Many countries lack capacity to prevent and treat hearing loss

28 February 2014 | GENEVA - Many of the countries who responded to a new WHO survey lack the capacity to prevent and care for hearing loss, according to a report published on International Ear Care Day, 3 March.

Results of the survey

“The results of this survey are a clear call to action for governments and partners to invest in hearing care especially at community and primary level.”

Dr Etienne Krug, Director of the WHO Department of Violence and Injury Prevention and Disability

WHO estimates that over 5% of the world’s population – 360 million people - has disabling hearing loss. The highest prevalence is found in the Asia Pacific, South Asia and sub-Saharan Africa. About half of all cases of hearing loss worldwide are easily prevented or treated.

A leading cause for hearing loss in younger ages, particularly in low- and middle-income countries, is untreated ear infections, which often presents with discharge from the ear. Vaccine-preventable infectious diseases such as rubella, meningitis, measles, or mumps can also lead to hearing loss.

Just 32 of the 76 countries who responded have developed plans and programmes to prevent and control ear diseases and hearing loss. According to the report, many lack trained health personnel, educational facilities, data and national plans to address the needs of those living with ear and hearing problems. The information received also indicates that the gap between need and services is greatest in sub-Saharan Africa.

“The results of this survey are a clear call to action for governments and partners to invest in hearing care especially at community and primary level,” says Dr Etienne Krug, Director of the WHO Department of Violence and Injury Prevention and Disability. “The programmes must aim to benefit all, including disadvantaged parts of the population who are least able to access hearing services.”

Prevention and treatment of hearing loss at primary level

Good ear care practices, such as reducing exposure to noise and avoiding insertion of objects into the ears, can prevent many from developing ear and hearing problems. A large percentage of people living with hearing loss can benefit from early identification and appropriate treatment.

For example, screening programmes for infant hearing can minimize the impact of hearing loss on a child’s development.

“Ear and hearing problems and the use of hearing aids are often associated with myths and misconceptions”, says Dr Shelly Chadha of the WHO unit for the Prevention of Blindness and Deafness. “National programmes should therefore not only focus on prevention and service provision but also on awareness raising.”

The national plans that already exist in some countries can serve as a model for countries that still lack strategies to better address disabling hearing loss. However, each country needs to develop a unique plan based on its specific situation, the prevalent causes of hearing loss as well as the available health infrastructure.

For more information please contact:

Tarik Jasarevic
WHO, Geneva
Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 79367 6214
E-mail:jasarevict@who.int

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Progress in diagnosing multidrug-resistant tuberculosis

20 March 2014 | Geneva - Almost half a million people fell ill with multidrug-resistant tuberculosis (MDR-TB) in 2012, yet less than one in 4 of these people was diagnosed, mainly due to a lack of access to quality diagnostic services.

But with an innovative international project, 27 countries are making promising progress in diagnosing MDR-TB, says WHO in the lead-up to World TB Day, 24 March.

The project known as EXPAND-TB (Expanding Access to New Diagnostics for TB), financed by UNITAID, helped to triple the number of MDR-TB cases diagnosed in participating countries.

“Earlier and faster diagnosis of all forms of TB is vital,” says Dr Margaret Chan, WHO Director-General. “It improves the chances of people getting the right treatment and being cured, and it helps stop spread of drug-resistant disease.”

World TB Day 2014: Reach the 3 million

"Earlier and faster diagnosis of all forms of TB is vital. It improves the chances of people getting the right treatment and being cured...”

Dr Chan, WHO Director-General

The theme for World TB Day 2014 is “Reach the 3 Million”. One third of the estimated 9 million people falling ill with TB each year do not get the care they need. In many countries, it is hard for people to access diagnostic services – particularly for MDR-TB. Some countries have only one central laboratory, which often has limited capacity to diagnose MDR-TB. In some cases, patient samples have to be sent to other countries for testing. Moreover, traditional diagnostic tests can take more than 2 months to get results.

But the situation is beginning to change. New technologies can rapidly diagnose TB and drug-resistant TB in as little as two hours.

