Friday, August 19

One Humanity

The World Humanitarian Day is today August 19th, 2016 and the theme for this year is “One Humanity”. The day was designated in 2003 to honor the lives of 22 humanitarian workers who were killed in  a terrorist attack in Baghdad, Iraq.

Currently, there are 130 million people who are living in crisis and face impossible choices. All wars, conflicts and internal displacements disrupt the strong social, economic and cultural support systems that people have built and cultivated over the years. This decimation of all forms of support has a direct impact on people’s mental and physical health. The consequences also extend to our colleagues who put their lives in danger to serve people in many conflict zones. You will recall the loss of lives from the many acts of violence against hospitals and clinics.

As global/public health professionals, it is our duty to take a stand and commit today to move the needle on the 7 core commitments that were identified at the World Humanitarian Summit that happened in May 2016.

Source: LEARN, World Humanitarian Summit

At a minimum, we can do these few things listed below, learn more about these here (scroll down to the bottom of the page):.
  1. Support the Agenda for Humanity
  2. Take the Humanitarian Quiz and see the impossible choices people face
  3. Tweet your country's leader and ask them to commit to action
  4. Donate to the UN's Emergency Response Fund
  5. Sign Up to Messengers of Humanity so you can stay involved
  6. Start Impossible Choices to walk in the shoes of a refugee

If you are in the mood to learn about some of the horrendous choices people in conflict zones have to make, take the “Would You Rather” quiz here.

This post has been cross posted to the IH blog.

Wednesday, May 25

A tale of resistance

Antibiotic resistance poses a serious threat to the gains we have made in curbing infectious diseases caused due to bacteria.Simply put, it is the bacteria’s way of putting up a fight to survive and persist.

To understand what antibiotic resistance is, let’s delve a little into the biology of these famed, overused drugs and into the history of how we got here.

Antibiotics are drugs that are effective in treating and preventing bacterial infections. Barring a few antibiotics with anti-protozoan activity, antibiotics are largely anti-bacterial and are ineffective against viruses.

The word antibiotics might elicit an image of Sir Alexander Fleming, and the famous story of the serendipitous discovery of penicillin in 1928, for which he shared a Nobel Prize with Howard Florey and Ernst Boris Chain. Some studies have even revealed traces of tetracycline in human skeletal remains from ancient Sudanese Nubia (350–550 CE) and femoral midshafts of the late Roman period skeletons from the Dakhleh Oasis, Egypt.  

There are about 12 classes of antibiotics and the last class of antibiotics, lipopeptides, was discovered in 1987. No new classes of antibiotics have been discovered since then!

Unfortunately, the success of antibiotics as a chemotherapy agent, has also led to the misuse and overuse of these agents. We have moved away from using them judiciously and today, antibiotics are being used rampantly not just to treat infections in humans but to fatten animals that we intend to eat.

  Source: Antibiotic resistance, PEW Charitable Trusts

In an interview shortly after winning the Nobel Prize in 1945, Alexander Fleming said:

"The thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism."

While the molecular mechanisms of antibiotic resistance have been studied extensively, we know that misuse and overuse of antibiotics have played a key role in the creation of “superbugs”.  Antimicrobial resistance is prevalent world wide and new mechanisms of resistance emerge and spread. 

Percentage change in antibiotic consumption per capita 2000–2010*, by country
Source: Center for Disease Dynamics, Economics & Policy. State of the World’s Antibiotics, 2015.

The State of World's Antibiotics released in 2015 identified the different kinds of antibiotic resistant bacterial strains including Methicillin-resistant Staphylococcus aureus (MRSA) and Carbapenem-resistant Enterobacteriaceae. According to the WHO, in 2013, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) has been identified in about 100 countries. The treatment courses for MDR-TB is long and usually less effective, posing a greater threat to the progress that has been to curb TB.
The SWA report describes six strategies (listed below from the report) that nations can take to:
  1. Reduce the need for antibiotics through improved water, sanitation, and immunization.
  2. Improve hospital infection control and antibiotic stewardship.
  3. Change incentives that encourage antibiotic overuse and misuse to incentives that encourage antibiotic stewardship.
  4. Reduce and eventually phase out antibiotic use in agriculture.
  5. Educate and inform health professionals, policymakers, and the public on sustainable antibiotic use.
  6. Ensure political commitment to meet the threat of antibiotic resistance.

Resistance Map: A useful resource from CDDEP that you could use to explore antibiotic resistance trends, rates and antibiotic use by country, pathogens and much more.

We have to take smart, swift action to reduce unnecessary use and misuse of antibiotics and use them with caution.

I still remember that growing up in India, I could just walk into a pharmacy and get a bunch of antibiotics without a proper prescription. Hopefully that practice is a thing of past!

