World Health Organization

Study: Malaria death toll nearly twice the official count, kills many adults

Flickr, ACJ1

A new global estimate of malaria deaths by researchers in Seattle has revealed the death toll is much greater than most experts had thought — and is not, as had been universally assumed, mostly a killer of children.

The study found more than 1.2 million people died from malaria in 2010, nearly twice the official estimate put out by the World Health Organization, and more than a third of the deaths were in adults.

The common wisdom has been that 99 percent of malaria deaths are in young children because adults develop immunity.

“This radically changes the picture,” said Dr. Christopher Murray, lead author of the study and director of the University of Washington’s Institute for Health Metrics and Evaluation (IHME).

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FILED UNDER: Health, Science, Chris Murray, Institute for Health Metrics and Evaluation, malaria, mortality, World Health Organization

January 12, 2012 | 10:56 AM | By Tom Paulson

India marks one year without polio, inches toward eradication goal line

UNICEF

Child receives polio vaccine

India will have made it one year, as of Friday, without a reported case of polio — a milestone everyone in the global health community is celebrating.

Except for maybe all those skeptics who say, or said, polio will never be eradicated.

The goal here is a world completely without polio, of course, since if this infectious disease exists anywhere it can spread everywhere — as China recently discovered.

But this accomplishment by India, which not that long ago had the world’s lion share of polio cases, does a lot to get us closer to the day when this crippling, sometimes deadly, disease is eradicated.

I’ve seen the ravages of polio in poor countries and, back in 2003 when I was a reporter for the Seattle PI, traveled to parts of India where the polio cases were exploding and reported on the country’s difficulties trying to rid itself of this infectious disease.

It may sound a simple enough goal to vaccinate all kids against polio, but it’s not. I can attest to how complex and challenging it has been — because of the nature of this disease, the lack of health care resources in the countries most in need and the various forms of political opposition that can emerge to obstruct what might seem to many an obvious good.

India’s not out of the woods yet and the disease remains entrenched in three countries, Afghanistan, Pakistan and Nigeria. But the fact that India appears to have completely rid itself of this disease is evidence that the global campaign to eradicate polio is that much closer to reality.

Indian health officials deserve a lot of credit for reaching this milestone, but credit for getting us where we are today should go first to Rotary International — which for decades has sustained the global vaccination effort against all odds (and lots of skepticism) — and then to organizations like UNICEF, the World Health Organization and, lately, the Bill & Melinda Gates Foundation.

The Gates Foundation has thrown a lot of money at this effort over the last ten years or so. Both Bill Gates and his father Bill Sr. also have been outspoken public champions of polio eradication — even to the point of apparently finally winning over the world’s leading polio eradication skeptic D.A. Henderson.

Here’s Bill Gates’ celebrating India’s achievement on Huffington Post

FILED UNDER: Health, Bill & Melinda Gates Foundation, eradication, India, polio, Rotary International, UNICEF, vaccines, World Health Organization

November 21, 2011 | 3:54 PM | By Keith Seinfeld

Update: Private funding of the world’s public health agency

A robust debate continues over at the journal Foreign Affairs — over how much the World Health Organization is depending on private sources of funding these days.

Flickr, Public Domain Photos

Last week, we highlighted a critique written by journalist Sonia Shah. That prompted some thoughtful exchanges over on Humanosphere’s Facebook page.

Now, Foreign Affairs has a rebuttal called “Setting the record straight …” from the WHO’s communications director Christy Feig, who says Shah made a number of “erroneous statements”:

“To set the record straight: Eighty percent of WHO’s budget now comes from governments.”

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FILED UNDER: Health, WHO, World Health Organization

November 14, 2011 | 5:15 AM | By Jaclyn Schiff

Corporate donors needed (stat!) to solve World Health Organization’s budget woes

Updated Nov. 14 2011, 12:05pm

Private sector donors have been controversial for the embattled World Health Organization. But one counter-intuitive suggestion says, Don’t forgo corporate donors; just find more of them.

: Flickr, Public Domain Photos

Journalist Sonia Shah outlines that recommendation in a Foreign Affairs article detailing how private groups – from the mining, soft-drink and pharmaceutical industries — have been able to manipulate the global health agenda to suit their interests.

