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Nature. 2005 Jan 13; 433(7022):91.For Mrs Luat, the H5N1 avian flu virus could bring economic ruin. Three years ago, she and her husband borrowed US$12,500 to establish a small chicken farm in Hay Tay province, near the Vietnamese capital Hanoi. They raise 6,000 chickens at a time in their single shed, selling the entire stock every couple of months to a Thai company that distributes the meat within Vietnam. But last year, their shed lay empty for six months after H5N1 flu hit neighbouring farms. Mrs Luat estimates the couple's losses at $1,500. If it happens again, they maybe unable to service their debts. While smallholders such as the Luats face the most immediate threat, the continuing presence of the H5N1 virus in Vietnam and neighbouring countries could spell a global disaster, in both economic and humanitarian terms. H5N1 is deadly to both chickens and people, but thankfully isn't easily transmitted from person to person. But if it exchanges genes with a mammalian flu virus, H5N1 could become a mass killer that would rapidly sweep the globe. If that happens, tens of millions of people could perish. Since H5N1 starting spreading through Asian poultry flocks in 2003, the World Health Organization (WHO) has been sounding the pandemic alarm. Two main actions are required. First, surveillance for human and animal flu viruses in affected countries needs to be stepped up, to provide an early warning of the emergence of a possible pandemic strain. Second, nations around the world must develop plans to protect their populations should this occur. This will require stringent quarantine procedures, plus the rapid deployment of vaccines and antiviral drugs. (excerpt)
Lancet. 2003 Dec 20-27; 362(9401):2071.Following a 2-year drought, Ethiopia—a country already battling malnutrition and food shortages—is now facing a severe malaria epidemic. WHO is forecasting that up to 15 million of the 65 million population could be affected—three times the normal caseload. The worst-hit regions are in Amhara, Tigray, and the southern nations; Somalia is also affected. (excerpt)
Epidemic of sexually transmitted diseases in Eastern Europe. Report of a WHO meeting, Copenhagen, Denmark, 13-15 May 1996.
Copenhagen, Denmark, WHO, Regional Office for Europe, 1996. , 14 p. (EUR/ICP/CMDS 08 01 01)In response to the alarming rise in sexually transmitted diseases (STDs) in the newly independent states, the WHO Regional Office for Europe, WHO headquarters and the Joint United Nations Programme on AIDS organized a meeting of experts from the most affected countries to exchange information and to identify priority actions for the control of the epidemic. The participants included 15 experts from Belarus, Kazakhstan, Latvia, the Republic of Moldova, the Russian Federation and Ukraine. The participants called for urgent action, including a careful assessment of the existing systems for STD control, reallocation of resources among the various activity areas and strong advocacy to generate awareness at the top level of government and strengthen its support for the recommended initiatives. They also urged that national coordination of programmes to promote sexual health and prevent STDs and HIV be strengthened, that statutory services be made more accessible and acceptable to patients and that efforts be made to ensure that all health workers managing patients with STDs, including those in the private sector, provide high-quality care. (author's)
New York, New York, Global Alliance for TB Drug Development, 2002. 2 p.A Lethal Synergy: While HIV/AIDS has exploded over the last decade, TB has increased 20% rise and today TB kills one out of three AIDS patient worldwide. The two diseases represent a deadly combination, since both are more destructive together than either is alone. HIV infection is the most potent risk factor for converting latent TB into active transmissible TB - accelerating the spread of the disease - while TB bacteria help accelerate the progress of the AIDS infection in the patient. Today TB is the leading cause of death in persons who are HIV positive. (excerpt)
Unintended consequences: drug policies fuel the HIV epidemic in Russia and Ukraine. A policy report prepared for the UN Commission on Narcotic Drugs and national governments.
New York, New York, Open Society Institute, International Harm Reduction Development program, 2003. 16 p.Taking action now to reduce HIV transmission rates and treat those already infected is critical. With the goal of avoiding adverse effects on social welfare and public health, the Russian and Ukrainian governments should reconsider how they interpret international treaties. Policy changes should be made in the following areas: Harm reduction. The governments should play an active role in establishing and supporting a large, strategically located network of harm reduction programs that provide services for IDUs, including needle exchange, HIV transmission education, condom distribution, and access to viable treatment programs such as methadone substitution. Similar services should be available in all prisons. Education. Simple, direct, and dear information about HIV transmission should be made available to all citizens-especially those most at risk. Similarly, society at large should be educated about the realities of drug use and addiction as part of an effort to reduce stigma. Discrimination and law enforcement abuse. Public health and law enforcement authorities should take the lead in eliminating discrimination, official and de facto, toward people with HIV and marginalized risk groups such as drug users. Authorities must no longer condone or ignore harassing and abusive behavior, including physical attacks, arrest quotas, arbitrary searches, detainment without charges, and other violations of due process. HIV-positive people, including IDUs, should be included in all policy discussions related to them in the public health and legal spheres. Legislation. Laws that violate the human rights of people with HIV and at-risk groups should be repealed or restructured to better reflect public health concerns. Moving forward with the above strategies may make it appear that the governments are backing away from the goals and guidelines of the UN drug conventions. They may be criti- cized severely by those who are unable or unwilling to understand that meeting the goals of the conventions, some of which were promulgated more than 40 years ago, is far too great a price to bear for countries in the midst of drug use and HIV epidemics. Governments ultimately have no choice, though, if they hope to maintain any semblance of moral legitimacy among their own people. (excerpt)
1999 World TB Day: WHO TB report shows global response to epidemic inadequate. WHO Director-General calls for political commitment to Stop TB. "We must act now or multi-drug resistant TB will thrive," warns Dr. Gro Harlem Brundtland. Press release.
