7 million premature deaths annually linked to air pollution

25 March 2014 | Geneva - In new estimates released today, WHO reports that in 2012 around 7 million people died - one in eight of total global deaths – as a result of air pollution exposure. This finding more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. Reducing air pollution could save millions of lives.

New estimates

In particular, the new data reveal a stronger link between both indoor and outdoor air pollution exposure and cardiovascular diseases, such as strokes and ischaemic heart disease, as well as between air pollution and cancer. This is in addition to air pollution’s role in the development of respiratory diseases, including acute respiratory infections and chronic obstructive pulmonary diseases.

The new estimates are not only based on more knowledge about the diseases caused by air pollution, but also upon better assessment of human exposure to air pollutants through the use of improved measurements and technology. This has enabled scientists to make a more detailed analysis of health risks from a wider demographic spread that now includes rural as well as urban areas.

Regionally, low- and middle-income countries in the WHO South-East Asia and Western Pacific Regions had the largest air pollution-related burden in 2012, with a total of 3.3 million deaths linked to indoor air pollution and 2.6 million deaths related to outdoor air pollution.

“Cleaning up the air we breathe prevents non-communicable diseases as well as reduces disease risks among women and vulnerable groups, including children and the elderly...”

Dr Flavia Bustreo, WHO Assistant Director-General Family, Women and Children’s Health

“Cleaning up the air we breathe prevents noncommunicable diseases as well as reduces disease risks among women and vulnerable groups, including children and the elderly,” says Dr Flavia Bustreo, WHO Assistant Director-General Family, Women and Children’s Health. “Poor women and children pay a heavy price from indoor air pollution since they spend more time at home breathing in smoke and soot from leaky coal and wood cook stoves.”

Included in the assessment is a breakdown of deaths attributed to specific diseases, underlining that the vast majority of air pollution deaths are due to cardiovascular diseases as follows:

Outdoor air pollution-caused deaths – breakdown by disease:

• 40% – ischaemic heart disease;
• 40% – stroke;
• 11% – chronic obstructive pulmonary disease (COPD);
• 6% - lung cancer; and
• 3% – acute lower respiratory infections in children.

Indoor air pollution-caused deaths – breakdown by disease:

• 34% - stroke;
• 26% - ischaemic heart disease;
• 22% - COPD;
• 12% - acute lower respiratory infections in children; and
• 6% - lung cancer.

The new estimates are based on the latest WHO mortality data from 2012 as well as evidence of health risks from air pollution exposures. Estimates of people’s exposure to outdoor air pollution in different parts of the world were formulated through a new global data mapping. This incorporated satellite data, ground-level monitoring measurements and data on pollution emissions from key sources, as well as modelling of how pollution drifts in the air.

Risks factors are greater than expected

“The risks from air pollution are now far greater than previously thought or understood, particularly for heart disease and strokes,” says Dr Maria Neira, Director of WHO’s Department for Public Health, Environmental and Social Determinants of Health. “Few risks have a greater impact on global health today than air pollution; the evidence signals the need for concerted action to clean up the air we all breathe.”

After analysing the risk factors and taking into account revisions in methodology, WHO estimates indoor air pollution was linked to 4.3 million deaths in 2012 in households cooking over coal, wood and biomass stoves. The new estimate is explained by better information about pollution exposures among the estimated 2.9 billion people living in homes using wood, coal or dung as their primary cooking fuel, as well as evidence about air pollution's role in the development of cardiovascular and respiratory diseases, and cancers.

In the case of outdoor air pollution, WHO estimates there were 3.7 million deaths in 2012 from urban and rural sources worldwide.

Many people are exposed to both indoor and outdoor air pollution. Due to this overlap, mortality attributed to the two sources cannot simply be added together, hence the total estimate of around 7 million deaths in 2012.

“Excessive air pollution is often a by-product of unsustainable policies in sectors such as transport, energy, waste management and industry. In most cases, healthier strategies will also be more economical in the long term due to health-care cost savings as well as climate gains,” says Dr Carlos Dora, WHO Coordinator for Public Health, Environmental and Social Determinants of Health. “WHO and health sectors have a unique role in translating scientific evidence on air pollution into policies that can deliver impact and improvements that will save lives.”

