Cambodia - WHO eyes new TB test regime for Kingdom

A quicker diagnosis and a shorter and cheaper course of treatment for multidrug-resistant TB patients in Cambodia could soon be on the horizon.

The World Health Organization recommends countries with high incidences of TB, including Cambodia, begin implementing the new treatment regimen based on studies in 10 countries.

“Cambodia, as a WHO member state, is of course expected to take note of this recommendation and adapt it, according to its local epidemical context,” said Ernesto Jaramillo, a TB expert with the WHO.

Health officials in Cambodia will develop a plan to implement the new regimen by late 2017 or early 2018, said Dr Mao Tan Eang, director of the National Centre for Tuberculosis and Leprosy Control.

The new treatment, which costs less than $1,000 per patient, could be completed in nine to 12 months, compared to the current period of 18 to 24 months, said Tan Eang. Officials would phase out the existing regimen.

“We hope to be more efficient and cost-effective,” he said.

Although TB is a leading cause of death in Cambodia, a 2015 Yale Global Heath Review study found that multi-drug resistant TB hasn’t been a significant problem, but rates are rising.

In 2015, 70 multidrug-resistant TB cases were identified in the Kingdom, and officials expect to identify 145 this year, Tan Eang said. It’s too early to estimate funding levels needed, he said.

US Embassy spokesman Courtney Woods said that once the WHO releases the guidelines in June, USAID will discuss with the national centre how it can “support the roll-out of the new recommendations at the country level”.

Yesenia Amaro

phnompenhpost

Indonesia - Indonesia in top five for countries with diabetes: WHO

INDONESIA (REUTERS) - Mr Tonny Soerianto takes a pill every day and gives himself a vitamin injection to help fight the disease he's living with - type-2 diabetes.

Mr Soerianto has been fighting it for nine years, the result of a lifetime of poor dietary decisions.

It's caused by obesity, he says. "It's my bad lifestyle choices and a lack of exercise."

And he's not alone. A report by the World Health Organisation says some ten million Indonesians have diabetes.

Dietary staples like rice and oily fried foods contain high levels of carbohydrates which cause blood sugar levels to skyrocket.

Doctors say medicating patients is not enough. They must be educated about food and lifestyle, Mr Soerianto's doctor said.

Companies like Mymeal are trying to help.

The catering firm delivers precooked, healthy food to customers for about US$5 (S$6.72) per meal.

The service is a luxury however - some 40 per cent of the population live on about US$1 per day.

According to the WHO's report, the world's top five countries suffering from diabetes included Indonesia, China, India, Brazil and the US.

straitstimes

Malaysia - Malaysia focuses on dengue at World Health Assembly

KUALA LUMPUR: Malaysia will take the lead in bringing dengue fever concerns to the world's attention at the coming World Health Assembly, said Datuk Seri Dr S. Subramaniam.

The Health Minister said that Malaysia would host a side event on dengue at the meeting in Geneva, Switzerland, at the end of May.

"Dengue has never been given the ‘centre stage’.

"Through our initiative, we have taken dengue to the centre stage of the World Health Assembly itself and for the first time, we will be hosting a side event there," he said in his speech at the Asia Dengue Conference on Saturday.

Dr Subramaniam said that various experts would be invited to share information on dengue during the event.

He said that dengue had spread to many parts of the world and yet it had not received much attention in international meetings.

It is a serious issue in Malaysia and affected those in the productive age, he said.

As many as 42,271 dengue cases were reported from January to April 22, a 10.8% increase compared with 38,139 cases for the same period last year.

However, there were 94 deaths for the same period this year compared with 119 during the same period last year, a decrease of 21%.

He said that in the last two years, the pattern of dengue cases had changed and had affected more of the heart, brain and kidneys.

Meanwhile, deputy health director-general Datuk Dr Lokman Hakim Sulaiman said that 60,682 premises had been inspected since the nationwide enforcement operations on dengue began on April 11.

Out of the number, 351 were fined, with the total fine collected amounted to RM175,500.

Dr Lokman said that 105 construction sites were also inspected and four of the sites were ordered to close until they were cleaned up while another seven cases were brought to court.

"We have found less premises with mosquito breeding sites. Perhaps people have started to check their homes after hearing of the enforcement operations," he said.

