WMA calls for health system funding to combat climate change

The World Medical Association has issued a call for national governments to provide designated funds for the strengthening of health systems to combat climate change.

In a policy statement adopted at its annual Assembly in Chicago, the WMA emphasises the urgency for taking action and for emergency planning on local, national and international levels.

WMA President Dr Yoshitake Yokokura said: “It is important that the voice of the world’s physicians be heard about the risks posed to health by climate change.”

The WMA says that human influence on the climate system is clear, with recent emissions of green-house gases the highest in history. Evidence shows numerous health risks from climate change which threaten all countries. These include more frequent and potentially more severe heatwaves, droughts, floods, storms and bushfires.

Climate change, especially warming, is already leading to changes in the environment in which disease paths flourish. There is reduced availability and quality of potable water, and worsening food insecurity leading to malnutrition and population displacement. And although climate change is universal, its effects are uneven, with many of the areas most affected the least able to manage the challenges it poses. Those with generally the poorest health and lowest life and health expectancy will be least able to adapt to the adverse effects of climate.

Dr Yokokura said: “We are also urging national governments to provide for the health and wellbeing of people displaced by environmental causes, including those becoming refugees because of the consequences of climate change.”


Dementia Discovery Fund attracts $50 million investment from Bill Gates

The Dementia Discovery Fund (DDF) in November announced a $50 million investment from Bill Gates. The investment is Gates’ first to accelerate progress toward disease-modifying therapies for Alzheimer’s disease. The DDF, managed by SV Health, is a unique venture fund focused entirely on discovering and developing novel therapies for dementia and was formed through the collaboration of leading pharmaceutical companies, the UK Department of Health and the charity Alzheimer’s Research UK (ARUK).

Commenting on the investment, Bill Gates said: “I believe we are at a turning point in Alzheimer’s research and development, which the Dementia Discovery Fund is playing an important role in by exploring new approaches to treat the disease. This is a frontier where we can dramatically improve human life. It’s a miracle that people are living so much longer, but longer life expectancies alone are not enough. People should be able to enjoy their later years – and we need a breakthrough in Alzheimer’s to fulfil that. I’m excited to join the fight and can’t wait to see what happens next.

Since its launch in October 2015, the DDF has made significant progress building an initial portfolio of 12 investments in drug discovery companies and projects predominantly in the UK and US in areas including microglial biology and inflammation, mitochondrial dynamics, trafficking and membrane biology and synaptic physiology and function. The DDF team believes there is a significant opportunity to develop dementia drugs targeting biological pathways beyond the prevailing amyloid beta hypothesis and to apply insights from areas such as oncology and immunology to develop novel drugs targeting these other biological pathways that may drive different forms of dementia.

The DDF is uniquely positioned to benefit from the expertise of its world-class Scientific Advisory Board (SAB) which includes heads of Neuroscience and/or R&D from seven major pharma companies (Biogen, Eli Lilly and Company, GSK, Johnson & Johnson, Otsuka (Astex), Pfizer and Takeda) and ARUK, who collectively have a large network and experience in neuroscience drug discovery. The SAB provides ongoing advice and knowledge, offers insights on different approaches and historical failures, suggests priority areas to explore new approaches to treat dementia worldwide monitor and advises on strategies to drugging these new pathways.

Doug Giordano, Senior Vice President, Worldwide Business Development, Pfizer, said: “Dementia, including Alzheimer’s disease, is one of the greatest healthcare challenges facing the world today. Forty-seven million people were living with dementia in 2015 and this is projected to nearly double every 20 years. The work that the DDF is doing has enormous potential to produce treatments that could arrest the course of dementia and we look forward to continuing to support these efforts.”

Patrick Vallance, President, R&D, GSK, said: “Dementia is one of the biggest challenges of global healthcare today and it’s a challenge that isn’t going to be solved by working in silos. To address the growing burden of dementia, we must collaborate and invest in the early science to really enhance our understanding of the disease and its complex biology, and then apply this knowledge in a way that is targeted towards making treatments. As a founding investor in DDF, we wanted to be part of a fund dedicated to rooting out the new, exciting, different ideas outside of the mainstream, with the focus needed to tackle dementia in the right way.”

Hilary Evans, Chief Executive, Alzheimer’s Research UK, said: “The gravity of the impact of dementia increases every day and the millions affected worldwide desperately need effective treatment options. We’re seeing a step change in global ambitions around tackling dementia, both in understanding the diseases behind the condition and translating the most innovative ideas towards new therapies. I believe that the DDF offers an ideal approach for accelerating the search for new treatments, investing in nimble and innovative drug discovery work in small, focused projects and companies, which have the advantage of being cost and time effective.”

Interim results of global survey show people with Type 2 diabetes underestimate cardiovascular risk

The International Diabetes Federation (IDF) recently presented the interim re-sults of the first ever multi-country online survey on CVD risk awareness and knowledge among people living with type 2 diabetes, indicating low levels of awareness and limited dialogue between patients and healthcare professionals. The global survey - Taking Diabetes to Heart - developed in partnership with Novo Nordisk, runs until March 2018 and is open to all people with type 2 diabetes.

