive way.
I have mentioned the role of changes in the way humanity inhabits the planet. A list of some of these helps us understand the multiple dimensions of health security. Constant evolution is the survival mechanism of the microbial world. Organisms that can replicate more than a million times a day are well-equipped to exploit any opportunities we give them to adapt, invade, and evade.
The opportunities are multiple. The pressures of population growth push people into previously uninhabited areas, disrupting the delicate equilibrium between microbes and their natural reservoirs. This creates opportunities for new diseases to emerge.
Population growth also puts people in close proximity to domestic animals, creating evolutionary pressures and opportunities for pathogens to jump the species barrier. Of the emerging pathogens capable of infecting humans, around 75% originated as diseases of animals.
Urbanization has encouraged insect vectors to adapt their breeding habits. They have learned how to thrive in urban litter and filth. Urban crowding under unsanitary conditions also creates ideal conditions for explosive epidemics of well-known diseases, such as yellow fever and dengue.
Environmental degradation and changing weather patterns allow known diseases to flare up in unexpected places, at unexpected times, and with unprecedented numbers of cases.
Intensive food production, including the use of antibiotics in animals, creates additional pressures on the microbial world, leading to mutations and adaptations, including drug resistance.
In humans, our misuse of antimicrobials is causing mainstay drugs to fail much faster than the pace of development of replacement drugs. If this trend continues, we can begin to think of a world where mainstay antibiotics are no longer effective. And we must not forget: drug-resistant strains of viruses and bacteria also travel well internationally.
World Health Day, devoted this year to international health security, focuses attention on these complex and interrelated threats to our collective security.
In our mobile, interdependent, and interconnected world, threats arising from emerging and epidemic-prone diseases affect all countries. They reinforce our need for shared responsibility and collective action in the face of universal vulnerability, in sectors well beyond health.
n/a Птичий грипп - ситуация в Лаосской Народно-Демократической Республике - обновленная информация
8 марта 2007 года
Министерство здравоохранения Лаосской Народно-Демократической Республики подтвердило первый случай смерти в стране от птичьего гриппа H5N1. 7 марта скончалась 15-летняя девочка из Вьентьяна, госпитализированная в соседний Таиланд. Об ее инфицировании было объявлено 27 февраля.
n/a Neurological disorders affect millions globally: WHO report
A new report from the World Health Organization (WHO) shows that neurological disorders, ranging from epilepsy to Alzheimer disease, from stroke to headache, affect up to one billion people worldwide. Neurological disorders also include brain injuries, neuroinfections, multiple sclerosis and Parkinson disease.
The report, Neurological disorders: Public health challenges, reveals that of the one billion people affected worldwide, 50 million suffer from epilepsy and 24 million from Alzheimer and other dementias. Neurological disorders affect people in all countries, irrespective of age, sex, education or income.
An estimated 6.8 million people die every year as a result of neurological disorders. In Europe, the economic cost of neurological diseases was estimated at about 139 billion euros in 2004.* Access to appropriate care is difficult for many people with neurological disorders, their families and caregivers. WHO advocates for the integration of neurological care into primary health care. For many people, primary health care is the only access to medical care they have. In these settings, doctors can use low-technology interventions. Community-based rehabilitation is also an option.
"Despite the fact that highly effective, low-cost treatments are available, as many as nine out of 10 people suffering from epilepsy in Africa go untreated. Health systems need to be strengthened to deliver better care for people with neurological disorders," said Dr Margaret Chan, WHO Director-General.
The reasons for the non-availability of treatment include inadequate health delivery systems, lack of trained personnel, the absence of essential drugs and prevalence of traditional beliefs and practices. "In order to reduce the impact of neurological disorders, innovative approaches involving strong partnerships must be put in place," said Professor Johan Aarli, President of the World Federation of Neurology and member of the group that wrote the report.
As the global population ages, the impact of neurological disorders will be felt both in developed and developing countries. Rita Levi-Montalcini, winner of the Nobel Prize in Medicine, commented: "The burden of neurological disorders is reaching a significant proportion in countries with a growing percentage of the population over 65 years."
The report recommends a series of simple but effective actions. It argues for greater commitment from decision makers, increased social and professional awareness, strategies that address stigma and discrimination, national capacity building and international collaboration.
The use of helmets by motorcyclists and of seat-belts in motor vehicles can prevent traumatic brain injury. Immunization against meningitis and the early identification and treatment of malaria are additional examples of concrete actions to reduce the burden of neurological disorders.
The new report was developed by WHO in partnership with key nongovernmental organizations in the field of neurological disorders and organizations caring for people affected by these conditions. It benefited from contributions of experts and reviewers from all regions of the world.
* According to a study published in the European Journal of Neurology, June 2005.
For more information, please contact:
Dr José Manoel Bertolote
Tel +41 22 791 3627
Fax: +41 22 791 4160
Tel: +41 22 791 2222
22/02/2007 WHO reports some promising results on avian influenza vaccines
WHO also concerned by global vaccine production capacity
16 FEBRUARY 2007 | GENEVA -- Experts meeting over the past two days at the World Health Organization (WHO) on advances in pandemic influenza vaccine development reported encouraging progress.
Sixteen manufacturers from 10 countries are developing prototype pandemic influenza vaccines against H5N1 avian influenza virus. Five of them are also involved in the development of vaccines against other avian viruses (H9N2, H5N2, and H5N3).
At present, more then 40 clinical trials have been completed or are ongoing. Most of them have focused on healthy adults. Some companies, after completing safety analyses in adults, have initiated clinical trials in the elderly and in children. All vaccines were safe and well tolerated in all age groups tested.
For the first time, results presented at the meeting have convincingly demonstrated that vaccination with newly developed avian influenza vaccines can bring about a potentially protective immune response against strains of H5N1 virus found in a variety of geographical locations. Some of the vaccines work with low doses of antigen, which means that significantly more vaccine doses can be available in case of a pandemic.
These developments were discussed at the WHO meeting on the evaluation of pandemic influenza prototype vaccines in clinical trials that took place in Geneva, Switzerland, on 15-16 February 2007. This was a third such meeting in just two years and its objectives were to review progress in the development of candidate vaccines against pandemic influenza viruses and to reach consensus on future priority activities.
More than 100 influenza vaccine experts—from academia, national and regional public health institutions, the pharmaceutical industry and regulatory bodies throughout the world—attended the meeting convened by the WHO Initiative for Vaccine Research and the WHO Global Influenza Programme. Information on more than 20 projects was presented and discussed. Most manufacturers are using reference vaccine strains corresponding to H5N1 viruses provided from by WHO Collaborating Centres.
In spite of the encouraging progress noted at the WHO meeting, WHO stresses that the world still lacks the manufacturing capacity to meet potential global pandemic influenza vaccine demand as current capacity is estimated at less than 400 million doses per year of trivalent seasonal influenza vaccine.
In response to this challenge, WHO launched in 2006 the Global pandemic influenza action plan (GAP) to increase vaccine supply, a US$10 billion effort over 10 years. One of its aims is to enable developing countries to establish their own influenza vaccine production facilities through transfer of technology, providing them with the most sustainable and reliable response to the threat of pandemic influenza. WHO is currently working with several vaccine producers, mainly in developing countries affected by H5N1, to facilitate establishment of in-country influenza vaccine production.
For further information, journalists may contact:
WHO Department of Immunization, Vaccines and Biologicals
Telephone: +41 22 791 2535
Mobile phone: +41 79 477 1738
WHO Department of Immunization, Vaccines and Biologicals
Telephone: +41 22 791 2103
Mobile phone: +41 76 509 4413