Comprehensive plan to step up global access to vaccines

Ministers of Health from 194 countries at the Sixty-fifth World Health Assembly have endorsed a landmark Global Vaccine Action Plan (GVAP), a roadmap to prevent millions of deaths by 2020 through more equitable access to existing vaccines for people in all communities.

The GVAP was coordinated by the Decade of Vaccines Collaboration, a group of leading international vaccine experts, and represents the collective vision of hundreds of global health stakeholders to extend the full benefits of immunisation to all people, regardless of where they are born, who they are, or where they live.

Currently, four out of every five children receive at least a basic set of vaccinations during infancy that allow them to lead healthy, productive lives. However, this means 20 percent of children still do not benefit from basic immunisation.

This comprehensive plan involves four mutually reinforcing goals: strengthening routine immunisation to meet vaccination coverage targets; accelerating control of vaccine-preventable diseases with polio eradication as the first milestone; introducing new and improved vaccines; and spurring research and development for the next generation of vaccines and technologies. The plan is expected to reduce global childhood mortality, surpassing the targets of the United Nations Millennium Development Goal 4.

“The Global Vaccine Action Plan focuses on the health needs of people at all stages of life,” said Dr. Flavia Bustreo, Assistant Director-General for Family, Women's and Children's Health of the World Health Organisation.

“The plan promotes greater coordination and synergies between immunization and other child, adolescent and reproductive health interventions leading to healthier communities everywhere.”

“While immunisation already prevents millions of deaths and uncounted illness, we cannot rest until life-saving, cost-effective vaccine technology reaches people in every community and every country through this global plan,” said Dr. Ciro de Quadros, Executive Vice President of the Sabin Vaccine Institute and co-chair of the Decade of Vaccines Collaboration's Steering Committee.

Following approval by the World Health Assembly, the GVAP will be adapted for implementation at the regional and country level. Country involvement in this process reinforces a key tenet of the GVAP, which is to increase national ownership of immunisation programs. The collaboration will also establish a monitoring and evaluation framework and finalise estimates for funding needs as well as potential cost savings.

“By supporting countries to strengthen their health systems and introduce powerful vaccines that prevent the biggest killers of children, we can have a dramatic impact on the lives of millions of people. We need to work together to make the vision of the Global Vaccine Action Plan a reality, and I am proud that GAVI will play its part in this,” said Dr. Seth Berkley, CEO of the GAVI Alliance.

Innovation is a guiding principle of the GVAP beyond the vaccines themselves. The plan identifies priorities for improving program efficiency and increasing vaccine coverage. This includes the use of modern communication technologies for immunisation programs; research to understand the cultural, economic and organisational determinants of immunisation; and the development of diagnostic tools for conducting surveillance in low-income countries. The plan also focuses on building capacity and human resources in low- and middle-income countries to conduct research and development and operational research.

“We know vaccines work to save and improve lives,” said Dr. Chris Elias, president of the global development program at the Bill Melinda Gates Foundation.

“We must urgently work to reach all children with the vaccines they need.”

Lending further support to the Decade of Vaccines, world health ministers also endorsed a resolution declaring polio a global public health emergency. The eradication of polio is a critical step in protecting all children from vaccine-preventable diseases and is an important early milestone in the Decade of Vaccines.

A large and diverse group of stakeholders representing 290 organisations - including representatives and elected officials, health professionals, academics, manufacturers, global agencies, development partners, civil society, media and the private sector in more than 140 countries - contributed their expertise to the development of the GVAP in a year-long consultation process.

“It is unacceptable that children are still dying from diseases that are preventable with existing vaccines,” said Dr. Abdul Majeed Siddiqi, Head of Mission for HealthNet TPO in Afghanistan and Pakistan and Chair of the GAVI Civil Society Steering Committee.

“This is an actionable plan across the discovery, development and delivery of vaccines - now we must all do our part to make it happen.”

MNT

World No-Tobacco Day:

Smoking contributes to lung cancer, heart disease

by Nilma DOLE

World Tobacco Day was commemorated on May 31 but that hasn't stopped the on-going battle against no-tobacco and campaigning for a pollution-free tomorrow. Smoking is a dangerous habit and it isn't easy to ask a smoker to just ‘quit'; it comes with real discipline and self-determination. According to the World Health Organisation (WHO), tobacco use is the second cause of death globally (after hypertension) and is currently responsible for killing one in 10 adults around the world. Peer-pressure, cultural influence and the ‘trend’ of smoking gets adolescents and young adults to dabble in the habit at a young age with grave consequences. Any role model or idol who smokes will influence young people to smoke because it is seen as a ‘cool’ thing to do. It is also possible that children who have parents who smoke are more likely to be smokers when they grow up.

Even though nicotine is an appetite suppressant and stops food cravings, it hasn't been extensively researched as to whether it helps in losing weight.

However, the disadvanges outweigh the advantages because smoking contributes to lung cancer, heart disease and impotence.