He advised the public to check on the ant trap in the floor, water containers that are used for washing dishes, roof gutters, air-condition compressor and homes that people themselves had left empty.

thestar

Philippines - WHO Subnational Initiative: Accelerating Convergence Efforts Through Systems Strengthening for Maternal and Newborn Health (AcCESS for MNH) in Davao, Philippines

The Accelerating Convergence Efforts Through Systems Strengthening for Maternal and Newborn Health (AcCESS for MNH), a project of the World Health Organization Sub National Initiative (WHO SNI) in partnership with the Department of Health Regional Office XI (DOH RO XI), shared its insights and experiences in addressing maternal and newborn health challenges in Davao Region in a forum entitled “Stories from the Field: Walang Nanay at Sanggol ang Mamamatay dahil sa Panganganak” (No mother and newborn shall die from childbirth-related causes) in Davao City.

The forum was an avenue for project partners to take stock of what was done so far, and re-evaluate what works and what doesn’t. It was an opportunity to share early wins, insights, and experiences in implementing activities and strategies on maternal and newborn health. Various stakeholders such as barangay officials, community leaders, barangay health workers, midwives, and other health service providers committed to continuously work together to improve maternal and neonatal health in Davao Region.

AcCESS for MNH is a three-year project launched in 2015 with funding support from the Korean International Cooperation Agency (KOICA). It is part of WHO’s Sub National Initiative to model a systematic and evidence-based approach in improving implementation of the country’s Universal Health Care at community level, capitalizing on WHO’s core function as a global leader in public health. AcCESS for MNH seeks to provide catalytic technical and advisory support to DOH RO XI and partner local government units (LGUs) to accelerate convergence of efforts for the health and survival of mothers and newborns, especially among the most disadvantaged populations. It aims to strengthen health systems and governance, establish a functional network of services, and improve utilization of quality maternal and newborn services in the neediest communities in the region, towards the overarching goal of reducing maternal and neonatal deaths in Davao Region. It is being implemented in ten LGUs in the four provinces of Davao as follows: Malita, Sta. Maria, and Don Marcelino in Davao Occidental; Maco, Mabini, and Pantukan in Compostela Valley; Tagum City and New Corella in Davao del Norte; and Manay and Caraga in Davao Oriental.

The forum, held last February 9, was attended by DOH Assistant Secretary Dr. Nestor Santiago, KOICA Deputy Director Heesoo Hong and Health Specialist Dr Michelle Apostol, DOH RO XI Regional Director Dr. Abdullah B. Dumama Jr. and Assistant RD Dr. Annabelle Yumang, WHO Philippines Technical Officers led by Dr Benjamin Lane and Ms Lucille Angela Nievera, other DOH officials, municipal mayors, Provincial Health Officers, DOH Representatives, and community health service providers.

WHO

Myanmar - Increasing anti-venom production to prevent snakebite fatalities across Myanmar

Snake bites are well-known medical emergencies in many parts of the world, especially in rural areas.

The incidence of snake bite mortality is particularly high in South-East Asia, home to many different venomous snakes, and farmers, rural workers and children are often the most at risk. In 2009, snake bites were included in WHO’s list of neglected tropical diseases, recognising how snake bites represent a common occupational hazard and result in thousands of deaths and chronic physical handicap cases every year.

Much is now known about the species of venomous snakes responsible for these bites and the clinical effects of their venom in humans. In Myanmar, the most common venomous snakes are the Russell’s viper (Daboia siamensis) – responsible for almost 90% of bites in the country, the Monocellate cobra (Naja kaouthia) and the Banded krait (Bungarus fasciatus), which are widespread throughout the nation.

In 1999, the Ministry of Health initiated a programme for the management and prevention of snake bites, with technical support from WHO especially in terms of capacity building. Fellowships are provided to both staff members of the MoH and of the Myanmar Pharmaceutical Factory to conduct research in different institutions of the South East Asia region and receive training on the production of anti-snake venom and the clinical management of snake bites. In-country training is also provided to health personnel, especially in high risk townships where the occurrence of snake bites is most frequent.

The Anti Snake-Venom Production Centre of the Ministry of Industry in Yangon is one of the high-technology facilities that have benefitted from the collaboration with external partners, in particular Australian, Brazilian (Instituto Butanta, Sao Paulo, Brazil) and Thailand (Thai Red Cross) institutions” . The Production centre is responsible for the nationwide production of anti-venom, and is now able to cover for the country’s needs thanks to increased investments and the implementation of new technologies.