WHO financing from member states has virtually run dry and the agency has “nowhere else to turn,” she writes, noting this stark reality:

~~“Private interests now bankroll four out of every five dollars of the WHO’s budget.”~~ (editor’s note – Sonia Shah modified her statement:)

“Most telling is the fact that voluntary contributions from private interests and others now bankroll four out of every five dollars of the WHO’s budget.”

(By this, Shah means 80-percent comes from all donations combined, which includes private companies, NGO’s and governments who make voluntary, additional donations, beyond their annual dues.)

As far as privatization of global health funding goes, the genie is out of the lamp, says Shah, who is the author of several global health books. So the answer is to recruit more private sector involvement “to include those companies whose financial interests directly align with those of global health.” She writes:

In addition to mining companies, the fight against malaria could, for example, include insurance companies and tourism operators who will reap long-term profits from healthier customers and less fearful tourists. … Private companies like these, with health-aligned business interests, are much more likely to realize the promise of private-public partnerships than those that have damages to hide. Continue reading →

FILED UNDER: Health, public-private partnership, World Health Organization

October 19, 2011 | 10:50 AM | By Tom Paulson

Gates Malaria Forum: Optimism, Urgency and a bit of Kumbaya

Analysis

The Bill & Melinda Gates Foundation‘s Malaria Forum in Seattle comes to an end today and has certainly lived up to its theme of “Optimism and Urgency.”

Tom Paulson

Bill and Melinda Gates speak at Malaria Forum, with moderator ABC News' Richard Besser

There is legitimate cause for optimism, especially if you look at where the world is today in its efforts to combat this leading killer as compared to where we were a decade ago.

Malaria deaths are down, an experimental vaccine is showing modest success against the parasite and this once-neglected disease and poorly funded field is now big news with a lot more money behind it. I think it’s fair to say the Gates Foundation, which has spent $1.5 billion on (and advocated for) malaria efforts over the past decade, is responsible for much of that transformation.

But the Gates Foundation, and to some extent the entire global health community, has a tendency to only want to talk about good news — to be optimistic. It’s understandable, but that also poses a risk.

“It’s been a bit like singing ‘Kumbaya‘ around the campfire,” said one top malaria researcher. It’s nice to celebrate progress, he said, but the structure of the meeting — which included the Gateses’ call for a ‘re-commitment’ to eradication — somewhat tended to discourage dissent and debate. Continue reading →

FILED UNDER: Health, Science, Bill & Melinda Gates Foundation, malaria, Malaria Forum, Margaret Chan, Robert Newman, World Health Organization

October 17, 2011 | 7:00 AM | By Tom Paulson

Gates Foundation confabs, and confounds, on malaria eradication

Flickr, Gustavo

Four years ago, Bill and Melinda Gates shocked, and to some degree dismayed, many in the global health community by calling for the eradication of malaria.

Starting today in Seattle, four years to the day after the Gateses’ made the call for eradication, the world’s richest couple will host the Bill & Melinda Gates Foundation’s second global Malaria Forum aimed at celebrating progress, confronting the remaining challenges and re-committing to eradication.

It’s mostly that last bit, eradication, which tends to stick in some folks’ craw.

At the 2007 meeting, many of the top malaria experts in attendance were critical (privately, for the most part) of the Gateses’ call to eradication. Some said it was irresponsible, or at best naïve, given the sorry history of earlier attempts at eradicating this global killer. I covered the 2007 meeting for the Seattle PI and quoted two leading experts:

“Everyone is in favor of eradicating malaria,” said Dr. Brian Greenwood, a malaria expert at the London School of Tropical Medicine and Hygiene. What has so often bedeviled such good intentions, Greenwood said, is the hazard of raising expectations too high and creating a culture of impatient demand rather than steadfast progress.

“We will have to be extremely careful how this is translated into action,” said Dr. Marcel Tanner, director of the Swiss Tropical Institute in Basel, Switzerland. Unless the international community also is willing to help improve the poor health systems of these countries, Tanner said, the noble goal of eradicating malaria is unlikely to succeed.

“If we don’t do that, though I hesitate to say it, we will surely fail,” Tanner said.

