Oven building in an Eritrean camp for internally displaced persons, Red Cross

Government intolerance towards any forms of independent press, religious organizations, and the majority of civil society activity has created an environment of aggressive legal policies that deny prisoners any form of representation in a court of law

Eritrea, located in north-eastern Africa, has long been a nation plagued with political unrest resulting in public health and human rights violations. Of Eritrea’s population of approximately 5 million individuals, almost half of this population is reliant on international food aid support and nearly 85,000 children were identified as suffering from the long term health affects of malnourishment.

Recently, political and military unrest such as armed conflict between Eritrean and Djibouti forces has exacerbated turbulence in the region. Furthermore, Eritrea’s role as host to the Asmara wing of the Alliance for the Re-Liberation of Somalia (ARS) and position as subsequent transit point providing weapons and ammunition to Somalia has created a militarily volatile region.

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 Students at Chancellor College -  Photograph courtesy of the author.

Today’s blog is from Devan Jaganath, a medical student from the David Geffen School of Medicine at the University of California, Los Angeles. Devan writes about his thoughts on HIV education and prevention strategies aimed at university students following his experiences in Malawi.

While there is a strong foundation in HIV education for students, there is a missing piece that bars behavioral change.

Youth between 15-24 contribute to the majority of new cases of HIV worldwide, university students fall into this range and several programs in Sub-Saharan Africa focus on this community. I am spending three weeks at Chancellor College, in Zomba, Malawi, to learn of the unique risks that students face in getting HIV and why increased focused should be placed on this group. In some ways it is difficult to imagine that students at Chancellor would be at risk of HIV.The entire University of Malawi system has around 7000 students; for a nation of about 14 million people, these individuals are considered among the best and brightest in the country. As I walk around the campus, endless posters by faith-based groups promote abstinence and deride sexual misconduct. Also, first year students attend an orientation program by Zamanawe (“Give it a Try”), a HIV peer education program organized by four universities in sub-Saharan Africa, including Chancellor. For fourth years, there is Why Wait?, a program that promotes abstinence.

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The DDT Molecule, www.worldofmolecules.com

Today we’d like to announce the publication of Himali Weerahandi’s artice on the Indian Comprehensive Rural Health Project, an effort to improve rural healthcare in the country by involving local village women. Read it here.

We’d also like to announce that the Australian Medical Students Association (AMSA) Global Health Conference will be held in Brisbane from tomorrow onwards. The conference will attract students from Australia, New Zealand and the Asia-Pacific region who share an interest and passion for global heath and the desire to be involved in improving the health outcomes of population in their local, national and global communities. An academic program reflecting the core challenges and issues pertaining to global health will be complemented by an enticing social program, seeking to capture the spirit of cultural diversity in Australia and around the world. We look forward to hearing all about it in AMSA’s conference report - check it out next week.

Meanwhile, today’s blog is on the efforts to combat the use of DDT to fight malaria.

The international community has labelled DDT as one of what the WHO describe as a ‘dirty dozen’ of organic pollutants

The World Health organization (WHO) and UN Environments Programme (UNEP) have announced that they are working with the Global Environment Facility on an international effort to find sustainable alternatives to the synthetic pesticide DDT in combating the spread of malaria. A mainstay of the WHO’s anti-malaria campaigns in the 1950s and 1960s, DDT is increasingly being seen as a solution “rooted in the scientific knowledge and simplistic options of a previous age”, according to UNEP Executive Director Achim Steiner.

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An engraving depicting the plague from the sixteenth century (Wellcome Library, London).

Today’s podcast contains an interview with top climate change campaigner Mustafa Abbas, he talks to John and Erica about working on the recent Lancet report on climate change and health as well as the Healthy Planet campaign and Copenhagen conference. Listen in here.
The scourge of the plague persists in many areas of the world.

If, like me, you thought that the bubonic plague died out long ago with other medieval relics, you may be surprised to hear that it is alive, kicking and in Libya. Following a number of reported cases in the northeast and northwest Libya, the World Health Organisation (WHO) have sent a team to investigate.

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REUTERS/Kevin Lamarque

This new and powerful measure is being celebrated as a major move against one of America’s greatest killers.

Over 400,000 deaths occur yearly in the U.S. as a result of tobacco consumption. Targeting consumers at a young age with child friendly advertising, the tobacco industry has cultivated generations of smokers whose addiction fuelled product loyalty is to the death. Most who smoke are vulnerable to the highly addictive properties of nicotine and will face an average seven year battle before winning the fight to quit for good. U.S. President Barack Obama is no exception. And now Obama’s white house has taken land mark action as the Family Smoking Prevention and Tobacco Regulation Control Act passed by Congress has been signed into law.

