Showing posts with label Keynote. Show all posts
Showing posts with label Keynote. Show all posts

Monday, October 13, 2014

A Dire Ebola Assessment By The WHO

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@WHO & Partners Ebola Response In Guinea

 


# 9186

 

The World Health Organization has circulated the following text of a keynote speech delivered to the The Regional Committee for the Western Pacific, Sixty-fifth session in Manila, Philippines, on  13 October 2014.

 

Of particular note, the speaker’s choice not to provide current numbers (which are quickly changing and highly suspect), and stressing instead their exponential growth. 

I’ve included the whole address as emailed, but I have bolded a couple of passages.

        

KEYNOTE ADDRESS

The Regional Committee for the Western Pacific, Sixty-fifth session
Manila, Philippines, 13 October 2014
Keynote address to the Regional Committee
for the Western Pacific, Sixty-fifth session

Manila, Philippines, 13 October 2014


Mr Chairman, Excellencies, honourable ministers, distinguished delegates, Dr Shin, ladies and gentlemen,
The Director-General sends you her best wishes for a productive session. She is fully occupied with coordinating the international response to what is unquestionably the most severe acute public health emergency in modern times.


I am delivering her messages to you, in the words she wanted to use.


I begin here.


These days, people from WHO are expected to say something about the Ebola outbreak that is raving parts of West Africa. I will do so as well.


In my long career in public health, which includes managing the H5N1 and SARS outbreaks in Hong Kong, and managing the 2009 influenza pandemic at WHO, I have never before seen a health event attract such a high level of international media coverage, day after day after day. I have never seen a health event strike such fear and terror, well beyond the affected countries.


I have never seen a health event threaten the very survival of societies and governments in already very poor countries. I have never seen an infectious disease contribute so strongly to potential state failure.


All of this was confirmed on 18 September when the UN Security Council convened an unprecedented emergency session to address what has moved from a public health crisis to become a crisis for international peace and security.


I will not give you the latest figures for cases and deaths, as the number of new cases is now rising exponentially in the three hardest-hit countries, Guinea, Liberia, and Sierra Leone.


But I will use the outbreak to show how some messages, some key arguments that WHO has been making for decade, are now falling on receptive ears.


First, the outbreak spotlights the dangers of the world’s growing social and economic inequalities. The rich get the best care. The poor are left to die.


Second, rumours and panic are spreading faster than the virus. And this costs money.


Ebola sparks nearly universal fear. Fear vastly amplifies social disruption and economic losses well beyond the outbreak zones.


The World Bank estimates that 90% of economic losses during any outbreak arise from the uncoordinated and irrational efforts of the public to avoid infection.


Third, when a deadly and dreaded virus hits the destitute and spirals out of control, the whole world is put at risk.

Our 21st century societies are interconnected, interdependent, and electronically wired together as never before.


Fourth, decades of neglect of fundamental health systems and services mean that a shock, like an extreme weather event in a changing climate, armed conflict, or a disease run wild, can bring a fragile country to its knees.


In the simplest terms, this outbreak shows how one of the deadliest pathogens on earth can exploit any weakness in the health infrastructure, be it inadequate numbers of health care staff or the virtual absence of isolation wards and intensive care facilities throughout much of sub-Saharan Africa.


You cannot build these systems up during a crisis. Instead, they collapse.

A dysfunctional health system means zero population resilience to the range of shocks that our world is delivering, with ever greater frequency and force.

We know that higher numbers of deaths from other causes are occurring, whether from malaria and other infectious diseases, or zero capacity for safe childbirth.

Here is one of the few things WHO is glad to see.

When presidents and prime ministers in non-affected countries make statements about Ebola, they rightly attribute the outbreak’s unprecedented spread and severity to the “failure to put basic public health infrastructures in place.”


Fifth, Ebola emerged nearly 40 years ago. Why are clinicians still empty-handed, with no vaccines and no cure? Because Ebola has been, historically, geographically confined to poor African nations.

The R&D incentive is virtually non-existent. A profit-driven industry does not invest in products for markets that cannot pay.

We have been trying to make this issue visible for ages, most recently through the deliberations of the Consultative Expert Working Group on Research and Development: Financing and Coordination.

Finally, the world is ill-prepared to respond to any severe, sustained, and threatening public health emergency.


This statement may sound familiar to some of you, as it was one of the main conclusions of the IHR Review Committee convened to assess the response to the 2009 influenza pandemic.

The Ebola outbreak proves, beyond any shadow of a doubt, that this conclusion was spot on.

“So what does all this tell us? Fundamentally, we have the priorities right, and these priorities finally have high visibility and high-level political support.


They underscore how right WHO and its Regional Offices have been in arguing for the strengthening of basic public health infrastructures, aiming for universal health coverage, and recognizing the urgent need to strengthen IHR core capacities.


We must continue along these appropriate, and now widely embraced paths to better health and stronger resilience for all.”


Thank you.

Tuesday, March 25, 2014

WHO Director Chan: The Next New Virus Lurks . . .

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Photo Credit WHO

 


# 8399

 

 

The World Health Organization’s Director General Margaret Chan, addressing the Credit Suisse Asian investment conference in Hong Kong yesterday, warned that - despite the fact that the world was better equipped to deal with infectious disease outbreaks than ever before - dangerous new diseases will continue to emerge, and that the pace of new emerging health threats was accelerating.