Thanks to improvements in all steps of the production process – from ensuring better health and survival rates of horses and sheep, from which the anti-venom anti-bodies are extracted, to using new purification methods to improve the quality of the product – the Production Centre has been able to increase production of specific anti-venom vials (anti-viper and anti-cobra the two most common forms of snake bites) from around 30,000 in 2007-08 to 80,000 vials in 2015-16”.

The production of anti-venom is essential to ensure that the consequences of snake-bites can be mitigated: around 8 vials are needed to treat a single bite, and there is a limited time span (only 3-4 hours after the bite) within which the anti-venom can be fully effective. The time limitations for treatment call for an increased dissemination of anti-venom across the country, in particular in Rural and Sub-rural health centres, where most cases are likely to be reported. In order to tackle the difficulties of storing the anti-venom vials and prolonging their shelf life, the Ministry of Industry and the MPF Anti Snake -Venom Production Centre has implemented a new technology for producing anti-venom, which will allow the lyophilisation of the product to ensure its durability and prolonging its effectiveness even in more difficult storage conditions.

WHO remains committed to supporting the Ministry of Health and the Ministry of Industry in improving the production and dissemination of anti-venom across the country, to ensure that this important public health threat for Myanmar can be effectively managed and controlled.

who

Indonesia - Indonesia To Tackle The Shackling Of The Mentally Ill

Indonesia is seeking to end the lockdown and shackling of thousands of mental health patients.

Indonesia is seeking to boost its community mental health services in an effort to end the lockdown and shackling of thousands of mental health patients.

“The practice of shackling mentally-ill people still exists and eliminating it is one of our priorities for 2013,” Diah Setia Utami, director of mental health at the Health Ministry, told IRIN, noting that the country’s “serious” shortage of mental health professionals has been one of the biggest obstacles.

The government aims to provide 30 percent of the country’s 9,000 community health clinics and 1,700 general hospitals with staff to provide basic mental health care by 2014, Utami said.

The Health Ministry estimates 19 million people nationwide have various mental health disorders, including anxiety and depression, and another one million have severe psychoses.

Currently, 33 specialized mental health hospitals and 600 psychiatrists offer public mental health care.

“These hospitals are adequately equipped to treat mental patients, but in the future, patients will be encouraged to have treatment outside [the] hospital under the care of families and community caregivers,” Utami added.

The Health Ministry estimates some 18,000 people with mental disorders, mostly in rural areas and bereft of any mental health services, are still subjected to ‘pasung’ (shackling) to prevent them from attacking others. In villages, people with mental disorders are typically chained behind their homes, while in cities, limited space and stigma confine a number of them to small rooms.

Opposition to the practice has grown along with local media reports of people – at times undiagnosed – wasting away after years in chains.

Yusuf said people still resort to ‘pasung’ – banned since 1977 – because they cannot afford mental health care and to escape stigma associated with mental illness.

A psychiatric consultation costs on average US$25, not including drugs. The government plans to implement nationwide universal health coverage in 2014, which is expected to cover most mental health costs.

Government initiative

In 2011 the Health Ministry launched the ‘Menuju Indonesia Bebas Pasung’ program (Towards a Shackle-Free Indonesia), but lack of trained health professionals and funding have stalled progress, say officials.

Nova Rianti Yusuf, a member of a parliamentary health commission, noted the lack of data and research on ‘pasung,’ with the exception of two recent studies of 49 shackled mental health patients that showed 90 percent of them had schizophrenia and 70 percent were receiving improper treatment.

The country’s decentralized health care system accounts for uneven attention to mental health care across the country’s 34 provinces, said Utami. “There are some regional governments that pay little or no attention to mental health and, therefore, allocate little or no budget.”

But, in some places, there are signs of improvement.

Asmarahadi (one name), a psychiatrist at the state-run Soeharto Heerdjan mental hospital in Jakarta, said mental health care has improved there “significantly” over the past 10 years. “People used to call the place a prison, but now it’s like a hotel – at least a one-star hotel.”

The hospital receives 150 patients daily and has a policy of not turning anyone away even if they cannot pay, he said.