This post is cross-posted to the IH blog.

Friday, April 22

Earth day- do you care?

File:Earth Day - Earth from Space.jpg

Why should we celebrate earth day?

Because this earth that we live, this environment that we live in and the land we till to produce our food is inherently intertwined with our bodies and minds.

We can’t simply take, take, take, and take from the earth- there will be and there already are consequences. I would even argue that we have been the most destructive of all species on this planet. Our actions have put the lives of every single living being on this planet in jeopardy.

We have to stop making excuses and start acting toward a healthier earth and eventually a healthier US. Don’t wait for governments to change or enact policies or sign climate deals- do your part, whatever you can! It is time to act-

Gandhi said “The good man is the friend of all living things.” We have a responsibility, every single one of us.

But it can't be just this one day- celebrate earth day every day!

Thursday, April 7

Beat Diabetes WHO call to action

It’s World Health Day today and the WHO has issued a call to action to “Beat Diabetes”.

World Health Day 2016 poster: Halt the rise in diabetes

Diabetes is  a set of diseases that result in excessive amounts of sugar in the blood a.k.a high blood glucose. Type 2 diabetes is among the most common types of diabetes and it occurs when the body stops using insulin properly ultimately leading to “insulin resistance”. The other common types are
  1. Type 1 diabetes
  • occurs due to lack of insulin production
  • poorly understood form of diabetes
  1. Gestational diabetes
  • occurs during pregnancy
  • risk factor for pregnancy related complications
  • increased risk of Type 2 diabetes for both the mothers and their children.

Diabetes is a metabolic disorder and its long term complications include heart disease, strokes, diabetic retinopathies, kidney failure  and poor blood flow to the limbs that could result in amputations. It is also among the leading cause of death. In 2012 nearly 1.5 million deaths were directly attributed to diabetes. Early diagnosis, management of blood glucose levels through diet, physical activity and medication when necessary and routine screenings are not only cost-effective but are effective interventions to prevent diabetes-related complications from occurring or worsening.

A new study published in The Lancet this month has raised the alarm by showing that there has been quadrupling of the number of people with diabetes since 1980. The pooled analysis of 751 population-based studies involving nearly 4.4 million participants from 146 countries shows increasing burden of diabetes, more so in low and middle income countries than in high-income countries. This number is startling and is  a wake up call to public health and health care professionals. 

World Health Day 2016 banner

Diabetes is a treatable disease and efforts to prevent/treat it, will help achieve MDG 3 target of preventing premature mortality from noncommunicable diseases by one-third by 2030. We should be working together to raise awareness about diabetes with a particular focus on low and middle income countries, scale up prevention strategies that are specific, effective and affordable.

For this campaign, WHO has created a quiz-take it to test your knowledge.

Note: This was cross-posted to IHblog

Monday, February 8

Zika Virus: An Emerging Threat

Note: This was cross posted to the IH blog
Zika virus was originally reported in 1952 in the Transactions of Royal Society of Tropical Medicine and Hygiene. The original study involved placing a Rhesus monkey in a cage in the ZIka forest in Uganda. The monkey subsequently developed a fever and the researchers were identified a transmissible agent from its serum, and called it the ZIka virus. The virus belongs to the Flaviviridae virus family, related to dengue, yellow fever and West Nile virus, and it is transmitted by the day-time active mosquitoes, such as those of the genus Aedes.

CDC estimates that “about 1 in 5 people infected with Zika will get sick and for those who get sick, the illness is usually mild. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito.”

Currently, the virus has spread to nearly 23 countries, with countries like Colombia reporting that they have about 20,000 confirmed cases that include ~2000 pregnant women. Pregnant women are the focus of this epidemic, as recent studies showed a link between Zika virus infection and microcephaly, a devastating birth defect that results in smaller brain size. CDC has issued travel warnings for nearly 25 countries, and several South American countries are strongly urging women to not get pregnant.

WHO recently declared Zika virus a global health emergency with the potential for infecting nearly 4 million people. In the US there have been 36 cases including 4 pregnant women and in Houston, where I live and work, thus far seven cases have been reported. All cases in the US are travel-related and not due to local transmission.

There is real concern at the alarming rise in the number of infected individuals. The other
potential cause for worry might be the summer Olympics in Rio De Janeiro in a few months. Brazil has stepped up its surveillance program and the hope is that the cooler, drier climate will control the mosquito population.

President Obama has called on U.S. health officials and scientists to examine the link with microcephaly and rapid development and testing of vaccines for Zika virus.

While we wait, protect yourself from mosquito bites and if you are traveling make sure to check the CDC ZIka Virus page. 

