Medical workers in a emergency care unit for Ebola patients in Beni, Democratic Republic of Congo © AFP
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Africa may be rising economically, but progress on the health of its inhabitants remains strikingly sluggish. As the World Health Organization’s regional committee wrapped up its meeting in Senegal, it issued a sobering report on the state of the continent’s health.

Outcomes have been rising gently and differences between countries reducing, but healthy life expectancy remains at just 53.8 years. As the latest Ebola outbreak this month in DRC highlights, with 77 deaths so far, infectious diseases are a significant threat in the region. Lower respiratory tract infections, HIV, diarrhoea and malaria remain the top four causes of death.

Yet Africa is also being increasingly squeezed by non-communicable “rich-world” diseases such as diabetes, not to mention road injuries. Preventable unhealthy lifestyle habits including drinking, smoking, lack of exercise and poor diets are on the rise.

The report highlights big gaps in access to and quality of services, and modest spending on healthcare workers. Overall, just nine governments in Africa are spending more than $500 per head a year on health, and half spend less than $140. Without greater commitment from African governments, health gains and access to treatment will remain limited.

The warning was reinforced by a study of poorer countries across the globe suggesting that poor quality healthcare causes up to 8.4m or 15 per cent of deaths a year and lost productivity of up to $1.6tn.

The solution, according to the US National Academies, is not just “investment and committed action” but “scientifically-grounded redesign of healthcare systems”.


Chartwatch

China cheer Big Pharma is increasingly optimistic about prospects in China, the world's second-largest market. Sales growth and drug approvals are accelerating despite Beijing forcing price cuts on best-selling products. (FT) 


News round-up

Children under pressure Keeping up with society’s expectations is having serious effects on children, including a disturbing rise in self-harm. The latest Good Childhood Report suggests happiness levels took a downwards turn around 2010. Suicide rates among teens in the US have jumped over the past ten years. Pre-teen cases are also rising. (The Children's Society, USA Today)

Snake oil news The story of Flat Tummy Co and how unregulated social media marketing “can repackage questionable science in the feel-good trappings of a wellness brand and spin women’s insecurities into cash”. (The Guardian)

From Monkey Dust to Krokodil Containing the use of recreational drugs is becoming increasingly difficult as users turn to combinations of different ingredients. Concoctions containing the opioid fentanyl are particularly deadly. The unveiling of the poppy genome shows how the plant developed as a pain reliever. (The Conversation, Science)

US STDs hit new record “Steep and sustained” increases in STDs highlight the growing threat of antibiotic-resistant gonorrhoea in the US. Chlamydia is the most common condition with more than 1.7m cases diagnosed, 45 per cent of which were among 15- to 24-year-old women. Europe is also experiencing drug-resistance problems. (Cidrap, ECDC)

A cure for PTSD? It is often said that time heals all wounds, but the opposite can hold true for psychological trauma, an injury as insidious as it is invisible. One hundred years since “shell shock” was first recognised, is a cure for post-traumatic stress on the horizon? (FT)

Care crisis England is lagging behind countries such as Germany and Japan in adapting funding systems for care of the elderly. Another study says the number of people in England needing round-the-clock care in later years will double by 2035. (Age UK, The Lancet)

Booze battles Up to seven per cent of the US population has “alcohol use disorder” but how should clinicians tackle the problem with their patients? Hangovers are not just bad for your health — they also damage the economy: they cost the UK £2bn a year in absenteeism and lost productivity. (Jama audio 24m, The Conversation)

Wire power A UK ban on sales of energy drinks to children could be a serious blow to the industry: the UK is their third-biggest market after the US and China. But it should spur companies to move into healthier drinks, say the FT’s Lex analysts. Listen to our podcast on the UK’s anti-obesity strategy. (FT)

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Podcast of the week

Internet addiction The WHO decision to add “gaming disorder” to its official list of diseases throws the spotlight on the wider problem of addictive behaviours around internet use. We speak to addiction expert Henrietta Bowden-Jones and Hannah Redler Hawes, curator of a new art exhibition on addiction and recovery. (FT, 11m)

Save the date Internet addiction will be the theme of the next FT Health live event on November 21. Details to follow.


Best from the journals

Climate change and health A new study highlights how temperature can be used to predict epidemics of mosquito-borne diseases. Weather data from the UK Met Office and Nasa are being used to predict cholera outbreaks in Yemen. Increasing carbon dioxide in the atmosphere is having a negative effect on the nutritional value of crops and consequently on human health. (ELife, Telegraph, Nature)

Pollution and intelligence Long-term exposure to air pollution can affect cognitive ability, according to a new study from China. The condition worsens as people age, especially among men. China is also a hotspot for surface level ozone pollution. (PNAS, Environmental Science & Technology Letters)

Child disability Although death rates for under-fives in poorer countries have dropped sharply over the last 25 years, there has been little improvement for children suffering from developmental disabilities — epilepsy, intellectual disability, hearing loss, vision loss, autism spectrum disorder, and attention deficit hyperactivity disorder. (The Lancet Global Health) 

Pneumonia Despite being the leading infectious cause of child mortality worldwide, the struggle against pneumonia does not enjoy the global profile of other major diseases. An international summit is needed to galvanise the fight. (The Lancet)

Typhoid in Pakistan An outbreak of extremely drug-resistant typhoid means South Asia is “on the cusp of a public health disaster”. S Typhi, spread through contaminated water and food, causes up to 20m cases of typhoid fever each year and 161,000 deaths. (The Lancet)

Smoke signals The arteries of teenagers who drink and smoke are already starting to stiffen by the age of 17, possibly leading to heart attacks and stroke later in life. Exposure to ecigarette adverts reduces children’s perceptions of the harm of tobacco smoking, according to another study. US regulators are investigating whether Juul, the leading ecigarette company, deliberately targeted marketing at young people. (European Heart Journal, BMJ, NYT)

Gun deaths An estimated 251,000 people worldwide died from gun injuries in 2016, and Brazil, the US, Mexico, Colombia, Venezuela and Guatemala between them accounted for half. Some 64 per cent were homicides and 27 per cent suicides, while 9 per cent were unintentional. (Jama) 


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Final thought

Nanny state or public health priority? The Royal Society for Public Health's “Scroll-free September” campaign aims to encourage healthier use of social media. Choose your role model: Cold Turkey (total abstinence), Social Butterfly (drop the Insta posts), Night Owl (nothing after 6pm), Busy Bee (avoid while at work or school) or Sleeping Dog (keep it out of the bedroom.)

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