Geneva, Switzerland, WHO, 1999 Mar 23. 3 p. (Press Release WHO/16)Annually, there are 8 million new cases of tuberculosis (TB) and multi-drug resistant TB is on the rise. According to the 1999 WHO Global TB Report, the spread of TB and the emergence of multi-drug resistance can be stopped through the WHO recommended Direct Observation Treatment, Short-course. But still, only 16% of the world's infectious TB sufferers receive the TB treatment recommended by WHO. In this regard, WHO has launched the Stop TB Initiative in partnership with the World Bank, the Centers for Disease Control and Prevention and a coalition of nongovernmental organizations working to stop the spread of TB. The Initiative aims to accelerate TB control by expanding the global coalition of partners beyond the health sector; place TB higher on international political and health agendas; and significantly increase investment in TB control. The WHO Director-General Dr. Gro Harlem Brundtland, calls for political commitment to stop TB before multi-drug resistant TB will thrive.
BMJ (CLINICAL RESEARCH ED.). 1998 Jul 4; 317(7150):11.While most industrialized nations and a handful of developing countries are seeing the spread of HIV infection level off or even decline, infection rates are reaching alarming new highs in much of the developing world, according to the first country by country analysis by the joint United Nations Programme on HIV/AIDS (UNAIDS). Along with the widening gap in infection rates, the report also reveals a looming divide between countries where rates of new AIDS cases and deaths from AIDS are falling and countries where they are rising as people infected with the disease succumb in greater numbers than before. The major reason is uneven access to newer antiretroviral drugs, which forestall the development of AIDS. Among the report's most striking findings was new information concerning 13 countries in sub-Saharan Africa, where at least 10% of all adults are infected with HIV, with the prevalence in many capital cities 35% or more. Botswana and Zimbabwe have each reached a prevalence of 25%, a new world high. (full text)
Washington, D.C., National Academy Press, 1988. x, 239 p.The Committee for the Oversight of AIDS Activities presents an update to and review of the progress made since the publication 1 1/2 years ago of Confronting Aids. Chapter 1 discusses the special nature of AIDS (Acquired Immunodeficiency Syndrome) as an incurable fatal infection, striking mainly young adults (particularly homosexuals and intravenous drug users), and clustering in geographic areas, e.g., New York and San Francisco. Chapter 2 states conclusively that HIV (Human Immunodeficiency Virus) causes AIDS and that HIV infection leads inevitably to AIDS, that sexual contact and contaminated needles are the main vehicles of transmission, and that the future composition of AIDS patients (62,000 in the US) will be among poor, urban minorities. Chapter 3 discusses the utility of mathematical models in predicting the future course of the epidemic. Chapter 4 discusses the negative impact of discrimination, the importance of education (especially of intravenous drug users), and the need for improved diagnostic tests. It maintains that screening should generally be confidential and voluntary, and mandatory only in the case of blood, tissue, and organ donors. It also suggests that sterile needles be made available to drug addicts. Chapter 5 stresses the special care needs of drug users, children, and the neurologically impaired; discusses the needs and responsibilities of health care providers; and suggests ways of distributing the financial burden of AIDS among private and government facilities. Chapter 6 discusses the nomenclature and reproductive strategy of the virus and the needs for basic research, facilities and funding to develop new drugs and possibly vaccines. Chapter 7 discusses the global nature of the epidemic, the responsibilities of the World Health Organization (WHO) Global Program on AIDS, the need for the US to pay for its share of the WHO program, and the special responsibility that the US should assume in view of its resources in scientific personnel and facilities. Chapter 8 recommends the establishment of a national commission on AIDS with advisory responsibility for all aspects of AIDS. There are 4 appendices: Appendix A summarizes the 1986 publication Confronting Aids; Appendix B reprints the Centers for Disease Control (CDC) classification scheme for HIV infections; Appendix C is a list of the 60 correspondents who prepared papers for the AIDS Activities Oversight Committee; and Appendix D gives biographical sketches of the Committee members.