Public Health

Where is the worst place for children to be born in 2009, especially girls? Surprise! Afghanistan. Today, UNICEF published a special report titled State of the World's Children; Daniel Toole, UNICEF regional director for South Asia, told a news briefing in Geneva earlier today: 

Afghanistan today is without a doubt the most dangerous place to be born.

After eight years since the U.S. invasion, this is just one more incentive to encouarge the Obama administration to make a decision on its role in the region.

More optimistically, the reports highlights signatory countries of the UN's Convention on the Rights of the Child who have shown marked improvement, including India, Serbia and Sierra Leone.

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Over a million people die unnecessarily from malaria in Africa, according to a survey by ACTWatch. The group released a study of seven countries in Africa today, it found that most people in these countries are obtaining ineffective anti-malarials in the private market, due to the low availability and high prices of the far more successful Artemisinin combination therapy (ACT). ACT costs 20 times more than the older medications to which malaria has developed resistance. At about $11 it's 65 times more than the average daily wage in many of these countries.

Malaria needs to be treated with speed, explained Dr. Desmond Chavasse, speaking from the Pan-African Malaria conference being held in Nairobi. Children must receive medication within 48 hours of displaying malarial symptoms if they are to survive. This is why ACTs must get "out through the marketplace, so they are available at the end of the supply chain, in small shops, at affordable prices."

The study, funded by the Bill and Melinda Gates foundation, is intended to provide baseline information for a program that will subsidize ACT medication.

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Combating alchohol abuse has always been something of a non-starter in Russian politics. This is, after all, a country whose former president was once found by the Secret Servce thoroughly sauced outside the White House, wearing nothing but his underwear trying to hail a cab so he could get a pizza.

But current President Dmitry Medvedev is trying to change things with a proposal to ban outdoor beer sales in his country, a first step in getting Muscovites to lay off alcohol. He also wants to limit the hours of the day alcohol can be sold.

This week, a bill was submitted to lawmakers that would triple the tax on beer from 3 rubles per liter to 10 rubles per liter by 2012. Wine and spirits would also see a sharp increase.

State prosecutors are also moving to ban liquor sales in airports. Under Russian law, no beverage with alcohol content above 15 percent can be sold in crowded or dangerous places, and prosecutors say this means airports.

Russians drink five gallons of pure ethanol a year, double what is considered dangerous by the WHO. And on average, 30,000 people a year die from alcohol poisoning in the country. Over half of the deaths of the 15 to 54-year-old demographic between 1990 and 2001 are attributed to alcohol.

"I have been astonished to find out that we now drink more than we did in the 1990s, although those were very tough times," Medvedev said.

He is a fan of Soviet Premier Mikhail Gorbachev's anti-alcohol reforms in the 1980s aimed at curbing consumption, even though he acknowledges that the plan had major flaws. Gorbachev destroyed the majority of vineyards and wineries in Georgia, probably the birthplace of wine (This didn't help the growing anti-Russia sentiment in the Southern Caucasus at the time). He also shut down distilleries and breweries. Most notably, the Soviet Union suffered tremendous sugar shortages, because people turned to moon shining. (The Russian word for ‘shine is Samogon) Stores also ran out of window cleaner and aftershave. It is estimated that 13,000-25,000 people died from drinking ill-made moonshine.

Medvedev's plan is much more cautious but many Russians are still wary.

"It's impossible. He doesn't stand a chance," a Russian construction worker told The Los Angeles Times."The Russian man will always be drinking. Russians don't surrender."

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The city council of Nairobi passed a series of by-laws yesterday outlining new illegal activities for the streets of Kenya's capital. Newly outlawed activities include blowing one's nose in public without using a hankercheif and spitting into trash cans. Another of the laws criminalizes loud noise.

This particular ordinance may have the biggest impact on the economy of Nairobi, in which street hawkers, cab drivers and store owners rely on verbally cajoling customers into their services. One resident argued the city is just trying to make money, either from imposed fines or bribes, and directly ignoring the needs of its citizens:

"We get our daily bread here,We are not making noise. The council must know that we are self-employed."

The city maintains that the purpose of the news laws is to make the city more habitable and reduce general nuisance. 

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China's food and drug administration has approved the world's first vaccine for the H1N1 virus and the government has announced plans to 5 percent of the Chinese population by the end of this year. Not everyone's so sure about it though:

Skeptics, however, have a hard time believing that a one-dose vaccine lacking a special substance called an adjuvant -- which primes the body to react to the dead virus and produce antigens against it more efficiently and effectively -- can work as well as a two-dose one.

"It would be hard for me to imagine a single-shot vaccine without an adjuvant," says Barry R. Bloom, the former dean of Harvard's School of Public Health. "My understanding in trials here is that you need more than one shot with just the straight virus to get a good enough immune response."

The study that preceded the vaccine's approval tested it on 1,614 participants from age three to over 60, according to Sinovac's head of investor relations, Helen Yang.

Stanford researcher David B. Lewis, who is involved in studies that test how adjuvants can improve seasonal flu vaccines, says it could be misleading to lump the results of all age groups together.

 The WHO has also expressed some reservations about the size of China's vaccination plan, noting that "adverse effects that are too rare to show up in a large clinical trial could become apparent when much larger numbers of people receive the vaccine."

Given the speed at which China rushed this vaccine into production and the past record of the country's pharmaceutical industry, I think I would take my chances with the swine flu. 

Even as it has become clear that the swine flu pandemic (at least in its current mutation) isn't much more serious or deadly than normal flu, stories of prominent people getting infected with it continue to be covered as if they had contracted bubonic plague.

Probably the best way to put swine flu stories in perspective is to just remove the words "swine" or "H1N1" from before the words "flu" and "virus." For instance:

Colombian President Alvaro Uribe has contracted the [...] flu virus and is being treated by doctors while continuing to work from his residence, government spokesman Cesar Velasquez said on Sunday. 

That doesn't sound so bad, now does it?

I'm sorry for sounding flip. H1N1 is a legitimate public health concern that continues to claim lives around the globe. But still, when I see headlines like "Bangladesh reports first H1N1 flu death," I have to wonder how many how many people in that country have died of normal flu (or any number of other diseases) this year without it warranting international media attention.

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No, this is not a Mel Brooks movie:

On Monday morning an Arkia airlines plane took off from Ben Gurion Airport carrying rabbis and kabbalists and flew over the country in a flight aimed at preventing the swine flu virus from spreading in Israel through prayers.

"The purpose of the flight was to stop the epidemic, thus preventing further deaths," explained Rabbi Yitzhak Batzri whose father, Rabbi David Batzri had initiated the flight. "We are certain that because of our prayers danger is already behind us," he added.

During the flight the passengers blew the shofar seven times and said prayers intended for abolishing illnesses.

There have been over 2,000 recorded cases of swine flu in Israel.

Hat tip: On Deadline 

The stance is particularly aggressive — and perhaps unenforceable — especially in a nation where cigarettes sell for as little as 40 cents a pack and smoking in public areas and workplaces is widespread. But it coincides with the government’s attempts to improve living conditions here, like Prime Minister Nuri Kamal al-Maliki’s order on Wednesday to remove blast walls from most of Baghdad within 40 days.