H5N1

Religion and Ebola: Learning from experience

Via The Lancet: Religion and Ebola: learning from experience. Excerpt:

Knowledge gaps about west Africa's diverse religious communities (table) delayed partnerships, obscured potential ways to mobilise their assets (ie, knowledge, trust, infrastructure, and networks), and complicated assessment of the impact of interventions. 

Wide-ranging estimates of different religious communities reflect the complexities arising from overlapping religious affiliations and poor data. Identification of roles of religious actors, robust mapping of their presence and work, and forging of operational, institutionalised links between partners could contribute to fast, organised responses. 

Many faith-inspired initiatives started quickly and delivered wide-ranging support (eg, Caritas Internationalis and the Methodist Church); these initiatives included (besides health care) training of pastors and mobilisation of volunteers, texting of health messages to congregations, and care for abandoned orphans. 

However, coordination was restricted and many opportunities were missed. If better equipped for public health challenges than at present, inter-religious structures could more readily coordinate efforts of both local denominations and international groups. Rich knowledge of, and appreciation for, the many roles of religious actors could enhance both health service delivery and public health approaches more generally. 

This crisis and long HIV experience show how and why improved interdisciplinary approaches to public health are needed. Complex interrelationships of culture, tradition, stigma, and discrimination affect uptake of health services and health systems' interface with communities. Practical multidisciplinary approaches can achieve results; for example, the World Vision's Channels of Hope programme in Sierra Leone combines scientific information and theology and engages religious leaders (Muslim and Christian).

Christian Health Associations active in Liberia and Sierra Leone engaged international volunteers, organised training, and imported medical supplies, but unclear relations with government health systems resulted in inadequate support to faith-run hospitals and clinics. 

Strategies to strengthen basic health systems and public health approaches will benefit if they take full account of the on-the-ground presence of religious institutions and draw in an integrated way on relevant disciplines (for example, anthropology, religious studies, and social and behavioural sciences). 

Health messages, crucial in public health approaches to infectious disease, are more readily accepted if developed with communities through two-way communication and respect for community expertise that is concentrated prominently in religious institutions. Ebola's close association with cultural and religious practices makes active community engagement especially important. Change of funeral practices was imperative to reversing the epidemic and religious leaders (modern and traditional, Muslim and Christian) had to be involved. 

The resulting WHO Safe and Dignified Burial Protocol was vital in halting spread of the disease and laying foundations for community trust. In many respects, the protocol was a game changer in the overall trajectory of crisis response. Organisation of home care and guarantee of proper quarantine procedures likewise demand religious communities' involvement. 

These lessons apply to the Ebola-affected countries and beyond. They affect preparedness, strengthening of health and community systems, and development of meaningful partnerships, notably looking towards implementation of the post-2015 Sustainable Development Goals. Faith communities, omnipresent in Africa, can be part of the solution if included as full partners, engaging their powerful communications networks and local knowledge. 

Assessment of how faith resources were, and were not, engaged should be reflected on by the governments concerned and international partners.

Belluz: Oregon teenager infected with bubonic plague

Via Vox.com, Julia Belluz writes: An Oregon teenager was just diagnosed with bubonic plague. Here's what you need to know. Excerpt:

A teenage girl in Oregon has been hospitalized after contracting the bubonic plague, according to state officials. 

The state department of health reported that the girl acquired the disease from a flea bite while on a hunting trip. She fell sick by October 21 and was hospitalized in Bend on October 24, where she remains in the hospital’s intensive care unit. 

Plague is an extremely rare disease, though there has been more activity in the US than usual of late. Every year, the US records about a dozen plague deaths. According to the latest data from the Centers for Disease Control and Prevention, there were 11 cases and three deaths in six states in just five months, between April and August. 

In Oregon, only eight human cases have been diagnosed since 1995, and no deaths have been reported.

Refugees in Sweden: 'In the long run our system will collapse'

Via The Local.se: 'In the long run our system will collapse'. Excerpt:

Sweden's outspoken foreign minister, Margot Wallström, has hit out at fellow EU member states over the refugee crisis, saying the union needs to do more to relieve the pressure on her country.

Wallström, who was deputy chairperson of the EU commission in 2004-2010, told the Dagens Nyheter newspaper that Sweden would be taking a tougher stance in summits in an attempt to secure financial support and help to accommodate the 140,000-190,000 asylum seekers the country is expected to receive in 2015. 

Sweden is currently campaigning for other EU member states to take in a greater share of refugees fleeing violence in the Middle East and Africa. But the minister said negotiations have so far not produced the desired result. 

