Poor diets threaten health more than malaria, tuberculosis, measles – new UN report

The report, entitled “Preventing nutrient loss and waste across the food system: Policy actions for high-quality diets”, concludes that regularly eating poor-quality food has become a greater public health threat than malaria, tuberculosis or measles.

Meanwhile, approximately one-third of food produced for human consumption never reaches the consumer’s plate or bowl. Nutrient-rich foods, such as fruits, vegetables, seafood, and meats are highly perishable, rendering them susceptible to losses throughout increasingly complex food production systems.

According to the report, each year more than half of all globally-produced fruits and vegetables are lost or wasted. Moreover, around 25 percent of all meat produced, equivalent to 75 million cows, goes uneaten.

Reducing food loss and waste, particularly high-nutrient foods, not only has nutritional benefits, but also contributes to the Sustainable Development Goals (SDGs), and should be a new priority for improving nutrition.

To remedy this the report proposes a series of policy actions across the entire food system, including educating all concerned; focusing on perishable foods; improving public and private infrastructure; and closing data gaps on food losses and waste.

FAO data indicates that in low-income countries, food is mostly lost during harvesting, storage, processing, and transportation; while in high-income nations, the problem lies in retail and consumer level waste. Together, they directly impact the number of calories and nutrients actually available for consumption.

Given the direct impact on wellbeing, learning capacity and productivity, the loss and waste of micronutrients are of particular concern.

Globally, agriculture produces 22 percent more vitamin A than we require. However, after loss and waste, the amount available for human consumption is 11 percent less than required. Reducing the loss and waste of nutritious foods could, therefore, yield substantial health benefits.

With the value of global food lost or wasted annually, estimated to be around $1 trillion, cutting down on waste would also yield major economic benefits. Additionally, eating more of the food already produced, would avoid wasting the water, land, and energy that went into its production, said FAO.

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National Commission for Safai Karamcharis

The Union Cabinet chaired by Prime Minister Shri Narendra Modi has approved the creation of one post each of Vice-Chairperson and Member in the National Commission for Safai Karmacharis.

The decision is intended to optimize the functioning of the Commission and for fulfilling desired objectives of welfare and development of the target group.

The National Commission for SafaiKarmacharis is working for the welfare of both SafaiKaramcharis and Manual Scavengers. It is mandated to work towards the elimination of inequalities in status facilities and opportunities for SafaiKaramcharis and has an important role to ensure rehabilitation of all the identified manual scavengers on a time-bound basis. Under Section 31 of the Prohibition of Employment as Manual Scavengers and their Rehabilitation Act 2013, the Commission is to perform functions namely:

To monitor the implementation of the Act;

To enquire into complaints regarding contravention of provisions of the Act; and

To advice Central and State Governments for effective implementation of the Act.

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Maternal mortality drops to 130, Kerala top, big improvement in backward states

India has registered a significant improvement in an area where it has lagged — maternal deaths have reduced from 167 in 2011-13 to 130 (per 100,000 live births) in 2014-16 with Kerala leading the table, according to new data released by the registrar general of India.

The maternal mortality ratio (MMR) provides a measure of the quality of safe deliveries and maternal care and India’s healthcare services have lagged in this respect in comparison to neighbours like China, Sri Lanka, and the Maldives.

The decline has been most significant in the “empowered action group (EAG)” states and Assam, from 246 to 188, in the last three years. These are states where economic and development indicators are a particular concern, like Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh.

Among the southern states, the decline is from 93 to 77 and in the other states from 115 to 93. The heartening statistics point to steady gains, likely linked to more focused efforts to improve maternal care and rising number of institutional deliveries and more attention to health protocols.

As compared to other states, MMR continues to be substantially high in EAG states despite the drop. Assam still recorded the highest maternal death ratio at 237, though down from 300 in 2011-13. Similarly, UP and Uttarakhand registered an MMR of 201, down from 285 in the last three years.

Kerala has turned in a stellar performance, in what can be seen as evidence of a robust public health system as well as high levels of education and awareness, with the lowest MMR of 46, falling from 61 in 2011-13.

Apart from Kerala, Tamil Nadu and Andhra Pradesh also performed well after recording MMR of 66 and 74, respectively.

Maternal and child mortality and morbidity are considered key health indicators as they reflect the state of female healthcare. Over the years, the government has taken initiatives to improve these health indicators. India has reduced its maternal mortality by over 69 per cent since 1990, though it still has some catching up to do with better-performing Asian countries. Despite this, India, along with Nigeria, accounted for one-third of the global maternal deaths in 2015.

India ranks 129 among 184 nations on maternal mortality and 145 out of 193 nations on infant mortality, according to the World Bank.