“The MDR-TB story is being transformed by a fertile mix of collaborators, including those working on access to diagnosis,” says Philippe Meunier, the French Government’s Ambassador for the fight against HIV/AIDS and communicable diseases. “Increased capacity and reduced prices mean more patients can be served, and global health risks would be diminished.”

In 2009, UNITAID provided US$ 87 million to support the EXPAND-TB multi-partner project to enable effective and sustained access, and use of recommended new TB diagnostic technologies in 27 low- and middle-income countries. These countries together carry 40% of the estimated global MDR-TB burden.

The project delivers positive results

The project has delivered impressive results. Over 30% of the MDR-TB cases detected globally in 2012 were from EXPAND-TB countries. 90% of India’s detected MDR-TB cases were through EXPAND-TB supported services. Use of these tests requires strengthened laboratory services. By the end of 2013, 92 laboratories were fully operational. From 2009 to 2013, the number of MDR-TB cases diagnosed in the 27 countries tripled, with 36 000 diagnosed in 2013 alone.

The project has enabled more patients to be treated with quality-assured second-line TB medicines. Through that demand, the project has helped to reduce the price of individual medicines and MDR-TB treatment regimens by one third. Prices have also dropped for diagnostic commodities.

Project partners are WHO and the Global Laboratory Initiative (GLI), the Stop TB Partnership’s Global Drug Facility and FIND. Project funds have been used to purchase testing equipment and commodities, and to train laboratory technicians.

The EXPAND-TB project complements investments in laboratory infrastructure and diagnostic services from international partners, including The Global Fund to Fight AIDS, TB and Malaria, The World Bank and the United States Government.

“The gap in access to TB diagnostics and care is far from filled, but is narrowing. With the impetus of modern laboratories, we are on the right track finally to handle MDR-TB,” says Dr Mario Raviglione, Director of WHO’s Global TB Programme.

Ministries of health are now working on securing domestic funding for the medium-term and working with partners to fill financing shortfalls for quality diagnostic tests and services.

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Note to editors

EXPAND-TB Partners, and additional quotes from participants in the 20 March press briefing

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.

UNITAID is a global health initiative launched in 2006 by the Governments of Brazil, Chile, France, Norway and the United Kingdom to provide sustainable funding for the fight against HIV/AIDS, malaria and tuberculosis. About 70% of UNITAID’s funds come from a small levy on airline tickets. Through implementers, UNITAID finances the purchase of quality-assured drugs and diagnostics for patients in poor countries, using its market power to expand supply, promote development of new and better products, cut delivery lead times and reduce prices.

Dr Philippe Duneton, Executive Director a.i., UNITAID said, “The EXPAND-TB project has been an important part of UNITAID’s TB investment portfolio as identifying cases has been, and remains, essential. To reach the missing three million, we must continue to find and use ever-better diagnostics technologies, but also enable access for low- and middle-income countries to the new medicines now available.”

The Stop TB Partnership’s Global Drug Facility (GDF) coordinates and manages procurement and delivery of TB commodities like quality assured medicines, diagnostic equipment and supplies to eligible countries, offering as well technical assistance for building more sustainable supply chain systems. The GDF has procured and distributed diagnostics and laboratory equipment for the project and, by pooling the global demand for Second Line anti-TB Drugs within one single procurement platform, has reached up to 32% cost reduction for MDR-TB treatment, bringing a broader basis of suppliers producing quality assured medicines and allowing more market competition.

“We need to ensure that diagnostics are accessible and closer to people. This project is a successful multi-partner strategic approach where diagnostic, treatment capacity and medicines supply have been linked together, showing the path for a stronger fight against MDR-TB " said Dr Joel Keravec, GDF Special Advisor.

FIND is an international non-profit organization that drives development and delivery of innovative diagnostic solutions for poverty-related diseases. As the main implementing partner for EXPAND-TB, FIND works closely with national TB programmes and multiple international and local partners to build laboratory capacity, accelerate uptake and establish the know-how needed for correct use of new TB technologies. FIND helps ensure that all the key components that are needed for successful diagnostic implementation are put in place, and aims to maximise patient impact.

