Europe Must take advantage of ‘COVID-19 Ceasefire’ to Prepare for Next Wave, says WHO’s Kluge 04/05/2022 Maayan Hoffman Dr Hans Kluge, WHO Regional Director for Europe. The European Region and COVID-19 are in a “kind of ceasefire,” according to World Health Organization’s (WHO) Regional Director for Europe, Dr Hans Kluge. It is now up to the region’s 53 member states to take advantage of this window to prepare for the next fight, he said. “It is quiet and we have to take advantage of this, because obviously the fact that the virus spread so fast and so many people have been infected means that a new mutant is already here,” Kluge said Wednesday during an interview at the Geneva Health Forum. “The virus has surprised us many times.” Kluge, who started his role on 1 February 2020 just as the pandemic began, spoke via video link from his office in Denmark. There have been at least 191 million reported COVID-19 infections in Europe and more than 2.2 million deaths since the start of the pandemic two years ago, according to Reuters COVID tracker. The average new daily cases in the region have dropped from a recent peak of 1.7 million in February to fewer than 230,000 in recent days. However, Germany leads the world in the daily average number of new cases, Reuters said, accounting for one in every six infections reported worldwide. Moreover, as Kluge noted, it is not possible to track how fast the virus is spreading in Ukraine as a result of the Russian invasion. Reuters COVID-19 tracker shows a decline in average daily cases across the European region. He urged the region to implement a pan-European system that could pick up on any threat from antimicrobial resistance, a dangerous virus or climate change “very quickly – we need an alert system.” And he said that the region needs its political systems to take action when there is such an alert. Kluge also said that the most important ingredient in any COVID-19 toolkit must be equal access to vaccines and affordable antivirals. “The best way to combat infectious disease is a combination of prevention and treatment: vaccines and medicines,” according to Kluge. The comments were especially meaningful on Wednesday, a day after the World Trade Organization’s TRIPS Council announced that it will finally discuss a compromise proposal on a waiver of intellectual property rights on COVID-19 vaccines. However, antivirals are not included in the compromise. While Pfizer and Merck – the companies with effective COVID-19 antivirals – have entered into voluntary licensing agreements with the Medicine Patents Pool to enable generic companies to make the drugs for certain low-income countries, the agreements and countries the deal applies to are restricted. Kluge offered a four-step COVID-19 exit strategy for the region: 1. Implement a plan for protecting the most vulnerable “We may at some point have to shift from mass action to more routine vaccination of just the vulnerable people,” Kluge said. 2. Vaccinate and boost “We will need to do whatever it takes to vaccinate the unvaccinated and boost the vaccinated,” he added. 3. Beef up surveillance “We need a system that is able to pick up new COVID-19 variants very quickly so that national lockdowns can be avoided,” said Kluge. 4. Deal with the backlog of patients with other diseases Kluge noted that the healthcare sector is also facing a shadow pandemic – dealing with the backlog of patients who are suffering due to postponement of elective surgeries, cancer and other screenings, mental health issues and long COVID. He said around 20% of people infected with the virus continue to experience some symptoms even months later. “We need more knowledge about long COVID,” Kluge stressed. But he admitted that rolling out this exit strategy could be “tricky,” as a result of complacency by the public and political leaders whose memories are “very short.” “Heads of states and governments need to make the investment in health and health systems that is key for a resilient society and preparedness,” said Kluge. “Health is not everything, but without health, there is nothing.” Image Credits: WHO, Screenshot. Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. Funding and Education Are Key to Effective Implementation of ‘One Health’ Agenda 03/05/2022 Maayan Hoffman The Geneva Health Forum opened with a panel discussion on “One Health: is there a paradigm shift?” From left: Andrea Sylvia Winkler, Peter Ben Embarek, Lisa Crump, Jean Philippe Dop and Keith Sumption. More accessible funding will be required for the international community to implement a broad One Health approach, scientist Lisa Crump of the UN Environmental Program (UNEP) told Health Policy Watch on Tuesday. Speaking on the sidelines of the Geneva Health Forum’s (GHF) kick-off discussion, “One Health: is there a paradigm shift?” Crump said that “we need ways to get funding so that it is easy to access. We have some very old ways of releasing funds and they are not reactive or responsive, and that is what we need”. “We need to make funding more accessible, make more of it and put fewer strings on it,” she continued. “It has to make economic sense. Or at least there has to be some benefit. It can be economic savings or it can be improved health or increased ecosystem resilience. It is not always money. But it takes money to figure out what is going to work and we cannot ignore that fact.” Crump was one of four panellists who spoke during the session. The others included Jean Philippe Dop of the World Organization for Animal Health (OIE), Keith Sumption of the Food and Agriculture Organization (FAO) and Peter Ben Embarek of the World Health Organization (WHO). The session was moderated by Andrea Sylvia Winkler of the Center for Global Health at the Technical University of Munich and the Centre for Global Health at the University of Oslo. More than 1,000 people attended the forum on Tuesday and almost as many were watching a selection of sessions that were aired virtually. The concept of One Health is a big focus of the GHF after decades of the topic being consigned to the margins of health agendas. The COVID-19 pandemic has highlighted the importance of a holistic approach to health across species as the virus was most likely to have been transmitted to humans from a bat, via infected mammals housed and slaughtered in unsanitary conditions at a marketplace in Wuhan, China. “The COVID-19 pandemic highlighted the intimate links between health, humans, animals and our environment,” stressed WHO Director-General Dr Tedros Adhanom Ghebreyesus in a video message to the conference. “Reducing future pandemics demands closer collaboration across sectors.” Around 60% of known infectious diseases and as many as 75% of new or emerging infectious diseases are zoonotic in origin. As a result, the One Health approach is receiving broad support from the WHO, FAO, OIE and, most recently, UNEP – together, formally known as the Quadripartite. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.” Tuesday’s GHF session marked the first time that all four lead technical focal points of the quadripartite organizations have appeared together in a public forum to discuss the changing One Health landscape. Common sense has come to the political arena Ben Embarek explained that the biggest shift he has seen since COVID-19 is that now politicians and government officials are buying into One Health, too. “When common sense comes into the political arena, that is where things start changing,” he said. “When we have heads of states talking about One Health, this is a shift for sure.” Dop expressed similar sentiments, noting the involvement of these decision-makers in the One Health agenda as “a good effect of the pandemic, if there can be one”. And he said that this involvement will play a key role in being able to implement One Health concepts aligned by professors and doctors in academia in the field. Another shift is the new and formal involvement of UNEP, with Crump saying that her organisation is ready to “mobilize our assets and partnerships to support a One Health approach”. The UNEP has already helped establish a multi-partner trust seeded with €50 million to enhance countries’ investments in nature with the goal of stopping pandemics. Those funds will also go for working towards establishing four outcomes: providing multidisciplinary evidence on the links between biodiversity, climate change and health; enhancing One Health preventative actions and policies; providing target-specific capacity building and knowledge management, advocacy and awareness-raising programs on those links; and to create sustainable One Health collaborations with government structures. Having UNEP involved in a greater capacity should also enable the team to focus more on issues such as soil, water and other environmental factors that play a role in health and wellbeing, said Sumption. He expects new opportunities from environmental ministries monitoring for pathogens to ecosystem restoration and biodiversity maintenance. “There are hundreds of thousands of people whose livelihoods depend on forests so we need sustainable wildlife management in those settings,” Sumption stressed. Food and Agriculture Organization Director-General Qu Dongyu addressed the One Health opening session via video. ‘Widening the perspective of students’ But the key to the future is educating the younger generation to take a One Health approach from the onset of their careers, said Ben Embarek. He addressed students and teachers and called on them to break down silos in their universities from the podium. “It is widening the perspective of students in the existing silos,” Ben Embarek told Health Policy Watch after the session. For example, he said, “medical students should be exposed to what vets are doing and what is happening out there in the environment so that they will get a better perspective and that they will see that the health of humans is connected to all of these things.” At the same, he noted, while vets might be focused on producing healthy animals, at some point, someone is going to eat these animals and those who are going to do so should not die from eating them. “It is important to not only protect the animals from animal disease but also to protect animals from pathogens that will affect humans,” Ben Embarek continued, “It is really about exposing students and including in their curriculum the perspectives that exist in other sectors, and understanding that some of the issues they are trained to solve in the future will depend on the health and actions of other sectors. “So, when they are in these positions later on in life it will be easier to understand what others are doing, why they are doing it and how to change.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. ‘Making Pandemics’: Deforestation is Laying Groundwork for Next Global Health Crisis 03/05/2022 Elaine Ruth Fletcher When we think about the critical drivers of disease prevention and control – we need to stop thinking only about medicines, vaccines and diagnostics. In fact some of the most important forms of disease control can be found in forests – which harbor thousands of pathogens, known and unknown in relative isolation from humans and the damage that they could otherwise cause. But humankind is felling forests and wreaking other kinds of damage on ecosystems at an unprecedented rate – laying the groundwork for the next pandemic as we speak endlessly about how to get the world out of the present one. That is the key message of the new film “La Fabrique des pandémies” (Making Pandemics) by the French journalist and documentary filmmaker, Marie Monique Robin. Avant-premiere at Geneva Health Forum French star, Juliette Bionoche, who narrates the film. The film will be aired at a public avant-premiere on Wednesday 4 May at 6 p.m – as part of the Geneva Health Forum. The Forum, which begins on Tuesday, has a climate and environmental health focus this year. The film, born out of reflections during the COVID lockdown, took Robin to eight countries across Africa, Asia and the Americas – from French Guinea to DR Congo, Malaysia and Mexico, as well as upstate New York. The result is the product of the relentless detective work of Robin, a seasoned journalist who also directed “The World According to Monsanto”, a critical look at the pesticide industry. Narrated by the French film star, Juliette Bionoche, the film aims to make the issue more accessible to the general public – despite its highly technical material. So it is Binoche that relates the stories of the deadly viruses, bacteria and parasites that have “escaped” from the wild to become major plagues to human health – as seen through the eyes of the scientists who have documented their destructive pathway. Pig farm in Sarawak, Borneo, Malaysia – a reservoir for Nipah virus. The examples include the story of Malaysia’s deadly, bat-borne Nipah virus which became a threat to humans as bats driven from rainforests destroyed to create palm oil plantations found new homes in agricultural areas, and particularly around pig farms. Infected pigs, close to people both genetically and proximally, then began transmitting the virus to humans. While most of the stories relate to developing countries, developed regions are not immune. Lyme disease, transmitted by ticks in North America, has posed an increasing threat to human health as forests there become fragmented, biodiversity is reduced, and species such as the white-footed mouse proliferate, which are a reservoir for the deadly Borrelia bacterium that causes Lyme disease. COVID lockdown reflections Filming of Making Pandemics. Robin, on right, conducts an interview. The film began with Robin’s own reading and reflections during the COVID lockdown – including an article that she read in the New York Times, which struck a special chord entitled “We made a pandemic.” “I began searching and contacting scientists with whom I have been working for more than 30 years,” she relates. Among them was Serge Morand, a parasitologist living in Thailand – who will also be appearing himself at the Geneva Health Forum, running from 3-5 May. “And he said, oh it would be great if you could put all of us together in a book or a film. “The thing is,” Robin adds, “is that there have been many, many dozens of studies published, showing the link between the destruction of biodiversity, on the one hand, and on the other, the emergence of infectious diseases. “And so Morand told me, ‘if you could put all of us together, it would be very powerful. Because we have been sounding the alarm for so many years, and just nobody is paying attention.” Robin went on to interview some 62 scientists working in various parts of the world – with the stories of 14 condensed into the book, Making Pandemics, published last year, which has now been made into a film. Three drivers of disease Deforestation is a key driver of new infectious diseases – which leap from wild animal species to humans. The interviews all weave together to underline a single message about the ecological factors driving the emergence of new infectious diseases – and the expansion of already well-known diseases. “The first factor is, of course, deforestation in tropical areas,” Robin says of the key drivers. “And then intensive breeding [of animals], and then globalization. “It means growing soybeans in Argentina or Brazil, to feed European cattle. It means cultivating palm trees. It means mining, gold, copper, etc. And also urbanization. All of these factors which contribute to deforestation in tropical areas.” The dilution effect Maintaining biodiversity alongside food production is critical to preventing new pandemics. While there is some growing awareness about how climate change and biodiversity loss is increasing the frequency at which diseases like Ebola, Nipah and others are emerging or expanding, Robin offers fresh insights into why this is the case. Just imagine the forest as a massive universe of bacteria, parasites and viruses, both known and unknown, circulating among the animal species that live there. When forests are deep and expansive, pathogens are more likely to stay within their natural geographic boundaries, Robin explains. And when animal species are diverse and plentiful, then dangerous viruses are largely contained by a set of natural biological checks and balances that keep other species in check too. In a well-balanced ecosystem, when pathogens have lots of different animals to infect – they won’t infect species that can transmit the disease to humans as frequently or as intensively – something that she describes as the “dilution effect”. Animals that are more prone to dangerous infections also cannot become too dominant as a species, and thus pose an even greater risk to humans – because they also are the prey of other animals that keep them in check. Biodiversity protects your health Deer in North America are becoming more infected with ticks carrying Lyme disease But when the forest is cut away or fragmented – and its animals hunted down or otherwise destroyed by humans – then the chances of a pathogen infecting an animal species with a dangerous pathogen that may then carry the same disease to humans increase. Lyme disease is a good example of that principle, she explains. “The dilution effect means that when you have a big community of mammals floating around in the forest, then the probability that a tick will feed on a white-footed mouse, which is a reservoir of the Borrelia bacterium, is diluted. “A tick, which needs a blood meal, may land on an opossum instead of a mouse – and the opossum won’t get infected because he cannot be a host for the bacteria,” says Robin. And meanwhile other predators, like foxes, hunt and eat the mice, also keeping them in check. “But if you fragment the forest as we have seen in the state of New York, then most of the predators, like foxes for instance, leave.” The ticks left with fewer animal choices, feed more on mice – in a vicious cycle. “So the white-footed mouse is proliferating, and becoming more infected by ticks,” says Robin. More infected ticks also land on deer, who are hunted by humans. “And scientists have shown that the probability of [humans] also getting infected in a fragmented forest is five times higher; this is the dilution effect,” she says. “The dilution effect shows that biodiversity protects your health because when you have a lot of biodiversity, the chances of anyone [human] getting infected are reduced.” Click here to reserve a free ticket to the film., See the complete programme for GHF 2022 here – and register for the full event Tuesday-Thursday or daily, in person or remotely. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Thomas Quine/Flickr , nosha/Flickr. Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Four COVID-19 Lessons and How to Make Humanity More Resilient 04/05/2022 Maayan Hoffman Tatiana Valovaya, Director-General of the United Nations Office at Genevai during World Humanitarian Day. 19 August 2019. The COVID-19 pandemic blindsided most of the world as it swept from China across the world at an unprecedent pace, infecting, ultimately killing millions of people. But more than two years later, there are some lessons that can be learned, said Tatiana Valovaya, director-general of the United Nations in Geneva on Tuesday evening. At the Opening Ceremony for the Geneva Health Forum, Valovaya delivered the four key takeaways from the pandemic for public health professionals. Her colleague, likewise, offered “concerned actions” that could be taken in at least five key areas to make humanity more resilient to future health threats. In total, nine people addressed attendees during the opening ceremony, which drew over 1000 people and is the first major global health event hosted in Geneva since the pandemic began. The speakers included Valovaya; Antoine Geissbuhler and Véronique Maye, Geneva Health Forum’s co-presidents; Bertrand Levrat, CEO of the University Hospitals of Geneva; Mauro Poggia, minister of health, population and security for the state of Geneva; Jürg Lauber, Swiss ambassador and permanent representative to the Office of the United Nations in Geneva; Zsuzsanna Jakab, deputy director-general of the World Health Organization; Monique Eloit, director-general of the World Organisation for Animal Health (OIE); and Peter Maurer, president of the International Committee of the Red Cross. What lessons were learned? 1 – We live in a globalized world and are all interconnected and interdependent. “We can only be as safe or as healthy as all other people around that world are,” said Valovaya. “That means we have to work in solidarity.” 2 – We can do a lot to improve environmental degradation. This notion was supported by Eloit in her keynote address. “I will insist on how it is crucial to transform our relationship with the environment,” she said. “We need to move from response to prevention.” 3 – We have to fight inequality. “During the pandemic, we saw that those who were very vulnerable were the first to suffer,” noted Valovaya. “We saw this with access to healthcare, vaccines and even clean water.” 4 – All of the challenges that humanity is facing are global. “Global challenges need global solutions,” she said. “We need multilateralism that is inclusive and integrated. Only together can we find solutions.” While the world continues to tackle COVID-19, something which Eloit stressed is “still ongoing, while we continue to face other challenges,” the international community must simultaneously fight the climate crisis, she said. Dr. Zsuzsanna Jakab, Deputy Director-General of the World Health Organization, at the Palais des Nations, Geneva, Switzerland, February 24, 2020, in one of the last face-to-face UN meetings before the COVID pandemic. Thirteen million people die from preventable environmental factors WHO estimates that 13 million people die every year as a result of preventable environmental factors and that 90% of the global population breathes unhealthy air, Jakab noted. “Concerted action is needed across at least five key areas to make humanity more resilient to future health threats,” she stressed. The first is understanding that health is not negotiable. The second is the need to shift from health systems focused purely on treating diseases to health systems focused on disease prevention and health promotion. Next, equity is not a ‘nice to have’. “The vulnerability of one single nation makes the whole world more vulnerable to disease threats,” she said, echoing Valovaya’s sentiments. “We must move from a fragmented health architecture to a cohesive architecture with stronger governance, financing and tools. Finally, we must shift from a siloed, sectored approach to human health to a One Health approach, said Jakab. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. It was a major focus of the first day of the Geneva Health Forum. “OHHLEP’s goal is to move One Health from concept to practice,” Eloit stressed in her talk, which helped culminate the formal opening ceremony. In the morning, the opening panel was on “One Health: is there a paradigm shift?” “We all have a role to play,” concluded Eloit. “We have a responsibility to make tomorrow safer than today.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Flickr. ‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. Funding and Education Are Key to Effective Implementation of ‘One Health’ Agenda 03/05/2022 Maayan Hoffman The Geneva Health Forum opened with a panel discussion on “One Health: is there a paradigm shift?” From left: Andrea Sylvia Winkler, Peter Ben Embarek, Lisa Crump, Jean Philippe Dop and Keith Sumption. More accessible funding will be required for the international community to implement a broad One Health approach, scientist Lisa Crump of the UN Environmental Program (UNEP) told Health Policy Watch on Tuesday. Speaking on the sidelines of the Geneva Health Forum’s (GHF) kick-off discussion, “One Health: is there a paradigm shift?” Crump said that “we need ways to get funding so that it is easy to access. We have some very old ways of releasing funds and they are not reactive or responsive, and that is what we need”. “We need to make funding more accessible, make more of it and put fewer strings on it,” she continued. “It has to make economic sense. Or at least there has to be some benefit. It can be economic savings or it can be improved health or increased ecosystem resilience. It is not always money. But it takes money to figure out what is going to work and we cannot ignore that fact.” Crump was one of four panellists who spoke during the session. The others included Jean Philippe Dop of the World Organization for Animal Health (OIE), Keith Sumption of the Food and Agriculture Organization (FAO) and Peter Ben Embarek of the World Health Organization (WHO). The session was moderated by Andrea Sylvia Winkler of the Center for Global Health at the Technical University of Munich and the Centre for Global Health at the University of Oslo. More than 1,000 people attended the forum on Tuesday and almost as many were watching a selection of sessions that were aired virtually. The concept of One Health is a big focus of the GHF after decades of the topic being consigned to the margins of health agendas. The COVID-19 pandemic has highlighted the importance of a holistic approach to health across species as the virus was most likely to have been transmitted to humans from a bat, via infected mammals housed and slaughtered in unsanitary conditions at a marketplace in Wuhan, China. “The COVID-19 pandemic highlighted the intimate links between health, humans, animals and our environment,” stressed WHO Director-General Dr Tedros Adhanom Ghebreyesus in a video message to the conference. “Reducing future pandemics demands closer collaboration across sectors.” Around 60% of known infectious diseases and as many as 75% of new or emerging infectious diseases are zoonotic in origin. As a result, the One Health approach is receiving broad support from the WHO, FAO, OIE and, most recently, UNEP – together, formally known as the Quadripartite. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.” Tuesday’s GHF session marked the first time that all four lead technical focal points of the quadripartite organizations have appeared together in a public forum to discuss the changing One Health landscape. Common sense has come to the political arena Ben Embarek explained that the biggest shift he has seen since COVID-19 is that now politicians and government officials are buying into One Health, too. “When common sense comes into the political arena, that is where things start changing,” he said. “When we have heads of states talking about One Health, this is a shift for sure.” Dop expressed similar sentiments, noting the involvement of these decision-makers in the One Health agenda as “a good effect of the pandemic, if there can be one”. And he said that this involvement will play a key role in being able to implement One Health concepts aligned by professors and doctors in academia in the field. Another shift is the new and formal involvement of UNEP, with Crump saying that her organisation is ready to “mobilize our assets and partnerships to support a One Health approach”. The UNEP has already helped establish a multi-partner trust seeded with €50 million to enhance countries’ investments in nature with the goal of stopping pandemics. Those funds will also go for working towards establishing four outcomes: providing multidisciplinary evidence on the links between biodiversity, climate change and health; enhancing One Health preventative actions and policies; providing target-specific capacity building and knowledge management, advocacy and awareness-raising programs on those links; and to create sustainable One Health collaborations with government structures. Having UNEP involved in a greater capacity should also enable the team to focus more on issues such as soil, water and other environmental factors that play a role in health and wellbeing, said Sumption. He expects new opportunities from environmental ministries monitoring for pathogens to ecosystem restoration and biodiversity maintenance. “There are hundreds of thousands of people whose livelihoods depend on forests so we need sustainable wildlife management in those settings,” Sumption stressed. Food and Agriculture Organization Director-General Qu Dongyu addressed the One Health opening session via video. ‘Widening the perspective of students’ But the key to the future is educating the younger generation to take a One Health approach from the onset of their careers, said Ben Embarek. He addressed students and teachers and called on them to break down silos in their universities from the podium. “It is widening the perspective of students in the existing silos,” Ben Embarek told Health Policy Watch after the session. For example, he said, “medical students should be exposed to what vets are doing and what is happening out there in the environment so that they will get a better perspective and that they will see that the health of humans is connected to all of these things.” At the same, he noted, while vets might be focused on producing healthy animals, at some point, someone is going to eat these animals and those who are going to do so should not die from eating them. “It is important to not only protect the animals from animal disease but also to protect animals from pathogens that will affect humans,” Ben Embarek continued, “It is really about exposing students and including in their curriculum the perspectives that exist in other sectors, and understanding that some of the issues they are trained to solve in the future will depend on the health and actions of other sectors. “So, when they are in these positions later on in life it will be easier to understand what others are doing, why they are doing it and how to change.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. ‘Making Pandemics’: Deforestation is Laying Groundwork for Next Global Health Crisis 03/05/2022 Elaine Ruth Fletcher When we think about the critical drivers of disease prevention and control – we need to stop thinking only about medicines, vaccines and diagnostics. In fact some of the most important forms of disease control can be found in forests – which harbor thousands of pathogens, known and unknown in relative isolation from humans and the damage that they could otherwise cause. But humankind is felling forests and wreaking other kinds of damage on ecosystems at an unprecedented rate – laying the groundwork for the next pandemic as we speak endlessly about how to get the world out of the present one. That is the key message of the new film “La Fabrique des pandémies” (Making Pandemics) by the French journalist and documentary filmmaker, Marie Monique Robin. Avant-premiere at Geneva Health Forum French star, Juliette Bionoche, who narrates the film. The film will be aired at a public avant-premiere on Wednesday 4 May at 6 p.m – as part of the Geneva Health Forum. The Forum, which begins on Tuesday, has a climate and environmental health focus this year. The film, born out of reflections during the COVID lockdown, took Robin to eight countries across Africa, Asia and the Americas – from French Guinea to DR Congo, Malaysia and Mexico, as well as upstate New York. The result is the product of the relentless detective work of Robin, a seasoned journalist who also directed “The World According to Monsanto”, a critical look at the pesticide industry. Narrated by the French film star, Juliette Bionoche, the film aims to make the issue more accessible to the general public – despite its highly technical material. So it is Binoche that relates the stories of the deadly viruses, bacteria and parasites that have “escaped” from the wild to become major plagues to human health – as seen through the eyes of the scientists who have documented their destructive pathway. Pig farm in Sarawak, Borneo, Malaysia – a reservoir for Nipah virus. The examples include the story of Malaysia’s deadly, bat-borne Nipah virus which became a threat to humans as bats driven from rainforests destroyed to create palm oil plantations found new homes in agricultural areas, and particularly around pig farms. Infected pigs, close to people both genetically and proximally, then began transmitting the virus to humans. While most of the stories relate to developing countries, developed regions are not immune. Lyme disease, transmitted by ticks in North America, has posed an increasing threat to human health as forests there become fragmented, biodiversity is reduced, and species such as the white-footed mouse proliferate, which are a reservoir for the deadly Borrelia bacterium that causes Lyme disease. COVID lockdown reflections Filming of Making Pandemics. Robin, on right, conducts an interview. The film began with Robin’s own reading and reflections during the COVID lockdown – including an article that she read in the New York Times, which struck a special chord entitled “We made a pandemic.” “I began searching and contacting scientists with whom I have been working for more than 30 years,” she relates. Among them was Serge Morand, a parasitologist living in Thailand – who will also be appearing himself at the Geneva Health Forum, running from 3-5 May. “And he said, oh it would be great if you could put all of us together in a book or a film. “The thing is,” Robin adds, “is that there have been many, many dozens of studies published, showing the link between the destruction of biodiversity, on the one hand, and on the other, the emergence of infectious diseases. “And so Morand told me, ‘if you could put all of us together, it would be very powerful. Because we have been sounding the alarm for so many years, and just nobody is paying attention.” Robin went on to interview some 62 scientists working in various parts of the world – with the stories of 14 condensed into the book, Making Pandemics, published last year, which has now been made into a film. Three drivers of disease Deforestation is a key driver of new infectious diseases – which leap from wild animal species to humans. The interviews all weave together to underline a single message about the ecological factors driving the emergence of new infectious diseases – and the expansion of already well-known diseases. “The first factor is, of course, deforestation in tropical areas,” Robin says of the key drivers. “And then intensive breeding [of animals], and then globalization. “It means growing soybeans in Argentina or Brazil, to feed European cattle. It