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global health

Richard Smith: Being creative in developing primary care

26 Sep, 16 | by BMJ

richard_smith_2014Primary care covers the whole population, but it’s underfunded and has increasing difficulty recruiting doctors; and there are worries about equity and the quality of care. This could be the NHS in Britain, but it’s the health system in Florianópolis, Brazil. The NHS can learn from the Brazilian experience, and Jorge Zepeda, a family physician and former director of primary care in Florianópolis, shared how the services have responded creatively to the pressures at a C3 breakfast seminar last week.

The development of primary care in Brazil

Brazil committed itself to universal health coverage soon after democracy was restored in 1988 after years of military rule. Recognising the importance of primary care, the country introduced more…

Naveed Ahmed Khan: The increase in cases of brain eating amoeba

23 Sep, 16 | by BMJ

naveed_khanThere has been an alarming increase in the number of reported deaths due to brain-eating amoeba, Naegleria fowleri, a parasite that invades the brain through the nose via water. [1] The parasite feeds on the brain and causes severe haemorrhage and inflammation resulting in widespread brain tissue destruction. Even with treatments, the fatality rate is almost 100%. [2] The reported number of deaths is likely to represent only the tip of the iceberg and the actual number of deaths is most likely far higher.  more…

Arthy Santhakumar: The verdict is out on superbugs

22 Sep, 16 | by BMJ

arthy-santhakumarA global health peril that demands global action. 

For only the fourth time in history, a health issue has reached the great political heights of the United Nations General Assembly. Following HIV, non-communicable diseases, and Ebola—antimicrobial resistance (AMR) has taken the grand stage, receiving a standing ovation in the form of a united political declaration which promises to combat AMR and has been signed by 193 member states.

The high-level meeting, held on 21 September concluded with world leaders making a pledge of more than £600 million, to mobilise the human and financial resources needed for innovation and preservation of this public common good. more…

Zaher Sahloul: Practising medicine in Aleppo

9 Sep, 16 | by BMJ

zaher_sahloulIn my first medical mission to Aleppo in October 2013, I was asked to examine a toddler who had arrived at our hospital after being shot in the head by a sniper one hour earlier. He was just 3 years old. His heart was beating, but he exhibited no other signs of life. I was told that snipers had targeted him, his mother, and his sister as they tried to sprint through the passage separating the opposition-controlled east side of Aleppo to the regime-controlled west.

That two block street has now come to be known as “The Corridor of Death.” Snipers perched on the roofs of three regime-controlled buildings more…

Kawaldip Sehmi: Shopping around for the best system of universal health coverage

30 Aug, 16 | by BMJ

Kawaldip SehmiIn September 2015, 194 member states of the United Nations agreed to adopt the resolution A/RES/70/1 from Transforming our world: the 2030 Agenda for Sustainable Development. By accepting this resolution they have set themselves 17 social, economic, educational, and health goals to achieve by 2030.

Sustainable Development Goal 3 (SDG 3) declares that the state will ensure healthy lives and promotes wellbeing for all at all ages. Potentially, the most important sub-health goal is SDG 3.8—each country will establish a system of universal health coverage (UHC), including financial risk protection; access to quality essential healthcare services; and access to safe, effective, quality and affordable essential medicines and vaccines for all by 2030. more…

Nora Hellman: Responding to an outbreak of yellow fever

24 Aug, 16 | by BMJ

nora_hellmanResponding to an outbreak of yellow fever is not as exotic as you may imagine.

What kind of exciting and interesting things do you do as an emergency response nurse with Save the Children’s emergency health unit in the Democratic Republic of Congo (DRC) the day before one of the largest ever vaccination campaigns in Africa starts? Label things. 204 vaccine carriers, to be exact, carefully labelled in permanent marker. In a response of this scale the details are important—a label could make the difference between life and death. more…

Lee Schroeder, Timothy Amukele, and Madhukar Pai: Why the world needs an essential diagnostics list

5 Aug, 16 | by BMJ

Dried blood spots

Without diagnostic tests, medicine is blind. And yet, diagnostics receive much less attention than vaccines and drugs. Imagine a sick infant with bacterial sepsis in sub-Saharan Africa. Without diagnostics, they will likely get incorrectly treated for malaria. Every year, one million patients with TB in India are either not diagnosed or not reported. Pregnant women with anaemia, syphilis, and diabetes are often missed in low income countries where laboratory capacity is severely lacking. And where there is available testing, it is often of low quality.

A recent NEJM article proposed a simple way to improve access to critical diagnostics: make a list. more…

Diana Quirmbach, Laura Cornelsen, Richard Smith: The rise of soft drinks—sugar is not the only concern

5 Aug, 16 | by BMJ

While sugar sweetened beverages (SSBs) are increasingly being targeted by governments in their efforts to halt and reverse rising levels of obesity, energy drinks in particular have been singled out as a soft drink category that might constitute a double whammy for health. First of all, they contain high levels of both sugar and caffeine, as well as other substances; and secondly, these drinks are predominantly marketed to adolescents and young adults, for whom consumption of drinks that have the caffeine levels of up to two cups of coffee per serving are likely to be even more harmful than the “traditional” sugary soft drinks.

In a recent report for the Food Research Collaboration, Visram and Hashem review the evidence on energy drink consumption among children and adolescents, highlighting that, according to a 2011 EU survey, across Europe two thirds of adolescents report drinking energy drinks. more…

Jean-Hervé Bradol: Humanitarian emergency in northeast Nigeria

4 Aug, 16 | by BMJ


Credit: Claire Magone/MSF

Several days ago I returned from Borno state in northeast Nigeria, where a catastrophic humanitarian emergency is quietly unfolding.

I was there to assess the situation and help set up Médecins Sans Frontières’ aid activities in one of those towns—Bama, approximately 70 kilometers southeast of Maiduguri, the state capital. On arrival, we found high numbers of people on the brink of death and in urgent need of food and medical care.

Until recently, Bama and the surrounding area had been under control of Boko Haram and completely inaccessible. For close to two years, people in the region had extremely limited access to medical care and food. more…

David Hughes: London, Zika, and the Rio Olympics

2 Aug, 16 | by BMJ

david_hughes_2I remember clearly the night of the London 2012 Olympics opening ceremony. I was team doctor for the Australian women’s basketball team, the Opals. The Australian Olympic Team (AOT) usually sends one or two doctors to the opening and closing ceremonies, with a few basic medical supplies, to take care of any medical issues that may arise among the marching team members. I was delighted to be asked to perform this role at the London opening ceremony.

London was special. The village was immaculate and from it the stadium was visible and audible—hours before the ceremony began, we could hear the noise of the crowd and the entertainment booming out of the stadium. more…

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