Diabetes currently affects 425 million adults worldwide, with most cases being type 2 diabetes. Cardiovascular disease, which includes stroke, coronary heart disease and peripheral artery disease, is the leading cause of disability and death in people with type 2 diabetes.

As of 6 December, 943 responses to the survey have been received from 32 countries and interim findings show that:

  • 1 in 3 respondents living with type 2 diabetes consider their risk of CVD to be low
  • 26% of respondents had either never learned about CVD or received information on CVD several years following their type 2 diabetes diagnosis
  • 1 in 6 respondents had never discussed their type 2 diabetes and CVD risk with a healthcare professional

“The interim results of Taking Diabetes to Heart reiterate the importance of raising awareness of the association between type 2 diabetes and cardiovascular disease to promote prevention, timely diagnosis and appropriate treatment to help reduce the current burden that the two conditions represent,” said Dr Shaukat Sadikot, outgoing IDF President. “With the world facing an increase in the prevalence of type 2 diabetes, better understanding the link between these conditions is needed more than ever.”


World Hepatitis Alliance calls for better screening of expectant mothers and treatment of children

New data presented at this year’s World Hepatitis Summit in Sao Paulo, Brazil in November show that 52 million children are living with viral hepatitis worldwide, compared to 2.1 million children living with HIV/AIDS.

An estimated 325 million people were living with viral hepatitis worldwide in 2016. Of these, 4 million were children living with hepatitis C (under 19 years) and 48 million (under 18 years) were children living with hepatitis B. Both viruses can lead to liver disease, liver cancer and deaths.

“Children are suffering a huge burden of viral hepatitis worldwide, and the public health implications of this are enormous,” says Raquel Peck, CEO of World Hepatitis Alliance. “Most infected infants and children are not diagnosed, prioritised or treated effectively.”

According to new analysis on hepatitis C in children, from Manal El-Sayed, Professor of Pediatrics at Ain Shams University, Cairo, Egypt, and Dr Homie Razavi and his team from the Polaris Observatory, the Center for Disease Analysis (CDA)Foundation, Lafayette, CO, USA, just 21 countries are responsible for around 80% of these paediatric hepatitis C infections, with the highest prevalence rates generally found in developing countries.

Mother to Child Transmission is one of the main causes of hepatitis C in children. However, neither pregnant women nor young children with this cancer-causing illness can be treated with the highly-effective direct-acting antiviral (DAA) medications. Various regulatory agencies such as the US FDA and the European Medicines Agency have now approved DAAs for use in children aged 12 years and over. But in high-income countries, there is as yet little evidence they are being used in this age group. WHO is also yet to recommend DAA in any children regardless of age.

As a result, almost all children are only treated with older pegylated interferon regimens, which often have severe side effects including stunting growth, influenza-like symptoms, anaemia and weight loss, and do not always cure the virus. Trials of DAA drugs in children under 12 years are also ongoing, but they have notbeen approved yet in any country for these younger children.

“Currently, 4 million children are living with hepatitis C, which can be cured and 48 million with hepatitis B, which has a vaccine,” said Charles Gore, President of the World Hepatitis Alliance. “Enough is enough. Governments and global health organisations must ensure all children are vaccinated for hepatitis B and provided with DAAs for hepatitis C, and that all pregnant women are screened.”

Compared to hepatitis C, new hepatitis B infections among children are declining – from approximately 4.7% prevalence in the pre-vaccination era of the early 1980s to 1.3% – due to scaled-up efforts to prevent mother-to-child transmission and global coverage with the three doses of hepatitis B vaccine. Currently, 84% of countries offer hepatitis B vaccinations. However, coverage with the initial birth dose vaccination needed to provide protection to newborns, is still low at 39%.

Cases of hepatitis C in children are, however, likely to continue growing for years to come, given the lack of prevention and control programs for pregnant women living with hepatitis C and women of child bearing age. This is exacerbated by the absence of a public health approach for case definition and management of expectant mothers or children.

“We must act and treat as many children as possible. The economic and social benefit of early hepatitis C treatment inchildren is substantial,” Professor El- Sayed explained. “This includes avoiding disease progression, removing social stigma and improving activity and school performance, and reducing fatigue. However, the fundamental principle is to avoid transmission by adopting ‘cure as prevention’ at an early age and before high risk behaviours emerge that enable transmission.”

“Children are the future,” Peck said. “It’s imperative that we get it right from the beginning and give them the best possible start in life. Without eliminating viral hepatitis amongst children, its elimination will be impossible.”

New IDF figures show diabetes increasing worldwide

To mark World Diabetes Day on 14 November, the International Diabetes Federation (IDF) released new estimates on the prevalence of diabetes around the world, which confirm that diabetes is one of the largest global health emergencies.