means cultivating palm trees. It means mining, gold, copper, etc. And also urbanization. All of these factors which contribute to deforestation in tropical areas.” The dilution effect Maintaining biodiversity alongside food production is critical to preventing new pandemics. While there is some growing awareness about how climate change and biodiversity loss is increasing the frequency at which diseases like Ebola, Nipah and others are emerging or expanding, Robin offers fresh insights into why this is the case. Just imagine the forest as a massive universe of bacteria, parasites and viruses, both known and unknown, circulating among the animal species that live there. When forests are deep and expansive, pathogens are more likely to stay within their natural geographic boundaries, Robin explains. And when animal species are diverse and plentiful, then dangerous viruses are largely contained by a set of natural biological checks and balances that keep other species in check too. In a well-balanced ecosystem, when pathogens have lots of different animals to infect – they won’t infect species that can transmit the disease to humans as frequently or as intensively – something that she describes as the “dilution effect”. Animals that are more prone to dangerous infections also cannot become too dominant as a species, and thus pose an even greater risk to humans – because they also are the prey of other animals that keep them in check. Biodiversity protects your health Deer in North America are becoming more infected with ticks carrying Lyme disease But when the forest is cut away or fragmented – and its animals hunted down or otherwise destroyed by humans – then the chances of a pathogen infecting an animal species with a dangerous pathogen that may then carry the same disease to humans increase. Lyme disease is a good example of that principle, she explains. “The dilution effect means that when you have a big community of mammals floating around in the forest, then the probability that a tick will feed on a white-footed mouse, which is a reservoir of the Borrelia bacterium, is diluted. “A tick, which needs a blood meal, may land on an opossum instead of a mouse – and the opossum won’t get infected because he cannot be a host for the bacteria,” says Robin. And meanwhile other predators, like foxes, hunt and eat the mice, also keeping them in check. “But if you fragment the forest as we have seen in the state of New York, then most of the predators, like foxes for instance, leave.” The ticks left with fewer animal choices, feed more on mice – in a vicious cycle. “So the white-footed mouse is proliferating, and becoming more infected by ticks,” says Robin. More infected ticks also land on deer, who are hunted by humans. “And scientists have shown that the probability of [humans] also getting infected in a fragmented forest is five times higher; this is the dilution effect,” she says. “The dilution effect shows that biodiversity protects your health because when you have a lot of biodiversity, the chances of anyone [human] getting infected are reduced.” Click here to reserve a free ticket to the film., See the complete programme for GHF 2022 here – and register for the full event Tuesday-Thursday or daily, in person or remotely. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Thomas Quine/Flickr , nosha/Flickr. Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
‘Epidemic’ of Obesity in Europe 03/05/2022 Kerry Cullinan Impact of obesity on health Almost two-thirds of adults and a third of children are overweight or obese in the World Health Organization (WHO) European Region and this is driving cancer and other diseases, according to the WHO European Regional Obesity Report 2022 report released on Tuesday. The highest prevalence is in Turkey, Malta, Israel and the UK (WHO Europe has different members from the European Union), but there is an upward trend in all 53 member countries. Driving cancers Obesity is the cause of 13 different types of cancer, as well as a risk factor in strokes, heart attacks, type 2 diabetes and other non-communicable diseases, according to the report. For some countries in the region, obesity is predicted to overtake smoking as the main risk factor for preventable cancer. The report also highlights that obesity is a condition, not just a risk factor, that needs to be specifically treated and managed. “In Europe and Central Asia, no single country is going to meet the WHO Global NCD target of halting the rise of obesity by 2025,” said Dr Hans Kluge, WHO Regional Director for Europe. Adult obesity in the 53-country European Region is higher than in any other WHO region except the the Americas. More males (63%) are overweight than among females (54%) while obesity is more prevalent among females (24%) than among males (22%). Obesity rates in Europe (2016) 50% 60% 70% Orange = all adults, Blue = males, Green = females The COVID-19 pandemic has highlighted the danger of obesity, with patients with obesity being more likely to experience complications and death from the virus. “Preliminary data also suggest that during the current pandemic, people have had higher exposure to obesity risk factors, including an increase in sedentary lifestyles and consumption of unhealthy foods,” according to the report. Addressing unhealthy environments “Obesity is influenced by the environment, so it is important to look at this problem from the perspective of every stage of life. For example, the life of children and adolescents is impacted by digital environments, including marketing of unhealthy food and drinks,” said Dr Kremlin Wickramasinghe, Acting Head of the WHO European Office for the Prevention and Control of NCDs, which produced the report. “Restricting the marketing of unhealthy foods to children, taxation of sugar-sweetened beverages and improving health system response for obesity management are currently among the most actively discussed policy areas in the WHO European Region,” Wickramasinghe added. Other policies that show promise in reducing levels of obesity and overweight include improving access to obesity and overweight management services in primary health care, promoting breastfeeding and school-based interventions. The report also highlights interventions at supermarkets and takeaway outlets, which are the primary food sources. These include removing unhealthy foods from checkouts and nearby aisles and restricting takeaway outlets. Improving the quality of parks and playgrounds, as well as providing adequate infrastructure for active transport are other suggestions. Image Credits: rawpixel/unsplash. After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. Funding and Education Are Key to Effective Implementation of ‘One Health’ Agenda 03/05/2022 Maayan Hoffman The Geneva Health Forum opened with a panel discussion on “One Health: is there a paradigm shift?” From left: Andrea Sylvia Winkler, Peter Ben Embarek, Lisa Crump, Jean Philippe Dop and Keith Sumption. More accessible funding will be required for the international community to implement a broad One Health approach, scientist Lisa Crump of the UN Environmental Program (UNEP) told Health Policy Watch on Tuesday. Speaking on the sidelines of the Geneva Health Forum’s (GHF) kick-off discussion, “One Health: is there a paradigm shift?” Crump said that “we need ways to get funding so that it is easy to access. We have some very old ways of releasing funds and they are not reactive or responsive, and that is what we need”. “We need to make funding more accessible, make more of it and put fewer strings on it,” she continued. “It has to make economic sense. Or at least there has to be some benefit. It can be economic savings or it can be improved health or increased ecosystem resilience. It is not always money. But it takes money to figure out what is going to work and we cannot ignore that fact.” Crump was one of four panellists who spoke during the session. The others included Jean Philippe Dop of the World Organization for Animal Health (OIE), Keith Sumption of the Food and Agriculture Organization (FAO) and Peter Ben Embarek of the World Health Organization (WHO). The session was moderated by Andrea Sylvia Winkler of the Center for Global Health at the Technical University of Munich and the Centre for Global Health at the University of Oslo. More than 1,000 people attended the forum on Tuesday and almost as many were watching a selection of sessions that were aired virtually. The concept of One Health is a big focus of the GHF after decades of the topic being consigned to the margins of health agendas. The COVID-19 pandemic has highlighted the importance of a holistic approach to health across species as the virus was most likely to have been transmitted to humans from a bat, via infected mammals housed and slaughtered in unsanitary conditions at a marketplace in Wuhan, China. “The COVID-19 pandemic highlighted the intimate links between health, humans, animals and our environment,” stressed WHO Director-General Dr Tedros Adhanom Ghebreyesus in a video message to the conference. “Reducing future pandemics demands closer collaboration across sectors.” Around 60% of known infectious diseases and as many as 75% of new or emerging infectious diseases are zoonotic in origin. As a result, the One Health approach is receiving broad support from the WHO, FAO, OIE and, most recently, UNEP – together, formally known as the Quadripartite. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.” Tuesday’s GHF session marked the first time that all four lead technical focal points of the quadripartite organizations have appeared together in a public forum to discuss the changing One Health landscape. Common sense has come to the political arena Ben Embarek explained that the biggest shift he has seen since COVID-19 is that now politicians and government officials are buying into One Health, too. “When common sense comes into the political arena, that is where things start changing,” he said. “When we have heads of states talking about One Health, this is a shift for sure.” Dop expressed similar sentiments, noting the involvement of these decision-makers in the One Health agenda as “a good effect of the pandemic, if there can be one”. And he said that this involvement will play a key role in being able to implement One Health concepts aligned by professors and doctors in academia in the field. Another shift is the new and formal involvement of UNEP, with Crump saying that her organisation is ready to “mobilize our assets and partnerships to support a One Health approach”. The UNEP has already helped establish a multi-partner trust seeded with €50 million to enhance countries’ investments in nature with the goal of stopping pandemics. Those funds will also go for working towards establishing four outcomes: providing multidisciplinary evidence on the links between biodiversity, climate change and health; enhancing One Health preventative actions and policies; providing target-specific capacity building and knowledge management, advocacy and awareness-raising programs on those links; and to create sustainable One Health collaborations with government structures. Having UNEP involved in a greater capacity should also enable the team to focus more on issues such as soil, water and other environmental factors that play a role in health and wellbeing, said Sumption. He expects new opportunities from environmental ministries monitoring for pathogens to ecosystem restoration and biodiversity maintenance. “There are hundreds of thousands of people whose livelihoods depend on forests so we need sustainable wildlife management in those settings,” Sumption stressed. Food and Agriculture Organization Director-General Qu Dongyu addressed the One Health opening session via video. ‘Widening the perspective of students’ But the key to the future is educating the younger generation to take a One Health approach from the onset of their careers, said Ben Embarek. He addressed students and teachers and called on them to break down silos in their universities from the podium. “It is widening the perspective of students in the existing silos,” Ben Embarek told Health Policy Watch after the session. For example, he said, “medical students should be exposed to what vets are doing and what is happening out there in the environment so that they will get a better perspective and that they will see that the health of humans is connected to all of these things.” At the same, he noted, while vets might be focused on producing healthy animals, at some point, someone is going to eat these animals and those who are going to do so should not die from eating them. “It is important to not only protect the animals from animal disease but also to protect animals from pathogens that will affect humans,” Ben Embarek continued, “It is really about exposing students and including in their curriculum the perspectives that exist in other sectors, and understanding that some of the issues they are trained to solve in the future will depend on the health and actions of other sectors. “So, when they are in these positions later on in life it will be easier to understand what others are doing, why they are doing it and how to change.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. ‘Making Pandemics’: Deforestation is Laying Groundwork for Next Global Health Crisis 03/05/2022 Elaine Ruth Fletcher When we think about the critical drivers of disease prevention and control – we need to stop thinking only about medicines, vaccines and diagnostics. In fact some of the most important forms of disease control can be found in forests – which harbor thousands of pathogens, known and unknown in relative isolation from humans and the damage that they could otherwise cause. But humankind is felling forests and wreaking other kinds of damage on ecosystems at an unprecedented rate – laying the groundwork for the next pandemic as we speak endlessly about how to get the world out of the present one. That is the key message of the new film “La Fabrique des pandémies” (Making Pandemics) by the French journalist and documentary filmmaker, Marie Monique Robin. Avant-premiere at Geneva Health Forum French star, Juliette Bionoche, who narrates the film. The film will be aired at a public avant-premiere on Wednesday 4 May at 6 p.m – as part of the Geneva Health Forum. The Forum, which begins on Tuesday, has a climate and environmental health focus this year. The film, born out of reflections during the COVID lockdown, took Robin to eight countries across Africa, Asia and the Americas – from French Guinea to DR Congo, Malaysia and Mexico, as well as upstate New York. The result is the product of the relentless detective work of Robin, a seasoned journalist who also directed “The World According to Monsanto”, a critical look at the pesticide industry. Narrated by the French film star, Juliette Bionoche, the film aims to make the issue more accessible to the general public – despite its highly technical material. So it is Binoche that relates the stories of the deadly viruses, bacteria and parasites that have “escaped” from the wild to become major plagues to human health – as seen through the eyes of the scientists who have documented their destructive pathway. Pig farm in Sarawak, Borneo, Malaysia – a reservoir for Nipah virus. The examples include the story of Malaysia’s deadly, bat-borne Nipah virus which became a threat to humans as bats driven from rainforests destroyed to create palm oil plantations found new homes in agricultural areas, and particularly around pig farms. Infected pigs, close to people both genetically and proximally, then began transmitting the virus to humans. While most of the stories relate to developing countries, developed regions are not immune. Lyme disease, transmitted by ticks in North America, has posed an increasing threat to human health as forests there become fragmented, biodiversity is reduced, and species such as the white-footed mouse proliferate, which are a reservoir for the deadly Borrelia bacterium that causes Lyme disease. COVID lockdown reflections Filming of Making Pandemics. Robin, on right, conducts an interview. The film began with Robin’s own reading and reflections during the COVID lockdown – including an article that she read in the New York Times, which struck a special chord entitled “We made a pandemic.” “I began searching and contacting scientists with whom I have been working for more than 30 years,” she relates. Among them was Serge Morand, a parasitologist living in Thailand – who will also be appearing himself at the Geneva Health Forum, running from 3-5 May. “And he said, oh it would be great if you could put all of us together in a book or a film. “The thing is,” Robin adds, “is that there have been many, many dozens of studies published, showing the link between the destruction of biodiversity, on the one hand, and on the other, the emergence of infectious diseases. “And so Morand told me, ‘if you could put all of us together, it would be very powerful. Because we have been sounding the alarm for so many years, and just nobody is paying attention.” Robin went on to interview some 62 scientists working in various parts of the world – with the stories of 14 condensed into the book, Making Pandemics, published last