Loads of really good conferences going on just now. Yesterday we heard about the one on Climate Change at the Royal College of Physicians, London. Today Johnny Currie reports on the UK NGO Forum - a multi-sectoral conference which brought together leading figures from public health to discuss and debate the issues around social determinants of health. So over to Johnny- Rhona

With the recognition of wide-ranging roots of health inequalities by the Department of Health (England), and the strong commitment to tackling them, it was timely for the NGO Forum to select the ‘social determinants of health’ as its conference’s theme this year.

Yesterday brought together non-governmental public health organisations from across the country, exploring how NGOs (non-governmental organisations) can work with the Department of Health (DoH) to improve health and reduce health inequalities. Previous reports have entrusted the NGO forum to acting as a “gateway to community involvement” and to act as advocates on health and well-being. Did the conference fulfil such a lofty goal though? (more…)

Rob Hughes went to a  very important conference on climate change yesterday on behalf of The Lancet Student and reports back below. And more on this later as we will be covering more on the conference in this week’s Lancet Student podcast -Rhona

photo courtesy of Oxfam
Climate change- what an crucial issue, and about time the medical profession better engaged in the debates surrounding it. Yesterday’s conference on ‘Climate Change and Health’ at the Royal College of Physicians in London, was a welcome sign of the important shift from the realm of ‘bunny lovers and tree huggers’ into the mainstream.

The morning spent hearing from some of the top scientists tracking the unprecedented changes occurring as a result of increased greenhouse gas emissions was enough to answer any lingering questions from naysayers. Those who continue to challenge the growing consensus about the enormity and immediacy of the threat of climate change were convincingly discredited by the wealth of shocking evidence presented, which appropriately focused on the present and future human impact of climate change. What is increasingly clear is that we will all be affected by climate change, but that perversely those who have produced little of the CO2 - people in developing countries - will be effected first and most severely. (more…)

Hi. Today has been a really busy day running around the office as it is Lancet press day. So since I haven’t got time to write much today,  I thought you might be interested to read an interview with Kevin De Cock, the director of WHO’s HIV/AIDS department which has just been published in the February issue of The Lancet Infectious Diseases (TLID). I have copied it for you below. As you can see, it is very interesting stuff! Rhona

 Kevin De Cock
The Lancet Infectious Diseases Interview
Kevin De Cock is the the director of WHO’s HIV/AIDS department. Formerly director of the US Centers for Disease Control and Prevention in Kenya, he is an infectious disease specialist, with expertise in HIV/AIDS, tuberculosis, liver disease, and tropical diseases such as yellow fever and viral haemorrhagic fevers.

TLID: How has your time as WHO’s HIV/AIDS director been?

KDC: It has been extremely interesting. AIDS policy is always challenging and changing. WHO’s HIV efforts up to 2005 were very much oriented around the 3 by 5 initiative. The G8 in 2005 made an announcement about working towards universal access, which became an AIDS rallying cry. So we’ve had to reorganise ourselves around that as a theme. Some internal reorganisation was necessary to focus not only on treatment, but also on broader issues. We now have five key strategic directions: increasing access to HIV testing and counselling, maximising prevention, accelerating treatment scale-up, strengthening health systems, and investing in strategic information. We have also been working on some important technical areas. One is the issuing of guidance on both provider-initiated testing and male circumcision. In April, 2007, we also issued a report, in response to a request from the World Health Assembly, on the health sector’s progress towards universal access. (more…)

Unbelievably, today the UK Prime Minister, Gordon Brown, announced on a TV breakfast show that McDonald’s (that’s right- as in ‘burger’ McDonald’s) has won approval to offer courses which could form part of a qualification at the standard of A-levels or advanced Diplomas. According to a report on BBC on-line, this means that students could combine units from in-house courses with others to obtain the new Diplomas, which combine practical and theoretical learning. As you can see from the BBC coverage, the debate seems to be over the quality of the training rather than whether offering education is something that McDonald’s should be doing in the first place. Enter the new era of Social Corporate Responsibility (SCR). We have touched on this issue before in an article The Global compact: human rights protection, so I thought you might be interested to read the recent very enlightening special report from The Economist on Social Corporate Responsibility. And just as tobacco companies are about to join the wave of SCR (eg. Philip Morris have recently set up a “health research unit,”) I also thought you might be interested to read a Lancet editorial about tobacco companies published in this week’s issue which I have copied for you below. Just in case any of you are ever lulled into thinking that it is time to give tobacco companies a break! Rhona (more…)

The road situation in Ho Chi Minh City , Vietnam BEFORE the policy of compulsory helmet use was implemented on 15th December 2007. See our elective report

Hi again. Just wanted to draw your attention to this week’s Lancet Student podcast. This week, I discuss the importance of global health in the undergraduate medical curriculum with two UK medical students, Rob Hughes (studying at Bristol and currently an intern with us) and Aditi Das (studying medicine at Manchester but currently studying for an international BSc in International Health).