No matter what the reason, smoking does endanger health and no matter what excuse is given, second-hand smoke is worse than the smoke emitted by smokers.

In Sri Lanka, nearly 60 people die every day from the effects of smoking and the annual per capita consumption of tobacco cigarettes in Sri Lanka is 205. The National Authority on Tobacco Control states that the annual premature death toll because of tobacco smoking is around 22,000 in Sri Lanka and there are more male smokers than women.

Hampering the economic loss of the country and also putting more people in hospital, the productivity loss to the country far exceeds the income derived from tobacco. While some may argue that cigarette and alcohol smokers pay a high amount of tax, there is a definite problem of hospital admissions due to cancer, heart attacks and ailments as a direct link to smoking.

One of the ways of stopping the habit of smoking among females is the fact that pregnancy will affect the child and endanger their health. In Sri Lanka, smoking among females is taboo and this has prevented most women from taking the habit. While women might accept the habit of their husbands, fathers, relatives or friends, they always insist their male counterparts from quitting.

Since the majority of people in Sri Lanka are non-smokers, changes in attitudes and control interventions should be done in promoting the quitting the habit of smoking in society.

In a survey done in 2005 by The Department of Community Medicine, Faculty of Medicine, University of Ruhuna, it was shown that 41 percent of men were yearly smokers, 27.8 percent were monthly smokers and 21 percent daily smokers. The corresponding figures for women were 3.4 percent, 2 percent and 0.6 percent respectively. Even though smoking is seen as an affluent habit that only the rich can afford, there was a tendency for less educated, middle-aged men from underprivileged families who were a part of the considerable proportion of smokers.

According to the Global Youth Tobacco Survey conducted in 2007, 5.1 percent youth (13-15 years old) smoke cigarettes, 39.5 percent of them smoked cigarettes before the age of 10, 8.6 percent are current users of other tobacco products, 65.9 percent are exposed to secondhand smoke in public places. According to the 2008 WHO Report on the Global Tobacco Epidemic, 29.9 percent males and 2.5 percent females are current smokers.

Workplaces, education institutes and public areas should have a stricter tolerance to smoking and also, it should reflect that a non-smoker is healthier than a smoker.

Each year, the WHO highlights the health risks that come with cigarette smoking by commemorating work tobacco day and the need to enforce no-smoking policies on World No Tobacco Day. The World Health Assembly created World No Tobacco Day in 1987 emphasised that global attention to the tobacco epidemic and its lethal effects was imperative. It also provided an opportunity to highlight specific tobacco control messages and to promote adherence to the WHO Framework Convention on Tobacco Control.

According to the WHO, tobacco use is the number one preventable epidemic that the health community faces.

The good news is that Sri Lanka was the first country in Asia to ratify the Framework Convention on Tobacco Control (FCTC), the international tobacco treaty negotiated under the auspices of the World Health Organisation that was made international law in 2005. President Mahinda Rajapaksa also envisioned a Tobacco-free Sri Lanka by the year 2015. In 2006, Sri Lanka enacted a Tobacco Control Act for comprehensive tobacco control and established the National Authority on Tobacco and Alcohol (NATA) to implement the Act.

Even though alcohol use seems to be positively associated with smoking because it is used to socialise, there are plenty of chain smokers and this is increasing. Warnings on cigarette packs, signs and advertisements are simply not enough to tackle the no-smoking policy.Against this backdrop, the Government is refocusing its health priorities to address the issues of NCDs, including effective control of tobacco use. If we are to implement a no-smoking policy, we should start at the root and stop adolescents from getting into the habit.

If there is enough awareness and education on the effects of smoking in schools, colleges and universities then the problem can be tackled at a grass-root level. If there is more that is done to give a negative impression of cigarette smoking, then people won't take to the habit.

With a pinch of salt …

Fast food can be made less salty, finds research. But companies refuse to do so.

Claims made by fast food giants that they cannot reduce the high salt content in their products, which is a serious health concern, have been belied by a study.

Transnational food chains have all along held that making their products less salty would pose technological problems as it would entail adjustments in other processing parameters.

They also claim that reducing salt would compromise taste. Salt plays an important role in food processing - it improves taste, texture and acts as a preservative. But the joint study by senior health researchers in six countries has convincingly nailed the companies’ lie.

The research proves that companies are capable of making these adjustments. Crunchy nuggets that sells in the UK have two-and-a-half times less salt than the same nuggets it sells in the US. In fact in the UK, where food regulators have taken up salt reduction as priority, most products have far less salt than in the US.

Researchers studied the nutritional information provided on the websites of six leading fast food chains for seven food categories in Australia, Canada, France, New Zealand, the US and the UK. They collected data on 2,124 products categorised as breakfast items. They measured the salt content in every serving and in every 100 g.

The variations - among food categories, companies and countries - were greater when measured per serving than when measured per 100g.

This, researchers explain, was due to non-uniformity in the serving sizes. Large serving means more salt. In Australia, a pizza is not more than 65 g, almost one-sixth of a Double Whopper in Canada.