The gap in maternal healthcare between urban and rural areas is often blamed for the overall poor scores and the inequalities are also evident through varying maternal mortality ratios across the country.

The health ministry has introduced as well as expanded coverage of various schemes to address these challenges, with its main focus on remote areas. It has also started some new schemes to provide care to women at different stages of pregnancy and increase institutional deliveries to prevent deaths.

The Janani Suraksha Yojna, or the maternity benefit scheme, has brought about a surge in institutional deliveries and financial uptakes in most states. Besides, the Rashtriya Kishor Swasthya Karyakram focuses on adolescent health and improving nutritional status and “Partnerships and Opportunities to Strengthen and Harmonise Actions for Nutrition (Poshan)” aims at community-based management of malnourished children.

Globally, the annual number of maternal deaths per 100,000 live births dropped by 44 per cent between 1990 and 2015 — from 385 to 216. The sub-Saharan African region accounted for an estimated 66 per cent (201,000) of global maternal deaths, followed by southern Asia at 22 per cent (66,000 deaths). In fact, only 5 per cent of the world’s countries accounted for 59 per cent of the total maternal deaths globally.

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Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP)

Union Minister of State for Chemicals & Fertilizers, Road Transport & Highways, Shipping, Shri Mansukh L. Mandaviya, launched the ‘JANAUSHADHI SUVIDHA’, the Oxo-biodegradable Sanitary Napkin, under the Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), here today. The affordable sanitary napkins will now become available at over 3600 Janaushadhi Kendras functional in 33 States/UTs across India, as promised by Union Minister, Chemical & Fertilizers and Parliamentary Affairs, Shri Ananthkumar on March 8, 2018 (World Women’s day).

According to the National Family Health Survey 2015-16, about 58 percent of women aged between 15 to 24 years use locally prepared napkins, sanitary napkins, and tampons. Further, about 78 percent women in urban areas use hygienic methods of protection during menstrual period; only 48 percent women in rural areas have access to clean sanitary napkins.

About Janaushadhi Suvidha:

Jan Aushadhi Suvidha comes with a special additive, which makes Sanitary napkin biodegradable when it comes in contact with oxygen after being discarded. This would ensure ‘Swachhta, Swasthya and Suvidha’ for the underprivileged Women of India and go a long way in the achievement of vision of Affordable and Quality Healthcare for All.

The average price of sanitary napkins available in the market today is around Rs. 8 per pad, whereas now with the launch of the SUVIDHA napkins at Rs. 2.50 per pad, this will go a long way in making the basic hygiene requirement aid for Women affordable for the underprivileged sections.

This is one of the most important requirements in ensuring the Health Security to that section of Women in India who still use unhygienic aids during the menstrual period due to non-affordability of some of the popular brands of sanitary napkins available in the market today. Such unhygienic aids cause fungal infections, Reproductive Tract Infection, Urinary Tract Infection, Cervical cancer and also make women vulnerable to infertility.

According to the National Family Health Survey 2015-16, about 58% of women aged between 15 to 24 years use locally prepared napkins, sanitary napkins, and tampons. Further, about 78% women in urban areas use hygienic methods of protection during menstrual period; only 48% women in rural areas have access to clean sanitary napkins.

‘Pradhan Mantri Bhartiya Janaushadhi Pariyojana’ is a campaign launched by the Department of Pharmaceuticals, Govt. Of India, to provide quality medicines at affordable prices to the masses through special Kendra’s known as Pradhan Mantri Bhartiya Jan Aushadhi Kendra. Pradhan Mantri Bhartiya Jan Aushadhi Kendra (PMBJK) has been set up to provide generic drugs, which are available at lesser prices but are equivalent in quality and efficacy as expensive branded drugs.

Bureau of Pharma PSUs of India (BPPI) is the implementing agency of PMBJP. BPPI (Bureau of Pharma Public Sector Undertakings of India) has been established under the Department of Pharmaceuticals, Govt. of India, with the support of all the CPSUs.

What is a Generic Medicine?

Generic medicines are unbranded medicines which are equally safe and having the same efficacy as that of branded medicines in terms of their therapeutic value. The prices of generic medicines are much cheaper than their branded equivalent.

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Nepal first country in south-east Asia to eliminate Trachoma: WHO

Nepal has become the first country in south-east Asia to eliminate trachoma, world’s leading cause of preventable blindness of infectious origin, the World Health Organisation (WHO)

Trachoma was the second leading cause of preventable blindness in the Himalayan nation in the 1980s.

In 2002, the Government of Nepal had stepped up the efforts to eliminate trachoma with the establishment of a national trachoma programme. The prevalence of active (inflammatory) trachoma in the country fell by 40 per cent following the implementation of sustained control activities from 2002 to 2005, the WHO statement said.

