#UNHealthAgency; #WHO; #WHO’sGlobalactionplan 

United Nations, May 14 (Canadian-Media/UN): ​Key lifestyle choices such as getting regular exercise, not smoking or drinking too much, can reduce the risk of dementia and cognitive decline, the United Nations (UN) health agency said today, UN reports said.

An elderly woman rides her bike in Croatia (13 February 2013). New World Health Organization (WHO) guidelines stress the value of regular exercise to prevent the onset of dementia. Image Credit: World Bank/Miso Lisanin

In recommendations to counter an expected tripling in the number of people with the degenerative condition in the next 30 years, the World Health Organization (WHO) guidelines are designed to help medical professionals and governments to develop national policies.

Today, around 50 million people globally suffer from dementia and there are nearly 10 million new cases every year.

“We need to do everything we can to reduce our risk of dementia,” said WHO Director-General Tedros Adhanom Ghebreyesus. “The scientific evidence gathered for these guidelines confirm what we have suspected for some time: that what is good for our heart, is also good for our brain.”

According to WHO’s new guidelines, other lifestyle choices that people can make to reduce the risk of dementia include controlling their weight, eating healthily and maintaining healthy blood pressure, cholesterol and blood sugar levels.

Last year, WHO provided support to countries such as Bosnia and Herzegovina, Croatia, Qatar, Slovenia and Sri Lanka to develop a comprehensive, multi-sectoral public health response to dementia, it said in a statement.

Reducing the risk of lifestyle choices linked to dementia is one of several areas of action included in WHO’s Global action plan for the public health response to the illness.

Other areas include strengthening diagnosis, treatment and care, with a particular emphasis on online support for carers of people with dementia.
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“Dementia carers are very often family members who need to make considerable adjustments to their family and professional lives to care for their loved ones,” said Dr Dévora Kestel, Director of the Department of Mental Health and Substance Abuse at WHO. “This is why WHO created iSupport…an online training programme providing carers of people with dementia with advice on overall management of care, dealing with behaviour changes and how to look after their own health.”

#UnitedNations; #DRC; #Ebolaepidemic; #InternationalFederationofRedCross; 
​#WHO; #EbolaVaccinationGuidelines

United Nations, May 8 (Canadian-Media/UN): Now in its tenth month, the Ebola epidemic in the Democratic Republic of the Congo (DRC) has claimed more than a thousand lives, prompting Secretary-General António Guterres to throw the support of “the whole United Nations system” into stemming the spread of the deadly virus, ​United Nations (UN) reports said.

Clinic in Mbandaka, Democratic Republic of the Congo, where health care workers treat Ebola patients. Image Credit: International Federation of Red Cross and Red Crescent Societies

Guterres expressed concern over the number of new Ebola cases in the east of the DRC on Wednesday, reiterating UN support “for efforts to end the outbreak”.

“With important shifts in the response now being implemented, the Secretary-General has emphasized his commitment to a collective UN-wide approach, both in Kinshasa, where the UN is led by his special representative, and in the areas affected by the virus, where the response is led by WHO [World Health Organization], all in close liaison with Congolese leaders both in Kinshasa and eastern DRC”, said his Deputy Spokesperson, Farhan Haq, in a statement on behalf of the UN chief.

"Full involvement and engagement of local people remains the key" – UN chief

Guterres expressed his condolences to the victims’ families and reiterated that the full involvement and engagement of local people “remains the key to successfully controlling the outbreak”.

He also urged “all Congolese leaders to work together across parties and across communities to tackle the outbreak”.

“At this critical juncture”, Mr. Guterres underscored the need for “additional resources” and called on Member States and partner organizations “to ensure the responding agencies have the resources needed to succeed”.

The Secretary-General commended the Government, institutions and Congolese people themselves on the overall response so far, which has contained the outbreak to within parts of two provinces, which are home to multiple armed groups, which have been battling each other and Government forces for years.

He also applauded “the bravery of security, health and humanitarian workers who have put their lives on the line in a challenging environment marked by conflict and insecurity”, including attacks on Ebola Treatment Centres and healthcare facilities and recognized their work in vaccinating more than 100,000 people and saving the lives of hundreds who have contracted the disease.