I have also published two peer reviewed articles today and an elective report. Katie (Catherine) Pastorius, from the University of Minnesota Medical School, discusses the One Laptop Per Child Initiative, including the latest hiccup when Intel withdrew its funding and technical support from the project. Chinelo Enwonwu, a student at the Case Western Reserve University in Clevelend, looks at the epidemiologic transmission of chronic diseases in developing countries, particularly in Nigeria. And finally, Alan Huynh, from the University of Queensland, Australia, shares his elective experiences at Cho Ray Hospital in Ho Chi Minh City, Vietman. And of course, don’t forget about this week’s Lancet Digest which highlights all the latest important and relevant Lancet content. So happy reading (and listening) and I hope you have a great weekend. Rhona

Editor of The Lancet Student, Rhona MacDonald, discusses the imprtance of global health in the undergraduate medical curriculum with UK medical students Rob Hughes and Aditi Das

 

 The Lancet Student 25/01/08: Play Now | Play in Popup | Download

Good friend of The Lancet Student, Stephanie Devita from the Universities Coalitions for Global Health (UCGH), tells us more about the “Pep up PEPFAR” campaign. Also, check out UCGH’s new website. It has tons of information about student advocacy and examples of campaigning activities for students to do on their own campuses. But enough of me. Over to Stephanie- Rhona

Hi All! As many of you know it’s now time to “Pep Up PEPFAR” because the program is up for reauthorization this spring and we need your help in encouraging congress to keep it going!

What is PEPFAR?
In January 2003 in the State of the Union Address, President Bush unveiled his new initiative to address the global AIDS pandemic. A few months later Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, which lead to the creation of the President’s Emergency Plan for AIDS Relief (commonly known at PEPFAR). (more…)

 Photo: REUTERS/Georgina Cranston shown on the International Medical Corps website

As the leaders of the two rival parties in Kenya’s disputed December election finally meet the American NGO International Medical Corps (IMC) has reported this week how the ongoing insecurity in the country is affecting access to vital healthcare services. With as many as 250,000 people displaced, clearly access to healthcare services has been severely affected. The IMC report focuses on TB treatment and highlights the dangers of interruptions to regimens, particularly in the early phase of treatment. At this stage, an interruption of just seven days can necessitate restarting the course. Additionally, such gaps in treatment encourage development of resistance to oral agents and therefore a switch to intravenous medicines. There is also growing concern about the impact on adherence to anti-retroviral HIV treatment, and the health effects of continuing food insecurity in the country.

While today’s meeting of Kibaki and Odinga seems to be a positive step towards some resolution to the recent turmoil, it remains to be seen how long the unrest will continue.

In the meantime it would be great to hear from any student in Kenya; please get in touch (Email us at student@lancet.com)   if you are interested in writing anything about this or any other issues. Our thoughts are with you. The Lancet Student

Diabetic Retinopathy: from www.eyeweb.org

I have a connective tissue disease, which among other things,  sometimes affects my eyes. But I am lucky. Any visual impairment I ever experience is only temporary. So why am I mentioning this? Because I have just published the second (peer reviewed) article in our series on the global diabetes epidemic (the first article was on diabetic foot disease) where Joshua Schulman-Marcus describes the global burden of diabetic eye disease, particularly diabetic retinopathy. I am struck by just how many people around the world are affecting by this condition. People with diabetes are twenty-five times more likely to become blind than people who do not have diabetes. And for people in developing countries, this poses additional challenges. In addition to the decreased work opportunities and lost earning potential, which is especially devastating to poor households, culturally, blindness is one of the most feared disabilities. In his article, Joshua cites a survey from India where most )sighted) respondents feared blindness more than loss of a limb or cancer. And as beggars in India are frequently blind or have disfigured eyes, blindness is consequently associated with poverty and stigma. Therefore, unfortunately, fears about the socio-economic and cultural implications of being diagnosed as visually impaired or blind may dissuade people with diabetes from early follow-up. I would really encourage you to read Joshua’s article. You will learn a lot from it. I certainly did. Rhona

Pseudomonas aeruginosa, a pesky Gram negative bacteria which is a frequent cause of health-care-associated infections

As I am sure you are aware, hospital acquired infections, also known as health-care-associated infections, are big news. In Europe, several million patients are hospitalised each year of which more than 2 million will acquire health-care-associated infections, resulting in around 175000 deaths per year. As you know, health-care-associated infections often occur after surgery or from the use of indwelling devices such as endotracheal tubes, intravenous lines, or urinary catheters. The most frequent types of health-care-associated infections are pneumonia and surgical site, urinary and bloodstream infections. Then of course there is the matter of antibiotic-resistance to hospital acquired infections. Resistance to first-line agents often results in less effective drugs being given which could lead to an increase in the length of hospital stay, other complications, or both. So why am I telling you all this? Well, The Lancet Infectious Diseases (TLID) has just published a consensus statement from a group of academic and industrial experts who met to consider the issues associated with the treatment of hospital infections caused by Gram-negative bacteria. They conclude that, “If society is to avoid a return to the pre-antibiotic era, particularly for the treatment of health-care-associated infections, then further investment in antimicrobial drug discovery is essential now.” This is an issue which is relevant wherever you live and so I have copied the main findings for you below-Rhona (more…)