year, which has now been made into a film. Three drivers of disease Deforestation is a key driver of new infectious diseases – which leap from wild animal species to humans. The interviews all weave together to underline a single message about the ecological factors driving the emergence of new infectious diseases – and the expansion of already well-known diseases. “The first factor is, of course, deforestation in tropical areas,” Robin says of the key drivers. “And then intensive breeding [of animals], and then globalization. “It means growing soybeans in Argentina or Brazil, to feed European cattle. It means cultivating palm trees. It means mining, gold, copper, etc. And also urbanization. All of these factors which contribute to deforestation in tropical areas.” The dilution effect Maintaining biodiversity alongside food production is critical to preventing new pandemics. While there is some growing awareness about how climate change and biodiversity loss is increasing the frequency at which diseases like Ebola, Nipah and others are emerging or expanding, Robin offers fresh insights into why this is the case. Just imagine the forest as a massive universe of bacteria, parasites and viruses, both known and unknown, circulating among the animal species that live there. When forests are deep and expansive, pathogens are more likely to stay within their natural geographic boundaries, Robin explains. And when animal species are diverse and plentiful, then dangerous viruses are largely contained by a set of natural biological checks and balances that keep other species in check too. In a well-balanced ecosystem, when pathogens have lots of different animals to infect – they won’t infect species that can transmit the disease to humans as frequently or as intensively – something that she describes as the “dilution effect”. Animals that are more prone to dangerous infections also cannot become too dominant as a species, and thus pose an even greater risk to humans – because they also are the prey of other animals that keep them in check. Biodiversity protects your health Deer in North America are becoming more infected with ticks carrying Lyme disease But when the forest is cut away or fragmented – and its animals hunted down or otherwise destroyed by humans – then the chances of a pathogen infecting an animal species with a dangerous pathogen that may then carry the same disease to humans increase. Lyme disease is a good example of that principle, she explains. “The dilution effect means that when you have a big community of mammals floating around in the forest, then the probability that a tick will feed on a white-footed mouse, which is a reservoir of the Borrelia bacterium, is diluted. “A tick, which needs a blood meal, may land on an opossum instead of a mouse – and the opossum won’t get infected because he cannot be a host for the bacteria,” says Robin. And meanwhile other predators, like foxes, hunt and eat the mice, also keeping them in check. “But if you fragment the forest as we have seen in the state of New York, then most of the predators, like foxes for instance, leave.” The ticks left with fewer animal choices, feed more on mice – in a vicious cycle. “So the white-footed mouse is proliferating, and becoming more infected by ticks,” says Robin. More infected ticks also land on deer, who are hunted by humans. “And scientists have shown that the probability of [humans] also getting infected in a fragmented forest is five times higher; this is the dilution effect,” she says. “The dilution effect shows that biodiversity protects your health because when you have a lot of biodiversity, the chances of anyone [human] getting infected are reduced.” Click here to reserve a free ticket to the film., See the complete programme for GHF 2022 here – and register for the full event Tuesday-Thursday or daily, in person or remotely. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Thomas Quine/Flickr , nosha/Flickr. Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
After Months of Deadlock, WTO’s TRIPS Council Will Finally Discuss Intellectual Property Waiver Compromise 03/05/2022 Kerry Cullinan WTO Director-General Ngozi Okonjo-Iweala In a significant breakthrough, the World Trade Organization’s (WTO) TRIPS Council on Friday will finally discuss a compromise proposal on a waiver of intellectual property (IP) rights on COVID-19 vaccines – almost 18 months after it was first proposed by India and South Africa. Members attending an informal meeting of the TRIPS Council on Tuesday were told that the text of an “outcome document” from the “quad” of the European Union, US, India and South Africa would be circulated to them “within hours” from WTO Director-General Ngozi Okonjo-Iweala’s office. The outcome document, which was later posted on the WTO website, is very similar to that which was leaked in mid-March – but it has been termed an “outcome document” rather than an agreement as there are still a couple of points of disagreement. Disagreement over who should be eligible The main point of disagreement relates to which countries should be able to benefit from the waiver (footnote 1). All developing country members that have not yet achieved a significant export capacity – namely 10% of the world’s COVID-19 vaccine market – are supposed to benefit from the flexibilities. Apparently, China has been unhappy about being excluded while a country like India with large generic manufacturing capacity, may be included. But the new TRIPS Council chairperson, Sierra Leone’s Ambassador Lansana Gberie, told Tuesday’s meeting that the superpower “seemed favourably disposed” towards the compromise – also contained in footnote 1 – that states “all developing country members with capacity are encouraged to opt out from these flexibilities”, according to a WTO official. While the waiver only applies to vaccines, WTO members will have six months to decide whether to extend it to cover the production and distribution of COVID-19 diagnostics and therapeutics. According to the draft document, eligible WTO members will be able to limit TRIPS article Section 28, which deals with exclusive patents, by authorizing the production and supply of COVID-19 vaccines without the patent holder’s consent, and with minimal transaction costs. Single authorisation for multiple patents Another deviation from draft agreement that was leaked in mid-March is related to whether countries will have to list all the patents that they will be waiving – widely criticised for imposing onerous requirements on countries. This appears set to go, according to footnote 3. Eligible countries may issue a single authorisation to use multiple patents and can export the vaccines they produce under this authorisation to other eligible members, particularly countries in greatest need, and to supply regional or international initiatives such as COVAX (a waiver of TRIPS Art. 31(f).) Eligible members will also be able to use any of their legal instruments to impose a waiver on vaccines, and the protection of clinical trial data under TRIPS will not be an obstacle to implementing this proposal. Payment for any vaccines produced under TRIPS waiver conditions for export is to take account of the humanitarian and not-for-profit purpose of the vaccine programme, to support manufacturers to produce and supply vaccines at affordable prices. The duration of the flexibilities would be either three or five years, and eligible members would be exempted from legal challenges under the WTO dispute settlement mechanism. The earlier agreement was widely condemned by health activist groups, who objected the waiver being confined to vaccines and excluding some of the world’s major COVID-19 vaccine producers. In addition, a diplomatic source told Health Policy Watch that he did not know the value of the waiver given that there was an apparent surplus of COVID-19 vaccines. The results of the formal discussion on Friday will be reported to the General Council, which is scheduled to meet on 9 and 10 May. Image Credits: Jess Hurd/ Global Justice Now, Africa Centre for International Trade&Development. Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. Funding and Education Are Key to Effective Implementation of ‘One Health’ Agenda 03/05/2022 Maayan Hoffman The Geneva Health Forum opened with a panel discussion on “One Health: is there a paradigm shift?” From left: Andrea Sylvia Winkler, Peter Ben Embarek, Lisa Crump, Jean Philippe Dop and Keith Sumption. More accessible funding will be required for the international community to implement a broad One Health approach, scientist Lisa Crump of the UN Environmental Program (UNEP) told Health Policy Watch on Tuesday. Speaking on the sidelines of the Geneva Health Forum’s (GHF) kick-off discussion, “One Health: is there a paradigm shift?” Crump said that “we need ways to get funding so that it is easy to access. We have some very old ways of releasing funds and they are not reactive or responsive, and that is what we need”. “We need to make funding more accessible, make more of it and put fewer strings on it,” she continued. “It has to make economic sense. Or at least there has to be some benefit. It can be economic savings or it can be improved health or increased ecosystem resilience. It is not always money. But it takes money to figure out what is going to work and we cannot ignore that fact.” Crump was one of four panellists who spoke during the session. The others included Jean Philippe Dop of the World Organization for Animal Health (OIE), Keith Sumption of the Food and Agriculture Organization (FAO) and Peter Ben Embarek of the World Health Organization (WHO). The session was moderated by Andrea Sylvia Winkler of the Center for Global Health at the Technical University of Munich and the Centre for Global Health at the University of Oslo. More than 1,000 people attended the forum on Tuesday and almost as many were watching a selection of sessions that were aired virtually. The concept of One Health is a big focus of the GHF after decades of the topic being consigned to the margins of health agendas. The COVID-19 pandemic has highlighted the importance of a holistic approach to health across species as the virus was most likely to have been transmitted to humans from a bat, via infected mammals housed and slaughtered in unsanitary conditions at a marketplace in Wuhan, China. “The COVID-19 pandemic highlighted the intimate links between health, humans, animals and our environment,” stressed WHO Director-General Dr Tedros Adhanom Ghebreyesus in a video message to the conference. “Reducing future pandemics demands closer collaboration across sectors.” Around 60% of known infectious diseases and as many as 75% of new or emerging infectious diseases are zoonotic in origin. As a result, the One Health approach is receiving broad support from the WHO, FAO, OIE and, most recently, UNEP – together, formally known as the Quadripartite. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.” Tuesday’s GHF session marked the first time that all four lead technical focal points of the quadripartite organizations have appeared together in a public forum to discuss the changing One Health landscape. Common sense has come to the political arena Ben Embarek explained that the biggest shift he has seen since COVID-19 is that now politicians and government officials are buying into One Health, too. “When common sense comes into the political arena, that is where things start changing,” he said. “When we have heads of states talking about One Health, this is a shift for sure.” Dop expressed similar sentiments, noting the involvement of these decision-makers in the One Health agenda as “a good effect of the pandemic, if there can be one”. And he said that this involvement will play a key role in being able to implement One Health concepts aligned by professors and doctors in academia in the field. Another shift is the new and formal involvement of UNEP, with Crump saying that her organisation is ready to “mobilize our assets and partnerships to support a One Health approach”. The UNEP has already helped establish a multi-partner trust seeded with €50 million to enhance countries’ investments in nature with the goal of stopping pandemics. Those funds will also go for working towards establishing four outcomes: providing multidisciplinary evidence on the links between biodiversity, climate change and health; enhancing One Health preventative actions and policies; providing target-specific capacity building and knowledge management, advocacy and awareness-raising programs on those links; and to create sustainable One Health collaborations with government structures. Having UNEP involved in a greater capacity should also enable the team to focus more on issues such as soil, water and other environmental factors that play a role in health and wellbeing, said Sumption. He expects new opportunities from environmental ministries monitoring for pathogens to ecosystem restoration and biodiversity maintenance. “There are hundreds of thousands of people whose livelihoods depend on forests so we need sustainable wildlife management in those settings,” Sumption stressed. Food and Agriculture Organization Director-General Qu Dongyu addressed the One Health opening session via video. ‘Widening the perspective of students’ But the key to the future is educating the younger generation to take a One Health approach from the onset of their careers, said Ben Embarek. He addressed students and teachers and called on them to break down silos in their universities from the podium. “It is widening the perspective of students in the existing silos,” Ben Embarek told Health Policy Watch after the session. For example, he said, “medical students should be exposed to what vets are doing and what is happening out there in the environment so that they will get a better perspective and that they will see that the health of humans is connected to all of these things.” At the same, he noted, while vets might be focused on producing healthy animals, at some point, someone is going to eat these animals and those who are going to do so should not die from eating them. “It is important to not only protect the animals from animal disease but also to protect animals from pathogens that will affect humans,” Ben Embarek continued, “It is really about exposing students and including in their curriculum the perspectives that exist in other sectors, and understanding that some of the issues they are trained to solve in the future will depend on the health and actions of other sectors. “So, when they are in these positions later on in life it will be easier to understand what others are doing, why they are doing it and how to change.