Life-saving vaccinations

Meanwhile, amidst continuing violence, WHO experts (SAGE) have recommended new Ebola Vaccination Guidelines to address the challenges in stemming the virus.

Since the outbreak was declared in August 2018, WHO has said that despite the use of a highly efficacious vaccine, the number of new cases continues to rise, in part due to repeated violence, which has prevented response teams from immediately identifying and creating vaccination rings around all people at risk of contracting Ebola.

“We know that vaccination is saving lives in this outbreak,” said WHO Director-General Tedros Adhanom Ghebreyesus, but “we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible”.

“These recommendations account for ongoing insecurity and incorporate feedback from experts and from the affected communities that will help us continue to adapt the response”, he affirmed.

Among other things, new SAGE recommendations endorse pop-up and targeted geographic vaccination approaches, when appropriate; advise vaccinating the next level of people who may be exposed, such as in neighborhoods where cases have been reported within the past 21 days; and adjusting the current dose to ensure that the vaccine continues to be available to those at greatest risk of Ebola.​

#WHO; #SAGE; #Ebolaoutbreak; DRC; #CoalitionforEpidemicPreparedness; #CEPI; #ringvaccination; #rVSV- ZEBOVGPvaccine; #SAGEEbolaVaccineWorkingGroup

Geneva, May 8 (Canadian-Media/WHO): World Health Organization's (WHO’s) Strategic Advisory Group of Experts (SAGE) today issued new recommendations to address vaccination challenges in the ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC), WHO reports said.

WHO/Official Logo

The recommendations include endorsing operational adjustments that make the vaccination process faster and adjusting the dosage based on available efficacy data. The SAGE also suggested expanding the population eligible for vaccination with rVSV-ZEBOV-GP (developed by Merck & Co., Inc), introducing an additional experimental vaccine (developed by Johnson & Johnson), and redoubling ongoing efforts to train nurses, doctors and medical students from Ebola-affected communities to work on vaccination teams.

​Vaccination saving lives but challenges remain

More than 111 000 people have been vaccinated in the DRC since the outbreak was declared in August 2018. However, despite the use of a highly efficacious vaccine, the number of new cases continues to rise, in part due to repeated incidents of violence affecting the ability of response teams to immediately identify and create vaccination rings around all people at risk of contracting Ebola.

“We know that vaccination is saving lives in this outbreak,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We also know that we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible. These recommendations account for ongoing insecurity and incorporate feedback from experts and from the affected communities that will help us continue to adapt the response.”
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Professor Jean-Jacques Muyembe, Director of the INRB and Principle Investigator for the rVSV ZEBOV Ebola vaccine protocol, also welcomed the recommendations.

“The DRC Presidential Commission on Ebola highly appreciates the new SAGE recommendations for the rVSV- ZEBOV GP vaccine,” said Professor Muyembe. “This will allow us to address the increasing demand for this vaccine from the communities. In my role as the Principal Investigator of this study, I will work with the teams to ensure the recommendations are implemented as soon as possible.”

Adapting ring vaccination operational approaches: pop-up and targeted geographic vaccination

The SAGE endorsed the use of pop-up and targeted geographic approaches to vaccination when appropriate. These vaccination approaches have already been used successfully in the field by WHO to make the ring vaccination process faster, more secure, and more responsive to community feedback.

In view of the fact that insecurity limits the time that vaccination teams can spend in some communities, and in response to community requests, SAGE recommended steps to streamline implementation of the vaccination protocol. SAGE also endorsed a modified follow-up for safety monitoring.

Adjusting rVSV ZEBOV GP vaccine dosage and eligible population

In addition to vaccinating contacts and contacts of contacts, SAGE now also recommends vaccinating those who could be part of tertiary chains of transmission, such as people in villages and neighborhoods where cases have been reported within the past 21 days. SAGE noted that increasing access to vaccination in the broader community may help enhance community acceptance of the vaccine and other control measures.

SAGE also recommended adjusting the dose of the vaccine currently being used.

“The SAGE emphasized that ring vaccination of contacts and contacts of contacts continues to be the preferred strategy.  However, the Working Group recognized that the current emergency and the available evidence called for a dose-adjusted approach to ensure vaccine continues to be available and offered to individuals at greatest risk of Ebola,” said Helen Rees, Co-Chair of the SAGE Ebola Vaccines Working Group.