The release of today’s data is a significant step in advancing a WHO roadmap for preventing diseases related to air pollution. This involves the development of a WHO-hosted global platform on air quality and health to generate better data on air pollution-related diseases and strengthened support to countries and cities through guidance, information and evidence about health gains from key interventions.

Later this year, WHO will release indoor air quality guidelines on household fuel combustion, as well as country data on outdoor and indoor air pollution exposures and related mortality, plus an update of air quality measurements in 1600 cities from all regions of the world.

For more information, contact

Mr Tarik Jasarevic
Mobile: +41 79 367 6214
Telephone: +41 22 791 5099
E-mail: jasarevict@who.int

Glenn Thomas
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

Nada Osseiran
Communications Officer, Department of Public Health, Environmental and Social Determinants of Health
Telephone: +41 22 791 4475
Mobile: +4179 445 1624
E-mail: osseirann@who.int

View the original article here

Big Cigarette Tax Hikes Might Prevent 200 Million Deaths in a Century

Study authors suggest that nations triple tobacco taxes

View the original article here

Over 23 million children to be vaccinated in mass polio immunization campaign across Middle East

9 December 2013 | CAIRO, AMMAN - The largest-ever immunization response in the Middle East is under way this week, aiming to vaccinate more than 23 million children against polio in Syria and neighbouring countries over the coming weeks.

The campaign is a crucial part of the response to an outbreak of the virus-borne disease in Syria, where 17 cases have so far been confirmed, and to the detection of the virus in environmental samples in other parts of the Middle East.

In order to stop the outbreak and prevent further spread, organizers aim to vaccinate, repeatedly over the next few months, all children under the age of 5, whether they are living at home or displaced by conflict. Depending on the area, vaccination will be offered at fixed sites at populous locations or by going from house to house. The activities are carried out by national and local health authorities supported by UNICEF, WHO, the Syrian Arab Red Crescent and other partners.

Inside Syria, the campaign aims to reach 2.2 million children, including those who live in contested areas and those who were missed in an earlier campaign. Many children in Syria remain inaccessible, particularly those trapped in sealed off areas or living in areas where conflict is ongoing.

Despite the gaps in coverage, initial information suggests that vaccine is getting to more areas of Syria than has so far been the case for health interventions delivered as part of the larger ongoing humanitarian effort. In parallel with the vaccination effort, work is going on to bolster systems for verifying coverage data in upcoming campaigns inside the war-torn country.

“All Syrian children should be protected from disease,” noted Dr. Ala Alwan, Regional Director, WHO Eastern Mediterranean Region. “To eradicate polio, we need to eradicate any reason for failing to reach children. We appeal to all parties of the conflict in Syria to cooperate and facilitate pauses in hostilities over the coming 6 months to allow vaccination campaigns to reach all children.”

“As if children in Syria had not suffered enough, they now have to contend with yet another threat to their health and well-being,” said Maria Calivis, UNICEF Regional Director for the Middle East and North Africa. “The current polio vaccination efforts are a huge undertaking by many partners, but we can only halt the spread of the virus if we reach those children who have remained out of reach."

Over the coming months, UNICEF is planning to deliver 10 million doses of polio vaccine to Syria. The first shipment of 2 million vaccines arrived in Damascus on Friday 29 November.

The total cost to UNICEF and WHO of supporting the seven-country polio response from November through April is US$ 39 million, based on a strategic plan developed for the Middle East.

Note to editors

As of 26 November, 17 children have been paralyzed by polio in Syria: 15 of these children are in the contested governorate of Deir Ez Zour, 1 is in Aleppo and another in Douma, near Damascus. Prior to this outbreak, no polio cases have been recorded in Syria since 1999. The risk of spread to countries in the region and beyond is considered high, and health authorities from 21 countries have declared a public health emergency. Further polio immunization campaigns will be repeated across the region. In Syria, they will be carried out at monthly intervals until April 2014.