“People in Jakarta and its surrounding areas are increasingly aware of mental problems,” he said. “Mental health care is not expensive and even atypical, third-generation anti-psychotic drugs are accessible at affordable prices,” he said.

“Treatment failure is usually caused by a lack of patients’ compliance and family support,” he said.

This is if someone seeks formal medical treatment at all. Large pockets of the country still believe magic spells cause mental illness, with families turning to shamans and religious leaders for cures.

WHO plan

Under the 2013-2020 World Health Organization (WHO) global mental health action plan, 80 percent of member countries are expected to update their mental health policies and laws by 2016, while allocating at least 5 percent of public health expenses to mental health care by 2020.

It also seeks to decrease the number of beds used for long-term stays in mental hospitals (which medical studies link to poor treatment and human rights abuses) by 20 percent by 2020, and increase the availability of places for community-based residential care and supported housing.

“The government has the responsibility to provide mental health care for the poor and it should do so by involving local communities,” said Yusuf.

The WHO plan also calls for doubling the treatment of severe mental disorders. Up to 85 percent of such disorders are not currently treated in low- and middle-income countries,WHO estimates.

Source: IRIN.

IRIN News | Health & Medicine

http://www.asianscientist.com

Asia - 65% Of Air Pollution Deaths Occur In Asia: WHO Study

A new global study ranks air pollution as one of the top 10 killers in the world, with 65 percent of the air pollution deaths occurring in Asia.

A new global study ranks air pollution as one of the top 10 killers in the world, with 65 percent of the air pollution deaths occurring in Asia.

The findings of the new Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD) were released at a public event at the Royal Society of London on Friday.

The launch coincides with the publication in The Lancet of seven original research articles and eight commentaries describing the findings.

Based on the latest tally, air pollution causes 3.2 million deaths worldwide, a whopping 300 percent increase from the 800,000 estimate in 2000. The new estimates of particulate air pollution are based on ground-level measurements, satellite remote sensing, and global chemical transport models to capture population exposure.

In South Asia, air pollution has been ranked as the sixth most dangerous killer, just below blood pressure, tobacco smoking, indoor air pollution, poor intake of fruits, and diabetes.

Outdoor air pollution is a leveler that makes everyone – rich or poor – vulnerable, says The Center for Science and Environment (CSE) based in New Delhi, India,

“This GBD count on air pollution and its health risks must trigger urgent, aggressive, and most stringent action in India to curb air pollution to protect public health. India cannot afford to enhance health risk at a time when much of its economic growth and motorization are yet to happen,” said Anumita Roychowdhury, CSE executive director of research and advocacy and head of its air pollution unit.

The GBD estimates that over 2.1 million premature deaths and 52 million years of healthy life lost in 2010 are due to fine particle air pollution in Asia.

1.2 million deaths occurred in East Asia which is in throes of high level of economic growth and motorization, and 712,000 deaths occurred in South Asia which is at the take-off stage.

These figures are much higher than the combined toll of 400,000 in EU 27, Eastern Europe, and Russia.

The CSE recommends that National Ambient Air Quality Standards be legally binding across India. Better fuel quality and in-use vehicle management could also cut the health impact of motorization, it says.

India must also control and cut the explosive increase in vehicle numbers by scaling up public transport, non-motorized transport, and compact city planning, while also cleaning up critically polluted areas, it adds.

The latest GBD results were produced by more than 450 global experts and partner institutions including the World Health Organization, Johns Hopkins University, and the University of Tokyo.

Source: CSE India

Health & Medicine

http://www.asianscientist.com

World - Organ trafficking – business built on grief

According to the WHO, in 2010, 107,000 both legal and illegal transplants of human organs were carried out. Two-thirds of all transplanted organs are kidneys. Experts believe that ten percent of all kidney transplants are illegal. The organization Organ Watch provided a different number – from 15 to 20,000 illegal operations a year.

At least two illegal human organs transplantation surgeries performed in the capital of the Republic of Kosovo trace back to Germany. In 2008, according to the newspaper Spiegel, in the clinic of Pristina 74-year-old German businessman named Walter (last name is not mentioned for obvious reasons) of the State of North Rhine-Westphalia has been illegally transplanted an organ from a 50-year-old Russian woman Vera Schewdko, an immigrant to Israel, who sold her left kidney for 8,100 euros.