The Nepal government, through the ministry of water supply and sanitation, provided incentives to local communities and districts to build and maintain latrines, measures that were crucial to improve sanitation and reduce the disease carrying flies.

The national trachoma programme in that country also collaborated with the ministry of education to include a module on trachoma in the school curriculum, the statement said.

In 1998, the World Health Assembly had resolved to eliminate trachoma as a public health problem.

About Trachoma:

Trachoma is a chronic infective disease of the eye and is the leading cause of infective blindness globally. Trachoma is a disease of poor environmental and personal hygiene and inadequate access to water and sanitation.

It affects the conjunctiva under the eyelids. Repeated infections cause scarring leading to in-turning of the eyelashes and eyelids. This further causes damage to the cornea and blindness.

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Habitat loss may have triggered Nipah outbreak

Can human-caused factors like habitat loss and climate change trigger outbreaks such as the recent Nipah cases in Kerala? Existing literature does hint at this possibility.

According to a report by the World Health Organization, there is “strong evidence” that the emergence of bat-related viral infections can be attributed to the loss of the animal’s natural habitats. “As the flying fox [fruit bat] habitat is destroyed by human activity, the bats get stressed and hungry, their immune system gets weaker, their virus load goes up and a lot of virus spills out in their urine and saliva,” the report adds.

Environmental stress:

“There are studies on Hendra and Nipah viruses that hint at reproductive and nutritional stress [fewer food resources] as potential role players in virus spillover,”

In the case of the Hendra virus — the Nipah equivalent in Australia — scientists found that when fruit bats are stressed (through habitat fragmentation, habitat reduction, and physiological stress), the percentage of bats infected with the virus increases drastically, increasing the likelihood of passing it to humans through horses.

Nutritional stress through the loss of food resources — a direct consequence of habitat loss and climate change — brings bats closer to urban areas. According to a study in Malaysia, rapid urbanization of bat-rich rainforests contributed to the emergence of Nipah virus there: the regions most adversely affected were those that suffered from maximum deforestation. Forest fragmentation and hunting bats for food also bring them closer to humans and is often an important cause of disease transmission, says Rohit Chakravarty who studies bats in India.

Conservationists worry that the recent Nipah outbreak could cause a knee-jerk reaction of calls for bat culling. Culling bat populations may seem like an easy solution — and has been tried in Australia — but studies warn that instead of reducing the outbreak of such zoonotic diseases, it could cause even more damage, chiefly ecological.

That’s because about a quarter of the more than 1,300 bat species seen worldwide feed on fruit and nectar and are crucial pollinators (of fruit trees, including mango, guava, and banana), helping maintain genetic diversity in agricultural systems. They are also important seed dispersers; other bat species help bring rodent and insect numbers under control.

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India Ranks 145th among 195 Countries In Healthcare Access, Quality: Lancet

The recently conducted Global Burden Of Disease Study reinforced once again the fact that India is still has a lot of catching up to do with its neighbors in terms of health care. The study published in a medical journal, The Lancet, ranks India at a lowly 145th place out of 195 countries in terms of healthcare access and quality (HAQ).

India, which has jumped nine places from last year’s 154th position, still lags behind countries like Sri Lanka (71), Bangladesh (133) and Bhutan (134) in terms of HAQ.

To add to the problem, the study has pointed out the widespread internal disparity in terms of HAQ in India, with a maximum gap of 30.8 (up from 23.4 in 1990).

“Although India’s improvements on the (health care access and quality) HAQ index hastened from 2000 to 2016, the gap between the country’s highest and lowest scores widened (23·4-point difference in 1990, and the 30·8-point difference in 2016),”

The study also reported that India’s performance in tackling diseases like tuberculosis, rheumatic heart diseases, Ischaemic heart diseases, stroke, testicular cancer, colon cancer and chronic kidney disease among others were subpar.

The Study:

To arrive at a definitive conclusion, the study took into consideration 32 causes of deaths which can be otherwise prevented by the effective medical attention.

Each of the 195 assessed countries was given a score between 0 to 100. The highest scorers were Iceland (97.1), Norway (96.6), Netherlands (96.1), Luxembourg (96.0), and Finland and Australia (95.9 each).

This was also the first time when the study conducted research across regions within seven countries: Brazil, China, England, India, Japan, Mexico, and the US.

“These results emphasize the urgent need to improve both access to and quality of healthcare across service areas and for all populations; otherwise, health systems could face widening gaps between the health services they provide and the disease burden experienced by local communities,” said the study.

Understanding the reasons behind India’s dismal ranking:

One of the major problems with regard to the quality of healthcare in India has been low public spending in the sector. India presently spends a little over 1% of its GDP on public healthcare.