Dr Catharina Boehme, FIND’s Chief Executive Officer, said “Without diagnostics, medicine is blind. The EXPAND TB project is critical for scaling up the capacity to detect TB drug resistance. It has also laid the ground for rapid uptake and proper use of future diagnostic innovations that are urgently needed to effectively fight TB and drug resistance. Continued commitment from the global health community in support of new tools, especially point-of-care diagnostics, should remain a high priority.”

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For more information, contact

Mr Tarik Jasarevic
Mobile: +41 79 367 6214
Tel.: +41 22 791 5099
Email: jasarevict@who.int

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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

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Biocon to start selling breast cancer drug in India in February

MUMBAI (Reuters) - Biocon Ltd said its generic version of Roche's Herceptin breast cancer treatment would be available to patients in India from the first week of February.

Bangalore-based Biocon jointly developed biosimilar trastuzumab, which received the Indian drug regulator's marketing approval in November, with U.S.-based Mylan Inc.

About 150,000 people are diagnosed with breast cancer every year in India, of which 25 percent are eligible for treatment with trastuzumab, Biocon said.

Roche decided not to pursue a patent application for its breast cancer drug Herceptin in India, paving the way for generic drugmakers to produce cheaper copies, known as biosimilars because they are not identical to the original drug.

Global sales for Herceptin were valued at about $6.4 billion in 2012, including about $21 million in India, Biocon said.

(Reporting by Aradhana Aravindan; Editing by Sonya Hepinstall)

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Smooth sailing: Rough surfaces that can reduce drag

Jan. 17, 2014 — From the sleek hulls of racing yachts to Michael Phelps' shaved legs, most objects that move through the water quickly are also smooth. But researchers from UCLA have found that bumpiness can sometimes be better.

"A properly designed rough surface, contrary to our intuition, can reduce skin-friction drag," said John Kim, a professor in the mechanical and aerospace engineering department at UCLA. Kim and his colleagues modeled the fluid flow between two surfaces covered with tiny ridges. They found that even in turbulent conditions the rough surface reduced the drag created by the friction of flowing water. The researchers report their findings in the journal Physics of Fluids.

The idea of using a rough surface for reduced drag had been explored before, but resulted in limited success. More recently scientists have begun experimenting with rough surfaces that are also extremely difficult to wet, a property called superhydrophobicity. In theory this means that the surfaces can trap air bubbles, creating a hydrodynamic cushion, but in practice they often lose their air cushions in chaotic flows.

The ULCA team chose to model a superhydrophobic surface design that another group of researchers at UCLA had already observed could keep air pockets entrapped, even in turbulent conditions. The surface was covered with small ridges aligned in the direction of flow.

The researchers modeled both laminar and turbulent flows, and unexpectedly found that the drag-reduction was larger in turbulent conditions. The irregular fluctuations and swirling vortices in turbulent flows on smooth surfaces generally increase drag, Kim explained. However, the air cushion created by the superhydrophobic ridges altered the turbulent patterns near the surface, reducing their effect, he said.

The team expects insights gleaned from their numerical simulations to help further refine the design of rough, drag-reducing surfaces. Further down the line, such surfaces might cover the undersides of cargo vessels and passenger ships. "It could lead to significant energy savings and reduction of greenhouse gas emissions," Kim said.

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Two students wounded in Philadelphia high school shooting

By Daniel Kelley

PHILADELPHIA (Reuters) - Two students were shot and wounded on Friday afternoon at a charter high school in northern Philadelphia, police said, in the latest school shooting to fuel a national debate over gun control laws.

A teenaged girl and a boy were shot in their arms at the Delaware Valley Charter High School at about 3:30 p.m. when a young male pulled a handgun in a gymnasium with about seven students in it, officials and media reports said.

Police said the young man who fired the gun was part of the group, CNN reported. The shooting may have been an accident, police said.

Investigators have not said who fired the shots. A boy was taken into custody, but later cleared, said Philadelphia Police Lieutenant John Stanford.

"Initially, he was thought to be the shooter, but investigators were able to determine the kid was not a shooter," Stanford said. "He was there but I don't believe he was involved."