When the businessman landed on the hospital bed, the medical verdict was harsh. He had a few months to live, and his family began to seek ways of approaching illegal traffickers in human organs. They saw a television documentary story that condemned the inhumane practice of trafficking human organs. But as Walter’s health deteriorated, his relatives saw saviors in the villains. Since the television show named no names, they asked the author of the story to provide them with contact information. In July of 2008, Walter flew to Istanbul to meet with one of the mediators and then got on a plane to Kosovo.

Vera Schewdko was on the same plane. A few months earlier she emigrated from Moscow to Israel in search of a better life. She worked as a maid at a hotel in the Promised Country, and her salary was desperately small to be able to bring her 10-year-old daughter Nastya into the country. When talking on the phone to her daughter, the child cried all the time and asked her mother to come get her. Vera was divorced, and could not visit home often due to lack of money.

By chance on a bus station in Tel Aviv she stumbled upon a free Russian-language newspaper with the announcement of the purchase of organs for transplantation. When Vera called the advertiser, the person on the other side of the line promised to pay her 10 thousand dollars in cash, or 8,100 euros. From the airport, they headed to the outskirts of Pristina, where a clinic partially funded by a German doctor was located.

Journalists from Spiegel who unveiled the story correctly pointed out that it did not look like a charity story when one person saves another in a desperate situation, and not just because Vera was paid 8,100 Euros. This situation has exposed the structure of the illegal trade in human organs cashing in on human health and distress with no qualms.

Special investigator, Canadian Jonathan Ratel, argues that in Pristina a network of international human organs dealers along with unscrupulous doctors, starting in 2010, took kidneys from 20 or 30 hospital patients to be used for transplants for paying patients.

According to the site wsws.org (World Socialist Web Site that publishes materials of the International Committee of the Fourth International, IKVI), gangs of traffickers in human organs make millions in profits in this illegal business. According to the unanimous opinion of the majority of reputable media outlets, the cost of any human body organ intended for transplantation is estimated at 200,000 dollars or 160,000 euros on the black market. The dealers shamelessly use the plight of the donors. However, these people are often deceived and paid only part of the agreed amount, and at times they are left with nothing.

Republic of Kosovo is considered the “capital” of the illegal trade in human organs. Initially it was caused by the war launched by the leading powers of Europe and the U.S. that led to the disintegration of Yugoslavia. Organs were removed from the killed or captured Serbs for transplants for wealthy customers. This was the birth of an illegal business – trading in human organs. Until 2008, the surgeries with illegal organ transplants were carried out in Pristina.

Evening newspaper Hamburger Abendblatt wrote that back in 1995 a colleague of the two suspected doctors from Göttingen questioned the legality of a large number of organ transplant surgeries. Now, 23 organ transplant surgeries performed between 2010 and 2011 are under investigation. 45-year-old surgeon Aiman ​ and 60-year-old gastroenterologist Giuliano are being accused of corruption and suspected of murder through negligence.

Source: Pravda

Cambodia - Doctor slams WHO for causing virus panic

“The WHO in Cambodia should be closed” is the emphatic sign-off to a lengthy and vivid analysis by Kantha Bopha Children’s Hospitals of the recent “mystery disease” scare.

While the World Health Organization and Ministry of Health have declared that a series of recent child deaths are linked to EV-71, causing severe hand, foot and mouth disease, Kantha Bopha founder Dr Beat Richner has slammed the conclusion as a “catastrophic declaration”.

Richner said 72 cases of the unexplained illness have appeared in his hospitals, and of those, 68 have died.

The WHO yesterday said the totals from the Ministry of Health stood at 61 cases and 56 deaths, including one new death over the weekend that fit the case definition of severe HFMD.

The “case definition” is the critical impasse between the MoH and WHO, and Kantha Bopha, which treat 85 per cent of all Cambodian children.

Kantha Bopha’s “case definition” is encephalitis and complete lung destruction leading to a rapid death.

Not one of these cases showed lesions associated with HFMD, Richner’s statement says.

However, WHO communications officer Sonny Inbaraj Krishnan told the Post yesterday that of the cases recorded by the UN agency and the MoH, rashes and blisters were present.

“Sometimes, with EV-71, either blister or rash appears and it could be one or the other,” he said. “The case definition [for WHO and MoH] is that the child has fever with neurological systems such as vomiting and prolonged stretches of sleepiness or convulsions and respiratory symptoms such as difficulty breathing.”