People at highest risk (contacts and contacts of contacts) will now receive 0.5ml of vaccine instead of 1ml. This dosage is equal to that used in the successful Ebola ça suffit ring vaccination trial in Guinea in 2015, and is expected to provide the same level of protection.

Those for whom a rapid evolution of the immune response is less critical (people who are considered lower-risk / those who could be potentially involved in tertiary transmission) will receive 0.2ml (1/5 of the current dose).

Use of additional Ebola vaccines: plans for deployment of an additional vaccine underway   

The SAGE reiterated its previous stance stating the need to assess additional Ebola vaccines. SAGE now additionally recommends offering an alternative vaccine (other than rVSV-ZEBOV-GP) to those at lower risk within affected health areas.

Proposed studies should be scientifically and epidemiologically justified, have appropriate approvals including from all relevant national and other regulatory and ethics authorities, and have defined endpoints suitable for licensure.

The adenovirus 26 vectored glycoprotein / MVA-BN (Ad26.ZEBOV/MVA-BN) investigational Ebola vaccine, developed by Johnson & Johnson, is being considered and a coalition led by the Coalition for Epidemic Preparedness (CEPI) and the London School of Hygiene and Tropical Medicine, and other partners, with support from WHO, are at an advanced stage towards the deployment and assessment of this vaccine.​

Training and engaging more members of affected communities

WHO and partners are working to further engage Congolese nationals from within Ebola-affected communities. The goal is that by end of the month a majority of vaccination team members are healthcare workers, doctors and medical students from affected communities who also speak the local languages.
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#WHO; #snakebiteEnvenoming; #tropicalDisease; #SDGs; #antivenoms; #ancillarymedicalcare; 

​Geneva, May 8 (Canadian-Media/WHO): World Health Organization (WHO)  released on May 6 further details of its strategy to prevent and control snakebite envenoming, a neglected tropical disease that affects 1.8–2.7 million people each year, claiming 81 000–138 000 lives and causing 400 000 cases of permanent disability, WHO reports said.

WHO/Official Logo

​The aim of the strategy is to halve the numbers of deaths and cases of disability due to snakebite envenoming over the next 12 years through a programme that targets affected communities and their health systems, and by ensuring access to safe, effective treatment through increased cooperation, collaboration and partnership at all levels.

The strategy was developed by a 28-member panel of global experts in consultation with WHO regional offices, the scientific and research community, health foundations, advocacy groups and stakeholders. Given the importance of prevention, improved community education and empowerment and effective first response, the strategy commits to engaging communities to achieve these goals.
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In parallel, WHO will work with countries to strengthen health systems towards achieving the Sustainable Development Goals and its related targets including improving health and well-being and reducing inequity.
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A central objective will be the need to ensure access to safe, effective and affordable treatment such as antivenoms and ancillary medical care. Improved and strengthened production, supply and distribution of life-saving antivenoms and other commodities needed to treat snakebites will be prioritized.
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WHO will also work to encourage research on new treatments, diagnostics and health device breakthroughs that can improve treatment outcomes for victims and hasten recovery.

The strategy –Snakebite envenoming: a strategy for prevention and control – will be launched at a meeting hosted by the governments of the Republic of Costa Rica and the Federal Republic of Nigeria on 23 May 2019 in Geneva, Switzerland. 

#WHO; #IFBA; #eliminationOfTransFat; #BreastMilkSubstitutes

Geneva, May 7 (Canadian-Media/WHO): World Health Organization (WHO) welcomes the commitment by the International Food and Beverage Alliance (IFBA) to align with the WHO target to eliminate industrially produced trans fat from the global food supply by 2023, WHO reports said.

WHO/Official Logo

WHO Director-General Dr Tedros Adhanom Ghebreyesus met with IFBA representatives, including chief executive officers from several of the 12 companies comprising the alliance, on 2 May 2019 to discuss actions to take to eliminate industrial trans fats, and reduce salt, sugar and saturated fats in processed foods.