Genetically-related polioviruses, which originated in Pakistan, have also been detected in sewage samples in Egypt in December 2012, and in Israel and the West Bank and Gaza Strip earlier in 2013.

Inside Syria and for the past 2 years, immunization activities have been significantly constrained by ongoing conflict. Cold chain equipment in many districts has been lost and many mobile health teams have not been able to perform regular visits. This has led to missing out on vaccinating between 500?000–700?000 children in these areas.

For more information, please contact:

Rana Sidani
WHO Regional Office in Cairo
Telephone: +20 109 975 6506
E-mail: sidanir@who.int

Sona Bari
WHO Geneva
Telephone: +41 79 475 5511
E-mail: baris@who.int

Simon Ingram
UNICEF Regional Office for the Middle East and North Africa in Amman
Telephone: +962 79 590 4740
E-mail: singram@unicef.org

Najwa Mekki
UNICEF Regional Office for the Middle East and North Africa in Amman
Telephone: +962 79 573 2745
E-mail: nmekki@unicef.org

View the original article here

Global health workforce shortage to reach 12.9 million in coming decades

11 November 2013 | RECIFE, BRAZIL - The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. A WHO report released today warns that the findings – if not addressed now – will have serious implications for the health of billions of people across all regions of the world.

The report, "A universal truth: No health without a workforce", identifies several key causes. They include an ageing health workforce with staff retiring or leaving for better paid jobs without being replaced, while inversely, not enough young people are entering the profession or being adequately trained. Increasing demands are also being put on the sector from a growing world population with risks of noncommunicable diseases (e.g. cancer, heart disease, stroke etc.) increasing. Internal and international migration of health workers is also exacerbating regional imbalances.

The findings were released at the Third Global Forum on Human Resources for Health together with recommendations on actions to address workforce shortages in the era of universal health coverage. The main recommended actions include:

• Increased political and technical leadership in countries to support long-term human resource development efforts.
• Collection of reliable data and strengthening human resource for health databases.
• Maximizing the role of mid-level and community health workers to make frontline health services more accessible and acceptable.
• Retention of health workers in countries where the deficits are most acute and greater balancing of the distribution of health workers geographically.
• Providing mechanisms for the voice, rights and responsibilities of health workers in the development and implementation of policies and strategies towards universal health coverage.

“The foundations for a strong and effective health workforce for the future are being corroded in front of our very eyes by failing to match today’s supply of professionals with the demands of tomorrow’s populations,” says Dr. Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation. “To prevent this happening, we must rethink and improve how we teach, train, deploy and pay health workers so that their impact can widen.”

While the report highlights some encouraging developments, for example, more countries have increased their health workforce, progressing towards the basic threshold of 23 skilled health professionals per 10?000 people, there are still 83 countries below this basic threshold. But it is the future projections that raise the loudest alarms. In a stark assessment, the report says the current rate of training of new health professionals is falling well below current and projected demand. The result will be that in the future, the sick will find it even harder to get the essential services they need and preventive services will suffer.

Whilst the largest shortages in numerical terms are expected to be in parts of Asia, it is in sub-Saharan Africa where the shortages will be especially acute. On education and training, for example, in the 47 countries of sub-Saharan Africa, just 168 medical schools exist. Of those countries, 11 have no medical schools, and 24 countries have only one medical school.

“One of the challenges for achieving universal health coverage is ensuring that everyone – especially people in vulnerable communities and remote areas – has access to well-trained, culturally-sensitive and competent health staff,” says Dr. Carissa Etienne, WHO Regional Director for the Americas. “The best strategy for achieving this is by strengthening multidisciplinary teams at the primary health care level.”

Universal health coverage aims to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. In the Americas, 70% of countries have enough health care workers to carry out basic health interventions, but those countries still face significant challenges linked to the distribution of professionals, their migration and appropriate training and skills mix.

“Training of health professionals must be aligned with the health needs of the country,” adds Dr. Etienne.