This conclusion is wrong and is still confusing the media and public, Richner rebuts in his statement.

The question that has still not been answered, Richner said, is “what is destroying the lungs in these 72 cases of encephalitis in the last 6 hours of their life, all treated in private clinics?”

Richner believes that the administration of incorrect drugs to these 72 children could be a factor in the astonishing destruction of the lungs present in the cases that have been recorded by his hospitals.

The most “catastrophic” press release by the MoH and WHO, according to the Swiss doctor, was the most recent, in which the joint investigation conclusion is that a mix of pathogens and a root affliction with EV-71 has been aggravated and worsened by the use of steroids.

The Post previously reported Richner decrying WHO’s criticism of the use of steroids as “absolute nonsense”.

The doctor emphasised that all patients arriving with the unknown illness at Kantha Bopha hospitals showed signs of encephalitis, which requires steroids to stem fatal swelling of the brain.

A high number of platelets during the final moments before death could be a sign that underlying tuberculosis is complicating treatment, Richner said in the statement.

Kantha Bopha Children’s Hospitals operate in parallel to the public health system in Cambodia and provide outpatient and emergency care free of charge at their five hospitals in Phnom Penh and Siem Reap.

However, a bitter relationship between Kantha Bopha and the WHO appears to be complicating investigations into and solutions to the child deaths.

MoH Secretary of State Heng Tay Kry said only the minister or WHO could respond about Richner’s allegations.

Minister Mam Bunheng, Communicable Disease Control Department director Sok Touch and his deputy, Ly Sovann, could not be contacted yesterday.

WHO country representative Pieter Van Maaren, told the Post he considered Richner’s statement “irrelevant”.

“We don’t communicate with Kantha Bopha through the media,” Van Maaren said. “And we don’t give comment [on press releases]. The Ministry of Health and WHO joint press releases state what is our position [on the child deaths]."

Bridget Di Certo

With assistance from Chhay Channyda

http://www.phnompenhpost.com/

Switzerland - WHO agrees to address research on neglected diseases

GENEVA: Campaigners on Saturday welcomed a World Health Organization pledge to tackle research and funding gaps concerning some of the developing world's biggest killer diseases.

Member countries are expected to hold talks later this year on an expert group's recommendations that a globally binding convention is needed to address neglected tropical diseases (NTD), tuberculosis and others currently overlooked by the research industry.

It follows a meeting of the WHO's decision-making body, the World Health Assembly, in Geneva where members adopted a resolution calling on director general Margaret Chan to set up the meeting.

The document, the result of three-day negotiations, meanwhile urges governments and the private sector to boost investment in health research for diseases which disproportionately affect the developing world.

"These were extremely tough negotiations with the US, the EU -- led by France -- and Japan making every effort to block progress on what health experts agree should be the way forward to meet the medical needs of people in developing countries," said Michelle Childs from Medecins Sans Frontieres.

"While there's no doubt we are disappointed that there was not an immediate decision to move towards a research and development convention, countries have agreed to a formal process for considering the report's recommendations and will bring these discussions back to the WHO in January," said the policy director for medical charity's access campaign.

The WHO-appointed group said in a report published last month that public investment in health research was currently dominated by wealthy countries and their own needs.

The panel recommended a "global binding instrument" to help developing countries access the drugs and technologies they require and suggested member states commit 0.01 percent of their GDP to fund the work.

In a draft resolution submitted to the WHO, Kenya urged the immediate set-up of a negotiating body to develop a convention based on the group's recommendations.

This was countered by a document from the US, Japan and others supporting more informal consultations.

After about 15 hours of talks the agreed resolution requested WHO chief Margaret Chan "hold an open-ended member states meeting in order to analyse the report and the feasibility of the recommendations."

The Drugs for Neglected Diseases initiative (DNDi) said it hopes that national and regional-level talks also requested in the resolution will pave the way for a global response.

- AFP/al

Thailand - WHO warns ASEAN about drug-resistant malaria

BANGKOK: The World Health Organization (WHO) on Wednesday hailed major gains in the fight against malaria, one of the developing world's biggest killers, as part of World Malaria Day celebrations.

