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global health

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…

Pietro Dionisio: The shortage of medicines in Venezuela is a humanitarian crisis

28 Jul, 16 | by BMJ

Pietro DionisioVenezuela is a powder keg. A major objective of the Chávez government after the Bolivarian revolution was to improve healthcare for the Venezuelan people, and they built thousands of new clinics, hospitals, and diagnostic centres across the country. But now there is a grave risk that all this progress will vanish and those living in poverty will suffer more than anyone else.

The Venezuelan healthcare sector is facing an unprecedented meltdown due to shortages of basic equipment. The origin of the problem is the collapse of oil prices. Additionally, the government’s huge borrowing has helped to bring the crisis to a head because Venezuela now has far less money to repay its foreign debt, forcing a slash of imports to avoid default. more…

Chris​ Simms: The Iraq war, Chilcot, and cherry picking data: How to find a way forward?

20 Jul, 16 | by BMJ

Chris_simsThe first week of July 2016 was a week to remember. A cluster of war related stories dominated the media, including the 100th anniversary of the Battle of the Somme (1 July), the death of Elie Weisel on 2 July, on 3 July there was the deadliest bombing in Bagdad since 2003, three days later we had the release of the Chilcot report and the 45 minute response it drew from former Prime Minister Tony Blair, and on 8 July the deployment of NATO troops into Eastern Europe (for the first time since the end of the Cold War).

These events tend to underscore the importance of careful assessment of past mistakes and taking measures to prevent their reoccurrence. more…

Madhukar Pai: How drug resistant TB can show the path to tackling antimicrobial resistance

18 Jul, 16 | by BMJ

Madhukar PaiAntimicrobial resistance (AMR) is a global health threat, and it is estimated that if we do not find solutions to tackle the rise of drug resistant pathogens, by 2050 10 million lives a year and a cumulative 100 trillion USD of economic output will be at risk.

Since the introduction of antibiotics, microbes have evolved a variety of methods to resist antibiotics. We are now dealing with “superbugs” that are virtually untreatable, including colistin resistant E coli, drug resistant gonorrhoea, carbapenem resistant enterobacteriaceae, methicillin resistant Staphylococcus aureus, extensively drug resistant tuberculosis, and extended-spectrum beta-lactamase producing strains. The antibiotic pipeline is running dry, and AMR is threatening to undo major gains made in the control of infectious diseases. more…

Lara Fairall: Serendipity and scaling up towards universal primary care

14 Jul, 16 | by BMJ

lara_fairallA Brazilian adaptation of our PACK training programme for primary care doctors and nurses went live last week in the Southern city of Florianὸpolis, or Floripa as it is known to locals, amid great excitement including a clip on local television. We’ve spent 15 years in South Africa developing, researching, and fine tuning our programme. PACK, or the Practical Approach to Care Kit, combines a clinical decision support guide with onsite, interactive, team-based training sessions to familiarise health workers with its content and support scalable implementation. It covers an approach to the most commonly seen symptoms and conditions amongst adults attending primary care services, integrating content on communicable diseases, NCDs, mental disorders and women’s health. We’ve demonstrated positive impacts on quality of care in a series of pragmatic trials mainly in the area of communicable diseases. The programme has been scaled up in South Africa reaching more than 20 000 nurses and doctors across more than 2000 clinics. Last year we partnered with the BMJ’s Evidence Centre to keep the guide up to date with the latest evidence, and to respond to the many requests we’ve had to adapt and implement the programme in other countries. You can read more about our journey over the past 15 years in an article published last year. more…

Andy Haines: Why health partnerships are good for global health

11 Jul, 16 | by BMJ

andy_hainesGlobal health is in a state of constant flux. Trends are perpetually changing and evolving, and new challenges arise on an almost weekly basis. The great gains seen in the fight against many infectious diseases are accompanied by increases in mental ill health, and non-communicable diseases such as diabetes, heart disease, stroke and cancer in many low and middle income countries. These trends are the result of several factors including increasingly obesogenic environments and diets based largely on processed foods high in sugar and saturated fat. These evolving challenges require integrated solutions that address both the underlying determinants of health as well as the need for universal health coverage with affordable and effective healthcare. more…

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