Some chicken products and burgers had more than 6 g of salt per serving; some salads had more than 7 g per serving. The saltiest sandwich had around 8 g of salt per serving, while the saltiest pizza had 10 g.

World Health Organisation (WHO) targets reduction of the per capita salt intake to 5 g per day. Researchers also found huge variations in the salt content of the same products that companies sell in different countries. Similarly, the same company uses varied amount of salt in its different products.

“Through the study we wanted to highlight that even in very similar products salt content varies greatly,” says lead researcher Elizabeth Dunford, who works with the Australian division of World Action on Salt and Health.

In a lab study of salt, sugar and fat content in junk foods available in India, CSE found the levels varied considerably from the information companies provided on their websites or the product labels.

The human body requires very little sodium, which is sourced mainly from salt. High salt intake can cause blood pressure to shoot up and lead to cardiovascular diseases. According to WHO, there is enough evidence that reducing salt intake can minimise the risk of hypertension and cardiovascular diseases.

The National Institute of Nutrition (NIN) recommends not more than six grams salt per person per day. People around the world eat a lot more salt than is required.

In India, salt consumption varies between 5 g and 30 g per person per day, says NIN.

The average salt consumption in the US by those above two years is around 8.6 g per day, according to Centres for Disease Control and Prevention.

In Australia, men consume about 10 g salt per day, while women’s daily intake is 7 g, according to Australian division of World Action on Salt and Health.

In Canada, the contribution of processed food to dietary salt is 77 percent, according to Statistics Canada, the country’s national statistical agency.

In India, Associated Chamber of Commerce and Industries conducted a study in the country’s major cities and found that 86 per cent of the households preferred instant food over home cooked food. Eighty-five percent familes with children below five years of age ate ready-to-eat meals seven to 10 times a month.

The UK and Finland have shown the way to a healthier lifestyle. The UK managed to reduce salt consumption of its people by 0.9 g per day. The Finnish government launched a project in North Karelia over 30 years ago and reduced the average salt consumption by one-third.

Salt content in food items of transnational chains varies from one country to another.

“This means there is scope for reducing the salt content,” says Anoop Misra, chairperson of National Diabetes, Obesity and Cholesterol Foundation. Strict regulations from government on food labelling can help solve this, he adds.

- Down To Earth

Immune system may protect against Alzheimer's changes in humans

Recent work in mice suggested that the immune system is involved in removing beta-amyloid, the main Alzheimer's-causing substance in the brain. Researchers have now shown for the first time that this may apply in humans.

Researchers at the Peninsula College of Medicine and Dentistry, University screened the expression levels of thousands of genes in blood samples from nearly 700 people.

The telltale marker of immune system activity against beta-amyloid, a gene called CCR2, emerged as the top marker associated with memory in people.

The team used a common clinical measure called the Mini Mental State Examination to measure memory and other cognitive functions.

The previous work in mice showed that augmenting the CCR2-activated part of the immune system in the blood stream resulted in improved memory and functioning in mice susceptible to Alzheimer's disease.

Prof David Melzer, who led the work, commented: “This is a very exciting result.

It may be that CCR2-associated immunity could be strengthened in humans to slow Alzheimer's disease, but much more work will be needed to ensure that this approach is safe and effective”.

Dr Lorna Harries, co-author, said: “Identification of a key player in the interface between immune function and cognitive ability may help us to gain a better understanding of the disease processes involved in Alzheimer's disease and related disorders.” Alzheimer's disease is the most common form of dementia and affects around 496,000 people in the UK. - MNT

NASA team finds ‘new way’ to spot osteoporosis

NASA scientists believe they have found a way to spot osteoporosis bone loss at the earliest disease stages.

Currently, the condition can go undetected for years and may only be diagnosed with scans after weakening of the bones has led to a fracture.

The new test - designed partly with astronauts in mind as they too can suffer bone loss due to the microgravity of space - looks for traces of bone calcium in the urine.

The technique developed by scientists working with the US space agency analyses calcium isotopes - different atoms of the element calcium, derived from bone and each with their own specific number of neutrons. The balance or abundance of these different isotopes changes when bone is destroyed and formed and can therefore indicate early changes in bone density.

To put it to the test, the researchers studied a dozen healthy volunteers whom they confined to bed rest for 30 days. Prolonged bed rest triggers bone loss.

The technique was able to detect bone loss after as little as one week of bed rest - long before changes in bone density would be detectable on conventional medical scans such as dual-energy X-ray absorptiometry (DXA).

And, unlike other biochemical tests for bone loss that look for blood markers of increased bone turnover, it can give a direct measure of net bone loss. Lead researcher Prof Ariel Anbar said: “The next step is to see if it works as expected in patients with bone-altering diseases. That would open the door to clinical applications.”As well as being useful for diagnosing osteoporosis it could help with monitoring other diseases that affect the bones, including cancer.

-BBC