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Congolese refugees seeking medical attention, WHO

In this week’s podcast, we introduce our new intern Erica and she chats about, amongst other things, her experiences with the British medical students’ association Medsin. Listen in here. In today’s blog, we continue our series on human rights throughout the world, focussing on the Democratic Republic of Congo.

The majority of the population lives in abject poverty where more than two thirds suffer from malnutrition and the average life expectancy is 45.8 years

The Democratic Republic of Congo (DRC) is a country in central Africa, known until 1997 as Zaire. It is a country rich in mineral resources such as cobalt ore, copper and industrial diamonds, and, as a result, the country has been exploited by mining corporations and a government that sells off this natural wealth without the workers receiving any benefit. The majority of the population lives in abject poverty where more than two thirds suffer from malnutrition and the average life expectancy is 45.8 years.

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 UNODC, unodc.org

A major burden on healthcare is illicit drug abuse with 200 million people using drugs every year, and a mortality rate of 200,000 in drug related diseases worldwide.

To help the wider UN World Drug Campaign, the United Nations Office on Drugs and Crimes (UNODC) publishes the World Drug Report, launched on 24th June, and promotes the International Day against Drug Abuse and Illicit Trafficking, on 26th June. The UN World Drug Campaign is aimed at promoting health in youngsters, informing them of the dangers of illicit drug use within society, and encouraging action against drug abuse.

The World Drug Report gave evidence on annual trends in the world drug markets. Highlights of the report include steady or falling global markets for cannabis, cocaine and opiates compared to sharp rises in synthetic drugs, chemically synthesised, within developing countries. The Report has shown a shift in the $50 billion cocaine trafficking market with a fall in seizures, increasing prices and fluctuating consumption patterns. This has led to conflicts between cartels in Central America fighting for falling demand. The falling markets have been recognised by Antonio Costa, director of UNODC, commenting: “International efforts are paying off.”

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A displaced Kenyan mother and child in a refugee camp, MSF

Today we’ve published Bharat Kumar’s interview with Doctor Frank Bai, Medical Director of AmeriCares, America’s largest humanitarian aid organisation. Read the interview here. Meanwhile, today’s blog is from Vinit Shah, a 4th year medical student at Manchester University. He writes about the breakdown of the health services in Kenya after last year’s post-election violence.

Although the conflict is largely resolved at present, the death toll rose to 1,000 in the first month, while half a million people were displaced before international mediation arrived

It seems it was a moment long past and neatly tucked away into the world history books when a country overnight turned from a haven in the east of Africa to the centre of a bloodbath. Kenya, for many years, had maintained a united state and even though surrounded by countries facing internal violence and turmoil, kept its peace. However things took a turn for the worst on December 27, 2007, the day of election results, when opposition supporters were unsatisfied with results. This was a modern example of how quickly and substantially civil conflict can show its colours. Although the conflict is largely resolved at present, the death toll rose to 1,000 in the first month, while half a million people were displaced before international mediation arrived in February 2008. However this was the least of the suffering of the peoples of this geographically amazing country.

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 Allan Gichigi/IRIN - The Lancet

The actors involved in global health have changed dramatically in recent years, as detailed in the report below (also featured in this week’s The Lancet). Our very own editor, Rhona Macdonald, is currently attending the meeting in Venice on the subject.

GHIs have been flying blind, apparently indifferent to knowledge about the effects of their investments in countries.

The past two decades have seen dramatic shifts in power among those who share responsibility for leading global health. In 1990, development assistance for health—a crude, but still valid measure of influence—was dominated by the UN system (WHO, UNICEF, and UNFPA) and bilateral development agencies in donor countries. Today, while donor nations have maintained their relative importance, the UN system has been severely diluted. This marginalisation, combined with serious anxieties about the unanticipated adverse effects of new entrants into global health, should signal concern about the current and future stewardship of health policies and services for the least advantaged peoples of the world.

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This investment will also not only benefit Americans, but also people in developing countries, where US rare diseases are often common and the limited treatments are very expensive

The US National Institute of Health (NIH) defines a rare disease as one that affects fewer than 200,000 Americans. However, the NIH Office of Rare Disease Research (ORDR) estimates that between 25 and 30 million people in the USA suffer from one of these diseases. More than 6,800 diseases fall into this classification, but of those, only around 200 are treatable.

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