All countries are urged to heed the signals of shortages. For example, in developed countries, 40% of nurses will leave health employment in the next decade. With demanding work and relatively low pay, the reality is that many young health workers receive too few incentives to stay in the profession.

The publication also identifies maternal and child health as an urgent health workers’ action area. Around 90% of all maternal deaths and 80% of all still births occur in 58 countries, largely because those countries lack trained midwives. Also, of the 6.6 million under-five year olds who died in 2012, most deaths were from treatable and preventable diseases. Again, more health workers would prevent most of those unnecessary young deaths.

The Third Global Forum for Human Resources for Health is the largest event ever held on human resources for health, with more than 1300 participants from 85 countries, including 40 ministers of health.

For more information please contact:

Glenn Thomas
Communications Officer
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

Sonali Reddy
GHWA Communications Officer
Mobile: +41 79 509 0647
E-mail: reddys@who.int

Sebastian Oliel
Public Information Officer
PAHO/WHO
Telephone: +1202 316 5679
E-mail: oliels@paho.org

View the original article here

Sanofi in $40 million settlement over obesity drug linked to suicidal thoughts

By Jonathan Stempel

NEW YORK (Reuters) - Sanofi SA has reached a $40 million settlement of a U.S. lawsuit accusing the French drugmaker of misleading investors about the safety of a weight loss pill that a U.S. regulatory panel linked to suicidal thoughts.

The all-cash settlement was disclosed in a court filing on Thursday, and requires approval by U.S. District Judge George Daniels in Manhattan.

It resolves claims that arose after a U.S. Food and Drug Administration advisory committee on June 13, 2007 urged that the agency reject Sanofi's drug rimonabant, known by the trade names Acomplia and Zimulti, on concern that using it could increase suicidal thinking and depression.

Sanofi is the world's fourth-largest pharmaceutical company as measured by prescription drug sales. European regulators had approved use of rimonabant prior to the FDA panel action, but sales were later suspended.

Plaintiffs led by the Hawaii Annuity Trust for Operating Engineers accused Sanofi of touting the drug as a possible "blockbuster" to treat obesity, with only mild side effects.

But they said Sanofi concealed clinical tests that showed a statistically significant increase in "suicidality" among people taking the drug.

The release of the advisory committee recommendation caused Sanofi's shares in Europe and American depository receipts in the United States to fall in price.

Thursday's settlement covers investors in Sanofi ADRs between February 24, 2006 and June 13, 2007, and equates to about 37 cents for each of Sanofi's roughly 108 million ADRs at the time.

It also resolves claims against Gerard Le Fur, the former chief executive, and Hanspeter Spek, an executive vice president of pharmaceutical operations, court papers show.

"The settlement, in light of all the risks, was exceedingly fair, and represented a high percentage of the total damages suffered by the class," said Tor Gronborg, a partner at Robbins Geller Rudman & Dowd who represents the plaintiffs, in an interview.

Sanofi did not immediately respond to requests for comment.

The plaintiffs' law firm plans to seek a fee of $11 million, or 27.5 percent of the settlement amount, court papers show.

The case is In re: Sanofi-Aventis Securities Litigation, U.S. District Court, Southern District of New York, No. 07-10279.

(Editing by Eric Walsh)

View the original article here

U.S. poverty rate flat, 48 million people uninsured: Census

(Reuters) - The number of Americans living in poverty remained steady last year at 15 percent after rising for several years in the wake of the recession, while the number of people without health insurance fell slightly to 48 million, U.S. government data released on Tuesday showed.

The Census Bureau in its annual report said about 46.5 million Americans were living in poverty last year, little changed from 46.2 million in 2011.

The Census data also showed the 2012 median U.S. income was $51,017, also statistically unchanged from the previous year.

The share of Americans without health insurance coverage - another key indicator economic of well-being - was 15.4 percent in 2012 compared with 15.7 percent in 2011.