IDF estimates indicate that 1 in 11 adults are living with diabetes, 10 million more than in 2015. Data published in the 8th edition of the IDF Diabetes Atlas. The IDF says more action is required at the national level to reduce the economic and social burden that it causes.

Diabetes, which is associated with a number of debilitating complications affecting the eyes, heart, kidneys, nerves and feet, is set to affect almost 700 million people by 2045. Over 350 million adults are currently at high risk of developing type 2 diabetes, the most prevalent form of the disease. Half of all adults with diabetes remain undiagnosed, emphasizing the importance of screening and early diagnosis. Two-thirds of adults with diabetes are of working age and 8 million more adults living with diabetes are over 65 years old.

“Diabetes causes devastating personal suffering and drives families into poverty,” said Dr Nam Cho, IDF President- Elect and Chair of the IDF Diabetes Atlas committee. “There is urgency for more collective, multi-sectoral action to improve diabetes outcomes and reducethe global burden of diabetes. If we do not act in time to prevent type 2 diabetes and improve management of all types of diabetes, we place the livelihood of future generations at risk.”

Diabetes has a disproportionate impact on women, which was the focus of IDF and its affiliated members in over 160 countries on World Diabetes Day. Over 200 million women are living with diabetes and many face multiple barriers in accessing cost-effective diabetes prevention, early detection, diagnosis, treatment and care, particularly in developing countries.

Women with diabetes are more likely to be poor and have less resources, face discrimination and have to survive in hostile social environments. Diabetes is also a serious and neglected threat to the health of mother and child, affecting one in six births and linked to complications during and after delivery. “Women and girls are key agents in the adoption of healthy lifestyles to prevent the further rise of diabetes and so it is important that they are given affordable and equitable access to the medicines, technologies, education and information they require to achieve optimal diabetes outcomes and strengthen their capacity to promote healthy behaviours,” said Dr Shaukat Sadikot, IDF President.

IDF welcomes all the international commitments on diabetes that have been made over the past few years and acknowledges that some advances have taken place. However, it is clear that urgent action is still required to achieve the targets agreed by UN member states in 2013 and 2015. These include a 0% increase in diabetes and obesity prevalence; 80% access to essential medicines and devices by 2025; and a 30% reduction in premature mortality from NCDs by 2030. To this end, IDF has launched a call to action for the 2018 High Level Meeting on NCDs, calling on governments to renew their commitments and increase their efforts towards achieving the agreed targets.

“IDF is calling for all nations affected by the diabetes pandemic to work towards the full implementation of the commitments that have been made. We have both the knowledge and the expertise to create a brighter future for generations to come,” said Dr Sadikot.

• IDF Diabetes Atlas 8th edition: www.diabetesatlas.org


Global ministerial meeting commits to end tuberculosis

On 17 November 2017, 75 ministers gathered in Moscow agreed to take urgent action to end tuberculosis by 2030 with the issuing of the ‘Moscow Declaration to End TB’.

The announcement came at the first WHO Global Ministerial Conference on Ending Tuberculosis in the Sustainable Development Era: A Multisectoral Response, which brought together delegates from 114 countries. President Vladimir Putin of the Russian Federation opened the Conference, with UN Deputy Secretary General, Amina J Mohammed and Dr Tedros Adhanom Ghebreyesus, Director-General of WHO.

“Today marks a critical landmark in the fight to end TB,” said Dr Ghebreyesus. “It signals a long overdue global commitment to stop the death and suffering caused by this ancient killer.”

The Moscow Declaration to End TB is a promise to increase multisectoral action as well as track progress, and build accountability. It will also inform the first UN General Assembly High-Level Meeting on TB in 2018, which will seek further commitments from heads of state.

Global efforts to combat tuberculosis TB have saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37%. However, progress in many countries has stalled, global targets are off-track and persistent gaps remain in TB care and prevention.

As a result, TB still kills more people than any other infectious disease. There are major problems associated with antimicrobial resistance, and it is the leading killer of people with HIV.

“One of the main problems has been lack of political will and inadequate investment in fighting TB,” added Dr Ghebreyesus. “Today’s declaration must go hand in hand with increased investment.”

The meeting was attended by ministers, country delegations, as well as representatives of civil society and international organizations, scientists and researchers. More than 1000 participants took part in the two-day conference which resulted in collective commitment to ramp up action on four fronts:

  1. Move rapidly to achieve universal health coverage – by strengthening health systems and improving access to peoplecentred TB prevention and care, ensuring no one is left behind;
  2. Mobilize sufficient and sustainable financing through increased domestic and international investments to close gaps in implementation and research;
  3. Advance research and development of new tools to diagnose, treat, and prevent TB; and
  4. Build accountability through a framework to track and review progress on ending TB including multisectoral approaches. Ministers also promised to minimize the risk and spread of drug resistance and do more to engage people and communities affected by, and at risk of, TB.


Date of upload: 18th Jan 2018

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