“I have to admit that there have been moments recently of very great disappointment. I have heard statements from member states that have been completely astonishing and very discouraging,” Wallström said in the interview which was published on Friday morning. 

An unprecedented number of people are expected to seek asylum in the Nordic nation in 2015 and while Prime Minister Stefan Löfven has widely praised his country's response to the crisis he has said that Sweden is "approaching the limit" of its reception capacity. 

“I think most people feel that we cannot maintain a system where perhaps 190,000 people will arrive every year – in the long run, our system will collapse. And that welcome is not going to receive popular support,” said Wallström, echoing her Social Democrat colleague's comments.

Nobel prize winners point the way in battle against diseases of poverty

Via The Guardian: Nobel prize winners point the way in battle against diseases of poverty. Excerpt:

What does it take to bring the fruits of scientific innovation to vulnerable patients in the world’s poorest communities? 

The discoveries recognised by the 2015 Nobel prize for medicine are perfect examples of the journey from test tube to bedside, and tell a fascinating geopolitical story of how effective drugs for neglected diseases are discovered, made, and distributed. Importantly, they show what happens when we work together for patients, not just profits. 

The Nobel recipient Dr Tu Youyou is credited with the discovery of artemisinin, which led to the current arsenal of antimalarial drugs – artemisinin-based combination treatments (ACTs) that have saved millions of lives. 

Similarly, avermectin, the compound discovered by the other two recipients, professors Satoshi Omura and William Campbell, generated the drug ivermectin, an effective treatment against river blindness and lymphatic filariasis, diseases that cause immense suffering and severe disfigurement. 

When these discoveries were made in the 1970s, there was a desperate lack of research and development for diseases that were devastating poor communities in Africa, Asia and Latin America. It was the start of more attention from UN agencies, and the development of numerous organisations to build this capacity. 

Tu was able to get support for her discovery from international and national research institutions, and forged connections with key international pharmaceutical companies. They in turn partnered with new, not-for-profit research foundations to ensure the development of badly needed ACTs that met World Health Organisation recommendations for adults and children. 

Political will eventually coalesced, resulting in a twentyfold increase in malaria funding from 2000 until 2015. To date, artemisinin-based antimalarials have been delivered to more than 600 million people. Treatment for river blindness and lymphatic filiariasis benefited from a similar private-public collaboration. But sadly these important advances were exceptions, particularly for poverty-related diseases where commercial incentives for research are not sustainable. 

On a positive note, a report released on 13 October by the research group Policy Cures at an event organised by the German government in Berlin shows that there are nearly 500 product candidates in the pipeline for neglected diseases, including treatments, diagnostics, and vaccines. Nearly half of these are being developed through public-private “product development partnerships”.

Fukushima: High radiation levels halt inspections

I haven't paid much attention to Fukushima lately. That will change. Via The Japan Times: Deadly 9.4 sieverts detected outside Fukushima reactor 2 containment vessel; checks stop.

Tokyo Electric Power Co. said Thursday that radiation levels of up to 9.4 sieverts per hour have been detected outside a reactor containment vessel at the meltdown-hit Fukushima No. 1 nuclear power plant. 

People exposed to the maximum radiation dose for some 45 minutes will die. Tepco expects decontamination work to take at least one month. 

Sept. 4-25 checks found the extremely high radiation levels at a cell that accommodates a pipe connected to the containment vessel of reactor 2 at the plant, which was devastated by the March 2011 earthquake and tsunami, Tepco said. 

The highest contamination was detected on the floor. Details behind the situation are unknown, according to the company. 

Tepco planned to start in August to check the inside of the containment vessel by using a remote-controlled robot but high radiation levels have stalled the examination. 

Extremely high radiation levels and the inability to grasp the details about melted nuclear fuel make it impossible for the utility to chart the course of its planned decommissioning of the reactors at the plant.

Nigeria: Thousands more birds dead in H5N1 outbreak

Via The Poultry Site, an OIE report: Thousands More Poultry Dead in Nigerian Bird Flu Outbreak.

Another outbreak of H5N1 highly pathogenic avian influenza has caused the deaths of 1000 birds in Nigeria. 

The outbreak affected both 14-month-old layers and 8-week-old broilers on a farm in the Rivers area. Another 2500 birds were destroyed to prevent the disease spreading. 

Movement controls, disinfection, stamping out and official disposal are all being used to try and control the spread of avian flu in Nigeria.