About 48 million people were uninsured in 2012 compared with 48.6 million in 2011, a change the Census Bureau described as statistically insignificant. The number of people with health insurance increased to 263.2 million in 2012 from 260.2 million in 2011, the bureau said.

The uninsured rate for people ages 19 to 25 fell to 27.2 percent, down from 27.7 percent a year earlier, and for ages 26 to 34 year fell to 27.2 percent from 27.5 percent a year earlier.

Employment-based insurance coverage fell to 54.9 percent from 55.1 percent. The rate of people insured through government programs like Medicare and Medicaid rose to 32.6 percent from 32.2 percent.

The rate of uninsured by race fell the most for the Asian population to 15.1 percent from 16.8 percent in 2011. The uninsured rate for Hispanic people fell to 29.1 percent from 30.1 percent.

In 2012, the uninsured rate for households with annual income less than $25,000 was 24.9 percent compared with a 7.9 percent rate for those households with income of $75,000 or more, the report said.

(Reporting by Caroline Humer and Susan Heavey; Editing by Vicki Allen)

View the original article here

UN: 6.6 million children under 5 died last year

LAGOS, Nigeria (AP) — Childhood death rates around the world have halved since 1990 but an estimated 6.6 million children under the age of 5 still died last year, the U.N. children's agency said Friday.

Nearly half of all children who die are in five countries: Nigeria, Congo, India, Pakistan and China, it said in a report.

"Progress can and must be made," said Anthony Lake, UNICEF's executive director. "When concerted action, sound strategies, adequate resources and strong political will are harnessed in support of child and maternal survival, dramatic reductions in child mortality aren't just feasible, they are morally imperative."

The top killers are malaria, pneumonia and diarrhea, the report said, taking the lives of about 6,000 children under age 5 daily. A lack of nutrition contributes to almost half of these deaths, the U.N. said.

Eastern and Southern Africa have reduced their death rates for children under 5 by more than 50 percent since 1990. West and Central Africa are the only regions not to have at least halved the number of children under 5 dying over the past 22 years, the U.N. said.

Nigeria bears more than 30 percent of early childhood deaths for malaria and 20 percent of the deaths associated with HIV. Globally, the country accounts for one in every eight child deaths, the U.N. said.

While these numbers are grim, the rate of improvement globally seems to have plateaued at about 4 percent improvement per year since 2005, the report said. The estimated numbers are based on solid data from about half the world's countries. And for regions with the biggest problems, they had to rely on modeling techniques.

Countries like Bangladesh, Ethiopia and Brazil showed tremendous progress, due in part to increased community health care. Affordable and increased interventions — like treated mosquito nets, medicines, rehydration treatments and improved access to safe water — helped improve the early childhood death rate in other countries as well.

But improvements were not as bold in countries like Nigeria, Congo, Sierra Leone and Pakistan, the report showed.

Lake said a new sense of urgency was needed to improve the figures.

"Yes, we should celebrate the progress," he said. "But how can we celebrate when there is so much more to do?"

Copyright c 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

View the original article here

Current pledges to reduce greenhouse gas emissions put over 600 million people at risk of higher water scarcity

Sep. 12, 2013 — Our current pledges to reduce greenhouse gas emissions, which are projected to set the global mean temperature increase at around 3.5°C above pre-industrial levels, will expose 668 million people worldwide to new or aggravated water scarcity.

This is according to a new study published today, 13 September, in IOP Publishing's journal Environmental Research Letters, which has calculated that a further 11 per cent of the world's population, taken from the year 2000, will live in water-scarce river basins or, for those already living in water-scarce regions, find that the effects will be aggravated.

The results show that people in the Middle East, North Africa, Southern Europe and the Southwest of the USA will experience the most significant changes.

The results show that if the global mean temperature increases by 2°C -- the internationally agreed target -- then eight per cent of the world population (486 million people) will be exposed to new or aggravated water scarcity, specifically in the Near and Middle East.

Lead author of the research Dr Dieter Gerten, from the Potsdam Institute for Climate Impact Research, said: "Our global assessments suggest that many regions will have less water available per person.

