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global health

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…

Katherine Sievert, Suong Le, Paul O’Neill: Engaging new migrant populations—a lesson in humility

7 Jul, 16 | by BMJ

Katherine-SievertSuong-LePaul-O'Neill

Our Rohingyan community leader sits with us in Springvale Community Centre, Melbourne, Australia, educating us on what he perceives as the major risks for the transmission of hepatitis B virus in Myanmar. He reports that Burmese people love to drink Red Bull, Coca Cola, and tinned juice. However, in Myanmar these canned drinks are kept on store shelves for a long time. Here, he says, is the risk. Drinking the expired tinned drinks and the exposure to “gas” is how hepatitis B is acquired. more…

Peter Thomson: Standing up for the rights of migrants and refugees in Europe

7 Jul, 16 | by BMJ

Recently I had the opportunity to watch a special screening of “Frontline Doctors: Winter Migrant Crisis” supported by Doctors of the World UK. Originally shown on the BBC in March, this uncompromising documentary follows Chris and Xand Van Tulleken across Europe, observing migrants fleeing during winter, and offers an insight into the sheer scale of the medical and humanitarian crisis.

The fact that 52,000 refugees and migrants crossed the eastern Mediterranean to reach Europe in January 2016 alone, facing rough seas, strong winds, and freezing conditions, demonstrates the desperation of the situation from which they are escaping. more…

Rosanna O’ Keeffe: A week in Calais

6 Jul, 16 | by BMJ

rosannaMy teenage patient presents with a cough, fever, and a sore throat. This sounds like an ordinary, everyday consultation in general practice. The only difference is that this time the consultation is taking place in a caravan, in the refugee camp (also known as the Jungle) in Calais.

My father and I (GP and GP Trainee) went to Calais to volunteer for one week in April. We were working with a group of nurses, doctors, paramedics, and allied health professionals from the UK and Ireland.

The refugee camp in Calais is home to between 4000 and 6000 undocumented, displaced people. People who have fled war, poverty, famine, and risk of death more…

Jane Parry: Without incentives, health data sharing systems don’t work for patients

5 Jul, 16 | by BMJ

jane_parry3In the multi-payer systems that characterize primary health care in Asia and the Pacific, both developed and developing countries suffer a way of delivering care that works against data sharing.

Even in Hong Kong, China—which has one of the highest standards of health care in the region—services are rendered without a sharable electronic medical records system, as I witnessed in a recent encounter with the medical profession that gave me first-hand insight into the matter. more…

William Cayley: What happened? A US doctor on Brexit

27 Jun, 16 | by BMJ

bill_cayley_2What just happened? Sitting in my clinical office in rural Wisconsin, the outcome of the “Brexit” vote seems quite far away—yet the day after 23 June’s vote, the shock and surprise emanating from the news stories is almost palpable.

While I can’t claim to know much about the inner workings of British domestic politics, as I’ve followed recent news the parallels between the options facing voters in the UK and in the US are strikingly clear: one finds strength in rugged independence, in nationalism, and keeping “them” at bay; while the other side represents (or represented?) a choice for collaboration and for the (perhaps uninspiring?) status quo. more…

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