MSF: Massive displacement in northern Syria as violence escalates and intensifies

Via MSF.org: Syria: Massive displacement in Northern Syria as violence escalates and intensifies. Excerpt:

At least 35 Syrian patients and medical staff have been killed, and 72 wounded, in a significant increase of air strikes on hospitals in Northern Syria, according to health staff supported by Médecins Sans Frontières (MSF) inside Syria. 

The escalation of attacks, which began in late September, have targeted twelve hospitals in Idlib, Aleppo, and Hama governorates throughout October, including six hospitals supported by MSF. 

Overall, six hospitals were forced to close, including three supported by MSF, and four ambulances destroyed. One hospital has since reopened yet access to emergency, maternity, paediatric and primary health care services remains severely disrupted. 

As a result of the wider attacks in the region, tens of thousands of people have been forced to flee their homes. Some have sought refuge in fields and nearby villages. According to MSF community health workers, others have fled further with some 1,700 families joining an existing 110,000 internally displaced Syrians in four cluster camps spread around Atmeh, located in Idlib governorate. Two hundred and twenty five additional families alone have arrived over the past week alone. 

“After more than four years of war, I remain flabbergasted at how International Humanitarian Law can be so easily flouted by all parties to this conflict,” said Sylvain Groulx, Head of MSF for Syria. “We can only wonder whether this concept is dead. So many humanitarians and health actors including MSF have repeatedly called and are calling for an immediate halt to such attacks across the country, but are our voices being heard?”

Saudi Arabia: No new MERS cases, one death as of noon October 30

Via the KSA MOH Command and Control Center: MOH: 'No New Corona Cases Recorded'. A 61-year-old Saudi man has died in Hofuf. No recoveries are reported. 

The numbers are now 14 persons under care, 717 recovered, 1,273 total plus one asymptomatic case, and 543 deaths.

Canada's healthy future?

Via The Lancet, an editorial: Canada's healthy future?

Justin Trudeau, Canada's new Prime Minister-designate, laid out several policies in his Liberal Party's manifesto in the run-up to the Oct 19 national election, which will see the return of the Trudeau family to 24 Sussex Drive, Ottawa. 

There are promises to re-engage with First Nation Canadians, abandoned from health service planning by the Stephen Harper stewardship of the past decade; appoint a Chief Science Officer within government (to help the nation re-connect with a community often viewed by the previous administration with mistrust and suspicion); legalise cannabis; commit to stronger action on climate change; and increase funding for the devolved provincial and territory health systems to offer improved services, notably in the areas of elderly care and mental health. 

Delivery on these policies could have positive effects on Canada's future health and reverse a decade during which health has been largely ignored by the federal government. 

Beyond the election pledges, Trudeau's new administration should articulate the meaning of public health for Canada at a federal level, how it can influence policy in the devolved regional health systems, and how it can redistribute resources to help contribute to national health equity. 

Globally, the new government should build on Harper's Muskoka Initiative—one surprisingly positive legacy of the Harper years, which highlighted Canada's outstanding advocacy for a global health programme that has already had a substantial impact in maternal, newborn, and child health across seven low-income settings, mainly in sub-Saharan Africa. 

Canada has committed a further CAN$3·5 billion over the next 5 years to the next phase of the Muskoka Initiative. We would like Trudeau to embrace the Muskoka movement and broaden it to define Canada's future global health strategy in the new era of sustainable development. 

Pre-election excitement and post-election euphoria bring high expectations. But If Trudeau appoints bold, progressive, and technically able ministers—and we will learn more when his cabinet is announced on Nov 4—then Canada could well have a healthier future, and recover from its lean Harperesque past.

Deforestation 'may have started West Africa's Ebola outbreak'

Via The Guardian: Deforestation 'may have started west Africa's Ebola outbreak'. Excerpt:

Deforestation may have triggered the recent Ebola outbreak in west Africa, France’s environment minister Ségolène Royal told a London summit hosted by the Prince of Wales ahead of next month’s Cop21 conference. 

Addressing the British energy and climate change secretary, Amber Rudd, representatives from forest nation governments and global companies, Royal said researchers believe the destruction of forest habitat brought bats, known to carry the virus, into greater contact with humans. 

“They had to clear the forest to begin subsistence agriculture and the deforestation has also been caused by mining activity and large-scale logging for export,” she told the high-level meeting at Lancaster House. 

“This destruction of the natural habitat of fruit-eating bats drove the animals to approach human settlements to find food and the virus may have been transmitted during this increased contact resulting from deforestation,” she said.