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. ‘Making Pandemics’: Deforestation is Laying Groundwork for Next Global Health Crisis 03/05/2022 Elaine Ruth Fletcher When we think about the critical drivers of disease prevention and control – we need to stop thinking only about medicines, vaccines and diagnostics. In fact some of the most important forms of disease control can be found in forests – which harbor thousands of pathogens, known and unknown in relative isolation from humans and the damage that they could otherwise cause. But humankind is felling forests and wreaking other kinds of damage on ecosystems at an unprecedented rate – laying the groundwork for the next pandemic as we speak endlessly about how to get the world out of the present one. That is the key message of the new film “La Fabrique des pandémies” (Making Pandemics) by the French journalist and documentary filmmaker, Marie Monique Robin. Avant-premiere at Geneva Health Forum French star, Juliette Bionoche, who narrates the film. The film will be aired at a public avant-premiere on Wednesday 4 May at 6 p.m – as part of the Geneva Health Forum. The Forum, which begins on Tuesday, has a climate and environmental health focus this year. The film, born out of reflections during the COVID lockdown, took Robin to eight countries across Africa, Asia and the Americas – from French Guinea to DR Congo, Malaysia and Mexico, as well as upstate New York. The result is the product of the relentless detective work of Robin, a seasoned journalist who also directed “The World According to Monsanto”, a critical look at the pesticide industry. Narrated by the French film star, Juliette Bionoche, the film aims to make the issue more accessible to the general public – despite its highly technical material. So it is Binoche that relates the stories of the deadly viruses, bacteria and parasites that have “escaped” from the wild to become major plagues to human health – as seen through the eyes of the scientists who have documented their destructive pathway. Pig farm in Sarawak, Borneo, Malaysia – a reservoir for Nipah virus. The examples include the story of Malaysia’s deadly, bat-borne Nipah virus which became a threat to humans as bats driven from rainforests destroyed to create palm oil plantations found new homes in agricultural areas, and particularly around pig farms. Infected pigs, close to people both genetically and proximally, then began transmitting the virus to humans. While most of the stories relate to developing countries, developed regions are not immune. Lyme disease, transmitted by ticks in North America, has posed an increasing threat to human health as forests there become fragmented, biodiversity is reduced, and species such as the white-footed mouse proliferate, which are a reservoir for the deadly Borrelia bacterium that causes Lyme disease. COVID lockdown reflections Filming of Making Pandemics. Robin, on right, conducts an interview. The film began with Robin’s own reading and reflections during the COVID lockdown – including an article that she read in the New York Times, which struck a special chord entitled “We made a pandemic.” “I began searching and contacting scientists with whom I have been working for more than 30 years,” she relates. Among them was Serge Morand, a parasitologist living in Thailand – who will also be appearing himself at the Geneva Health Forum, running from 3-5 May. “And he said, oh it would be great if you could put all of us together in a book or a film. “The thing is,” Robin adds, “is that there have been many, many dozens of studies published, showing the link between the destruction of biodiversity, on the one hand, and on the other, the emergence of infectious diseases. “And so Morand told me, ‘if you could put all of us together, it would be very powerful. Because we have been sounding the alarm for so many years, and just nobody is paying attention.” Robin went on to interview some 62 scientists working in various parts of the world – with the stories of 14 condensed into the book, Making Pandemics, published last year, which has now been made into a film. Three drivers of disease Deforestation is a key driver of new infectious diseases – which leap from wild animal species to humans. The interviews all weave together to underline a single message about the ecological factors driving the emergence of new infectious diseases – and the expansion of already well-known diseases. “The first factor is, of course, deforestation in tropical areas,” Robin says of the key drivers. “And then intensive breeding [of animals], and then globalization. “It means growing soybeans in Argentina or Brazil, to feed European cattle. It means cultivating palm trees. It means mining, gold, copper, etc. And also urbanization. All of these factors which contribute to deforestation in tropical areas.” The dilution effect Maintaining biodiversity alongside food production is critical to preventing new pandemics. While there is some growing awareness about how climate change and biodiversity loss is increasing the frequency at which diseases like Ebola, Nipah and others are emerging or expanding, Robin offers fresh insights into why this is the case. Just imagine the forest as a massive universe of bacteria, parasites and viruses, both known and unknown, circulating among the animal species that live there. When forests are deep and expansive, pathogens are more likely to stay within their natural geographic boundaries, Robin explains. And when animal species are diverse and plentiful, then dangerous viruses are largely contained by a set of natural biological checks and balances that keep other species in check too. In a well-balanced ecosystem, when pathogens have lots of different animals to infect – they won’t infect species that can transmit the disease to humans as frequently or as intensively – something that she describes as the “dilution effect”. Animals that are more prone to dangerous infections also cannot become too dominant as a species, and thus pose an even greater risk to humans – because they also are the prey of other animals that keep them in check. Biodiversity protects your health Deer in North America are becoming more infected with ticks carrying Lyme disease But when the forest is cut away or fragmented – and its animals hunted down or otherwise destroyed by humans – then the chances of a pathogen infecting an animal species with a dangerous pathogen that may then carry the same disease to humans increase. Lyme disease is a good example of that principle, she explains. “The dilution effect means that when you have a big community of mammals floating around in the forest, then the probability that a tick will feed on a white-footed mouse, which is a reservoir of the Borrelia bacterium, is diluted. “A tick, which needs a blood meal, may land on an opossum instead of a mouse – and the opossum won’t get infected because he cannot be a host for the bacteria,” says Robin. And meanwhile other predators, like foxes, hunt and eat the mice, also keeping them in check. “But if you fragment the forest as we have seen in the state of New York, then most of the predators, like foxes for instance, leave.” The ticks left with fewer animal choices, feed more on mice – in a vicious cycle. “So the white-footed mouse is proliferating, and becoming more infected by ticks,” says Robin. More infected ticks also land on deer, who are hunted by humans. “And scientists have shown that the probability of [humans] also getting infected in a fragmented forest is five times higher; this is the dilution effect,” she says. “The dilution effect shows that biodiversity protects your health because when you have a lot of biodiversity, the chances of anyone [human] getting infected are reduced.” Click here to reserve a free ticket to the film., See the complete programme for GHF 2022 here – and register for the full event Tuesday-Thursday or daily, in person or remotely. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Thomas Quine/Flickr , nosha/Flickr. Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Europeans May Have to Sleep Under Mosquito Nets as Climate Change Alters Disease Patterns 03/05/2022 Maayan Hoffman Geneva Health Forum session, “Impact of climate change on health.” From left: Moderator Maximilian Jungmann, University of Heidelberg; Alfonso Gomez, City of Geneva; Maria Neira, World Health Organization; Gueladio Cisse, CGIEC Swiss TPH; and Valérie D’Acremont, University of Lausanne. Children sick with malaria, adults in bed with fevers and rashes as a result of the Zika virus, tick-borne illnesses – all of these diseases are on the rise as a result of climate change, according to Valérie D’Acremont of the University of Lausanne. She spoke on Tuesday at the Geneva Health Forum during a special session on the impact of climate change on health, addressing the question: “what is the scale of the problem and what action needs to be taken?” “It is clear that there has been an increase in transmission of [existing] pathogens and of new pathogens,” said D’Acremont, a Swiss physician who is also working on a project in Africa. For example, the spread of malaria, caused by a parasite that spreads to humans and other animals through the bites of infected female mosquitoes, increases in temperatures of around 25ºC. “In West Africa, it is too hot, so malaria might be going down, but in East Africa, the opposite is the case and we see an increase in malaria,” she said. Adding to the challenge are compromised health systems, the result of two years of the COVID-19 pandemic, which has seen the world losing some of its gains against malaria over the last 20 years. Mosquitoes, similarly, are more prone to spreading Zika virus in around 30ºC, which means that the world’s tropical areas are seeing more and more of the disease, and it is likely to extend to Europe and other countries. “We see it already in Italy,” D’Acremont stressed. “We might one day have to sleep under bed nets like they do in Africa.” Tick-borne diseases are spreading in Switzerland, also as a result of climate change, she added. There has been a two-thirds increase in the number of people hospitalized for ticks in Switzerland from 2009 to 2019, according to a recent report by RTS. Moreover, the number of tick bites rose from around 10,000 per year between 2012 and 2016 to around 14,000 a year in the last four years. “Journalists like to hear this story because it frightens people,” D’Acremont said but added that the main challenge was that people die from these diseases when coupled with other pre-existing conditions, such as diabetes, hypertension or malnutrition. These are also often a result of climate change or failing to take care of the environment and our food sources. “Climate change has a huge impact on this too, especially undernutrition and respiratory problems,” she said. Alfonso Gomez of the City of Geneva addresses the Geneva Health Forum on May 3, 2022. We need to stop exploiting animals, destroying nature Climate change has become an inescapable reality. The most recent Intergovernmental Panel on Climate Change (IPPC) report showed what people already knew: There is now scientific consensus that climate change is impacting people’s health and wellbeing in all hemispheres. Sometimes the effect is direct, Gueladio Cisse of CGIEC Swiss TPH, who also spoke at the session, said. Sometimes it is indirect. Sometimes the effect comes at once, and other times it has a slower but also longer-term impact. “If there is a heatwave, the next thing you know people are dying over the course of two or three days,” Cisse said as an example. Other times, a general increase in temperature allows pathogens to grow and makes humans more vulnerable to disease. The good news, said Dr Maria Neira, of the World Health Organization, is that the scientific community has been “pulling together in a historic way all the evidence we have on climate change… They are telling us things like if we don’t take measure now, this might put civilization at risk.” D’Acremont agreed but said that while research was useful, now is the time to do research in the field by monitoring the impact of steps taken to curb environmental hazards. “We need a paradigm shift to go to prevention,” she said. “Take COVID. It is nice to have a preparedness plan, but the problem is that another pandemic or event could come and it is new and we cannot be prepared.” Instead, she said, “we need to stop destroying nature, stop exploiting animals and start preparing ourselves by being in better health. During the crisis is too late… We have to shift the reality now to preventive care. That is true for northern and southern countries.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. Funding and Education Are Key to Effective Implementation of ‘One Health’ Agenda 03/05/2022 Maayan Hoffman The Geneva Health Forum opened with a panel discussion on “One Health: is there a paradigm shift?” From left: Andrea Sylvia Winkler, Peter Ben Embarek, Lisa Crump, Jean Philippe Dop and Keith Sumption. More accessible funding will be required for the international community to implement a broad One Health approach, scientist Lisa Crump of the UN Environmental Program (UNEP) told Health Policy Watch on Tuesday. Speaking on the sidelines of the Geneva Health Forum’s (GHF) kick-off discussion, “One Health: is there a paradigm shift?” Crump said that “we need ways to get funding so that it is easy to access. We have some very old ways of releasing funds and they are not reactive or responsive, and that is what we need”. “We need to make funding more accessible, make more of it and put fewer strings on it,” she continued. “It has to make economic sense. Or at least there has to be some benefit. It can be economic savings or it can be improved health or increased ecosystem resilience. It is not always money. But it takes money to figure out what is going to work and we cannot ignore that fact.” Crump was one of four panellists who spoke during the session. The others included Jean Philippe Dop of the World Organization for Animal Health (OIE), Keith Sumption of the Food and Agriculture Organization (FAO) and Peter Ben Embarek of the World Health Organization (WHO). The session was moderated by Andrea Sylvia Winkler of the Center for Global Health at the Technical University of Munich and the Centre for Global Health at the University of Oslo. More than 1,000 people attended the forum on Tuesday and almost as many were watching a selection of sessions that were aired virtually. The concept of One Health is a big focus of the GHF after decades of the topic being consigned to the margins of health agendas. The COVID-19 pandemic has highlighted the importance of a holistic approach to health across species as the virus was most likely to have been transmitted to humans from a bat, via infected mammals housed and slaughtered in unsanitary conditions at a marketplace in Wuhan, China. “The COVID-19 pandemic highlighted the intimate links between health, humans, animals and our environment,” stressed WHO Director-General Dr Tedros Adhanom Ghebreyesus in a video message to the conference. “Reducing future pandemics demands closer collaboration across sectors.” Around 60% of known infectious diseases and as many as 75% of new or emerging infectious diseases are zoonotic in origin. As a result, the One Health approach is receiving broad support from the WHO, FAO, OIE and, most recently, UNEP – together, formally known as the Quadripartite. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.” Tuesday’s GHF session marked the first time that all four lead technical focal points of the quadripartite organizations have appeared together in a public forum to discuss the changing One Health landscape. Common sense has come to the political arena Ben Embarek explained that the biggest shift he has seen since COVID-19 is that now politicians and government officials are buying into One Health, too. “When common sense comes into the political arena, that is where things start changing,” he said. “When we have heads of states talking about One Health, this is a shift for sure.” Dop expressed similar sentiments, noting the involvement of these decision-makers in the One Health agenda as “a good effect of the pandemic, if there can be one”. And he said that this involvement will play a key role in being able to implement One Health concepts aligned by professors and doctors in academia in the field. Another shift is the new and formal involvement of UNEP, with Crump saying that her organisation is ready to “mobilize our assets and partnerships to support a One Health approach”. The UNEP has already helped establish a multi-partner trust seeded with €50 million to enhance countries’ investments in nature with the goal of stopping pandemics. Those funds will also go for working towards establishing four outcomes: providing multidisciplinary evidence on the links between biodiversity, climate change and health; enhancing One Health preventative actions and policies; providing target-specific capacity building and knowledge management, advocacy and awareness-raising programs on those links; and to create sustainable One Health collaborations with government structures. Having UNEP involved in a greater capacity should also enable the team to focus more on issues such as soil, water and other environmental factors that play a role in health and wellbeing, said Sumption. He expects new opportunities from environmental ministries monitoring for pathogens to ecosystem restoration and biodiversity maintenance. “There are hundreds of thousands of people whose livelihoods depend on forests so we need sustainable wildlife management in those settings,” Sumption stressed. Food and Agriculture Organization Director-General Qu Dongyu addressed the One Health opening session via video. ‘Widening the perspective of students’ But the key to the future is educating the younger generation to take a One Health approach from the onset of their careers, said Ben Embarek. He addressed students and teachers and called on them to break down silos in their universities from the podium. “It is widening the perspective of students in the existing silos,” Ben Embarek told Health Policy Watch after the session. For example, he said, “medical students should be exposed to what vets are doing and what is happening out there in the environment so that they will get a better perspective and that they will see that the health of humans is connected to all of these things.” At the same, he noted, while vets might be focused on producing healthy animals, at some point, someone is going to eat these animals and those who are going to do so should not die from eating them. “It is important to not only protect the animals from animal disease but also to protect animals from pathogens that will affect humans,” Ben Embarek continued, “It is really about exposing students and including in their curriculum the perspectives that exist in other sectors, and understanding that some of the issues they are trained to solve in the future will depend on the health and actions of other sectors. “So, when they are in these positions later on in life it will be easier to understand what others are doing, why they are doing it and how to change.