The meeting also stressed the value of regulatory action on labelling, marketing and called industry to full adherence to the WHO Code of marketing of Breast Milk Substitutes.

“The commitment made by IFBA is in line with WHO’s target to eliminate industrial trans fat from the global food supply by 2023,” Dr Tedros said. “WHO will be monitoring the next steps to be taken by companies to help ensure the commitment is realized.”

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Of particular note was the decision to by IFBA members to ensure that the amount of industrial trans fat (iTFA) in their products does not exceed 2 g of iTFA per 100 g fat/oil globally by 2023. This is in line with the WHO’s objective and recommendations of its REPLACE action package, which was developed and launched in 2018.

“Eliminating industrially-produced trans fat is one of the simplest and most effective ways to save lives and create a healthier food supply,” added Dr Tedros.

In line with the REPLACE initiative, WHO has called on all food producers and oil and fat manufacturers, not only IFBA members, to commit to elimination of industrial trans fat from the global food supply.

Trans fat intake is responsible for over 500,000 deaths from coronary heart disease each year globally.

#TheBritishHeartFoundation; #Tadalafil; #medicalnews; #AndrewTrafford

England, May 2 (Canadian-Media): A drug used to treat erectile dysfunction has been found by University of Manchester, England scientists to slow or even reverse the progression of heart failure in sheep.

Image Credit: CC0 Public Domain

The British Heart Foundation funded study is a breakthrough in the treatment for the disease in which five year survival rates are lower than most common cancers.
The study of Tadalafil—which is in the same class as Viagra—proves that the drug is biologically effective as a treatment for heart failure in sheep.

However, lead author Professor Andrew Trafford argues the effect is likely to also be shown in humans. The study is published in the journal Scientific Reports.

Heart failure is a devastating condition, occurring when the heart is too weak to pump enough blood to meet the body's needs.

It also causes a build-up of fluid that backs up into the lungs, resulting in breathlessness as well fluid retention, resulting in swelling of different parts of the body.

Most current treatments are ineffective.

"This discovery is an important advance in a devastating condition which causes misery for thousands of people across the UK and beyond," said Professor Trafford.
"We do have limited evidence from human trials and epidemiological studies that show Tadalafil can be effective in treating heart failure.
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"This study provides further confirmation, adds mechanistic details and demonstrates that Tadalafil could now be a possible therapy for heart failure.

"It's entirely possible that some patients taking it for erectile dysfunction have also unwittingly enjoyed a protective effect on their heart."

Sheep were used by the team as the physiology their hearts is similar to human hearts.

When the animals had heart failure—induced by pace makers—which was sufficiently advanced to need treatment, the team administered the drug. Within a short period the progressive worsening of the heart failure was stopped and, importantly the drug reversed the effects of heart failure.

And the biological cause of breathlessness in heart failure- the inability of the heart to respond to adrenaline was almost completely reversed.

The dose the sheep received were similar to the dose humans are given when being treated for erectile dysfunction.

Tadalafil blocks an enzyme called Phosphodiesterase 5 or PDE5S for short, which regulates how our tissue responds to hormones like adrenaline.

The research team found that in heart failure, the drug altered the signalling cascade—a series of chemical reactions in the body—to restore the hearts ability to respond to adrenaline.

And that increases the ability of the heart to force blood around the body when working harder.

Professor Trafford added: "This is a widely used and very safe drug with minimal side effects.

"However we would not advise the public to treat themselves with the drug and should always speaking to their doctor if they have any concerns or questions.

"Tadalafil is only suitable as a treatment for systolic heart failure—when the heart is not able to pump properly—and there may be interactions with other drugs patients are taking."

Professor Metin Avkiran, Associate Medical Director at the British Heart Foundation, said:
"Viagra-type drugs were initially developed as potential treatments for heart disease before they were found to have unexpected benefits in the treatment of erectile dysfunction. We seem to have gone full-circle, with findings from recent studies suggesting that they may be effective in the treatment of some forms of heart disease—in this case, heart failure.

"We need safe and effective new treatments for heart failure, which is a cruel and debilitating condition that affects almost a million people in the UK. The evidence from this study—that a Viagra-like drug could reverse heart failure—should encourage further research in humans to determine if such drugs may help to save and improve lives."