Protect Yourself from Mosquito Bites  Mosquitoes spread chikungunya, dengue, and zika viruses
Source: Zika virus (CDC)

Thursday, January 14

Big Losses for Big Tobacco

Six million people die annually as a result of tobacco. Many governments have adopted the WHO framework for tobacco control and have since taken measures (policy changes, cessation programs, etc.) to reduce mortalities and morbidities that occur due to tobacco. Not surprisingly, big tobacco companies like Philip Morris International have pushed back against countries that have enacted stringent packaging laws. 

In a much-awaited decision, Australia won an international legal battle to uphold its tobacco policies that include the plain packaging laws. Australia has enacted some of the toughest measures to reduce the harm caused by tobacco and plain packaging laws are among them. These laws are intended to prevent the tobacco companies from displaying their distinctive designs, colors or even their brand logos (companies can include their names and logos, but they cannot have flashy, enticing packaging). Instead, the companies would be required to use olive-green packs with health warnings and graphic color images that would cover nearly 75% of the front of the packs. The Plain Packaging Act passed by the Australian parliament became law in 2011 and, shortly thereafter, Hong Kong-based PMI sought legal action against Australia citing that, by stripping logos off the packs, these stringent laws violated the bilateral investment treaty between Australia and Hong Kong, thereby severely diminishing their brand value.

This is not the first time Philip Morris has dragged governments into legal battles over stricter anti-smoking and tobacco laws.

While global rate of lung cancer mortality was increasing between 1990 and 2013, owing to stricter anti-tobacco measures, Uruguay saw a 15% reduction in lung cancer mortality. PMI, a company whose revenues were nearly $80 billion in 2013, sued Uruguay, a small country of 3 million with a GDP of about $56 billion, in 2013. The lawsuit was brought to the International Center for Settlement of Investment Disputes (ICSID) in 2010 and the company is seeking $25 million in damages from Uruguay, once again, citing violation of bilateral investment treaty between Uruguay and Switzerland. The ICSID is expected to settle this case by arbitration.

The upholding of the anti-tobacco laws in Australia will hopefully set a precedent and allow countries to move forward with legitimate public health actions to curb the global tobacco epidemic without interference from tobacco companies.

You will find my post and other international health related posts/news round-ups over at the IH blog.

If you want to get this information with some humor sprinkled in- watch John Oliver tear down the tobacco industry

Friday, January 1

So the verdict on my reading challenges this year...

Not so good, I am afraid. I wanted to read 40 books this year but managed to read only 20, and the 20th was a mad dash to finish last night. Below is the break down from the challenges over at Bev's.

Color Coded Reading Challenge

2015 Color Coded Headquarters

1. A book with "Blue" or any shade of Blue (Turquoise, Aquamarine, Navy, etc) in the title/on the cover 

2. A book with "Red" or any shade of Red (Scarlet, Crimson, Burgandy, etc) in the title/on the cover. RED POPPIES BY ALAI

3. A book with "Yellow" or any shade of Yellow (Gold, Lemon, Maize, etc.) in the title/on the cover. YELLOW BIRDS by KEVIN POWERS

4. A book with "Green" or any shade of Green (Emerald, Lime, Jade, etc) in the title/on the cover. Green on Blue by Elliot Ackerman

5. A book with "Brown" or any shade of Brown (Tan, Chocolate, Beige, etc) in the title/on the cover.

6. A book with "Black" or any shade of Black (Jet, Ebony, Charcoal, etc) in the title/on the cover. 
Spectre Black by J. Carson Black

7. A book with "White" or any shade of White (Ivory, Eggshell, Cream, etc) in the title/on the cover. Winter Journey by Diane Armstrong (this was the book I finished last night!)

8. A book with any other color in the title/on the cover (Purple, Orange, Silver, Pink, Magneta, etc.). PURPLE CLOUD BY M.P.SHIEL (this is cool sci-fi/fantasy from 1901)

9. A book with a word that implies color (Rainbow, Polka-dot, Plaid, Paisley, Stripe, etc.). 
Claire of the Sea Light by Edwidge Danticat

I did not complete my bingo challenges this year but I did get to read some pretty awesome mysteries by some of the best authors (I especially love mysteries from the golden era)

The body in the library (Agatha Christie)
And then there were none (Agatha Christie)
The circular staircase (Mary Reinhart Roberts, first published 1908)
The Nursing Home murder (Ngaio Marsh, 1935) 
Death at a bar (Ngaio Marsh, 1940)
The moving toyshop (Edmund Crispin, 1946)

Silver: 1960-1989
There hangs a knife (Marcia Muller, 1988)
Killing of Katie Steelstock, Michael Gilbert (1980)