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    Millions at risk from cholera due to lack of clean water, soap and toilets, and shortage of cholera vaccine

    Immediate action is needed to stem an unprecedented multi-year upsurge in cholera cases worldwide, according to the International Coordinating Group (ICG) on Vaccine Provision. Actions include investing in access to safe water, sanitation and hygiene, testing and detecting outbreaks quickly, improving quality of and access to healthcare, and fast-tracking additional production of affordable oral cholera vaccine (OCV) doses to better prevent cases. The ICG manages the global cholera vaccine stockpile. The group includes the International Federation of Red Cross and Red Crescent Societies, Médecins Sans Frontières, UNICEF and WHO. Gavi, the Vaccine Alliance, finances the vaccine stockpile and the delivery of OCV. ICG members are calling for governments, donors, vaccine manufacturers, partners and communities to join in an urgent effort to halt and reverse the rise in cholera.  Cholera has been surging globally since 2021, with the 473 000 cases reported to WHO in 2022, more than double those reported in 2021. Preliminary data for 2023 reveal further increases, with over 700 000 cases reported. Several of the outbreaks have high case fatality rates, exceeding the 1% threshold used as an indicator for early and adequate treatment of cholera patients. These trends are tragic given that cholera is a preventable and treatable disease and that cases had been declining in previous years.     Cholera is an acute intestinal infection that spreads through food and water contaminated with faeces containing the bacterium Vibrio cholerae. The rise in cholera is being driven by persistent gaps in access to safe water and sanitation. Although efforts are being made to close these gaps in places, in many others the gaps are growing, driven by climate-related factors, economic insecurity, conflict, and population displacement. Safely managed water and sanitation are prerequisites for stopping the transmission of cholera. Currently, the most severely impacted countries include the Democratic Republic of the Congo, Ethiopia, Haiti, Somalia, Sudan, Syria, Zambia, and Zimbabwe.  Now more than ever, countries must adopt a multisectoral response to fight cholera. Members of the ICG call on currently and potentially affected countries to take urgent steps to ensure their populations have access to clean water, hygiene and sanitation services, and the information critical to prevent cholera’s spread. The establishment of these services requires political will and investment at the country level. This includes creating capacity for early detection and response, enhanced disease detection, rapid access to treatment and care, and working closely with communities, including on risk communication and community engagement.   The severe gap in the number of available vaccine doses, compared with the level of current need, puts unprecedented pressure on the global stockpile of vaccines. Between 2021 and 2023, more doses were requested for outbreak response than the entire previous decade. In October 2022, the ongoing vaccine shortage necessitated the ICG to recommend a single vaccine dose, down from a previous, long-standing two-dose regimen. Approximately 36 million doses were produced last year, while 14 affected countries registered a need for 72 million doses for a one-dose reactive strategy. These requests understate the true need. Preventive vaccination campaigns have had to be delayed to preserve doses for emergency outbreak control efforts, creating a vicious cycle. The change in strategy enabled available vaccines to protect more people and respond to more cholera outbreaks amid the ongoing supply shortfall, but a return to a two-dose regimen and a resumption of preventive vaccination would provide longer protection. Global production capacity in 2024 is forecast to be 37-50 million doses but will likely continue to be inadequate to serve the needs of millions of people directly affected by cholera. Only one manufacturer, EuBiologics, currently produces the vaccine; while the company is doing its utmost to maximize output, more doses are needed. Currently, new manufacturers are not expected to join the market before 2025; they must be fast-tracked. The same urgency and innovation that we saw for COVID-19 must be applied to cholera. Additional manufacturers planning to enter the market need to accelerate their efforts and make doses available at affordable prices. We appeal to vaccine manufacturers, governments, donors and partners to prioritize an urgent scale-up of vaccine production, and to invest in all the efforts needed to prevent and control cholera.   

    • 26 March, 08:50
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    Over 1 in 3 people affected by neurological conditions

    A major new study released by The Lancet Neurology shows that, in 2021, more than 3 billion people worldwide were living with a neurological condition. The World Health Organization (WHO) contributed to the analysis of the Global Burden of Disease, Injuries, and Risk Factor Study (GBD) 2021 data. Neurological conditions are now the leading cause of ill health and disability worldwide. The overall amount of disability, illness and premature death (known as disability-adjusted life years, DALYs) caused by neurological conditions has increased by 18% since 1990. Over 80% of neurological deaths and health loss occur in low- and middle-income countries, and access to treatment varies widely: high-income countries have up to 70 times more neurological professionals per 100 000 people than low- and middle-income countries. “Neurological conditions cause great suffering to the individuals and families they affect, and rob communities and economies of human capital,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This study should serve as an urgent call to action to scale up targeted interventions to allow the growing number of people living with neurological conditions to access the quality care, treatment and rehabilitation they need. It is more important than ever to ensure brain health is better understood, valued and protected, from early childhood to later life.” The top ten neurological conditions contributing to loss of health in 2021 were stroke, neonatal encephalopathy (brain injury), migraine, dementia, diabetic neuropathy (nerve damage), meningitis, epilepsy, neurological complications from preterm birth, autism spectrum disorder, and nervous system cancers. Overall, neurological conditions cause more disability and health loss in men compared to women, but there are some conditions like migraine or dementia where women are disproportionately affected. Since 1990, the absolute number of individuals living with, or dying from, neurological conditions has increased, while age-standardized DALY rates have dropped. This means that increases in absolute numbers are mainly driven by demographic change and people living longer. Diabetic neuropathy was the fastest growing neurological condition. The number of people with diabetic neuropathy has more than tripled globally since 1990, rising to 206 million cases in 2021. This increase is in line with the worldwide increase in diabetes. Other conditions such as neurological complications from COVID-19 (for example, cognitive impairment and Guillain-Barré syndrome) did previously not exist and now account for over 23 million cases. At the same time, neurological burden and health loss due to other conditions decreased by 25% or more since 1990 as a result of improved prevention (including vaccines), care and research: tetanus, rabies, meningitis, neural tube defects, stroke, neurocysticercosis (parasitic infection that affects the central nervous system), encephalitis (inflammation of the brain), and neonatal encephalopathy (brain injury). The study also examined 20 modifiable risk factors for potentially preventable neurological conditions such as stroke, dementia and idiopathic intellectual disability. Eliminating key risk factors – most importantly, high systolic blood pressure and ambient and household air pollution – could prevent up to 84% of stroke DALYs. Similarly, preventing exposure to lead could reduce the burden of idiopathic intellectual disability by 63.1%, and reducing high fasting plasma glucose levels could reduce the burden of dementia by 14.6%. Smoking significantly contributed to stroke, dementia and multiple sclerosis risk.