Another boy turned himself in and was being interviewed by police late Friday night, Stanford said. A third boy was also supposed to turn himself in, but had not yet done so.

Local television station 6ABC reported the girl and boy who were shot were both 15 and in stable condition.

Philadelphia Police Commissioner Charles Ramsey said the shooting was caught on video.

Earlier, police used Twitter to urge the suspected shooter to surrender.

"SHOOTER - Turn yourself in. Get it over with now," they said.

School shootings such as the one at Sandy Hook elementary school in December 2012 that left 26 people dead have intensified a national debate over whether gun control regulations need to be stricter to curb gun violence.

In another shooting incident on Friday, a 16-year-old student was shot in the arm, apparently by a student with whom he had a dispute, as he walked away from Albany High School, about 165 miles south of Atlanta, WALB-TV reported.

In October, a 12-year-old boy killed a teacher and wounded two students at his school in Sparks, Nevada, before killing himself. Another 12-year-old boy in New Mexico is accused of seriously wounding two students with a shotgun on Tuesday.

(Reporting by Daniel Kelley; Additional reporting by Marina Lopes, Lisa Maria Garza, and Eric M. Johnson; Editing by Ellen Wulfhorst, Gunna Dickson, Sharon Bernstein, Lisa Shumaker and Sonya Hepinstall)

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Searching for magic bullet against cancer caused by asbestos: One step closer?

Jan. 17, 2014 — Mesothelioma is a very aggressive cancer associated with asbestos exposure, which is usually diagnosed in an advanced stage. So far no therapeutic strategy has proven effective against this deadly cancer and the prognosis remains very poor with only few exceptions.

In December, the research team of Antonio Giordano, a pathologist, Director and Founder of the Sbarro Health Research Organization in Philadelphia, PA, and Professor of Pathology and Oncology at the University of Siena, Italy, published two separate studies aiming to address the urgent need to identify possible new methods for mesothelioma treatment.

In the first study, published in the scientific journal Cell Cycle, Giordano's researchers tested on mesothelioma cells the effect of two drugs designed to reactivate the p53 protein, one of the most important 'tumor suppressors', which is turned off in most human cancers. "In mesothelioma, although p53 is rarely mutated, it is inactivated by alterations in its pathway," says Francesca Pentimalli of the National Cancer Institute of Naples, Italy, lead author of the study. Both of the drugs used in the study target p53, but with different mechanisms of action. One in particular, called RITA, proved to be very toxic. Specifically, RITA caused mesothelioma cells, and not 'healthy' cells, to undergo apoptosis -- a type of programmed cell death that occurs through the activation of a specific 'cascade' of events.

"The ability of RITA to induce apoptosis is remarkable considering that mesothelioma is very refractory to this process. In fact the most aggressive and rare variant, sarcomatoid mesothelioma, did not respond to the treatment probably because of its intrinsically high levels of molecules acting as inhibitors of this process" says Alfredo Budillon, Head of the Experimental Pharmacology Unit of the National Cancer Institute of Naples and coauthor of the study. "It remains to be seen whether the combination of RITA with other activators of apoptosis can achieve efficacy also against the more aggressive cases."

Furthermore, challenging mesothelioma cells with RITA worked in synergy with the chemotherapy drug cisplatin, which is the mainstay of treatment for this disease, suggesting that its use in a clinical setting could possibly help to reduce the required doses and the side effects of chemotherapy, thereby improving patients' quality of life.

The second study, published online in Cancer Biology and Therapy and led by Paola Indovina of the University of Siena and the Sbarro Institute for Cancer Research and Molecular Medicine, Temple University in Philadelphia, was designed along the same lines as the first study. In the second study, the authors tested, for the first time in mesothelioma, a new drug called MK-1775 in combination with cisplatin. MK-1775 is a selective inhibitor of WEE1, a protein that is crucial in activating a 'checkpoint' for the repair of damaged DNA before the cell starts its division process. The rationale for this strategy is based on the fact that many cancer cells, especially those with non-functional p53, rely on WEE1 to stall cell division and allow cells to repair the damage induced by genotoxic agents, such as many chemotherapeutic drugs, including cisplatin. WEE1 inhibition limits the time available for repair and, therefore, sensitizes cancer cells to DNA-damaging agents. Indeed, inhibiting WEE1 with MK-1775 selectively sensitized mesothelioma cells to the genotoxic action of cisplatin by preventing checkpoint activation and forcing the cells to divide despite the damage, thus triggering apoptosis.