A full transcript of Director Chan’s remarks can be found at:

 

WHO Director-General addresses the Asian Investment Conference

Dr Margaret Chan

Director-General of the World Health Organization

Keynote address at the 2014 Credit Suisse
Asian Investment Conference: Are we winning the fight against infectious diseases?
Hong Kong, the People's Republic of China
24 March 2014

In this address, Director Chan addresses numerous topics, including the industrialization of food production, the threat of growing antibiotic resistance, and the potential for climate change to exacerbate the emergence of new disease threats . . . to name just a few.  


Her address is well worth reading in its entirety, but I’ve excerpted a few passages:

Today, the biggest threat from infectious diseases comes from the unknown: the next new virus lurking in the jungles of sub-Saharan Africa or in the wet markets and teeming cities of Asia.

These two geographical areas have traditionally been regarded as the breeding ground for new diseases. Around 75% of new diseases emerge following close contact between humans and domestic or wild animals. Africa and Asia offer multiple opportunities for these contacts to occur.

<snip>

A strong preference for freshly slaughtered poultry keeps the wet markets open in several parts of Asia. Most scientists view wet markets as hotspots for the emergence of new viruses that could spark the next influenza pandemic.

The practice or raising chickens near homes has been the source of numerous human cases of H5N1 infection, also among very young children who play or crawl near birds or their droppings.

All of these trends, like unprecedented population density, incursions into previously uninhabited areas, people crowded together with domestic animals, a changing climate, and the industrialization of food production, put our world on a dangerous trajectory, with new diseases just one of many prices to pay.

 

Local media coverage, as provided below by the Hong Kong Standard, understandably focused primarily on her remarks regarding the importation and sale of live poultry in the wake of the year-long outbreak of H7N9 in China. 

 

Although a temporary ban is in place, the long-term policy regarding live poultry imports remains uncertain, with many top scientists urging that the ban not be lifted.

 

This from the Hong Kong Standard.

 

WHO chief urges end to sale of live poultry

Mary Ann Benitez

Tuesday, March 25, 2014

The World Health Organization director- general Margaret Chan Fung Fu-chun is urging Hong Kong to consider banning the sale of live poultry to stop bird flu.

Speaking at a conference in the territory, Chan said that wet markets are a breeding ground for the deadly new diseases. But Chan, the territory's former director of health, said that it would be difficult to impose a ban because of the local preference for fresh chicken.

(Continue . . . )

 

 

The evidence that closing live-bird markets reduces the spread of avian flu viruses is pretty solid (see The Lancet: Poultry Market Closure Effect On H7N9 Transmission), making it an obvious mitigation strategy.  But old habits die hard; purchasing live market birds is deeply ingrained in the Chinese culture, and there has been much public resistance to closing these markets.


Which illustrates the fact that public health policies cannot be made in a scientific vacuum; that economic, political, and societal factors (which vary widely around the world) will always influence what can – and what cannot – be readily accomplished.

 

While outbreaks of exotic diseases, or the specter of a pandemic, typically garners the biggest headlines, the bulk of Director Chan’s remarks were related to the growing antibiotic resistance crisis -  which, if it continues – truly threatens a dark future for all aspects of medicine.  A few excerpts:

 

We are losing our first-line antibiotics, our miracle cures. Replacement treatments are more costly, more toxic, need much longer durations of treatment, and may require treatment in intensive care units. For some diseases, the death rate doubles when drug resistance develops.

Many common bacteria have developed resistance to multiple drugs, some to nearly all. Hospitals have become hotbeds for highly-resistant superbugs, increasing the risk that hospitals kill rather than heal. These are end-of-the-road pathogens that are resistant to last-line drugs.

If current trends continue, the future is easy to predict. Some experts say we are moving back to the pre-antibiotic era. No. This will be a post-antibiotic era. In terms of new replacement antibiotics, the pipeline is virtually dry, the cupboard is nearly bare.

A post-antibiotic era means, in effect, an end to modern medicine as we know it. Common infections will once again kill. Some sophisticated interventions, like hip replacements, organ transplants, cancer chemotherapy, and care of preterm infants, will become far more difficult or even too dangerous to undertake.

Even simple interventions, like surgery to treat myopia, will become too dangerous to perform.

 

While a stark prediction, in some places in the world – and with some bacterial infections – we are already there (see ECDC/WHO: World TB Day - Focus On MDR & XDR Treatment Outcomes).

 

In EU, only 1 in every 3 MDR TB patients has a successful treatment outcome; more than half either die, fail treatment or default (stop taking treatment). XDR TB has even worse treatment outcomes: only 1 in 4 patients finishes treatment successfully

 

For more on the spread of antibiotic resistance around the globe, you may wish to revisit:

 

EID Journal: Acquisition of Drug Resistant Genes Through International Travel
UK CMO: Antimicrobial Resistance Poses `Catastrophic Threat’
MMWR Vital Signs: Carbapenem-Resistant Enterobacteriaceae (CRE)
Chan: World Faces A `Post-Antibiotic Era’