However, WHO warned that universal access to treatment remains elusive, and that concerted regional coordination is needed to stop the spread of drug-resistant malaria in Southeast Asia.

The poor and migrant populations, who may lack access to medical care and treatment, are the most vulnerable to the disease.

Strains of malaria resistant to first-line treatment have also emerged along the Thailand-Cambodia and Thailand-Myanmar borders, rendering even the best drugs ineffective against the endemic disease.

The drug-resistant malaria parasites take longer to kill and have also cropped up in Southern Vietnam, putting the entire Greater Mekong sub-region at risk.

Although one million lives have been saved over the last decade, substandard or fake drugs are making malaria harder than ever to eradicate, WHO said.

Another drug, primaquine, has been shown to cure malaria by killing off the parasites before they can reproduce and infect other people, said Dr Pascal Ringwald, coordinator of the WHO Global Malaria Programme.

However, the drug is not without complications.

"There is a problem of implementing primaquine, because this drug creates haemolysis (uncontrolled destruction of red blood cells) in patients that have deficiency in an enzyme," Dr Ringwald said.

"And if they (patients) are deficient in this enzyme, ... this drug will in fact destroy your red blood cells. And people will develop severe anemia (a condition in which the body does not have enough health red blood cells)."

"This is why the drug cannot be given as simple as that," Dr Ringwald added.

The prevention of the spread of drug-resistant malaria should be a top priority before the integration of the ASEAN Economic Community in 2015, WHO said.

If the issue is not addressed, opening borders to easier economic migration may prove to have a very dangerous downside when it comes to malaria transmission, WHO added.

- CNA/wm

Laos - Health Ministry, WHO work to combat TB in Laos

The Ministry of Health of Laos and the World Health Organisation (WHO) marked World Tuberculosis (TB) Day on April 4 at the National University of Laos to support the Global Fund and Lao students' “Stop TB in My Lifetime” campaign.

The campaign is intended to build public awareness about the global tuberculosis epidemic with the aim of eliminating the disease through the sharing of information and experiences between healthcare workers and experts.

March 24 is World Tuberculosis Day and marks the 130th anniversary of Dr Robert Koch's discovery of Mycobacterium tuberculosis , the microbe that causes tuberculosis.

This year, the Stop TB Partnership, which is an international collaboration of governmental and non-governmental organisations, the private sector, and others dedicated to fighting tuberculosis, has launched the "Stop TB in My Lifetime" campaign as a theme for World Tuberculosis Day.

Students at the ceremony participated in activities that raised awareness of the dangers of tuberculosis and highlighted ways the illness could be prevented.

Tuberculosis is one of the most widespread infectious diseases in the world with, according to WHO, an estimated one-third of the world's population infected with the bacteria that causes TB.

WHO reported that there were an alarming 8.8 million new cases of active tuberculosis and 1.4 million deaths caused by the disease in 2010, making it the eighth leading cause of death globally.

However, these numbers represent a decline in new cases since 2005. With 95 perce nt of TB deaths occurring in developing countries, tuberculosis is a public health problem that disproportionately affects the poor and young adults in their most productive years. Furthermore, there were 9.7 million orphaned children as a result of their parents' death from TB.

Nearly a cent ury and a half after Koch's discovery, stopping tuberculosis in our lifetime is a formidable challenge.

In Laos, among the 100,000 people tested in 2010-2011, 251 people tested positive for TB that was acquired through direct contact with infected people and an additional 572 people contracted the virus through indirect contact.

Tuberculosis monitoring agencies have improved their strategy for providing care throughout Laos to patients in isolated areas and to people at risk for contracting TB, such as people who are HIV positive, prisoners, drug users, malnourished, elderly or members of families in which people have already contracted the disease.

The symptoms of tuberculosis include coughing, chest pain, fatigue, fever, weight loss, chills, night sweats and loss of appetite. Although TB most often affects the lungs, it can also affect the brain, kidneys, and spine.

The disease can be easily spread when an individual with active tuberculosis - a disease state characterised by actively dividing bacteria - coughs, sneezes, talks, or spits releasing droplets containing M. tuberculosis into the air. If other people inhale these droplets, they may acquire the disease.

Significant progress has been made in the fight against TB in recent decades and since 1990 there has been a 40 per cent decline in the global death rate for the disease.

Sisouphan Amphonephong

Vientiane Times