"Overall our studies are aimed at identifying promising new molecular therapies against mesothelioma that hold the potential for clinical use in the near future. MK-1775, for example, is already being utilized in clinical trials for other types of tumors in the United States," Giordano concludes.

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Is Europe equipped with enough medical oncologists? Horizon still unknown

Jan. 17, 2014 — The European Society for Medical Oncology (ESMO) has welcomed a recent survey that shows the number of medical oncologists in Western Europe appears to be keeping pace with the rising toll of cancer.

But the society has also warned that a worrying lack of information about the situation in Eastern Europe must be urgently addressed.

Published in the Annals of Oncology this week, the survey provides the first detailed information on the current number of medical oncologists in 12 European Union countries, mostly in Western Europe, and their predicted availability by 2020.

Around the world countries are struggling to ensure their medical oncology systems can deal with the increase in cancer cases, says ESMO Press Officer Solange Peters, a lung cancer expert from the university of Lausanne, Switzerland. Until now, nobody could say what the situation was in Europe.

The survey, led by Evandro de Azambuja from Jules Bordet Institute, Brussels, shows that Austria, Belgium, Bulgaria, Finland, France, Germany, Hungary, Italy, The Netherlands, Portugal, Sweden and the UK will probably have enough medical oncologists over the next eight years since data collection to meet the needs of an increasing cancer patient population.

The study provides the current ratio of cancer cases to medical oncologists for each country, and shows the annual increase in the total number of medical oncologists.

However, despite repeated attempts, researchers were not able to gather adequate information from the 15 other EU Member States, making it impossible to paint a full picture of the situation in Europe.

"ESMO is willing to help countries work together to make this kind of data available for all of Europe," Peters says. "We need a complete picture and the current one is insufficient to draw firm conclusions."

"It is vital that we collect this data and we continuously monitor it, to optimise the medical oncology system in every European country," says the ESMO spokesperson.

"In the long term, we hope that it might be possible to build a Europe-wide system that will ensure we have a full picture of the needs across Europe, also beyond 2020, to guarantee optimal care to cancer patients" she says.

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LGBT tolerance growing in Jamaica, push to repeal of anti-gay law

By Aileen Torres-Bennett

KINGSTON (Reuters) - Prince Jones says he will never go back to Jamaica, not even to visit.

The 25-year-old, who is gay and uses a pseudonym to protect himself and his family, grew up in Kingston and recalls how he was repeatedly harassed over his sexuality before moving to the United States in 2012.

The plight of gays in Jamaica has cast an ugly spotlight on the Caribbean island, famous for its beaches, speedy athletes and laid-back culture.

When Jamaican Prime Minister Portia Simpson Miller visited New York to attend the 68th United Nations General Assembly meeting in September, she was greeted by protesters who chanted: "Shame on you, Portia. Gay rights, human rights."

Such protesting is uncommon in Jamaica, where homophobia is a cultural norm. Yet despite the stigma attached to homosexuality, the push for equal rights for the lesbian, gay, bisexual and transgender (LGBT) community is gaining momentum.

The government says it plans to test the waters by conducting a non-binding "conscience vote" in parliament on ending the notorious Jamaican Offenses Against the Person Act, which makes anal sex a crime, regardless of gender or consent, and prohibits "acts of gross indecency" between men, in public or in private.

The Minister of Justice, Mark Golding, told Reuters that a vote in parliament would take place before the end of the legislative year in March, opening the door for the law to be reviewed, possibly later in 2014.

The prime minister, although she was the target of gay rights protesters in New York, reflected this increasing tolerance during her election campaign in 2011, when she advocated repeal of the law.