The problem, as Greenwood said, isn’t the sentiment. Everyone would like to see malaria go the way of smallpox. The problem is that if eradication fails, again, many are concerned the more modest but life-saving efforts aimed at controlling the disease will be abandoned, again.

“There are people who are skeptical and we need to listen to them,” said David Brandling-Bennett, head of the malaria program at the Gates Foundation. “But the call for eradication has really created a sea change in the malaria community, getting us all to think about what can be done and what needs to be done.”

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FILED UNDER: Health, Bill & Melinda Gates Foundation, Brian Greenwood, David Brandling Bennett, malaria, World Health Organization

October 10, 2011 | 8:59 AM | By Tom Paulson

It’s World Most-Neglected-Health-Problem Day

Flickr, by Dierk Schaefer

Neon Brain

It’s actually World Mental Health Day, and also Columbus Day.

Neither of these calendrical milestones are likely to get much public attention, unless perhaps someone can combine them for a story suggesting that Christopher Columbus only discovered the New World in 1492 thanks to his megalomania and narcissistic, obsessive-compulsive disorder.

I am not doing much this year for Columbus Day (the state of Hawaii officially refuses to celebrate it, by the way) and would like to focus most on World Mental Health Day.

Not much to celebrate really. Overall, I think it’s fair to say we’re doing a lousy job on mental health.

As I’ve reported before, mental illness is one of the leading causes of death and disability worldwide, yet it remains a very low priority on the global health agenda. Leading mental health researcher Vikram Patel has noted that mental illness kills more women than maternal mortality.

My friend and colleague Joanne Silberner recently reported on this disparity — between the global burden of this disease and the low attention it gets — on PRI’s The World, after a visit she paid to a clinic in Uganda. Said Silberner:

The World Health Organization estimates that more than 450 million people suffer from mental disorders, and a new report by the World Economic Forum figures the annual global costs of mental and neurological illnesses at $2.5 trillion. That is three times the economic cost of heart disease.

Here are some of the stories today about World Mental Health Day:

The Independent World Mental Health Day: Time to Invest

Voice of America Treatment for Mental Health Underfunded, Inadequate

Huffington Post World Mental Health Day — A revolution needed

UN News Centre UN Secretary General Ban Ki-moon urges more resources for mental health

Actualitie news Afrique WHO highlights global under-investment in mental health

The gist of most of the news stories is that we aren’t spending enough on mental health and so many experts and leaders are calling for more money.

Talk is cheap, of course, and these are tough economic times. Donations are down for the global AIDS response. I recently attended a UN meeting focused on chronic diseases where advocates called for expanding the global health agenda to better respond to problems like diabetes, heart disease and cancer. There’s a push to expand the number of slices despite a shrinking pie.

Many argue we need to increase the size of the pie, that investment in global health provides many times more in return. In lieu of that happening, perhaps the best chance for mental health issues — as well as other neglected diseases — of receiving more attention and resources is if the experts can finally agree on how best to set priorities in the global health agenda.

One would think it should be based largely on the burden of disease as well as the socioeconomic and health benefits of reducing that burden. We’re not there yet, partly because some problems are easier to solve than others, despite the disease burden, and partly because achieving that cost-benefit analysis I mentioned is also easier said than done.

Still, many say the gross neglect of mental health is perhaps the strongest evidence of our misplaced priorities.

FILED UNDER: Health, Joanne Silberner, mental health, UN Week, Vikram Patel, World Health Organization

September 29, 2011 | 10:44 AM | By Tom Paulson

The haze hanging over WHO’s air pollution report

Where in the world is the air pollution worst? It’s not clear, pun intended.

Earlier this week, the World Health Organization released a report analyzing air pollution levels in nearly 1100 cities in 91 countries. The analysis was based on air particulate levels between 2003 and 2010.

WHO

There were plenty of news stories based on this report citing cities in Iran, Pakistan, India and Mongolia as having the worst air pollution. Forbes reported that the Iranian city of Ahvaz was the worst.

The Guardian did this breakout of the data on its wonderful DataBlog, which has the sub-headline “Facts are Sacred.”

Local aside: I didn’t see the specs on tree-hugging Seattle, but here’s one from my old Seattle PI buddy Scott Sunde citing studies showing how the poor neighborhoods seem to have crappier air. Continue reading →