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. ‘Making Pandemics’: Deforestation is Laying Groundwork for Next Global Health Crisis 03/05/2022 Elaine Ruth Fletcher When we think about the critical drivers of disease prevention and control – we need to stop thinking only about medicines, vaccines and diagnostics. In fact some of the most important forms of disease control can be found in forests – which harbor thousands of pathogens, known and unknown in relative isolation from humans and the damage that they could otherwise cause. But humankind is felling forests and wreaking other kinds of damage on ecosystems at an unprecedented rate – laying the groundwork for the next pandemic as we speak endlessly about how to get the world out of the present one. That is the key message of the new film “La Fabrique des pandémies” (Making Pandemics) by the French journalist and documentary filmmaker, Marie Monique Robin. Avant-premiere at Geneva Health Forum French star, Juliette Bionoche, who narrates the film. The film will be aired at a public avant-premiere on Wednesday 4 May at 6 p.m – as part of the Geneva Health Forum. The Forum, which begins on Tuesday, has a climate and environmental health focus this year. The film, born out of reflections during the COVID lockdown, took Robin to eight countries across Africa, Asia and the Americas – from French Guinea to DR Congo, Malaysia and Mexico, as well as upstate New York. The result is the product of the relentless detective work of Robin, a seasoned journalist who also directed “The World According to Monsanto”, a critical look at the pesticide industry. Narrated by the French film star, Juliette Bionoche, the film aims to make the issue more accessible to the general public – despite its highly technical material. So it is Binoche that relates the stories of the deadly viruses, bacteria and parasites that have “escaped” from the wild to become major plagues to human health – as seen through the eyes of the scientists who have documented their destructive pathway. Pig farm in Sarawak, Borneo, Malaysia – a reservoir for Nipah virus. The examples include the story of Malaysia’s deadly, bat-borne Nipah virus which became a threat to humans as bats driven from rainforests destroyed to create palm oil plantations found new homes in agricultural areas, and particularly around pig farms. Infected pigs, close to people both genetically and proximally, then began transmitting the virus to humans. While most of the stories relate to developing countries, developed regions are not immune. Lyme disease, transmitted by ticks in North America, has posed an increasing threat to human health as forests there become fragmented, biodiversity is reduced, and species such as the white-footed mouse proliferate, which are a reservoir for the deadly Borrelia bacterium that causes Lyme disease. COVID lockdown reflections Filming of Making Pandemics. Robin, on right, conducts an interview. The film began with Robin’s own reading and reflections during the COVID lockdown – including an article that she read in the New York Times, which struck a special chord entitled “We made a pandemic.” “I began searching and contacting scientists with whom I have been working for more than 30 years,” she relates. Among them was Serge Morand, a parasitologist living in Thailand – who will also be appearing himself at the Geneva Health Forum, running from 3-5 May. “And he said, oh it would be great if you could put all of us together in a book or a film. “The thing is,” Robin adds, “is that there have been many, many dozens of studies published, showing the link between the destruction of biodiversity, on the one hand, and on the other, the emergence of infectious diseases. “And so Morand told me, ‘if you could put all of us together, it would be very powerful. Because we have been sounding the alarm for so many years, and just nobody is paying attention.” Robin went on to interview some 62 scientists working in various parts of the world – with the stories of 14 condensed into the book, Making Pandemics, published last year, which has now been made into a film. Three drivers of disease Deforestation is a key driver of new infectious diseases – which leap from wild animal species to humans. The interviews all weave together to underline a single message about the ecological factors driving the emergence of new infectious diseases – and the expansion of already well-known diseases. “The first factor is, of course, deforestation in tropical areas,” Robin says of the key drivers. “And then intensive breeding [of animals], and then globalization. “It means growing soybeans in Argentina or Brazil, to feed European cattle. It means cultivating palm trees. It means mining, gold, copper, etc. And also urbanization. All of these factors which contribute to deforestation in tropical areas.” The dilution effect Maintaining biodiversity alongside food production is critical to preventing new pandemics. While there is some growing awareness about how climate change and biodiversity loss is increasing the frequency at which diseases like Ebola, Nipah and others are emerging or expanding, Robin offers fresh insights into why this is the case. Just imagine the forest as a massive universe of bacteria, parasites and viruses, both known and unknown, circulating among the animal species that live there. When forests are deep and expansive, pathogens are more likely to stay within their natural geographic boundaries, Robin explains. And when animal species are diverse and plentiful, then dangerous viruses are largely contained by a set of natural biological checks and balances that keep other species in check too. In a well-balanced ecosystem, when pathogens have lots of different animals to infect – they won’t infect species that can transmit the disease to humans as frequently or as intensively – something that she describes as the “dilution effect”. Animals that are more prone to dangerous infections also cannot become too dominant as a species, and thus pose an even greater risk to humans – because they also are the prey of other animals that keep them in check. Biodiversity protects your health Deer in North America are becoming more infected with ticks carrying Lyme disease But when the forest is cut away or fragmented – and its animals hunted down or otherwise destroyed by humans – then the chances of a pathogen infecting an animal species with a dangerous pathogen that may then carry the same disease to humans increase. Lyme disease is a good example of that principle, she explains. “The dilution effect means that when you have a big community of mammals floating around in the forest, then the probability that a tick will feed on a white-footed mouse, which is a reservoir of the Borrelia bacterium, is diluted. “A tick, which needs a blood meal, may land on an opossum instead of a mouse – and the opossum won’t get infected because he cannot be a host for the bacteria,” says Robin. And meanwhile other predators, like foxes, hunt and eat the mice, also keeping them in check. “But if you fragment the forest as we have seen in the state of New York, then most of the predators, like foxes for instance, leave.” The ticks left with fewer animal choices, feed more on mice – in a vicious cycle. “So the white-footed mouse is proliferating, and becoming more infected by ticks,” says Robin. More infected ticks also land on deer, who are hunted by humans. “And scientists have shown that the probability of [humans] also getting infected in a fragmented forest is five times higher; this is the dilution effect,” she says. “The dilution effect shows that biodiversity protects your health because when you have a lot of biodiversity, the chances of anyone [human] getting infected are reduced.” Click here to reserve a free ticket to the film., See the complete programme for GHF 2022 here – and register for the full event Tuesday-Thursday or daily, in person or remotely. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Thomas Quine/Flickr , nosha/Flickr. Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Funding and Education Are Key to Effective Implementation of ‘One Health’ Agenda 03/05/2022 Maayan Hoffman The Geneva Health Forum opened with a panel discussion on “One Health: is there a paradigm shift?” From left: Andrea Sylvia Winkler, Peter Ben Embarek, Lisa Crump, Jean Philippe Dop and Keith Sumption. More accessible funding will be required for the international community to implement a broad One Health approach, scientist Lisa Crump of the UN Environmental Program (UNEP) told Health Policy Watch on Tuesday. Speaking on the sidelines of the Geneva Health Forum’s (GHF) kick-off discussion, “One Health: is there a paradigm shift?” Crump said that “we need ways to get funding so that it is easy to access. We have some very old ways of releasing funds and they are not reactive or responsive, and that is what we need”. “We need to make funding more accessible, make more of it and put fewer strings on it,” she continued. “It has to make economic sense. Or at least there has to be some benefit. It can be economic savings or it can be improved health or increased ecosystem resilience. It is not always money. But it takes money to figure out what is going to work and we cannot ignore that fact.” Crump was one of four panellists who spoke during the session. The others included Jean Philippe Dop of the World Organization for Animal Health (OIE), Keith Sumption of the Food and Agriculture Organization (FAO) and Peter Ben Embarek of the World Health Organization (WHO). The session was moderated by Andrea Sylvia Winkler of the Center for Global Health at the Technical University of Munich and the Centre for Global Health at the University of Oslo. More than 1,000 people attended the forum on Tuesday and almost as many were watching a selection of sessions that were aired virtually. The concept of One Health is a big focus of the GHF after decades of the topic being consigned to the margins of health agendas. The COVID-19 pandemic has highlighted the importance of a holistic approach to health across species as the virus was most likely to have been transmitted to humans from a bat, via infected mammals housed and slaughtered in unsanitary conditions at a marketplace in Wuhan, China. “The COVID-19 pandemic highlighted the intimate links between health, humans, animals and our environment,” stressed WHO Director-General Dr Tedros Adhanom Ghebreyesus in a video message to the conference. “Reducing future pandemics demands closer collaboration across sectors.” Around 60% of known infectious diseases and as many as 75% of new or emerging infectious diseases are zoonotic in origin. As a result, the One Health approach is receiving broad support from the WHO, FAO, OIE and, most recently, UNEP – together, formally known as the Quadripartite. One Health was defined in December 2021 by the inter-agency One Health High-Level Expert Panel (OHHLEP) as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent.” Tuesday’s GHF session marked the first time that all four lead technical focal points of the quadripartite organizations have appeared together in a public forum to discuss the changing One Health landscape. Common sense has come to the political arena Ben Embarek explained that the biggest shift he has seen since COVID-19 is that now politicians and government officials are buying into One Health, too. “When common sense comes into the political arena, that is where things start changing,” he said. “When we have heads of states talking about One Health, this is a shift for sure.” Dop expressed similar sentiments, noting the involvement of these decision-makers in the One Health agenda as “a good effect of the pandemic, if there can be one”. And he said that this involvement will play a key role in being able to implement One Health concepts aligned by professors and doctors in academia in the field. Another shift is the new and formal involvement of UNEP, with Crump saying that her organisation is ready to “mobilize our assets and partnerships to support a One Health approach”. The UNEP has already helped establish a multi-partner trust seeded with €50 million to enhance countries’ investments in nature with the goal of stopping pandemics. Those funds will also go for working towards establishing four outcomes: providing multidisciplinary evidence on the links between biodiversity, climate change and health; enhancing One Health preventative actions and policies; providing target-specific capacity building and knowledge management, advocacy and awareness-raising programs on those links; and to create sustainable One Health collaborations with government structures. Having UNEP involved in a greater capacity should also enable the team to focus more on issues such as soil, water and other environmental factors that play a role in health and wellbeing, said Sumption. He expects new opportunities from environmental ministries monitoring for pathogens to ecosystem restoration and biodiversity maintenance. “There are hundreds of thousands of people whose livelihoods depend on forests so we need sustainable wildlife management in those settings,” Sumption stressed. Food and Agriculture Organization Director-General Qu Dongyu addressed the One Health opening session via video. ‘Widening the perspective of students’ But the key to the future is educating the younger generation to take a One Health approach from the onset of their careers, said Ben Embarek. He addressed students and teachers and called on them to break down silos in their universities from the podium. “It is widening the perspective of students in the existing silos,” Ben Embarek told Health Policy Watch after the session. For example, he said, “medical students should be exposed to what vets are doing and what is happening out there in the environment so that they will get a better perspective and that they will see that the health of humans is connected to all of these things.” At the same, he noted, while vets might be focused on producing healthy animals, at some point, someone is going to eat these animals and those who are going to do so should not die from eating them. “It is important to not only protect the animals from animal disease but also to protect animals from pathogens that will affect humans,” Ben Embarek continued, “It is really about exposing students and including in their curriculum the perspectives that exist in other sectors, and understanding that some of the issues they are trained to solve in the future will depend on the health and actions of other sectors. “So, when they are in these positions later on in life it will be easier to understand what others are doing, why they are doing it and how to change.” This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Maayan Hoffman. ‘Making Pandemics’: Deforestation is Laying Groundwork for Next Global Health Crisis 03/05/2022 Elaine Ruth Fletcher When we think about the critical drivers of disease prevention and control – we need to stop thinking only about medicines, vaccines and diagnostics. In fact some of the most important forms of disease control can be found in forests – which harbor thousands of pathogens, known and unknown in relative isolation from humans and the damage that they could otherwise cause. But humankind is felling forests and wreaking other kinds of damage on ecosystems at an unprecedented rate – laying the groundwork for the next pandemic as we speak endlessly about how to get the world out of the present one. That is the key message of the new film “La Fabrique des pandémies” (Making Pandemics) by the French journalist and documentary filmmaker, Marie Monique Robin. Avant-premiere at Geneva Health Forum French star, Juliette Bionoche, who narrates the film. The film will be aired at a public avant-premiere on Wednesday 4 May at 6 p.m – as part of the Geneva Health Forum. The Forum, which begins on Tuesday, has a climate and environmental health focus this year. The film, born out of reflections during the COVID lockdown, took Robin to eight countries across Africa, Asia and the Americas – from French Guinea to DR Congo, Malaysia and Mexico, as well as upstate New York. The result is the product of the relentless detective work of Robin, a seasoned journalist who also directed “The World According to Monsanto”, a critical look at the pesticide industry. Narrated by the French film star, Juliette Bionoche, the film aims to make the issue more accessible to the general public – despite its highly technical material. So it is Binoche that relates the stories of the deadly viruses, bacteria and parasites that have “escaped” from the wild to become major plagues to human health – as seen through the eyes of the scientists who have documented their destructive pathway. Pig farm in Sarawak, Borneo, Malaysia – a reservoir for Nipah virus. The examples include the story of Malaysia’s deadly, bat-borne Nipah virus which became a threat to humans as bats driven from rainforests destroyed to create palm oil plantations found new homes in agricultural areas, and particularly around pig farms. Infected pigs, close to people both genetically and proximally, then began transmitting the virus to humans. While most of the stories relate to developing countries, developed regions are not immune. Lyme disease, transmitted by ticks in North America, has posed an increasing threat to human health as forests there become fragmented, biodiversity is reduced, and species such as the white-footed mouse proliferate, which are a reservoir for the deadly Borrelia bacterium that causes Lyme disease. COVID lockdown reflections Filming of Making Pandemics. Robin, on right, conducts an interview. The film began with Robin’s own reading and reflections during the COVID lockdown – including an article that she read in the New York Times, which struck a special chord entitled “We made a pandemic.” “I began searching and contacting scientists with whom I have been working for more than 30 years,” she relates. Among them was Serge Morand, a parasitologist living in Thailand – who will also be appearing himself at the Geneva Health Forum, running from 3-5 May. “And he said, oh it would be great if you could put all of us together in a book or a film. “The thing is,” Robin adds, “is that there have been many, many dozens of studies published, showing the link between the destruction of biodiversity, on the one hand, and on the other, the emergence of infectious diseases. “And so Morand told me, ‘if you could put all of us together, it would be very powerful. Because we have been sounding the alarm for so many years, and just nobody is paying attention.” Robin went on to interview some 62 scientists working in various parts of the world – with the stories of 14 condensed into the book, Making Pandemics, published last year, which has now been made into a film. Three drivers of disease Deforestation is a key driver of new infectious diseases – which leap from wild animal species to humans. The interviews all weave together to underline a single message about the ecological factors driving the emergence of new infectious diseases – and the expansion of already well-known diseases. “The first factor is, of course, deforestation in tropical areas,” Robin says of the key drivers. “And then intensive breeding [of animals], and then globalization. “It means growing soybeans in Argentina or Brazil, to feed European cattle. It means cultivating palm trees. It means mining, gold, copper, etc. And also urbanization. All of these factors which contribute to deforestation in tropical areas.” The dilution effect Maintaining biodiversity alongside food production is critical to preventing new pandemics. While there is some growing awareness about how climate change and biodiversity loss is increasing the frequency at which diseases like Ebola, Nipah and others are emerging or expanding, Robin offers fresh insights into why this is the case. Just imagine the forest as a massive universe of bacteria, parasites and viruses, both known and unknown, circulating among the animal species that live there. When forests are deep and expansive, pathogens are more likely to stay within their natural geographic boundaries, Robin explains. And when animal species are diverse and plentiful, then dangerous viruses are largely contained by a set of natural biological checks and balances that keep other species in check too. In a well-balanced ecosystem, when pathogens have lots of different animals to infect – they won’t infect species that can transmit the disease to humans as frequently or as intensively – something that she describes as the “dilution effect”. Animals that are more prone to dangerous infections also cannot become too dominant as a species, and thus pose an even greater risk to humans – because they also are the prey of other animals that keep them in check. Biodiversity protects your health Deer in North America are becoming more infected with ticks carrying Lyme disease But when the forest is cut away or fragmented – and its animals hunted down or otherwise destroyed by humans – then the chances of a pathogen infecting an animal species with a dangerous pathogen that may then carry the same disease to humans increase. Lyme disease is a good example of that principle, she explains. “The dilution effect means that when you have a big community of mammals floating around in the forest, then the probability that a tick will feed on a white-footed mouse, which is a reservoir of the Borrelia bacterium, is diluted. “A tick, which needs a blood meal, may land on an opossum instead of a mouse – and the opossum won’t get infected because he cannot be a host for the bacteria,” says Robin. And meanwhile other predators, like foxes, hunt and eat the mice, also keeping them in check. “But if you fragment the forest as we have seen in the state of New York, then most of the predators, like foxes for instance, leave.” The ticks left with fewer animal choices, feed more on mice – in a vicious cycle. “So the white-footed mouse is proliferating, and becoming more infected by ticks,” says Robin. More infected ticks also land on deer, who are hunted by humans. “And scientists have shown that the probability of [humans] also getting infected in a fragmented forest is five times higher; this is the dilution effect,” she says. “The dilution effect shows that biodiversity protects your health because when you have a lot of biodiversity, the chances of anyone [human] getting infected are reduced.” Click here to reserve a free ticket to the film., See the complete programme for GHF 2022 here – and register for the full event Tuesday-Thursday or daily, in person or remotely. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Thomas Quine/Flickr , nosha/Flickr. Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
‘Making Pandemics’: Deforestation is Laying Groundwork for Next Global Health Crisis 03/05/2022 Elaine Ruth Fletcher When we think about the critical drivers of disease prevention and control – we need to stop thinking only about medicines, vaccines and diagnostics. In fact some of the most important forms of disease control can be found in forests – which harbor thousands of pathogens, known and unknown in relative isolation from humans and the damage that they could otherwise cause. But humankind is felling forests and wreaking other kinds of damage on ecosystems at an unprecedented rate – laying the groundwork for the next pandemic as we speak endlessly about how to get the world out of the present one. That is the key message of the new film “La Fabrique des pandémies” (Making Pandemics) by the French journalist and documentary filmmaker, Marie Monique Robin. Avant-premiere at Geneva Health Forum French star, Juliette Bionoche, who narrates the film. The film will be aired at a public avant-premiere on Wednesday 4 May at 6 p.m – as part of the Geneva Health Forum. The Forum, which begins on Tuesday, has a climate and environmental health focus this year. The film, born out of reflections during the COVID lockdown, took Robin to eight countries across Africa, Asia and the Americas – from French Guinea to DR Congo, Malaysia and Mexico, as well as upstate New York. The result is the product of the relentless detective work of Robin, a seasoned journalist who also directed “The World According to Monsanto”, a critical look at the pesticide industry. Narrated by the French film star, Juliette Bionoche, the film aims to make the issue more accessible to the general public – despite its highly technical material. So it is Binoche that relates the stories of the deadly viruses, bacteria and parasites that have “escaped” from the wild to become major plagues to human health – as seen through the eyes of the scientists who have documented their destructive pathway. Pig farm in Sarawak, Borneo, Malaysia – a reservoir for Nipah virus. The examples include the story of Malaysia’s deadly, bat-borne Nipah virus which became a threat to humans as bats driven from rainforests destroyed to create palm oil plantations found new homes in agricultural areas, and particularly around pig farms. Infected pigs, close to people both genetically and proximally, then began transmitting the virus to humans. While most of the stories relate to developing countries, developed regions are not immune. Lyme disease, transmitted by ticks in North America, has posed an increasing threat to human health as forests there become fragmented, biodiversity is reduced, and species such as the white-footed mouse proliferate, which are a reservoir for the deadly Borrelia bacterium that causes Lyme disease. COVID lockdown reflections Filming of Making Pandemics. Robin, on right, conducts an interview. The film began with Robin’s own reading and reflections during the COVID lockdown – including an article that she read in the New York Times, which struck a special chord entitled “We made a pandemic.” “I began searching and contacting scientists with whom I have been working for more than 30 years,” she relates. Among them was Serge Morand, a parasitologist living in Thailand – who will also be appearing himself at the Geneva Health Forum, running from 3-5 May. “And he said, oh it would be great if you could put all of us together in a book or a film. “The thing is,” Robin adds, “is that there have been many, many dozens of studies published, showing the link between the destruction of biodiversity, on the one hand, and on the other, the emergence of infectious diseases. “And so Morand told me, ‘if you could put all of us together, it would be very powerful. Because we have been sounding the alarm for so many years, and just nobody is paying attention.” Robin went on to interview some 62 scientists working in various parts of the world – with the stories of 14 condensed into the book, Making Pandemics, published last year, which has now been made into a film. Three drivers of disease Deforestation is a key driver of new infectious diseases – which leap from wild animal species to humans. The interviews all weave together to underline a single message about the ecological factors driving the emergence of new infectious diseases – and the expansion of already well-known diseases. “The first factor is, of course, deforestation in tropical areas,” Robin says of the key drivers. “And then intensive breeding [of animals], and then globalization. “It means growing soybeans in Argentina or Brazil, to feed European cattle. It means cultivating palm trees. It means mining, gold, copper, etc. And also urbanization. All of these factors which contribute to deforestation in tropical areas.” The dilution effect Maintaining biodiversity alongside food production is critical to preventing new pandemics. While there is some growing awareness about how climate change and biodiversity loss is increasing the frequency at which diseases like Ebola, Nipah and others are emerging or expanding, Robin offers fresh insights into why this is the case. Just imagine the forest as a massive universe of bacteria, parasites and viruses, both known and unknown, circulating among the animal species that live there. When forests are deep and expansive, pathogens are more likely to stay within their natural geographic boundaries, Robin explains. And when animal species are diverse and plentiful, then dangerous viruses are largely contained by a set of natural biological checks and balances that keep other species in check too. In a well-balanced ecosystem, when pathogens have lots of different animals to infect – they won’t infect species that can transmit the disease to humans as frequently or as intensively – something that she describes as the “dilution effect”. Animals that are more prone to dangerous infections also cannot become too dominant as a species, and thus pose an even greater risk to humans – because they also are the prey of other animals that keep them in check. Biodiversity protects your health Deer in North America are becoming more infected with ticks carrying Lyme disease But when the forest is cut away or fragmented – and its animals hunted down or otherwise destroyed by humans – then the chances of a pathogen infecting an animal species with a dangerous pathogen that may then carry the same disease to humans increase. Lyme disease is a good example of that principle, she explains. “The dilution effect means that when you have a big community of mammals floating around in the forest, then the probability that a tick will feed on a white-footed mouse, which is a reservoir of the Borrelia bacterium, is diluted. “A tick, which needs a blood meal, may land on an opossum instead of a mouse – and the opossum won’t get infected because he cannot be a host for the bacteria,” says Robin. And meanwhile other predators, like foxes, hunt and eat the mice, also keeping them in check. “But if you fragment the forest as we have seen in the state of New York, then most of the predators, like foxes for instance, leave.” The ticks left with fewer animal choices, feed more on mice – in a vicious cycle. “So the white-footed mouse is proliferating, and becoming more infected by ticks,” says Robin. More infected ticks also land on deer, who are hunted by humans. “And scientists have shown that the probability of [humans] also getting infected in a fragmented forest is five times higher; this is the dilution effect,” she says. “The dilution effect shows that biodiversity protects your health because when you have a lot of biodiversity, the chances of anyone [human] getting infected are reduced.” Click here to reserve a free ticket to the film., See the complete programme for GHF 2022 here – and register for the full event Tuesday-Thursday or daily, in person or remotely. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite This is part of a Health Policy Watch series of stories on feature themes at the 2022 Geneva Health Forum. Supported by a grant from the Canton of Geneva. Image Credits: Thomas Quine/Flickr , nosha/Flickr. Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
Digital Marketing Now Dominates Advertising of Breast-Milk Substitutes – Undermining Breast Feeding 02/05/2022 Raisa Santos Breast-feeding is key to improving health outcomes in mothers, babies, and communities Digital ads for breast-milk substitutes are now one of the most popular and effective marketing strategies – negatively impacting breastfeeding practices, according to a new report published Friday by the World Health Organization. The report, ‘Scope and impact of digital marketing strategies for promoting breastmilk substitutes’, found that digital marketing of infant formulas has increased sales in every country studied. It is thus fueling the steady growth of the breast milk industry, now valued at $52 billion – and increasingly threatening healthy breastfeeding in the early months of life. In some countries reviewed, more than 80% of women who reported seeing breast-milk substitutes (BMS) advertisements were now seeing the content online. This demonstrates the power of digital technologies, as they offer advertisers new marketing tools that are powerfully persuasive, extremely cost effective and often not easily recognizable as BMS promotions. Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems “We have a huge threat on breastfeeding. Digital marketing is really going to make things difficult for us on breastfeeding, and therefore is a huge challenge to the health of mothers and the health of babies,” said Lawrence Grummer-Strawn, WHO Unit Head of Food and Nutrition Action in Health Systems, during a launch of the report. “The reach of digital marketing is so great that, in many countries, it is inescapable… It is therefore not surprising that digital marketing has become the dominant form of BMS promotion,” reads the report. Ample evidence shows that exclusive and continued breastfeeding in the first months of life are key to health for children, women and communities. But far too few children are breastfed as recommended. And despite the World Health Assembly’s adoption of the International code of marketing of breast-milk substitutes (“the Code”) in 1981 – digital advertising is increasingly undermining the will of women to breast feed. The report includes findings from several studies including: a multi-country study of mothers’ and health professionals’ experience with digital marketing; individual country reports of BMS promotions; and an analysis of legal measures that have been taken to implement the Code to date. Studies captured digital interactions that referenced infant feeding in 11 languages that originated from 17 countries, which together account for 61% of the global population and span all six WHO regions. The report further confirms findings aired at the World Health Assembly in 2020, that breast mild substitutes were making new inroads into households in the global South, including through new and more effective modes of digital marketing. Breast-milk substitute sales boosted through online social media TV and the internet (social media) plays a huge role in BMS marketing across those included in the multi-country study In one of the reviews, women in seven countries – Bangladesh, China, Mexico, Morocco, United Kingdom, and Vietnam, who recorded BMS promotions in marketing diaries over a single week reported seeing advertisements for formula on social media and e-commerce sites. In Indonesia and Vietnam, the most frequently identified sources of advertising for BMS products were the Internet and Facebook. In Thailand, Facebook was the most commonly reported source of BMS marketing, with most of these advertisements (58%) originating from company/brand websites, followed by the companies’ Facebook accounts. Exploiting women’s most vulnerable moments to sell formula Seven of eight countries reported seeing increasing amounts of BMS promotions after one week of recording in phone diaries The Facebook promotions include targeted advertising about infant formulas, follow-on formula and toddler formula, virtual support groups known as baby clubs hosted by BMS brands, BMS branded apps and social media influencers promoting BMS products. “The precision with