"No leader at that level had ever made that kind of statement," said Dane Lewis, the executive director of the Jamaica Forum for Lesbians, All-Sexuals & Gays (J-FLAG). "It would normally have been political suicide, but their party won."

Time and effort are needed to prepare for the vote, according to J-FLAG. If it were held now, the group fears the law would likely stand because there would not be enough time for MPs to get feedback from their constituents on the issue.

Barely a third of MPs could be counted on to support repeal, Lewis said.

Even so, in the last few years the LGBT community has been making public inroads, according to Lewis. "There have been shifts in terms of increasing pockets of tolerance," he said.

Simpson Miller's declaration to put the Offenses Against the Person law on the national agenda is a far cry from former Prime Minister Bruce Golding's stance. In 2008, Golding openly stated that he would never appoint a gay cabinet minister.

Analysts say Simpson Miller's decision to seek a conscience vote could be politically well-timed as pressure from the gay community has been building on the island, which is sensitive to its international image in the tourism industry.

Legally, there are no rights in Jamaica pertaining specifically to the LGBT community. Public tolerance is growing, as evidenced by the willingness of the press in the last few years to cover LGBT issues, but open expression of homosexuality is still frowned upon.

At worst, the intolerance can lead to murder. In July, a cross-dressing male teenager from Montego Bay was stabbed to death after being accosted while dancing at a party dressed as a woman.

As a teenager, Jones shunned the island's macho culture, wearing elegant clothes and speaking with more refined language than the patois of his peers.

He didn't have to say he was gay. People put two and two together, and branded him. "Perception is all it takes," he said.

Throughout high school, being harassed "was my daily prescription," he told Reuters. He came to be known in his community as a "batty man," common slang in Jamaica for homosexuals derived from the male posterior.

In 2011 he was waiting at the bus stop when a group of men approached him, spouting slurs. One wielded a knife and another held a metal rod. "My heart just sank," said Jones, before he hopped on a passing bus to make a getaway.

Jones said he also lost friends because of his homosexuality and has experienced discrimination in his own family.

He moved to the United States in November 2012 and now has a job raising awareness for LGBT asylum-seekers.

He has gay relatives and close friends in Jamaica who have become victims of violence. "My cousin was murdered on suspicion that he was gay. A friend of mine was stabbed to death," he said.

The Offenses Against the Person law is rarely applied by prosecutors, in large part because it requires someone witnessing the sexual act and reporting it. But its continued presence on the books is more than symbolic, analysts say, pointing to police harassment of gays.

The latest report by the Inter-American Commission on Human Rights points a finger at civilians and the police for committing violence against LGBTs. The report states that LGBTs experience "police harassment, arbitrary detention, mob attacks, stabbings, and harassment ... by hospital and prison staff and targeted shooting of homosexuals."

In the Caribbean, Jamaica is not unique in its homophobia. The former British colonies in the region all have a history of anti-sodomy laws from the colonial era, according to the Commonwealth Human Rights Initiative.

Conservative groups, such as the Jamaica Coalition for a Healthy Society and the Lawyers Christian Fellowship, held a conference last December in Kingston where they advocated keeping the Offenses Against the Person law. They also took out a full page ad in one of the main daily newspapers, calling efforts to repeal the law an "international human rights scandal."

The Supreme Court is set to weigh in on the Offenses Against the Person law with a trial scheduled to start in November. Javed Jaghai Aajri, who used to work for J-FLAG, wants the Court to rule on whether the law violates the right to privacy under Jamaica's Charter of Fundamental Rights and Freedoms.

Jagai Aajri declined to be interviewed for this story.

Jamaica's Ministry of Justice established and filled a human rights officer post within the ministry last year and is looking to establish a Social Justice Commission to promote human rights. The ministry is also in talks with the United Nations Development Program for assistance in formulating the case for reform of the law.

These government-led efforts represent progress for the LGBT community, but "legislation is just one piece," said Lewis. "That's not a magic bullet. There has to be community-level work. The bigger issue is increasing the understanding of Jamaicans. People still think it's a choice."