"Even if the increase is restricted to 2°C above pre-industrial levels, many regions will have to adapt their water management and demand to a lower supply, especially since the population is expected to grow significantly in many of these regions."

"The unequal spatial pattern of exposure to climate change impacts sheds interesting light on the responsibility of high-emission countries and could have a bearing on both mitigation and adaption burden sharing."

According to Dr Gerten, the main driver of new or aggravated water scarcity is declining precipitation; however, increased temperatures will also lead to an increase in evapotranspiration of water and, thus, decrease the resources.

The anticipated increase in population will have even stronger effects on the ratio of water demand and water availability in some regions.

To assess the impacts of different mean global warming levels, the international group of researchers combined existing simulations from 19 climate change models with eight different global warming trajectories. The latter ranged from 1.5°C to 5°C increases above pre-industrial levels, resulting in a total of 152 climate change scenarios that were examined.

In addition to water shortages, the researchers assessed the impact that future climatic changes may have on global terrestrial ecosystems. They sought to discover what areas will be affected by strong ecosystem changes, and whether these areas are rich in biodiversity and/or contain unique species.

"At a global warming of 2°C, notable ecosystem restructuring is likely for regions such as the tundra and some semi-arid regions. At global warming levels beyond 3°C, the area affected by significant ecosystem transformation would significantly increase and encroach into biodiversity-rich regions," continued Dr Gerten.

"Beyond a mean global warming of 4°C, we show with high confidence that biodiversity hotspots such as parts of the Amazon will be affected."

View the original article here

6.6 Million Young Adults Joined Parents' Health Plans in 2011: Report

AppId is over the quota
AppId is over the quota

FRIDAY, June 8 (HealthDay News) -- About 6.6 million young American adults who would likely not have been able to be covered by their parents' health plans before the Affordable Care Act took effect joined such plans in 2011, a new report finds.

The new study from the Commonwealth Fund found that, in total, 13.7 million young American adults, aged 19 to 25, either stayed on or joined their parents' health plans last year.

But not all young adults can join their parents' health plans and many still have gaps in coverage and are burdened with medical bill problems and medical debt, the report found.

Nearly two in five young adults (39 percent) aged 19 to 29 went without health insurance at some time in 2011 and more than one-third (36 percent) had medical bill problems or were paying off medical debt. Of those who were dealing with medical bills or debt, many faced serious financial consequences such as using all of their savings (43 percent), being unable to make student loan or tuition payments (32 percent), delaying education or career plans (31 percent), or being unable to pay for necessities such as food, heat or rent (28 percent), the researchers said.

One-quarter of young adults with medical debt owed $4,000 or more, and 15 percent owed $8,000 or more, the report noted.

"While the Affordable Care Act has already provided a new source of coverage for millions of young adults at risk of being uninsured, more help is needed for those left behind," lead author and Commonwealth Fund Vice President Sara Collins said in a Commonwealth Fund news release.

Young adults in low-income households were most likely to be uninsured, the report said. Seventy percent of young adults with incomes below 133 percent of poverty ($14,484 for a single person) had a gap in coverage in 2011. That's more than three times the rate of those with incomes over 400 percent of poverty ($43,560 for a single person).

The study also found that only 17 percent of young adults aged 19 to 25 in low-income families stayed on or joined their parents' health plans, compared with 69 percent of those in the highest income households. Young adults older than 25 are not eligible.

Young adults who did not have insurance or had a gap in coverage were more likely than those with continuous coverage to skip or delay getting needed health care because of cost -- 60 percent, 56 percent and 29 percent, respectively.

However, Collins noted that "the law's major insurance provisions slated for 2014, including expanded Medicaid and subsidized private plans through state insurance exchanges, will provide nearly all young adults across the income spectrum with affordable and comprehensive health plans."

The findings are based on an online survey of 1,863 respondents, aged 19 to 29, that was conducted in November 2011.

More information

The U.S. Centers for Medicare and Medicaid Services has more about young adults and the Affordable Care Act.

Copyright c 2012?HealthDay. All rights reserved.