which digital marketing platforms can identify users by their characteristics, their traits, their spending patterns, and their likeness to other users is quite uncanny,” remarked Nina Chad, an expert in WHO’s Department of Nutrition and Food Safety. “When women share information about pregnancy with family and friends online or purchase maternity clothing, search for a health provider, or join an online support group, they’re often identified as targets for advertising for baby related products and brands, including BMS.” “This technology enables advertisers to exploit their most vulnerable moments, disguise their marketing content as information or advice and enlist people women respect most to influence their infant feeding choices,” the report adds. Only one in five countries prohibits online marketing of infant formulas BMS promotion through influencers, who cannot be regulated by the Code, as they are not directly employed by the BMS manufacturers/distributors. Digital marketing techniques described in the report present challenges for regulation with fewer than one in five countries (19%) explicitly prohibiting the promotion of BMS. These technologies enable advertisers to evade scrutiny from enforcement agencies by delivering BMS promotions to personal accounts without ever publishing them publicly. However, it is difficult to hold manufacturers and distributors of the products accountable as their promotions are generated by virtual support groups that consist of the general public and mothers, as well as social media influencers, who are not directly employed or contracted by these companies. Additionally, product promotions more frequently target the mothers of infants 6-12 months old, as compared to newborns. This practice, known as line extension or cross promotion, is used to circumvent regulation that prohibits the promotion of infant formula products suitable for infants up to 6 or 12 months of age. The report advises new approaches to implementing the Code and potentially even new and updated strategies to monitor and enforce its regulations in order to protect both mother and infants from the harms of digital marketing. “We need to have greater regulation of the platforms themselves. We can’t put all of this on the shoulders of those who want to be advertising. It’s also among those who are actually carrying out the advertising who are making this targeting possible and who are hiding the information that is needed for monitoring and enforcement,” said Grummer-Strawn. Image Credits: Flickr, WHO. People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy Loading Comments... You must be logged in to post a comment.
People with Severe Psychiatric Disorders are Twice as Likely to Die from COVID 02/05/2022 Maayan Hoffman Individuals who suffer from severe psychiatric disorders were at least twice as likely to die from COVID-19 than others who caught the virus, at least in the first year of the pandemic when the most deadly SARS-COV2 variants, including Delta, were predominant. That is the key finding in a new study published in Molecular Psychiatry, which is also the largest on COVID and psychiatry to date. The research team, led by Prof. Mark Weiser, director of the Psychiatric rehabilitation centre at Israel’s Sheba Hospital, examined anonymized medical records of all 125,273 Israelis over the age of 18 who had been hospitalized for psychiatric illness at any time in their lives. This included people diagnosed with schizophrenia, bipolar, post-traumatic stress or obsessive-compulsive disorder, among others. Prof. Mark Weiser, director of Sheba Medical Center’s Psychiatric Division The study reported on rates of testing, infection, hospitalization, mortality and vaccination between March 1, 2020 and March 31, 2021 – the first year of the pandemic. Patients who tested positive for COVID were twice as likely to be hospitalized and twice as likely to die from the virus. They were also 20% less likely than the general population to have been tested for COVID-19 and 25% less likely to have been vaccinated. The length of time for which people had been hospitalised for past psychiatric episodes, prior to becoming ill with COVID, had no impact on the outcome. “People get better or worse over time,” Weiser told Health Policy Watch. “Most people have a chronic illness and ongoing disability.” Additionally, he said that many severe psychiatric patients neglect their health, are more likely to smoke, be overweight or have diabetes, which would make them more prone to developing severe COVID. “People with severe mental illness are less likely to work, be active socially, less likely to be up and about and hence less likely to come in and get tested,” Weiser continued. Regarding vaccination, he said that “people have less initiative … and some might have cognitive impairment and therefore a lesser understanding of the importance of vaccination. Others might have vaccine hesitancy and be more likely to believe in conspiracy theories.” International challenge Although the study was conducted in Israel, Weiser stressed that tacking diseases among people with chronic and severe psychiatric disorders is an international challenge. Worldwide, around 2% to 3% of the population suffers from schizophrenia or bipolar disorder – which translates into over 150 million people worldwide. “The numbers are huge, and we are not only talking about schizophrenia and bipolar,” Weiser added. “When you add in severe PTSD, OCD and other personality disorders, you come to a prevalence of about 4% to 5% of the population if not higher. This is not something rare and unimportant.” This latest study is the only one that looks at people treated within an entire national health system. But it is also not the only study looking at the correlation between COVID and psychiatry to date. A series of studies done by New York University, for example, looked specifically at schizophrenia patients within the New York University health system and came up with similar results – that these patients were more likely to be hospitalized and die from COVID. One of the studies led by Prof. Donald Goff of the NYU School of Medicine retrospectively looked at 464 adult patients within the New York University Langone Health electronic health record system, who had a pre-existing diagnosis of schizophrenia, schizo-affective or bipolar disorder to see if antipsychotic treatment was associated with COVID mortality. The 60-day case fatality rate among patients with a schizophrenia spectrum disorder was 13.7% and the case fatality rate among patients with bipolar disorder was 5.7%, meaning a diagnosis of a schizophrenia spectrum disorder was associated with a nearly three-fold increased risk of mortality, as compared with bipolar disorder. And both mortality rates were far higher than in the general population. \ Moreover, being under medication did not seem to help. Of the 196 patients who were under treatment with antipsychotic medication and caught the virus, 41 patients (8.8%) died, not a significantly higher number than among those who were not treated with the medication. “A growing body of evidence has suggested that people with schizophrenia spectrum disorders may have an increased risk of fatal illness after COVID-19 infection, but the mechanism is not clear,” the authors wrote. That study was published by JAMA Psychiatry. Weiser stressed that his study is focused on people with severe psychiatric illnesses and not individuals with milder forms of mental disabilities, such as depression or anxiety, which are even more common among the population – but also may be less closely associated with COVID mortality. Time to act Weiser said that communities need to see how to better reach out to people with mental health challenges, and encourage them to get vaccinated, since they may not choose to come on their own. He also noted that people with schizophrenia who get COVID should be closely watched for medical complications. “The bottom line is that all over the world doctors are talking about people who have diabetes or cancer being at higher risk [for COVID death],” Weiser said. “These data call for public health measures.” Image Credits: PIX4FREE, Courtesy. Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts This site uses cookies to help give you the best experience on our website. Cookies enable us to collect information that helps us personalise your experience and improve the functionality and performance of our site. By continuing to read our website, we assume you agree to this, otherwise you can adjust your browser settings. Please read our cookie and Privacy Policy. Our Cookies and Privacy Policy
Reducing Newborn Deaths in Uganda and Beyond Through Real-Time Temperature Monitoring 29/04/2022 Paul Adepoju Registered nurses look after newborns at the Princess Christian Maternity Hospital, in Freetown Sierra Leone Geneva Health Forum’s Global Health Lab 3-5 May will showcase over 100 new diagnostics and treatment tools designed for resource-constrained settings. The Autothermo device for continuous, real-time temperature monitoring is one of the innovations being featured there. Early detection of patients’ temperature changes, especially in the case of newborns who lack adequate temperature control, can be lifesaving in almost any setting. This is especially the case for infants and newborns in hot climates, where conditions like hyperthermia, informally known as “evening fever syndrome” EFS can be life-threatening, particularly for premature babies in hospital and health clinic nurseries where cooling systems are inadequate and air conditioning frequently fails. In addition, being able to leverage technology to monitor a child’s temperature in real time can also be important in many other contexts of childhood illness. Autothermo Central Processing Unit and display screen Autothermo bracelet And this is what the new device Autothermo aims to achieve. Autothermo is a wearable continuous temperature measuring bracelet with a remote display. It includes an alarm system and SMS capability for remote caretaker notification. It is among more than 100 innovations on display at the Global Health Lab innovation exhibit next week. The exhibition is part of the Geneva Health Forum 3-5 May, which brings hundreds of global health policymakers and practitioners together from around the world. The Global Health Lab will be showcasing dozens of low-cost, digital, and hand-held tools that aim to make common diagnostic procedures and treatments more accessible, especially for resource-constrained countries. Simple needs often overlooked in access to healthcare debates Autothermo team leader Nura Izath When the poor state of healthcare in some African regions is discussed, it is often in the context of the lack of easy access to advanced automations and complex lifesaving procedures. While these concerns are valid, they often occlude, or minimize, the importance of certain basic-yet-essential indices such as body temperature. In human physiology, temperature is regarded as an index of illness because every metabolic reaction in the human body occurs at a certain temperature level. This makes it an age-old, but oft-forgotten index of disease and body states. However, a wide range of factors make adequate monitoring of this simple and basic metric challenging resource-constrained settings – including newborn nurseries. And this is what Autothermo is trying to address, the project’s team leader, Nura Izath, told Health Policy Watch. “First of all, we have very few health workers, including pediatricians, versus the large number of newborns they have to manage at a time. It becomes hard for them to identify which newborns are in urgent need of thermocare interventions,” said Izath, a science and tech developer based in Mbarara, a city in south-central Uganda, who is the front-end developer and co-founder of the Autothermo innovation. Managing 40 newborns at a time Autothermo’s innovation can be used to manage babies at risk. At the Mbarara Regional Referral Hospital, for instance, there is only one nurse per shift, managing over 40 newborns in the hospital nursery at a time, notes Izath, who holds a degree from the Mbarara University of Science and Technology. Many of the newborns are premature or have other sensitive conditions, in which slight and subtle changes in temperature could signal the difference between life or death. “It’s so hard that by the time this nurse knows there is a baby in need of thermocare, it’s very late. In such scenarios we have lost lives. These are things that can be prevented by using interventions such as Autothermo.” She says that the innovation should change the narrative regarding temperature management for newborns – insofar as health workers can remotely monitor babies at risk, and will also be able to prioritize thermocare interventions through the alerts they receive about newborns in need of the intervention. “It will help them to manage the daily routines and will also save many lives,” she added. Innovation emerged out of personal experience watching a young infant Izath’s innovation emerged out of a personal experience minding newborn at home. “In 2014, I was tasked to babysit my one-day old nephew as his mother had to go for an exam,” she relates. “I was excited and at the same time understood the importance of this task. At the beginning, I held the baby until he slept, then kept checking on an almost 10 minute interval while I was doing other house chores. “To be honest, the back and forth was a bit tiresome. That’s when I thought of innovating something that could monitor and inform the parent or caregiver the status of their newborns in case of emergency and also support health workers in hospitals during admissions.” She shared the idea with a local clinician and pediatrician, Dr. Gloria Karirirwe – who quickly recognized the need such a device could fill in light of the challenges she had faced in her own practice, managing newborns with temperature-related challenges. They shared the idea further. Together with a group of six other professionals, they took the concept to Dr. Data Santorino, director of the Consortium for Affordable Medical Technologies, an innovation hub based at Mbarara University of Science and Technology, where Izath earned her degree. “Dr. Data, together with his team, took us through concept development, proposal writing and the initial prototype development. Both the proposal and the initial prototype were helpful in aiding Autothermo to acquire its seed grant from the Ugandan Ministry of ICT and National Guidance. This fund was used to develop the minimum viable product that we currently have for studies.” Also practical for outpatient clinics – where fever is one of main motives for seeking healthcare Other diagnostics and treatment tools, including Autothermo for newborns, will be found at Geneva Health Forum’s Global Health Lab 3-5 May A fever also is one of the most common reasons for which parents will bring their toddlers and young children to a local health clinic or hospital, Izath adds. In fact, some 60% of children presenting to most medical emergency departments in Uganda have a raised temperature, she notes. Unfortunately, many arrive too late — after complications have already set in — leading to febrile seizures and worsening of the underlying illnesses. High fever among under-fives can also result in heat stroke, often leaving affected children paralyzed and, sometimes, death. Another selling point for Autothermo is that caregivers can easily interpret the temperature fluctuation situations and respond accordingly – based on the color-coded bars that it reports. And at a production cost of just $18 – it is a device that could be made widely available at simple health posts as well as hospitals. However, the Uganda-designed prototype still faces a long road ahead to obtain regulatory approval from the Ugandan National Council for Science and Technology. “The health workers want to start using it but they cannot use it yet because we need approval,” Izath said. “We are now seeking approval from the Mbarara University Of Science and Technology Ethics committee. After that, we will be moving to the Council. All these are the bodies that need to authorize the use of the Autothermo.” Izath will be attending the Geneva Health Forum, which will give her an opportunity to learn from other innovators in attendance, as well as seek out partnership and fund-raising opportunities. “We hope to see partnerships that can help us pilot studies in different facility settings. We also believe that the problem we are trying to solve is not only in Uganda, it’s a global challenge. We are not doing a solution only for Uganda. We would like to reach out to many stakeholders and see how we can make this come to light,” she concluded. See the complete GHF 2022 programme. Register here: Until 2 May fees are CHF 400 for the entire event and CHF 150 for participants from low- and middle-income countries (OECD classification). Daily rates are also available. Check out Health Policy Watch’s ongoing coverage of other themes featured at this year’s Forum on our GHF 2022 microsite Image Credits: World Bank/Flickr, Unicef, Geneva Health Forum . Posts navigation Older postsNewer posts