    • 20 March, 14:49
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    Over 1 Billion People Now Have Obesity, Study Finds: What To Know About Global Weight Trends

    Obesity rates severely increased between 1990 and 2022 while rates of underweight people decreased in most countries, according to a new study, and the researchers believe access to more nutritious foods is the key to simultaneously decreasing obesity while tackling the remaining rates of underweight. KEY FACTS Global obesity rates among adult women more than doubled between 1990 and 2022, while rates among adult men tripled, according to a study published Thursday in the Lancet; childhood obesity rates were four times higher in 2022 compared to 1990. The nations of Tonga and American Samoa had the highest adult female obesity rates, while Nauru and American Samoa had the rates among adult males, making up 60% of each population; Niue and the Cook Islands had the highest childhood obesity rates, where over 30% of kids have obesity. Obesity rates among U.S. women more than doubled from 21.2% in 1990 to 43.8% in 2022, while obesity rates among men soared from 16.9% in 1990 to 41.6% in 2022, putting the U.S. at No. 36 for highest female obesity rates and the 10th highest for male obesity rates. The U.K. ranked 87th for highest female obesity rates and 55th for highest male obesity rates, and China ranked the 11th lowest for women (190th highest) and the 52nd lowest for men (142th highest). Childhood obesity rates in the U.S. increased from 11.6% to 19.4% in girls—the 22nd highest—and from 11.5% to 21.7% in boys, making it the 26th-highest country. The U.K. ranked 72nd for highest childhood obesity rates among girls and 91st among boys, while China ranked 99th lowest (102nd highest) for girls and 70th highest for boys. KEY BACKGROUND Obesity and underweight are both forms of malnutrition, according to the World Health Organization. Climate change, the Covid pandemic and the war in Ukraine could potentially be causing a rise in malnutrition “by increasing poverty and the cost of nutrient-rich foods,” Guha Pradeepa, study co-author from the Madras Diabetes Research Foundation, said in a statement. The study researchers believe increasing access to nutrient-rich foods is needed to address the remaining underweight numbers while tackling the rise in obesity. The combined prevalence of both forms of malnutrition has increased in most countries—with the exception of some sub-Saharan African and south and southeast Asian countries—mainly driven by the global rise in obesity, according to the Lancet study’s authors. Both forms of malnutrition have detrimental effects on health. Being overweight or obese increases risk of death, high blood pressure, type 2 diabetes, stroke, high cholesterol, several types of cancers, coronary heart disease, sleep apnea, gallbladder disease and mental health issues like depression and anxiety. Being underweight increases the risk of bone less, delayed wound healing, nutrient deficiencies, anemia, heart irregularities, bone vessel disease and the loss of periods, troubles getting pregnant, depression and osteoporosis in women. BIG NUMBER 1 billion. That’s how many people globally were living with obesity in 2022, according to the Lancet paper. That’s 879 million adults, and 159 million children. SURPRISING FACT The number of adults who were underweight dropped by more than 50% in the same timeframe. The number of underweight girls fell by about 20% and underweight boys fell by around 33%, according to the study. Eritrea and Timor-Leste had the highest rates of underweight women, and Ethiopia and Eritrea had the highest rates of underweight men, totaling 20% of the adult populations in each country. Countries with the highest prevalence of underweight girls were India and Sri Lanka and India, and Niger for boys, where over 15% of children lived with obesity. CRUCIAL QUOTE “Getting back on track to meet the global targets for curbing obesity will take the work of governments and communities, supported by evidence-based policies from WHO and national public health agencies,” ​​Tedros Adhanom Ghebreyesus, WHO director-general, said in a statement. “Importantly, it requires the cooperation of the private sector, which must be accountable for the health impacts of their products.” TANGENT Though research is limited, there have been theories that the Covid pandemic worsened obesity. A study done on high-income countries found the pandemic resulted in a slight rise in obesity, while research done on low- and middle-income countries found diet quality and food scarcity worsened after the pandemic. However, the Lancet study authors are unsure “whether these effects are transitory or permanent.”

    • 6 March, 14:33
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    Using AI, MIT researchers identify a new class of antibiotic candidates

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    Unapproved 'fat-dissolving' injections are leaving patients maimed, FDA warns

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    11:50 / 30.11.2023

    Leaders of JSC "Dori-Darmon" visited the opening of a new Rusan Pharma facility in India

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    11:51 / 23.11.2023

    AI phone app detects worsening heart failure based on changes in patients' voices

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    12:07 / 07.11.2023

    Boss of Indonesia cough syrup maker jailed after child deaths

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