(Editing by David Adams and Ken Wills)

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Genomic study identifies subgroups of breast cancer with varying sensitivities to treatment

Jan. 17, 2014 — Research led by the Translational Genomics Group at Vall d'Hebron Institute of Oncology (VHIO) in Barcelona has not only shown that HER2+ breast cancer can be classified into four different subtypes, but also unmasked a subtype showing both a greater response to and increased benefit from chemotherapy and anti-HER2 therapy. Such newly, refined classification of different tumor subtypes will ultimately facilitate more effective treatment tailored to a specific tumor as well as advance targeted therapy against HER2+ breast cancer.

The study led by Aleix Prat, Principal Investigator of VHIO’s Translational Genomics Group, in collaboration with Jose Baselga, Physician-in-Chief of the Memorial Sloan Kettering Cancer Center, New York (USA), has today been published in the journal Clinical Cancer Research. The research centers on the fact that not all HER2+ tumors respond in the same way to anti-HER2 targeted therapy. Although tumors disappear in many patients, others show no response or become resistant to anti-HER2 therapy in combination with chemotherapy. This observation led to this present retrospective study of patients treated in the phase III NOAH clinical trial, with the objective of establishing the genomic differences of both the treatment-sensitive and the treatment-resistant tumors.

Determining the molecular subtype of any breast cancer is fundamental. Until recently, breast cancer had been classified into three groups according to the presence or absence of hormone receptors and the HER2 receptor: hormone-sensitive, HER2+ and triple-negative (when not included in either of these first two groups). Over recent years however, largely thanks to the stunning advancements in genomic technologies, this classification has been finely-tuned and subsequently shown that there are at least four major breast cancer subtypes (Luminal A, Luminal B, HER2-enriched and Basal-Like). Last year, this very group of researchers refined the classification of hormone-sensitive tumors by genomics.

In this study, the group focuses on HER2+ disease. HER2+ breast cancer affects 20% of women with breast cancer and is characterized by the presence of a large number of HER2 receptors and increased proliferative activity of the respective tumor cells -- all of which translates in a highly aggressive tumor and the consequent increased risk of relapse and cancer-related death. The development of HER2-targeted therapies, such as Trastuzumab or Lapatinib, has greatly improved the prospects and treatment options for patients suffering from this particular type of cancer. However, HER2+ breast cancer is still considered as a single subgroup and receives a similar kind of treatment overall, despite the fact that not all HER2+ breast cancer patients respond equally to such therapy.

This new study evaluated the response of the different molecular subtypes upon treatment with anti-HER2 therapy. The study reveals that the four genomic subtypes in breast cancer (Luminal A, Luminal B, HER2-enriched and Basal-like) are also found in HER2+ breast cancer, and they affect treatment response. "Specifically, we have found that HER2+ tumors in the HER2-enriched subtype have a highly activated HER2 signaling pathway, thereby making them especially sensitive to anti-HER2 targeted therapies such as Trastuzumab. Therefore, among the four defined subtypes, HER2-enriched benefits most from specific anti-HER2 therapy" explains Aleix Prat.

Establishing the genomic and clinical particularities between each of the subtypes may firstly drive more individually tailored treatment strategies, leading in turn to more robust treatment for those who stand to benefit from it. Second, more effectively targeted treatments may also be facilitated for those patients who may benefit from this strategy and thus ultimately receive a more personalized, precise therapy, resulting in better and longer survival. The PAMELA study led by Prat through the support of a Susan G. Komen Foundation grant, involving various Spanish sites coordinated by the SOLTI cooperative research group, will aim to address the latter. The PAMELA study's primary objective is to identify those patients with HER2-positive tumors who can be cured with anti-HER2 biological therapies without the need for chemotherapy.

Cancer genomics: research translated to the clinic

"There is no doubt that gene expression in breast cancer provides us with essential biological information to better determine the diagnosis, treatment, relapse risk and possibilities of survival" says Aleix Prat, "From this moment on, treatment strategies should be based on prior molecular characterization of the tumor, and we must therefore make every effort to ensure accuracy. Genomic tests provide such accuracy and are increasingly being used in daily practice. There really is no other option if we are to continue to combat cancer," he concludes.

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