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The elderly — especially those in Europe and the eastern Mediterranean where they are concentrated in cities — are most at risk from heat-related death and disease as climate change takes hold, says this week's report from Lancet Countdown, an international project tracking the effect on health.
Some 157m more people were exposed to heatwaves in 2017, compared with 1990, the study says. Climate change is also exacerbating problems of air pollution, causing problems in the food chain and facilitating the spread of vector-borne diseases such as dengue.
Both sets of data could help shift the perception of climate change from an environmental concern to an imminent public health danger. As the Countdown director puts it: “This is no longer about a polar bear a long way away, but a child with asthma standing next to you.”
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Barry Rassin, president of Rotary International, who this week presented Theresa May, the UK prime minister, with the Polio Champion Award for her commitment to an eradication campaign that has so far cost governments, donors and NGOs $15bn.
Why did Rotary first become involved in polio eradication?
Rotary in the Philippines wanted to get rid of polio over 30 years ago and helped with immunisation. What’s amazing is that we still have a strong passion to finish what we started. We believe we can eradicate the disease. We can get to communities nobody else can and advocate for government and private funding.
Do you think the disease will ever be eradicated?
The question is how long before it happens. We believe we will see the last case during the next calendar year. But we need to keep reminding Rotarians that we have to keep everything going for the coming three years until the world is certified polio-free.
Wouldn’t it be better to spend the money on other things?
If we stop the campaign, polio will spread again. The WHO estimates 200,000 children would be paralysed in the next decade otherwise. Last year we raised more funding than ever at $414m. But we have to rethink how we are going to finish this. We are in discussions about what to do differently.
2018 and beyond
What were your highlights and low points for global health this year? And what do you think will be the big themes for 2019? Email firstname.lastname@example.org or tweet us @fthealth and we will feature the best responses in our year-end issue.
Global Nutrition Report Malnutrition in one of its forms is responsible for more ill health than any other cause. Although the total number of stunted children is in decline, it remains a serious problem in south-east Asia. The number of overweight or obese adults is at a record 39 per cent. Malnutrition is said to cost the world economy up to $3.5tn a year. The WHO separately published a review of global policy on nutrition. (GNR, Straits Times, WHO)
HIV/Aids update New data ahead of World Aids Day on Saturday showed HIV infections in eastern Europe still growing in contrast to the west of the continent. A UNAids global report showed 75 per cent of all people living with HIV were now aware of their condition. It called for increased efforts to reach the 9.4m people still unaware they had HIV. A British MP announced he was HIV positive in parliament. (ECDC, UNAids, Pink News)
Access to drugs Many new drugs come on to the market with high price tags, creating difficult choices for policymakers in ensuring patients and payers have reasonable access. Possible solutions include more stakeholder involvement in R&D; better regulatory procedures; more efficient spending; and incentives to encourage innovation in areas of unmet need. (OECD)
Dutch direct action Authorities have allowed a hospital to make its own version of a medicine for a rare metabolic disorder after the Italian company Leadiant bought up rival suppliers and won exclusive patent rights that allowed it to raise its price 500-fold. (Dutch News, FT)
Measles multiplies Reported measles cases jumped in 2017 due to gaps in vaccination coverage. The largest surges were in the Americas, the eastern Mediterranean and Europe. As recently as the 1980s the disease killed more than 2.5m people every year. (CDC/WHO, Spectator)
Brazil Cuba tensions The departure of thousands of Cuban doctors from Brazil — after Jair Bolsonaro, Brazil's newly-elected president, placed strict restrictions on their employment — poses a severe threat to public health, especially in remote areas. The Pan-American Health Organization said tuberculosis, dengue fever, and malaria could start to spread if replacement doctors were not found quickly. (The Lancet)
Implants alarm An international media investigation raised the alarm over the lack of safeguards for medical implants. The findings raised concerns over poor regulation and testing regimes. (BBC Panorama video, Guardian)
Baby brouhaha Reports that a Chinese researcher had created the world's first genetically-edited babies reopened the ethics debate around gene editing of embryos. Amid criticism from fellow scientists and Chinese regulators, He Jiankui, the scientist involved, said a new baby might be on the way. The week ended with China calling a halt to all gene editing. (FT, MIT Technology Review, NYT, Deutsche Welle, He Jiankui video)
Patient data Google’s decision to move the health unit of its London-based DeepMind subsidiary to California raised concerns over access to UK patient data. A report says a “radical culture change” is needed if the NHS is to benefit from new technology and maintain trust. A study involving the Apple Watch said people were prepared to increase exercise in exchange for tangible rewards. (FT podcast, Academy of Medical Sciences, FT)
African health People in sub-Saharan Africa are living longer and child mortality is down but epidemics of high blood pressure, high blood sugar, and obesity could reverse these improvements. (Quartz/The Conversation)
Scorpion milking Scientists in Morocco are using scorpion-milking robots to extract venom from the creatures which can be used to help treat a range of conditions from arthritis to malaria. At $8,000 a gramme it might just be the most expensive liquid in the world. (FT video)
Best from the journals
Child pneumonia Global deaths from pneumonia for the under-fives have fallen substantially since 2000 but this trend is threatened by an increasing number of children born with a low birth weight and factors such as exposure to indoor air pollution. (The Lancet)
Ebola: hope and chaos An editorial calls for the response to Ebola in the Democratic Republic of Congo to be speeded up: “If we do not act now, the outbreak may become far harder and more expensive to stop.” The battle — against the second biggest outbreak in history — pits medical hope against local chaos. (NEJM, FT NYT)
Urban health South Asian cities are typical examples of rapid unplanned urbanisation and its negative effect on health. Solutions include better governance, affordable healthcare access and more action tackling the social determinants of health. (BMJ).
Tobacco packaging The upholding of Australia's strict rules on tobacco packaging marked a significant victory for global health and more than 20 countries have plans to follow the Australian lead. A Lancet editorial calls for stricter regulations on ecigarettes. (Jama, The Lancet Oncology, photograph from Quit Victoria)
Podcast of the week
Contagious cities A BBC radio series allows five writers to examine how a particular epidemic shaped their city. (BBC Radio iPlayer)
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♫ Neighbours, everybody needs good neighbours. ♫ Living in a rich but unfriendly neighbourhood is just as bad for your health as living in a deprived area, according to a new report. (Telegraph)
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