This year’s budget also saw the decline in budget allocation for National Health Mission– India’s largest programme for primary health care by 2.1 percent.

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The 71st World Health Assembly Begins in Geneva

In his plenary opening speech, the Director-General of WHO, Tedros Adhanom Ghebreyesus, highlighted WHO’s new General Programme of Work for the next five years. “[This] is not about reinventing the wheel. It’s about making a bigger impact than we already make. It is ambitious, as it should be. The vision set at our founding 70 years ago is not a modest vision.

World Health Assembly (WHA):

The World Health Assembly (WHA) is the forum through which the World Health Organization (WHO) is governed by its 194 member states. It is the world’s highest health policy setting body and is composed of health ministers from member states.

The members of the World Health Assembly generally meet every year in May in Geneva, the location of WHO Headquarters.

The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget.

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WHO RAISES EBOLA HEALTH RISK TO ‘VERY HIGH’ IN DR CONGO, NOT YET INTERNATIONAL EMERGENCY

The World Health Organization (WHO) has raised the Ebola health risk assessment to “very high” in the Democratic Republic of Congo, ahead of an emergency meeting Friday to discuss the worsening outbreak.

Concerns about the spread of the disease escalated Thursday when the health body announced the first case had been detected in Mbandaka, a city of nearly 1.2 million people.

More than 11,000 people died in the Ebola outbreak in West Africa in 2014-2015, mainly in Guinea, Sierra Leone and Liberia. The last outbreak in the DRC was in 2014 and killed more than 40 people. The region affected lies 1,300 km north-east of Kinshasa, close to the border with the Central African Republic.

Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.

Transmission: The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.

Prevention: Community engagement is key to successfully controlling outbreaks. Good outbreak control relies on applying a package of interventions, namely case management, surveillance and contact tracing, a good laboratory service and social mobilisation.

Early supportive care with rehydration, symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralise the virus but a range of blood, immunological and drug therapies are under development.

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First-ever WHO list of essential diagnostic tests to improve diagnosis and treatment outcomes

Today, many people are unable to get tested for diseases because they cannot access diagnostic services. Many are incorrectly diagnosed. As a result, they do not receive the treatment they need and, in some cases, may actually receive the wrong treatment.

For example, an estimated 46% of adults with Type 2 diabetes worldwide are undiagnosed, risking serious health complications and higher health costs. Late diagnosis of infectious diseases such as HIV and tuberculosis increases the risk of spread and makes them more difficult to treat.

To address this gap, WHO today published its first Essential Diagnostics List, a catalogue of the tests needed to diagnose the most common conditions as well as a number of global priority diseases.

The list concentrates on in vitro tests – i.e. tests of human specimens like blood and urine. It contains 113 products.

58 tests are listed for detection and diagnosis of a wide range of common conditions, providing an essential package that can form the basis for screening and management of patients.

55 tests are designed for the detection, diagnosis and monitoring of “priority” diseases such as HIV, tuberculosis, malaria, hepatitis B and C, human papillomavirus and syphilis.

Some of the tests are particularly suitable for primary health care facilities, where laboratory services are often poorly resourced and sometimes non-existent. These tests do not require electricity or trained personnel. Other tests are more sophisticated and therefore intended for larger medical facilities.

For each category of test, the Essential Diagnostics List specifies the type of test and intended use, format, and if appropriate for primary health care or for health facilities with laboratories. The list also provides links to WHO Guidelines or publications and, when available, to prequalified products.

Similar to the WHO Essential Medicines List, which has been in use for four decades, the Essential Diagnostics List is intended to serve as a reference for countries to update or develop their own list of essential diagnostics. In order to truly benefit patients, national governments will need to ensure appropriate and quality-assured supplies, training of health care workers and safe use. To that end, WHO will provide support to countries as they adapt the list to the local context.

An accurate diagnosis is the first step to getting effective treatment. However, many people are unable to get tested for diseases because they cannot access diagnostic services. Many are incorrectly diagnosed. As a result, they do not receive the treatment they need and, in some cases, may actually receive the wrong treatment.

For example, an estimated 46% of adults with Type 2 diabetes worldwide are undiagnosed, risking serious health complications and higher health costs. Late diagnosis of infectious diseases such as HIV and tuberculosis increases the risk of spread and makes them more difficult to treat.

WHO will update the Essential Diagnostics List on a regular basis. In the coming months, WHO will issue a call for applications to add categories to the next edition. The list will expand significantly over the next few years, as it incorporates other important areas including antimicrobial resistance, emerging pathogens, neglected tropical diseases and additional noncommunicable diseases.

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